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Sample records for aging patient population

  1. The influence of age on the management of patients with diabetes in the Israeli population.

    PubMed

    Tirosh, Amit; Stern, Zvi; Mazar, Marianna; Calderon-Margalit, Ronit

    2013-08-01

    The authors' aim was to study the association between age and the quality of community health care of diabetes mellitus (DM). This was a cross-sectional study of patients with DM in the setting of a large health maintenance organization (HMO) in Israel. The population included DM patients aged 40-84 years who were identified at emergency rooms or through the HMO's computerized database. A set of quality care indicators were determined. Logistic regressions were used to estimate the odds ratios (OR) for diabetes care indicators, controlling for age and other potential confounders. Older patients were more likely to be in the target range of glycemic control and to be vaccinated against influenza. Patients older than age 70 years received fewer recommendations for physical activity (OR 0.41, P<0.01) and self-foot examination (OR 0.57, P=0.024). The authors found decreased performance of recommendations for physical activity and self-foot examination, and a higher performance of annual blood tests and immunizations among elderly patients with diabetes.

  2. Hospital Implementation of Patient-Centered Communication with Aging Minority Populations

    ERIC Educational Resources Information Center

    Langer, Menachem; Langer, Nieli

    2009-01-01

    The composition and needs of culturally diverse older populations should encourage hospitals to address the conflicting demands for access and delivery of ethnically sensitive services. Health communication that is patient-centered and provides culturally and linguistically appropriate care has the potential to reduce racial and ethnic health…

  3. Women and population aging.

    PubMed

    Kunugi, T

    1989-06-01

    In 1985, there were approximately 427 million persons aged 60 and over in the world, accounting for about 9% of the world's population. By 2020, the elderly population will comprise 13% of the world's population and 70% of these people will live in developing countries. Governments and international agencies should increase their efforts and activities to improve care for the elderly within the family unit. The socioeconomic implications of aging are greater for females because of their higher life expectancy. In the year 2000, 11% of the world's female population will be aged 60 and over. By 2025, there will be 604 million elderly women in the world, 70% of whom will be living in developing countries, and among them, 70% in rural areas. An important issue requiring both research and policy attention is the interdependence among women's economic, health, and social concerns, which increase with age. The author calls for more specific policies that aim to eliminate discrimination against disabled persons, the elderly, and particularly elderly women. The author urges governmental and nongovernmental organizations to implement these recommendations: 1) promote research studies and the collection and analysis of information on the socioeconomic, health, legal, and demographic situation of elderly women; 2) promote awareness of elderly women's contribution to society; 3) eliminate discriminatory treatment of elderly women; 4) develop health promotion programs and services to meet elderly women's long-term care needs; 5) promote wider appreciation of continued participation of elderly women in social and cultural activities; 6) promote the development of elderly women's organizations and self-help groups; 7) promote and assure the participation of elderly women in the process of development; and 8) develop literacy programs and training programs for elderly women.

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

    PubMed

    Enblad, G; Glimelius, B; Sundström, C

    1991-04-01

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

  5. Oral medicine and the ageing population.

    PubMed

    Yap, T; McCullough, M

    2015-03-01

    The oral cavity is subject to age related processes such as cellular ageing and immunosenescence. The ageing population bears an increased burden of intraoral pathology. In oral medicine, the majority of presenting patients are in their fifth to seventh decade of life. In this review, we discuss the ageing population's susceptibility to mucosal disorders and the increased prevalence of potentially malignant disorders and oral squamous cell carcinoma, as well as dermatoses including oral lichen planus and immunobullous conditions. We also address the ageing population's susceptibility to oral discomfort and explore salivary secretion, ulceration and the symptoms of oral burning. Finally, we will describe orofacial pain conditions which are more likely encountered in an older population. This update highlights clinical presentations which are more likely to be encountered in the ageing population in a general practice setting and the importance of screening both new and long-term patients.

  6. Oral medicine and the ageing population.

    PubMed

    Yap, T; McCullough, M

    2015-03-01

    The oral cavity is subject to age related processes such as cellular ageing and immunosenescence. The ageing population bears an increased burden of intraoral pathology. In oral medicine, the majority of presenting patients are in their fifth to seventh decade of life. In this review, we discuss the ageing population's susceptibility to mucosal disorders and the increased prevalence of potentially malignant disorders and oral squamous cell carcinoma, as well as dermatoses including oral lichen planus and immunobullous conditions. We also address the ageing population's susceptibility to oral discomfort and explore salivary secretion, ulceration and the symptoms of oral burning. Finally, we will describe orofacial pain conditions which are more likely encountered in an older population. This update highlights clinical presentations which are more likely to be encountered in the ageing population in a general practice setting and the importance of screening both new and long-term patients. PMID:25762041

  7. Adverse anthropometric risk profile in biochemically controlled acromegalic patients: comparison with an age- and gender-matched primary care population

    PubMed Central

    Sievers, C.; Wittchen, H. U.; Pieper, L.; Klotsche, J.; Roemmler, J.; Schopohl, J.; Schneider, H. J.; Stalla, G. K.

    2010-01-01

    anthropometric measurements. Biochemically cured acromegalic patients pertain an adverse anthropometric risk profile, mainly because of elevated adiposity measurements, such as BMI, waist and hip circumference, compared to an age- and gender-matched primary care population. PMID:20131100

  8. [Telemedicine and the ageing population].

    PubMed

    Otto, Ulrich; Brettenhofer, Marlene; Tarnutzer, Silvan

    2015-09-01

    Telemedicine aims to create new forms of health care delivery by the use of information and communication technologies (ICT),for example, to improve the access to health care for patients in rural regions. There is a need for assistive technologies and innovative technological solutions due to the demographic change. Population trends of western societies show concurrently an ageing population and the wish of elderly people to live at home as long as possible while there is a tendency that older people live in greater distances to their kin nowadays. More complex diseases and multimorbidity urge improved interconnectedness between different health care professionals. Hence, different health systems pursue e-health strategies with the aim to implement electronic patient records (EPR) and similar technological solutions as a first approach to tackle those challenges. Telemedicine represents an open and evolving concept which is subject to a regular process of further development as a consequence of accelerated technological progress. The increased articulated demand for patient centered health care is one driver for the use of telemedicine. In the context of the trend of shorter hospital stays technological solutions can provide an opportunity for better support and care at home to reduce health risks and improve caregiving quality after hospital discharges. Despite the still prevalent reservations of elderly people about the use of ICT research shows that acceptance and the willingness to use technical devices is increasing. The article describes different aspects of telemedicine in the context of the aging population: definitions, an overview of trends and various fields of use with specific practical examples. A synoptic view of research results of evaluations of telemedicine applications regarding their effectiveness and cost-benefit analysis complement the paper.

  9. [Telemedicine and the ageing population].

    PubMed

    Otto, Ulrich; Brettenhofer, Marlene; Tarnutzer, Silvan

    2015-09-01

    Telemedicine aims to create new forms of health care delivery by the use of information and communication technologies (ICT),for example, to improve the access to health care for patients in rural regions. There is a need for assistive technologies and innovative technological solutions due to the demographic change. Population trends of western societies show concurrently an ageing population and the wish of elderly people to live at home as long as possible while there is a tendency that older people live in greater distances to their kin nowadays. More complex diseases and multimorbidity urge improved interconnectedness between different health care professionals. Hence, different health systems pursue e-health strategies with the aim to implement electronic patient records (EPR) and similar technological solutions as a first approach to tackle those challenges. Telemedicine represents an open and evolving concept which is subject to a regular process of further development as a consequence of accelerated technological progress. The increased articulated demand for patient centered health care is one driver for the use of telemedicine. In the context of the trend of shorter hospital stays technological solutions can provide an opportunity for better support and care at home to reduce health risks and improve caregiving quality after hospital discharges. Despite the still prevalent reservations of elderly people about the use of ICT research shows that acceptance and the willingness to use technical devices is increasing. The article describes different aspects of telemedicine in the context of the aging population: definitions, an overview of trends and various fields of use with specific practical examples. A synoptic view of research results of evaluations of telemedicine applications regarding their effectiveness and cost-benefit analysis complement the paper. PMID:26323956

  10. Anomalous Growth of Aging Populations

    NASA Astrophysics Data System (ADS)

    Grebenkov, Denis S.

    2016-04-01

    We consider a discrete-time population dynamics with age-dependent structure. At every time step, one of the alive individuals from the population is chosen randomly and removed with probability q_k depending on its age, whereas a new individual of age 1 is born with probability r. The model can also describe a single queue in which the service order is random while the service efficiency depends on a customer's "age" in the queue. We propose a mean field approximation to investigate the long-time asymptotic behavior of the mean population size. The age dependence is shown to lead to anomalous power-law growth of the population at the critical regime. The scaling exponent is determined by the asymptotic behavior of the probabilities q_k at large k. The mean field approximation is validated by Monte Carlo simulations.

  11. Economics of an aging population.

    PubMed Central

    Jackson, P M

    1985-01-01

    Throughout this century, as in many other countries, the proportion of the British population in the older age groups has increased. The effect this has on the economy is discussed. Topics covered include the determinants of the economic status of old people; the reasons for the choice of retirement ages; the burden of the aged on younger generations; the costs of pension schemes; the disincentive effects of pensions on savings; and poverty in old age. PMID:4009105

  12. Population ageing and dental care.

    PubMed

    Harford, Jane

    2009-04-01

    Population ageing is a fact in both developed and developing countries. The concern about population ageing largely arises from the combination of a greater number of older people requiring greater amounts of healthcare services and pensions, and relatively fewer people working to pay for them. Oral health and dental care are important aspects of health and health care. Lower rates of edentulism and an ageing population mean that older people will feature more prominently in dental services. Traditionally, economic studies of ageing have focused on the fiscal implications of ageing, projecting the increased burden on health and welfare services that accompanies ageing. It assumed that ageing is the major driver of recent changes and those past trends will simply be amplified by faster population ageing in the future. Less work has been done to understand other past drivers of increased healthcare spending and their implications for the future. The conclusion of these reports is usually that population ageing is unaffordable with current policy settings. They have proposed policies to deal with population ageing which focused on increasing workforce participation and worker productivity to increase the tax base and reducing entitlements. However, the affordability question is as much political as a numerical. There are no clearly articulated criteria for affordability and little opportunity for public discourse about what citizens are willing to pay in taxes to support an ageing population. While the reports do not necessarily reflect public opinion, they will certainly shape it. Predicting the future for oral health is more fraught than for general health, as oral health is in the midst of an epidemiological transition from high rates of edentulism and tooth loss to low rates. Changes in the pattern of dental expenditure in the past do not mirror the experience of rapid increases in per capita expenditure on older age groups as regards general health. Dentistry

  13. Population Pharmacokinetics Analysis To Inform Efavirenz Dosing Recommendations in Pediatric HIV Patients Aged 3 Months to 3 Years.

    PubMed

    Luo, Man; Chapel, Sunny; Sevinsky, Heather; Savant, Ishani; Cirincione, Brenda; Bertz, Richard; Roy, Amit

    2016-06-01

    Efavirenz (EFV) is a nonnucleoside reverse transcriptase inhibitor approved worldwide for the treatment of HIV in adults and children over 3 years of age or weighing over 10 kg. Only recently EFV was approved in children over 3 months and weighing at least 3.5 kg in the United States and the European Union. The objective of this analysis was to support the selection of an appropriate dose for this younger pediatric population and to explore the impact of CYP2B6 genetic polymorphisms on EFV systemic exposures. A population pharmacokinetic (PPK) model was developed using data from three studies in HIV-1-infected pediatric subjects (n = 168) and one study in healthy adults (n = 24). The EFV concentration-time profile was best described by a two-compartment model with first-order absorption and elimination. Body weight was identified as a significant predictor of efavirenz apparent clearance (CL), oral central volume of distribution (VC), and absorption rate constant (Ka). The typical values of efavirenz apparent CL, VC, oral peripheral volume of distribution (VP), and Ka for a reference pediatric patient were 4.8 liters/h (4.5 to 5.1 liters/h), 84.9 liters (76.8 to 93.0 liters), 287 liters (252.6 to 321.4 liters), and 0.414 h(-1) (0.375 to 0.453 h(-1)), respectively. The final model was used to simulate steady-state efavirenz concentrations in pediatric patients weighing <10 kg to identify EFV doses that produce comparable exposure to adult and pediatric patients weighing ≥10 kg. Results suggest that administration of EFV doses of 100 mg once daily (QD) to children weighing ≥3.5 to <5 kg, 150 mg QD to children weighing ≥5 to <7.5 kg, and 200 mg QD to children weighing ≥7.5 to <10 kg produce exposures within the target range. Further evaluation of the impact of CYP2B6 polymorphisms on EFV PK showed that the identification of CYP2B6 genetic status is not predictive of EFV exposure and thus not informative to guide pediatric dosing regimens. PMID:27067333

  14. Population Pharmacokinetics Analysis To Inform Efavirenz Dosing Recommendations in Pediatric HIV Patients Aged 3 Months to 3 Years.

    PubMed

    Luo, Man; Chapel, Sunny; Sevinsky, Heather; Savant, Ishani; Cirincione, Brenda; Bertz, Richard; Roy, Amit

    2016-06-01

    Efavirenz (EFV) is a nonnucleoside reverse transcriptase inhibitor approved worldwide for the treatment of HIV in adults and children over 3 years of age or weighing over 10 kg. Only recently EFV was approved in children over 3 months and weighing at least 3.5 kg in the United States and the European Union. The objective of this analysis was to support the selection of an appropriate dose for this younger pediatric population and to explore the impact of CYP2B6 genetic polymorphisms on EFV systemic exposures. A population pharmacokinetic (PPK) model was developed using data from three studies in HIV-1-infected pediatric subjects (n = 168) and one study in healthy adults (n = 24). The EFV concentration-time profile was best described by a two-compartment model with first-order absorption and elimination. Body weight was identified as a significant predictor of efavirenz apparent clearance (CL), oral central volume of distribution (VC), and absorption rate constant (Ka). The typical values of efavirenz apparent CL, VC, oral peripheral volume of distribution (VP), and Ka for a reference pediatric patient were 4.8 liters/h (4.5 to 5.1 liters/h), 84.9 liters (76.8 to 93.0 liters), 287 liters (252.6 to 321.4 liters), and 0.414 h(-1) (0.375 to 0.453 h(-1)), respectively. The final model was used to simulate steady-state efavirenz concentrations in pediatric patients weighing <10 kg to identify EFV doses that produce comparable exposure to adult and pediatric patients weighing ≥10 kg. Results suggest that administration of EFV doses of 100 mg once daily (QD) to children weighing ≥3.5 to <5 kg, 150 mg QD to children weighing ≥5 to <7.5 kg, and 200 mg QD to children weighing ≥7.5 to <10 kg produce exposures within the target range. Further evaluation of the impact of CYP2B6 polymorphisms on EFV PK showed that the identification of CYP2B6 genetic status is not predictive of EFV exposure and thus not informative to guide pediatric dosing regimens.

  15. Population Pharmacokinetics Analysis To Inform Efavirenz Dosing Recommendations in Pediatric HIV Patients Aged 3 Months to 3 Years

    PubMed Central

    Luo, Man; Chapel, Sunny; Sevinsky, Heather; Savant, Ishani; Cirincione, Brenda; Bertz, Richard

    2016-01-01

    Efavirenz (EFV) is a nonnucleoside reverse transcriptase inhibitor approved worldwide for the treatment of HIV in adults and children over 3 years of age or weighing over 10 kg. Only recently EFV was approved in children over 3 months and weighing at least 3.5 kg in the United States and the European Union. The objective of this analysis was to support the selection of an appropriate dose for this younger pediatric population and to explore the impact of CYP2B6 genetic polymorphisms on EFV systemic exposures. A population pharmacokinetic (PPK) model was developed using data from three studies in HIV-1-infected pediatric subjects (n = 168) and one study in healthy adults (n = 24). The EFV concentration-time profile was best described by a two-compartment model with first-order absorption and elimination. Body weight was identified as a significant predictor of efavirenz apparent clearance (CL), oral central volume of distribution (VC), and absorption rate constant (Ka). The typical values of efavirenz apparent CL, VC, oral peripheral volume of distribution (VP), and Ka for a reference pediatric patient were 4.8 liters/h (4.5 to 5.1 liters/h), 84.9 liters (76.8 to 93.0 liters), 287 liters (252.6 to 321.4 liters), and 0.414 h−1 (0.375 to 0.453 h−1), respectively. The final model was used to simulate steady-state efavirenz concentrations in pediatric patients weighing <10 kg to identify EFV doses that produce comparable exposure to adult and pediatric patients weighing ≥10 kg. Results suggest that administration of EFV doses of 100 mg once daily (QD) to children weighing ≥3.5 to <5 kg, 150 mg QD to children weighing ≥5 to <7.5 kg, and 200 mg QD to children weighing ≥7.5 to <10 kg produce exposures within the target range. Further evaluation of the impact of CYP2B6 polymorphisms on EFV PK showed that the identification of CYP2B6 genetic status is not predictive of EFV exposure and thus not informative to guide pediatric dosing regimens. PMID:27067333

  16. Dental care provided to sickle cell anemia patients stratified by age: A population-based study in Northeastern Brazil

    PubMed Central

    Costa, Cyrene Piazera Silva; Aires, Bárbara Tamires Cruz; Thomaz, Erika Bárbara Abreu Fonseca; Souza, Soraia de Fátima Carvalho

    2016-01-01

    Objective: To assess differences in the dental care provided to sickle cell anemia (SCA) patients depending on age. This retrospective study used secondary data from the dental records of the Center of Hematology and Hemotherapy in Maranhão (HEMOMAR). Materials and Methods: Data were obtained from 574 dental records of patients with SCA treated or under treatment in the Dental Department of HEMOMAR from 2000 to 2011. Data on the gender, age, duration of dental treatment, number of patients submitted to periodontal treatment (PT), number of filled teeth (FT), teeth extracted (EX), endodontically treated teeth (ET), and reason for the dental procedures were collected. The Kruskal–Wallis test together with Dunn's post hoc test, Chi-square test, and Spearman's correlation was used for statistical analysis. An alpha error of 5% was considered acceptable. Results: Significant differences were found for FT, EX (P < 0.05), ET and PT (P < 0.001) between the age groups. There were fewer FT in children compared to other age groups (P < 0.001). The most common reasons for restorations and endodontic treatment were dental caries (100%) and irreversible pulpitis (55.6%), respectively. The main reasons for teeth extractions were residual roots (21.3%), chronic apical periodontitis (19.7%), and crown destruction (19.3%). There were positive correlations between age and EX (r = 0.93; P = 0.025) and ET (r = 0.92; P = 0.028). Conclusions: FT, ET, EX, and PT procedures become more common in older patients. Tooth decay is the main reason for dental treatment in SCA patients. PMID:27403053

  17. Perioperative Cognitive Decline in the Aging Population

    PubMed Central

    Terrando, Niccolò; Brzezinski, Marek; Degos, Vincent; Eriksson, Lars I.; Kramer, Joel H.; Leung, Jacqueline M.; Miller, Bruce L.; Seeley, William W.; Vacas, Susana; Weiner, Michael W.; Yaffe, Kristine; Young, William L.; Xie, Zhongcong; Maze, Mervyn

    2011-01-01

    Elderly patients who have an acute illness or who undergo surgery often experience cognitive decline. The pathophysiologic mechanisms that cause neurodegeneration resulting in cognitive decline, including protein deposition and neuroinflammation, also play a role in animal models of surgery-induced cognitive decline. With the aging of the population, surgical candidates of advanced age with underlying neurodegeneration are encountered more often, raising concerns that, in patients with this combination, cognitive function will precipitously decline postoperatively. This special article is based on a symposium that the University of California, San Francisco, convened to explore the contributions of surgery and anesthesia to the development of cognitive decline in the aged patient. A road map to further elucidate the mechanisms, diagnosis, risk factors, mitigation, and treatment of postoperative cognitive decline in the elderly is provided. PMID:21878601

  18. Age-related trends of gastritis and intestinal metaplasia in gastric carcinoma patients and in controls representing the population at large.

    PubMed Central

    Sipponen, P.; Kekki, M.; Siurala, M.

    1984-01-01

    Age-related trends of gastritis and intestinal metaplasia (IM) were studied in 476 endoscopically examined and bioptically proved cases of gastric carcinoma (GC), 263 of which were of intestinal (IGC) and 213 of diffuse (DGC) types. Endoscopic biopsy specimens from the area around the tumour were available in all cases, and from the antrum and/or body distant from the tumour area in 238 cases. A representative sample of an endoscopically and bioptically examined Finnish population consisting of 431 subjects was used as control material. In patients with IGC the prevalence of atrophic gastritis in the gastric area affected by the tumour was higher and that of superficial gastritis lower than expected, and the age-group scores of gastritis and IM were situated above the age-dependent line of gastritis scores of controls in all age groups studied. This was seen to indicate a more rapid progression of gastritis in IGC patients than in the population at large. In the opposite area of the stomach, i.e. in the tumour-free area, the progression of gastritis and IM was virtually similar to that in controls. No such differences were seen with regard to DGC. It is concluded that IGC is dynamically closely linked to gastritis and IM, while in DGC no such relationship is demonstrable. PMID:6608953

  19. Fiscal implications of population ageing.

    PubMed

    Johnson, P

    1997-12-29

    In all developed countries the fiscal ties of the tax and benefit system serve to complement, and sometimes substitute for, traditional family bonds between young and old. Older people are major recipients of public pensions and public health care systems. Since these public transfers and services are financed primarily from the taxes paid by people of working age, the welfare system in effect transfers resources from young to old. But rather than see the fiscal interdependency between young and old as being analogous to the ties that bind children, parents and grandparents together in familial networks, it is often interpreted as an oppressive burden that the old place on the young. This paper examines arguments that population ageing will exacerbate this burden, and may lead to the collapse of public welfare systems. It shows that the financial problems currently associated with public pensions are a function of system design rather than demographic change, and that wholesale privatization of pension systems will do little to solve the major dilemma--of persuading people to transfer a larger part of their lifetime income to their later years in order to sustain a reasonable standard of living throughout an ever lengthening period of retirement. PMID:9460075

  20. Fiscal implications of population ageing.

    PubMed Central

    Johnson, P

    1997-01-01

    In all developed countries the fiscal ties of the tax and benefit system serve to complement, and sometimes substitute for, traditional family bonds between young and old. Older people are major recipients of public pensions and public health care systems. Since these public transfers and services are financed primarily from the taxes paid by people of working age, the welfare system in effect transfers resources from young to old. But rather than see the fiscal interdependency between young and old as being analogous to the ties that bind children, parents and grandparents together in familial networks, it is often interpreted as an oppressive burden that the old place on the young. This paper examines arguments that population ageing will exacerbate this burden, and may lead to the collapse of public welfare systems. It shows that the financial problems currently associated with public pensions are a function of system design rather than demographic change, and that wholesale privatization of pension systems will do little to solve the major dilemma--of persuading people to transfer a larger part of their lifetime income to their later years in order to sustain a reasonable standard of living throughout an ever lengthening period of retirement. PMID:9460075

  1. Advancing paternal age at birth is associated with poorer social functioning earlier and later in life of schizophrenia patients in a founder population.

    PubMed

    Liebenberg, Rudolf; van Heerden, Brigitte; Ehlers, René; Du Plessis, Anna M E; Roos, J Louw

    2016-09-30

    Consistent associations have been found between advanced paternal age and an increased risk of psychiatric disorders, such as schizophrenia, in their offspring. This increase appears to be linear as paternal age increases. The present study investigates the relationship between early deviant behaviour in the first 10 years of life of patients as well as longer term functional outcome and paternal age in sporadic Afrikaner founder population cases of schizophrenia. This might improve our understanding of Paternal Age-Related Schizophrenia (PARS). Follow-up psychiatric diagnoses were confirmed by the Diagnostic Interview for Genetic Studies (DIGS). An early deviant childhood behaviour semi-structured questionnaire and the Specific Level of Functioning Assessment (SLOF) were completed. From the logistic regression models fitted, a significant negative relationship was found between paternal age at birth and social dysfunction as early deviant behaviour. Additionally, regression analysis revealed a significant negative relationship between paternal age at birth and the SLOF for interpersonal relationships later in life. Early social dysfunction may represent a phenotypic trait for PARS. Further research is required to understand the relationship between early social dysfunction and deficits in interpersonal relationships later in life. PMID:27416538

  2. Population aging and its strategic options.

    PubMed

    Zhang, W

    1997-12-01

    Since population aging will challenge all societies in the future, all countries need to give priority attention to the matter. In 2000, more than 130 million of China's population will be aged 60 years, 10% of the total population. The proportion of China's population in that age group will then grow to 25% in 2050. Developing the economy is the most fundamental way to increase the country's population carrying capacity and to cope with population aging. Only a developed economy can solve the problems inherent to population aging. A relatively low total dependency ratio and an annual net increase of about 6 million working-age population during 1982-2025 will facilitate economic development in China. Complementary strategies to handle population aging in China include supporting and continuing the tradition of families supporting their elderly, developing a community-based support system, updating the existing social security system, and improving the legal system on aging to ensure that it protects the rights and interests of the elderly.

  3. The aging population: demographics and the biology of aging.

    PubMed

    Kanasi, Eleni; Ayilavarapu, Srinivas; Jones, Judith

    2016-10-01

    Epidemiologic studies show that 11% of the world's population is over 60 years of age; this is projected to increase, by 2050, to 22% of the population. Oral aging is a current focus of several organizations including the Federation Dentaire Internationale, the World Health Organization and the American and Japanese Dental Associations. In their Tokyo Declaration, the Japanese Association identified the elderly population as one of its main target groups. One of the WHO goals is for each person to retain more than 20 teeth by age 80, despite the fact that the prevalence of periodontal disease is continuously rising as the population is aging. Every species has its own characteristic lifespan, which is determined by its evolutionary history and is modified by multiple diverse factors, including biological mechanisms. In humans, the gradual accumulation of products of cellular metabolism and extensive DNA damage contribute to the aging process. Aging is thought to be associated with a low-grade inflammatory phenotype in mammals, called 'inflammaging', and is the result of autophagic capacity impairing so-called 'housekeeping activities' in the cells, resulting in protein aggregation, mitochondrial dysfunction and oxidative stress. Delayed stem-cell proliferation, associated with aging, may impact the maintenance and survival of a living being, but excessive proliferation could also result in depleted reserves of stem cells. Studies are needed to address the association of delayed cell proliferation and wound healing with the onset of periodontal diseases and response to treatment. The effects of systemic diseases, medications, psychological effects and decreased interest or ability in performing oral-hygiene practices are thought to result in periodontal diseases, and ultimately in tooth loss, in aged individuals. Together with an aging population comes a responsibility for 'healthy' and 'successful' aging. This article describes the changing global demographic

  4. SOME MACROECONOMIC ASPECTS OF GLOBAL POPULATION AGING*

    PubMed Central

    LEE, RONALD; MASON, ANDREW

    2012-01-01

    Across the demographic transition, declining mortality followed by declining fertility produces decades of rising support ratios as child dependency falls. These improving support ratios raise per capita consumption, other things equal, but eventually deteriorate as the population ages. Population aging and the forces leading to it can produce not only frightening declines in support ratios but also very substantial increases in productivity and per capita income by raising investment in physical and human capital. Longer life, lower fertility, and population aging all raise the demand for wealth needed to provide for old-age consumption. This leads to increased capital per worker even as aggregate saving rates fall. However, capital per worker may not rise if the increased demand for wealth is satisfied by increased familial or public pension transfers to the elderly. Thus, institutions and policies matter for the consequences of population aging. The accumulation of human capital also varies across the transition. Lower fertility and mortality are associated with higher human capital investment per child, also raising labor productivity. Together, the positive changes due to human and physical capital accumulation will likely outweigh the problems of declining support ratios. We draw on estimates and analyses from the National Transfer Accounts project to illustrate and quantify these points. PMID:21302431

  5. The economics of population aging in China.

    PubMed

    Yu, X

    1996-01-01

    This article relies on a Marxist framework for discussing the relationship between economic development and population aging in China. China places value on correctly understanding the causes, processes, trends, and socioeconomic consequences of population aging during the development of its socialist market economy. Many policies have an impact on the aged. Marxist theories of economic operations identify four key features--production, distribution, exchange, and consumption--which are affected by human activity. The age structure of population affects socioeconomic operations. An increase in accumulated capital means a decrease in consumption capital. China must maintain its high level of annual economic growth (6.0%-6.5%). 30% of China's national income must be used for accumulation of capital and investment, but the increase in the aged has led to growth in consumption capital. By 2050, it is expected that there will be over 100 million retirees needing about 800 billion RMB in pensions (20 times the amount in 1993). As the number of elderly grows, savings decline. The growth of the elderly will place demands on social security funds, which will in turn rely on an increased proportion of consumption capital. The increased labor force and the increased number of aged will both vie for a share in the national economy until about 2020, and then the problem will be declines in productivity in some areas. It is generally believed that support of the elderly should not rise above 10% of national income. In 1993, the elderly's share was 3.7%, and at the present rate of growth, it is expected that the share will be above 10% by 2030. Working families will have to carry a heavy domestic burden of care for their aged. Productivity will have to increase in order to offset the decline in per capita consumption capital due to aging. The author offers countermeasures at the macro- and microlevel for dealing with the demographic changes.

  6. Population ageing: what should we worry about?

    PubMed Central

    Turner, Adair

    2009-01-01

    Approximately half the world's population now has replacement-level fertility or below. The UK experience in accommodating to a changing dependency ratio provides some generalizable insights. A mechanistic approach assuming a fixed retirement age and a need to raise fertility or increase immigration in order to maintain pensions at a fixed proportion of the gross domestic product (GDP) is overstated and wrong. It needs to be replaced by a welfare optimizing model, which takes into account the increasing years of healthy life, a slow rise in the pensionable age, capital inheritance and wider welfare considerations of population density that are not reflected in GDP measures. A combined replacement ratio (CRR) is suggested for developed countries combining the impact of the fertility rate and immigration rate. A CRR above 2 implies continued population growth. The current UK CRR of 2.48 is higher than needed for pension reasons, and it is suggested that it exceeds the welfare maximizing level. PMID:19770152

  7. Effect of Age on Survival Outcome in Operated and Non-Operated Patients with Colon Cancer: A Population-Based Study

    PubMed Central

    Tan, XueMing; Fan, ZhiNing

    2016-01-01

    Objective To know the effect of age on survival outcome in operated and non-operated patients with colon cancer. Methods From the Surveillance, Epidemiology, and End Results database, we identified 123,356 patients with colon cancer who were diagnosed between 1996 and 2005, grouped them as older or younger than 40 years and analyzed their 5-year cancer-specific survival (CSS) data, along with some risk factors, using Kaplan–Meier methods and multivariable Cox regression models. Results The younger group had significantly higher pathological grades (P<0.001), more mucinous and signet-ring histology (P<0.001), advanced AJCC stage (P<0.001), and were more likely to undergo surgery (P<0.001). For surgically treated patients, age did not significantly affect 5-year CSS (younger: 66.7%; older: 67.3%; P = 0.86). Further analysis showed that age was an independent prognostic factor in stage I–IV disease (stage I: P = 0.001; P<0.001 for stages II–IV, in both uni- and multivariate analyses), but not for patients with unknown disease stage (P = 0.52). For non-surgically treated patients, age significantly affected 5-year CSS (younger: 16.2%; older: 12.9%; P<0.001) in univariate analysis; and was an independent prognostic factor (P<0.001) in multivariate analysis. Conclusion The CSS rate for younger CC patients was at least as high as for older patients, although they presented with higher proportions of unfavorable factors and more advanced disease. PMID:26789841

  8. Factors relating to poor survival rates of aged cervical cancer patients: a population-based study with the relative survival model in Osaka, Japan.

    PubMed

    Ioka, Akiko; Ito, Yuri; Tsukuma, Hideaki

    2009-01-01

    Poor survival of older cervical cancer patients has been reported; however, related factors, such as the extent of disease and the competitive risk by aging have not been well evaluated. We applied the relative survival model developed by Dickman et al to resolve this issue. Study subjects were cervical cancer patients retrieved from the Osaka Cancer Registry. They were limited to the 10,048 reported cases diagnosed from 1975 to 1999, based on the quality of data collection on vital status. Age at diagnosis was categorized into <30, 30-54, 55-64, and > or = 65 years. The impact of prognostic factors on 5-year survival was evaluated with the relative survival model, incorporating patients' expected survival in multivariate analysis. The age-specific relative excess risk (RER) of death was significantly higher for older groups as compared with women aged 30-54 years (RER, 1.58 at 55-64 and 2.51 at > or = 65 years). The RER was decreased by 64.8% among the 55-64 year olds as an effect of cancer stage at diagnosis, and by 43.4% among those 65 years old and over. After adding adjustment for treatment modalities, the RER was no longer significantly higher among 55-64 year olds; however, it was still higher among 65 year olds and over. Advanced stage at diagnosis was the main determinant of poor survival among the aged cervical cancer patients, although other factors such as limitations on the combination of treatment were also suggested to have an influence in those aged 65 years and over.

  9. Energy implications of an aging population

    SciTech Connect

    Not Available

    1980-08-01

    This study provides various demographic, medical, and economic information relative to energy usage on a segment of the population, the elderly, which is growing in absolute numbers and relative population percentage. This growth is expected to continue well into the twenty-first century. The US aging population numbered 3.1 million in 1900, and by 1977 it had climbed to 23.5 million. It can be stated with reasonable certainty that this figure will rise to 31 million in the year 2000 and 43 million in the year 2020. These figures, corresponding to more than 10% of our population, are by no means insignificant. As our fossil-fuel reserves are being depleted and the cost of energy mounts, it becomes apparent that the elderly will become increasingly vulnerable to the energy crisis, primarily beause of their physical tendency to infirmity, their economic and social situation, and their susceptibility to psychological depression. This white paper concentrates on those aspects of aging and the nation's energy problem which are not usually related in our everyday consideration of these as separable problems. It seeks to identify the peculiar energy problems of the aged and to consider alternatives in the solution of these problems in light of modern technology.

  10. Population genomics of Bronze Age Eurasia.

    PubMed

    Allentoft, Morten E; Sikora, Martin; Sjögren, Karl-Göran; Rasmussen, Simon; Rasmussen, Morten; Stenderup, Jesper; Damgaard, Peter B; Schroeder, Hannes; Ahlström, Torbjörn; Vinner, Lasse; Malaspinas, Anna-Sapfo; Margaryan, Ashot; Higham, Tom; Chivall, David; Lynnerup, Niels; Harvig, Lise; Baron, Justyna; Della Casa, Philippe; Dąbrowski, Paweł; Duffy, Paul R; Ebel, Alexander V; Epimakhov, Andrey; Frei, Karin; Furmanek, Mirosław; Gralak, Tomasz; Gromov, Andrey; Gronkiewicz, Stanisław; Grupe, Gisela; Hajdu, Tamás; Jarysz, Radosław; Khartanovich, Valeri; Khokhlov, Alexandr; Kiss, Viktória; Kolář, Jan; Kriiska, Aivar; Lasak, Irena; Longhi, Cristina; McGlynn, George; Merkevicius, Algimantas; Merkyte, Inga; Metspalu, Mait; Mkrtchyan, Ruzan; Moiseyev, Vyacheslav; Paja, László; Pálfi, György; Pokutta, Dalia; Pospieszny, Łukasz; Price, T Douglas; Saag, Lehti; Sablin, Mikhail; Shishlina, Natalia; Smrčka, Václav; Soenov, Vasilii I; Szeverényi, Vajk; Tóth, Gusztáv; Trifanova, Synaru V; Varul, Liivi; Vicze, Magdolna; Yepiskoposyan, Levon; Zhitenev, Vladislav; Orlando, Ludovic; Sicheritz-Pontén, Thomas; Brunak, Søren; Nielsen, Rasmus; Kristiansen, Kristian; Willerslev, Eske

    2015-06-11

    The Bronze Age of Eurasia (around 3000-1000 BC) was a period of major cultural changes. However, there is debate about whether these changes resulted from the circulation of ideas or from human migrations, potentially also facilitating the spread of languages and certain phenotypic traits. We investigated this by using new, improved methods to sequence low-coverage genomes from 101 ancient humans from across Eurasia. We show that the Bronze Age was a highly dynamic period involving large-scale population migrations and replacements, responsible for shaping major parts of present-day demographic structure in both Europe and Asia. Our findings are consistent with the hypothesized spread of Indo-European languages during the Early Bronze Age. We also demonstrate that light skin pigmentation in Europeans was already present at high frequency in the Bronze Age, but not lactose tolerance, indicating a more recent onset of positive selection on lactose tolerance than previously thought.

  11. Population genomics of Bronze Age Eurasia.

    PubMed

    Allentoft, Morten E; Sikora, Martin; Sjögren, Karl-Göran; Rasmussen, Simon; Rasmussen, Morten; Stenderup, Jesper; Damgaard, Peter B; Schroeder, Hannes; Ahlström, Torbjörn; Vinner, Lasse; Malaspinas, Anna-Sapfo; Margaryan, Ashot; Higham, Tom; Chivall, David; Lynnerup, Niels; Harvig, Lise; Baron, Justyna; Della Casa, Philippe; Dąbrowski, Paweł; Duffy, Paul R; Ebel, Alexander V; Epimakhov, Andrey; Frei, Karin; Furmanek, Mirosław; Gralak, Tomasz; Gromov, Andrey; Gronkiewicz, Stanisław; Grupe, Gisela; Hajdu, Tamás; Jarysz, Radosław; Khartanovich, Valeri; Khokhlov, Alexandr; Kiss, Viktória; Kolář, Jan; Kriiska, Aivar; Lasak, Irena; Longhi, Cristina; McGlynn, George; Merkevicius, Algimantas; Merkyte, Inga; Metspalu, Mait; Mkrtchyan, Ruzan; Moiseyev, Vyacheslav; Paja, László; Pálfi, György; Pokutta, Dalia; Pospieszny, Łukasz; Price, T Douglas; Saag, Lehti; Sablin, Mikhail; Shishlina, Natalia; Smrčka, Václav; Soenov, Vasilii I; Szeverényi, Vajk; Tóth, Gusztáv; Trifanova, Synaru V; Varul, Liivi; Vicze, Magdolna; Yepiskoposyan, Levon; Zhitenev, Vladislav; Orlando, Ludovic; Sicheritz-Pontén, Thomas; Brunak, Søren; Nielsen, Rasmus; Kristiansen, Kristian; Willerslev, Eske

    2015-06-11

    The Bronze Age of Eurasia (around 3000-1000 BC) was a period of major cultural changes. However, there is debate about whether these changes resulted from the circulation of ideas or from human migrations, potentially also facilitating the spread of languages and certain phenotypic traits. We investigated this by using new, improved methods to sequence low-coverage genomes from 101 ancient humans from across Eurasia. We show that the Bronze Age was a highly dynamic period involving large-scale population migrations and replacements, responsible for shaping major parts of present-day demographic structure in both Europe and Asia. Our findings are consistent with the hypothesized spread of Indo-European languages during the Early Bronze Age. We also demonstrate that light skin pigmentation in Europeans was already present at high frequency in the Bronze Age, but not lactose tolerance, indicating a more recent onset of positive selection on lactose tolerance than previously thought. PMID:26062507

  12. International Conference on Population Aging. Keynote address.

    PubMed

    Tabone, V

    1992-11-01

    This is the keynote address of H.E.Dr. Vincent Tabone, President of Malta, at the International Conference on Aging, which was held in San Diego in September 1992. He states that the conference celebrates the tenth anniversary of the Vienna International Plan of Action, and provides an opportunity to evaluate progress and plan future direction. Dr. Tabone, as Minister of Foreign Affairs, first introduced the question of aging at the UN General Assembly over twenty years ago; the United Nations Secretariat established its first program in the field of aging in 1970. At the World Assembly on Aging in 1982, all members adopted the International Plan of Action, which defined guidelines for policies and programs in support of the aging populations. As a direct result of this, and in support of the needs of developing countries, the UN signed an agreement with the government of Malta that established the International Institute on Aging as an autonomous body under the auspices of the UN; it is the major expression of the Vienna Plan of Action. Concern for aging populations has developed enough maturity and momentum to oversee its own progress. Although current events may relegate the social and economic implications of the aged to the sphere of rhetoric, they demand thinking in terms of generations and transcend all political boundaries. This conference will evaluate progress toward deflecting a situation where the elderly constitute an increasing proportion of the population, without adequate and appropriate provision for their livelihood, and could have direct bearing on encouraging and ensuring the continuity of the family's vital and traditional role in preserving the dignity, status, and well-being of its aging members. A nation which begrudges its dues to the elderly, the successful products of society and triumphs of life, denies its past. This conference is a reaffirmation of commitment to the United Nations Principles for Older Persons, an omen of the review of

  13. International Conference on Population Aging. Keynote address.

    PubMed

    Tabone, V

    1992-11-01

    This is the keynote address of H.E.Dr. Vincent Tabone, President of Malta, at the International Conference on Aging, which was held in San Diego in September 1992. He states that the conference celebrates the tenth anniversary of the Vienna International Plan of Action, and provides an opportunity to evaluate progress and plan future direction. Dr. Tabone, as Minister of Foreign Affairs, first introduced the question of aging at the UN General Assembly over twenty years ago; the United Nations Secretariat established its first program in the field of aging in 1970. At the World Assembly on Aging in 1982, all members adopted the International Plan of Action, which defined guidelines for policies and programs in support of the aging populations. As a direct result of this, and in support of the needs of developing countries, the UN signed an agreement with the government of Malta that established the International Institute on Aging as an autonomous body under the auspices of the UN; it is the major expression of the Vienna Plan of Action. Concern for aging populations has developed enough maturity and momentum to oversee its own progress. Although current events may relegate the social and economic implications of the aged to the sphere of rhetoric, they demand thinking in terms of generations and transcend all political boundaries. This conference will evaluate progress toward deflecting a situation where the elderly constitute an increasing proportion of the population, without adequate and appropriate provision for their livelihood, and could have direct bearing on encouraging and ensuring the continuity of the family's vital and traditional role in preserving the dignity, status, and well-being of its aging members. A nation which begrudges its dues to the elderly, the successful products of society and triumphs of life, denies its past. This conference is a reaffirmation of commitment to the United Nations Principles for Older Persons, an omen of the review of

  14. Designing new meals for an ageing population.

    PubMed

    Costa, Ana I A; Jongen, Wim M F

    2010-06-01

    Today's ageing population is an ever-increasing, highly diverse group of people wanting to live a healthy and enjoyable life. Seniors increasingly see the importance of eating healthy and delicious food in a pleasant environment in achieving happiness and well-being. Up until now, the food industry has been rather slow in transforming the wealth of available knowledge regarding the nutritional needs and sensory perception of the ageing into new food products. Based on our own and the published research of others, we discuss here how the design of new meals for an ageing population can be tackled by a consumer-led approach to food product development. After a brief overview of the underlying concepts and practices, a detailed description is given of how this approach could be used in the design of Home Meal Replacements for senior households. This description includes also a comprehensive review of the major determinants of food preference and meal choice behavior in a later age. Finally, relevant implications are derived from the work presented and future trends in the technological development of foods for the ageing highlighted.

  15. A population dynamics approach to biological aging

    NASA Astrophysics Data System (ADS)

    de Almeida, R. M. C.

    A dynamical model for aging in biological population is discussed where asexual reproduction is considered. The maximum life span is inherited from parent to offspring with some random mutations described by a transition matrix, and the fertile period begins at a defined age R. The intra species competition is modeled through a Verhulst-like factor. Discrete time evolution equations are iterated and the transient and asymptotic solutions are obtained. When only bad mutations are taken into account, the stationary solutions are obtained analytically. The results are applied to the Penna model.

  16. Population aging and endogenous economic growth.

    PubMed

    Prettner, Klaus

    2013-04-01

    We investigate the consequences of population aging for long-run economic growth perspectives. Our framework incorporates endogenous growth models and semi-endogenous growth models as special cases. We show that (1) increases in longevity have a positive impact on per capita output growth, (2) decreases in fertility have a negative impact on per capita output growth, (3) the positive longevity effect dominates the negative fertility effect in case of the endogenous growth framework, and (4) population aging fosters long-run growth in the endogenous growth framework, while its effect depends on the relative change between fertility and mortality in the semi-endogenous growth framework.Electronic supplementary material The online version of this article (doi:10.1007/s00148-012-0441-9) contains supplementary material, which is available to authorized users.

  17. Epidemiology of Chronic Obstructive Pulmonary Disease (COPD) in Aging Populations.

    PubMed

    Fragoso, Carlos A Vaz

    2016-01-01

    Current epidemiologic practice evaluates COPD based on self-reported symptoms of chronic bronchitis, self-reported physician-diagnosed COPD, spirometry confirmed airflow obstruction, or emphysema diagnosed by volumetric computed chest tomography (CT). Because the highest risk population for having COPD includes a predominance of middle-aged or older persons, aging related changes must also be considered, including: 1) increased multimorbidity, polypharmacy, and severe deconditioning, as these identify mechanisms that underlie respiratory symptoms and can impart a complex differential diagnosis; 2) increased airflow limitation, as this impacts the interpretation of spirometry confirmed airflow obstruction; and 3) "senile" emphysema, as this impacts the specificity of CT-diagnosed emphysema. Accordingly, in an era of rapidly aging populations worldwide, the use of epidemiologic criteria that do not rigorously consider aging related changes will result in increased misidentification of COPD and may, in turn, misinform public health policy and patient care. PMID:26629987

  18. Slowed ageing, welfare, and population problems.

    PubMed

    Wareham, Christopher

    2015-10-01

    Biological studies have demonstrated that it is possible to slow the ageing process and extend lifespan in a wide variety of organisms, perhaps including humans. Making use of the findings of these studies, this article examines two problems concerning the effect of life extension on population size and welfare. The first--the problem of overpopulation--is that as a result of life extension too many people will co-exist at the same time, resulting in decreases in average welfare. The second--the problem of underpopulation--is that life extension will result in too few people existing across time, resulting in decreases in total welfare. I argue that overpopulation is highly unlikely to result from technologies that slow ageing. Moreover, I claim that the problem of underpopulation relies on claims about life extension that are false in the case of life extension by slowed ageing. The upshot of these arguments is that the population problems discussed provide scant reason to oppose life extension by slowed ageing.

  19. The economic consequences of ageing populations.

    PubMed Central

    Mirrlees, J A

    1997-01-01

    The effect of low birth rates and lengthening lives on the economy is discussed. Two extreme cases are examined: where pensions are entirely on a pay-as-you-go basis, and where they are entirely funded. It is argued that the economy would grow faster in the latter case. The impact on the levels of consumption of each age cohort during its lifetime is assessed. The possible magnitude of changes in consumption as a result of an increase in the retired part of the population is illustrated. It is shown that, comparing later cohorts to earlier cohorts, the former are better off under a funded system. An argument is then sketched showing that a pay-as-you-go system favours earlier cohorts too much; while most probably, but not certainly, a fully funded system favours the later cohorts excessively. It is claimed that a gradual introduction of partial funding, and some increase in the length of working lives, can deal with the effects of an ageing population without an excessive burden on any cohort or age-group. PMID:9460073

  20. Changes in Chondrogenic Progenitor Populations Associated with Aging and Osteoarthritis.

    PubMed

    Brady, Kyla; Dickinson, Sally C; Hollander, Anthony P

    2015-04-01

    Chondrogenic progenitor populations, including mesenchymal stem cells, represent promising cell-based transplantation or tissue engineering therapies for the regeneration of damaged cartilage. Osteoarthritis (OA) predominantly affects the elderly and is a leading cause of disability worldwide. Advancing age is a prominent risk factor that is closely associated with the onset and progression of the disease. Understanding the influence that aging and OA have on chondrogenic progenitor cells is important to determine how these processes affect the cellular mechanisms of the cells and their capacity to differentiate into functional chondrocytes for use in therapeutic applications. Here, we review the effect of age- and OA-related changes on the growth kinetics and differentiation potential of chondrogenic progenitor cell populations. Aging differentially influences the proliferative potential of progenitor cells showing reduced growth rates with increased senescence and apoptotic activity over time, while chondrogenesis appears to be independent of donor age. Cartilage tissue affected by OA shows evidence of progenitor populations with some potential for repair, however reports on the proliferative propensity of mesenchymal stem cells and their chondrogenic potential are contradictory. This is likely attributed to the narrow age ranges of samples assessed and deficits in definitively identifying donors with OA versus healthy patients across a wide scope of advancing ages. Further studies that investigate the mechanistic effects of chondrogenic progenitor populations associated with aging and the progression of OA using clearly defined criteria and age-matched control subject groups are crucial to our understanding of the clinical relevance of these cells for use in cartilage repair therapies. PMID:27340514

  1. Changes in Chondrogenic Progenitor Populations Associated with Aging and Osteoarthritis

    PubMed Central

    Brady, Kyla; Dickinson, Sally C.

    2015-01-01

    Chondrogenic progenitor populations, including mesenchymal stem cells, represent promising cell-based transplantation or tissue engineering therapies for the regeneration of damaged cartilage. Osteoarthritis (OA) predominantly affects the elderly and is a leading cause of disability worldwide. Advancing age is a prominent risk factor that is closely associated with the onset and progression of the disease. Understanding the influence that aging and OA have on chondrogenic progenitor cells is important to determine how these processes affect the cellular mechanisms of the cells and their capacity to differentiate into functional chondrocytes for use in therapeutic applications. Here, we review the effect of age- and OA-related changes on the growth kinetics and differentiation potential of chondrogenic progenitor cell populations. Aging differentially influences the proliferative potential of progenitor cells showing reduced growth rates with increased senescence and apoptotic activity over time, while chondrogenesis appears to be independent of donor age. Cartilage tissue affected by OA shows evidence of progenitor populations with some potential for repair, however reports on the proliferative propensity of mesenchymal stem cells and their chondrogenic potential are contradictory. This is likely attributed to the narrow age ranges of samples assessed and deficits in definitively identifying donors with OA versus healthy patients across a wide scope of advancing ages. Further studies that investigate the mechanistic effects of chondrogenic progenitor populations associated with aging and the progression of OA using clearly defined criteria and age-matched control subject groups are crucial to our understanding of the clinical relevance of these cells for use in cartilage repair therapies. PMID:27340514

  2. Food and Addiction among the Ageing Population

    PubMed Central

    Murray, Susan; Kroll, Cindy; Avena, Nicole M.

    2014-01-01

    Obesity among the elderly is a growing public health concern. Among the various factors that may contribute to the current rates of obesity is the rewarding aspect of highly palatable foods and beverages, which may lead to overconsumption and excess caloric intake. The present review describes recent research supporting the hypothesis that, for some individuals, the consumption these highly palatable foods and beverages may lead to the development of addictive-like behaviors. In particular, the authors consider the relevance of this hypothesis to the ageing population. PMID:25449527

  3. Food and addiction among the ageing population.

    PubMed

    Murray, Susan; Kroll, Cindy; Avena, Nicole M

    2015-03-01

    Obesity among the elderly is a growing public health concern. Among the various factors that may contribute to the current rates of obesity is the rewarding aspect of highly palatable foods and beverages, which may lead to overconsumption and excess caloric intake. The present review describes recent research supporting the hypothesis that, for some individuals, the consumption these highly palatable foods and beverages may lead to the development of addictive-like behaviors. In particular, the authors consider the relevance of this hypothesis to the ageing population.

  4. Preparing for an epidemic: cancer care in an aging population.

    PubMed

    Shih, Ya-Chen Tina; Hurria, Arti

    2014-01-01

    The Institute of Medicine's (IOM) Committee on Improving the Quality of Cancer Care: Addressing the Challenges of an Aging Population was charged with evaluating and proposing recommendations on how to improve the quality of cancer care, with a specific focus on the aging population. Based on their findings, the IOM committee recently released a report highlighting their 10 recommendations for improving the quality of cancer care. Based on those recommendations, this article highlights ways to improve evidence-based care and addresses rising costs in health care for older adults with cancer. The IOM highlighted three recommendations to address the current research gaps in providing evidence-based care in older adults with cancer, which included (1) studying populations which match the age and health-risk profile of the population with the disease, (2) legislative incentives for companies to include patients that are older or with multiple morbidities in new cancer drug trials, and (3) expansion of research that contributes to the depth and breadth of data available for assessing interventions. The recommendations also highlighted the need to maintain affordable and accessible care for older adults with cancer, with an emphasis on finding creative solutions within both the care delivery system and payment models in order to balance costs while preserving quality of care. The implementation of the IOM's recommendations will be a key step in moving closer to the goal of providing accessible, affordable, evidence-based, high-quality care to all patients with cancer.

  5. Tumor Mismatch Repair Immunohistochemistry and DNA MLH1 Methylation Testing of Patients With Endometrial Cancer Diagnosed at Age Younger Than 60 Years Optimizes Triage for Population-Level Germline Mismatch Repair Gene Mutation Testing

    PubMed Central

    Buchanan, Daniel D.; Tan, Yen Y.; Walsh, Michael D.; Clendenning, Mark; Metcalf, Alexander M.; Ferguson, Kaltin; Arnold, Sven T.; Thompson, Bryony A.; Lose, Felicity A.; Parsons, Michael T.; Walters, Rhiannon J.; Pearson, Sally-Ann; Cummings, Margaret; Oehler, Martin K.; Blomfield, Penelope B.; Quinn, Michael A.; Kirk, Judy A.; Stewart, Colin J.; Obermair, Andreas; Young, Joanne P.; Webb, Penelope M.; Spurdle, Amanda B.

    2014-01-01

    Purpose Clinicopathologic data from a population-based endometrial cancer cohort, unselected for age or family history, were analyzed to determine the optimal scheme for identification of patients with germline mismatch repair (MMR) gene mutations. Patients and Methods Endometrial cancers from 702 patients recruited into the Australian National Endometrial Cancer Study (ANECS) were tested for MMR protein expression using immunohistochemistry (IHC) and for MLH1 gene promoter methylation in MLH1-deficient cases. MMR mutation testing was performed on germline DNA of patients with MMR-protein deficient tumors. Prediction of germline mutation status was compared for combinations of tumor characteristics, age at diagnosis, and various clinical criteria (Amsterdam, Bethesda, Society of Gynecologic Oncology, ANECS). Results Tumor MMR-protein deficiency was detected in 170 (24%) of 702 cases. Germline testing of 158 MMR-deficient cases identified 22 truncating mutations (3% of all cases) and four unclassified variants. Tumor MLH1 methylation was detected in 99 (89%) of 111 cases demonstrating MLH1/PMS2 IHC loss; all were germline MLH1 mutation negative. A combination of MMR IHC plus MLH1 methylation testing in women younger than 60 years of age at diagnosis provided the highest positive predictive value for the identification of mutation carriers at 46% versus ≤ 41% for any other criteria considered. Conclusion Population-level identification of patients with MMR mutation-positive endometrial cancer is optimized by stepwise testing for tumor MMR IHC loss in patients younger than 60 years, tumor MLH1 methylation in individuals with MLH1 IHC loss, and germline mutations in patients exhibiting loss of MSH6, MSH2, or PMS2 or loss of MLH1/PMS2 with absence of MLH1 methylation. PMID:24323032

  6. 11 CFR 110.18 - Voting age population.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 11 Federal Elections 1 2012-01-01 2012-01-01 false Voting age population. 110.18 Section 110.18... PROHIBITIONS § 110.18 Voting age population. There is annually published by the Department of Commerce in the Federal Register an estimate of the voting age population based on an estimate of the voting...

  7. 11 CFR 110.18 - Voting age population.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 11 Federal Elections 1 2010-01-01 2010-01-01 false Voting age population. 110.18 Section 110.18... PROHIBITIONS § 110.18 Voting age population. There is annually published by the Department of Commerce in the Federal Register an estimate of the voting age population based on an estimate of the voting...

  8. 11 CFR 110.18 - Voting age population.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 11 Federal Elections 1 2013-01-01 2012-01-01 true Voting age population. 110.18 Section 110.18... PROHIBITIONS § 110.18 Voting age population. There is annually published by the Department of Commerce in the Federal Register an estimate of the voting age population based on an estimate of the voting...

  9. 11 CFR 110.18 - Voting age population.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 11 Federal Elections 1 2014-01-01 2014-01-01 false Voting age population. 110.18 Section 110.18... PROHIBITIONS § 110.18 Voting age population. There is annually published by the Department of Commerce in the Federal Register an estimate of the voting age population based on an estimate of the voting...

  10. 11 CFR 110.18 - Voting age population.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 11 Federal Elections 1 2011-01-01 2011-01-01 false Voting age population. 110.18 Section 110.18... PROHIBITIONS § 110.18 Voting age population. There is annually published by the Department of Commerce in the Federal Register an estimate of the voting age population based on an estimate of the voting...

  11. Developing vaccines for an aging population.

    PubMed

    Black, Steven; De Gregorio, Ennio; Rappuoli, Rino

    2015-04-01

    The demographics of the world's population are changing, with many adults now surviving into their 80s. With this change comes the need to protect the aging and other underserved populations not only against infectious diseases but also against cancer and other chronic conditions. New technologies derived from recent advances in the fields of immunology, structural biology, synthetic biology, and genomics have brought a revolution in the vaccine field. Among them, vaccine adjuvants have the potential to harness the immune system to provide protection against new types of diseases, improve protection in young children, and expand this protection to adults and the elderly. However, in order to do so we need also to overcome the nontechnical challenges that could limit the implementation of innovative vaccines, including controversies regarding the safety of adjuvants, increasing regulatory complexity, the inadequate methods used to assess the value of novel vaccines, and the resulting industry alienation from future investment. This Perspective summarizes the outcome of a recent multidisciplinary symposium entitled "Enhancing Vaccine Immunity and Value," held in Siena, Italy, in July 2014, that addressed two related questions: how to improve vaccine efficacy by using breakthrough technologies and how to capture the full potential of novel vaccines.

  12. Population pharmacokinetics of imipenem in burn patients.

    PubMed

    Dailly, Eric; Kergueris, Marie France; Pannier, Michel; Jolliet, Pascale; Bourin, Michel

    2003-12-01

    The interindividual variability of imipenem pharmacokinetic parameters in burn patients suggest that these parameters have to be estimated with a large number of patients. The aim of this study is (i) to estimate these parameters with a population pharmacokinetic approach, and (ii) to test the influence of factors on pharmacokinetics parameters. Data are provided by therapeutic drug monitoring (n = 47,118 samples) and analysed by a nonlinear mixed effect modelling method. Among the tested covariates (age, gender, body weight, height, size of burn and creatinine plasma level) creatinine plasma level affects imipenem pharmacokinetic parameters substantially. The best fit is obtained with a two-compartment model integrating a linear-inverse relationship between imipenem clearance and creatinine plasma level. The estimates of imipenem clearance (16.37 +/- 0.204 L/h) and of the distribution volume of the central compartment (0.376 +/- 0.039 L/kg) are higher in the population of burn patients than the estimates in healthy subjects. This result is connected with high values of glomerule filtration rate and confirms the interest of therapeutic drug monitoring of imipenem in burn patients and particularly for patients with extreme values of creatinine clearance.

  13. Complexity in caring for an ageing heart failure population: concomitant chronic conditions and age related impairments.

    PubMed

    De Geest, Sabina; Steeman, Els; Leventhal, Marcia E; Mahrer-Imhof, Romy; Hengartner-Kopp, Beatrice; Conca, Antoinette; Bernasconi, Arlette T; Petry, Heidi; Brunner-La Rocca, Hanspeter

    2004-12-01

    The complexity of caring for the ageing heart failure (HF) population is further complicated by concomitant chronic conditions (i.e., polypharmacy, depression), age related impairments (i.e., hearing, visual and cognitive impairments, impairments in activities of daily living (ADL/IADL), and other issues (e.g., health illiteracy, lack of social support). This paper provides an overview of these risk factors, outlines how they individually and in interplay endanger favourable outcome by putting patients at risk for poor self-management. Moreover, suggestions are made on how these issues could be addressed and integrated in heart failure management by applying gerontological care principles in caring for the ageing heart failure population.

  14. Optimal lineage principle for age-structured populations

    NASA Astrophysics Data System (ADS)

    Kussell, Edo

    2012-02-01

    Populations whose individuals exhibit age-dependent growth have often been studied using temporal dynamics of age distributions. In this talk, I examine the dynamics of age along lineages. We will see that the lineage point-of-view provides fundamental insights into evolutionary pressures on individuals' aging profiles. I will describe a variational principle that enables exact results for lineage statistics, in a variety of models. I will also discuss measurements on continuously dividing bacterial populations growing in microfluidics devices.

  15. Rethinking Leisure Services in an Aging Population.

    ERIC Educational Resources Information Center

    Godbey, Geoffrey; And Others

    1982-01-01

    A survey examined fear of crime among an elderly population as it related to leisure behavior and the use of public recreation facilities. Response to the survey showed that, although the elderly population was surprisingly mobile, reasons preventing respondents from using parks and senior centers included: lack of interest, fear of crime, health,…

  16. China: Awakening Giant Developing Solutions to Population Aging

    ERIC Educational Resources Information Center

    Zhang, Ning Jackie; Guo, Man; Zheng, Xiaoying

    2012-01-01

    As the world's most populous country with the largest aging population and a rapidly growing economy, China is receiving increased attention from both the Chinese government and the governments of other countries that face low fertility and aging problems. This unprecedented shift of demographic structure has repercussions for many aspects of…

  17. Age-structured optimal control in population economics.

    PubMed

    Feichtinger, Gustav; Prskawetz, Alexia; Veliov, Vladimir M

    2004-06-01

    This paper brings both intertemporal and age-dependent features to a theory of population policy at the macro-level. A Lotka-type renewal model of population dynamics is combined with a Solow/Ramsey economy. We consider a social planner who maximizes an aggregate intertemporal utility function which depends on per capita consumption. As control policies we consider migration and saving rate (both age-dependent). By using a new maximum principle for age-structured control systems we derive meaningful results for the optimal migration and saving rate in an aging population. The model used in the numerical calculations is calibrated for Austria.

  18. The Flynn Effect and Population Aging

    ERIC Educational Resources Information Center

    Skirbekk, Vegard; Stonawski, Marcin; Bonsang, Eric; Staudinger, Ursula M.

    2013-01-01

    Although lifespan changes in cognitive performance and Flynn effects have both been well documented, there has been little scientific focus to date on the net effect of these forces on cognition at the population level. Two major questions moving beyond this finding guided this study: (1) Does the Flynn effect indeed continue in the 2000s for…

  19. Inferences about ungulate population dynamics derived from age ratios

    USGS Publications Warehouse

    Harris, N.C.; Kauffman, M.J.; Mills, L.S.

    2008-01-01

    Age ratios (e.g., calf:cow for elk and fawn:doe for deer) are used regularly to monitor ungulate populations. However, it remains unclear what inferences are appropriate from this index because multiple vital rate changes can influence the observed ratio. We used modeling based on elk (Cervus elaphus) life-history to evaluate both how age ratios are influenced by stage-specific fecundity and survival and how well age ratios track population dynamics. Although all vital rates have the potential to influence calf:adult female ratios (i.e., calf:xow ratios), calf survival explained the vast majority of variation in calf:adult female ratios due to its temporal variation compared to other vital rates. Calf:adult female ratios were positively correlated with population growth rate (??) and often successfully indicated population trajectories. However, calf:adult female ratios performed poorly at detecting imposed declines in calf survival, suggesting that only the most severe declines would be rapidly detected. Our analyses clarify that managers can use accurate, unbiased age ratios to monitor arguably the most important components contributing to sustainable ungulate populations, survival rate of young and ??. However, age ratios are not useful for detecting gradual declines in survival of young or making inferences about fecundity or adult survival in ungulate populations. Therefore, age ratios coupled with independent estimates of population growth or population size are necessary to monitor ungulate population demography and dynamics closely through time.

  20. Delivering Library Services to an Aging Population.

    ERIC Educational Resources Information Center

    Katz, Ruth M.

    This study guide was prepared to assist library personnel in using the VINTAGE series, which consists of five color videocassette programs and two slide/sound shows on topics relating to public library services to the aging. The guide to these programs, which were designed for use in staff development programs and to promote community involvement,…

  1. On Constructing Ageing Rural Populations: "Capturing" the Grey Nomad

    ERIC Educational Resources Information Center

    Davies, Amanda

    2011-01-01

    The world's population is ageing, with forecasts predicting this ageing is likely to be particularly severe in the rural areas of more developed countries. These forecasts are developed from nationally aggregated census and survey data and assume spatial homogeneity in ageing. They also draw on narrow understandings of older people and construct…

  2. Treatment planning concepts for the ageing patient.

    PubMed

    Ettinger, R L

    2015-03-01

    There is an ageing imperative in Australia as in many other industrialized nations, and these populations are extremely heterogeneous. In young adults, the factors which influence decision making for oral health care are whether the patient has the will, the time or the finances to pay for care, while for clinicians, the decisions are whether they have the skill and the resources to carry out the treatment plan. For older adults, the decision making includes all of the previous identified factors, but they are now complicated by the patient's medical and medication problems, the side effects of the medications they are taking, their cognitive status as well as the cumulative effects of a lifetime of physiological, traumatic and iatrogenic effects on the dentition and the oral cavity. The decision-making process which has evolved has been called many names, from cost-effective care to minimal invasive dentistry to rational dental care. Fundamentally, they are similar. Rational dental care has been defined as the process of decision making, which develops a treatment plan that is in the best interest of the patient after evaluating all of the modifying factors. This article will discuss the various concepts, and the strengths and weaknesses of some of these systems. It will also illustrate some of the clinical problems as there is very little evidence-based data to support any of these concepts. However, treatment planning is still an art, which can only be carried out for an individual and not a group, and the result must serve the needs of the patient and enhance the quality of his or her life. PMID:25762044

  3. Linear age-dependent population growth with seasonal harvesting.

    PubMed

    Sánchez, D A

    1980-06-01

    A population growth is modelled by the Von Foerster PDE with accompanying Lotka-Volterra integral equation describing the birth rate; the age specific death and fertility rates are assumed to depend only on age and not time. A harvesting policy where a fraction of the population of age greater than a given age is harvested for a fraction of a given season. This introduces a time dependence, but this difficulty is circumvented by devising approximate time-independent models whose birthrates bracket the true birthrate--the standard renewal equation theory applies to the approximate models so quantitative results can be obtained.

  4. US population aging and demand for inpatient services.

    PubMed

    Pallin, Daniel J; Espinola, Janice A; Camargo, Carlos A

    2014-03-01

    US inpatient capacity increased until the 1970s, then declined. The US Census Bureau expects the population aged ≥65 years to more than double by 2050. The implications for national inpatient capacity requirements have not been quantified. Our objective was to calculate the number of hospital admissions that will be necessitated by population aging, ceteris paribus. We estimated 2011 nationwide age-specific hospitalization rates using data from the Nationwide Inpatient Sample and Census data. We applied these rates to the population expected by the Census Bureau to exist through 2050. By 2050, the US population is expected to increase by 41%. Our analysis suggests that based on expected changes in the population age structure by then, the annual number of hospitalizations will increase by 67%. Thus, inpatient capacity would have to expand 18% more than population growth to meet demand. Total aggregate inpatient days is projected to increase 22% more than population growth. The total projected growth in required inpatient capacity is 72%, accounting for both number of admissions and length of stay. This analysis accounts only for changes in the population's age structure. Other factors could increase or decrease demand, as discussed in the article. PMID:24464735

  5. Polypharmacy in the Aging Patient

    PubMed Central

    Lipska, Kasia J.; Krumholz, Harlan; Soones, Tacara; Lee, Sei J.

    2016-01-01

    IMPORTANCE There is substantial uncertainty about optimal glycemic control in older adults with type 2 diabetes mellitus. OBSERVATIONS Four large randomized clinical trials (RCTs), ranging in size from 1791 to 11440 patients, provide the majority of the evidence used to guide diabetes therapy. Most RCTs of intensive vs standard glycemic control excluded adults older than 80 years, used surrogate end points to evaluate microvascular outcomes and provided limited data on which subgroups are most likely to benefit or be harmed by specific therapies. Available data from randomized clinical trials suggest that intensive glycemic control does not reduce major macrovascular events in older adults for at least 10 years. Furthermore, intensive glycemic control does not lead to improved patient-centered microvascular outcomes for at least 8 years. Data from randomized clinical trials consistently suggest that intensive glycemic control immediately increases the risk of severe hypoglycemia 1.5- to 3-fold. Based on these data and observational studies, for the majority of adults older than 65 years, the harms associated with a hemoglobin A1c (HbA1c) target lower than 7.5% or higher than 9% are likely to outweigh the benefits. However, the optimal target depends on patient factors, medications used to reach the target, life expectancy, and patient preferences about treatment. If only medications with low treatment burden and hypoglycemia risk (such as metformin) are required, a lower HbA1c target may be appropriate. If patients strongly prefer to avoid injections or frequent fingerstick monitoring, a higher HbA1c target that obviates the need for insulin may be appropriate. CONCLUSIONS AND RELEVANCE High-quality evidence about glycemic treatment in older adults is lacking. Optimal decisions need to be made collaboratively with patients, incorporating the likelihood of benefits and harms and patient preferences about treatment and treatment burden. For the majority of older

  6. School Age Populations Research Needs - NCS Dietary Assessment Literature Review

    Cancer.gov

    Drawing conclusions about the validity of available dietary assessment instruments in school age children is hampered by the differences in instruments, research design, reference methods, and populations in the validation literature.

  7. Modeling the brain morphology distribution in the general aging population

    NASA Astrophysics Data System (ADS)

    Huizinga, W.; Poot, D. H. J.; Roshchupkin, G.; Bron, E. E.; Ikram, M. A.; Vernooij, M. W.; Rueckert, D.; Niessen, W. J.; Klein, S.

    2016-03-01

    Both normal aging and neurodegenerative diseases such as Alzheimer's disease cause morphological changes of the brain. To better distinguish between normal and abnormal cases, it is necessary to model changes in brain morphology owing to normal aging. To this end, we developed a method for analyzing and visualizing these changes for the entire brain morphology distribution in the general aging population. The method is applied to 1000 subjects from a large population imaging study in the elderly, from which 900 were used to train the model and 100 were used for testing. The results of the 100 test subjects show that the model generalizes to subjects outside the model population. Smooth percentile curves showing the brain morphology changes as a function of age and spatiotemporal atlases derived from the model population are publicly available via an interactive web application at agingbrain.bigr.nl.

  8. Measuring the speed of aging across population subgroups.

    PubMed

    Sanderson, Warren C; Scherbov, Sergei

    2014-01-01

    People in different subgroups age at different rates. Surveys containing biomarkers can be used to assess these subgroup differences. We illustrate this using hand-grip strength to produce an easily interpretable, physical-based measure that allows us to compare characteristic-based ages across educational subgroups in the United States. Hand-grip strength has been shown to be a good predictor of future mortality and morbidity, and therefore a useful indicator of population aging. Data from the Health and Retirement Survey (HRS) were used. Two education subgroups were distinguished, those with less than a high school diploma and those with more education. Regressions on hand-grip strength were run for each sex and race using age and education, their interactions and other covariates as independent variables. Ages of identical mean hand-grip strength across education groups were compared for people in the age range 60 to 80. The hand-grip strength of 65 year old white males with less education was the equivalent to that of 69.6 (68.2, 70.9) year old white men with more education, indicating that the more educated men had aged more slowly. This is a constant characteristic age, as defined in the Sanderson and Scherbov article "The characteristics approach to the measurement of population aging" published 2013 in Population and Development Review. Sixty-five year old white females with less education had the same average hand-grip strength as 69.4 (68.2, 70.7) year old white women with more education. African-American women at ages 60 and 65 with more education also aged more slowly than their less educated counterparts. African American men with more education aged at about the same rate as those with less education. This paper expands the toolkit of those interested in population aging by showing how survey data can be used to measure the differential extent of aging across subpopulations.

  9. Measuring the speed of aging across population subgroups.

    PubMed

    Sanderson, Warren C; Scherbov, Sergei

    2014-01-01

    People in different subgroups age at different rates. Surveys containing biomarkers can be used to assess these subgroup differences. We illustrate this using hand-grip strength to produce an easily interpretable, physical-based measure that allows us to compare characteristic-based ages across educational subgroups in the United States. Hand-grip strength has been shown to be a good predictor of future mortality and morbidity, and therefore a useful indicator of population aging. Data from the Health and Retirement Survey (HRS) were used. Two education subgroups were distinguished, those with less than a high school diploma and those with more education. Regressions on hand-grip strength were run for each sex and race using age and education, their interactions and other covariates as independent variables. Ages of identical mean hand-grip strength across education groups were compared for people in the age range 60 to 80. The hand-grip strength of 65 year old white males with less education was the equivalent to that of 69.6 (68.2, 70.9) year old white men with more education, indicating that the more educated men had aged more slowly. This is a constant characteristic age, as defined in the Sanderson and Scherbov article "The characteristics approach to the measurement of population aging" published 2013 in Population and Development Review. Sixty-five year old white females with less education had the same average hand-grip strength as 69.4 (68.2, 70.7) year old white women with more education. African-American women at ages 60 and 65 with more education also aged more slowly than their less educated counterparts. African American men with more education aged at about the same rate as those with less education. This paper expands the toolkit of those interested in population aging by showing how survey data can be used to measure the differential extent of aging across subpopulations. PMID:24806337

  10. Population ageing in ghana: research gaps and the way forward.

    PubMed

    Mba, Chuks J

    2010-09-29

    This paper attempts to highlight research gaps and what should be done concerning population ageing in the Ghanaian context. The proportion of the elderly increased from 4.9 percent in 1960 to 7.2 percent in 2000, while the number rose from 0.3 million to 1.4 million over the same period (an increase of 367 percent). Projection results indicate that by 2050, the aged population will account for 14.1 percent of the total population. Very little is known about the living arrangements and health profile of Ghana's older population. With increasing urbanization and modernization, it is important to know something about intergenerational transfers from adult children to their elderly parents, and characterize the elderly persons' food security strategies. Training of researchers will be important in terms of strengthening Ghana's capacity to monitor trends, as well as to conduct research and explore new directions in population ageing research.

  11. Cardiovascular disease and type 1 diabetes: prevalence, prediction and management in an ageing population

    PubMed Central

    Lee, Siang Ing; Patel, Mitesh; Jones, Christopher M.; Narendran, Parth

    2015-01-01

    Cardiovascular disease (CVD) is a major cause of mortality in type 1 diabetes mellitus (T1D). However, evidence of its risks and management is often extrapolated from studies in type 2 diabetic (T2D) patients or the general population. This approach is unsatisfactory given that the underlying pathology, demographics and natural history of the disease differ between T1D and T2D. Furthermore, with a rising life expectancy, a greater number of T1D patients are exposed to the cardiovascular (CV) risk factors associated with an ageing population. The aim of this review is to examine the existing literature around CVD in T1D. We pay particular attention to CVD prevalence, how well we manage risk, potential biomarkers, and whether the studies included the older aged patients (defined as aged over 65). We also discuss approaches to the management of CV risk in the older aged. The available data suggest a significant CVD burden in patients with T1D and poor management of CV risk factors. This is underpinned by a poor evidence base for therapeutic management of CV risk specifically for patients with T1D, and in the most relevant population – the older aged patients. We would suggest that important areas remain to be addressed, particularly exploring the risks and benefits of therapeutic approaches to CVD management in the older aged. PMID:26568811

  12. Migration and regional population aging in the Philippines.

    PubMed

    Watkins, J F; Ulack, R

    1991-10-01

    There is a growing realization that developing countries will be affected in the future by the problems associated with population aging. Although internal migration could exacerbate the problems of aging at subnational levels, there remains a paucity of research on the role of migration in elderly population change for the developing countries of the world. This study uses 1980 census data for the Philippines to explore the spatial and temporal dynamics of the country's elderly population. Through examination of internal migration patterns among the thirteen regions of the country and population projections, this paper demonstrates the potentially large role that migration plays in determining local patterns of aging.The National Capital Region, which is a primary destination of labor force migrants, exhibits the greatest projected increase in the share of the nation's elderly population, while the centrally located Visayas regions show rapid reductions in the future. The Visayas regions, however, may be expected to have the highest concentrations of elderly in their populations. Such findings suggest that labor force migration patterns, with subsequent aging-in-place, will most strongly influence near future distributions and concentrations of the elderly, and that national planning for the future's elderly population should incorporate regional examinations as a means of appropriately distributing financial and service related support.

  13. Situation of population aging in China and the strategy.

    PubMed

    He, C

    1996-08-01

    This article describes the trends in population distribution in China and the prospects for population aging during 1990-2050. Party General-Secretary and President Jiang Zemin is quoted as requesting more public attention to the needs of the aged and more services and support for the aged. The current social security system is deficient in provisions for the elderly. Further research is needed on suitable strategies for service provision. President Jiang Zemin urged that more funding be secured for support of the aged and income generation programs for young people who had elderly parents to support. He urged that the Law on the Protection of the Rights and Interests of the Elderly be strictly and effectively enforced. The author expresses a concern about the timing that will be required to prepare for elderly care and support. It is suggested that a plan be devised for controlling the extent of population aging. Over the past 20 years, China went from a high birth rate, high death rate, and high rate of natural increase to a low birth rate, low death rate, and low rate of natural increase. The result was an increase in the number and proportion of the elderly. During 1970-95 the birth rate declined from 33.43/1000 to 17.43/1000. The death rate declined from 7.60/1000 to 6.48/1000. The rate of natural increase declined from 25.83/1000 to 10.95/1000. Average life expectancy increased from 65 to 70 years. The total fertility rate declined in 1995 to 2.0. In 1995 there were 110 million elderly aged 60 years and older (9.5% of total population). This elderly population is expected to increase to 130 million (10% of total population) by the year 2000. The elderly population aged 65 years and older is expected to increase from 50 million in 1995 to 92 million in 2000 and 200 million in 2025.

  14. Macroeconomic implications of population ageing and selected policy responses.

    PubMed

    Bloom, David E; Chatterji, Somnath; Kowal, Paul; Lloyd-Sherlock, Peter; McKee, Martin; Rechel, Bernd; Rosenberg, Larry; Smith, James P

    2015-02-14

    Between now and 2030, every country will experience population ageing-a trend that is both pronounced and historically unprecedented. Over the past six decades, countries of the world had experienced only a slight increase in the share of people aged 60 years and older, from 8% to 10%. But in the next four decades, this group is expected to rise to 22% of the total population-a jump from 800 million to 2 billion people. Evidence suggests that cohorts entering older age now are healthier than previous ones. However, progress has been very uneven, as indicated by the wide gaps in population health (measured by life expectancy) between the worst (Sierra Leone) and best (Japan) performing countries, now standing at a difference of 36 years for life expectancy at birth and 15 years for life expectancy at age 60 years. Population ageing poses challenges for countries' economies, and the health of older populations is of concern. Older people have greater health and long-term care needs than younger people, leading to increased expenditure. They are also less likely to work if they are unhealthy, and could impose an economic burden on families and society. Like everyone else, older people need both physical and economic security, but the burden of providing these securities will be falling on a smaller portion of the population. Pension systems will be stressed and will need reassessment along with retirement policies. Health systems, which have not in the past been oriented toward the myriad health problems and long-term care needs of older people and have not sufficiently emphasised disease prevention, can respond in different ways to the new demographic reality and the associated changes in population health. Along with behavioural adaptations by individuals and businesses, the nature of such policy responses will establish whether population ageing will lead to major macroeconomic difficulties.

  15. Macroeconomic implications of population ageing and selected policy responses.

    PubMed

    Bloom, David E; Chatterji, Somnath; Kowal, Paul; Lloyd-Sherlock, Peter; McKee, Martin; Rechel, Bernd; Rosenberg, Larry; Smith, James P

    2015-02-14

    Between now and 2030, every country will experience population ageing-a trend that is both pronounced and historically unprecedented. Over the past six decades, countries of the world had experienced only a slight increase in the share of people aged 60 years and older, from 8% to 10%. But in the next four decades, this group is expected to rise to 22% of the total population-a jump from 800 million to 2 billion people. Evidence suggests that cohorts entering older age now are healthier than previous ones. However, progress has been very uneven, as indicated by the wide gaps in population health (measured by life expectancy) between the worst (Sierra Leone) and best (Japan) performing countries, now standing at a difference of 36 years for life expectancy at birth and 15 years for life expectancy at age 60 years. Population ageing poses challenges for countries' economies, and the health of older populations is of concern. Older people have greater health and long-term care needs than younger people, leading to increased expenditure. They are also less likely to work if they are unhealthy, and could impose an economic burden on families and society. Like everyone else, older people need both physical and economic security, but the burden of providing these securities will be falling on a smaller portion of the population. Pension systems will be stressed and will need reassessment along with retirement policies. Health systems, which have not in the past been oriented toward the myriad health problems and long-term care needs of older people and have not sufficiently emphasised disease prevention, can respond in different ways to the new demographic reality and the associated changes in population health. Along with behavioural adaptations by individuals and businesses, the nature of such policy responses will establish whether population ageing will lead to major macroeconomic difficulties. PMID:25468167

  16. Biological ageing and frailty markers in breast cancer patients

    PubMed Central

    Hatse, Sigrid; Laenen, Annouschka; Kenis, Cindy; Swerts, Evalien; Neven, Patrick; Smeets, Ann; Schöffski, Patrick; Wildiers, Hans

    2015-01-01

    Older cancer patients are a highly heterogeneous population in terms of global health and physiological reserves, and it is often difficult to determine the best treatment. Moreover, clinical tools currently used to assess global health require dedicated time and lack a standardized end score. Circulating markers of biological age and/or fitness could complement or partially substitute the existing screening tools. In this study we explored the relationship of potential ageing/frailty biomarkers with age and clinical frailty. On a population of 82 young and 162 older non-metastatic breast cancer patients, we measured mean leukocyte telomere length and plasma levels of interleukin-6 (IL-6), regulated upon activation, normal T cell expressed and secreted (RANTES), monocyte chemotactic protein 1 (MCP-1), insulin-like growth factor 1 (IGF-1). We also developed a new tool to summarize clinical frailty, designated Leuven Oncogeriatric Frailty Score (LOFS), by integrating GA results in a single, semi-continuous score. LOFS' median score was 8, on a scale from 0=frail to 10=fit. IL-6 levels were associated with chronological age in both groups and with clinical frailty in older breast cancer patients, whereas telomere length, IGF-1 and MCP-1 only correlated with age. Plasma IL-6 should be further explored as frailty biomarker in cancer patients. PMID:25989735

  17. Age disorientation in schizophrenia: a constant prevalence of 25 per cent in a chronic mental hospital population?

    PubMed

    Stevens, M; Crow, T J; Bowman, M J; Coles, E C

    1978-08-01

    The prevalence of age disorientation was estimated in the population of patients with a diagnosis of schizophrenia in a large mental hospital. Of these 357 patients 25 per cent demonstrated age disorientation, defined as a five-year discrepancy between true and subjective age, and 11 per cent of the population believed themselves to be within five years of the age they were at admission, although they were a mean 28.9 years older. Age-disorientated patients differed from the age-orientated in being significantly older. However, when age-matched, they were younger at first admission and had a longer duration of stay than patients with a diagnosis of schizophrenia without age-disorientation. Age-disorientation may thus be a feature of a type of schizophrenic illness of early onset and poor prognosis.

  18. Demographic analysis from summaries of an age-structured population

    USGS Publications Warehouse

    Link, W.A.; Royle, J. Andrew; Hatfield, J.S.

    2003-01-01

    Demographic analyses of age-structured populations typically rely on life history data for individuals, or when individual animals are not identified, on information about the numbers of individuals in each age class through time. While it is usually difficult to determine the age class of a randomly encountered individual, it is often the case that the individual can be readily and reliably assigned to one of a set of age classes. For example, it is often possible to distinguish first-year from older birds. In such cases, the population age structure can be regarded as a latent variable governed by a process prior, and the data as summaries of this latent structure. In this article, we consider the problem of uncovering the latent structure and estimating process parameters from summaries of age class information. We present a demographic analysis for the critically endangered migratory population of whooping cranes (Grus americana), based only on counts of first-year birds and of older birds. We estimate age and year-specific survival rates. We address the controversial issue of whether management action on the breeding grounds has influenced recruitment, relating recruitment rates to the number of seventh-year and older birds, and examining the pattern of variation through time in this rate.

  19. Macroeconomic implications of population ageing and selected policy responses

    PubMed Central

    Bloom, David E; Chatterji, Somnath; Kowal, Paul; Lloyd-Sherlock, Peter; McKee, Martin; Rechel, Bernd; Rosenberg, Larry; Smith, James P

    2015-01-01

    Between now and 2030, every country will experience population ageing—a trend that is both pronounced and historically unprecedented. Over the past six decades, countries of the world had experienced only a slight increase in the share of people aged 60 years and older, from 8% to 10%. But in the next four decades, this group is expected to rise to 22% of the total population—a jump from 800 million to 2 billion people. Evidence suggests that cohorts entering older age now are healthier than previous ones. However, progress has been very uneven, as indicated by the wide gaps in population health (measured by life expectancy) between the worst (Sierra Leone) and best (Japan) performing countries, now standing at a difference of 36 years for life expectancy at birth and 15 years for life expectancy at age 60 years. Population ageing poses challenges for countries’ economies, and the health of older populations is of concern. Older people have greater health and long-term care needs than younger people, leading to increased expenditure. They are also less likely to work if they are unhealthy, and could impose an economic burden on families and society. Like everyone else, older people need both physical and economic security, but the burden of providing these securities will be falling on a smaller portion of the population. Pension systems will be stressed and will need reassessment along with retirement policies. Health systems, which have not in the past been oriented toward the myriad health problems and long-term care needs of older people and have not sufficiently emphasised disease prevention, can respond in different ways to the new demographic reality and the associated changes in population health. Along with behavioural adaptations by individuals and businesses, the nature of such policy responses will establish whether population ageing will lead to major macroeconomic difficulties. PMID:25468167

  20. Computer Simulation of Sexual Selection on Age-Structured Populations

    NASA Astrophysics Data System (ADS)

    Martins, S. G. F.; Penna, T. J. P.

    Using computer simulations of a bit-string model for age-structured populations, we found that sexual selection of older males is advantageous, from an evolutionary point of view. These results are in opposition to a recent proposal of females choosing younger males. Our simulations are based on findings from recent studies of polygynous bird species. Since secondary sex characters are found mostly in males, we could make use of asexual populations that can be implemented in a fast and efficient way.

  1. Population aging and its impact on elderly welfare in Africa.

    PubMed

    Darkwa, K; Mazibuko, F N M; Candidate, P H D

    2002-01-01

    This article discusses the demographic transition and its impact on the welfare of the elderly in Africa. It provides a brief socio-demographic profile on elderly Africans. Also, it addresses challenges brought about by population aging and how it affects the provision of services to address the care giving needs of the elderly. Additionally, it examines the major features and limitations of current social insurance and retirement programs in Africa. Finally, it proposes measures to better meet the challenges brought about by population aging.

  2. [Age structure and growth characteristic of Castanopsis fargesii population].

    PubMed

    Song, Kun; Da, Liang-jun; Yang, Tong-hui; Yang, Xu-feng

    2007-02-01

    In this paper, the age structure and growth characteristics of Castanopsis fargesii population in a shade-tolerant broadleaved evergreen forest were studied, aimed to understand more about the regeneration patterns and dynamics of this population. The results showed that the age structure of C. fargesii population was of sporadic type, with two death peaks of a 30-year gap. This population had a good plasticity in growth to light condition. Because there were no significant differences in light condition under the canopy in vertical, the saplings came into their first suppression period when they were 5-8 years old, with a height growth rate less than 0. 1 m x a(-1) lasting for 10 years. The beginning time of the first growth suppression period was by the end of the first death peak of the population, and the ending time of the first growth suppression period was at the beginning of the second death peak of the population, demonstrating that growth characteristic was the key factor affecting the age structure of C. fargesii.

  3. [Oromaxillofacial surgical treatment in aging patients].

    PubMed

    Hausamen, J E; Schliephake, H

    1990-01-01

    The oral and maxillofacial surgical therapy of the elderly patient must include considerations of age-related physiological changes, both of inner organs and oral structures. Decreased hepatic and renal function may lead to delayed elimination of anaesthetic drugs and thereby make dose reductions necessary. Sclerosis or osteoporosis of jaw bones may render the surgical treatment of odontogenic diseases more difficult due to the increased fracture hazard. Painful ankylosis and rheumatic arthritis of the temporo-mandibular joint, tumors and fractures are common diseases of the elderly patient that a maxillofacial surgeon has to deal with. Furthermore, preprosthetic and reconstructive surgery is often required after jaw resections or severe atrophy. Due to the polypathy frequently present in elderly patients maxillofacial surgery requires particular indications, special surgical performance, and extensive postoperative care. By using all possible means, a satisfactory treatment can be achieved even in this age patients, whose quality of life can thus be improved.

  4. The role of harvesting in age-structured populations: disentangling dynamic and age truncation effects.

    PubMed

    Wikström, Anders; Ripa, Jörgen; Jonzén, Niclas

    2012-12-01

    Understanding the processes generating fluctuations of natural populations lies at the very heart of academic ecology. It is also very important for applications such as fisheries management and pest control. We are interested in the effect of harvesting on population fluctuations and for that purpose we develop and analyze an age-structured model where recruitment is a stochastic process and the adult segment of the population is harvested. When a constant annual harvest is taken the coefficient of variation of the adult population increases for most parameter values due to the age truncation effect, i.e. an increased variability in a juvenescent population due to the removal of older individuals. However, if a constant proportion of the adults is harvested the age truncation effect is sometimes counteracted by a stabilizing dynamic effect of harvesting. Depending on parameter values mirroring different life histories, proportional harvest can either increase or decrease the relative fluctuations of an exploited population. When there is a demographic Allee effect the ratio of juveniles to adults may actually decrease with harvesting. We conclude that, depending on life history and harvest strategy, harvesting can either reinforce or dampen population fluctuations due to the relative importance of stabilizing dynamic effects and the age truncation effect. The strength of the latter is highly dependent on the fished population's endogenous, age-structured dynamics. More specifically, we predict that populations with strong and positively autocorrelated dynamics will show stronger age truncation effect, a testable prediction that offers a simple rule-of-thumb assessment of a population's vulnerability to exploitation.

  5. Population Aging and Its Impact on Elderly Welfare in Africa

    ERIC Educational Resources Information Center

    Darkwa, O. K.; Mazibuko, F. N. M.

    2002-01-01

    This article discusses the demographic transition and its impact on the welfare of the elderly in Africa. It provides a brief socio-demographic profile on elderly Africans. Also, it addresses challenges brought about by population aging and how it affects the provision of services to address the care giving needs of the elderly. Additionally, it…

  6. Surviving the Silver Tsunami: Training a Health Care Workforce to Care for North Carolina's Aging Population.

    PubMed

    Heflin, Mitchell T

    2016-01-01

    North Carolina's aging population will require a health care workforce prepared to meet patients' complex care needs. The keys to training this workforce include continuing to mobilize the state's educational infrastructure to provide interprofessional, community-based experiences and maximizing exposure to new models of care. PMID:26961830

  7. Surviving the Silver Tsunami: Training a Health Care Workforce to Care for North Carolina's Aging Population.

    PubMed

    Heflin, Mitchell T

    2016-01-01

    North Carolina's aging population will require a health care workforce prepared to meet patients' complex care needs. The keys to training this workforce include continuing to mobilize the state's educational infrastructure to provide interprofessional, community-based experiences and maximizing exposure to new models of care.

  8. Population pharmacokinetics of vancomycin in patients receiving extracorporeal membrane oxygenation

    PubMed Central

    Mulla, Hussain; Pooboni, Suneel

    2005-01-01

    Aims Extracorporeal membrane oxygenation (ECMO) is a life support system used during severe respiratory or cardiorespiratory failure. The objective of this study was to characterize the population pharmacokinetics of vancomycin during ECMO. Methods A population model was developed using WinNonMix (Version 2.0.1) from a total of 366 plasma observations in 45 patients, including term neonates, older children and adults. The study utilized both rich prospective and sparse retrospective data. Prospective samples were drawn at baseline and then 30, 60,90, 120, 180, 240, 300, 360 and 420 min postinfusion. Steady state concentrations were obtained retrospectively from an assay database, cross-referencing with the patients’ medical records. Results Data were examined using a two-compartment model with an additive and proportional residual error. Model fit improved substantially when clearance, CL (l kg−1 h−1) was modelled as a nonlinear function of serum creatinine (Cr) µmol l−1. There was a linear relationship between CL and age up to 1000 days: CL (Age < 1000 days) = [2.4 + 0.0018 × Age (days)]/Cr; CL (Age > 1000 days) = 4.3/Cr. Age also influenced central volume (V1) when included in the model as a dichotomous variable: V1 (Age < 4000 days) = 0.45 l kg−1; V1 (Age > 4000 days) = 0.36 l kg−1. Intercompartmental clearance and tissue volume were estimated to be 0.09 l kg−1 h−1 and 0.25 l kg−1, respectively. Model validation in a separate group of 20 patients revealed a bias of −7.7% and a precision of 26.7%. Conclusions The clearance of vancomycin was decreased and its volume of distribution increased in patients receiving ECMO, suggesting altered drug disposition during this treatment. PMID:16120065

  9. Obesity and diabetes in an aging population: time to rethink definitions and management?

    PubMed

    Rothberg, Amy E; Halter, Jeffrey B

    2015-02-01

    Regardless of pathophysiology and diagnostic criteria, the population of older adults with diabetes is highly heterogeneous. As adults with type 2 diabetes age and develop multiple comorbid health conditions, they may experience many challenges to good diabetes care and self-management. Age of diagnosis and duration of diabetes largely determine the likelihood for comorbidity. Treating such a diverse elderly population may result in inadequate glycemic control either because of overtreatment, leading to hypoglycemia, or because of other complications and preexisting comorbidities. It is imperative that treatment decisions are based on patient preferences, unique and likely evolving health status, and longevity.

  10. An Atypical Age-Specific Pattern of Hepatocellular Carcinoma in Peru: A Threat for Andean Populations

    PubMed Central

    Loli, Sebastian; Moura, Julien; Zimic, Mirko; Deharo, Eric; Ruiz, Eloy

    2013-01-01

    Background In South America, the highest incidence of primary liver cancer is observed in Peru. However, national estimations on hepatocellular carcinoma incidence and mortality are approximated using aggregated data from surrounding countries. Thus, there is a lack of tangible information from Peru that impairs an accurate description of the local incidence, presentation, and outcomes of hepatocellular carcinoma. The present study attempts to fill this gap and assesses the clinical epidemiology of hepatocellular carcinoma in this country. Methods A retrospective cohort study was conducted by analysing the medical charts of 1,541 patients with hepatocellular carcinoma admitted between 1997 and 2010 at the Peruvian national institute for cancer. The medical records including liver function, serologic status, and tumor pathology and stage were monitored. Statistical analyses were performed in order to characterize tumor presentation according to demographic features, risk factors, and regional origin. Results Surprisingly, the age distribution of the patient population displayed bimodality corresponding to two distinct age-based subpopulations. While an older group was in keeping with the age range observed for hepatocellular carcinoma around the world, a younger population displayed an abnormally juvenile mean age of 25.5 years old. In addition, each subpopulation displayed age-specific pathophysiological and clinical characteristics. Conclusions The analysis suggests two different age-specific natural histories of hepatocellular carcinoma in the Peruvian patient population. This otherwise unusual tumor process that is ongoing in younger patients leads to the hypothesis that there may be a Peru-endemic risk factor driving hepatocarcinogenesis in the local population. PMID:23840771

  11. Gene-drive in age-structured insect populations.

    PubMed

    Huang, Yunxin; Lloyd, Alun L; Legros, Mathieu; Gould, Fred

    2009-05-01

    To date, models of gene-drive mechanisms proposed for replacing wild-type mosquitoes with transgenic strains that cannot transmit diseases have assumed no age or mating structure. We developed a more detailed model to analyze the effects of age and mating-related factors on the number of engineered insects that must be introduced into a wild population to achieve successful gene-drive based on the Medea and engineered underdominance mechanisms. We found that models without age-structure and mating details can substantially overestimate or underestimate the numbers of engineered insects that must be introduced. In general, introduction thresholds are lowest when young adults are introduced. When both males and females are introduced, assortative mating by age has little impact on the introduction threshold unless the introduced females have diminished reproductive ability because of their age. However, when only males are introduced, assortative mating by age is generally predicted to increase introduction thresholds. In most cases, introduction thresholds are much higher for male-only introductions than for both-sex introductions, but when mating is nearly random and the introduced insects are adults with Medea constructs, male-only introductions can have somewhat lower thresholds than both-sex introductions. Results from this model suggest specific parameters that should be measured in field experiments.

  12. Measles revaccination response in a school-age population.

    PubMed

    Wittler, R R; Veit, B C; McIntyre, S; Schydlower, M

    1991-11-01

    Due to the dramatic upsurge in the incidence of measles, the American Academy of Pediatrics and the Immunization Practices Advisory Committee of the Centers for Disease Control revised their measles immunization policies in 1989 to include a routine two-dose schedule. The objectives of this study were the following: (1) determine the prevalence of immunologically measles-susceptible subjects in a previously vaccinated, school-age, military dependent population; and (2) assess risk factors to identify immunologically measles-susceptible subjects. Serum was collected just prior to measles revaccination and again 2 weeks later. Measles-specific IgG and IgM titers were determined by enzyme-linked immunosorbent assay. Immunologically measles-susceptible subjects constituted 9.8% of the population. The interval since previous measles vaccination was significantly related to pre- and postrevaccination IgG titers in a repeated-measures analysis of variance model. The magnitude of increase in IgG titer following revaccination and analysis of trend for proportions of measles-susceptible subjects were significantly related to the age of initial vaccination. This study supports continued measles revaccination; in addition, revaccination appears to be of greater value at 11 to 12 years of age than at 4 to 6 years of age.

  13. Changes in lymphoid populations of ageing CBA and NZB mice

    PubMed Central

    Zatz, Marion M.; Mellors, R. C.; Lance, E. M.

    1971-01-01

    Changes in subpopulations of lymphoid cells of normal (CBA) and autoimmune (NZB) mice were studied as a function of age, by observing migration patterns of 51Cr labelled lymph node, spleen and thymus cells from donors aged 8 days to 12 months. The method permits analysis of the proportions and numbers of recirculating and non-recirculating lymphocytes in lymphoid compartments. Changes in the lymphoid populations of CBA mice were found, which could be attributed to the normal processes of maturation and senescence. In NZB mice relative and absolute decreases in the recirculating cell content of lymph node and spleen were observed which coincided with the time of development of autoimmunity. The significance of these results, in relation to altered immunocompetence with age, is discussed. PMID:5576663

  14. Population ageing and its implications on aggregate health care demand: empirical evidence from 22 OECD countries.

    PubMed

    Palangkaraya, Alfons; Yong, Jongsay

    2009-12-01

    Recent evidence indicates that the relationship between age and health care expenditure is not as straightforward as it appears. In fact, micro-level studies find that time to death, rather than ageing, is possibly the main driver of the escalating health care costs in developed countries. Unfortunately, the evidence at the macro level is less clear and often depends on the specification of the empirical model used. We use an aggregate demand framework to assess whether health expenditure is more likely to be driven by ageing per se or proximity to death. Using panel data from 22 OECD countries from the first half of the 1990s, we find population ageing to be negatively correlated with health expenditure once proximity to death is accounted for. This suggests that the effects of ageing on health expenditure growth might be overstated while the effects of the high costs of medical care at the end of life are potentially underestimated. With respect to the latter, our finding highlights the importance of long-term and hospice care management. An expanded long-term care program may not only improve patient welfare, but also reduce costs of care by reducing the duration of hospital care for terminally ill patients. If expensive medical treatment for patients near the end of life can be controlled for, health expenditure growth resulting from population ageing is unlikely to present a most serious problem.

  15. Pharmacokinetics of Vancomycin in Elderly Patients Aged over 80 Years.

    PubMed

    Bourguignon, Laurent; Cazaubon, Yoann; Debeurme, Guillaume; Loue, Constance; Ducher, Michel; Goutelle, Sylvain

    2016-08-01

    Since the 1950s, vancomycin has remained a reference treatment for severe infections caused by Gram-positive bacteria, including methicillin-resistant Staphylococcus aureus Vancomycin is a nephrotoxic and ototoxic drug mainly eliminated through the kidneys. It has a large interindividual pharmacokinetic variability, which justifies monitoring its plasma concentrations in patients. This is especially important in patients aged over 80 years, who frequently have renal impairment. However, the pharmacokinetics of vancomycin in this population is very poorly described in the literature. The objective of this work was to propose a model able to predict the pharmacokinetics of vancomycin in very elderly people. First, a population pharmacokinetic model was carried out using the algorithm NPAG (nonparametric adaptive grid) on a database of 70 hospitalized patients aged over 80 years and treated with vancomycin. An external validation then was performed on 41 patients, and the predictive capabilities of the model were assessed. The model had two compartments and six parameters. Body weight and creatinine clearance significantly influenced vancomycin volume of distribution and body clearance, respectively. The means (± standard deviations) of vancomycin volume of distribution and clearance were 36.3 ± 15.2 liter and 2.0 ± 0.9 liter/h, respectively. In the validation group, the bias and precision were -0.75 mg/liter and 8.76 mg/liter for population predictions and -0.39 mg/liter and 2.68 mg/liter for individual predictions. In conclusion, a pharmacokinetic model of vancomycin in a very elderly population has been created and validated for predicting plasma concentrations of vancomycin.

  16. Pharmacokinetics of Vancomycin in Elderly Patients Aged over 80 Years.

    PubMed

    Bourguignon, Laurent; Cazaubon, Yoann; Debeurme, Guillaume; Loue, Constance; Ducher, Michel; Goutelle, Sylvain

    2016-08-01

    Since the 1950s, vancomycin has remained a reference treatment for severe infections caused by Gram-positive bacteria, including methicillin-resistant Staphylococcus aureus Vancomycin is a nephrotoxic and ototoxic drug mainly eliminated through the kidneys. It has a large interindividual pharmacokinetic variability, which justifies monitoring its plasma concentrations in patients. This is especially important in patients aged over 80 years, who frequently have renal impairment. However, the pharmacokinetics of vancomycin in this population is very poorly described in the literature. The objective of this work was to propose a model able to predict the pharmacokinetics of vancomycin in very elderly people. First, a population pharmacokinetic model was carried out using the algorithm NPAG (nonparametric adaptive grid) on a database of 70 hospitalized patients aged over 80 years and treated with vancomycin. An external validation then was performed on 41 patients, and the predictive capabilities of the model were assessed. The model had two compartments and six parameters. Body weight and creatinine clearance significantly influenced vancomycin volume of distribution and body clearance, respectively. The means (± standard deviations) of vancomycin volume of distribution and clearance were 36.3 ± 15.2 liter and 2.0 ± 0.9 liter/h, respectively. In the validation group, the bias and precision were -0.75 mg/liter and 8.76 mg/liter for population predictions and -0.39 mg/liter and 2.68 mg/liter for individual predictions. In conclusion, a pharmacokinetic model of vancomycin in a very elderly population has been created and validated for predicting plasma concentrations of vancomycin. PMID:27185796

  17. Age estimation charts for a modern Australian population.

    PubMed

    Blenkin, Matthew; Taylor, Jane

    2012-09-10

    Calculation of the biological age of an individual has application in many fields of dentistry. It can be used to determine the appropriate timing of interventionist treatment for example in orthodontics; to analyse the developmental stage of an individual relative to the general population in the management of genetic or congenital conditions which disturb growth; and to estimate the age of a living or deceased person for forensic purposes. Many of the techniques used to estimate age can be quite time consuming to complete. This time component is a major disadvantage in a forensic context when age estimations in mass disasters are required as part of the post-mortem examination process. Consequently, forensic practitioners have tended to use the simpler but less reliable atlas style techniques of Schour and Massler and Ubelaker in these situations. For mass disaster situations, such as the recent Victorian Bushfires, it would be advantageous to have access to Australian specific data in the convenient Schour and Massler format. This project reinterpreted the Australian data previously collected by Blenkin and other relevant studies and applied it to a schematic similar to that of Ubelaker to develop a reliable, convenient and contemporary reference for use in age estimation.

  18. [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.

  19. Association of Microalbuminuria with Metabolic Syndrome among Aged Population.

    PubMed

    Li, Xiao-Hong; Lin, Hai-Yan; Wang, Shu-Hua; Guan, Li-Ying; Wang, Yi-Bing

    2016-01-01

    Background. The impact of the various components of metabolic syndrome (MetS) on chronic kidney disease has been conflicting. We aim to investigate the association between MetS and microalbuminuria and identify the major contributing components of MetS that result in microalbuminuria in the Chinese aged population. Methods. A total of 674 adults aged 55-98 years (males: 266; mean age: 66.5 ± 7.5 years) were studied. MetS was defined by the 2004 Chinese Diabetes Society criteria and microalbuminuria by urine albumin-creatinine ratio (UACR) ≥3 mg/mmoL. Results. The prevalence of microalbuminuria was gradually increased with increasing number of MetS components (P < 0.05). In multivariate regression, after adjusting for age and sex, MetS was the strongest correlate of microalbuminuria (OR = 1.781, 95% CI = 1.226-2.587; P < 0.05) followed by the fasting plasma glucose (FPG) (OR = 1.217, 95% CI = 1.044-1.092; P < 0.05), systolic blood pressure (SBP) (OR = 1.011, 95% CI = 1.107-1.338; P < 0.05), and high-density lipoprotein cholesterol (HDL-C) (OR = 0.576, 95% CI = 0.348-0.953; P < 0.05). Conclusions. MetS is independently associated with microalbuminuria in the Chinese aged population. Elevated FPG is the most predominant component of metabolic syndrome associated with microalbuminuria followed by elevated SBP and reduced HDL-C. PMID:27200378

  20. Are breast conservation and mastectomy equally effective in the treatment of young women with early breast cancer? Long-term results of a population-based cohort of 1,451 patients aged ≤ 40 years.

    PubMed

    van der Sangen, Maurice J C; van de Wiel, Fenneke M M; Poortmans, Philip M P; Tjan-Heijnen, Vivianne C G; Nieuwenhuijzen, Grard A P; Roumen, Rudi M H; Ernst, Miranda F; Tutein Nolthenius-Puylaert, M Cathelijne B J E; Voogd, Adri C

    2011-05-01

    To compare the effectiveness of breast-conserving therapy (BCT) and mastectomy, all women aged ≤ 40 years, treated for early-stage breast cancer in the southern part of the Netherlands between 1988 and 2005, were identified. A total of 562 patients underwent mastectomy and 889 patients received BCT. During follow-up, 23 patients treated with mastectomy and 135 patients treated with BCT developed a local relapse without previous or simultaneous evidence of distant disease. The local relapse risk for patients treated with mastectomy was 4.4% (95% confidence interval (CI) 2.4-6.4) at 5 years and reached a plateau after 6 years at 6.0% (95% CI 3.5-8.5). After BCT, the 5-, 10- and 15-year risks were 8.3% (95% CI 6.3-10.5), 18.4% (95% CI 15.0-21.8) and 28.2% (95% CI 23.0-33.4), respectively (P < 0.0001). Adjuvant systemic therapy following BCT reduced the 15-year local relapse risk from 32.9% (95% CI 26.7-39.1) to 16.1% (95% CI 9.1-23.1), (P = 0.0007). In conclusion, local tumor control in young patients with early-stage breast cancer is worse after BCT than after mastectomy. Adjuvant systemic therapy significantly improves local control following BCT and also for that reason it should be considered for most patients ≤ 40 years. Long-term follow-up is highly recommended for young patients after BCT, because even with systemic treatment an annual risk of local relapse of 1% remains up to 15 years after treatment.

  1. Locations that Support Social Activity Participation of the Aging Population

    PubMed Central

    van den Berg, Pauline; Kemperman, Astrid; de Kleijn, Boy; Borgers, Aloys

    2015-01-01

    Social activities are an important aspect of health and quality of life of the aging population. They are key elements in the prevention of loneliness. In order to create living environments that stimulate older adults to engage in social activities, more insight is needed in the social activity patterns of the aging population. This study therefore analyzes the heterogeneity in older adults’ preferences for different social activity location types and the relationship between these preferences and personal and mobility characteristics. This is done using a latent class multinomial logit model based on two-day diary data collected in 2014 in Noord-Limburg in the Netherlands among 213 respondents aged 65 or over. The results show that three latent classes can be identified among the respondents who recorded social activities in the diary: a group that mainly socializes at home, a group that mainly socializes at a community center and a group that is more likely to socialize at public ‘third’ places. The respondents who did not record any interactions during the two days, are considered as a separate segment. Relationships between segment membership and personal and mobility characteristics were tested using cross-tabulations with chi-square tests and analyses of variance. The results suggest that both personal and mobility characteristics play an important role in social activity patterns of older adults. PMID:26343690

  2. 21 CFR 312.315 - Intermediate-size patient populations.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 5 2011-04-01 2011-04-01 false Intermediate-size patient populations. 312.315... for Treatment Use § 312.315 Intermediate-size patient populations. Under this section, FDA may permit an investigational drug to be used for the treatment of a patient population smaller than...

  3. 21 CFR 312.315 - Intermediate-size patient populations.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 5 2014-04-01 2014-04-01 false Intermediate-size patient populations. 312.315... for Treatment Use § 312.315 Intermediate-size patient populations. Under this section, FDA may permit an investigational drug to be used for the treatment of a patient population smaller than...

  4. 21 CFR 312.315 - Intermediate-size patient populations.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 5 2013-04-01 2013-04-01 false Intermediate-size patient populations. 312.315... for Treatment Use § 312.315 Intermediate-size patient populations. Under this section, FDA may permit an investigational drug to be used for the treatment of a patient population smaller than...

  5. 21 CFR 312.315 - Intermediate-size patient populations.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 5 2012-04-01 2012-04-01 false Intermediate-size patient populations. 312.315... for Treatment Use § 312.315 Intermediate-size patient populations. Under this section, FDA may permit an investigational drug to be used for the treatment of a patient population smaller than...

  6. Population Pharmacokinetics of Peramivir in Healthy Volunteers and Influenza Patients

    PubMed Central

    Matsuo, Yumiko; Ishibashi, Toru; Hollister, Alan S.

    2015-01-01

    Peramivir is an intravenous anti-influenza agent that inhibits viral growth by selectively inhibiting neuraminidase in human influenza A and B viruses. To characterize its pharmacokinetics, a population pharmacokinetic analysis of peramivir was performed using 3,199 plasma concentration data samples from 332 subjects in six clinical studies in Japan and the United States, including studies with renal impairment subjects, elderly subjects, and influenza patients. A three-compartment model well described the plasma concentration data for peramivir, and creatinine clearance was found to be the most important factor influencing clearance. Age and body weight were also found to be covariates for clearance and the volume of distribution, respectively. No difference in pharmacokinetics was found between genders or between Japanese and U.S. subjects. Small differences in pharmacokinetics were observed between uninfected subjects and influenza patients (clearance was 18% higher and the volume of distribution was 6% lower in influenza patients). Monte Carlo simulations indicated that single adjusted doses of 1/3- and 1/6-fold for patients with moderate and severe renal impairment, respectively, would give areas under the curve comparable to those for patients with normal renal function. The population pharmacokinetic model developed for peramivir should be useful for understanding its pharmacokinetic characteristics and for dose adjustment on the basis of renal function. PMID:26282420

  7. Enrichment design with patient population augmentation.

    PubMed

    Yang, Bo; Zhou, Yijie; Zhang, Lanju; Cui, Lu

    2015-05-01

    Clinical trials can be enriched on subpopulations that may be more responsive to treatments to improve the chance of trial success. In 2012 FDA issued a draft guidance to facilitate enrichment design, where it pointed out the uncertainty on the subpopulation classification and on the treatment effect outside of the identified subpopulation. We consider a novel design strategy where the identified subpopulation (biomarker-positive) is augmented by some biomarker-negative patients. Specifically, after sufficiently powering biomarker-positive subpopulation we propose to enroll biomarker-negative patients, enough to assess the overall treatment benefit. We derive a weighted statistic for this assessment, correcting for the disproportionality of biomarker-positive and biomarker-negative subpopulations under enriched trial setting. Screening information is utilized for weight determination. This statistic is an unbiased estimate of the overall treatment effect as that in all-comer trials, and is the basis to power for the overall treatment effect. For analysis, testing will be first performed on biomarker-positive subpopulation; only if treatment benefit is established in this subpopulation will overall treatment effect be tested using the weighted statistic. This design approach differs from typical enrichment design or stratified all-comer design in that the former enrolls only biomarker-positive patients and the latter enrolls a regular all-comer population. It also differs from adaptive enrichment by maintaining the trial design and analysis priority on biomarker-positive subpopulation. Therefore the proposed approach not only warrants a high probability of trial success on biomarker-positive subpopulation, but also efficiently assesses the overall treatment effect in the presence of an uncertain treatment benefit among biomarker-negative patients.

  8. Future challenges for clinical care of an ageing population infected with HIV: a modelling study

    PubMed Central

    Smit, Mikaela; Brinkman, Kees; Geerlings, Suzanne; Smit, Colette; Thyagarajan, Kalyani; Sighem, Ard van; de Wolf, Frank; Hallett, Timothy B

    2015-01-01

    Summary Background The population infected with HIV is getting older and these people will increasingly develop age-related non-communicable diseases (NCDs). We aimed to quantify the scale of the change and the implications for HIV care in the Netherlands in the future. Methods We constructed an individual-based model of the ageing HIV-infected population, which followed patients on HIV treatment as they age, develop NCDs—including cardiovascular disease (hypertension, hypercholesterolaemia, myocardial infarctions, and strokes), diabetes, chronic kidney disease, osteoporosis, and non-AIDS malignancies—and start co-medication for these diseases. The model was parameterised by use of data for 10 278 patients from the national Dutch ATHENA cohort between 1996 and 2010. We made projections up to 2030. Findings Our model suggests that the median age of HIV-infected patients on combination antiretroviral therapy (ART) will increase from 43·9 years in 2010 to 56·6 in 2030, with the proportion of HIV-infected patients aged 50 years or older increasing from 28% in 2010 to 73% in 2030. In 2030, we predict that 84% of HIV-infected patients will have at least one NCD, up from 29% in 2010, with 28% of HIV-infected patients in 2030 having three or more NCDs. 54% of HIV-infected patients will be prescribed co-medications in 2030, compared with 13% in 2010, with 20% taking three or more co-medications. Most of this change will be driven by increasing prevalence of cardiovascular disease and associated drugs. Because of contraindications and drug–drug interactions, in 2030, 40% of patients could have complications with the currently recommended first-line HIV regimens. Interpretation The profile of patients in the Netherlands infected with HIV is changing, with increasing numbers of older patients with multiple morbidities. These changes mean that, in the near future, HIV care will increasingly need to draw on a wide range of medical disciplines, in addition to evidence

  9. Population Pharmacokinetics of Fosfomycin in Critically Ill Patients

    PubMed Central

    Parker, Suzanne L.; Frantzeskaki, Frantzeska; Wallis, Steven C.; Diakaki, Chryssa; Giamarellou, Helen; Koulenti, Despoina; Karaiskos, Ilias; Lipman, Jeffrey; Dimopoulos, George

    2015-01-01

    This study describes the population pharmacokinetics of fosfomycin in critically ill patients. In this observational study, serial blood samples were taken over several dosing intervals of intravenous fosfomycin treatment. Blood samples were analyzed using a validated liquid chromatography-tandem mass spectrometry technique. A population pharmacokinetic analysis was performed using nonlinear mixed-effects modeling. Five hundred fifteen blood samples were collected over one to six dosing intervals from 12 patients. The mean (standard deviation) age was 62 (17) years, 67% of patients were male, and creatinine clearance (CLCR) ranged from 30 to 300 ml/min. A two-compartment model with between-subject variability on clearance and volume of distribution of the central compartment (Vc) described the data adequately. Calculated CLCR was supported as a covariate on fosfomycin clearance. The mean parameter estimates for clearance on the first day were 2.06 liters/h, Vc of 27.2 liters, intercompartmental clearance of 19.8 liters/h, and volume of the peripheral compartment of 22.3 liters. We found significant pharmacokinetic variability for fosfomycin in this heterogeneous patient sample, which may be explained somewhat by the observed variations in renal function. PMID:26239990

  10. The Aging of the Global Population: The Changing Epidemiology of Disease and Spinal Disorders.

    PubMed

    Fehlings, Michael G; Tetreault, Lindsay; Nater, Anick; Choma, Ted; Harrop, James; Mroz, Tom; Santaguida, Carlo; Smith, Justin S

    2015-10-01

    The global population is currently undergoing an upward shift in its age structure due to decreasing fertility rates and increasing life expectancy. As a result, clinicians worldwide will be required to manage an increasing number of spinal disorders specific to the elderly and the aging of the spine. Elderly individuals pose unique challenges to health care systems and to spinal physicians as these patients typically have an increased number of medical comorbidities, reduced bone density mass, more severe spinal degeneration and a greater propensity to falls. In anticipation of the aging of the population, we undertook this project to heighten physicians' awareness of age-related spinal disorders, including geriatric odontoid fractures, central cord syndrome, osteoporotic compression fractures, degenerative cervical myelopathy, lumbar spinal stenosis and degenerative spinal deformity. This introductory article provides an overview of the changing demographics of the global population; discusses the age-related alterations that may occur to the spine; and summarizes the purpose and contents of this focus issue. PMID:26378347

  11. Population Biology of Intestinal Enterococcus Isolates from Hospitalized and Nonhospitalized Individuals in Different Age Groups

    PubMed Central

    Tedim, Ana P.; Ruiz-Garbajosa, Patricia; Corander, Jukka; Rodríguez, Concepción M.; Cantón, Rafael; Willems, Rob J.; Baquero, Fernando

    2014-01-01

    The diversity of enterococcal populations from fecal samples from hospitalized (n = 133) and nonhospitalized individuals (n = 173) of different age groups (group I, ages 0 to 19 years; group II, ages 20 to 59 years; group III, ages ≥60 years) was analyzed. Enterococci were recovered at similar rates from hospitalized and nonhospitalized persons (77.44% to 79.77%) of all age groups (75.0% to 82.61%). Enterococcus faecalis and Enterococcus faecium were predominant, although seven other Enterococcus species were identified. E. faecalis and E. faecium (including ampicillin-resistant E. faecium) colonization rates in nonhospitalized persons were age independent. For inpatients, E. faecalis colonization rates were age independent, but E. faecium colonization rates (particularly the rates of ampicillin-resistant E. faecium colonization) significantly increased with age. The population structure of E. faecium and E. faecalis was determined by superimposing goeBURST and Bayesian analysis of the population structure (BAPS). Most E. faecium sequence types (STs; 150 isolates belonging to 75 STs) were linked to BAPS groups 1 (22.0%), 2 (31.3%), and 3 (36.7%). A positive association between hospital isolates and BAPS subgroups 2.1a and 3.3a (which included major ampicillin-resistant E. faecium human lineages) and between community-based ampicillin-resistant E. faecium isolates and BAPS subgroups 1.2 and 3.3b was found. Most E. faecalis isolates (130 isolates belonging to 58 STs) were grouped into 3 BAPS groups, BAPS groups 1 (36.9%), 2 (40.0%), and 3 (23.1%), with each one comprising widespread lineages. No positive associations with age or hospitalization were established. The diversity and dynamics of enterococcal populations in the fecal microbiota of healthy humans are largely unexplored, with the available knowledge being fragmented and contradictory. The study offers a novel and comprehensive analysis of enterococcal population landscapes and suggests that E. faecium

  12. Population biology of intestinal enterococcus isolates from hospitalized and nonhospitalized individuals in different age groups.

    PubMed

    Tedim, Ana P; Ruiz-Garbajosa, Patricia; Corander, Jukka; Rodríguez, Concepción M; Cantón, Rafael; Willems, Rob J; Baquero, Fernando; Coque, Teresa M

    2015-03-01

    The diversity of enterococcal populations from fecal samples from hospitalized (n = 133) and nonhospitalized individuals (n = 173) of different age groups (group I, ages 0 to 19 years; group II, ages 20 to 59 years; group III, ages ≥60 years) was analyzed. Enterococci were recovered at similar rates from hospitalized and nonhospitalized persons (77.44% to 79.77%) of all age groups (75.0% to 82.61%). Enterococcus faecalis and Enterococcus faecium were predominant, although seven other Enterococcus species were identified. E. faecalis and E. faecium (including ampicillin-resistant E. faecium) colonization rates in nonhospitalized persons were age independent. For inpatients, E. faecalis colonization rates were age independent, but E. faecium colonization rates (particularly the rates of ampicillin-resistant E. faecium colonization) significantly increased with age. The population structure of E. faecium and E. faecalis was determined by superimposing goeBURST and Bayesian analysis of the population structure (BAPS). Most E. faecium sequence types (STs; 150 isolates belonging to 75 STs) were linked to BAPS groups 1 (22.0%), 2 (31.3%), and 3 (36.7%). A positive association between hospital isolates and BAPS subgroups 2.1a and 3.3a (which included major ampicillin-resistant E. faecium human lineages) and between community-based ampicillin-resistant E. faecium isolates and BAPS subgroups 1.2 and 3.3b was found. Most E. faecalis isolates (130 isolates belonging to 58 STs) were grouped into 3 BAPS groups, BAPS groups 1 (36.9%), 2 (40.0%), and 3 (23.1%), with each one comprising widespread lineages. No positive associations with age or hospitalization were established. The diversity and dynamics of enterococcal populations in the fecal microbiota of healthy humans are largely unexplored, with the available knowledge being fragmented and contradictory. The study offers a novel and comprehensive analysis of enterococcal population landscapes and suggests that E. faecium

  13. Mitochondrial DNA variation in the Viking age population of Norway.

    PubMed

    Krzewińska, Maja; Bjørnstad, Gro; Skoglund, Pontus; Olason, Pall Isolfur; Bill, Jan; Götherström, Anders; Hagelberg, Erika

    2015-01-19

    The medieval Norsemen or Vikings had an important biological and cultural impact on many parts of Europe through raids, colonization and trade, from about AD 793 to 1066. To help understand the genetic affinities of the ancient Norsemen, and their genetic contribution to the gene pool of other Europeans, we analysed DNA markers in Late Iron Age skeletal remains from Norway. DNA was extracted from 80 individuals, and mitochondrial DNA polymorphisms were detected by next-generation sequencing. The sequences of 45 ancient Norwegians were verified as genuine through the identification of damage patterns characteristic of ancient DNA. The ancient Norwegians were genetically similar to previously analysed ancient Icelanders, and to present-day Shetland and Orkney Islanders, Norwegians, Swedes, Scots, English, German and French. The Viking Age population had higher frequencies of K*, U*, V* and I* haplogroups than their modern counterparts, but a lower proportion of T* and H* haplogroups. Three individuals carried haplotypes that are rare in Norway today (U5b1b1, Hg A* and an uncommon variant of H*). Our combined analyses indicate that Norse women were important agents in the overseas expansion and settlement of the Vikings, and that women from the Orkneys and Western Isles contributed to the colonization of Iceland.

  14. Challenges of Multimorbidities in the Era of an Aging Population.

    PubMed

    Jung, Minsoo

    2016-01-01

    The health care system introduced a reimbursement system based on the existing care when the prevalence rate of acute diseases was still. However, the types of diseases in developed countries are mostly noncommunicable diseases such as cancer or vascular disease, and thus, it impossible to fully recover from these chronic diseases. The increase in noncommunicable diseases is related to unhealthy lifestyle habits such as smoking, heavy drinking, and lack of exercise. Thus, the health care system is changing by improving the prevention of diseases and promoting healthy lifestyles. However, multimorbidities have emerged as an important concept in this process. In countries where the population is rapidly aging, those who have multimorbidities have become a burden to the health care system's revenue, manpower, and service quality. Therefore, health care reform to cope with those who are aging and have multimorbidities is necessary to establish. Reform measures can consist of the following suggestions. First, proper medical guidelines for multiple diseases need to be developed. Second, professional manpower should be trained. Third, the reimbursement system should be improved to relieve those with multimorbidities. Fourth, disease prevention services should be improved. Finally, instruments to measure health care service quality for chronic disease need to be developed.

  15. Mitochondrial DNA variation in the Viking age population of Norway.

    PubMed

    Krzewińska, Maja; Bjørnstad, Gro; Skoglund, Pontus; Olason, Pall Isolfur; Bill, Jan; Götherström, Anders; Hagelberg, Erika

    2015-01-19

    The medieval Norsemen or Vikings had an important biological and cultural impact on many parts of Europe through raids, colonization and trade, from about AD 793 to 1066. To help understand the genetic affinities of the ancient Norsemen, and their genetic contribution to the gene pool of other Europeans, we analysed DNA markers in Late Iron Age skeletal remains from Norway. DNA was extracted from 80 individuals, and mitochondrial DNA polymorphisms were detected by next-generation sequencing. The sequences of 45 ancient Norwegians were verified as genuine through the identification of damage patterns characteristic of ancient DNA. The ancient Norwegians were genetically similar to previously analysed ancient Icelanders, and to present-day Shetland and Orkney Islanders, Norwegians, Swedes, Scots, English, German and French. The Viking Age population had higher frequencies of K*, U*, V* and I* haplogroups than their modern counterparts, but a lower proportion of T* and H* haplogroups. Three individuals carried haplotypes that are rare in Norway today (U5b1b1, Hg A* and an uncommon variant of H*). Our combined analyses indicate that Norse women were important agents in the overseas expansion and settlement of the Vikings, and that women from the Orkneys and Western Isles contributed to the colonization of Iceland. PMID:25487335

  16. Mitochondrial DNA variation in the Viking age population of Norway

    PubMed Central

    Krzewińska, Maja; Bjørnstad, Gro; Skoglund, Pontus; Olason, Pall Isolfur; Bill, Jan; Götherström, Anders; Hagelberg, Erika

    2015-01-01

    The medieval Norsemen or Vikings had an important biological and cultural impact on many parts of Europe through raids, colonization and trade, from about AD 793 to 1066. To help understand the genetic affinities of the ancient Norsemen, and their genetic contribution to the gene pool of other Europeans, we analysed DNA markers in Late Iron Age skeletal remains from Norway. DNA was extracted from 80 individuals, and mitochondrial DNA polymorphisms were detected by next-generation sequencing. The sequences of 45 ancient Norwegians were verified as genuine through the identification of damage patterns characteristic of ancient DNA. The ancient Norwegians were genetically similar to previously analysed ancient Icelanders, and to present-day Shetland and Orkney Islanders, Norwegians, Swedes, Scots, English, German and French. The Viking Age population had higher frequencies of K*, U*, V* and I* haplogroups than their modern counterparts, but a lower proportion of T* and H* haplogroups. Three individuals carried haplotypes that are rare in Norway today (U5b1b1, Hg A* and an uncommon variant of H*). Our combined analyses indicate that Norse women were important agents in the overseas expansion and settlement of the Vikings, and that women from the Orkneys and Western Isles contributed to the colonization of Iceland. PMID:25487335

  17. Challenges of Multimorbidities in the Era of an Aging Population.

    PubMed

    Jung, Minsoo

    2016-01-01

    The health care system introduced a reimbursement system based on the existing care when the prevalence rate of acute diseases was still. However, the types of diseases in developed countries are mostly noncommunicable diseases such as cancer or vascular disease, and thus, it impossible to fully recover from these chronic diseases. The increase in noncommunicable diseases is related to unhealthy lifestyle habits such as smoking, heavy drinking, and lack of exercise. Thus, the health care system is changing by improving the prevention of diseases and promoting healthy lifestyles. However, multimorbidities have emerged as an important concept in this process. In countries where the population is rapidly aging, those who have multimorbidities have become a burden to the health care system's revenue, manpower, and service quality. Therefore, health care reform to cope with those who are aging and have multimorbidities is necessary to establish. Reform measures can consist of the following suggestions. First, proper medical guidelines for multiple diseases need to be developed. Second, professional manpower should be trained. Third, the reimbursement system should be improved to relieve those with multimorbidities. Fourth, disease prevention services should be improved. Finally, instruments to measure health care service quality for chronic disease need to be developed. PMID:27111685

  18. Probiotics and prebiotics and health in ageing populations.

    PubMed

    Duncan, Sylvia H; Flint, Harry J

    2013-05-01

    In healthy adults microbial communities that colonise different regions of the human colon contribute nutrients and energy to the host via the fermentation of non-digestible dietary components in the large intestine. A delicate balance of microbial species is required to maintain healthy metabolism and immune function. Disturbance in this microbial balance can have negative consequences for health resulting in elevated inflammation and infection, that are contributory factors in diabetes and cancer. There is a growing awareness that the microbial balance in the colon may become increasingly perturbed with aging and therefore hasten the onset of certain diseases. Societal and dietary factors influence microbial community composition both in the short and long term in the elderly (>65 years old) whilst immunosenescence may also be linked to a perturbed distal gut microbiota and frailty in the elderly. Significant progress has been made in defining some of the dominant members of the microbial community in the healthy large intestine and in identifying their roles in metabolism. There is therefore an urgent need for better awareness of the impact of diet, prebiotic and probiotic strategies in driving human colonic microbial composition in order to understand the possibilities for maintaining healthy gut function and well-being in an increasingly elderly population. Here we review gut microbial changes associated with aging and how diet, prebiotics and probiotics may modulate the gut microbiota to maintain health in the elderly. PMID:23489554

  19. Perceived health in the Portuguese population aged ≥ 35

    PubMed Central

    de Figueiredo, João Paulo; Cardoso, Salvador Massano

    2014-01-01

    OBJECTIVE To evaluate the exploratory relationship between determinants of health, life satisfaction, locus of control, attitudes and behaviors and health related quality of life in an adult population. METHODS Observational study (analytical and cross-sectional) with a quantitative methodological basis. The sample was composed oy 1,214 inhabitants aged ≥ 35 in 31 civil parishes in the County of Coimbra, Portugal, 2011-2012. An anonymous and voluntary health survey was conducted, which collected the following information: demographic, clinical record, health and lifestyle behaviors; health related quality of life (Medical Outcomes Study, Short Form-36); health locus of control; survey of health attitudes and behavior, and quality of life index. Pearson’s Linear Correlation, t-Student, Wilcoxon-Mann-Whitney; One-way ANOVA; Brown-Forsythe’s F; Kruskal-Wallis; Multiple Comparisons: Tukey (HSD), Games-Howell and Conover were used in the statistical analysis. RESULTS Health related quality of life was shown to be lower in females, in older age groups, in obese/overweight individuals, widows, unassisted, those living alone, living in rural/suburban areas, those who did not work and with a medium-low socioeconomic level. Respondents with poor/very poor self-perceived health (p < 0.0001), with chronic disease (p < 0.0001), who consumed < 3 meals per day (p ≤ 0.01), who were sedentary, who slept ≤ 6 h/day and had smoked for several years revealed the worst health results. Health related quality of life was positively related with a bigger internal locus, with better health attitudes and behaviors (physical exercise, health and nutritional care, length of dependence) and with different areas of life satisfaction. CONCLUSIONS Better health related quality of life was associated with certain social, psychological, family and health characteristics, a satisfactory lifestyle, better socioeconomic conditions and a good internal locus of control over health attitudes and

  20. Age-dependent vitreous separation from the macula in a clinic population

    PubMed Central

    Syed, Zahid; Stewart, Michael W

    2016-01-01

    Background Vitreous degeneration begins soon after birth and accelerates throughout life. Vitreous liquefaction with a slowly progressive separation of the posterior hyaloid from the peripheral macula usually leads to complete posterior vitreous detachment. The purpose of this study is to measure the age-related prevalence of partial vitreous separation and the length of residual vitreous adhesion in an ophthalmology clinic population. Methods Patients examined by the senior author (MWS) during a 6-month period were included in a retrospective chart review. Demographic data and spectral domain optical coherence tomography scan results were gathered. Data analysis with descriptive statistics focused on the prevalence and extent of partial vitreous separation. Results The mean age of the study patients was 69.9 years, and 62% were phakic. The highest prevalence of partial posterior hyaloid separation from the internal limiting membrane (71.2%) was seen in the 50- to 54-year age group. This prevalence rate steadily decreased to 5.6% in the 95- to 99-year age group. The prevalence of complete vitreous detachment as determined by slit-lamp biomicroscopy increased from 1.7% in the <50-year age group to a maximum of 29.2% in the 75- to 79-year group. The length of vitreomacular adhesion averaged 4.6 mm in the 50- to 54-year age group and steadily decreased to 2.1 mm in the 90- to 95-year group. Conclusion Vitreomacular separation affects the majority of eyes in the sixth decade of life. The prevalence of partial vitreous separation decreases with advancing age, probably because an increasing number of these patients progress to complete posterior vitreous detachment. PMID:27462138

  1. Effects of age, sex and smoking on ankle-brachial index in a Finnish population at risk for cardiovascular disease

    PubMed Central

    Syvänen, Kari; Aarnio, Pertti; Jaatinen, Pekka; Korhonen, Päivi

    2007-01-01

    BACKGROUND Smoking is a well-known risk factor for peripheral arterial disease (PAD). Data regarding differences in the prevalence of PAD between sexes are somewhat controversial. In addition, most studies indicate that the prevalence of PAD increases with age in both sexes. In the present study, the effects of sex, age and smoking on the ankle-brachial index (ABI) in a Finnish cardiovascular risk population were investigated. OBJECTIVES To investigate the relationship between the ankle-brachial index, and age, sex and smoking in a Finnish population at risk for cardiovascular disease. METHODS All men and women between 45 and 70 years of age living in a rural town (Harjavalta, Finland; total population 7700) were invited to participate in a population survey (Harmonica study). Patients with previously diagnosed diabetes or vascular disease were excluded. In total, 2856 patients were invited to participate in the study. From these subjects, a cardiovascular risk population was screened. Complete data were available from 1028 persons. ABI (the ratio between the posterior tibial or dorsalis pedis artery and brachial artery pressures) was measured, and questionnaires were used to detect smoking status and relevant medical history. Only current smoking status was taken into account. RESULTS The mean ABI for the entire study population was 1.10 (range 0.56 to 1.64). Current smokers had a lower mean ABI (1.06; P<0.001). There was no statistically significant difference in ABI values among age groups, although the majority of patients with ABI values below 0.9 were older than 60 years of age. There was no statistically significant difference in ABI between sexes. CONCLUSION As previously reported, the present study shows the significant effect of smoking in the development of PAD. No statistically significant difference was found among age groups, but the tendency was toward lower ABIs in the oldest age groups. Sex had a minimal effect on the ABI. PMID:22477327

  2. Sex ratio of congenital abnormalities in the function of maternal age: a population-based study.

    PubMed

    Csermely, Gyula; Urbán, Robert; Czeizel, Andrew E; Veszprémi, Béla

    2015-05-01

    Maternal age effect is well-known in the origin of numerical chromosomal aberrations and some isolated congenital abnormalities (CAs). The sex ratio (SR), i.e. number of males divided by the number of males and females together, of most CAs deviates from the SR of newborn population (0.51). The objective of this analysis was to evaluate the possible association of maternal age with the SR of isolated CAs in a population-based large dataset of the Hungarian Case-Control Surveillance of Congenital Abnormalities, 1980-1996. First, SR of 24 CA entities/groups was estimated in 21,494 patients with isolated CA. In the next step SR of different maternal age groups was compared to the mean SR of the given CA-groups. The SR of four CA-groups showed some deviation in certain maternal age groups. Cases with anencephaly had female excess in young mothers (<25 years). Cases with skull's CAs particularly craniosynostosis had a male excess in cases born to women over 30 years. Two other CA groups (cleft lip ± palate and valvar pulmonic stenosis within the group of right-sided obstructive defect of heart) had significant deviation in SR of certain maternal age groups from the mean SR, but these deviations were not harmonized with joining age groups and thus were considered as a chance effect due to multiple testing. In conclusion, our study did not suggest that in general SR of isolated CAs might be modified by certain maternal age groups with some exception such as anencephaly and craniosynostosis.

  3. Sex ratio of congenital abnormalities in the function of maternal age: a population-based study.

    PubMed

    Csermely, Gyula; Urbán, Robert; Czeizel, Andrew E; Veszprémi, Béla

    2015-05-01

    Maternal age effect is well-known in the origin of numerical chromosomal aberrations and some isolated congenital abnormalities (CAs). The sex ratio (SR), i.e. number of males divided by the number of males and females together, of most CAs deviates from the SR of newborn population (0.51). The objective of this analysis was to evaluate the possible association of maternal age with the SR of isolated CAs in a population-based large dataset of the Hungarian Case-Control Surveillance of Congenital Abnormalities, 1980-1996. First, SR of 24 CA entities/groups was estimated in 21,494 patients with isolated CA. In the next step SR of different maternal age groups was compared to the mean SR of the given CA-groups. The SR of four CA-groups showed some deviation in certain maternal age groups. Cases with anencephaly had female excess in young mothers (<25 years). Cases with skull's CAs particularly craniosynostosis had a male excess in cases born to women over 30 years. Two other CA groups (cleft lip ± palate and valvar pulmonic stenosis within the group of right-sided obstructive defect of heart) had significant deviation in SR of certain maternal age groups from the mean SR, but these deviations were not harmonized with joining age groups and thus were considered as a chance effect due to multiple testing. In conclusion, our study did not suggest that in general SR of isolated CAs might be modified by certain maternal age groups with some exception such as anencephaly and craniosynostosis. PMID:25354028

  4. 76 FR 37314 - Estimates of the Voting Age Population for 2010

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-27

    ... Office of the Secretary Estimates of the Voting Age Population for 2010 AGENCY: Office of the Secretary, Commerce. ACTION: General Notice Announcing Population Estimates. SUMMARY: This notice announces the voting age population estimates as of July 1, 2010, for each state and the District of Columbia. We...

  5. 75 FR 4343 - Estimates of the Voting Age Population for 2009

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-27

    ... Office of the Secretary Estimates of the Voting Age Population for 2009 AGENCY: Office of the Secretary, Commerce. ACTION: General Notice Announcing Population Estimates. SUMMARY: This notice announces the voting age population estimates as of July 1, 2009, for each state and the District of Columbia. We...

  6. 78 FR 6289 - Estimates of the Voting Age Population for 2012

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-30

    ... Office of the Secretary Estimates of the Voting Age Population for 2012 AGENCY: Office of the Secretary, Commerce. ] ACTION: General notice announcing population estimates. SUMMARY: This notice announces the voting age population estimates as of July 1, 2012, for each state and the District of Columbia. We...

  7. 77 FR 4000 - Estimates of the Voting Age Population for 2011

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-26

    ... Office of the Secretary Estimates of the Voting Age Population for 2011 AGENCY: Office of the Secretary, Commerce. ACTION: General Notice Announcing Population Estimates. SUMMARY: This notice announces the voting age population estimates as of July 1, 2011, for each state and the District of Columbia. We...

  8. Preschool Age Populations Research Needs - NCS Dietary Assessment Literature Review

    Cancer.gov

    Drawing conclusions from the validation studies on preschool populations discussed in this chapter is difficult because of the varied study designs, the relatively small study populations, and limited number of studies on each dietary assessment method.

  9. Age and Time Population Differences: Young Adults, Gen Xers, and Millennials

    ERIC Educational Resources Information Center

    Menard, Lauren A.

    2013-01-01

    Age and Time disparities in young adult research populations are common because young adults are defined by varying age spans; members of Generation X and Millennial generations may both be considered young adults; study years vary, affecting populations; and qualitative methods with limited age/year samples are frequently utilized. The current…

  10. Sequential population-based studies over 25 years on the incidence and survival of acute de novo leukemias in Estonia and in a well-defined region of western Sweden during 1982-2006: a survey of patients aged ≥65 years.

    PubMed

    Punab, Mari; Palk, Katrin; Varik, Mirja; Laane, Edward; Everaus, Hele; Holmberg, Erik; Hulegårdh, Erik; Wennström, Lovisa; Safai-Kutti, Soodabeh; Stockelberg, Dick; Kutti, Jack

    2013-03-01

    Estonia regained independence in 1991 after five decades of occupation by the Soviet Union. The present population-based survey was carried out over five consecutive 5-year study periods (1982-2006) on the incidence and survival of de novo acute leukemia patients aged ≥65 years at diagnosis in Estonia and in a well-defined area in western Sweden. During the study period of retrospective work (1982-1996), the first 10 years were carried out while Estonia was still under the mentorship of the Soviet Union. Over these years, Estonian hematologists did not have access to therapeutic measures readily available to Swedish hematologists, and the results for survival for western Swedish patients with acute myeloid leukemia (AML) far exceeded those of their Estonian counterparts. However, the results for acute lymphoblastic leukemia were equally dismal in the two countries. Subsequent prospective population-based studies were carried out during the years 1997-2006. A gradual improvement as to long-term relative survival of the Estonian AML patients was observed. When studying 2002-2006, no difference as regards relative survival at 5 years was anymore present between the two countries. Over the first 20 years of our population-based studies, it was repeatedly observed that the age-standardized incidence rate particularly for de novo AML was considerably higher for the western Swedish as compared to the Estonian cohorts. During the last 5-year study period (2002-2006), no such difference between the two countries was present, indicating that some true changes in the reporting procedure in Estonia had occurred.

  11. Pial synangiosis in patients with moyamoya younger than 2 years of age.

    PubMed

    Jackson, Eric M; Lin, Ning; Manjila, Sunil; Scott, R Michael; Smith, Edward R

    2014-04-01

    Object Patients with moyamoya who are younger than 2 years of age represent a therapeutic challenge because of their frequent neurological instability and concomitant anesthetic risks. The authors report their experience with pial synangiosis revascularization in this population. Methods The authors reviewed the clinical and radiographic records of all patients with moyamoya in a consecutive series of patients under 2 years of age, who underwent cerebral revascularization surgery using pial synangiosis at a single institution. Results During a 12-year period (1994-2005), 34 procedures (bilateral in 15 patients, unilateral in 4) were performed in 19 patients younger than 2 years (out of a total of 456 procedures in 240 patients). Eighteen of these patients presented with either stroke or transient ischemic attack. The average age of the 19 patients at first surgery was 1.4 years (range 6 months-1.9 years). Unanticipated staged operations occurred in 3 patients, due to persistent electroencephalographic changes during the initial surgery in 2 cases and due to brain swelling during the procedure requiring ventriculostomy in the other. There were 2 perioperative strokes; both patients had postoperative seizures but made clinical recoveries. The average follow-up was 7 years (range 1-14 years). Long term, at follow-up, 13 patients (68%) were clinically independent for their age, with 8 (42%) having no significant deficit. Late complications included subdural hygroma evacuation (1), additional revascularization procedures performed years later for frontal lobe ischemia (2), late infarction (1), and asymptomatic ischemic change on routine follow-up MRI studies (1). All patients who had both pre- and postoperative angiography demonstrated progression of disease. Conclusions Despite the challenges inherent to this population, the majority of children with moyamoya under the age of 2 years have a good long-term prognosis. The data from this study support the use of pial

  12. Aging in France: Population Trends, Policy Issues, and Research Institutions

    ERIC Educational Resources Information Center

    Beland, Daniel; Durandal, Jean-Philippe Viriot

    2013-01-01

    Like in other advanced industrial countries, in France, demographic aging has become a widely debated research and policy topic. This article offers a brief overview of major aging-related trends in France. The article describes France's demographics of aging, explores key policy matters, maps the institutional field of French social gerontology…

  13. Food Patterns in an Urban Population: Age and Sociodemographic Correlates.

    ERIC Educational Resources Information Center

    Slesinger, Doris P.; And Others

    1980-01-01

    Examined age and sociodemographic differentials in food intake and eating patterns in households in a midwestern metropolitan county. Meat was the only food consumed with recommended frequency by all ages. Food intake and eating pattern differences by age remained when effects of income, education, household composition, and gender were…

  14. Replacement Migration: Is It a Solution to Declining and Ageing Populations?

    ERIC Educational Resources Information Center

    United Nations, New York, NY. Dept. of Economic and Social Affairs.

    The United Nations (UN) Population Division monitors fertility, mortality, and migration trends for all countries as a basis for producing the official UN population estimates and projections. Among recent demographic trends, two are prominent: (1) population decline and (2) population aging. Focusing on these two critical trends, a study…

  15. The effect of age on cognitive performance of frontal patients

    PubMed Central

    Cipolotti, Lisa; Healy, Colm; Chan, Edgar; MacPherson, Sarah E.; White, Mark; Woollett, Katherine; Turner, Martha; Robinson, Gail; Spanò, Barbara; Bozzali, Marco; Shallice, Tim

    2015-01-01

    Age is known to affect prefrontal brain structure and executive functioning in healthy older adults, patients with neurodegenerative conditions and TBI. Yet, no studies appear to have systematically investigated the effect of age on cognitive performance in patients with focal lesions. We investigated the effect of age on the cognitive performance of a large sample of tumour and stroke patients with focal unilateral, frontal (n=68), or non-frontal lesions (n=45) and healthy controls (n=52). We retrospectively reviewed their cross sectional cognitive and imaging data. In our frontal patients, age significantly predicted the magnitude of their impairment on two executive tests (Raven's Advanced Progressive Matrices, RAPM and the Stroop test) but not on nominal (Graded Naming Test, GNT) or perceptual (Incomplete Letters) task. In our non-frontal patients, age did not predict the magnitude of their impairment on the RAPM and GNT. Furthermore, the exacerbated executive impairment observed in our frontal patients manifested itself from middle age. We found that only age consistently predicted the exacerbated executive impairment. Lesions to specific frontal areas, or an increase in global brain atrophy or white matter abnormalities were not associated with this impairment. Our results are in line with the notion that the frontal cortex plays a critical role in aging to counteract cognitive and neuronal decline. We suggest that the combined effect of aging and frontal lesions impairs the frontal cortical systems by causing its computational power to fall below the threshold needed to complete executive tasks successfully. PMID:26102190

  16. An agent-based computational model for tuberculosis spreading on age-structured populations

    NASA Astrophysics Data System (ADS)

    Graciani Rodrigues, C. C.; Espíndola, Aquino L.; Penna, T. J. P.

    2015-06-01

    In this work we present an agent-based computational model to study the spreading of the tuberculosis (TB) disease on age-structured populations. The model proposed is a merge of two previous models: an agent-based computational model for the spreading of tuberculosis and a bit-string model for biological aging. The combination of TB with the population aging, reproduces the coexistence of health states, as seen in real populations. In addition, the universal exponential behavior of mortalities curves is still preserved. Finally, the population distribution as function of age shows the prevalence of TB mostly in elders, for high efficacy treatments.

  17. Advanced paternal age increases the risk of schizophrenia and obsessive–compulsive disorder in a Chinese Han population

    PubMed Central

    Wu, Yuejing; Liu, Xiang; Luo, Hongrong; Deng, Wei; Zhao, Gaofeng; Wang, Qiang; Zhang, Lan; Ma, Xiaohong; Liu, Xiehe; Murray, Robin A.; Collier, David A.; Li, Tao

    2012-01-01

    Using the Structured Clinical Interview for DSM-IV, patient and non-patient version (SCID-P/NP), this study investigated 351 patients with schizophrenia, 122 with obsessive–compulsive disorder (OCD), and 238 unrelated healthy volunteers in a Chinese Han population. The relative risks posed by advanced paternal age for schizophrenia and OCD in offspring were computed under logistic regression analyses and adjusted for the participant's sex, age and co-parent age at birth. Compared to the offspring with paternal age of 25–29 years old, the relative risks rose from 2.660 to 10.183 in the paternal age range of 30–34 and ≥ 35. The relative risks for OCD increased from 2.225 to 5.413 in 30–34 and ≥ 35. For offspring with paternal age of < 25, the odds ratios of developing schizophrenia and OCD were 0.628 and 0.289 respectively, whereas an association between increased maternal age and risk for schizophrenia/OCD was not seen. Interaction analysis showed an interaction effect between paternal age and maternal age at birth. Such a tendency of risk affected by parental age for schizophrenia and OCD existed after splitting out the data of early onset patients. Sex-specific analyses found that the relative risks for schizophrenia with paternal age of 30–34 and ≥ 35 in male offspring were 2.407 and 10.893, and in female offspring were 3.080 and 9.659. The relative risks for OCD with paternal age of 30–34 and ≥ 35 in male offspring were 3.493 and 7.373, and in female offspring 2.005 and 4.404. The mean paternal age of schizophrenia/OCD patients born before the early 1980s was much greater than that of patients who were born after then. The findings illustrated that advanced paternal age is associated with increased risk for both schizophrenia and OCD in a Chinese Han population, prominently when paternal age is over 35. Biological and non-biological mechanisms may both be involved in the effects of advanced paternal age on schizophrenia and OCD. PMID

  18. Alcohol Drinking Pattern: A Comparison between HIV-Infected Patients and Individuals from the General Population

    PubMed Central

    Ikeda, Maria Leticia R.; Barcellos, Nemora T.; Alencastro, Paulo R.; Wolff, Fernando H.; Moreira, Leila B.; Gus, Miguel; Brandão, Ajacio B. M.; Fuchs, Flavio D.; Fuchs, Sandra C.

    2016-01-01

    Background Alcohol consumption is highly prevalent in the general population and among HIV-infected population. This study aimed to compare the pattern of alcohol consumption and to describe characteristics associated with heavy alcohol consumption in individuals from the general population with patients infected with HIV. Methods Participants for this analysis came from a population-based cross-sectional study and from a consecutive sampling of patients infected with HIV. Participants aged 18 years or older were interviewed using similar questionnaires with questions pertaining to socio-demographic characteristics, alcohol consumption, smoking, physical activity, and HIV-related characteristics, among others. Blood pressure and anthropometric measures were measured using standardized procedures. Results Weekly alcohol consumption was more prevalent among individuals from the general population than HIV-infected patients: 57.0 vs. 31.1%, P<0.001. The prevalence of heavy episodic drinking was higher in the population sample as well: 46.1 vs. 17.0%, P<0.001. In the general population, heavy alcohol consumption was more prevalent in men. Cigarette smoking was independently associated with heavy alcohol consumption among HIV infected (Prevalence Ratio; PR = 5.9; 95%CI 2.6–13.9; P<0,001) and general population (PR = 2.6; 95%CI 1.9–3.0; P<0.001). Years at school were inversely associated with heavy alcohol consumption among HIV-infected patients and directly associated among participants from the general population, even after controlling for sex, age, skin color, and smoking. Conclusions Heavy alcohol consumption is more prevalent in the general population than among HIV-infected patients. Individuals aware about their disease may reduce the amount of alcoholic beverages consumption comparatively to healthy individuals from the general population. PMID:27362541

  19. Outsourcing Memory in Response to an Aging Population.

    PubMed

    Ross, Michael; Schryer, Emily

    2015-11-01

    With baby boomers entering old age and longevity increasing, policymakers have focused on the physical, social, and health needs of older persons. We urge policymakers to consider cognitive aging as well, particularly normal, age-related memory decline. Psychological scientists attribute memory decline mainly to cognitive overload stemming from age-related reductions in sensory capacities, speed of cognitive processing, and the ability to filter out irrelevant information. Even in the absence of decline, however, memory is imperfect and forgetting can be especially consequential for older adults. For example, forgetting to take prescription medicines is an age-related problem largely because older adults tend to ingest many more prescription drugs. We propose that policymakers focus on increasing environmental support for memory that can reduce the burden on cognitive resources and thus improve recall. In providing environmental support, policymakers need to pay careful attention to potential age-related changes in physical and cognitive capacity, as well as behavior.

  20. Disaster resilience and population ageing: the 1995 Kobe and 2004 Chuetsu earthquakes in Japan.

    PubMed

    Chen, Haili; Maki, Norio; Hayashi, Haruo

    2014-04-01

    This paper provides a framework for evaluating the effects of population ageing on disaster resilience. In so doing, it focuses on the 1995 Kobe and 2004 Chuetsu earthquakes, two major disasters that affected Japan before the 2011 Great East Japan earthquake. It analyses regional population recovery on the basis of pre-disaster and post-recovery demographic characteristics using defined transition patterns of population ageing. The evaluation framework demonstrates that various recovery measures make different contributions to disaster resilience for each transition pattern of population ageing. With reference to regional population ageing, the framework allows for a prediction of disaster resilience, facilitating place vulnerability assessments and potentially informing policy-making strategies for Japan and other countries with ageing populations.

  1. Disaster resilience and population ageing: the 1995 Kobe and 2004 Chuetsu earthquakes in Japan.

    PubMed

    Chen, Haili; Maki, Norio; Hayashi, Haruo

    2014-04-01

    This paper provides a framework for evaluating the effects of population ageing on disaster resilience. In so doing, it focuses on the 1995 Kobe and 2004 Chuetsu earthquakes, two major disasters that affected Japan before the 2011 Great East Japan earthquake. It analyses regional population recovery on the basis of pre-disaster and post-recovery demographic characteristics using defined transition patterns of population ageing. The evaluation framework demonstrates that various recovery measures make different contributions to disaster resilience for each transition pattern of population ageing. With reference to regional population ageing, the framework allows for a prediction of disaster resilience, facilitating place vulnerability assessments and potentially informing policy-making strategies for Japan and other countries with ageing populations. PMID:24601918

  2. Long-term care of the aging population with intellectual and developmental disabilities.

    PubMed

    Kim, Nae-Hwa; Hoyek, Georges El; Chau, Diane

    2011-05-01

    The aging population with intellectual and developmental disabilities (I/DD) deserves appropriate health care and social support. This population poses unique medical and social challenges to the multidisciplinary team that provides care. In the past, long-term care (LTC) facilities played an essential role in the livelihood of this population. The likelihood that the geriatric LTC system must prepare for adequately caring for this population is high. This article conveys the need to prepare for the inclusion of the growing aging population with I/DD into long-term care with the general elderly population in the near future.

  3. Identifying risk of hospital readmission among Medicare aged patients: an approach using routinely collected data.

    PubMed

    Navarro, Adria E; Enguídanos, Susan; Wilber, Kathleen H

    2012-01-01

    Readmission provisions in the Patient Protection and Affordable Care Act of March 2010 have created urgent fiscal accountability requirements for hospitals, dependent upon a better understanding of their specific populations, along with development of mechanisms to easily identify these at-risk patients. Readmissions are disruptive and costly to both patients and the health care system. Effectively addressing hospital readmissions among Medicare aged patients offers promising targets for resources aimed at improved quality of care for older patients. Routinely collected data, accessible via electronic medical records, were examined using logistic models of sociodemographic, clinical, and utilization factors to identify predictors among patients who required rehospitalization within 30 days. Specific comorbidities and discharge care orders in this urban, nonprofit hospital had significantly greater odds of predicting a Medicare aged patient's risk of readmission within 30 days. PMID:22656916

  4. Identifying risk of hospital readmission among Medicare aged patients: an approach using routinely collected data.

    PubMed

    Navarro, Adria E; Enguídanos, Susan; Wilber, Kathleen H

    2012-01-01

    Readmission provisions in the Patient Protection and Affordable Care Act of March 2010 have created urgent fiscal accountability requirements for hospitals, dependent upon a better understanding of their specific populations, along with development of mechanisms to easily identify these at-risk patients. Readmissions are disruptive and costly to both patients and the health care system. Effectively addressing hospital readmissions among Medicare aged patients offers promising targets for resources aimed at improved quality of care for older patients. Routinely collected data, accessible via electronic medical records, were examined using logistic models of sociodemographic, clinical, and utilization factors to identify predictors among patients who required rehospitalization within 30 days. Specific comorbidities and discharge care orders in this urban, nonprofit hospital had significantly greater odds of predicting a Medicare aged patient's risk of readmission within 30 days.

  5. Age Disparity in Palliative Radiation Therapy Among Patients With Advanced Cancer

    SciTech Connect

    Wong, Jonathan; Xu, Beibei; Yeung, Heidi N.; Roeland, Eric J.; Martinez, Maria Elena; Le, Quynh-Thu; Mell, Loren K.; Murphy, James D.

    2014-09-01

    Purpose/Objective: Palliative radiation therapy represents an important treatment option among patients with advanced cancer, although research shows decreased use among older patients. This study evaluated age-related patterns of palliative radiation use among an elderly Medicare population. Methods and Materials: We identified 63,221 patients with metastatic lung, breast, prostate, or colorectal cancer diagnosed between 2000 and 2007 from the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked database. Receipt of palliative radiation therapy was extracted from Medicare claims. Multivariate Poisson regression analysis determined residual age-related disparity in the receipt of palliative radiation therapy after controlling for confounding covariates including age-related differences in patient and demographic covariates, length of life, and patient preferences for aggressive cancer therapy. Results: The use of radiation decreased steadily with increasing patient age. Forty-two percent of patients aged 66 to 69 received palliative radiation therapy. Rates of palliative radiation decreased to 38%, 32%, 24%, and 14% among patients aged 70 to 74, 75 to 79, 80 to 84, and over 85, respectively. Multivariate analysis found that confounding covariates attenuated these findings, although the decreased relative rate of palliative radiation therapy among the elderly remained clinically and statistically significant. On multivariate analysis, compared to patients 66 to 69 years old, those aged 70 to 74, 75 to 79, 80 to 84, and over 85 had a 7%, 15%, 25%, and 44% decreased rate of receiving palliative radiation, respectively (all P<.0001). Conclusions: Age disparity with palliative radiation therapy exists among older cancer patients. Further research should strive to identify barriers to palliative radiation among the elderly, and extra effort should be made to give older patients the opportunity to receive this quality of life-enhancing treatment at the end

  6. The aging HIV/AIDS population: fragile social networks.

    PubMed

    Shippy, R A; Karpiak, S E

    2005-05-01

    Social support becomes an increasingly critical resource for people as they age. In New York City, 25% of all people living with HIV/AIDS are over age 50, and 64% are over age 40. This study sample (n=160) reflects current HIV/AIDS epidemiology, with 34% females and 89% people of color. This study provides a detailed profile of this growing, aging cohort and their social networks. Our study finds this growing group of aging adults is isolated from informal networks due to the stigma of HIV/AIDS and ageism. Typically, partners and family members are key sources of informal support, but only 1/3 of respondents had a partner and 71% lived alone. This group relies heavily on friends, many of whom are also HIV-positive. Participants were in primary care and many (86%) utilized Medicaid. The fragile networks of these older adults will be challenged by age-related comorbidities. Without traditional caregivers, these aging adults with HIV/AIDS will have an immense impact on healthcare delivery and community-based programs.

  7. The Stem Cell Research and the Aging of Brazilian Population.

    PubMed

    Evangelista, Laura S M; Devina, Florentin; Carvalho, Braulio F de

    2015-02-01

    The developing countries are experiencing a shift in the population profile, faster than that experienced by developed countries, especially due to the consolidation of health practices and technological advances. These social changes also imply new socioeconomic models, able to escort social demands caused by the growth of the elderly population and the decrease in young economically active population. Several countries seek for actions that do not marginalize the elderly, and invest heavily in new technologies to ensure health access and active participation of this group in society. Stem cell research may reflect at an improvement of public health, reduction in costs of hospitalization and lead to prevention and treatment of extremely debilitating illness, like the neurodegenerative diseases. Preserving the physical and mental functional capacity is of extreme importance to ensure the active participation of elderly population in society.

  8. Prevalence of Methylphenidate Prescription among School-Aged Children in a Swiss Population: Increase in the Number of Prescriptions in the Swiss Canton of Vaud, from 2002 to 2005, and Changes in Patient Demographics

    ERIC Educational Resources Information Center

    Gumy, Cedric; Huissoud, Therese; Dubois-Arber, Francoise

    2010-01-01

    Objective: Methylphenidate is prescribed for children and adolescents to treat ADHD. As in many Western countries, the increase in methylphenidate consumption is a public concern in Switzerland. The article discusses the authors' assessment of prescription prevalence in 2002 and 2005 for school-aged children in the canton of Vaud. Method: Pharmacy…

  9. Patient care in a technological age.

    PubMed

    Dragon, Natalie

    2006-07-01

    In this electronically wired world of the 21 st century, the health care system has tapped into technology available at the touch of a button. Scientific discoveries, high-tech equipment, electronic medical records, Smarticards, and long distance diagnosis using telehealth technology have all been embraced. But Natalie Dragon asks, what are the implications for nurses and the outcomes on patient care?

  10. Exercise improves cognitive function in aging patients

    PubMed Central

    Hu, Jian-Ping; Guo, Yan-Hua; Wang, Feng; Zhao, Xin-Ping; Zhang, Quan-Hai; Song, Qing-Hua

    2014-01-01

    A decline in cognitive ability commonly occurs among older individuals. This study sought to explore the restorative effects of exercise in older patients with existing cognitive disabilities. Ninety-six patients with mild cognitive impairment were placed in an exercise program for six months. Following completion of the program, participants were assessed via the Chinese Mini Mental Status Examination (MMSE), Activity of Daily Living (ADL) assessment, and body movement testing and compared to a control group of patients with mild cognitive impairment who did not participate in the exercise program (N = 102). Statistical analyses were performed using the Student’s t-test and chi-square test to compare results between groups. Compared with control group, patients who exercised showed improved cognitive function in immediate memory (p < 0.001) and delayed recall (p = 0.004) function. In addition, activities associated with daily living showed improvement (p < 0.001), as did body movement (p < 0.05), arm stability (p < 0.001), and the appearance of rotation (p < 0.05). Based on these results, we conclude that participation in an exercise program can improve patients’ cognitive function, physical abilities, and body movement capacity. PMID:25419345

  11. Programs for the Aging Population. Professional Standards Development.

    ERIC Educational Resources Information Center

    Boarman, A. Marie

    1989-01-01

    This article provides an overview of recent AAHPERD activities in aging and adult development, with emphasis on the need for qualified leaders and practitioners in the areas of physical activity, exercise, health promotion, and recreation for older adults. (IAH)

  12. Bilingualism provides a neural reserve for aging populations.

    PubMed

    Abutalebi, Jubin; Guidi, Lucia; Borsa, Virginia; Canini, Matteo; Della Rosa, Pasquale A; Parris, Ben A; Weekes, Brendan S

    2015-03-01

    It has been postulated that bilingualism may act as a cognitive reserve and recent behavioral evidence shows that bilinguals are diagnosed with dementia about 4-5 years later compared to monolinguals. In the present study, we investigated the neural basis of these putative protective effects in a group of aging bilinguals as compared to a matched monolingual control group. For this purpose, participants completed the Erikson Flanker task and their performance was correlated to gray matter (GM) volume in order to investigate if cognitive performance predicts GM volume specifically in areas affected by aging. We performed an ex-Gaussian analysis on the resulting RTs and report that aging bilinguals performed better than aging monolinguals on the Flanker task. Bilingualism was overall associated with increased GM in the ACC. Likewise, aging induced effects upon performance correlated only for monolinguals to decreased gray matter in the DLPFC. Taken together, these neural regions might underlie the benefits of bilingualism and act as a neural reserve that protects against the cognitive decline that occurs during aging.

  13. Psychological Frailty in the Aging Patient.

    PubMed

    Fitten, L Jaime

    2015-01-01

    There is little written in the geriatric literature about the concept of psychological frailty which encompasses cognitive, mood, and motivational components. The concept is intended to consider brain changes that are beyond normal aging, but not necessarily inclusive of disease, that result in decreased cognitive or mood resilience in the presence of modest stressors, and may eventually lead to negative health outcomes in a manner parallel to physical frailty, an entity well known to clinicians. Most work exploring the interface between cognition, mood, and physical frailty has demonstrated a bidirectional association between the two domains. Psychological symptoms or deficits have been described as either worsening the degree of physical frailty, or physical frailty has been viewed as a risk to a worsening cognition or depression. However, psychological frailty, a consequence of age-altered brain function, has not been studied for itself. By what possible mechanism does the brain reveal its loss of resiliency under modest stress and how can this be visualized? Are there markers that predate a psychological decline that might permit a preventive intervention which could delay the appearance of negative health outcomes such as reduced functional capacity or increased dependency? The present review will explore these concepts and possibilities. PMID:26484526

  14. [Age estimation based on sternal rib ends changes in Bosnian male population].

    PubMed

    Sarajlić, Nermin

    2006-01-01

    One of the methods used for age estimation of exhumed remains of the missing persons from the recent war in Bosnia and Herzegovina is Iscan et al. rib phase analysis method, developed o n American population. Several researches have tested this method on other populations and proposed modifications for age estimation in a certain population. The purpose of this study is to test the applicability of the mentioned method for age assessment on Bosnian male population. The sample consistS of ribs from 410 identified deceased persons, from the recent war in Bosnia and Herzegovina. Whenever possible, the 4th rib has been used. In other cases 3rd, 5th or 6th rib has been used. Adjusted age ranges for each phase were developed specifically for the Bosnian male population. Up to the phase 7 Bosnians reach and finish each phase a little later t han Americans. However phases 7 and 8 were achieved andended earlier in Bosnian population.

  15. Growing old together: the influence of population and workforce aging on supply and use of family physicians.

    PubMed

    Watson, Diane E; Reid, Robert; Roos, Noralou; Heppner, Petra

    2005-01-01

    Canadians have expressed concern that access to a family physician (FP) has declined precipitously. Yet FP-topopulation ratios remained relatively stable over the last decade, and there were perceptions of physician surpluses, at least in urban centres, 10 years ago. We evaluated whether demographic changes among patients and FPs, and in the volume of care received and provided over the period, contribute to this paradox. Given the relationship between age and FP use in fiscal year 1991/1992, an aging population should have been associated with a 2 per cent increase in visits by 2000/2001. Likewise, given the relationship between FP age and workloads in 1991/1992, an aging workforce should have been associated with a 12 per cent increase in service provision a decade later. Yet visit rates and average FP workloads remained unchanged. There was an increase in age-specific rates of FP use among older adults and a decline in rates among the young, and an increase in age-specific workloads such that older FPs provided many more services than their predecessors (30%) and younger FPs provided many fewer (20%). In terms of impact on future requirements for FPs, both changes in age-specific rates of use, and changes in age-specific patterns of FP productivity, trump population aging as key drivers. PMID:16080135

  16. [Population].

    PubMed

    1979-01-01

    Data on the population of Venezuela between 1975 and 1977 are presented in descriptive tables and graphs. Information is included on the employed population according to category, sex, and type of economic activity, and by sex, age, and area on the employment rate and the total, the economically active, and the unemployed population.

  17. White matter hyperintensities and imaging patterns of brain ageing in the general population.

    PubMed

    Habes, Mohamad; Erus, Guray; Toledo, Jon B; Zhang, Tianhao; Bryan, Nick; Launer, Lenore J; Rosseel, Yves; Janowitz, Deborah; Doshi, Jimit; Van der Auwera, Sandra; von Sarnowski, Bettina; Hegenscheid, Katrin; Hosten, Norbert; Homuth, Georg; Völzke, Henry; Schminke, Ulf; Hoffmann, Wolfgang; Grabe, Hans J; Davatzikos, Christos

    2016-04-01

    White matter hyperintensities are associated with increased risk of dementia and cognitive decline. The current study investigates the relationship between white matter hyperintensities burden and patterns of brain atrophy associated with brain ageing and Alzheimer's disease in a large populatison-based sample (n = 2367) encompassing a wide age range (20-90 years), from the Study of Health in Pomerania. We quantified white matter hyperintensities using automated segmentation and summarized atrophy patterns using machine learning methods resulting in two indices: the SPARE-BA index (capturing age-related brain atrophy), and the SPARE-AD index (previously developed to capture patterns of atrophy found in patients with Alzheimer's disease). A characteristic pattern of age-related accumulation of white matter hyperintensities in both periventricular and deep white matter areas was found. Individuals with high white matter hyperintensities burden showed significantly (P < 0.0001) lower SPARE-BA and higher SPARE-AD values compared to those with low white matter hyperintensities burden, indicating that the former had more patterns of atrophy in brain regions typically affected by ageing and Alzheimer's disease dementia. To investigate a possibly causal role of white matter hyperintensities, structural equation modelling was used to quantify the effect of Framingham cardiovascular disease risk score and white matter hyperintensities burden on SPARE-BA, revealing a statistically significant (P < 0.0001) causal relationship between them. Structural equation modelling showed that the age effect on SPARE-BA was mediated by white matter hyperintensities and cardiovascular risk score each explaining 10.4% and 21.6% of the variance, respectively. The direct age effect explained 70.2% of the SPARE-BA variance. Only white matter hyperintensities significantly mediated the age effect on SPARE-AD explaining 32.8% of the variance. The direct age effect explained 66.0% of the SPARE

  18. Is Our Aging Population a Threat to Education?

    ERIC Educational Resources Information Center

    Francese, Peter

    2014-01-01

    A great many New England institutions of higher education are about to find out if demography will determine their fate because unprecedented and substantial population change is sweeping across the region. With fewer than 15 million year-round residents, it is the nation's smallest and one of the slowest-growing of the nine census divisions.…

  19. [Depression in Patients with Age-Related Macular Degeneration].

    PubMed

    Narváez, Yamile Reveiz; Gómez-Restrepo, Carlos

    2012-09-01

    Age-related macular degeneration is a cause for disability in the elderly since it greatly affects their quality of life and increases depression likelihood. This article discusses the negative effect depression has on patients with age-related macular degeneration and summarizes the interventions available for decreasing their depression index. PMID:26572116

  20. [Depression in Patients with Age-Related Macular Degeneration].

    PubMed

    Narváez, Yamile Reveiz; Gómez-Restrepo, Carlos

    2012-09-01

    Age-related macular degeneration is a cause for disability in the elderly since it greatly affects their quality of life and increases depression likelihood. This article discusses the negative effect depression has on patients with age-related macular degeneration and summarizes the interventions available for decreasing their depression index.

  1. Exceptional Brain Aging in a Rural Population-Based Cohort

    ERIC Educational Resources Information Center

    Kaye, Jeffrey; Michael, Yvonne; Calvert, James; Leahy, Marjorie; Crawford, Debbie; Kramer, Patricia

    2009-01-01

    Context: The 2000 US Census identified 50,454 Americans over the age of 100. Increased longevity is only of benefit if accompanied by maintenance of independence and quality of life. Little is known about the prevalence of dementia and other disabling conditions among rural centenarians although this information is important to clinicians caring…

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

    PubMed

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

    2016-01-01

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

  3. [Anesthesia for geriatric patients. Part 1: age, organ function and typical diseases].

    PubMed

    Herminghaus, A; Löser, S; Wilhelm, W

    2012-02-01

    Due to demographic changes in the population of industrial nations the number of elderly patients undergoing elective or emergency procedures will rise significantly in the coming years. Anesthesia for geriatric patients is challenging for the anesthesiologist in many ways: with increasing age numerous physiological changes occur which all lead to a subsequent reduction of physical performance and compensatory capacity of the organism, in many cases additionally aggravated by chronic illness. Subsequently, these age-dependent changes (with or without chronic illness) increase the risk for admission to intensive care units, perioperative death, treatment costs and a prolonged length of hospital stay. Therefore, subtle preoperative assessment and tailored anesthetic management are essential in elderly patients. Part 1 of this continuous education article covers the influence of age on organ functions and describes typical comorbidities which are of high relevance for the perioperative care of geriatric patients. The special features of anesthetic agents and anesthesia management in the elderly will be presented in part 2.

  4. Population Pharmacokinetics of Pyronaridine in Pediatric Malaria Patients

    PubMed Central

    Ayyoub, Amal; Methaneethorn, Janthima; Ramharter, Michael; Djimde, Abdoulaye A.; Tekete, Mamadou; Duparc, Stephan; Borghini-Fuhrer, Isabelle; Shin, Jang-Sik

    2015-01-01

    Pyramax is a pyronaridine (PYR)-artesunate (PA) combination for the treatment of uncomplicated malaria in adult and pediatric patients. A granule formulation of this combination is being developed for treatment of uncomplicated P. falciparum and P. vivax malaria in pediatric patients. The aims of this study were to describe the pharmacokinetics of PYR using a total of 1,085 blood PYR concentrations available from 349 malaria patients younger than 16 years of age with mild to moderate uncomplicated malaria and to confirm the dosing regimen for the pediatric granule formulation. Nonlinear mixed-effects modeling using NONMEM software was used to obtain the pharmacokinetic and inter- and intraindividual variability parameter estimates. The population pharmacokinetics of PYR were described by a two-compartment model with first-order absorption and elimination. Allometric scaling was implemented to address the effect of body weight on clearance and volume parameters. The final parameter estimates of PYR apparent clearance (CL/F), central volume of distribution (V2/F), peripheral volume of distribution (V3/F), intercompartmental clearance (Q/F), and absorption rate constant (Ka) were 377 liters/day, 2,230 liters, 3,230 liters, 804 liters/day and 17.9 day−1, respectively. Covariate model building conducted using forward addition (P < 0.05) followed by backward elimination (P < 0.001) yielded two significant covariate-parameter relationships, i.e., age on V2/F and formulation on Ka. Evaluation of bootstrapping, visual predictive check, and condition number indicated that the final model displayed satisfactory robustness, predictive power, and stability. Simulations of PYR concentration-time profiles generated from the final model show similar exposures across pediatric weight ranges, supporting the proposed labeling for weight-based dosing of Pyramax granules. (These studies have been registered at ClinicalTrials.gov under registration no. NCT00331136 [phase II study] and

  5. 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 ...

  6. Calculating summary statistics for population chemical biomonitoring in women of childbearing age with adjustment for age-specific natality.

    PubMed

    Axelrad, Daniel A; Cohen, Jonathan

    2011-01-01

    The effects of chemical exposures during pregnancy on children's health have been an increasing focus of environmental health research in recent years, leading to greater interest in biomonitoring of chemicals in women of childbearing age in the general population. Measurements of mercury in blood from the National Health and Nutrition Examination Survey are frequently reported for "women of childbearing age," defined to be of ages 16-49 years. The intent is to represent prenatal chemical exposure, but blood mercury levels increase with age. Furthermore, women of different ages have different probabilities of giving birth. We evaluated options to address potential bias in biomonitoring summary statistics for women of childbearing age by accounting for age-specific probabilities of giving birth. We calculated median and 95th percentile levels of mercury, PCBs, and cotinine using these approaches: option 1: women aged 16-49 years without natality adjustment; option 2: women aged 16-39 years without natality adjustment; option 3: women aged 16-49 years, adjusted for natality by age; option 4: women aged 16-49 years, adjusted for natality by age and race/ethnicity. Among the three chemicals examined, the choice of option has the greatest impact on estimated levels of serum PCBs, which are strongly associated with age. Serum cotinine levels among Black non-Hispanic women of childbearing age are understated when age-specific natality is not considered. For characterizing in utero exposures, adjustment using age-specific natality provides a substantial improvement in estimation of biomonitoring summary statistics. PMID:21035114

  7. Proton Beam Therapy for Aged Patients With Hepatocellular Carcinoma

    SciTech Connect

    Hata, Masaharu Tokuuye, Koichi; Sugahara, Shinji; Tohno, Eriko; Nakayama, Hidetsugu; Fukumitsu, Nobuyoshi; Mizumoto, Masashi; Abei, Masato; Shoda, Junichi; Minami, Manabu; Akine, Yasuyuki

    2007-11-01

    Purpose: To investigate the safety and efficacy of proton beam therapy for aged patients with hepatocellular carcinoma (HCC). Methods and Materials: Twenty-one patients aged {>=}80 years with HCC underwent proton beam therapy. At the time of irradiation, patient age ranged from 80 to 85 years (median, 81 years). Hepatic tumors were solitary in 17 patients and multiple in 4. Tumor size ranged from 10 to 135 mm (median, 40 mm) in maximum diameter. Ten, 5, and 6 patients received proton beam irradiation with total doses of 60 Gy in 10 fractions, 66 Gy in 22 fractions, and 70 Gy in 35 fractions, respectively, according to tumor location. Results: All irradiated tumors were controlled during the follow-up period of 6-49 months (median, 16 months). Five patients showed new hepatic tumors outside the irradiated volume, 2-13 months after treatment, and 1 of them also had lung metastasis. The local progression-free and disease-free rates were 100% and 72% at 3 years, respectively. Of 21 patients, 7 died 6-49 months after treatment; 2 patients each died of trauma and old age, and 1 patient each died of HCC, pneumonia, and arrhythmia. The 3-year overall, cause-specific, and disease-free survival rates were 62%, 88%, and 51%, respectively. No therapy-related toxicity of Grade {>=} 3 but thrombocytopenia in 2 patients was observed. Conclusions: Proton beam therapy seems to be tolerable, effective, and safe for aged patients with HCC. It may contribute to prolonged survival due to tumor control.

  8. Preparing for an aging population and improving chronic disease management.

    PubMed

    Dexter, Paul R; Miller, Douglas K; Clark, Daniel O; Weiner, Michael; Harris, Lisa E; Livin, Lee; Myers, Isaac; Shaw, David; Blue, Lee Ann; Kunzer, John; Overhage, J Marc

    2010-11-13

    New models of health care delivery are inevitable. There is likely to be increasing emphasis on patient self-monitoring, health care delivery at patient homes, interdisciplinary treatment plans, a greater percentage of medical care delivered by non-physician health professionals, targeted health educational materials, and greater involvement and training of informal caregivers. The Information Technologies (IT) infrastructure of health systems will need to adapt. We have begun sorting out the implications of this future within a County public hospital system: defining the desirable features, relevant technologies, necessary modifications to the network, and additional data elements to be captured. We seek to build an infrastructure that will support new patient-focused technologies designed to more efficiently and effectively support older individuals. We hypothesize utility to further exploring the impact that new health care delivery models will have on health systems' IT infrastructures.

  9. Hyperpharmacotherapy in ageing cystic fibrosis patients: The first report of an atypical hip fracture

    PubMed Central

    Al-Azzani, W.A.K.; Evans, L.; Speight, L.; Lea-Davies, M.; Stone, M.D.; Lau, D.; Ketchell, R.I.; Duckers, J.

    2015-01-01

    Cystic fibrosis (CF) is a common autosomal recessive disorder in Caucasian populations with respiratory, gastrointestinal and endocrine manifestations. Thanks to recent advances in medical therapies and infection control, life expectancy of a patient with CF has significantly increased from less than 5 years in the mid-1900s to almost 50 years nowadays. However, as CF patients are living longer, multimorbidity and Hyperpharmacotherapy are becoming more common. This case illustrates a cascade of problems that ensued from medication side-effects, highlighting the increasing challenge of managing an ageing CF population. PMID:26744685

  10. National Lung Screening Trial Findings by Age: Medicare-Eligible Versus Under-65 Population

    PubMed Central

    Pinsky, Paul F.; Gierada, David S.; Hocking, William; Patz, Edward F.; Kramer, Barnett S.

    2015-01-01

    Background The NLST (National Lung Screening Trial) showed reduced lung cancer mortality in high-risk participants (smoking history of ≥30 pack-years) aged 55 to 74 years who were randomly assigned to screening with low-dose computed tomography (LDCT) versus those assigned to chest radiography. An advisory panel recently expressed reservations about Medicare coverage of LDCT screening because of concerns about performance in the Medicare-aged population, which accounted for only 25% of the NLST participants. Objective To examine the results of the NLST LDCT group by age (Medicare-eligible vs. <65 years). Design Secondary analysis of a group from a randomized trial (NCT00047385). Setting 33 U.S. screening centers. Patients 19 612 participants aged 55 to 64 years (under-65 cohort) and 7110 participants aged 65 to 74 years (65+ cohort) at randomization. Intervention 3 annual rounds of LDCT screening. Measurements Demographics, smoking and medical history, screening examination adherence and results, diagnostic follow-up procedures and complications, lung cancer diagnoses, treatment, survival, and mortality. Results The aggregate false-positive rate was higher in the 65+ cohort than in the under-65 cohort (27.7% vs. 22.0%; P < 0.001). Invasive diagnostic procedures after false-positive screening results were modestly more frequent in the older cohort (3.3% vs. 2.7%; P = 0.039). Complications from invasive procedures were low in both groups (9.8% in the under-65 cohort vs. 8.5% in the 65+ cohort). Prevalence and positive predictive value (PPV) were higher in the 65+ cohort (PPV, 4.9% vs. 3.0%). Resection rates for screen-detected cancer were similar (75.6% in the under-65 cohort vs. 73.2% in the 65+ cohort). Five-year all-cause survival was lower in the 65+ cohort (55.1% vs. 64.1%; P = 0.018). Limitation The oldest screened patient was aged 76 years. Conclusion NLST participants aged 65 years or older had a higher rate of false-positive screening results than those

  11. Optimizing Population Screening of Bullying in School-Aged Children

    ERIC Educational Resources Information Center

    Vaillancourt, Tracy; Trinh, Vi; McDougall, Patricia; Duku, Eric; Cunningham, Lesley; Cunningham, Charles; Hymel, Shelley; Short, Kathy

    2010-01-01

    A two-part screening procedure was used to assess school-age children's experience with bullying. In the first part 16,799 students (8,195 girls, 8,604 boys) in grades 4 to 12 were provided with a definition of bullying and then asked about their experiences using two general questions from the Olweus Bully/Victim Questionnaire (1996). In the…

  12. Is prosthodontic treatment age-dependent in patients 60 years and older in Public Dental Services?

    PubMed

    Hiltunen, K; Vehkalahti, M M; Mäntylä, P

    2015-06-01

    Prosthodontic treatment is a common procedure for the elderly as tooth loss is a reality in old age. Dentists take care of increasingly older patients with physiological age manifesting as cognitive impairment, frailty or multiple chronic diseases or who have side effects of medicines. We evaluated how patients' age affects prosthodontic treatment choice and whether we could identify the age when a change in practice occurs. In addition, we determined how common the treatment method of fixed prostheses is among patients aged 60 years or over in Public Dental Services (PDS) and how common rehabilitation of dentition with new dentures is compared with repair of existing dentures. Our data cover all patients aged 60 years and older (n = 130,060) treated in Helsinki PDS in 2007-2012. Data were aggregated into seven groups: 60-64, 65-69, 70-74, 75-79, 80-84, 85-89, and 90 years and over. During the 6-year period, the mean annual number of the population was about 114,000 and the mean annual number of patients treated with prosthodontics 1700. Prosthodontic treatment choices (repair, removable prosthodontics, fixed prostheses, fibre-reinforced composite fixed prostheses) vary by age; the older the patient, the rarer fixed or fibre-reinforced composite fixed prostheses and removable prostheses and the more frequent repairs (P < 0.001). Denture repair was virtually the only treatment that patients over 90 years received. Based on our results, the age at which prosthodontic treatment practices in PDS change is around 70 years. Beyond this age, fixed prosthodontic treatment modalities are very rare and repairs are more common.

  13. Frequency of Dental Caries in Four Historical Populations from the Chalcolithic to the Middle Ages

    PubMed Central

    Grimoud, A.-M.; Lucas, S.; Sevin, A.; Georges, P.; Passarrius, O.; Duranthon, F.

    2011-01-01

    The majority of dental carie studies over the course of historical period underline mainly the prevalence evolution, the role of carbohydrates consumption and the impact of access to dietary resources. The purpose of the present investigation was to compare population samples from two archaeological periods the Chacolithic and Middle Age taking into account the geographical and socio economical situation. The study concerned four archaelogical sites in south west France and population samples an inlander for the Chalcolithic Age, an inlander, an costal and urban for the Middle Age. The materials studied included a total of 127 maxillaries, 103 mandibles and 3316 teeth. Data recorded allowed us to display that the Chalcolithic population sample had the lowest carie percentage and the rural inlander population samples of Middle Age the highest; in all cases molars were teeth most often affected. These ones differences could be explained according to time period, carious lesions were usually less recorded in the Chalcolithic Age than the Middle because of a lesser cultivation of cereals like in les Treilles Chacolithic population sample. In the Middle Age population samples, the rural inland sample Marsan showed the highest frequency of caries and ate more cereal than the coastal Vilarnau and the poor urban St Michel population samples, the first one ate fish and Mediterranean vegetal and fruits and the second one met difficulties to food access, in both cases the consumption of carbohydrates was lesser than Marsan population sample who lived in a geographical land convice to cereals cultivation. PMID:22145000

  14. Cost comparison of mechanically ventilated patients across the age span

    PubMed Central

    Hayman, William R.; Leuthner, Steven R.; Laventhal, Naomi T.; Brousseau, David; Lagatta, Joanne M.

    2016-01-01

    Objective to compare use of mechanical ventilation and hospital costs across ventilated patients of all ages, preterm through adults, in a nationally-representative sample. Study Design secondary analysis of the 2009 Agency for Healthcare Research and Quality National Inpatient Sample. Results 1,107,563 (2.8%) patients received mechanical ventilation. For surviving ventilated patients, median costs for infants ≤32 weeks’ gestation were $51,000–$209,000, whereas median costs for older patients were lower, from $17,000–$25,000. For non-surviving ventilated patients, median costs were $27,000–$39,000 except at the extremes of age; the median cost was $10,000 for <24 week newborns, and $14,000 for 91+ year adults. Newborns of all gestational ages had a disproportionate share of hospital costs relative to their total volume. Conclusions Most ICU resources at the extremes of age are not directed toward non-surviving patients. From a perinatal perspective, attention should be directed toward improving outcomes and reducing costs for all infants, not just at the earliest gestational ages. PMID:26468935

  15. Existing General Population Models Inaccurately Predict Lung Cancer Risk in Patients Referred for Surgical Evaluation

    PubMed Central

    Isbell, James M.; Deppen, Stephen; Putnam, Joe B.; Nesbitt, Jonathan C.; Lambright, Eric S.; Dawes, Aaron; Massion, Pierre P.; Speroff, Theodore; Jones, David R.; Grogan, Eric L.

    2013-01-01

    Background atients undergoing resections for suspicious pulmonary lesions have a 9-55% benign rate. Validated prediction models exist to estimate the probability of malignancy in a general population and current practice guidelines recommend their use. We evaluated these models in a surgical population to determine the accuracy of existing models to predict benign or malignant disease. Methods We conducted a retrospective review of our thoracic surgery quality improvement database (2005-2008) to identify patients who underwent resection of a pulmonary lesion. Patients were stratified into subgroups based on age, smoking status and fluorodeoxyglucose positron emission tomography (PET) results. The probability of malignancy was calculated for each patient using the Mayo and SPN prediction models. Receiver operating characteristic (ROC) and calibration curves were used to measure model performance. Results 89 patients met selection criteria; 73% were malignant. Patients with preoperative PET scans were divided into 4 subgroups based on age, smoking history and nodule PET avidity. Older smokers with PET-avid lesions had a 90% malignancy rate. Patients with PET- non-avid lesions, or PET-avid lesions with age<50 years or never smokers of any age had a 62% malignancy rate. The area under the ROC curve for the Mayo and SPN models was 0.79 and 0.80, respectively; however, the models were poorly calibrated (p<0.001). Conclusions Despite improvements in diagnostic and imaging techniques, current general population models do not accurately predict lung cancer among patients ref erred for surgical evaluation. Prediction models with greater accuracy are needed to identify patients with benign disease to reduce non-therapeutic resections. PMID:21172518

  16. Relationship of Tooth Wear to Chronological Age among Indigenous Amazon Populations

    PubMed Central

    Vieira, Elma Pinto; Barbosa, Mayara Silva; Quintão, Cátia Cardoso Abdo; Normando, David

    2015-01-01

    In indigenous populations, age can be estimated based on family structure and physical examination. However, the accuracy of such methods is questionable. The aim of this cross-sectional study was to evaluate occlusal tooth wear related to estimated age in the remote indigenous populations of the Xingu River, Amazon. Two hundred and twenty three semi-isolated indigenous subjects with permanent dentition from the Arara (n = 117), Xicrin-Kayapó (n = 60) and Assurini (n = 46) villages were examined. The control group consisted of 40 non-indigenous individuals living in an urban area in the Amazon basin (Belem). A modified tooth wear index was applied and then associated with chronological age by linear regression analysis. A strong association was found between tooth wear and chronological age in the indigenous populations (p <0.001). Tooth wear measurements were able to explain 86% of the variation in the ages of the Arara sample, 70% of the Xicrin-Kaiapó sample and 65% of the Assurini sample. In the urban control sample, only 12% of ages could be determined by tooth wear. These findings suggest that tooth wear is a poor estimator of chronological age in the urban population; however, it has a strong association with age for the more remote indigenous populations. Consequently, these findings suggest that a simple tooth wear evaluation method, as described and applied in this study, can be used to provide a straightforward and efficient means to assist in age determination of newly contacted indigenous groups. PMID:25602501

  17. Relationship of tooth wear to chronological age among indigenous Amazon populations.

    PubMed

    Vieira, Elma Pinto; Barbosa, Mayara Silva; Quintão, Cátia Cardoso Abdo; Normando, David

    2015-01-01

    In indigenous populations, age can be estimated based on family structure and physical examination. However, the accuracy of such methods is questionable. The aim of this cross-sectional study was to evaluate occlusal tooth wear related to estimated age in the remote indigenous populations of the Xingu River, Amazon. Two hundred and twenty three semi-isolated indigenous subjects with permanent dentition from the Arara (n = 117), Xicrin-Kayapó (n = 60) and Assurini (n = 46) villages were examined. The control group consisted of 40 non-indigenous individuals living in an urban area in the Amazon basin (Belem). A modified tooth wear index was applied and then associated with chronological age by linear regression analysis. A strong association was found between tooth wear and chronological age in the indigenous populations (p <0.001). Tooth wear measurements were able to explain 86% of the variation in the ages of the Arara sample, 70% of the Xicrin-Kaiapó sample and 65% of the Assurini sample. In the urban control sample, only 12% of ages could be determined by tooth wear. These findings suggest that tooth wear is a poor estimator of chronological age in the urban population; however, it has a strong association with age for the more remote indigenous populations. Consequently, these findings suggest that a simple tooth wear evaluation method, as described and applied in this study, can be used to provide a straightforward and efficient means to assist in age determination of newly contacted indigenous groups. PMID:25602501

  18. Therapeutic Strategies to Treat Dry Eye in an Aging Population

    PubMed Central

    Ezuddin, Nisreen S.; Alawa, Karam A.; Galor, Anat

    2015-01-01

    Dry eye (DE) is a prevalent ocular disease that primarily affects the elderly. Affecting up to 30% of adults aged 50 years and older, dry eye affects both visual function and quality of life. Symptoms of dry eye which include ocular pain (aching, burning), visual disturbances, and tearing can be addressed with therapeutic agents that target dysfunction of the meibomian glands, lacrimal glands, goblet cells, ocular surface and/or neural network. This review provides an overview of the efficacy, use, and limitations of current therapeutic interventions being used to treat DE. PMID:26123947

  19. Noncarious dental "abfraction" lesions in an aging population.

    PubMed

    Owens, B M; Gallien, G S

    1995-06-01

    A new classification for noncarious dental lesions has evolved from the dental literature. The name given to these lesions, dental "abfractions," is a theory propounding tooth fatigue, flexure, and deformation through biomechanical loading of tooth structure, primarily at the cervical regions of the dentition. These lesions are typically wedge shaped with sharp line angles, but occlusal abfractions have been observed as circular invaginations. Dental abfractions can occur alone and are sometimes associated with toothbrush abrasion and erosion from endogenous or exogenous acids. Treatment consists of the application of composite resin or glass-ionomer cement restorations and/or the discontinuance of the etiology of these lesions. If esthetics are not a primary concern of the patient and the tooth is not structurally compromised, many of these lesions can be observed, provided that the patient is informed that bruxism or malocclusion problems exist.

  20. Population Aging and the Determinants of Healthcare Expenditures: The Case of Hospital, Medical and Pharmaceutical Care in British Columbia, 1996 to 2006

    PubMed Central

    Cunningham, Colleen

    2011-01-01

    There is a gap between rhetoric and reality concerning healthcare expenditures and population aging: although decades-old research suggests otherwise, there is widespread belief that the sustainability of the healthcare system is under serious threat owing to population aging. To shed new empirical light on this old debate, we used population-based administrative data to quantify recent trends and determinants of expenditure on hospital, medical and pharmaceutical care in British Columbia. We modelled changes in inflation-adjusted expenditure per capita between 1996 and 2006 as a function of two demographic factors (population aging and changes in age-specific mortality rates) and three non-demographic factors (age-specific rates of use of care, quantities of care per user and inflation-adjusted costs per unit of care). We found that population aging contributed less than 1% per year to spending on medical, hospital and pharmaceutical care. Moreover, changes in age-specific mortality rates actually reduced hospital expenditure by —0.3% per year. Based on forecasts through 2036, we found that the future effects of population aging on healthcare spending will continue to be small. We therefore conclude that population aging has exerted, and will continue to exert, only modest pressures on medical, hospital and pharmaceutical costs in Canada. As indicated by the specific non-demographic cost drivers computed in our study, the critical determinants of expenditure on healthcare stem from non-demographic factors over which practitioners, policy makers and patients have discretion. PMID:22851987

  1. Gut Bifidobacteria Populations in Human Health and Aging

    PubMed Central

    Arboleya, Silvia; Watkins, Claire; Stanton, Catherine; Ross, R. Paul

    2016-01-01

    The intestinal microbiota has increasingly been shown to have a vital role in various aspects of human health. Indeed, several studies have linked alterations in the gut microbiota with the development of different diseases. Among the vast gut bacterial community, Bifidobacterium is a genus which dominates the intestine of healthy breast-fed infants whereas in adulthood the levels are lower but relatively stable. The presence of different species of bifidobacteria changes with age, from childhood to old age. Bifidobacterium longum, B. breve, and B. bifidum are generally dominant in infants, whereas B. catenulatum, B. adolescentis and, as well as B. longum are more prevalent in adults. Increasingly, evidence is accumulating which shows beneficial effects of supplementation with bifidobacteria for the improvement of human health conditions ranging from protection against infection to different extra- and intra-intestinal positive effects. Moreover, bifidobacteria have been associated with the production of a number of potentially health promoting metabolites including short chain fatty acids, conjugated linoleic acid and bacteriocins. The aim of this mini-review is to describe the bifidobacteria compositional changes associated with different stages in life, highlighting their beneficial role, as well as their presence or absence in many disease states.

  2. Gut Bifidobacteria Populations in Human Health and Aging

    PubMed Central

    Arboleya, Silvia; Watkins, Claire; Stanton, Catherine; Ross, R. Paul

    2016-01-01

    The intestinal microbiota has increasingly been shown to have a vital role in various aspects of human health. Indeed, several studies have linked alterations in the gut microbiota with the development of different diseases. Among the vast gut bacterial community, Bifidobacterium is a genus which dominates the intestine of healthy breast-fed infants whereas in adulthood the levels are lower but relatively stable. The presence of different species of bifidobacteria changes with age, from childhood to old age. Bifidobacterium longum, B. breve, and B. bifidum are generally dominant in infants, whereas B. catenulatum, B. adolescentis and, as well as B. longum are more prevalent in adults. Increasingly, evidence is accumulating which shows beneficial effects of supplementation with bifidobacteria for the improvement of human health conditions ranging from protection against infection to different extra- and intra-intestinal positive effects. Moreover, bifidobacteria have been associated with the production of a number of potentially health promoting metabolites including short chain fatty acids, conjugated linoleic acid and bacteriocins. The aim of this mini-review is to describe the bifidobacteria compositional changes associated with different stages in life, highlighting their beneficial role, as well as their presence or absence in many disease states. PMID:27594848

  3. Gut Bifidobacteria Populations in Human Health and Aging.

    PubMed

    Arboleya, Silvia; Watkins, Claire; Stanton, Catherine; Ross, R Paul

    2016-01-01

    The intestinal microbiota has increasingly been shown to have a vital role in various aspects of human health. Indeed, several studies have linked alterations in the gut microbiota with the development of different diseases. Among the vast gut bacterial community, Bifidobacterium is a genus which dominates the intestine of healthy breast-fed infants whereas in adulthood the levels are lower but relatively stable. The presence of different species of bifidobacteria changes with age, from childhood to old age. Bifidobacterium longum, B. breve, and B. bifidum are generally dominant in infants, whereas B. catenulatum, B. adolescentis and, as well as B. longum are more prevalent in adults. Increasingly, evidence is accumulating which shows beneficial effects of supplementation with bifidobacteria for the improvement of human health conditions ranging from protection against infection to different extra- and intra-intestinal positive effects. Moreover, bifidobacteria have been associated with the production of a number of potentially health promoting metabolites including short chain fatty acids, conjugated linoleic acid and bacteriocins. The aim of this mini-review is to describe the bifidobacteria compositional changes associated with different stages in life, highlighting their beneficial role, as well as their presence or absence in many disease states. PMID:27594848

  4. Third mandibular molar radiological development as an indicator of chronological age in a European population.

    PubMed

    De Salvia, Alessandra; Calzetta, Corinne; Orrico, Marco; De Leo, Domenico

    2004-12-01

    Assessing biological age in the youth nearby legal age has always represented a stimulating issue for the Italian forensic scientist as far as he deals with matter of imputability and legal or illegal immigration of uncertain age subjects. Since any method of evaluation should of course be accurate, not invasive, reproducible and, as possible, easily exploitable, radiological investigation of age dependent features is the most appropriate instrument to the purpose. Dental development is slower and delayed compared with skeletal bone one, occurring according to a known, regular pattern from whose evaluation a biological age can be assessed with a reasonably restricted span for a certain radiological image. This is the assumption which inspired since 1941 (Schour e Massler) so many anthropologists and forensic and clinic odontologist in investigating biological age by the study of radiological dental morphology. Demirjian and Goldstein [New systems for dental maturity based on seven and four teeth, Ann. Hum. Biol. 3 (1976) 411-421] obtained no differences between two groups of subjects whose age was extimated by the evaluation of 14 teeth in one case and 7 teeth in another, the last being greatly simpler. Afterwards, Thorson (1991), Mincer et al. [The A.B.F.O. study of third molar development and its use as estimator of chronological age, J. Forensic Sci. 38 (1993) 379], Solari and Abramovitc [The accuracy and precision of third molar development as an indicator of chronological age in Hispanic, J. Forensic Sci. (3) (2002) 531-535] and then Prieto Carrero [Evaluation of Chronological Age Based on Third Molar Development in the Spanish Population, Atti del XIX Congresso IALM, Milano, 2003], developed a method based on the evaluation of the radiological development of the alone third molar, according to Demirjian's schematic definitions of crown and root formation. Eight stages of development of the third molar are defined from the time of mineralization appearance of

  5. Implants for the aged patient: biological, clinical and sociological considerations.

    PubMed

    Bartold, P Mark; Ivanovski, Saso; Darby, Ivan

    2016-10-01

    Until recently, age, particularly old age, was considered a contraindication to the placement of dental implants. However, this was based largely on anecdotal dogma rather than on empirical information. This review considers the biological, clinical and socio-economic implications of implants placed in the aged population. Aging has been shown to have an influence on the biological aspects of soft- and hard-tissue wound healing and tissue remodeling, which may influence the establishment and maintenance of implant integration. However, information to date indicates that age should not be an a priori contraindication for implant placement and there is good evidence to indicate that dental implants can be placed successfully in the elderly with good clinical and socio-economic outcomes. PMID:27501495

  6. Patient barriers to insulin use in multi-ethnic populations.

    PubMed

    Visram, Hasina

    2013-06-01

    Insulin administration is often required in the management of type 2 diabetes mellitus for optimal glycemic control. Despite this, however, many patients are reluctant to initiate insulin treatment. In the general population, there are multiple factors leading to this reluctance including fear of hypoglycemia, needle phobia and weight gain. These barriers are also present in multi-ethnic populations. However, there are several patient barriers that are more prevalent in various ethnic backgrounds that need to be addressed. These barriers include language barriers, poor health literacy, social factors and religious implications. The awareness of these factors as well as potential strategies to help overcome them can lead to the improved management of patients with diabetes from multi-ethnic populations. PMID:24070844

  7. Age, race, diabetes, blood pressure, and mortality among hemodialysis patients.

    PubMed

    Myers, Orrin B; Adams, Christopher; Rohrscheib, Mark R; Servilla, Karen S; Miskulin, Dana; Bedrick, Edward J; Zager, Philip G

    2010-11-01

    Observational studies involving hemodialysis patients suggest a U-shaped relationship between BP and mortality, but the majority of these studies followed large, heterogeneous cohorts. To examine whether age, race, and diabetes status affect the association between systolic BP (SBP; predialysis) and mortality, we studied a cohort of 16,283 incident hemodialysis patients. We constructed a series of multivariate proportional hazards models, adding age and BP to the analyses as cubic polynomial splines to model potential nonlinear relationships with mortality. Overall, low SBP associated with increased mortality, and the association was more pronounced among older patients and those with diabetes. Higher SBP associated with increased mortality among younger patients, regardless of race or diabetes status. We observed a survival advantage for black patients primarily among older patients. Diabetes associated with increased mortality mainly among older patients with low BP. In conclusion, the design of randomized clinical trials to identify optimal BP targets for patients with ESRD should take age and diabetes status into consideration.

  8. Estimating Small-area Populations by Age and Sex Using Spatial Interpolation and Statistical Inference Methods

    SciTech Connect

    Qai, Qiang; Rushton, Gerald; Bhaduri, Budhendra L; Bright, Eddie A; Coleman, Phil R

    2006-01-01

    The objective of this research is to compute population estimates by age and sex for small areas whose boundaries are different from those for which the population counts were made. In our approach, population surfaces and age-sex proportion surfaces are separately estimated. Age-sex population estimates for small areas and their confidence intervals are then computed using a binomial model with the two surfaces as inputs. The approach was implemented for Iowa using a 90 m resolution population grid (LandScan USA) and U.S. Census 2000 population. Three spatial interpolation methods, the areal weighting (AW) method, the ordinary kriging (OK) method, and a modification of the pycnophylactic method, were used on Census Tract populations to estimate the age-sex proportion surfaces. To verify the model, age-sex population estimates were computed for paired Block Groups that straddled Census Tracts and therefore were spatially misaligned with them. The pycnophylactic method and the OK method were more accurate than the AW method. The approach is general and can be used to estimate subgroup-count types of variables from information in existing administrative areas for custom-defined areas used as the spatial basis of support in other applications.

  9. The Incidence Rate and Economic Burden of Community-Acquired Pneumonia in a Working-Age Population

    PubMed Central

    Broulette, Jonah; Yu, Holly; Pyenson, Bruce; Iwasaki, Kosuke; Sato, Reiko

    2013-01-01

    Background Community-acquired pneumonia (CAP) is frequently associated with the very young and the elderly but is a largely underrecognized burden among working-age adults. Although the burden of CAP among the elderly has been established, there are limited data on the economic burden of CAP in the employed population. Objective To assess the economic impact of CAP in US working-age adults from an employer perspective by estimating the incidence rate and costs of healthcare, sick time, and short-term disability for this patient population. Methods This retrospective cohort study is based on data from 2 Truven Health Analytics databases. The study population consisted of commercially insured active employees aged 18 to 64 years, early retirees aged <65 years, and adult dependents of both cohorts. CAP was identified using medical claims with pneumonia diagnosis codes during the 2009 calendar year. Incidence rate, episode level, and annual costs were stratified by age and by risk based on the presence of comorbidities. Descriptive statistics were used to compare healthcare (ie, medical and pharmacy) costs, sick time, and short-term disability costs between the cohorts with and without CAP. Linear regression was used to estimate the average annual incremental healthcare cost in employed patients with inpatient or outpatient CAP versus individuals without CAP. Results Study eligibility was met by 12,502,017 employed individuals, including 123,920 with CAP and 12,378,097 without CAP; the overall incidence rate of CAP was 10.6 per 1000 person-years. Among individuals with and without CAP, the costs of healthcare, sick time, and short-term disability increased with advancing age and with higher risk status. The mean annual healthcare costs were $20,961 for patients with CAP and $3783 for individuals without CAP. Overall, the mean costs of sick time and short-term disability were $1129 and $1016, respectively, in active employees with CAP, and $853 and $322, respectively

  10. Anti-aging medicine: a patient/practitioner movement to redefine aging.

    PubMed

    Mykytyn, Courtney Everts

    2006-02-01

    Having enjoyed tremendous growth for the past 5 years, the anti-aging medicine movement is redefining aging so that it becomes a target for biomedical intervention. Targeting aging for intervention dislodges popular understandings of aging: for anti-aging practitioners it no longer matters if aging is natural since it can be itself the target of therapy. So-called "age-associated" diseases like cancer are, in this framework, conceived of as symptoms of aging. Anti-aging medicine is a broad term that may comprise groups selling remedies over the Internet, companies touting the "anti-aging"ness of their products, practitioners who work outside of scientific medicine, and practitioners of anti-aging medicine in clinics who believe that their work is strictly scientific. This article, drawing from more than 3 years of ethnographic interviews, participant observation in clinics and conferences, and a review of the literature, considers the last group. It examines the involvement stories of anti-aging medicine practitioners in two Western United States metropolitan cities. These stories reflect the practices of anti-aging medicine practitioners and the accompanying rationale for involvement. Often originally patients themselves, practitioners frame their involvement with the anti-aging movement in three ways. First, they describe aging as it is currently experienced as a time of decline, suffering, and weakness. This anguish is not inevitable, they argue, and their work toward treating aging biomedically is situated as clearly moral. Secondly, intense frustration with the current biomedical environment has motivated practitioners to look for other ways in which to practice: anti-aging medicine is their chosen alternative. Finally, with dramatic expectations of future biotechnologies and disdain for current medical treatments of old age, anti-aging practitioners embrace a scientific revolutionary identity. These stories of migrations from patient to practitioner reveal

  11. The tight subgiant branch of the intermediate-age star cluster NGC 411 implies a single-aged stellar population

    NASA Astrophysics Data System (ADS)

    Li, C.; de Grijs, R.; Bastian, N.; Deng, L.; Niederhofer, F.; Zhang, C.

    2016-09-01

    The presence of extended main-sequence turn-off (eMSTO) regions in intermediate-age star clusters in the Large and Small Magellanic Clouds is often interpreted as resulting from extended star formation histories (SFHs), lasting ≥300 Myr. This strongly conflicts with the traditional view of the dominant star formation mode in stellar clusters, which are thought of as single-aged stellar populations. Here we present a test of this interpretation by exploring the morphology of the subgiant branch (SGB) of NGC 411, which hosts possibly the most extended eMSTO among all known intermediate-age star clusters. We show that the width of the NGC 411 SGB favours the single-aged stellar population interpretation and rules out an extended SFH. In addition, when considering the red clump (RC) morphology and adopting the unproven premise that the widths of all features in the colour-magnitude diagram are determined by an underlying range in ages, we find that the SFH implied is still very close to that resulting from a single-aged stellar population, with a minor fraction of stars scattering to younger ages compared with the bulk of the population. The SFHs derived from the SGB and RC are both inconsistent with the SFH derived from the eMSTO region. NGC 411 has a very low escape velocity and it has unlikely undergone significant mass-loss at an early stage, thus indicating that it may lack the capacity to capture most of its initial, expelled gas from stellar evolutionary processes, a condition often required for extended SFHs to take root.

  12. Lung cancer in patients under the age of 40 years

    PubMed Central

    Kaczmarczyk, Grzegorz; Porębska, Irena; Szmygin-Milanowska, Katarzyna; Gołecki, Marcin

    2012-01-01

    Aim of the study In the paper clinical cases of individuals diagnosed with lung cancer below the age of 40 years have been analyzed. Material and methods The analysis included: sex, age, clinical symptoms found before and at the moment of diagnosis, character of changes visible in radiological imaging, time that passed from the first symptoms to reporting to a doctor and to establishing a diagnosis, type of diagnostic method used in establishing the final diagnosis, histopathologic type of cancer, degree of cancer progression. Results The results have been compared with a peer group who had been diagnosed 20 years earlier. Currently 7% of patients were diagnosed at the age of 25 or younger, whereas in the previous cohort patients in this age constituted 2%. The predominant pathological type was adenocarcinoma (currently 33%, previously 4%) in contrast to the earlier group in which 57% of patients had small cell lung cancer (57%). The incidence is equally distributed between both sexes, although there is an evident increase in female lung cancer cases. In the majority of patients the clinical presentation is a peripheral mass on chest X-ray. 20% of patients present pleural effusion on diagnosis. Patients reported the following complaints: breathlessness, chest pain, weight loss and fatigue. The majority of cases were diagnosed in advanced stages on the basis of a bronchoscopy acquired specimen. Time course from symptoms to diagnosis tends to be shorter than 20 years ago. PMID:23788919

  13. Anchoring the Population II Distance Scale: Accurate Ages for Globular Clusters

    NASA Technical Reports Server (NTRS)

    Chaboyer, Brian C.; Chaboyer, Brian C.; Carney, Bruce W.; Latham, David W.; Dunca, Douglas; Grand, Terry; Layden, Andy; Sarajedini, Ataollah; McWilliam, Andrew; Shao, Michael

    2004-01-01

    The metal-poor stars in the halo of the Milky Way galaxy were among the first objects formed in our Galaxy. These Population II stars are the oldest objects in the universe whose ages can be accurately determined. Age determinations for these stars allow us to set a firm lower limit, to the age of the universe and to probe the early formation history of the Milky Way. The age of the universe determined from studies of Population II stars may be compared to the expansion age of the universe and used to constrain cosmological models. The largest uncertainty in estimates for the ages of stars in our halo is due to the uncertainty in the distance scale to Population II objects. We propose to obtain accurate parallaxes to a number of Population II objects (globular clusters and field stars in the halo) resulting in a significant improvement in the Population II distance scale and greatly reducing the uncertainty in the estimated ages of the oldest stars in our galaxy. At the present time, the oldest stars are estimated to be 12.8 Gyr old, with an uncertainty of approx. 15%. The SIM observations obtained by this key project, combined with the supporting theoretical research and ground based observations outlined in this proposal will reduce the estimated uncertainty in the age estimates to 5%).

  14. Nutrition and Aging: Assessment and Treatment of Compromised Nutritional Status in Frail Elderly Patients

    PubMed Central

    Wells, Jennie L; Dumbrell, Andrea C

    2006-01-01

    Nutrition is an important determinant of health in persons over the age of 65. Malnutrition in the elderly is often underdiagnosed. Careful nutritional assessment is necessary for both the successful diagnosis and development of comprehensive treatment plans for malnutrition in this population. The purpose of this article is to provide clinicians with an educational overview of this essential but often underecognized aspect of geriatric assessment. This article will review some common issues in nutrition for the elderly in both hospital and community settings. The complexity and impact of multiple comorbidities on the successful nutritional assessment of elderly patients is highlighted by using case scenarios to discuss nutritional issues common to elderly patients and nutritional assessment tools. Three case studies provide some context for an overview of these issues, which include the physiology of aging, weight loss, protein undernutrition, impaired cognition, malnutrition during hospitalization, screening procedures, and general dietary recommendations for patients 65 years of age and older. PMID:18047259

  15. Epigenome-Wide Scans Identify Differentially Methylated Regions for Age and Age-Related Phenotypes in a Healthy Ageing Population

    PubMed Central

    Yang, Tsun-Po; Pidsley, Ruth; Nisbet, James; Glass, Daniel; Mangino, Massimo; Zhai, Guangju; Zhang, Feng; Valdes, Ana; Shin, So-Youn; Dempster, Emma L.; Murray, Robin M.; Grundberg, Elin; Hedman, Asa K.; Nica, Alexandra; Small, Kerrin S.; Dermitzakis, Emmanouil T.; McCarthy, Mark I.; Mill, Jonathan; Spector, Tim D.; Deloukas, Panos

    2012-01-01

    Age-related changes in DNA methylation have been implicated in cellular senescence and longevity, yet the causes and functional consequences of these variants remain unclear. To elucidate the role of age-related epigenetic changes in healthy ageing and potential longevity, we tested for association between whole-blood DNA methylation patterns in 172 female twins aged 32 to 80 with age and age-related phenotypes. Twin-based DNA methylation levels at 26,690 CpG-sites showed evidence for mean genome-wide heritability of 18%, which was supported by the identification of 1,537 CpG-sites with methylation QTLs in cis at FDR 5%. We performed genome-wide analyses to discover differentially methylated regions (DMRs) for sixteen age-related phenotypes (ap-DMRs) and chronological age (a-DMRs). Epigenome-wide association scans (EWAS) identified age-related phenotype DMRs (ap-DMRs) associated with LDL (STAT5A), lung function (WT1), and maternal longevity (ARL4A, TBX20). In contrast, EWAS for chronological age identified hundreds of predominantly hyper-methylated age DMRs (490 a-DMRs at FDR 5%), of which only one (TBX20) was also associated with an age-related phenotype. Therefore, the majority of age-related changes in DNA methylation are not associated with phenotypic measures of healthy ageing in later life. We replicated a large proportion of a-DMRs in a sample of 44 younger adult MZ twins aged 20 to 61, suggesting that a-DMRs may initiate at an earlier age. We next explored potential genetic and environmental mechanisms underlying a-DMRs and ap-DMRs. Genome-wide overlap across cis-meQTLs, genotype-phenotype associations, and EWAS ap-DMRs identified CpG-sites that had cis-meQTLs with evidence for genotype–phenotype association, where the CpG-site was also an ap-DMR for the same phenotype. Monozygotic twin methylation difference analyses identified one potential environmentally-mediated ap-DMR associated with total cholesterol and LDL (CSMD1). Our results suggest that in a

  16. Remaining teeth, oral dryness and dental health habits in middle-aged Norwegian rheumatoid arthritis patients.

    PubMed

    Arneberg, P; Bjertness, E; Storhaug, K; Glennås, A; Bjerkhoel, F

    1992-10-01

    The aim of the study was to assess the effect of rheumatoid arthritis (RA) upon dental health. A questionnaire was mailed to all seropositive rheumatoid arthritis (RA) patients aged 44-56 yr in the files of the two main departments of rheumatology in South Eastern Norway. Data were obtained from 125 patients, constituting 91% of the target group. The number of remaining teeth in these patients was not related to disease duration or physical dysfunction, whereas a relationship to prolonged use of medication for pain relief was indicated. Factors known to affect tooth loss in the general population, such as smoking habits, dental attendance, interdental cleaning habits, previous dental disease, and place of residence were found to be important in RA patients as well. The RA patients from Oslo had a mean number of 25 remaining teeth, which is the same as reported for the general Oslo population at this age. Oral dryness was reported by more than 50% of the RA patients, but was not related to the number of teeth. The conclusion is that serious and long lasting rheumatoid arthritis had little influence on the number of remaining teeth in this middle-aged group of Norwegians. PMID:1424551

  17. Advancing Telemedicine Services for the Aging Population: The challenge of Interoperability.

    PubMed

    van Velsen, Lex; Solana, Javier; Oude-Nijeweme D'Hollosy, Wendy; Garate-Barreiro, Francisco; Vollenbroek-Hutten, Miriam

    2015-01-01

    We reflect on our experiences in two projects in which we developed interoperable telemedicine applications for the aging population. While technically data exchange could be implemented technically, uptake was impeded by a lack of working procedures. We argue that development of interoperable health technology for the aging population should go accompanied by a thorough study into working protocols by consulting all end-users and stakeholders.

  18. AGE AND GENDER DIFFERENCES IN ACUTE STROKE HOSPITAL PATIENTS.

    PubMed

    Kes, Vanja Bašić; Jurašić, Miljenka-Jelena; Zavoreo, Iris; Lisak, Marijana; Jelec, Vjekoslav; Matovina, Lucija Zadro

    2016-03-01

    Stroke is the second leading cause of death and the most important cause of adult disability worldwide and in Croatia. In the past, stroke was almost exclusively considered to be a disease of the elderly; however, today the age limit has considerably lowered towards younger age. The aim of this study was to determine age and gender impact on stroke patients in a Croatian urban area during one-year survey. The study included all acute stroke patients admitted to our Department in 2004. A compiled stroke questionnaire was fulfilled during hospitalization by medical personnel on the following items: stroke risk factors including lifestyle habits (smoking and alcohol), pre-stroke physical ability evaluation, stroke evolution data, laboratory and computed tomography findings, outcome data and post-stroke disability assessment. Appropriate statistical analysis of numerical and categorical data was performed at the level of p < 0.05. Analysis was performed on 396 patients, 24 of them from the younger adult stroke group. Older stroke patients had worse disability at hospital discharge and women had worse disabilities at both stroke onset and hospital discharge, probably due to older age at stroke onset. Younger patients recovered better, while older patients had to seek secondary medical facilities more often, as expected. The most important in-hospital laboratory findings in young stroke patients were elevated lipid levels, while older patients had elevated serum glucose and C-reactive protein. Stroke onset in younger patients most often presented with sudden onset headache; additionally, onset seizure was observed more frequently than expected. Stroke risk factor analysis showed that women were more prone to hypertension, chronic heart failure and atrial fibrillation, whereas men had carotid disease more frequently, were more often smokers and had higher alcohol intake. Additionally, age analysis showed that heart conditions and smoking were more prevalent among older

  19. Comparison of age-related changes in anti-Müllerian hormone levels and other ovarian reserve tests between healthy fertile and infertile population.

    PubMed

    Bozkurt, Banu; Erdem, Mehmet; Mutlu, Mehmet Firat; Erdem, Ahmet; Guler, Ismail; Mutlu, Ilknur; Oktem, Mesut

    2016-09-01

    In this study, we aimed to determine whether anti-Müllerian hormone (AMH) levels vary between fertile and infertile populations and compare them with basal follicle-stimulating hormone (FSH) levels and antral follicle count (AFC). This was a prospective study that included 177 primarily infertile patients who underwent IVF treatment and 162 healthy fertile patients admitted to our clinic for benign diseases. FSH and AMH levels and the AFC of the infertile and fertile populations were compared between the age categories <30, 30-39 and ≥40. Correlations between AMH, basal FSH, and AFC with age were evaluated. AFC and AMH levels did not differ between the fertile and infertile groups in all age categories. AMH was inversely correlated with age in both the fertile and infertile populations. However, AFC revealed a stronger correlation with age in both the fertile and infertile populations compared with basal FSH and AMH. Age was positively correlated with basal FSH and inversely correlated with AMH and AFC. In conclusion, there was no significant difference between the fertile and infertile populations in terms of AMH or AFC. The decrease in ovarian reserve in infertile patients is directly related to age, not infertility.

  20. Pharmacotherapy in the ageing patient: The impact of age per se (A review).

    PubMed

    Singh, Shamsher; Bajorek, Beata

    2015-11-01

    A literature search was carried out to review the influence of 'ageing' on pharmacotherapeutic decision-making, specifically how 'age' is defined and considered in the utilisation of medication. Embase, Medline, International Pharmaceutical Abstracts, and Google scholar were canvassed in a three-tiered search according to pre-established inclusion criteria. In tier 1, a total of 22 studies were identified highlighting the underutilisation of medication in elderly patients, with a particular focus on warfarin. Four studies highlighted an age-bias in medication-prescribing for elderly patients, specifically in relation to medicines for rheumatoid arthritis, angina, and hypertension. Tier 2 identified diverse definitions for 'elderly', including biological age, chronological age, physiological age, as well as various descriptions of 'elderly' in clinical trials and guidelines. Finally, medication optimisation tools were identified through the third tier, emphasising the use of chronological age to describe the 'elderly'. Old age influences pharmacotherapeutic decision-making at various levels, however, what complicates the situation is the absence of a comprehensive definition of 'elderly'. Clinical recommendations need to be based more on objective factors known to affect medication effectiveness and safety.

  1. Acute promyelocytic leukemia in patients aged >70 years: the cure beyond the age.

    PubMed

    Finsinger, Paola; Breccia, Massimo; Minotti, Clara; Carmosino, Ida; Girmenia, Corrado; Chisini, Marta; Volpicelli, Paola; Vozella, Federico; Romano, Angela; Montagna, Chiara; Colafigli, Gioia; Cimino, Giuseppe; Avvisati, Giuseppe; Petti, Maria Concetta; Lo-Coco, Francesco; Foà, Roberto; Latagliata, Roberto

    2015-02-01

    All-trans retinoic acid (ATRA) has made acute promyelocytic leukemia (APL) a very curable disease also in patients aged >60 years; however, there are only few case reports in very elderly APL patients. To address this issue, we reviewed treatment results in 13 patients aged >70 years with newly diagnosed APL followed at our institution from January 1991 to December 2008. According to Sanz score, seven patients were at low risk, five at intermediate risk, and one at high risk. Induction therapy consisted of ATRA + idarubicin in nine patients (3/9 with reduced idarubicin dosage) and ATRA alone in four patients; in this latter group, however, 2/4 needed to add chemotherapy (CHT) due to hyperleukocytosis during ATRA treatment. All patients achieved both morphological and molecular complete remission (CR) after a median time of 51 [interquartile range (IR) 43-55] and 114 (IR 74-155) days, respectively. Infective complications were observed in 10/13 patients, APL differentiation syndrome in 3/13 patients. Twelve patients received consolidation therapy, followed by maintenance treatment in nine patients. Five patients relapsed after 7, 8, 11, 35, and 56 months. At present, seven patients are still alive, five died due to disease progression (four) or senectus while in CR (one), and one was lost to follow-up while in CR. The 5-year event-free survival was 56.1 % (95 % CI, 26.0-86.2); the 5-year overall survival (OS) was 64.5 % (95 % CI, 35.6-93.4). ATRA-based treatment of APL is safe and effective also in very elderly patients, with long-lasting disease-free OS. PMID:25186786

  2. Age at breast cancer diagnosis in populations of african and European ancestry.

    PubMed

    Kadhel, Philippe; Multigner, Luc

    2014-01-01

    Based on US national cancer registry data, age differences at breast cancer diagnosis have been reported between African-American women and European-American women. Such differences between populations of African and European ancestry have not been studied in other countries at a nationwide level. Here, we report and compare descriptive nationwide epidemiological indicators of invasive breast cancer for the populations of European ancestry living in the US and in mainland France and for women of African ancestry living in the US and in the French West Indies (Martinique and Guadeloupe). Based on the available data, we determined age frequency distributions, world age-standardized incidence, and the distribution of expected cases of breast cancer in a standard population of women by age. The age frequency distributions revealed that women of African ancestry were younger at diagnosis than women of European ancestry. By contrast, compared with the US regardless of ancestry and mainland France, the standardized incidences appeared lower, and the largest numbers of expected cases younger, in the French West Indies. The populations with African ancestry were not homogeneous in terms of epidemiologic indicators of age-related breast cancer. These descriptive findings suggest that populations of African ancestry cannot be considered uniform when determining whether it would be appropriate to decrease the age of entry into screening programs for breast cancer.

  3. Crisis Model for Older Adults: Special Considerations for an Aging Population

    ERIC Educational Resources Information Center

    Jungers, Christin M.; Slagel, Leslie

    2009-01-01

    As the U.S. population ages, counselors must begin structuring their interactions to meet the unique needs of older adults, especially in the area of crisis intervention. The purposes of this article are to draw attention to the rapidly growing, often disregarded older population and to introduce the Crisis Model for Older Adults (CM-OA), an…

  4. Population Aging in Australia: Implications for Social and Economic Policy. Number 98.

    ERIC Educational Resources Information Center

    Hugo, Graeme

    This report begins by recognizing that Australia's recent immigration, fertility, and mortality trends have resulted in a rapid increase not only in the numbers of older Australians but also in their proportion of the total population. After briefly reviewing the contemporary demographic aging of Australia's population and its likely course over…

  5. Alcohol Habits in Patients with Long-Term Musculoskeletal Pain: Comparison with a Matched Control Group from the General Population

    ERIC Educational Resources Information Center

    Thelin Bronner, Kerstin Birgitta; Wennberg, Peter; Kallmen, Hakan; Schult, Marie-Louise Birgitta

    2012-01-01

    This prospective study aimed to describe alcohol habits in patients with chronic pain compared with those in a matched control group from the general Swedish population. In total, 100 consecutive patients enrolled were matched against 100 individuals in a control group on the basis of age and sex. Alcohol habits were measured using the Alcohol Use…

  6. Comparison of Statistical Population Reconstruction Using Full and Pooled Adult Age-Class Data

    PubMed Central

    Skalski, John R.; Millspaugh, Joshua J.; Clawson, Michael V.

    2012-01-01

    Background Age-at-harvest data are among the most commonly collected, yet neglected, demographic data gathered by wildlife agencies. Statistical population construction techniques can use this information to estimate the abundance of wild populations over wide geographic areas and concurrently estimate recruitment, harvest, and natural survival rates. Although current reconstruction techniques use full age-class data (0.5, 1.5, 2.5, 3.5, … years), it is not always possible to determine an animal's age due to inaccuracy of the methods, expense, and logistics of sample collection. The ability to inventory wild populations would be greatly expanded if pooled adult age-class data (e.g., 0.5, 1.5, 2.5+ years) could be successfully used in statistical population reconstruction. Methodology/Principal Findings We investigated the performance of statistical population reconstruction models developed to analyze full age-class and pooled adult age-class data. We performed Monte Carlo simulations using a stochastic version of a Leslie matrix model, which generated data over a wide range of abundance levels, harvest rates, and natural survival probabilities, representing medium-to-big game species. Results of full age-class and pooled adult age-class population reconstructions were compared for accuracy and precision. No discernible difference in accuracy was detected, but precision was slightly reduced when using the pooled adult age-class reconstruction. On average, the coefficient of variation increased by 0.059 when the adult age-class data were pooled prior to analyses. The analyses and maximum likelihood model for pooled adult age-class reconstruction are illustrated for a black-tailed deer (Odocoileus hemionus) population in Washington State. Conclusions/Significance Inventorying wild populations is one of the greatest challenges of wildlife agencies. These new statistical population reconstruction models should expand the demographic capabilities of wildlife agencies

  7. Upper Extremity Proprioception in Healthy Aging and Stroke Populations, and the Effects of Therapist- and Robot-Based Rehabilitation Therapies on Proprioceptive Function

    PubMed Central

    Hughes, Charmayne Mary Lee; Tommasino, Paolo; Budhota, Aamani; Campolo, Domenico

    2015-01-01

    The world’s population is aging, with the number of people ages 65 or older expected to surpass 1.5 billion people, or 16% of the global total. As people age, there are notable declines in proprioception due to changes in the central and peripheral nervous systems. Moreover, the risk of stroke increases with age, with approximately two-thirds of stroke-related hospitalizations occurring in people over the age of 65. In this literature review, we first summarize behavioral studies investigating proprioceptive deficits in normally aging older adults and stroke patients, and discuss the differences in proprioceptive function between these populations. We then provide a state of the art review the literature regarding therapist- and robot-based rehabilitation of the upper extremity proprioceptive dysfunction in stroke populations and discuss avenues of future research. PMID:25784872

  8. Dental age assessment validity of radiographic methods on Serbian children population.

    PubMed

    Djukic, Ksenija; Zelic, Ksenija; Milenkovic, Petar; Nedeljkovic, Nenad; Djuric, Marija

    2013-09-10

    In order to establish reliable age estimation method based on dental development, various correlations between chronological age and real growth were tested. Demirjian's scheme was mostly used, but lately the Willems' method has been found to be more reliable. The aim of this study was to evaluate the accuracy of Demirjian's and Willems' methods for dental age estimation in Serbian children population. The study sample encompassed panoramic radiographs of 686 children (322 boys and 364 girls) with age range from 4 to 15 years. The dental age was assed using Demirjian's and Willems' maturity scores. Statistical analysis was performed to test the accuracy of investigated methods by comparing the mean chronological and mean estimated age in total sample, as well as in each group comprising individuals within one-year-age-interval. Both methods showed discrepancy between obtained and chronological age. The Demirjian's method overestimated age with a mean accuracy of 0.45 in boys and 0.42 in girls, while Willems' method showed lower discrepancy (0.12 and 0.16 in boys and girls, respectively). Overall, both methods were unsatisfactory in some age groups, however, Willems' method provided more accurate age estimation in majority of categories. In summary, our results suggest that Willem's method was more accurate for estimating dental age in contemporary Serbian children population. PMID:23835078

  9. Age and gender might influence big five factors of personality: a preliminary report in Indian population.

    PubMed

    Magan, Dipti; Mehta, Manju; Sarvottam, Kumar; Yadav, Raj Kumar; Pandey, R M

    2014-01-01

    Age and gender are two important physiological variables which might influence the personality of an individual. The influence of age and gender on big five personality domains in Indian population was assessed in this cross-sectional study that included 155 subjects (female = 76, male = 79) aged from 16-75 years. Big five personality factors were evaluated using 60-item NEO-Five Factor Inventory (NEO-FFI) at a single point in time. Among the big five factors of personality, Conscientiousness was positively correlated (r = 0.195; P < 0.05) with age in total study population, and retained the significance (P < 0.05) in men only when analyzed by gender subgroups. Further, age and gender sub-group analysis also showed that Neuroticism was inversely correlated with age in women aged 26-35 years (P < 0.05). Neuroticism and Extraversion showed a positive correlation with age in men aged 36-45 years (P < 0.001 and P < 0.05, respectively). Neuroticism was inversely correlated with age in men aged 46-55 years (P < 0.05). This preliminary report suggested that personality traits might change with age, and is gender-dependent.

  10. [The aging of the population: a challenge that goes beyond the year 2000].

    PubMed

    Litvak, J

    1990-07-01

    This report analyzes the causes and characteristics of the aging trend in the world's population, which has been witnessed in recent decades. Measures are proposed for dealing with the health problems that have arisen as a result of this aging trend, as well as for guaranteeing the delivery of full health services to the elderly. PMID:2145854

  11. Obsessive-compulsiveness in a population of tinnitus patients.

    PubMed

    Folmer, Robert L; Griest, Susan E; Martin, William Hal

    2008-01-01

    The purpose of this study was to use the Maudsley Obsessional-Compulsive Inventory (MOCI) to assess obsessive-compulsiveness in a population of 196 tinnitus patients and to correlate MOCI scores with measures of anxiety, depression, and tinnitus severity. Tinnitus severity was positively correlated with measures of anxiety and depression. Depression was positively correlated with MOCI and anxiety scores. MOCI scores exhibited weaker positive correlations with tinnitus severity and anxiety. Effective management of tinnitus requires identification of psychological disorders or symptoms when they are present so that patients can receive appropriate treatment as soon as possible. The MOCI can be used to assess obsessive-compulsiveness in tinnitus patients. PMID:19205163

  12. [Methodological note on subnational population projections by age and sex (author's transl)].

    PubMed

    Itoh, T

    1980-07-01

    The purposes of this paper were to discuss the methods and assumptions on subnational population projections by age and sex, and to present 2 models on population projection for 47 Prefectures in Japan by age and sex up to 2000. Data are obtained from the results of the 1970 and 1975 population censuses of Japan for population by age and sex, and interprefectural migration streams by age and sex based on the 1970 population census. The 2 models are a sort of cohort-component method: 1 is the (NMR) net-migration model and the other is the (MTX) migration matrix model. The essential difference between the 2 is the separate consideration of out- and inmigration models. The formulas for estimating numbers of net migration in the NMR model are (4) and (5) in the text, where P is the number of the population, S is the life table survival ratios, and m is the rate of net migration. The formulas for estimating numbers of outmigration, migration streams from region i to region j, and inmigration, in the MTX model are (17)-(21), where E is the numbers of outmigration, e is the rate of outmigration, m (i,j) is the proportion of the number of migrants from i to j to total numbers of outmigrants from region i, and I is the numbers of inmigration for each region. Under constant conditions, for all rates, the projected population for 47 prefectures by age and sex up to 2000 using models NMR and MTX was obtained. The projected number of population in 2000 are shown in figures on pages 66 and 67. As the results of these projections, the increase in aged population between 1975-200 in the metropolitan areas, especially Tokyo (1), are greater than that in other areas, since the concentration of the young in the 3 metropolitan areas has rapidly dropped since 1950. (Author's modified)

  13. Does breeding population trajectory and age of nesting females influence disparate nestling sex ratios in two populations of Cooper's hawks?

    PubMed

    Rosenfield, Robert N; Stout, William E; Giovanni, Matthew D; Levine, Noah H; Cava, Jenna A; Hardin, Madeline G; Haynes, Taylor G

    2015-09-01

    Offspring sex ratios at the termination of parental care should theoretically be skewed toward the less expensive sex, which in most avian species would be females, the smaller gender. Among birds, however, raptors offer an unusual dynamic because they exhibit reversed size dimorphism with females being larger than males. And thus theory would predict a preponderance of male offspring. Results for raptors and birds in general have been varied although population-level estimates of sex ratios in avian offspring are generally at unity. Adaptive adjustment of sex ratios in avian offspring is difficult to predict perhaps in part due to a lack of life-history details and short-term investigations that cannot account for precision or repeatability of sex ratios across time. We conducted a novel comparative study of sex ratios in nestling Cooper's hawks (Accipiter cooperii) in two study populations across breeding generations during 11 years in Wisconsin, 2001-2011. One breeding population recently colonized metropolitan Milwaukee and exhibited rapidly increasing population growth, while the ex-Milwaukee breeding population was stable. Following life-history trade-off theory and our prediction regarding this socially monogamous species in which reversed sexual size dimorphism is extreme, first-time breeding one-year-old, second-year females in both study populations produced a preponderance of the smaller and cheaper sex, males, whereas ASY (after-second-year), ≥2-year-old females in Milwaukee produced a nestling sex ratio near unity and predictably therefore a greater proportion of females compared to ASY females in ex-Milwaukee who produced a preponderance of males. Adjustment of sex ratios in both study populations occurred at conception. Life histories and selective pressures related to breeding population trajectory in two age cohorts of nesting female Cooper's hawk likely vary, and it is possible that these differences influenced the sex ratios we documented for

  14. Does breeding population trajectory and age of nesting females influence disparate nestling sex ratios in two populations of Cooper's hawks?

    PubMed

    Rosenfield, Robert N; Stout, William E; Giovanni, Matthew D; Levine, Noah H; Cava, Jenna A; Hardin, Madeline G; Haynes, Taylor G

    2015-09-01

    Offspring sex ratios at the termination of parental care should theoretically be skewed toward the less expensive sex, which in most avian species would be females, the smaller gender. Among birds, however, raptors offer an unusual dynamic because they exhibit reversed size dimorphism with females being larger than males. And thus theory would predict a preponderance of male offspring. Results for raptors and birds in general have been varied although population-level estimates of sex ratios in avian offspring are generally at unity. Adaptive adjustment of sex ratios in avian offspring is difficult to predict perhaps in part due to a lack of life-history details and short-term investigations that cannot account for precision or repeatability of sex ratios across time. We conducted a novel comparative study of sex ratios in nestling Cooper's hawks (Accipiter cooperii) in two study populations across breeding generations during 11 years in Wisconsin, 2001-2011. One breeding population recently colonized metropolitan Milwaukee and exhibited rapidly increasing population growth, while the ex-Milwaukee breeding population was stable. Following life-history trade-off theory and our prediction regarding this socially monogamous species in which reversed sexual size dimorphism is extreme, first-time breeding one-year-old, second-year females in both study populations produced a preponderance of the smaller and cheaper sex, males, whereas ASY (after-second-year), ≥2-year-old females in Milwaukee produced a nestling sex ratio near unity and predictably therefore a greater proportion of females compared to ASY females in ex-Milwaukee who produced a preponderance of males. Adjustment of sex ratios in both study populations occurred at conception. Life histories and selective pressures related to breeding population trajectory in two age cohorts of nesting female Cooper's hawk likely vary, and it is possible that these differences influenced the sex ratios we documented for

  15. Menarcheal age in a sample of Basque schoolgirls: a comparative study with other Spanish populations.

    PubMed

    Rebato, E; Rosique, J; González Apraiz, A

    1994-06-01

    Reported data on age at menarche in a sample of Biscayan schoolgirls are compared with data from several Spanish populations. Though the mean age falls in the range of variation of the Spanish means, the analysis of variance shows significant differences among the series. With regard to the possible secular trend of this event in the Biscay province, both a stability of menarcheal age and a diminution of the process of variability are observed.

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

    PubMed

    Wikan, Arild

    2012-06-01

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

  17. The relationship between health expenditures and the age structure of the population in OECD countries.

    PubMed

    O'Connell, J M

    1996-01-01

    The purpose of this study was to analyse national health expenditures of OECD countries relative to their age structures. Using econometric techniques designed to analyse cross-sectional time series data, the ageing of the population was found to affect health spending in several countries while having no effect in others. In addition, the effect of income on health spending was lower than that generally reported in the literature. These findings suggest that unobserved country-specific factors play a major role in determining the amount of resources allocated to health services in a country. Such factors also determine if the ageing of the population with increased health spending.

  18. Dental age estimation from the developmental stage of the third molars in western Chinese population.

    PubMed

    Li, Guo; Ren, Jiayin; Zhao, Shuping; Liu, Yuanyuan; Li, Na; Wu, Wanhong; Yuan, Shanshan; Wang, Hu

    2012-06-10

    The purpose of this study is to provide reference data about estimating dental age from third molars of the western Chinese population for comparing with other populations and being applied to the age estimation of western Chinese juveniles and adolescents. A total of 2078 digital panoramic radiographs of 989 male and 1089 female Chinese subjects aged between 5 and 23 years were examined. The mineralization status of the third molars was assessed using the formation stages described by Demirjian et al. with two modifications. The results showed that the development of third molars in the western Chinese population was likely to begin at age 5 in both males and females. The third molars 28 and 48 showed significantly higher frequency in females than in males. The third molars 18 in the stage 1, 38 in the stages 1, A and G, and 48 in the stage H showed significantly older average age in females than in males. The Demirjian's stages C and D could be used as a reference stage to determine dichotomously whether a western Chinese is more likely to be under or above age 14 or 16, respectively. This study provided reference data for the age estimation of western Chinese juveniles and adolescents by the mineralization stages of the third molar. Apart from forensic age determination in living subjects, the presented reference data can also be used for age estimations of unidentified corpses and skeletons.

  19. Letter report: Population estimates by age, sex and race for 10-county study area

    SciTech Connect

    Pittenger, D B

    1992-02-01

    The Hanford Environmental Does Reconstruction (HEDR) Project was established to estimate radiation doses that people could have received from nuclear operations at the Hanford Site since 1944. To identify groups that may have received doses, population estimates containing age, race, and sex detail for ten counties in Washington and Oregon for the years 1940 to 1980 were prepared by the Demographics Laboratory under a subcontract with the Pacific Northwest Laboratory (PNL). A data base of population information was developed from census reports and published and unpublished collections from the Washington State Office of Financial Management and Center for Population Research. Three estimation methods were then explored: the cohort-component model, cohort interpolation, and age-group interpolation. The estimates generated through cohort and age-group interpolation are considered adequate for initial use in the HEDR Project. Results are presented in two forms: (1) county populations by sex and single year of age and (2) county populations by sex and race for age groupings. These results are made available to the HEDR Project for further refinement into population estimates by county census divisions.

  20. [Age structure and dynamics of Quercus wutaishanica population in Lingkong Mountain of Shanxi Province, China].

    PubMed

    Zhang, Jie; Shangguan, Tie-Liang; Duan, Yi-Hao; Guo, Wei; Liu, Wei-Hua; Guo, Dong-Gang

    2014-11-01

    Using the plant survivorship theory, the age structure, and the relationship between tree height and diameter (DBH) of Quercus wutaishanica population in Lingkong Mountain were analyzed, and the static life table was compiled and the survival curve plotted. The shuttle shape in age structure of Q. wutaishanica population suggested its temporal stability. The linear regression significantly fitted the positive correlation between tree height and DBH. The maximal life expectancy was observed among the trees beyond the age of the highest mortality and coincided with the lowest point of mortality density, suggesting the strong vitality of the seedlings and young trees that survived in the natural selection and intraspecific competition. The population stability of the Q. wutaishanica population was characterized by the Deevey-II of the survival curve. The dynamic pattern was characterized by the recession in the early phase, growth in the intermediate phase, and stability in the latter phase. PMID:25898607

  1. Breast Cancer Subtypes in Patients Aged 70 Years and Older.

    PubMed

    Königsberg, Robert; Pfeiler, Georg; Hammerschmid, Nicole; Holub, Oliver; Glössmann, Kerstin; Larcher-Senn, Julian; Dittrich, Christian

    2016-05-27

    Recurrence and survival pattern in breast cancer (bc) patients (pts) ≥ 70 years subcategorized according to subtype and age are still an area of uncertainty. Tumor characteristics, patient demographics, therapies applied, and recurrence pattern were compared between luminal A (LA), luminal B (LB), Her2/neu overexpressing (Her+) and triple-negative (TN) bc subtypes and the age subcategories 70-74, 75-79, ≥80 years. Based on univariate Cox-regression-analyses distant-disease-free-survival (DDFS) differed significantly for bc subtypes (p = 0.0002), notably for Her+ vs. LA (p = 0.0014), TN vs. LA (p < 0.001), and TN vs. LB (p = 0.0086). Not age, but Her+ and TN represented prognostic factors for DDFS. PMID:27215407

  2. Does income-related health inequality change as the population ages? Evidence from Swedish panel data.

    PubMed

    Islam, M Kamrul; Gerdtham, Ulf-G; Clarke, Philip; Burström, Kristina

    2010-03-01

    This paper explains and empirically assesses the channels through which population aging may impact on income-related health inequality. Long panel data of Swedish individuals is used to estimate the observed trend in income-related health inequality, measured by the concentration index (CI). A decomposition procedure based on a fixed effects model is used to clarify the channels by which population aging affects health inequality. Based on current income rankings, we find that conventional unstandardized and age-gender-standardized CIs increase over time. This trend in CIs is, however, found to remain stable when people are instead ranked according to lifetime (mean) income. Decomposition analyses show that two channels are responsible for the upward trend in unstandardized CIs - retired people dropped in relative income ranking and the coefficient of variation of health increases as the population ages.

  3. Sarcopenia: a potential cause and consequence of type 2 diabetes in Australia's ageing population?

    PubMed

    Scott, David; de Courten, Barbora; Ebeling, Peter R

    2016-10-01

    The incidence of type 2 diabetes is increasing in Australia's older adult population. Sarcopenia, the age-related decline in skeletal muscle mass, quality and function, may make a significant but under-appreciated contribution to increasing the risk of type 2 diabetes. As skeletal muscle is the largest insulin-sensitive tissue in the body, low muscle mass in sarcopenia likely results in reduced capacity for glucose disposal. Age-related declines in muscle quality, including increased mitochondrial dysfunction and fat infiltration, are also implicated in skeletal muscle inflammation and subsequent insulin resistance. Prospective studies have shown that low muscle mass and strength are associated with increased risk of incident type 2 diabetes. Prevalent type 2 diabetes also appears to exacerbate progression of sarcopenia in older adults. Recently developed operational definitions and the inclusion of sarcopenia in the International classification of diseases, 10th revision, clinical modification, provide impetus for clinicians to diagnose and treat sarcopenia in older patients. Simple assessments to diagnose sarcopenia can potentially play a role in primary and secondary prevention of type 2 diabetes in older patients. Lifestyle modification programs for older adults with type 2 diabetes, particularly for those with sarcopenia, should incorporate progressive resistance training, along with adequate intakes of protein and vitamin D, which may improve both functional and metabolic health and prevent undesirable decreases in muscle mass associated with weight loss interventions. As some older adults with type 2 diabetes have a poor response to exercise, clinicians must ensure that lifestyle modification programs are appropriately prescribed, regularly monitored and modified if necessary. PMID:27681976

  4. Age trends in prevalence of cardiovascular risk factors in Roma minority population of Croatia.

    PubMed

    Zeljko, Hrvojka Marija; Skarić-Jurić, Tatjana; Narančić, Nina Smolej; Barešić, Ana; Tomas, Zeljka; Petranović, Matea Zajc; Miličić, Jasna; Salihović, Marijana Peričić; Janićijević, Branka

    2013-07-01

    The Roma (Gypsy) are the largest European minority population characterized by poverty, social exclusion as well as by numerous life-style and cultural specificities, which all could have an adverse impact on their cardiovascular health. This study assesses the prevalence of cardiovascular diseases (CVD) risk factors in community-based sample of 430 adult Roma, living in rural area of Croatia, by providing the actual and age-adjusted estimates using the European standard population. The most prominent classical CVD risk phenotypes (blood pressure, obesity, smoking, glucose and lipid profile) were selected, and the standard risk cut-offs were applied. The study has shown that compared to general population of Croatia, the Roma population bears a high CVD risk factors load related to smoking and high glucose level. The CVD risk factors prevalence in Roma also showed important sex and age patterns, the most imposing of which are the findings of higher prevalence of CVD risks in women (especially obesity and triglyceride levels) and the trend of higher body mass index (BMI) level in younger age group (18-34 years) which both stand in contrast to the trends characterizing the general population of Croatia. These findings are complemented by the trend of decreased risk in the oldest age group (65+ years) for all investigated CVD risk factors (with exception of triglycerides level) compared to the 50-64 age group. We conclude that the age and sex CVD risks pattern point to the health transition of this rural Roma population. As we expect the proportion of CVD in the Roma minority of Croatia to increase in the future along with further modernization of their lifestyle, the CVD prevention measures in this population are urgent and should be primarily targeted at women and at the younger segment of this population.

  5. Skeletal age estimation in a contemporary Western Australian population using the Tanner-Whitehouse method.

    PubMed

    Maggio, Ariane; Flavel, Ambika; Hart, Rob; Franklin, Daniel

    2016-06-01

    Various age estimation techniques have been utilised in Australia to evaluate the age of individuals who do not have documentation to determine legal majority/culpability. These age estimation techniques rely on the assessment of skeletal development as visualised in radiographs, CT scans, MRI or ultrasound modalities, and subsequent comparison to reference standards. These standards are not always population specific and are thus known to be less accurate when applied outside of the original reference sample, leading to potential ethical implications. Therefore, the present study aims to: (i) explore the variation in developmental trajectories between the established Tanner-Whitehouse (TW) age estimation standards and a Western Australian population; and (ii) develop specific hand-wrist age estimation standards for the latter population. The present study examines digital anterior-posterior hand-wrist radiographs of 360 individuals 0 to 24.9 years of age, equally represented by sex. Each radiograph was assessed using the RUS, Carpal and 20-bone methods of Tanner et al. The standard error of the estimate (SEE) was calculated for each method (range: ♀ SEE ±0.4-11.5 years; ♂ SEE ±0.9-10.1 years). The most accurate method was TW3 RUS for females and the TW2 Carpal system for males. The 50th centile skeletal maturity scores for each year age group were plotted against average chronological age to produce polynomial regression standards with a demonstrated accuracy of (♀ SEE ±0.09-3.46 years; ♂ SEE ±0.02-3.42 years) for females and males, respectively. The standards presented here can be used in future forensic investigations that require age estimation of hand-wrist bones in a Western Australian population, however, they are not appropriate for establishing age of majority (18 years), as skeletal maturity was attained on average earlier than 15 years of age in both sexes for all three systems examined. PMID:27080619

  6. Predictors of Death among Patients Who Completed Tuberculosis Treatment: A Population-Based Cohort Study

    PubMed Central

    Millet, Juan-Pablo; Orcau, Angels; Rius, Cristina; Casals, Marti; de Olalla, Patricia Garcia; Moreno, Antonio; Nelson, Jeanne L.; Caylà, Joan A.

    2011-01-01

    Background Mortality among patients who complete tuberculosis (TB) treatment is still high among vulnerable populations. The objective of the study was to identify the probability of death and its predictive factors in a cohort of successfully treated TB patients. Methods A population-based retrospective longitudinal study was performed in Barcelona, Spain. All patients who successfully completed TB treatment with culture-confirmation and available drug susceptibility testing between 1995–1997 were retrospectively followed-up until December 31, 2005 by the Barcelona TB Control Program. Socio-demographic, clinical, microbiological and treatment variables were examined. Mortality, TB Program and AIDS registries were reviewed. Kaplan-Meier and a Cox regression methods with time-dependent covariates were used for the survival analysis, calculating the hazard ratio (HR) with 95% confidence intervals (CI). Results Among the 762 included patients, the median age was 36 years, 520 (68.2%) were male, 178 (23.4%) HIV-infected, and 208 (27.3%) were alcohol abusers. Of the 134 (17.6%) injecting drug users (IDU), 123 (91.8%) were HIV-infected. A total of 30 (3.9%) recurrences and 173 deaths (22.7%) occurred (mortality rate: 3.4/100 person-years of follow-up). The predictors of death were: age between 41–60 years old (HR: 3.5; CI:2.1–5.7), age greater than 60 years (HR: 14.6; CI:8.9–24), alcohol abuse (HR: 1.7; CI:1.2–2.4) and HIV-infected IDU (HR: 7.9; CI:4.7–13.3). Conclusions The mortality rate among TB patients who completed treatment is associated with vulnerable populations such as the elderly, alcohol abusers, and HIV-infected IDU. We therefore need to fight against poverty, and promote and develop interventions and social policies directed towards these populations to improve their survival. PMID:21980423

  7. White matter hyperintensities and imaging patterns of brain ageing in the general population.

    PubMed

    Habes, Mohamad; Erus, Guray; Toledo, Jon B; Zhang, Tianhao; Bryan, Nick; Launer, Lenore J; Rosseel, Yves; Janowitz, Deborah; Doshi, Jimit; Van der Auwera, Sandra; von Sarnowski, Bettina; Hegenscheid, Katrin; Hosten, Norbert; Homuth, Georg; Völzke, Henry; Schminke, Ulf; Hoffmann, Wolfgang; Grabe, Hans J; Davatzikos, Christos

    2016-04-01

    White matter hyperintensities are associated with increased risk of dementia and cognitive decline. The current study investigates the relationship between white matter hyperintensities burden and patterns of brain atrophy associated with brain ageing and Alzheimer's disease in a large populatison-based sample (n = 2367) encompassing a wide age range (20-90 years), from the Study of Health in Pomerania. We quantified white matter hyperintensities using automated segmentation and summarized atrophy patterns using machine learning methods resulting in two indices: the SPARE-BA index (capturing age-related brain atrophy), and the SPARE-AD index (previously developed to capture patterns of atrophy found in patients with Alzheimer's disease). A characteristic pattern of age-related accumulation of white matter hyperintensities in both periventricular and deep white matter areas was found. Individuals with high white matter hyperintensities burden showed significantly (P < 0.0001) lower SPARE-BA and higher SPARE-AD values compared to those with low white matter hyperintensities burden, indicating that the former had more patterns of atrophy in brain regions typically affected by ageing and Alzheimer's disease dementia. To investigate a possibly causal role of white matter hyperintensities, structural equation modelling was used to quantify the effect of Framingham cardiovascular disease risk score and white matter hyperintensities burden on SPARE-BA, revealing a statistically significant (P < 0.0001) causal relationship between them. Structural equation modelling showed that the age effect on SPARE-BA was mediated by white matter hyperintensities and cardiovascular risk score each explaining 10.4% and 21.6% of the variance, respectively. The direct age effect explained 70.2% of the SPARE-BA variance. Only white matter hyperintensities significantly mediated the age effect on SPARE-AD explaining 32.8% of the variance. The direct age effect explained 66.0% of the SPARE

  8. When ageing meets the blues: Are current antidepressants effective in depressed aged patients?

    PubMed

    Felice, Daniela; O'Leary, Olivia F; Cryan, John F; Dinan, Timothy G; Gardier, Alain M; Sánchez, Connie; David, Denis J

    2015-08-01

    "I had to wait 110 years to become famous. I wanted to enjoy it as long as possible.", Jeanne Louise Calment (1875-1997). This review summarizes current knowledge of the effects of antidepressant drugs in elderly patients (double-blind placebo (n=27) or active comparator-controlled clinical trials (n=21) indexed in Pubmed in depressed patients aged ≥60) and in aged mice (≥9 months) and middle-aged rats (≥14 months) on depression-related symptoms and cognitive performances. Finally, other potential therapeutic targets for treating depression-related disorders in elderly patients are also addressed (neurogenesis, GABAB receptor, 5-HT4 receptor, mTOR signaling). Overall, the very few published preclinical studies (n=12 in total) in middle-aged and aged rodents seem to suggest that selective serotonin reuptake inhibitors (SSRIs) may be less effective than tricyclic antidepressant drugs (TCAs) in ameliorating depression-like behavior and cognitive functions. On the other hand, results from clinical trials suggest that there is not a marked difference in efficacy and safety profiles of current marketed classes of antidepressant drugs.

  9. When phenology matters: age-size truncation alters population response to trophic mismatch.

    PubMed

    Ohlberger, Jan; Thackeray, Stephen J; Winfield, Ian J; Maberly, Stephen C; Vøllestad, L Asbjørn

    2014-10-22

    Climate-induced shifts in the timing of life-history events are a worldwide phenomenon, and these shifts can de-synchronize species interactions such as predator-prey relationships. In order to understand the ecological implications of altered seasonality, we need to consider how shifts in phenology interact with other agents of environmental change such as exploitation and disease spread, which commonly act to erode the demographic structure of wild populations. Using long-term observational data on the phenology and dynamics of a model predator-prey system (fish and zooplankton in Windermere, UK), we show that age-size truncation of the predator population alters the consequences of phenological mismatch for offspring survival and population abundance. Specifically, age-size truncation reduces intraspecific density regulation due to competition and cannibalism, and thereby amplifies the population sensitivity to climate-induced predator-prey asynchrony, which increases variability in predator abundance. High population variability poses major ecological and economic challenges as it can diminish sustainable harvest rates and increase the risk of population collapse. Our results stress the importance of maintaining within-population age-size diversity in order to buffer populations against phenological asynchrony, and highlight the need to consider interactive effects of environmental impacts if we are to understand and project complex ecological outcomes. PMID:25165767

  10. Gender Differences in Clinical Presentations of Cystic Fibrosis Patients in Azeri Turkish Population

    PubMed Central

    Vahedi, Leila; Jabarpoor-Bonyadi, Morteza; Ghojazadeh, Morteza; Vahedi, Amir

    2016-01-01

    Background Cystic fibrosis (CF) is an autosomal recessive disorder with several clinical presentations. This study was undertaken in the Azeri Turkish population in Iran, to investigate gender differences in the age at onset and diagnosis, age of death, and duration of illness of CF. Methods The data of 331 CF patients from 2001 to 2015 was surveyed. Parameters including age, sex, ΔF508 mutation, age at onset, age at diagnosis, age of death and clinical presentations were evaluated for both sexes, using descriptive analysis. The association of gender with these variables was studied using logistic regression, chi-square test and Mann-Whitney U test by SPSS version 18. Odds ratio with a confidence interval of 95% and p≤0.05 was considered statistically significant. Results The study included 191 males (57.7%) and 140 females (42.3%), all showing statistically significant difference (p<0.001). Age duration differed between genders. Male and female patients were further under 9 and 4 years, respectively. The occurrence of ΔF508 mutation was 0.51 times more in females than in males. Age, diagnosis and sex were closely associated: males were diagnosed at a significantly later age than females (p=0.05). While this compression performed based on clinical presentations, males with respiratory disease had a later median age at diagnosis than females at lifespan (p=0.001). The risk of infertility in males was approximately two times greater than in females (p=0.02). Conclusion These findings indicate gender differences in CF patients. Future studies are needed to establish other differences and evaluate the causes for the gender variations.

  11. [Metastatic non-small cell lung cancer: Systemic treatment of patients aged 70 and over].

    PubMed

    Quoix, Elisabeth; Ducoloné, Alain; Mennecier, Bertrand; Fraisse, Philippe

    2011-04-01

    Patients aged 70 and over represent the third of the population of patients with lung cancer. There has been for a long time a certain nihilism regarding the treatment of elderly patients with advanced lung cancer as well from medical doctors but also from families and patients themselves with the false belief of an indolent course of the disease in elderly patients. As a result, clinical trials devoted to elderly patients were quite scarce until the end of the last decade. Nevertheless, an important trial was published in 1999 with the comparison of vinorelbine as a single agent versus best supportive care only in patients aged 70 and over with an advanced non-small cell lung cancer. The survival benefit with vinorelbine was important. Then two trials were published comparing monotherapy with either vinorelbine or gemcitabine to the doublet vinorelbine and gemcitabine without convincing results. As a consequence, the ASCO 2004 recommendations were to treat elderly patients with a monotherapy (gemcitabine or vinorelbine). Recently an IFCT trial was presented at the plenary session of the ASCO 2010. A carboplatin (every 4weeks)+weekly paclitaxel doublet was compared to a vinorelbine or gemcitabine (choice of the center). The survival benefit was of such magnitude that the paradigm of treatment of elderly patients PS 0-2 with advanced NSCLC should be modified in favor of the tested doublet. There should be a reappraisal of the geriatric indexes recommended by the oncogeriatricians regarding their exact prognostic or predictive role. PMID:21388776

  12. Colour pairs for constraining the age and metallicity of stellar populations

    NASA Astrophysics Data System (ADS)

    Li, Zhongmu; Han, Zhanwen

    2008-04-01

    Using a widely used stellar-population synthesis model, we study the possibility of using pairs of AB system colours to break the well-known stellar age-metallicity degeneracy and to give constraints on two luminosity-weighted stellar-population parameters (age and metallicity). We present the relative age and metallicity sensitivities of the AB system colours that relate to the u,B,g,V,r,R,i, I,z,J,H and K bands, and we quantify the ability of various colour pairs to break the age-metallicity degeneracy. Our results suggest that a few pairs of colours can be used to constrain the above two stellar-population parameters. This will be very useful for exploring the stellar populations of distant galaxies. In detail, colour pairs [(r-K), (u-R)] and [(r-K), (u-r)] are shown to be the best pairs for estimating the luminosity-weighted stellar ages and metallicities of galaxies. They can constrain two stellar-population parameters on average with age uncertainties less than 3.89 Gyr and metallicity uncertainties less than 0.34 dex for typical colour uncertainties. The typical age uncertainties for young populations (age < 4.6 Gyr) and metal-rich populations (Z >= 0.001) are small (about 2.26 Gyr) while those for old populations (age >= 4.6 Gyr) and metal-poor populations (Z < 0.001) are much larger (about 6.88 Gyr). However, the metallicity uncertainties for metal-poor populations (about 0.0024) are much smaller than for other populations (about 0.015). Some other colour pairs can also possibly be used for constraining the two parameters. On the whole, the estimation of stellar-population parameters is likely to be reliable only for early-type galaxies with small colour errors and globular clusters, because such objects contain less dust. In fact, no galaxy is totally dust-free and early-type galaxies are also likely have some dust [e.g. E(B- V) ~ 0.05], which can change the stellar ages by about 2.5 Gyr and metallicities (Z) by about 0.015. When we compare the

  13. Using eHealth to improve health literacy among the patient population.

    PubMed

    Landry, Kathryn E

    2015-01-01

    There is no denying the global influence of eHealth, in its various forms, on the health care system in the 21st Century. Health care professionals are often familiar with technological tools used to enhance health outcomes by assisting clinicians in meeting the needs of the patient population. In an age of social media, web-based information, and material available literally in an instant, it is crucial for nurses to use and proactively share their knowledge regarding accessing and finding credible sources of online health information with the patient population. By improving health literacy among consumers, self-sufficiency and competence can be developed and promoted to improve health outcomes, placing the patient in a participatory starring role of managing and improving his or her overall well-being. PMID:25842526

  14. Using eHealth to improve health literacy among the patient population.

    PubMed

    Landry, Kathryn E

    2015-01-01

    There is no denying the global influence of eHealth, in its various forms, on the health care system in the 21st Century. Health care professionals are often familiar with technological tools used to enhance health outcomes by assisting clinicians in meeting the needs of the patient population. In an age of social media, web-based information, and material available literally in an instant, it is crucial for nurses to use and proactively share their knowledge regarding accessing and finding credible sources of online health information with the patient population. By improving health literacy among consumers, self-sufficiency and competence can be developed and promoted to improve health outcomes, placing the patient in a participatory starring role of managing and improving his or her overall well-being.

  15. Medico-legal aspects of dental treatment of the ageing and aged patient.

    PubMed

    Story, R D

    2015-03-01

    The medico-legal aspects of the dental management of ageing and aged patients relate mainly to the assessment of the patient's competence and the role of substitute decision makers. Dentists will assess whether or not a patient is competent to give informed consent to treatment. Lawyers use the word 'capacity' when deciding whether a person can make an important decision about their life. Competence and capacity mean the same thing. Assessment of competence and the role of substitute decision makers rests firmly on a sound understanding of the ethical basis of dental practice. This article will discuss the ethical basis of dental practice; the assessment of competence and the gaining of informed consent; the role of substitute decision makers and the nature of the decisions that are made at the end of life. PMID:25762043

  16. Genetic Structure in Dwarf Bamboo (Bashania fangiana) Clonal Populations with Different Genet Ages

    PubMed Central

    Ma, Qing-qing; Song, Hui-xing; Zhou, Shi-qiang; Yang, Wan-qin; Li, De-sheng; Chen, Jin-song

    2013-01-01

    Amplified fragment length polymorphism (AFLP) fingerprints were used to reveal genotypic diversity of dwarf bamboo (Bashania fangiana) clonal populations with two different genet ages (≤30 years versus >70 years) at Wolong National Natural Reserve, Sichuan province, China. We generated AFLP fingerprints for 96 leaf samples, collected at 30 m intervals in the two populations, using ten selective primer pairs. A total of 92 genotypes were identified from the both populations. The mean proportion of distinguishable genotypes (G/N) was 0.9583 (0.9375 to 0.9792) and Simpson's index of diversity (D) was 0.9982 (0.9973 to 0.9991). So, two B. fangiana populations were multiclonal and highly diverse. The largest single clone may occur over a distance of about 30 m. Our results demonstrated that the genotypic diversity and genet density of B. fangiana clonal population did not change significantly (47 versus 45) with genet aging and low partitioned genetic differentiation was between the two populations (Gst = 0.0571). The analysis of molecular variance consistently showed that a large proportion of the genetic variation (87.79%) existed among the individuals within populations, whereas only 12.21% were found among populations. In addition, the high level of genotypic diversity in the two populations implies that the further works were needed to investigate the reasons for the poor seed set in B. fangiana after flowering. PMID:24244360

  17. [Rehabilitation of aged patients with bicycle ergometer after coronary surgery].

    PubMed

    Lomama, E; Helft, G; Dufour, J C; Laudy, C; Monnet de Lorbeau, B; Vacheron, A

    1996-11-01

    This study was undertaken to assess the contraindications to rehabilitation by exercise testing on a bicycle ergometer and the tolerance of this procedure in elderly patients recovering from coronary surgery. One hundred and eighty-four patients aged over 65 years were included (Group I). The rehabilitation program consisted of exercise testing on admission period. The results were compared with those of 146 patients aged 65 or less (Group II). Twenty-six per cent of the elderly patients had a contraindications to this type of rehabilitation compared with only 4.8% in Group II. The main contraindications were extracardiac (21.7%), including infectious causes (4.3%), neuropsychiatric (3.3%), respiratory (2.7%) and rheumatological conditions (2.2%). Cardiac causes represented only 4.3% of the contraindications. In the patients undergoing the training program, the maximum power and the duration of exercise testing increased respectively from 81 +/- 17 to 97 +/- 21 watts (+21% ; p < 10(-3)) and 7 +/- 1.7 to 9 +/- 2 minutes (+28.6%, p < 10(-3)). The change in these parameters was comparable in the other group: 94.5+/- to 118 +/- 26 watts (+24.8% ; p < 10(-3)) and 8.5 +/- 1.9 to 10.9 +/- 2.4 minutes (+28.2% ; p < 10(-3)). On the other hand, the rate-pressure product decreased slightly in the elderly patients (-5.5% ; p = 0.07, compared with -13% in Group II, p = 0.001). Complications were rare: 1.6% of temporary interruption of a session (versus 0.6%). No serious complications were observed. The authors conclude that, after coronary surgery, the majority of elderly coronary patients can participate in physical training programs on bicycle ergometers without major complications. In the absence of contraindications, patients, and even elderly patients, should be encouraged to enroll for these programs after coronary bypass surgery.

  18. Nutrition initiatives in the context of population aging: where does the United States stand?

    PubMed

    Chalé, Angela; Unanski, Amanda G; Liang, Raymond Y

    2012-01-01

    In 2011, the earliest segment of the baby boom generation turned 65 years of age. This event marks the beginning of a new phase of growth of the older adult population in the United States and is in line with what is referred to worldwide as "population aging." By 2030, older adults will comprise 20% of the U.S. population. With the impending increase in the older adult population, the United States is unprepared to handle the accompanying social and economic impact of growing rates of age-related diseases such as diabetes, hypertension, and cardiovascular disease. These diseases have nutritional determinants and, as such, they signify the need for effective preventive nutrition initiatives to address population aging in the United States. Comparatively, the European Union (EU) is projected to reach an older adult population of 24% by 2030. In this special article we evaluate nutrition initiatives for older adults in the United States and also examine nutrition initiatives in the European Union in search of an ideal model. However, we found that available data for EU initiatives targeted at population aging were limited. We conclude by offering the proposal of a physician-based model that establishes the primary care physician as the initiator of nutrition screening, education, referrals, and follow-up for the older adult population in the United States as a long-term goal. Apropos of the immediate future, we consider barriers that underscore the establishment of a physician-based model and suggest objectives that are attainable. Although the data are limited for the European Union, this model may serve to guide management of chronic diseases with a nutritional component in economies similar to the United States worldwide. PMID:22335437

  19. ALPS: The Age-Layered Population Structure for Reducing the Problem of Premature Convergence

    NASA Technical Reports Server (NTRS)

    Hornby, Gregory S.

    2006-01-01

    To reduce the problem of premature convergence we define a new attribute of an individual, its age, and propose the Age-Layered Population Structure (ALPS), in which age is used to restrict competition and breeding between members of the population. ALPS differs from a typical EA by segregating individuals into different age-layers by their age - a measure of how long the genetic material has been in the population - and by regularly replacing all individuals in the bottom layer with randomly generated ones. The introduction of new, randomly generated individuals at regular intervals results in an EA that is never completely converged and is always looking at new parts of the fitness landscape. By using age to restrict competition and breeding search is able to develop promising young individuals without them being dominated by older ones. We demonstrate the effectiveness of the ALPS algorithm on an antenna design problem in which evolution with ALPS produces antennas more than twice as good as does evolution with two other types of EAs. Further analysis shows that the ALPS model does allow the offspring of newly generated individuals to move the population out of mediocre local-optima to better parts of the fitness landscape.

  20. Skin aging in patients with acquired immunodeficiency syndrome.

    PubMed

    de Aquino Favarato, Grace Kelly Naves; da Silva, Aline Cristina Souza; Oliveira, Lívia Ferreira; da Fonseca Ferraz, Mara Lúcia; de Paula Antunes Teixeira, Vicente; Cavellani, Camila Lourencini

    2016-10-01

    To evaluate the histomorphometric skin changes over aging patients with autopsied acquired immunodeficiency syndrome (AIDS). In 29 skin fragments of autopsied elderly (older than 50 years) and nonelderly patients with AIDS, epidermal thickness, the number of layers, the diameter of cells, the percentage of collagen and elastic fibers in the dermis, and the number and morphology of Langerhans cells were assessed. Statistical analysis was performed by SigmaStat 2.03 program. The thickness of the epidermis (92.55 × 158.94 μm), the number of layers (7 × 9 layers), and the diameter of the cells (13.27 × 17.6 μm) were statistically lower among the elderly. The quantity of collagen fibers (9.68 × 14.11%) and elastic fibers (11.89 × 15.31%) was also significantly lower in the elderly. There was a decrease in total (10.61 × 12.38 cel/mm(2)) and an increase in immature Langerhans cells (6.31 × 4.98 cel/mm(2)) in elderly patients with AIDS. The aging of the skin of patients with AIDS is amended in different histomorphometric aspects, the epidermis constituents suffer less pronounced changes in normal aging, and the dermis has more intense changes in elastic fibers and collagen.

  1. Skin aging in patients with acquired immunodeficiency syndrome.

    PubMed

    de Aquino Favarato, Grace Kelly Naves; da Silva, Aline Cristina Souza; Oliveira, Lívia Ferreira; da Fonseca Ferraz, Mara Lúcia; de Paula Antunes Teixeira, Vicente; Cavellani, Camila Lourencini

    2016-10-01

    To evaluate the histomorphometric skin changes over aging patients with autopsied acquired immunodeficiency syndrome (AIDS). In 29 skin fragments of autopsied elderly (older than 50 years) and nonelderly patients with AIDS, epidermal thickness, the number of layers, the diameter of cells, the percentage of collagen and elastic fibers in the dermis, and the number and morphology of Langerhans cells were assessed. Statistical analysis was performed by SigmaStat 2.03 program. The thickness of the epidermis (92.55 × 158.94 μm), the number of layers (7 × 9 layers), and the diameter of the cells (13.27 × 17.6 μm) were statistically lower among the elderly. The quantity of collagen fibers (9.68 × 14.11%) and elastic fibers (11.89 × 15.31%) was also significantly lower in the elderly. There was a decrease in total (10.61 × 12.38 cel/mm(2)) and an increase in immature Langerhans cells (6.31 × 4.98 cel/mm(2)) in elderly patients with AIDS. The aging of the skin of patients with AIDS is amended in different histomorphometric aspects, the epidermis constituents suffer less pronounced changes in normal aging, and the dermis has more intense changes in elastic fibers and collagen. PMID:27649952

  2. The contributions of age and sex to variation in common tern population growth rate.

    PubMed

    Ezard, T H G; Becker, P H; Coulson, T

    2006-11-01

    1. The decomposition of population growth rate into contributions from different demographic rates has many applications, ranging from evolutionary biology to conservation and management. Demographic rates with low variance may be pivotal for population persistence, but variable rates can have a dramatic influence on population growth rate. 2. In this study, the mean and variance in population growth rate (lambda) is decomposed into contributions from different ages and demographic rates using prospective and retrospective matrix analyses for male and female components of an increasing common tern (Sterna hirundo) population. 3. Three main results emerged: (1) subadult return was highly influential in prospective and retrospective analyses; (2) different age-classes made different contributions to variation in lambda: older age classes consistently produced offspring whereas young adults performed well only in high quality years; and (3) demographic rate covariation explained a significant proportion of variation in both sexes. A large contribution to lambda did not imply a large contribution to its variation. 4. This decomposition strengthens the argument that the relationship between variation in demographic rates and variation in lambda is complex. Understanding this relationship and its consequences for population persistence and evolutionary change demands closer examination of the lives, and deaths, of the individuals within populations within species.

  3. Elderly multiple myeloma patients experience less deterioration in health-related quality of life than younger patients compared to a normative population: a study from the population-based PROFILES registry.

    PubMed

    van der Poel, M W M; Oerlemans, S; Schouten, H C; van de Poll-Franse, L V

    2015-04-01

    The objectives of this study were to compare health-related quality of life (HRQOL) between multiple myeloma (MM) patients aged ≤65 and >65 years and to compare this with a normative population. Factors associated with HRQOL were identified. The population-based Eindhoven Cancer Registry was used to select MM patients diagnosed from 1999 to 2010. Patients (n = 289) were invited to complete the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) and Quality of Life Questionnaire Multiple Myeloma Module 20 (QLQ-MY20), and 212 patients responded (73 %). Data from the normative population (n = 568) were used for comparison. MM patients >65 years scored better on emotional functioning (p < 0.05) and financial problems (p < 0.01) compared to patients ≤65 years. Patients ≤65 years reported better body image and future perspective (p < 0.01). Compared to the normative population, patients ≤65 years scored worse on all EORTC QLQ-C30 functioning scales and on global health/QOL, fatigue, pain, dyspnea, appetite loss, and financial problems (p < 0.01). Patients >65 years scored worse on social, physical, and role functioning and on global health/QOL, fatigue, pain, and dyspnea (p < 0.01). Younger patients had worse HRQOL compared to the normative population than elderly patients. Patients with comorbidities reported lower QOL. The longer the time since diagnosis, the better the physical functioning. No major differences in HRQOL were found between younger and older MM patients. Compared to that of the normative population, HRQOL in younger patients was worse than that in older patients. The number of comorbidities and time since diagnosis were associated with HRQOL. MM patients reported that a high symptom burden and therapy should, besides prolonging survival, be aimed at improving HRQOL.

  4. Cluster Headache: Special Considerations for Treatment of Female Patients of Reproductive Age and Pediatric Patients.

    PubMed

    VanderPluym, Juliana

    2016-01-01

    Cluster headache is a rare disorder that is more common in adult male patients. It has a unique phenotype of unilateral, severe, to very severe headaches lasting 15 to 180 min with ipsilateral autonomic symptoms. Time to correct diagnosis can be protracted. A number of treatment options exist for the standard cluster headache patient, but special considerations must be made for female patients of reproductive age and pediatric patients. The objective of this article is to explore the current literature pertaining to special considerations in cluster headache management, including treatment of pregnant or breastfeeding patients and pediatric patients. PMID:26711274

  5. Age and education adjusted normative data and discriminative validity for Rey's Auditory Verbal Learning Test in the elderly Greek population.

    PubMed

    Messinis, Lambros; Nasios, Grigorios; Mougias, Antonios; Politis, Antonis; Zampakis, Petros; Tsiamaki, Eirini; Malefaki, Sonia; Gourzis, Phillipos; Papathanasopoulos, Panagiotis

    2016-01-01

    Rey's Auditory Verbal Learning Test (RAVLT) is a widely used neuropsychological test to assess episodic memory. In the present study we sought to establish normative and discriminative validity data for the RAVLT in the elderly population using previously adapted learning lists for the Greek adult population. We administered the test to 258 cognitively healthy elderly participants, aged 60-89 years, and two patient groups (192 with amnestic mild cognitive impairment, aMCI, and 65 with Alzheimer's disease, AD). From the statistical analyses, we found that age and education contributed significantly to most trials of the RAVLT, whereas the influence of gender was not significant. Younger elderly participants with higher education outperformed the older elderly with lower education levels. Moreover, both clinical groups performed significantly worse on most RAVLT trials and composite measures than matched cognitively healthy controls. Furthermore, the AD group performed more poorly than the aMCI group on most RAVLT variables. Receiver operating characteristic (ROC) analysis was used to examine the utility of the RAVLT trials to discriminate cognitively healthy controls from aMCI and AD patients. Area under the curve (AUC), an index of effect size, showed that most of the RAVLT measures (individual and composite) included in this study adequately differentiated between the performance of healthy elders and aMCI/AD patients. We also provide cutoff scores in discriminating cognitively healthy controls from aMCI and AD patients, based on the sensitivity and specificity of the prescribed scores. Moreover, we present age- and education-specific normative data for individual and composite scores for the Greek adapted RAVLT in elderly subjects aged between 60 and 89 years for use in clinical and research settings.

  6. Age and education adjusted normative data and discriminative validity for Rey's Auditory Verbal Learning Test in the elderly Greek population.

    PubMed

    Messinis, Lambros; Nasios, Grigorios; Mougias, Antonios; Politis, Antonis; Zampakis, Petros; Tsiamaki, Eirini; Malefaki, Sonia; Gourzis, Phillipos; Papathanasopoulos, Panagiotis

    2016-01-01

    Rey's Auditory Verbal Learning Test (RAVLT) is a widely used neuropsychological test to assess episodic memory. In the present study we sought to establish normative and discriminative validity data for the RAVLT in the elderly population using previously adapted learning lists for the Greek adult population. We administered the test to 258 cognitively healthy elderly participants, aged 60-89 years, and two patient groups (192 with amnestic mild cognitive impairment, aMCI, and 65 with Alzheimer's disease, AD). From the statistical analyses, we found that age and education contributed significantly to most trials of the RAVLT, whereas the influence of gender was not significant. Younger elderly participants with higher education outperformed the older elderly with lower education levels. Moreover, both clinical groups performed significantly worse on most RAVLT trials and composite measures than matched cognitively healthy controls. Furthermore, the AD group performed more poorly than the aMCI group on most RAVLT variables. Receiver operating characteristic (ROC) analysis was used to examine the utility of the RAVLT trials to discriminate cognitively healthy controls from aMCI and AD patients. Area under the curve (AUC), an index of effect size, showed that most of the RAVLT measures (individual and composite) included in this study adequately differentiated between the performance of healthy elders and aMCI/AD patients. We also provide cutoff scores in discriminating cognitively healthy controls from aMCI and AD patients, based on the sensitivity and specificity of the prescribed scores. Moreover, we present age- and education-specific normative data for individual and composite scores for the Greek adapted RAVLT in elderly subjects aged between 60 and 89 years for use in clinical and research settings. PMID:26588427

  7. A Hierarchical Kinetic Theory of Birth, Death and Fission in Age-Structured Interacting Populations

    NASA Astrophysics Data System (ADS)

    Chou, Tom; Greenman, Chris D.

    2016-07-01

    We develop mathematical models describing the evolution of stochastic age-structured populations. After reviewing existing approaches, we formulate a complete kinetic framework for age-structured interacting populations undergoing birth, death and fission processes in spatially dependent environments. We define the full probability density for the population-size age chart and find results under specific conditions. Connections with more classical models are also explicitly derived. In particular, we show that factorial moments for non-interacting processes are described by a natural generalization of the McKendrick-von Foerster equation, which describes mean-field deterministic behavior. Our approach utilizes mixed-type, multidimensional probability distributions similar to those employed in the study of gas kinetics and with terms that satisfy BBGKY-like equation hierarchies.

  8. Population pharmacokinetics of oxaliplatin in patients with metastatic cancer.

    PubMed

    Bastian, G; Barrail, A; Urien, S

    2003-11-01

    Our aim was to develop a population pharmacokinetic model of ultrafilterable oxaliplatin in metastatic cancer patients. Oxaliplatin was administered by 2- or 4-h infusions, 50, 65, 75, 85, 100 or 130 mg/m2 to 56 patients. Blood samples were collected over 28 h. Plasma concentrations of ultrafilterable oxaliplatin were determined by flameless atomic absorption spectrophotometry. Population pharmacokinetic analysis was performed using a non-linear mixed-effects modeling method. Ultrafilterable oxaliplatin concentration-time profiles showed a secondary peak or a shoulder aspect post-infusion, attributed to the existence of an enterohepatic recirculation (EHR). They were best described by a two-compartment model incorporating an EHR component. Plasma clearance (CL) was related positively to body weight (BW) and negatively to serum creatinine (SCr), and was greater in male patients than in female patients. This covariate modeling resulted in a decrease in the interindividual variability for CL from 104 to 62%. The central distribution volume (V1) and inter-compartmental clearance (Q) were related to BW. Typical population estimates of CL, central distribution volume (V1), input rate constant into gallbladder (k1B) and lag time for drug reabsorption (TLAG) were 14.1 or 8.5 l/h (male or female patients), 24.9 l, 1.8 h-1 and 2.0 h, respectively. The final pharmacokinetic model was validated using 200 bootstrap samples of the original data. We conclude that a two-compartment with EHR model adequately described ultrafilterable oxaliplatin pharmacokinetics, explaining a secondary transient increase in concentration. This study identified combined-covariate-effects ultrafilterable oxaliplatin clearance, supporting dose adjustment of oxaliplatin based on BW, gender and corrected for SCr level, if drug exposure is thought to be related to therapeutic or toxic issues.

  9. Population pharmacokinetics of oxaliplatin in patients with metastatic cancer.

    PubMed

    Bastian, G; Barrail, A; Urien, S

    2003-11-01

    Our aim was to develop a population pharmacokinetic model of ultrafilterable oxaliplatin in metastatic cancer patients. Oxaliplatin was administered by 2- or 4-h infusions, 50, 65, 75, 85, 100 or 130 mg/m2 to 56 patients. Blood samples were collected over 28 h. Plasma concentrations of ultrafilterable oxaliplatin were determined by flameless atomic absorption spectrophotometry. Population pharmacokinetic analysis was performed using a non-linear mixed-effects modeling method. Ultrafilterable oxaliplatin concentration-time profiles showed a secondary peak or a shoulder aspect post-infusion, attributed to the existence of an enterohepatic recirculation (EHR). They were best described by a two-compartment model incorporating an EHR component. Plasma clearance (CL) was related positively to body weight (BW) and negatively to serum creatinine (SCr), and was greater in male patients than in female patients. This covariate modeling resulted in a decrease in the interindividual variability for CL from 104 to 62%. The central distribution volume (V1) and inter-compartmental clearance (Q) were related to BW. Typical population estimates of CL, central distribution volume (V1), input rate constant into gallbladder (k1B) and lag time for drug reabsorption (TLAG) were 14.1 or 8.5 l/h (male or female patients), 24.9 l, 1.8 h-1 and 2.0 h, respectively. The final pharmacokinetic model was validated using 200 bootstrap samples of the original data. We conclude that a two-compartment with EHR model adequately described ultrafilterable oxaliplatin pharmacokinetics, explaining a secondary transient increase in concentration. This study identified combined-covariate-effects ultrafilterable oxaliplatin clearance, supporting dose adjustment of oxaliplatin based on BW, gender and corrected for SCr level, if drug exposure is thought to be related to therapeutic or toxic issues. PMID:14597876

  10. The role of age structure in the persistence of a chronic pathogen in a fluctuating population.

    PubMed

    Laverty, Sean M; Adler, Frederick R

    2009-03-01

    Small mammal populations exhibit large fluctuations, potentially leading to local extinction of specialist pathogens after bottlenecks. Pathogen persistence in recovering populations depends on the epidemiological characteristics of the hosts that survive the bottlenecks. Sin Nombre virus is a largely asymptomatic infection of deer mice, which creates a chronic lifelong infection. Earlier work on this virus has shown that males play a key role in pathogen persistence through a combination of longer lifespan and higher seroprevalence. Other evidence indicates that mouse age could play an equally important role, as older mice may have higher survivorship and higher contact rates. We use age structured models to examine the relationships among prevalence, age-dependent demographics, and age-dependent epidemiology.

  11. Time-evolution of age-dependent mortality patterns in mathematical model of heterogeneous human population.

    PubMed

    Avraam, Demetris; Arnold-Gaille, Séverine; Jones, Dyfan; Vasiev, Bakhtier

    2014-12-01

    The widely-known Gompertz law of mortality states the exponential increase of mortality with age in human populations. Such an exponential increase is observed at the adulthood span, roughly after the reproductive period, while mortality data at young and extremely old ages deviate from it. The heterogeneity of human populations, i.e. the existence of subpopulations with different mortality dynamics, is a useful consideration that can explain age-dependent mortality patterns across the whole life-course. A simple mathematical model combining the heterogeneity of populations with an assumption that the mortality in each subpopulation grows exponentially with age has been proven to be capable of reproducing the entire mortality pattern in a human population including the observed peculiarities at early- and late-life intervals. In this work we fit this model to actual (Swedish) mortality data for consecutive periods and consequently describe the evolution of mortality dynamics in terms of the evolution of the model parameters over time. We have found that the evolution of the model parameters validates the applicability of the compensation law of mortality to each subpopulation separately. Furthermore, our study has indicated that the population structure changes so that the population tends to become more homogeneous over time. Finally, our analysis of the decrease of the overall mortality in a population over time has shown that this decrease is mainly due to a change in the population structure and to a lesser extent to a reduction of mortality in each of the subpopulations, the latter being represented by an alteration of the parameters that outline the exponential dynamics.

  12. Yeast Population Dynamics during the Fermentation and Biological Aging of Sherry Wines

    PubMed Central

    Esteve-Zarzoso, B.; Peris-Torán, M. J.; García-Maiquez, E.; Uruburu, F.; Querol, A.

    2001-01-01

    Molecular and physiological analyses were used to study the evolution of the yeast population, from alcoholic fermentation to biological aging in the process of “fino” sherry wine making. The four races of “flor” Saccharomyces cerevisiae (beticus, cheresiensis, montuliensis, and rouxii) exhibited identical restriction patterns for the region spanning the internal transcribed spacers 1 and 2 (ITS-1 and ITS-2) and the 5.8S rRNA gene, but this pattern was different, from those exhibited by non-flor S. cerevisiae strains. This flor-specific pattern was detected only after wines were fortified, never during alcoholic fermentation, and all the strains isolated from the velum exhibited the typical flor yeast pattern. By restriction fragment length polymorphism of mitochondrial DNA and karyotyping, we showed that (i) the native strain is better adapted to fermentation conditions than commercial strains; (ii) two different populations of S. cerevisiae strains are involved in the process of elaboration, of fino sherry wine, one of which is responsible for must fermentation and the other, for wine aging; and (iii) one strain was dominant in the flor population integrating the velum from sherry wines produced in González Byass wineries, although other authors have described a succession of races of flor S. cerevisiae during wine aging. Analyzing all these results together, we conclude that yeast population dynamics during biological aging is a complex phenomenon and differences between yeast populations from different wineries can be observed. PMID:11319081

  13. Age and Sex Ratios in a High-Density Wild Red-Legged Partridge Population

    PubMed Central

    Nadal, Jesús; Ponz, Carolina; Margalida, Antoni

    2016-01-01

    The dynamics of a wild red-legged partridge population were examined over a 14-year period in Spain to identify patterns in age and sex ratios in relation to weather parameters, and to assess the importance of these parameters in population dynamics and management. The results gave age ratios of 1.07 (but 2.13 in July counts), juvenile sex ratios of 1.01 and adult sex ratios of 1.47. Overall, 12% more females were hatched and female juvenile mortality was 7.3% higher than in males. Sex differential mortality explains the 19.2% deficit in adult females, which are more heavily predated than males during the breeding period. Accordingly, age ratios are dependent on sex ratios and both are density dependent. Over time, ratios and density changes appear to be influenced by weather and management. When the habitat is well conserved, partridge population dynamics can be explained by a causal chain: weather operates on net primary production, thereby affecting partridge reproduction and predation and, as a result, age and sex ratios in the October population. A reduction in the impact of predation (i.e. the effects of ground predators on eggs, chicks and breeding females) is the key factor to improve the conservation of partridge populations and associated biological processes. PMID:27508503

  14. Age and Sex Ratios in a High-Density Wild Red-Legged Partridge Population.

    PubMed

    Nadal, Jesús; Ponz, Carolina; Margalida, Antoni

    2016-01-01

    The dynamics of a wild red-legged partridge population were examined over a 14-year period in Spain to identify patterns in age and sex ratios in relation to weather parameters, and to assess the importance of these parameters in population dynamics and management. The results gave age ratios of 1.07 (but 2.13 in July counts), juvenile sex ratios of 1.01 and adult sex ratios of 1.47. Overall, 12% more females were hatched and female juvenile mortality was 7.3% higher than in males. Sex differential mortality explains the 19.2% deficit in adult females, which are more heavily predated than males during the breeding period. Accordingly, age ratios are dependent on sex ratios and both are density dependent. Over time, ratios and density changes appear to be influenced by weather and management. When the habitat is well conserved, partridge population dynamics can be explained by a causal chain: weather operates on net primary production, thereby affecting partridge reproduction and predation and, as a result, age and sex ratios in the October population. A reduction in the impact of predation (i.e. the effects of ground predators on eggs, chicks and breeding females) is the key factor to improve the conservation of partridge populations and associated biological processes. PMID:27508503

  15. Implications of issues in typographical design for readability and reading satisfaction in an aging population.

    PubMed

    Adams, J M; Hoffman, L

    1994-01-01

    The issues in typographical design that influence readability in an aging population are explored. The traditional response to age-related changes in vision has been "bigger is better," but we explore other major variables and vocabulary associated with page layout and design, including type classification and readability, justification, traditional rules of page composition, and issues of word forms versus character strategies. Other research areas that should be explored are also considered. PMID:8194577

  16. Population ageing in Lebanon: current status, future prospects and implications for policy.

    PubMed Central

    Sibai, Abla Mehio; Sen, Kasturi; Baydoun, May; Saxena, Prem

    2004-01-01

    During the past three decades, fast declines in fertility and mortality in Lebanon have created a compressed demographic transition, a growing trend towards survival into later life, and a larger proportion of elderly people in the population. Projections show that people aged 65 years and over are expected to constitute 10.2% of the population by 2025. Nevertheless, changes to the structure and composition of the population remain unmatched by any corresponding increase in support measures either through formal channels such as pension plans or through health or socioeconomic security measures such as the provision of subsidies for health care, home help or any form of nursing care. This means that an older person is forced to be dependent upon family support if it exists. We examine demographic trends of population ageing in Lebanon between 1970 and 1995 and provide projections until 2025. Variations in population ageing within the country are also considered. We also assess health care and social policy implications of demographic changes in the context of health and economic sector reforms initiated recently by the state, and explore their impact upon the expanding population of elderly people. PMID:15112011

  17. Modeling tracers of young stellar population age in star-forming galaxies

    SciTech Connect

    Levesque, Emily M.; Leitherer, Claus

    2013-12-20

    The young stellar population of a star-forming galaxy is the primary engine driving its radiative properties. As a result, the age of a galaxy's youngest generation of stars is critical for a detailed understanding of its star formation history, stellar content, and evolutionary state. Here we present predicted equivalent widths for the Hβ, Hα, and Brγ recombination lines as a function of stellar population age. The equivalent widths are produced by the latest generations of stellar evolutionary tracks and the Starburst99 stellar population synthesis code, and are the first to fully account for the combined effects of both nebular emission and continuum absorption produced by the synthetic stellar population. Our grid of model stellar populations spans six metallicities (0.001 < Z < 0.04), two treatments of star formation history (a 10{sup 6} M {sub ☉} instantaneous burst and a continuous star formation rate of 1 M {sub ☉} yr{sup –1}), and two different treatments of initial rotation rate (v {sub rot} = 0.0v {sub crit} and 0.4v {sub crit}). We also investigate the effects of varying the initial mass function. Given constraints on galaxy metallicity, our predicted equivalent widths can be applied to observations of star-forming galaxies to approximate the age of their young stellar populations.

  18. Reduced lifespan and increased ageing driven by genetic drift in small populations.

    PubMed

    Lohr, Jennifer N; David, Patrice; Haag, Christoph R

    2014-09-01

    Explaining the strong variation in lifespan among organisms remains a major challenge in evolutionary biology. Whereas previous work has concentrated mainly on differences in selection regimes and selection pressures, we hypothesize that differences in genetic drift may explain some of this variation. We develop a model to formalize this idea and show that the strong positive relationship between lifespan and genetic diversity predicted by this model indeed exists among populations of Daphnia magna, and that ageing is accelerated in small populations. Additional results suggest that this is due to increased drift in small populations rather than adaptation to environments favoring faster life histories. First, the correlation between genetic diversity and lifespan remains significant after statistical correction for potential environmental covariates. Second, no trade-offs are observed; rather, all investigated traits show clear signs of increased genetic load in the small populations. Third, hybrid vigor with respect to lifespan is observed in crosses between small but not between large populations. Together, these results suggest that the evolution of lifespan and ageing can be strongly affected by genetic drift, especially in small populations, and that variation in lifespan and ageing may often be nonadaptive, due to a strong contribution from mutation accumulation.

  19. Cosmic Evolution of X-ray Binary Populations: Probes of Changing Chemistry and Aging Stellar Populations in the Universe

    NASA Astrophysics Data System (ADS)

    Lehmer, Bret; Basu-Zych, Antara; Mineo, Stefano; Brandt, W. Niel; Eufrasio, Rafael T.; Fragos, Tassos; Hornschemeier, Ann E.; Luo, Bin; Xue, Yongquan; Bauer, Franz E.; Gilfanov, Marat; Kalogera, Vassiliki; Ranalli, Piero; Schneider, Donald P.; Shemmer, Ohad; Tozzi, Paolo; Trump, Jonathan; Vignali, Cristian; Wang, JunXian; Yukita, Mihoko; Zezas, Andreas

    2016-01-01

    The 2-10 keV emission from normal galaxies is dominated by X-ray binary (XRB) populations. The formation of XRBs is sensitive to galaxy properties like stellar age and metallicity---properties that have evolved significantly in the broader galaxy population throughout cosmic history. The 6 Ms Chandra Deep Field-South (CDF-S) allows us to study how XRB emission has evolved over a significant fraction of cosmic history (since z ~ 4), without significant contamination from AGN. Using constraints from the CDF-S, I will show that the X-ray emission from normal galaxies from z = 0-7 depends not only on star-formation rate (SFR), but also on stellar mass (M) and redshift. Our analysis shows the that low-mass X-ray binary emission scales with stellar mass and evolves as LX(LMXB)/M ~ (1+z)^3, and high-mass X-ray binaries scale with SFR and evolve as LX(HMXB)/SFR ~ (1+z), consistent with predictions from population synthesis models, which attribute the increase in LMXB and HMXB scaling relations with redshift as being due to declining host galaxy stellar ages and metallicities, respectively. These findings have important implications for the X-ray emission from young, low-metallicity galaxies at high redshift, which are likely to be more X-ray luminous per SFR and play a significant role in the heating of the intergalactic medium.

  20. The variability of lower third molar development in Northeast Malaysian population with application to age estimation.

    PubMed

    Johan, N A; Khamis, M F; Abdul Jamal, N Sk; Ahmad, B; Mahanani, E S

    2012-07-01

    This study aimed to assess the variability of the lower third molar (tooth 38 and 48) development in Northeast Malaysian population with respect to the side of dentition, to generate age prediction models and to compare the outcome with other studies. A total of 1080 orthopantomograms of Northeast Malaysian population aged between 14 and 25 years (540 males and 540 females) from the Hospital Universiti Sains Malaysia's archive which met the inclusion and exclusion criteria were selected and the maturity stages of tooth 38 and 48 were scored using Demirjian's stages (A-H). The findings showed a wide variation of the development of lower third molars in the Northeast Malaysian population. The roots developed earlier in males than in females. The development of the dentition on opposite sides of the mandible was synchronously in females and males. A multiple regression analysis shows that 71.1% of variance in age was explained by sex and developmental stage of tooth 48. An age prediction model was generated from the regression analysis: [Age = 7.117 + 1.907*(stage of tooth 48) - 0.432*(sex)] with mean prediction errors between -0.17 to 3.14 years. The obtained data in the current study are useful for references and determining age of unidentified human remains for identification investigation.

  1. Hypersensitivity to major panallergens in a population of 120 patients

    PubMed Central

    Mezzacappa, Simona; Aruanno, Arianna; Pecora, Valentina; Rizzi, Angela; Ricci, Anna Giulia; Ferraironi, Manuela; Buonomo, Alessandro; Schiavino, Domenico

    2015-01-01

    Introduction Lipid transfer proteins (LTP), profilin and PR-10 are the most important panallergens in central and southern Italy. Lipid transfer proteins are stable molecules, predominantly present in the fruit peel, which can induce systemic symptoms after ingestion of vegetables. Profilin and PR-10 are randomly distributed in the pulp and peel. Both are labile proteins and usually determine reactions restricted to the oral cavity. Panallergens-specific IgE may cross-react with homologues from different plant sources, due to their conserved structure. Aim To assess the pattern of sensitization to panallergens and the correlation with the clinical history and the allergological evaluation of food and aeroallergens. Material and methods One hundred and twenty patients with adverse reactions after vegetables ingestion underwent skin prick tests (SPT) with commercial extracts of plant-derived foods and inhalant allergens and commercial extracts of LTP, profilin and PR-10. Results Many patients presented positive SPT with different plant-food allergens. We found that 76 patients were sensitized to LTP, 14 to profilin and 5 to PR-10. In the LTP-sensitized group, 64 (84%) patients suffered from systemic symptoms while the patients sensitized only to profilin referred the oral allergy syndrome. Conclusions This study shows a high rate of sensitization to LTP in our population according to the literature about food allergy in our geographical area and confirms the literature data about the symptoms referred by patients with sensitization to panallergens. Panallergens should be considered as clinically relevant food allergens. PMID:26366148

  2. Survival of Patients with Chronic Myelocytic Leukemia: Comparisons of Estimates from Clinical Trial Settings and Population-Based Cancer Registries

    PubMed Central

    Gondos, Adam; Redaniel, Maria Theresa; Brenner, Hermann

    2011-01-01

    Introduction. The survival of patients with chronic myelocytic leukemia (CML) has improved during the past decades. However, there have been discrepancies between results reported from clinical trials and population-based studies. We aimed to elucidate the extent of these discrepancies. Methods. We examined the 5-year survival rate of patients in clinical trials of CML treatment and compared these results with the survival of patients in the general population using the Surveillance, Epidemiology, and End Results (SEER) database, correcting for differences in the age structure of the patient populations. Results. Twenty-nine trials were identified for data extraction. The survival rate calculated from SEER data was lower than the survival rate in clinical trials in the corresponding period, with differences of 2.1%–50.7%. Age-adapted survival was similar for four trials, but differences up to 35.8% were seen in most. Limitations of the study include the lack of information on chemotherapy in the SEER database and possible heterogeneity of cases. Discussion. The survival rate in clinical trials of CML treatment is higher than the survival rate of all patients with CML. We speculate that the difference may be a result of access to better medications, selection of healthier patients for trials, and the time necessary for adoption of new treatments. This finding underscores the need for population-based studies to give a more realistic idea of survival for patients with a given malignancy in the general population. PMID:21471276

  3. Ageing of Jamaica's Population – What Are the Implications for Healthcare?

    PubMed Central

    Eldemire-Shearer, D; Mitchell-Fearon, K; Laws, H; Waldron, N; James, K; Holder-Nevins, DL

    2014-01-01

    The 2011 Census has confirmed the ageing of the Jamaican population. The over 60-year old population has increased while the under 15-year old population has decreased. Other demographic changes of note include the largest increase being in the old-old who are predominantly female. The demographic changes when considered with the increase in chronic disease indicate the need for consideration of healthcare specifically targeting the needs for older persons including increased prevention, continuous medical management, long term care and caregiver support. PMID:25303185

  4. Geriatric Trauma: A Radiologist's Guide to Imaging Trauma Patients Aged 65 Years and Older.

    PubMed

    Sadro, Claudia T; Sandstrom, Claire K; Verma, Nupur; Gunn, Martin L

    2015-01-01

    Radiologists play an important role in evaluation of geriatric trauma patients. Geriatric patients have injury patterns that differ markedly from those seen in younger adults and are susceptible to serious injury from minor trauma. The spectrum of trauma in geriatric patients includes head and spine injury, chest and rib trauma, blunt abdominal injury, pelvic fractures, and extremity fractures. Clinical evaluation of geriatric trauma patients is difficult because of overall frailty, comorbid illness, and medication effects. Specific attention should be focused on the effects of medications in this population, including anticoagulants, steroids, and bisphosphonates. Radiologists should use age-appropriate algorithms for radiography, computed tomography (CT), and magnetic resonance imaging of geriatric trauma patients and follow guidelines for intravenous contrast agent administration in elderly patients with impaired renal function. Because there is less concern about risk for cancer with use of ionizing radiation in this age group, CT is the primary imaging modality used in the setting of geriatric trauma. Clinical examples are provided from the authors' experience at a trauma center where geriatric patients who have sustained major and minor injuries are treated daily. PMID:26065932

  5. Intracranial haemorrhage among a population of haemophilic patients in Brazil.

    PubMed

    Antunes, S V; Vicari, P; Cavalheiro, S; Bordin, J O

    2003-09-01

    Intracranial haemorrhage (ICH) is a common cause of morbidity and mortality in haemophilic patients. The overall incidence of ICH has been reported to range from 2.2% to 7.5% in patients with haemophilia. From 1987 to 2001, 401 haemophilic patients from the Serviço de Hemofilia, Disciplina de Hematologia e Hemoterapia, Universidade Federal de São Paulo were evaluated. The episodes of ICH were documented by CT scan and the anatomic location, clinical presentation, relationship to trauma and clinical factors, including the presence of HIV infection and the presence of inhibitor, were reviewed. Among 401 haemophilic patients, 45 ICH episodes in 35 (8.7%) patients with age ranging from 4 days to 49 years (mean 10.6 years) were observed. A history of recent trauma was documented in 24 (53.3%) cases. Seventeen (37.8%) episodes occurred in more than one site of bleeding, 12 (26.7%) were subdural, seven (15.5%) subarachnoid, four (8.9%) epidural, two (4.4%) intracerebral and one (2.2%) intraventricular. The most frequent symptoms were headache and drowsiness. All patients were submitted to replacement therapy and neurosurgical intervention was performed in eight (17.8%) patients. Despite the treatment, three (8.6%) haemophilia A patients died due to the ICH event and three presented late sequelae. The most important aspect of ICH management is the early replacement therapy in haemophilic patients. This prompt treatment will increase the chances of a better prognosis. Another impact measure consists in the administration of the deficient coagulation factor after every head trauma, even when considered minor.

  6. Definitions of fitness in age-structured populations: Comparison in the haploid case.

    PubMed

    Lessard, Sabin; Soares, Cintia

    2016-02-21

    Fisher's (1930) Fundamental Theorem of Natural Selection (FTNS), and in particular the development of an explicit age-structured version of the theorem, is of everlasting interest. In a recent paper, Grafen (2015a) argues that Fisher regarded his theorem as justifying individual rather than population fitness maximization. The argument relies on a new definition of fitness in age-structured populations in terms of individual birth and death rates and age-specific reproductive values in agreement with a principle of neutrality. The latter are frequency-dependent and defined without reference to genetic variation. In the same paper, it is shown that the rate of increase in the mean of the breeding values of fitness weighted by the reproductive values, but keeping the breeding values constant as in Price (1972) is equal to the additive genetic variance in fitness. Therefore, this partial change is obtained by keeping constant not only the genotypic birth and death rates but also the mean age-specific birth and death rates from which the age-specific reproductive values are defined. In this paper we reaffirm that the Malthusian parameter which measures the relative rate of increase or decrease in reproductive value of each genotype in a continuous-time age-structured population is the definition of fitness used in Fisher's (1930) FTNS. This is shown by considering an age-structured asexual haploid population with constant age-specific birth and death (or survival) parameters for each type. Although the original statement of the FTNS is for a diploid population, this simplified haploid model allows us to address the definition of fitness meant in this theorem without the complexities and effects of a changing genic environment. In this simplified framework, the rate of change in mean fitness in continuous time is expected to be exactly equal to the genetic variance in fitness (or to the genetic variance in fitness divided by the mean fitness in discrete time), which can

  7. Correlation of Smoking and Myocardial Infarction Among Sudanese Male Patients Above 40 Years of Age

    PubMed Central

    Elkhader, Bahaaedin A.; Abdulla, Alsafi A.; Ali Omer, Mohammed A.

    2016-01-01

    Summary To find an association between smoking and the development of myocardial infarction in male patients above forty years of age presenting at the echocardiology department of Sudan heart center Khartoum. A prospective cohort study was carried out at the echocardiography department of Sudan Heart Center in Khartoum-Sudan between July 2012 and June 2014. The study population comprised a total of 168 adult male patients who underwent cardiac ultrasound scanning. Out of a total of 144 cases, 65% (94) of patients were smokers, 74% of the 94 cases smoked for more than 10 years, and 26% of the 94 cases smoked for less than 10 years. With this study it was concluded that smoking is a risk factor for the development of myocardial infarction. This study showed that patients with myocardial infarction are more likely to have a past history of smoking. PMID:27081418

  8. Prevalence and intensity of dentition defects and secondary deformations in the population of 15-40 age group.

    PubMed

    Kraveishvili, S; Shonia, N; Sakvarelidze, Z; Sakvarelidze, N

    2014-01-01

    Partial secondary adentia together with caries and parodont diseases is among the most widespread diseases of dentofacial system, correlated, in addition, to the number of lost teeth, with the age. Result in speech and chewing functions' disorders, change of face shape, esthetic and psychosocial inferiority, pathologies of digestive and other systems, formation of the chronic infection areas, changes of reactivity etc,. Improvement of the methods of prevention and treatment of the above diseases is one of the most significant problems in the dentistry. Effectiveness of dental assistance organization and planning is based on the epidemiological studies. In Georgia, epidemiological studies were conducted in the populations of various age groups in previous years though, according to our data, no studies of dentition defects and deformations were conducted in the recent decades. Goal of our research was study of prevalence and severity of dentition defects and deformations, regarding sizes of existing defects, their localization, causes and types of deformation in different age groups, for development of specialized dentistry assistance plans and prevention programs. We have studied 147 patients of ages between 15 and 40 years. We have developed special questionnaire. Researches showed that in the studied age group (15-40), 62% (96 patients), i.e. more than half of studied 147 patients had secondary adentia. Most of them had the defects in the buccal teeth area. 112 of studied 147 patients required orthopedic treatment but only 18 (16%) of them have visited the clinic for this purpose while 94 (83.9%) of them were unaware about need of prothetic assistance. Regarding significance of the mentioned problem, the obtained results show the need of timely orthopedic intervention for the purpose of prevention of further complications. As a result, a specialized dental assistance plan and prevention measures' program has been developed to prevent further complications.

  9. Glycolysis in Patients with Age-Related Macular Degeneration

    PubMed Central

    Yokosako, Kanako; Mimura, Tatsuya; Funatsu, Hideharu; Noma, Hidetaka; Goto, Mari; Kamei, Yuko; Kondo, Aki; Matsubara, Masao

    2014-01-01

    Purpose: Retinal adenosine triphosphate is mainly produced via glycolysis, so inhibition of glycolysis may promote the onset and progression of age-related macular degeneration (AMD). When glycolysis is inhibited, pyruvate is metabolized by lactic acid fermentation instead of entering the mitochondrial tricarboxylic acid (TCA) cycle. We measured urinary pyruvate and lactate levels in patients with AMD. Methods: Eight patients with typical AMD (tAMD group) and 9 patients with polypoidal choroidal vasculopathy (PCV group) were enrolled. Urinary levels of pyruvate, lactate, α-hydroxybutyrate, and β-hydroxybutyrate were measured in all patients. Results: The mean urinary levels of pyruvate and lactate were 8.0 ± 2.8 and 7.5 ± 8.3 μg/mg creatinine (reference values: 0.5-6.6 and 0.0-1.6), respectively, with the mean increase over the reference value being 83.6 ± 51.1% and 426.5 ± 527.8%, respectively. In 12 patients (70.6%), the lactate/pyruvate ratio was above the reference range. Urinary levels of α-hydroxybutyrate and β-hydroxybutyrate were decreased by -31.9 ± 15.2% and -33.1 ± 17.5% compared with the mean reference values. There were no significant differences of any of these glycolysis metabolites between the tAMD and PCV groups. Multivariate analysis revealed that none of the variables tested, including patient background factors (age, hypertension, diabetes, hyperlipidemia, cerebrovascular disease, alcohol, smoking, visual acuity, and AMD phenotype), were significantly associated with the lactate/pyruvate ratio. Conclusion: A high lactate/pyruvate ratio is a well-known marker of mitochondrial impairment, and it indicates poor oxidative function in AMD. Our results suggest that increased lactate levels may be implicated in the pathogenesis of AMD. PMID:25191529

  10. Geriatric periodontology: how the need to care for the aging population can influence the future of the dental profession.

    PubMed

    Lamster, Ira B

    2016-10-01

    The world's population is aging, and it has been estimated that by 2050, the number of people 65 years of age and older will reach 1.5 billion. The aging population will be affected by noncommunicable chronic diseases, including diabetes mellitus, cardiovascular disease and cognitive impairment. This important demographic shift includes a reduction in tooth loss/edentulism, particularly in older adults of the developed countries in North America, western Europe and north-east Asia. Therefore, in the future, dental providers will be required to care for an expanded number of older adults who have retained teeth and are medically complex. As the linkage of oral disease and systemic disease has focused on the relationship of periodontitis and noncommunicable chronic diseases, a broad review of 'geriatric periodontology' is both timely and important. This volume of Periodontology 2000 covers a range of subjects under this heading. Included are the demographics of an aging world; the effect of aging on stem cell function in the periodontium; the periodontal microbiota associated with aging; the host response in the periodontium of aging individuals; an analysis of the prevalence of periodontitis in the USA on a national, state-wide and community basis; differentiation of physiologic oral aging from disease; treatment of periodontal disease in older adults; implant therapy for older patients; oral disease and the frailty syndrome; the relationship of tooth loss to longevity and life expectancy; and the relationship of periodontal disease to noncommunicable chronic diseases. Although 'geriatric dentistry' is not a recognized specialty in dentistry, and 'geriatric periodontology' is a descriptive title, the subject of this volume of Periodontology 2000 is critical to the future of clinical dentistry, dental public health and dental research. Any comprehensive focus on older patients can only be accomplished with an emphasis on interprofessional education and practice. If

  11. Age-dependent stochastic models for understanding population fluctuations in continuously cultured cells

    PubMed Central

    Stukalin, Evgeny B.; Aifuwa, Ivie; Kim, Jin Seob; Wirtz, Denis; Sun, Sean X.

    2013-01-01

    For symmetrically dividing cells, large variations in the cell cycle time are typical, even among clonal cells. The consequence of this variation is important in stem cell differentiation, tissue and organ size control, and cancer development, where cell division rates ultimately determine the cell population. We explore the connection between cell cycle time variation and population-level fluctuations using simple stochastic models. We find that standard population models with constant division and death rates fail to predict the level of population fluctuation. Instead, variations in the cell division time contribute to population fluctuations. An age-dependent birth and death model allows us to compute the mean squared fluctuation or the population dispersion as a function of time. This dispersion grows exponentially with time, but scales with the population. We also find a relationship between the dispersion and the cell cycle time distribution for synchronized cell populations. The model can easily be generalized to study populations involving cell differentiation and competitive growth situations. PMID:23760298

  12. MO-E-17A-10: Evaluation of Body and Head Dimensions of Pediatric Patients as a Function of Age

    SciTech Connect

    Seibert, JA; Boone, JM

    2014-06-15

    Purpose: Phantom development in medical physics plays an important role in radiation dose assessment and image quality evaluation, and this is especially true in the pediatric patient population. The purpose of this investigation was to establish the relationship between patient age and patient size, focusing on the abdomen-pelvis and head effective diameters, for patients ranging in age from newborn to 18 years. Methods: A dose reporting tool for computed tomography systems was installed at our institution to achieve compliance with state law commencing on July 1, 2012. The software records a number of patient-specific data, and also reports CT dose metrics (CTDIvol and DLP) into the patients interpretive report. The database generated by the software was mined to determine patient effective diameter as a function of age for pediatric patients aged 0–18 years. CT protocols including abdomen-pelvis and routine head were evaluated, and specific to this study the patients age, gender and equivalent diameter were recorded. Results: Six age ranges were evaluated: A(0–3), B(4–6), C(7–9), D(10–12),E(13–15),F(16–18). For the torso in these groups based upon 694 patients, median effective diameters were 147, 167, 184, 214, 231, 246 mm, respectively. For the head (N=1833), median diameters were 143, 157, 162, 168, 174, and 174, respectively. Conclusion: A solid understanding of the approximate dimensions of pediatric patients as a function of age is useful in the development of age-based imaging protocols and dose assessments. CT dose-reporting tools generate a great deal of data with respect to body dimensions automatically. In this study, median equivalent diameters for the abdomen-pelvis and head of pediatric patients were evaluated. These data may prove useful in the development of both mathematical and physical phantoms for dosimetry and image quality assessment.

  13. Thromboelastographic reference ranges for a cirrhotic patient population undergoing liver transplantation

    PubMed Central

    De Pietri, Lesley; Bianchini, Marcello; Rompianesi, Gianluca; Bertellini, Elisabetta; Begliomini, Bruno

    2016-01-01

    AIM To describe the thromboelastography (TEG) “reference” values within a population of liver transplant (LT) candidates that underline the differences from healthy patients. METHODS Between 2000 and 2013, 261 liver transplant patients with a model for end-stage liver disease (MELD) score between 15 and 40 were studied. In particular the adult patients (aged 18-70 years) underwent to a first LT with a MELD score between 15 and 40 were included, while all patients with acute liver failure, congenital bleeding disorders, and anticoagulant and/or antiplatelet drug use were excluded. In this population of cirrhotic patients, preoperative haematological and coagulation laboratory tests were collected, and the pretransplant thromboelastographic parameters were studied and compared with the parameters measured in a previously studied population of 40 healthy subjects. The basal TEG parameters analysed in the cirrhotic population of liver candidates were as follows: Reaction time (r), coagulation time (k), Angle-Rate of polymerization of clot (α Angle), Maximum strenght of clot (MA), Amplitudes of the TEG tracing at 30 min and 60 min after MA is measured (A30 and A60), and Fibrinolysis at 30 and 60 min after MA (Ly30 and Ly60). The possible correlation between the distribution of the reference range and the gender, age, MELD score (higher or lower than 20) and indications for transplantation (liver pathology) were also investigated. In particular, a MELD cut-off value of 20 was chosen to verify the possible correlation between the thromboelastographic reference range and MELD score. RESULTS Most of the TEG reference values from patients with end-stage liver disease were significantly different from those measured in the healthy population and were outside the suggested normal ranges in up to 79.3% of subjects. Wide differences were found among all TEG variables, including r (41.5% of the values), k (48.6%), α (43.7%), MA (79.3%), A30 (74.4%) and A60 (80

  14. Thromboelastographic reference ranges for a cirrhotic patient population undergoing liver transplantation

    PubMed Central

    De Pietri, Lesley; Bianchini, Marcello; Rompianesi, Gianluca; Bertellini, Elisabetta; Begliomini, Bruno

    2016-01-01

    AIM To describe the thromboelastography (TEG) “reference” values within a population of liver transplant (LT) candidates that underline the differences from healthy patients. METHODS Between 2000 and 2013, 261 liver transplant patients with a model for end-stage liver disease (MELD) score between 15 and 40 were studied. In particular the adult patients (aged 18-70 years) underwent to a first LT with a MELD score between 15 and 40 were included, while all patients with acute liver failure, congenital bleeding disorders, and anticoagulant and/or antiplatelet drug use were excluded. In this population of cirrhotic patients, preoperative haematological and coagulation laboratory tests were collected, and the pretransplant thromboelastographic parameters were studied and compared with the parameters measured in a previously studied population of 40 healthy subjects. The basal TEG parameters analysed in the cirrhotic population of liver candidates were as follows: Reaction time (r), coagulation time (k), Angle-Rate of polymerization of clot (α Angle), Maximum strenght of clot (MA), Amplitudes of the TEG tracing at 30 min and 60 min after MA is measured (A30 and A60), and Fibrinolysis at 30 and 60 min after MA (Ly30 and Ly60). The possible correlation between the distribution of the reference range and the gender, age, MELD score (higher or lower than 20) and indications for transplantation (liver pathology) were also investigated. In particular, a MELD cut-off value of 20 was chosen to verify the possible correlation between the thromboelastographic reference range and MELD score. RESULTS Most of the TEG reference values from patients with end-stage liver disease were significantly different from those measured in the healthy population and were outside the suggested normal ranges in up to 79.3% of subjects. Wide differences were found among all TEG variables, including r (41.5% of the values), k (48.6%), α (43.7%), MA (79.3%), A30 (74.4%) and A60 (80

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

    PubMed Central

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

    2016-01-01

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

  16. Analysis of spirometry results in hospitalized patients aged over 65 years

    PubMed Central

    Wróblewska, Izabela; Oleśniewicz, Piotr; Kurpas, Donata; Sołtysik, Mariusz; Błaszczuk, Jerzy

    2015-01-01

    Introduction and objective The growing population of the elderly, as well as the occurrence of coexisting diseases and polypharmacy, is the reason why diseases of patients aged $65 years belong to the major issues of the contemporary medicine. Among the most frequent diseases of the elderly, there are respiratory system diseases. They are difficult to diagnose because of the patient group specificity, which is the reason for increased mortality among seniors, caused by underdiagnosis. The study objective was to assess the factors influencing spirometry results in hospitalized patients aged ≥65 years with respiratory system disorders. Material and methods In the research, 217 (100%) patients aged ≥65 years who underwent spirometry at the Regional Medical Center of the Jelenia Góra Valley Hospital in Poland were analyzed. In the statistical analysis, the STATISTICA 9.1 program, the t-test, the Shapiro–Wilk test, the ANOVA test, and the Scheffé’s test were applied. Results The majority of the patients (59.4%) were treated in the hospital. The most frequent diagnosis was malignant neoplasm (18%). The study showed a statistically significant dependence between the forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), and FEV1/FVC parameters and the time of hospitalization, as well as between the FVC and FEV1 parameters and the age of patients. The FVC parameter values turned out to be dependent on the main diagnosis. Highest results were noted in patients with the diagnosis of sleep apnea or benign neoplasm. A low FVC index can reflect restrictive ventilation defects, which was supported by the performed analyses. Highest FEV1/FVC values were observed in nonsmokers, which confirms the influence of nicotine addiction on the incidence of respiratory system diseases. Conclusion The respondents’ sex and the established diagnosis statistically significantly influenced the FVC index result, and the diet influenced the FEV1/FVC parameter result

  17. Equilibrium population dynamics when mating is by mutual choice based on age.

    PubMed

    Alpern, Steve; Katrantzi, Ioanna; Ramsey, David

    2014-06-01

    We consider a steady state model of mutual mate choice in which an individual's mate preferences depend on his/her age, and the preferences are over the ages of prospective mates of the opposite sex. We present a discrete time (and age) model corresponding to successive mating seasons. Males are fertile for m periods (corresponding to 'age' i=1 to m) and females for n≤m periods (they have ages j=1 to n), which is all that distinguishes the sexes. Although we can deal with arbitrary preferences, we concentrate on a simple fertility model where the common utility to a male age i and female age j who mate is the number K=min(m-i+1,n-j+1) of future periods of joint fertility. The incoming sex ratio R of age 1 males to age 1 females is given exogenously. In each period individuals are randomly (non assortatively) matched and form a mated couple by mutual consent; otherwise they go into the next period unmated and older. We derive properties of equilibrium threshold acceptance strategies and establish the existence of time-invariant age distributions. Our methods determine the age distribution of couples at marriage (mating) and the population sex ratio (OSR) at equilibrium. Since this can be determined empirically in a population, our model can be used to rule out most systems of age preferences (those not consistent with the observed distribution). This extends earlier models of mutual choice with one dimensional types of Alpern and Reyniers [1999. Strategic mating with homotypic preferences. J. Theor. Biol. 198, 71-88; 2005. Strategic mating with common preferences. J. Theor. Biol. 237, 337-354] where individuals sought, respectively, individuals with similar or high types, but in those models an individual's type was fixed over time. Under the simple fertility model, at equilibrium the maximum age of an acceptable partner is increasing in the age of the searcher. Our results relate to discussions in the literature regarding optimal parental age differences, age

  18. Equilibrium population dynamics when mating is by mutual choice based on age.

    PubMed

    Alpern, Steve; Katrantzi, Ioanna; Ramsey, David

    2014-06-01

    We consider a steady state model of mutual mate choice in which an individual's mate preferences depend on his/her age, and the preferences are over the ages of prospective mates of the opposite sex. We present a discrete time (and age) model corresponding to successive mating seasons. Males are fertile for m periods (corresponding to 'age' i=1 to m) and females for n≤m periods (they have ages j=1 to n), which is all that distinguishes the sexes. Although we can deal with arbitrary preferences, we concentrate on a simple fertility model where the common utility to a male age i and female age j who mate is the number K=min(m-i+1,n-j+1) of future periods of joint fertility. The incoming sex ratio R of age 1 males to age 1 females is given exogenously. In each period individuals are randomly (non assortatively) matched and form a mated couple by mutual consent; otherwise they go into the next period unmated and older. We derive properties of equilibrium threshold acceptance strategies and establish the existence of time-invariant age distributions. Our methods determine the age distribution of couples at marriage (mating) and the population sex ratio (OSR) at equilibrium. Since this can be determined empirically in a population, our model can be used to rule out most systems of age preferences (those not consistent with the observed distribution). This extends earlier models of mutual choice with one dimensional types of Alpern and Reyniers [1999. Strategic mating with homotypic preferences. J. Theor. Biol. 198, 71-88; 2005. Strategic mating with common preferences. J. Theor. Biol. 237, 337-354] where individuals sought, respectively, individuals with similar or high types, but in those models an individual's type was fixed over time. Under the simple fertility model, at equilibrium the maximum age of an acceptable partner is increasing in the age of the searcher. Our results relate to discussions in the literature regarding optimal parental age differences, age

  19. Population Pharmacokinetics of Vancomycin in Postoperative Neurosurgical Patients.

    PubMed

    Li, Xingang; Wu, Yuanxing; Sun, Shusen; Mei, Shenghui; Wang, Jiaqing; Wang, Qiang; Zhao, Zhigang

    2015-11-01

    Neurosurgical procedures may damage the blood-brain barrier to allow more vancomycin distribution into the cerebrospinal fluid (CSF) from blood after intravenous administration. However, a large intersubject variability in CSF vancomycin concentration was observed. We aimed to develop a population pharmacokinetic model to guide vancomycin dosing in patients after neurosurgical operation. Blood and CSF samples were collected and determined from postoperative neurosurgical patients after vancomycin administration. A three-compartment (central, peripheral, and CSF) model was proposed to characterize the pharmacokinetics of vancomycin. A nonlinear mixed-effects modeling approach was applied to fit the blood and CSF data simultaneously. The covariate analysis found that the CSF albumin level was strongly associated with the clearance between central and CSF compartment. Visual predictive check indicated that the proposed population pharmacokinetic model agrees well with the observed vancomycin concentrations. Individualized vancomycin dosage regimens could be developed for postoperative neurosurgical patients with different CSF albumin levels through model simulations. The CSF albumin level is a determinant of CSF vancomycin concentration.

  20. Radiation exposures of cancer patients from medical X-rays: how relevant are they for individual patients and population exposure?

    PubMed

    Brix, Gunnar; Nissen-Meyer, Sven; Lechel, Ursula; Nissen-Meyer, Johannes; Griebel, Jürgen; Nekolla, Elke A; Becker, Christoph; Reiser, Maximilian

    2009-11-01

    X-ray procedures have a substantial impact not only on patient care but also on man-made radiation exposure. Since a reliable risk-benefit analysis of medical X-rays can only be performed for diagnosis-related groups of patients, we determined specific exposure data for patients with the ten most common types of cancer. For all patients with the considered cancers undergoing medical X-ray procedures in a maximum-care hospital between 2000 and 2005, patient- and examination-specific data were retrieved from the hospital/radiology information system. From this data, the cumulative 5-year effective dose was estimated for each patient as well as the mean annual effective dose per patient and the mean patient observation time for each cancer site. In total, 151,439 radiographic, fluoroscopic, and CT procedures, carried out in 15,866 cancer patients (age, 62+/-13 years), were evaluated. The mean 5-year cumulative dose varied between 8.6 mSv (prostate cancer) and 68.8 mSv (pancreas cancer). Due to an increasing use of CT scans, the mean annual effective dose per patient increased from 13.6 to 18.2 mSv during the 6-year period. Combining the results obtained in this study for a particular hospital with cancer incidence data for Germany, we estimated that cancer patients having X-ray studies constitute at least 1% of the population but receive more than 10% of the total effective dose related to all medical X-ray procedures performed nationwide per year. A large fraction of this dose is radiobiologically ineffective due to the reduced life expectancy of cancer patients.

  1. Dynamical properties of the Penna aging model applied to the population of wolves

    NASA Astrophysics Data System (ADS)

    Makowiec, Danuta

    1997-02-01

    The parameters of th Penna bit-string model of aging of biological systems are systematically tested to better understand the model itself as well as the results arising from applying this model to studies of the development of the stationary population of Alaska wolves.

  2. Changing Literacies, Changing Populations, Changing Places--English Teachers' Work in an Age of Rampant Standardisation

    ERIC Educational Resources Information Center

    Comber, Barbara

    2011-01-01

    School-age populations in many nations are becoming increasingly diverse (in terms of languages, countries of origin, ethnicity, faith traditions and so on) especially in low socio-economic communities where recent arrivals tend to be accommodated. In Australian classrooms, it is not unusual for a single classroom to include children who speak…

  3. Economic Implications of Japan's Ageing Population: A Macro-economic Demographic Modelling Approach.

    ERIC Educational Resources Information Center

    Ogawa, Naohiro

    1982-01-01

    This study discusses the impact of the aging of the Japanese population upon various socioeconomic factors. Major findings are that the rate of real gross national product growth will decline continuously and that more financial resources will be required for government social security programs. (Editor/CT)

  4. HIV/AIDS Interventions in an Aging U.S. Population

    ERIC Educational Resources Information Center

    Jacobson, Stephanie A.

    2011-01-01

    According to the Centers for Disease Control and Prevention (CDC), 25 percent of people living with HIV in the United States in 2006 were age 50 and older. HIV prevention for people over 50 is an important health concern, especially as the U.S. population grows older. Scholarly research has identified the need for HIV/AIDS interventions in the…

  5. Pontryagin's principle for control problems in age-dependent population dynamics.

    PubMed

    Brokate, M

    1985-01-01

    In this paper, Pontryagin's principle is proved for a fairly general problem of optimal control of populations with continuous time and age variable. As a consequence, maximum principles are developed for an optimal harvesting problem and a problem of optimal birth control.

  6. Forces and Factors Likely to Influence Vocational Education: The Aging Population.

    ERIC Educational Resources Information Center

    Lewis, Morgan V.; Norton, Lee

    The aging of the population is one of the major influences on the environment in which vocational education operates. The number of people 65 and older will increase more slowly in next 25 years than in the past. Improvements in working conditions, health care, and pension plans since World War II have made those who will be 65 by the end of the…

  7. META-ANALYSIS OF THE LIFE STYLE FACTORS RELEVANT TO ENVIRONMENTAL HAZARDS FOR THE AGING POPULATION

    EPA Science Inventory

    The goal of this U.S. Environmental Protection Agency (EPA) study is to characterize activity patterns, physiological changes, and environmental exposures for the aging population. Meta analysis was performed on more than 2000 reviewed articles to evaluate the lifestyle factors ...

  8. Radiotherapy service delivery models for a dispersed patient population.

    PubMed

    Dunscombe, P; Roberts, G

    2001-01-01

    Access to health care interventions can be impeded when significant patient travel is required. In this economic evaluation we compare, from a societal perspective, three scenarios for the delivery of radiation treatment to an idealized population of 1,600 patients distributed between two urban nodes (1,200 + 400 patients each) separated by up to 500 km. As it is implicitly assumed that the clinical outcome for those patients who access the system is independent of the service delivery model, this study constitutes a cost minimization analysis from a societal perspective. The costs to the health care system are based on an activity costing model developed by us and consistent with recent Canadian studies. The costs to the patient are approximated by a formula that includes direct costs (travel and accommodation) and indirect (time) costs, with the latter based on a human capital approach. A sensitivity analysis has been performed to confirm the robustness of our conclusions both to uncertainties in the input data and to the inclusion of time costs, the estimation of which remains controversial. From a societal cost perspective only, we show that outreach radiotherapy (central comprehensive facility and satellite) is the economically superior service delivery model for separations between 30 km and 170 km. Beyond 170 km, a fully decentralized service would be warranted if the only consideration were societal economic advantage. PMID:11292133

  9. AGE AND MASS SEGREGATION OF MULTIPLE STELLAR POPULATIONS IN GALACTIC NUCLEI AND THEIR OBSERVATIONAL SIGNATURES

    SciTech Connect

    Perets, Hagai B.; Mastrobuono-Battisti, Alessandra

    2014-04-01

    Nuclear stellar clusters (NSCs) are known to exist around massive black holes in galactic nuclei. They are thought to have formed through in situ star formation following gas inflow to the nucleus of the galaxy and/or through the infall of multiple stellar clusters. Here we study the latter, and explore the composite structure of the NSC and its relation to the various stellar populations originating from its progenitor infalling clusters. We use N-body simulations of cluster infalls and show that this scenario may produce observational signatures in the form of age segregation: the distribution of the stellar properties (e.g., stellar age and/or metallicity) in the NSCs reflects the infall history of the different clusters. The stellar populations of clusters, infalling at different times (dynamical ages), are differentially segregated in the NSC and are not fully mixed even after a few gigayears of evolution. Moreover, the radial properties of stellar populations in the progenitor cluster are mapped to their radial distribution in the final NSC, potentially leading to efficient mass segregation in NSCs, even those where relaxation times are longer than a Hubble time. Finally, the overall structures of the stellar populations present non-spherical configurations and show significant cluster to cluster population differences.

  10. The influence of persistent individual differences and age at maturity on effective population size

    PubMed Central

    Lee, Aline Magdalena; Engen, Steinar; Sæther, Bernt-Erik

    2011-01-01

    Ratios of effective populations size, Ne, to census population size, N, are used as a measure of genetic drift in populations. Several life-history parameters have been shown to affect these ratios, including mating system and age at sexual maturation. Using a stochastic matrix model, we examine how different levels of persistent individual differences in mating success among males may affect Ne/N, and how this relates to generation time. Individual differences of this type are shown to cause a lower Ne/N ratio than would be expected when mating is independent among seasons. Examining the way in which age at maturity affects Ne/N, we find that both the direction and magnitude of the effect depends on the survival rate of juveniles in the population. In particular, when maturation is delayed, lowered juvenile survival causes higher levels of genetic drift. In addition, predicted shifts in Ne/N with changing age at maturity are shown to be dependent on which of the commonly used definitions of census population size, N, is employed. Our results demonstrate that patterns of mating success, as well as juvenile survival probabilities, have substantial effects on rates of genetic drift. PMID:21436183

  11. An apocalyptic vision of ageing in China: Old age care for the largest elderly population in the world.

    PubMed

    Liu, Tao; Sun, Li

    2015-06-01

    According to the National Bureau of Statistics of China, by 2010 the number of people aged 60 or over had reached 178 million in China or 13% of its population. With the largest elderly population in the world in absolute numbers, China faces a challenge of providing care for the elderly both in the present and the future. Unlike old age pensions and health protection for the elderly, in Chinese society elderly care had never been considered to be a social problem but rather the individual family's responsibility. After the turn of the millennium, as the repercussions of increasingly ageing demographics, the results of the One-Child Policy and drastic changes in traditional family structures gradually became more apparent, this issue of elderly care has increasingly become one of the most pressing concerns for the ageing society. As there is little existing research on this particular topic, this article aims to shed light on elderly care in China, focusing on the care of elderly needing assistance with activities of daily living, since this group of elderly are most in need of care, their numbers having risen to 33 million in 2010. This article argues it is urgent for China to switch from informal family-based elderly care to the state's formal long-term care, illustrates that a model of social insurance (e.g. as in Germany) is advocated by many Chinese scholars and points out the ways in which it is different from both the commercialized models (e.g. as in the USA) and state organized "Beveridge" models (e.g. as in Sweden).

  12. Investigation of the maxillary lateral incisor agenesis and associated dental anomalies in an orthodontic patient population

    PubMed Central

    Kamak, Hasan; Yildirim, Hanifi; Ceylan, Ismail

    2012-01-01

    Objectives: The aim of this study was to investigate the prevalence of maxillary lateral incisor (MLI) agenesis and associated dental anomalies as well as skeletal patterns in an orthodontic population, and then to compare it with the prevalence of these anomalies in the general population. Study Design: The material of the present study included the records of the 3872 orthodontic patients. The followings were recorded for each subject with the agenesis of MLI: Age, sex, unilateral or bilateral absence, anterior-posterior skeletal relationship of the maxilla and mandible, and presence of associated dental anomalies. The occurrence of these anomalies was compared with data previously reported for the general populations. Results: Of the 3872 patients examined, 94 were found to have agenesis of the MLI, representing a prevalence of 2.4 per cent, with females being more frequently observed. The most commonly found associated anomalies were ectopic eruption of maxillary canines and reduced or peg- shaped contralateral incisor with the frequencies of 21.3 per cent and 20.2 per cent respectively. Conclusions: Patients with agenesis of MLI showed a significantly higher prevalence of skeletal Class III malocclusion compared with the general population. The prevalence of ectopic eruption, transposition, and transmigration of the maxillary canine and reduced or peg- shaped MLIs were significantly increased. Key words:Hypodontia, missing laterals, associated dental anomalies. PMID:22549676

  13. Can Functional Cardiac Age be Predicted from ECG in a Normal Healthy Population

    NASA Technical Reports Server (NTRS)

    Schlegel, Todd; Starc, Vito; Leban, Manja; Sinigoj, Petra; Vrhovec, Milos

    2011-01-01

    In a normal healthy population, we desired to determine the most age-dependent conventional and advanced ECG parameters. We hypothesized that changes in several ECG parameters might correlate with age and together reliably characterize the functional age of the heart. Methods: An initial study population of 313 apparently healthy subjects was ultimately reduced to 148 subjects (74 men, 84 women, in the range from 10 to 75 years of age) after exclusion criteria. In all subjects, ECG recordings (resting 5-minute 12-lead high frequency ECG) were evaluated via custom software programs to calculate up to 85 different conventional and advanced ECG parameters including beat-to-beat QT and RR variability, waveform complexity, and signal-averaged, high-frequency and spatial/spatiotemporal ECG parameters. The prediction of functional age was evaluated by multiple linear regression analysis using the best 5 univariate predictors. Results: Ignoring what were ultimately small differences between males and females, the functional age was found to be predicted (R2= 0.69, P < 0.001) from a linear combination of 5 independent variables: QRS elevation in the frontal plane (p<0.001), a new repolarization parameter QTcorr (p<0.001), mean high frequency QRS amplitude (p=0.009), the variability parameter % VLF of RRV (p=0.021) and the P-wave width (p=0.10). Here, QTcorr represents the correlation between the calculated QT and the measured QT signal. Conclusions: In apparently healthy subjects with normal conventional ECGs, functional cardiac age can be estimated by multiple linear regression analysis of mostly advanced ECG results. Because some parameters in the regression formula, such as QTcorr, high frequency QRS amplitude and P-wave width also change with disease in the same direction as with increased age, increased functional age of the heart may reflect subtle age-related pathologies in cardiac electrical function that are usually hidden on conventional ECG.

  14. Trajectories of gambling problems from mid-adolescence to age 30 in a general population cohort.

    PubMed

    Carbonneau, René; Vitaro, Frank; Brendgen, Mara; Tremblay, Richard E

    2015-12-01

    Studies of gambling starting before adulthood in the general population are either cross-sectional, based on the stability of these behaviors between 2 time points, or cover a short developmental period. The present study aimed at investigating the developmental trajectories of gambling problems across 3 key periods of development, mid-adolescence, early adulthood, and age 30, in a mixed-gender cohort from the general population. Using a semiparametric mixture model, trajectories were computed based on self-reports collected at ages 15 (N = 1,882), 22 (N = 1,785), and 30 (N = 1,358). Two distinct trajectories were identified: 1 trajectory including males and females who were unlikely to have experienced gambling problems across the 15-year period, and 1 trajectory including participants likely to have experienced at least 1 problem over the last 12 months at each time of assessment. Participants following a high trajectory were predominantly male, participated frequently in 3 to 4 different gambling activities, and were more likely to report substance use and problems related to their alcohol and drug consumption at age 30. Thus, gambling problems in the general population are already observable at age 15 in a small group of individuals, who maintain some level of these problems through early adulthood, before moderately but significantly desisting by age 30, while also experiencing other addictive behaviors and related problems. PMID:26168229

  15. Cognitive estimation in aged patients with major depressive disorder.

    PubMed

    Barabassy, Agota; Beinhoff, Ulrike; Riepe, Matthias W

    2010-03-30

    In everyday life, we often estimate rather than know. It was the goal of this study to assess the effect of depressed mood on cognitive estimation in old age. Cognitive estimation was performed in 44 subjects with major depressive disorder (MDD; DSM-IV) and 48 age-matched healthy subjects (HS). Severity of depressive symptoms was rated with the Montgomery-Asberg Depression Rating Scale (MADRS, mean=18.6+/-S.D. 4.85). Estimation tasks comprised the dimensions length (coin diameter), weight (pile of paper), quantity (number of marbles in a glass jar), and time (estimation of time it takes for a marble to roll down a marble track both before and after having observed it). Other than the procedure followed in previous tests on cognitive estimation, the tasks were performed by observing objects rather than pictures thereof. MDD patients overestimated time (before and after observation) and underestimated quantity. Cognitive estimation was not correlated to measures of frontal functioning or semantic knowledge. We conclude that MDD patients in old age are impaired to some extent in cognitive estimation and in the ability to correct themselves, deficits that are likely to affect the performance of everyday activities. PMID:20064666

  16. Quantitative Genetics of Postponed Aging in Drosophila Melanogaster. I. Analysis of Outbred Populations

    PubMed Central

    Hutchinson, E. W.; Rose, M. R.

    1991-01-01

    Selection has been used to create replicated outbred stocks of Drosophila melanogaster with increased longevity, increased later fecundity, and increased levels of physiological performance at later ages. The present study analyzed the quantitative transmission patterns of such stocks, employing extensive replication in numbers of stocks, individuals, and assayed characters. The populations used derived from five lines with postponed aging and five control lines, all created in 1980 from the same founding base population. The following characters were studied: early 24-hr fecundity, early ovary weight, early female starvation resistance, early male starvation resistance, female longevity and male longevity. Numerous crosses were performed to test for non-Mendelian inheritance, average dominance, maternal effects, sex-linkage and between-line heterogeneity. There was only slight evidence for any of these phenomena arising reproducibly in the characters studied. These findings suggest the value of this set of stocks for studies of the physiological basis of postponed aging. PMID:1903116

  17. Equations to estimate fetal age at the moment of death in the Mexican population.

    PubMed

    Chávez-Martínez, Perla; Ortega-Palma, Albertina; Castrejón-Caballero, José Luis; Arteaga-Martínez, Manuel

    2016-09-01

    Metric standards are presented for the estimation of fetal age at the time of death in the Mexican population. To obtain these standards, both metric and radiological studies were conducted on 97 fetuses and complete stillborn infants of both sexes, phenotypically normal between 10 and 38 weeks of morphological age. All the fetuses used were the product of spontaneous abortions in Mexico City between 1990 and 2000. Equations were obtained by calibrating quadratic linear regression models adjusted for the diaphyseal length of the humerus, radius, ulna, femur, tibia and fibula, characterized as the most adequate indicators to represent the growth of long bones in this age group, and verified by the evaluation of the model assumptions and the coefficient of determination (R(2)). To conclude, these models facilitate a more precise prediction in fetuses of the Mexican population, constituting the first metric standards of their type at a national level.

  18. Is Low Fertility Really a Problem? Population Aging, Dependency, and Consumption*

    PubMed Central

    2015-01-01

    Longer lives and fertility far below the replacement level of 2.1 births per woman are leading to rapid population aging in many countries. Many observers are concerned that aging will adversely affect public finances and standards of living. Analysis of newly available National Transfer Accounts data for 40 countries shows that fertility well above replacement would typically be most beneficial for government budgets. However, fertility near replacement would be most beneficial for standards of living when the analysis includes the effects of age structure on families as well as governments. And fertility below replacement would maximize per capita consumption when the cost of providing capital for a growing labor force is taken into account. While low fertility will indeed challenge government programs and very low fertility undermines living standards, we find that moderately low fertility and population decline favor the broader material standard of living PMID:25301626

  19. The risk of atrial fibrillation in patients with gout: a nationwide population-based study

    PubMed Central

    Kuo, Yu-Jui; Tsai, Tzu-Hsien; Chang, Hui-Ping; Chua, Sarah; Chung, Sheng-Ying; Yang, Cheng-Hsu; Lin, Cheng-Jei; Wu, Chiung-Jen; Hang, Chi-Ling

    2016-01-01

    Many studies have found that systemic inflammation plays an important role in the pathogenesis of atrial fibrillation (AF). Gout is a chronic systemic inflammatory disorder, but little evidence exists regarding whether the risk of AF is increased in patients with gout. The National Health Insurance Research Database in Taiwan was used in this study, and gout was defined as the occurrence of at least one episode of an acute gout attack requiring medical treatment. A total of 63264 gout and 63264 age- and gender-matched patients were included as the study population. The Cox model was used to evaluate the risk of AF in patients with gout. Patients with gout experienced a greater frequency of co-morbidities compared to patients without gout. The cumulative incidences of AF were 4.61% and 3.04% in patients with and without gout, respectively (log-rank test, P < 0.001). After adjusting for co-morbidities and prescription medication use, gout was found to be associated with AF [hazard ratio (HR), 1.38]. Moreover, the HR for AF decreased with increasing age in our study. Gout was found to be associated with an increased risk of developing AF after adjusting for potential confounders. PMID:27599578

  20. The risk of atrial fibrillation in patients with gout: a nationwide population-based study

    NASA Astrophysics Data System (ADS)

    Kuo, Yu-Jui; Tsai, Tzu-Hsien; Chang, Hui-Ping; Chua, Sarah; Chung, Sheng-Ying; Yang, Cheng-Hsu; Lin, Cheng-Jei; Wu, Chiung-Jen; Hang, Chi-Ling

    2016-09-01

    Many studies have found that systemic inflammation plays an important role in the pathogenesis of atrial fibrillation (AF). Gout is a chronic systemic inflammatory disorder, but little evidence exists regarding whether the risk of AF is increased in patients with gout. The National Health Insurance Research Database in Taiwan was used in this study, and gout was defined as the occurrence of at least one episode of an acute gout attack requiring medical treatment. A total of 63264 gout and 63264 age- and gender-matched patients were included as the study population. The Cox model was used to evaluate the risk of AF in patients with gout. Patients with gout experienced a greater frequency of co-morbidities compared to patients without gout. The cumulative incidences of AF were 4.61% and 3.04% in patients with and without gout, respectively (log-rank test, P < 0.001). After adjusting for co-morbidities and prescription medication use, gout was found to be associated with AF [hazard ratio (HR), 1.38]. Moreover, the HR for AF decreased with increasing age in our study. Gout was found to be associated with an increased risk of developing AF after adjusting for potential confounders.

  1. The risk of atrial fibrillation in patients with gout: a nationwide population-based study.

    PubMed

    Kuo, Yu-Jui; Tsai, Tzu-Hsien; Chang, Hui-Ping; Chua, Sarah; Chung, Sheng-Ying; Yang, Cheng-Hsu; Lin, Cheng-Jei; Wu, Chiung-Jen; Hang, Chi-Ling

    2016-01-01

    Many studies have found that systemic inflammation plays an important role in the pathogenesis of atrial fibrillation (AF). Gout is a chronic systemic inflammatory disorder, but little evidence exists regarding whether the risk of AF is increased in patients with gout. The National Health Insurance Research Database in Taiwan was used in this study, and gout was defined as the occurrence of at least one episode of an acute gout attack requiring medical treatment. A total of 63264 gout and 63264 age- and gender-matched patients were included as the study population. The Cox model was used to evaluate the risk of AF in patients with gout. Patients with gout experienced a greater frequency of co-morbidities compared to patients without gout. The cumulative incidences of AF were 4.61% and 3.04% in patients with and without gout, respectively (log-rank test, P < 0.001). After adjusting for co-morbidities and prescription medication use, gout was found to be associated with AF [hazard ratio (HR), 1.38]. Moreover, the HR for AF decreased with increasing age in our study. Gout was found to be associated with an increased risk of developing AF after adjusting for potential confounders. PMID:27599578

  2. Mixing times towards demographic equilibrium in insect populations with temperature variable age structures.

    PubMed

    Damos, Petros

    2015-08-01

    In this study, we use entropy related mixing rate modules to measure the effects of temperature on insect population stability and demographic breakdown. The uncertainty in the age of the mother of a randomly chosen newborn, and how it is moved after a finite act of time steps, is modeled using a stochastic transformation of the Leslie matrix. Age classes are represented as a cycle graph and its transitions towards the stable age distribution are brought forth as an exact Markov chain. The dynamics of divergence, from a non equilibrium state towards equilibrium, are evaluated using the Kolmogorov-Sinai entropy. Moreover, Kullback-Leibler distance is applied as information-theoretic measure to estimate exact mixing times of age transitions probabilities towards equilibrium. Using empirically data, we show that on the initial conditions and simulated projection's trough time, that population entropy can effectively be applied to detect demographic variability towards equilibrium under different temperature conditions. Changes in entropy are correlated with the fluctuations of the insect population decay rates (i.e. demographic stability towards equilibrium). Moreover, shorter mixing times are directly linked to lower entropy rates and vice versa. This may be linked to the properties of the insect model system, which in contrast to warm blooded animals has the ability to greatly change its metabolic and demographic rates. Moreover, population entropy and the related distance measures that are applied, provide a means to measure these rates. The current results and model projections provide clear biological evidence why dynamic population entropy may be useful to measure population stability.

  3. Venous Thromboembolism and Cerebrovascular Events in Patients with Giant Cell Arteritis: A Population-Based Retrospective Cohort Study

    PubMed Central

    Crowson, Cynthia S.; Makol, Ashima; Ytterberg, Steven R.; Saitta, Antonino; Salvarani, Carlo; Matteson, Eric L.; Warrington, Kenneth J.

    2016-01-01

    Objective To investigate the incidence of venous thromboembolism (VTE) and cerebrovascular events in a community-based incidence cohort of patients with giant cell arteritis (GCA) compared to the general population. Methods A population-based inception cohort of patients with incident GCA between January 1, 1950 and December 31, 2009 in Olmsted County, Minnesota and a cohort of non-GCA subjects from the same population were assembled and followed until December 31, 2013. Confirmed VTE and cerebrovascular events were identified through direct medical record review. Results The study population included 244 patients with GCA with a mean ± SD age at diagnosis of 76.2 ± 8.2 years (79% women) and an average length of follow-up of 10.2 ± 6.8 years. Compared to non-GCA subjects of similar age and sex, patients diagnosed with GCA had a higher incidence (%) of amaurosis fugax (cumulative incidence ± SE: 2.1 ± 0.9 versus 0, respectively; p = 0.014) but similar rates of stroke, transient ischemic attack (TIA), and VTE. Among patients with GCA, neither baseline characteristics nor laboratory parameters at diagnosis reliably predicted risk of VTE or cerebrovascular events. Conclusion In this population-based study, the incidence of VTE, stroke and TIA was similar in patients with GCA compared to non-GCA subjects. PMID:26901431

  4. Factors impacting unbound vancomycin concentrations in different patient populations.

    PubMed

    Oyaert, Matthijs; Spriet, Isabel; Allegaert, Karel; Smits, Anne; Vanstraelen, Kim; Peersman, Nele; Wauters, Joost; Verhaegen, Jan; Vermeersch, Pieter; Pauwels, Steven

    2015-11-01

    The unbound drug hypothesis states that only unbound drug concentrations are active and available for clearance, and highly variable results regarding unbound vancomycin fractions have been reported in the literature. We have determined the unbound vancomycin fractions in four different patient groups by a liquid chromatography tandem mass spectrometry (LC-MS/MS) method and identified factors that modulate vancomycin binding. We have further developed and validated a prediction model to estimate unbound vancomycin concentrations. Vancomycin (unbound and total) concentrations were measured in 90 patients in four different hospital wards (hematology [n = 33 samples], intensive care unit [ICU] [n = 51], orthopedics [n = 44], and pediatrics [age range, 6 months to 14 years; n = 18]) by a validated LC-MS/MS method. Multiple linear mixed model analysis was performed to identify patient variables that were predictive of unbound vancomycin fractions and concentrations. The variables included in the model were patient age, ward, number of coadministered drugs with high protein binding, kidney function (estimated glomerular filtration rate [determined by Chronic Kidney Disease Epidemiology Collaboration formula]), alpha-1-acid glycoprotein, albumin, total bilirubin, IgA, IgM, urea, and total vancomycin concentrations. In the pediatric cohort, the median unbound vancomycin fraction was 81.3% (range, 61.9 to 95.9%), which was significantly higher (P < 0.01) than the unbound fraction found in the three adult patient cohorts (hematology, 60.6% [48.7 to 90.6%]; ICU, 61.7% [47.0 to 87.6%]; orthopedics, 56.4% [45.9 to 78.0%]). The strongest significant predictor of the unbound vancomycin concentration was the total drug concentration, completed by albumin in the pediatric cohort and albumin and IgA in the adult cohorts. Validation of our model was performed with data from 13 adult patients. A mean difference of 0.3 mg/liter (95% confidence interval [CI], -1.3 to 0.7 mg/liter; R(2

  5. Age, growth and mortality in four populations of the boring bivalve Lithophaga patagonica from Argentina

    NASA Astrophysics Data System (ADS)

    Bagur, María; Richardson, Christopher A.; Gutiérrez, Jorge L.; Arribas, Lorena P.; Doldan, M. Socorro; Palomo, M. Gabriela

    2013-08-01

    The boring bivalve Lithophaga patagonica (d'Orbigny, 1842) is a locally abundant inhabitant of hard substrata in the coastal waters of the Southwestern Atlantic. In this paper, we describe the growth, age and mortality of three intertidal rock-boring populations of L. patagonica and one subtidal oyster shell (Ostrea puelchana) boring population. An analysis of acetate peel replicas of shell sections showed that L. patagonica slows down its growth during autumn-winter, which leads to changes in the direction and rate of shell deposition and the formation of conspicuous annual (low temperature induced) clefts in the shell margin. Cleft counts and Von Bertalanffy growth analyses indicated that maximum age varies from 4 years in the oyster-boring population to 13 years in a rock-boring one (longevity estimates varied between 6.5 and 15 years, respectively). Maximum asymptotic length (L∞) and Von Bertalanffy growth constant (K) were also variable between populations (L∞ between 14.76 and 36.95 mm and K from 0.20 to 0.90 yr- 1 respectively). Mortality rates were higher at the two southernmost populations. Type (rock vs. oyster), composition and hardness of the substrata are likely the main factors controlling the observed differences between populations.

  6. Differences in selected medical care parameters in rheumatic disease ward patients of different ages of life

    PubMed Central

    Pobrotyn, Piotr; Susło, Robert; Milczanowski, Piotr; Drobnik, Jarosław

    2016-01-01

    Introduction Rheumatic diseases are becoming more and more common in Poland with the ageing of the population. Nearly 18% of the total hospital admissions in Poland result from rheumatic diseases, which was equivalent to 350 thousand cases in the year 2008. These diseases tend to last for many decades, decreasing both the quality of life and income of the patients as well as increasing the medical institutions’ workload and society's financial burden. The aim of the study was to determine whether the medical care parameters in a rheumatic disease hospital ward show any significant differences among different patient age groups – especially such that would support taking them into account as a basis for adjusting the financial coverage level of medical services. Material and methods Data on hospitalizations at the Rheumatic Diseases Ward of Wroclaw University Hospital in Wroclaw in the years 2009–2015 were analyzed, taking into account the age groups, number of hospital admissions, their duration and causes. Relevant statistical data analysis was performed. Discussion The study revealed that the number of old patients hospitalized at the rheumatic diseases ward increased over the last 6 years and that such statistically significant differences do exist: on average the old patients not only tend to stay much longer at the hospital, but also suffer from a different and more diverse spectrum of diseases in comparison to their younger counterparts. Conclusions The detected differences in medical care parameters support the need for more individualized medical care and increased cost of the hospital stay in the case of older patients. Consequently, those factors justify the necessity to increase the value of medical services in the case of old patients, possibly also taking into account the variation between age subgroups. PMID:27407280

  7. [Risk factors of serious bleeding among ambulatory patients taking antivitamin K aged 75 and over].

    PubMed

    Blas-Châtelain, C; Chauvelier, S; Foti, P; Debure, C; Hanon, O

    2014-05-01

    The benefits of anti-vitamin K (AVK) drugs have been acknowledged in several indications. Such indications increasing with increasing age, AVK prescriptions also increases with age. At the same time, conditions involving significant bleeding are common in this elderly population. It is thus essential to recognize the determining factors. This study included all patients taking AVK drugs aged 75 years and older who sought emergency care at the Cochin Hospital from January to December 2011 for significant bleeding. These patients were compared with a cohort of patients aged 75 years or older who were taking AVK drugs and who were admitted to the same unit during the same time period for other reasons. The case-control comparison included demographic data, comorbidity factors, multiple medications, emergency measured INR, and CHA2DS2VASC level. The hemorrhagic risk was evaluated by HEMORR2HAGES and HAS-BLED. A total of 34 patients were studied and compared with 70 case-controls. The Charlson comorbidity index was higher in patients than case-controls (P<0.05), with a much higher hemorrhagic risk for scores ≥ 9 (OR=2.5; P<0.05). Multiple medication was also more predominant in patients (P<0.05). The risk of serious hemorrhage was also higher when the hemorrhagic scores were high, especially for HEMORR2HAGES (P<0.0001) and HAS-BLED (P<0.001). The risk of serious hemorrhage in elderly outpatients taking AVK drugs is related to their higher comorbidity and hemorrhagic levels which need to be evaluated before starting or stopping AVK treatment.

  8. Demographic Aspects of Aging and the Older Population in the United States. Current Population Reports, Special Studies, Series P-23, No. 59.

    ERIC Educational Resources Information Center

    Siegel, Jacob S.; And Others

    This report presents a statistical portrait of the demographic aspects of aging and the older population in the Unites States. Most of the estimates are based on data from decennial censuses, the program of nonsurvey population estimates and projections carried out by the U.S. Bureau of the Census, the Current Population Survey, and other census…

  9. Usefulness of a normal coronary angiogram in patients aged ≥65 years to foretell survival.

    PubMed

    Moreyra, Abel E; Charalambous, Marinos; Cosgrove, Nora M; Rajaei, Sheeva; Cullen, Kathryn; Cheng, Jerry Q; David, Alice; Kostis, William J; Kostis, John B

    2015-11-15

    A normal coronary angiogram (CA) has been reported to confer a good prognosis. However, how this applies to patients aged ≥65 years is not well known. From 1986 to 1996, 11,625 patients aged ≥65 underwent coronary angiography. We identified 271 patients with either normal (NORM, n = 160) CA or <30% diameter stenosis disease (NEAR-NORM, n = 111). Using the Myocardial Infarction Data Acquisition System, we examined the probability of survival and the risk of developing an ischemic event or undergoing a revascularization procedure during an average of 15.1 ± 6.2 years (range 0.5 to 25.8 years). Matched actuarial subjects were used to compare survival to the general population. The incidence of an ischemic event was low (2.0 events per 100 persons/year for the NORM and 2.8 patients per 100 persons/year for the NEAR-NORM group, p = NS). Rates of revascularization were higher in the NEAR-NORM group compared to the NORM group (1 per 100 persons/year vs 0.5 per 100 persons/year, p = 0.04). During the 25.8-year follow-up, there were 77 deaths (48.4%) for the NORM and 64 (57.1%) for the NEAR-NORM group (χ2 = 1.7, NS). The NORM group survived 6,789 days, 1,517 more days than the actuarial subjects (95% confidence interval [CI] 1,072 to 1,956; p <0.0001) and the NEAR-NORM group survived 5,922 days, 875 more days (95% CI 368 to 1,376; p <0.005). In conclusion, patients with normal or near-normal CA at age ≥65 years have a low rate of myocardial ischemic events and have significantly longer survival than matched subjects from the general population. PMID:26411358

  10. Evolution of a plastic quantitative trait in an age-structured population in a fluctuating environment.

    PubMed

    Engen, Steinar; Lande, Russell; Saether, Bernt-Erik

    2011-10-01

    We analyze weak fluctuating selection on a quantitative character in an age-structured population not subject to density regulation. We assume that early in the first year of life before selection, during a critical state of development, environments exert a plastic effect on the phenotype, which remains constant throughout the life of an individual. Age-specific selection on the character affects survival and fecundity, which have intermediate optima subject to temporal environmental fluctuations with directional selection in some age classes as special cases. Weighting individuals by their reproductive value, as suggested by Fisher, we show that the expected response per year in the weighted mean character has the same form as for models with no age structure. Environmental stochasticity generates stochastic fluctuations in the weighted mean character following a first-order autoregressive model with a temporally autocorrelated noise term and stationary variance depending on the amount of phenotypic plasticity. The parameters of the process are simple weighted averages of parameters used to describe age-specific survival and fecundity. The "age-specific selective weights" are related to the stable distribution of reproductive values among age classes. This allows partitioning of the change in the weighted mean character into age-specific components.

  11. Cutaneous Resonance Running Time Varies with Age, Body Site and Gender in a Normal Chinese Population

    PubMed Central

    Xin, Shujun; Man, Wenyan; Fluhr, Joachim W.; Song, Shunpeng; Elias, Peter M; Man, Mao-Qiang

    2010-01-01

    Background/objectives One phenomenon of skin aging is loss of cutaneous elasticity. Measurement of cutaneous resonance running time (CRRT) is a method to assess skin elasticity. Yet, information regarding directional changes of CRRT associated with age, body sites and gender is not yet available. In the present study, we assessed whether changes in CRRT vary with age, body sites and gender in a normal Chinese population. Methods A Reviscometer was used to measure CRRTs in various directions on the left dorsal hand, the forehead and the left canthus of 806 normal Chinese volunteers, aged 2.5-94 years. Results With aging, CRRTs decreased in all directions on the hand, the forehead, and the canthus. A more dramatic reduction of CRRTs on the forehead and the canthus were observed at both the 2–8 and 3–9 o’clock directions. CRRTs in males aged 11– 20 years old were longer than those in females at some directions on all three body sites. Females between 21 and 40 years old showed longer CRRTs than males in some directions of the hand. There were no gender differences in subjects aged 0–10 (except on the canthus) and over 81 years old. Conclusion CRRTs vary with age, body sites and gender. PMID:21039906

  12. The Burden and Etiology of Community-Onset Pneumonia in the Aging Japanese Population: A Multicenter Prospective Study

    PubMed Central

    Ishifuji, Tomoko; Yaegashi, Makito; Asoh, Norichika; Hamashige, Naohisa; Abe, Masahiko; Aoshima, Masahiro; Ariyoshi, Koya

    2015-01-01

    Background The increasing burden of pneumonia in adults is an emerging health issue in the era of global population aging. This study was conducted to elucidate the burden of community-onset pneumonia (COP) and its etiologic fractions in Japan, the world’s most aged society. Methods A multicenter prospective surveillance for COP was conducted from September 2011 to January 2013 in Japan. All pneumonia patients aged ≥15 years, including those with community-acquired pneumonia (CAP) and health care-associated pneumonia (HCAP), were enrolled at four community hospitals on four major islands. The COP burden was estimated based on the surveillance data and national statistics. Results A total of 1,772 COP episodes out of 932,080 hospital visits were enrolled during the surveillance. The estimated overall incidence rates of adult COP, hospitalization, and in-hospital death were 16.9 (95% confidence interval, 13.6 to 20.9), 5.3 (4.5 to 6.2), and 0.7 (0.6 to 0.8) per 1,000 person-years (PY), respectively. The incidence rates sharply increased with age; the incidence in people aged ≥85 years was 10-fold higher than that in people aged 15-64 years. The estimated annual number of adult COP cases in the entire Japanese population was 1,880,000, and 69.4% were aged ≥65 years. Aspiration-associated pneumonia (630,000) was the leading etiologic category, followed by Streptococcus pneumoniae-associated pneumonia (530,000), Haemophilus influenzae-associated pneumonia (420,000), and respiratory virus-associated pneumonia (420,000), including influenza-associated pneumonia (30,000). Conclusions A substantial portion of the COP burden occurs among elderly members of the Japanese adult population. In addition to the introduction of effective vaccines for S. pneumoniae and influenza, multidimensional approaches are needed to reduce the pneumonia burden in an aging society. PMID:25822890

  13. A population pharmacokinetic model for perioperative dosing of factor VIII in hemophilia A patients

    PubMed Central

    Hazendonk, Hendrika; Fijnvandraat, Karin; Lock, Janske; Driessens, Mariëtte; van der Meer, Felix; Meijer, Karina; Kruip, Marieke; Gorkom, Britta Laros-van; Peters, Marjolein; de Wildt, Saskia; Leebeek, Frank; Cnossen, Marjon; Mathôt, Ron

    2016-01-01

    The role of pharmacokinetic-guided dosing of factor concentrates in hemophilia is currently a subject of debate and focuses on long-term prophylactic treatment. Few data are available on its impact in the perioperative period. In this study, a population pharmacokinetic model for currently registered factor VIII concentrates was developed for severe and moderate adult and pediatric hemophilia A patients (FVIII levels <0.05 IUmL−1) undergoing elective, minor or major surgery. Retrospective data were collected on FVIII treatment, including timing and dosing, time point of FVIII sampling and all FVIII plasma concentrations achieved (trough, peak and steady state), brand of concentrate, as well as patients’ and surgical characteristics. Population pharmacokinetic modeling was performed using non-linear mixed-effects modeling. Population pharmacokinetic parameters were estimated in 75 adults undergoing 140 surgeries (median age: 48 years; median weight: 80 kg) and 44 children undergoing 58 surgeries (median age: 4.3 years; median weight: 18.5 kg). Pharmacokinetic profiles were best described by a two-compartment model. Typical values for clearance, intercompartment clearance, central and peripheral volume were 0.15 L/h/68 kg, 0.16 L/h/68 kg, 2.81 L/68 kg and 1.90 L/68 kg. Interpatient variability in clearance and central volume was 37% and 27%. Clearance decreased with increasing age (P<0.01) and increased in cases with blood group O (26%; P<0.01). In addition, a minor decrease in clearance was observed when a major surgical procedure was performed (7%; P<0.01). The developed population model describes the perioperative pharmacokinetics of various FVIII concentrates, allowing individualization of perioperative FVIII therapy for severe and moderate hemophilia A patients by Bayesian adaptive dosing. PMID:27390359

  14. Estimating risks of heat strain by age and sex: a population-level simulation model.

    PubMed

    Glass, Kathryn; Tait, Peter W; Hanna, Elizabeth G; Dear, Keith

    2015-05-18

    Individuals living in hot climates face health risks from hyperthermia due to excessive heat. Heat strain is influenced by weather exposure and by individual characteristics such as age, sex, body size, and occupation. To explore the population-level drivers of heat strain, we developed a simulation model that scales up individual risks of heat storage (estimated using Myrup and Morgan's man model "MANMO") to a large population. Using Australian weather data, we identify high-risk weather conditions together with individual characteristics that increase the risk of heat stress under these conditions. The model identifies elevated risks in children and the elderly, with females aged 75 and older those most likely to experience heat strain. Risk of heat strain in males does not increase as rapidly with age, but is greatest on hot days with high solar radiation. Although cloudy days are less dangerous for the wider population, older women still have an elevated risk of heat strain on hot cloudy days or when indoors during high temperatures. Simulation models provide a valuable method for exploring population level risks of heat strain, and a tool for evaluating public health and other government policy interventions.

  15. Age- and sex-specific mortality and population structure in sea otters

    USGS Publications Warehouse

    Bodkin, J.L.; Burdin, A.M.; Ryazanov, D.A.

    2000-01-01

    We used 742 beach-cast carcasses to characterize age- and sex-specific sea otter mortality during the winter of 1990-1991 at Bering Island, Russia. We also examined 363 carcasses recovered after the 1989 grounding of the T/V Exxon Valdez, to characterize age and sex composition in the living western Prince William Sound (WPWS) sea otter population. At Bering Island, mortality was male-biased (81%), and 75% were adults. The WPWS population was female-biased (59%) and most animals were subadult (79% of the males and 45% of the females). In the decade prior to 1990-1991 we found increasing sea otter densities (particularly among males), declining prey resources, and declining weights in adult male sea otters at Bering Island. Our findings suggest the increased mortality at Bering Island in 1990-1991 was a density-dependent population response. We propose male-maintained breeding territories and exclusion of juvenile females by adult females, providing a mechanism for potentially moderating the effects of prey reductions on the female population. Increased adult male mortality at Bearing Island in 1990-1991 likely modified the sex and age class structure there toward that observed in Prince William Sound.

  16. Fine resolution mapping of population age-structures for health and development applications

    PubMed Central

    Alegana, V. A.; Atkinson, P. M.; Pezzulo, C.; Sorichetta, A.; Weiss, D.; Bird, T.; Erbach-Schoenberg, E.; Tatem, A. J.

    2015-01-01

    The age-group composition of populations varies considerably across the world, and obtaining accurate, spatially detailed estimates of numbers of children under 5 years is important in designing vaccination strategies, educational planning or maternal healthcare delivery. Traditionally, such estimates are derived from population censuses, but these can often be unreliable, outdated and of coarse resolution for resource-poor settings. Focusing on Nigeria, we use nationally representative household surveys and their cluster locations to predict the proportion of the under-five population in 1 × 1 km using a Bayesian hierarchical spatio-temporal model. Results showed that land cover, travel time to major settlements, night-time lights and vegetation index were good predictors and that accounting for fine-scale variation, rather than assuming a uniform proportion of under 5 year olds can result in significant differences in health metrics. The largest gaps in estimated bednet and vaccination coverage were in Kano, Katsina and Jigawa. Geolocated household surveys are a valuable resource for providing detailed, contemporary and regularly updated population age-structure data in the absence of recent census data. By combining these with covariate layers, age-structure maps of unprecedented detail can be produced to guide the targeting of interventions in resource-poor settings. PMID:25788540

  17. Estimating Risks of Heat Strain by Age and Sex: A Population-Level Simulation Model

    PubMed Central

    Glass, Kathryn; Tait, Peter W.; Hanna, Elizabeth G.; Dear, Keith

    2015-01-01

    Individuals living in hot climates face health risks from hyperthermia due to excessive heat. Heat strain is influenced by weather exposure and by individual characteristics such as age, sex, body size, and occupation. To explore the population-level drivers of heat strain, we developed a simulation model that scales up individual risks of heat storage (estimated using Myrup and Morgan’s man model “MANMO”) to a large population. Using Australian weather data, we identify high-risk weather conditions together with individual characteristics that increase the risk of heat stress under these conditions. The model identifies elevated risks in children and the elderly, with females aged 75 and older those most likely to experience heat strain. Risk of heat strain in males does not increase as rapidly with age, but is greatest on hot days with high solar radiation. Although cloudy days are less dangerous for the wider population, older women still have an elevated risk of heat strain on hot cloudy days or when indoors during high temperatures. Simulation models provide a valuable method for exploring population level risks of heat strain, and a tool for evaluating public health and other government policy interventions. PMID:25993102

  18. Dissecting simulated disc galaxies - I. The structure of mono-age populations

    NASA Astrophysics Data System (ADS)

    Martig, Marie; Minchev, Ivan; Flynn, Chris

    2014-08-01

    We study seven simulated disc galaxies, three with a quiescent merger history, and four with mergers in their last 9 Gyr of evolution. We compare their structure at z = 0 by decomposing them into `mono-age populations' (MAPs) of stars within 500 Myr age bins. All studied galaxies undergo a phase of merging activity at high redshift, so that stars older than 9 Gyr are found in a centrally concentrated component, while younger stars are mostly found in discs. We find that most MAPs have simple exponential radial and vertical density profiles, with a scaleheight that typically increases with age. Because a large range of merger histories can create populations with simple structures, this suggests that the simplicity of the structure of mono-abundance populations observed in the Milky Way by Bovy et al. is not necessarily a direct indicator of a quiescent history for the Milky Way. Similarly, the anticorrelation between scalelength and scaleheight does not necessarily imply a merger-free history. However, mergers produce discontinuities between thin and thick disc components, and jumps in the age-velocity relation. The absence of a structural discontinuity between thin and thick disc observed in the Milky Way would seem to be a good indicator that no merger with a mass ratio larger than 1:15-1:10 occurred in the last 9 Gyr. Mergers at higher redshift might nevertheless be necessary to produce the thickest, hottest components of the Milky Way's disc.

  19. A scoping review of anorexia of aging correlates and their relevance to population health interventions.

    PubMed

    Roy, Mathieu; Gaudreau, Pierrette; Payette, Hélène

    2016-10-01

    Anorexia of aging (AA, i.e., loss of appetite and/or reduction of food intake with aging) is an important public health issue. It leads to unintentional weight loss, which is an independent risk factor for morbidity and mortality among seniors. AA has mainly been studied from a biological perspective and regarded as a normal physiological consequence of aging, rather than a negative health outcome with underlying determinants. Some potentially modifiable correlates have however been found to be associated with this geriatric condition. Here, we conducted a scoping review of the literature to: 1) identify AA correlates, and 2) discuss their relevance to population health interventions. Our results indicate two main categories of AA correlates, namely, physiopathological and non-physiopathological. The first category relates to physiological dysfunctions, pathologies involving (or culminating in) biomarker dysregulation, and polypharmacy. These correlates are difficult to modify, especially through population health interventions. The second category, which contains fewer correlates, includes potentially modifiable public health targets, such as food-related properties, psychological, sociocultural, and environmental issues. We conclude that there are several AA correlates. Some of them are modifiable and could be targeted for development and implementation as appropriate population health interventions to prevent appetite loss and promote maintenance of adequate food intake in aging.

  20. A scoping review of anorexia of aging correlates and their relevance to population health interventions.

    PubMed

    Roy, Mathieu; Gaudreau, Pierrette; Payette, Hélène

    2016-10-01

    Anorexia of aging (AA, i.e., loss of appetite and/or reduction of food intake with aging) is an important public health issue. It leads to unintentional weight loss, which is an independent risk factor for morbidity and mortality among seniors. AA has mainly been studied from a biological perspective and regarded as a normal physiological consequence of aging, rather than a negative health outcome with underlying determinants. Some potentially modifiable correlates have however been found to be associated with this geriatric condition. Here, we conducted a scoping review of the literature to: 1) identify AA correlates, and 2) discuss their relevance to population health interventions. Our results indicate two main categories of AA correlates, namely, physiopathological and non-physiopathological. The first category relates to physiological dysfunctions, pathologies involving (or culminating in) biomarker dysregulation, and polypharmacy. These correlates are difficult to modify, especially through population health interventions. The second category, which contains fewer correlates, includes potentially modifiable public health targets, such as food-related properties, psychological, sociocultural, and environmental issues. We conclude that there are several AA correlates. Some of them are modifiable and could be targeted for development and implementation as appropriate population health interventions to prevent appetite loss and promote maintenance of adequate food intake in aging. PMID:27374898

  1. Age-class structure and variability of two populations of the bluemask darter etheostoma (Doration) sp.

    USGS Publications Warehouse

    Simmons, J.W.; Layzer, J.B.; Smith, D.D.

    2008-01-01

    The bluemask darter Etheostoma (Doration) sp. is an endangered fish endemic to the upper Caney Fork system in the Cumberland River drainage in central Tennessee. Darters (Etheostoma spp.) are typically short-lived and exhibit rapid growth that quickly decreases with age. Consequently, estimating age of darters from length-frequency distributions can be difficult and subjective. We used a nonparametric kernel density estimator to reduce subjectivity in estimating ages of bluemask darters. Data were collected from a total of 2926 bluemask darters from the Collins River throughout three growing seasons. Additionally, data were collected from 842 bluemask darters from the Rocky River during one growing season. Analysis of length-frequencies indicated the presence of four age classes in both rivers. In each river, the majority of the population was comprised of fish 0.05). In both rivers, females were more abundant than males.

  2. Population Pharmacokinetics of Ciprofloxacin in Neonates and Young Infants Less than Three Months of Age

    PubMed Central

    Zhao, Wei; Hill, Helen; Le Guellec, Chantal; Neal, Tim; Mahoney, Sarah; Paulus, Stephane; Castellan, Charlotte; Kassai, Behrouz; van den Anker, Johannes N.; Kearns, Gregory L.; Turner, Mark A.

    2014-01-01

    Ciprofloxacin is used in neonates with suspected or documented Gram-negative serious infections. Currently, its use is off-label partly because of lack of pharmacokinetic studies. Within the FP7 EU project TINN (Treat Infection in NeoNates), our aim was to evaluate the population pharmacokinetics of ciprofloxacin in neonates and young infants <3 months of age and define the appropriate dose in order to optimize ciprofloxacin treatment in this vulnerable population. Blood samples were collected from neonates treated with ciprofloxacin and concentrations were quantified by high-pressure liquid chromatography–mass spectrometry. Population pharmacokinetic analysis was performed using NONMEM software. The data from 60 newborn infants (postmenstrual age [PMA] range, 24.9 to 47.9 weeks) were available for population pharmacokinetic analysis. A two-compartment model with first-order elimination showed the best fit with the data. A covariate analysis identified that gestational age, postnatal age, current weight, serum creatinine concentration, and use of inotropes had a significant impact on ciprofloxacin pharmacokinetics. Monte Carlo simulation demonstrated that 90% of hypothetical newborns with a PMA of <34 weeks treated with 7.5 mg/kg twice daily and 84% of newborns with a PMA ≥34 weeks and young infants receiving 12.5 mg/kg twice daily would reach the AUC/MIC target of 125, using the standard EUCAST MIC susceptibility breakpoint of 0.5 mg/liter. The associated risks of overdose for the proposed dosing regimen were <8%. The population pharmacokinetics of ciprofloxacin was evaluated in neonates and young infants <3 months old, and a dosing regimen was established based on simulation. PMID:25155587

  3. Population pharmacokinetics of ciprofloxacin in neonates and young infants less than three months of age.

    PubMed

    Zhao, Wei; Hill, Helen; Le Guellec, Chantal; Neal, Tim; Mahoney, Sarah; Paulus, Stephane; Castellan, Charlotte; Kassai, Behrouz; van den Anker, Johannes N; Kearns, Gregory L; Turner, Mark A; Jacqz-Aigrain, Evelyne

    2014-11-01

    Ciprofloxacin is used in neonates with suspected or documented Gram-negative serious infections. Currently, its use is off-label partly because of lack of pharmacokinetic studies. Within the FP7 EU project TINN (Treat Infection in NeoNates), our aim was to evaluate the population pharmacokinetics of ciprofloxacin in neonates and young infants <3 months of age and define the appropriate dose in order to optimize ciprofloxacin treatment in this vulnerable population. Blood samples were collected from neonates treated with ciprofloxacin and concentrations were quantified by high-pressure liquid chromatography-mass spectrometry. Population pharmacokinetic analysis was performed using NONMEM software. The data from 60 newborn infants (postmenstrual age [PMA] range, 24.9 to 47.9 weeks) were available for population pharmacokinetic analysis. A two-compartment model with first-order elimination showed the best fit with the data. A covariate analysis identified that gestational age, postnatal age, current weight, serum creatinine concentration, and use of inotropes had a significant impact on ciprofloxacin pharmacokinetics. Monte Carlo simulation demonstrated that 90% of hypothetical newborns with a PMA of <34 weeks treated with 7.5 mg/kg twice daily and 84% of newborns with a PMA ≥34 weeks and young infants receiving 12.5 mg/kg twice daily would reach the AUC/MIC target of 125, using the standard EUCAST MIC susceptibility breakpoint of 0.5 mg/liter. The associated risks of overdose for the proposed dosing regimen were <8%. The population pharmacokinetics of ciprofloxacin was evaluated in neonates and young infants <3 months old, and a dosing regimen was established based on simulation. PMID:25155587

  4. Color vision deficiency in a middle-aged population: the Shahroud Eye Study.

    PubMed

    Jafarzadehpur, Ebrahim; Hashemi, Hassan; Emamian, Mohammad Hassan; Khabazkhoob, Mehdi; Mehravaran, Shiva; Shariati, Mohammad; Fotouhi, Akbar

    2014-10-01

    The aim of this study was to determine the prevalence of color vision defects in the middle-age population of Shahroud, Iran. We selected 6,311 people from the 40- to 64-year-old population through random cluster sampling. Color vision testing was performed with the Farnsworth D-15. Cases with similar and symmetric results in both eyes were classified as hereditary, and those with asymmetric results were considered acquired. Cases that did not conform to standard patterns were classified as unknown category. Of 5,190 respondents (response rate 82.2 %), 5,102 participants underwent the color vision test. Of these, 14.7 % (95 % confidence interval 13.7-15.6) had some type of color vision deficiency. Of the 2,157 male participants, 6.2 % were hereditary and 10.2 % were acquired and of the 2,945 female participants, 3.1 % were hereditary and 10 % were acquired. Hereditary color deficiencies were mostly of the deutan form (63.8 %), and acquired deficiencies were mostly tritan (66.1 %). The prevalence of hereditary and acquired color vision deficiency, as well as different types of red-green and blue-yellow color vision defects significantly increased with age (p < 0.001). In conclusion, the pattern of color vision defects among the middle-aged population of Shahroud was significantly different from that seen in the younger population. This could be due to changes associated with age, gender, medical and ocular conditions, and differences in race and environment. Thus, results of previous examinations and the overall health status should be considered before making any judgment about the status of color vision in middle-aged people.

  5. Profile of diabetic ketoacidosis in a predominantly African American urban patient population.

    PubMed

    Seyoum, Berhane; Berhanu, Paulos

    2007-01-01

    The occurrence of diabetic ketoacidosis (DKA), a serious but largely preventable acute complication of diabetes mellitus, has been declining in recent years. However, empiric observations indicate that DKA continues to have a major effect on ethnic minority patients in inner-city settings. In this study, we conducted a retrospective analysis of five-year hospital admission data for DKA at a single inner-city hospital that serves a largely uninsured adult African American population. A computer-assisted search of the International Classification of Diseases, Ninth Revision, Clinical Modification codes for DKA revealed 847 admissions for confirmed DKA in 630 patients. Of these, 592 (94%) were African Americans, 22 (3.5%) were Whites, and 16 (2.5%) were Hispanics. The mean age was 43.4 +/- .4 years. Five hundred seventy-one (90.6%) of the patients had type 1 diabetes, and 59 (9.4%) had type 2 diabetes. One hundred forty-five patients (23%) were newly diagnosed with diabetes. Ninety-four (14.9%) of the patients had multiple admissions, ranging from 2 to 23 admissions per patient during the five-year period, while the remaining 391 (62.1%) patients were single admissions. Half of the patients (52%) did not have health insurance. Major precipitating factors for DKA included discontinuation of insulin, infection, and other medical illness in 501 (59.1%), 136 (16.1%), and 30 (3.5%) of the admissions, respectively. In conclusion, these data demonstrate that DKA continues to have a major effect in urban African American patients with diabetes. Therefore, multiple targeted interventions are needed in this population to improve diabetes care and thereby decrease the frequency of DKA.

  6. Genetic evidence for an origin of the Armenians from Bronze Age mixing of multiple populations

    PubMed Central

    Haber, Marc; Mezzavilla, Massimo; Xue, Yali; Comas, David; Gasparini, Paolo; Zalloua, Pierre; Tyler-Smith, Chris

    2016-01-01

    The Armenians are a culturally isolated population who historically inhabited a region in the Near East bounded by the Mediterranean and Black seas and the Caucasus, but remain under-represented in genetic studies and have a complex history including a major geographic displacement during World War I. Here, we analyse genome-wide variation in 173 Armenians and compare them with 78 other worldwide populations. We find that Armenians form a distinctive cluster linking the Near East, Europe, and the Caucasus. We show that Armenian diversity can be explained by several mixtures of Eurasian populations that occurred between ~3000 and ~2000 bce, a period characterized by major population migrations after the domestication of the horse, appearance of chariots, and the rise of advanced civilizations in the Near East. However, genetic signals of population mixture cease after ~1200 bce when Bronze Age civilizations in the Eastern Mediterranean world suddenly and violently collapsed. Armenians have since remained isolated and genetic structure within the population developed ~500 years ago when Armenia was divided between the Ottomans and the Safavid Empire in Iran. Finally, we show that Armenians have higher genetic affinity to Neolithic Europeans than other present-day Near Easterners, and that 29% of Armenian ancestry may originate from an ancestral population that is best represented by Neolithic Europeans. PMID:26486470

  7. Genetic evidence for an origin of the Armenians from Bronze Age mixing of multiple populations.

    PubMed

    Haber, Marc; Mezzavilla, Massimo; Xue, Yali; Comas, David; Gasparini, Paolo; Zalloua, Pierre; Tyler-Smith, Chris

    2016-06-01

    The Armenians are a culturally isolated population who historically inhabited a region in the Near East bounded by the Mediterranean and Black seas and the Caucasus, but remain under-represented in genetic studies and have a complex history including a major geographic displacement during World War I. Here, we analyse genome-wide variation in 173 Armenians and compare them with 78 other worldwide populations. We find that Armenians form a distinctive cluster linking the Near East, Europe, and the Caucasus. We show that Armenian diversity can be explained by several mixtures of Eurasian populations that occurred between ~3000 and ~2000 bce, a period characterized by major population migrations after the domestication of the horse, appearance of chariots, and the rise of advanced civilizations in the Near East. However, genetic signals of population mixture cease after ~1200 bce when Bronze Age civilizations in the Eastern Mediterranean world suddenly and violently collapsed. Armenians have since remained isolated and genetic structure within the population developed ~500 years ago when Armenia was divided between the Ottomans and the Safavid Empire in Iran. Finally, we show that Armenians have higher genetic affinity to Neolithic Europeans than other present-day Near Easterners, and that 29% of Armenian ancestry may originate from an ancestral population that is best represented by Neolithic Europeans. PMID:26486470

  8. Patient-reported outcome measures in a population of medically indigent patients with systemic lupus erythematosus in Puerto Rico

    PubMed Central

    Rodríguez-Rivera, Diana V; Rodríguez-Navedo, Yerania; Nieves-Plaza, Mariely; Vilá, Luis M

    2016-01-01

    Objective: To determine patient-reported outcomes measures in indigent patients with systemic lupus erythematosus receiving their healthcare through the Puerto Rico government managed care system and compare these measures with non-indigent patients treated in a private fee-for-service setting. Methods: A cross-sectional study was conducted in a cohort of 98 Puerto Ricans with systemic lupus erythematosus. Patients from the public group (n = 40) were treated in a university-based specialized systemic lupus erythematosus clinic and the private group (n = 58) in a community-based rheumatology practice. Demographic and clinical features and patient-reported outcomes measures per LupusPRO instrument were determined. LupusPRO captures quality-of-life measures in 12 domains. Differences among study groups were examined using chi-square, Fisher’s exact, t-tests, and the Wilcoxon signed-rank test. Results: The mean (standard deviation) age of the study population was 44.9 (12.0) years; 94 (95.9%) were women. Patients in the public setting were younger and were more likely to have renal disease and elevated anti-double-stranded DNA antibodies, and being treated with azathioprine and cyclophosphamide. Patients from the public sector were more likely to have better quality-of-life measures in the LupusPRO domains of pain/vitality and coping. No significant differences were observed for the domains of lupus symptoms, physical health, emotional health, body image, cognition, procreation, lupus medications, desires/goals, social support, and satisfaction with medical care. Conclusion: Despite having a lower socioeconomic status and worse clinical status, systemic lupus erythematosus patients from the public sector had equal or better patient-reported outcomes measures than those treated in the private setting. This favorable outcome may be associated with the comprehensive healthcare received by these patients in a specialized lupus clinic. PMID:27721978

  9. The Relative Ages and Fractions of the Accreted and In Situ Populations in the Galactic Halo

    NASA Astrophysics Data System (ADS)

    Hawkins, K.; Jofré, P.; Masseron, T.

    2016-10-01

    The inner Galactic halo is thought to be formed by a combination of stars formed in situ and in dwarf galaxies that were accreted onto the Milky Way at later times. The two populations have been shown to be chemically distinct primarily in the α-elements such that the accreted population has lower [α/Fe] compared to the in situ stars at a constant metallicity. In this paper, we outline a powerful new spectral-indexing method to measure the [α/Fe] from low-resolution Sloan Digital Sky Survey spectra, and use the method in addition to turnoff temperature to study the relative age difference between, and age-metallicity relation of, the accreted and in situ populations. Our results indicate that at high metallicities the α-poor population is systematically younger than the α-rich population, but becomes coeval at low metallicities. Finally, we discuss the implication of this finding and potential applications for the new method.

  10. Age and Abundance Discrimination in Old Stellar Populations Using Mid-Ultraviolet Colors

    NASA Astrophysics Data System (ADS)

    Dorman, Ben; O'Connell, Robert W.; Rood, Robert T.

    2003-07-01

    The rest-frame mid-ultraviolet spectral region (2000-3200 Å) is important in analyzing the stellar populations of the ``red envelope'' systems observed at high redshifts. Here we explore the usefulness of the mid-UV for determining ages and abundances of old populations. We work with a theoretical set of low-resolution spectra and broadband colors because tests show that these are at present more realistic than high-resolution models. A mid-UV to optical/IR wavelength baseline provides good separation of population components because the main-sequence turnoff dominates the integrated light between 2500 and 4000 Å. Mid-UV spectral features are not sensitive to the dwarf/giant mixture in the population, unlike those in the optical region. We find a 6 mag difference in the mid-UV continuum level (normalized at V) over the metallicity range -1.5ages in the range 4-16 Gyr. Logarithmic derivatives of mid-UV colors with respect to age or metal abundance are 3-10 times larger than for the UBV region. Most of the spectral information on old populations therefore resides below 4000 Å. Measurement of a single mid-UV color is capable of placing a strong lower bound on the mean metallicity of an old population. We investigate the capability of UBV and mid-UV broadband colors to separately determine age and abundance, taking into account precision in the color measurements. We find that the mid-UV improves resolution in logt, logZ space by about a factor of 3 for a given observational precision. Contamination by hot, post-He flash evolutionary phases can seriously affect the mid-UV spectra of old populations. A simple estimate shows that contamination can reach over 80% in some cases. However, this is straightforward to remove as long as far-UV measurements are available. We find that extinction should have relatively small effects on parameters derived for old populations from the mid-UV. Finally, we show

  11. Rejuvenation of the muscle stem cell population restores strength to injured aged muscles.

    PubMed

    Cosgrove, Benjamin D; Gilbert, Penney M; Porpiglia, Ermelinda; Mourkioti, Foteini; Lee, Steven P; Corbel, Stephane Y; Llewellyn, Michael E; Delp, Scott L; Blau, Helen M

    2014-03-01

    The elderly often suffer from progressive muscle weakness and regenerative failure. We demonstrate that muscle regeneration is impaired with aging owing in part to a cell-autonomous functional decline in skeletal muscle stem cells (MuSCs). Two-thirds of MuSCs from aged mice are intrinsically defective relative to MuSCs from young mice, with reduced capacity to repair myofibers and repopulate the stem cell reservoir in vivo following transplantation. This deficiency is correlated with a higher incidence of cells that express senescence markers and is due to elevated activity of the p38α and p38β mitogen-activated kinase pathway. We show that these limitations cannot be overcome by transplantation into the microenvironment of young recipient muscles. In contrast, subjecting the MuSC population from aged mice to transient inhibition of p38α and p38β in conjunction with culture on soft hydrogel substrates rapidly expands the residual functional MuSC population from aged mice, rejuvenating its potential for regeneration and serial transplantation as well as strengthening of damaged muscles of aged mice. These findings reveal a synergy between biophysical and biochemical cues that provides a paradigm for a localized autologous muscle stem cell therapy for the elderly.

  12. Modelling Anopheles gambiae s.s. Population Dynamics with Temperature- and Age-Dependent Survival.

    PubMed

    Christiansen-Jucht, Céline; Erguler, Kamil; Shek, Chee Yan; Basáñez, María-Gloria; Parham, Paul E

    2015-05-28

    Climate change and global warming are emerging as important threats to human health, particularly through the potential increase in vector- and water-borne diseases. Environmental variables are known to affect substantially the population dynamics and abundance of the poikilothermic vectors of disease, but the exact extent of this sensitivity is not well established. Focusing on malaria and its main vector in Africa, Anopheles gambiae sensu stricto, we present a set of novel mathematical models of climate-driven mosquito population dynamics motivated by experimental data suggesting that in An. gambiae, mortality is temperature and age dependent. We compared the performance of these models to that of a "standard" model ignoring age dependence. We used a longitudinal dataset of vector abundance over 36 months in sub-Saharan Africa for comparison between models that incorporate age dependence and one that does not, and observe that age-dependent models consistently fitted the data better than the reference model. This highlights that including age dependence in the vector component of mosquito-borne disease models may be important to predict more reliably disease transmission dynamics. Further data and studies are needed to enable improved fitting, leading to more accurate and informative model predictions for the An. gambiae malaria vector as well as for other disease vectors.

  13. Modelling Anopheles gambiae s.s. Population Dynamics with Temperature- and Age-Dependent Survival.

    PubMed

    Christiansen-Jucht, Céline; Erguler, Kamil; Shek, Chee Yan; Basáñez, María-Gloria; Parham, Paul E

    2015-06-01

    Climate change and global warming are emerging as important threats to human health, particularly through the potential increase in vector- and water-borne diseases. Environmental variables are known to affect substantially the population dynamics and abundance of the poikilothermic vectors of disease, but the exact extent of this sensitivity is not well established. Focusing on malaria and its main vector in Africa, Anopheles gambiae sensu stricto, we present a set of novel mathematical models of climate-driven mosquito population dynamics motivated by experimental data suggesting that in An. gambiae, mortality is temperature and age dependent. We compared the performance of these models to that of a "standard" model ignoring age dependence. We used a longitudinal dataset of vector abundance over 36 months in sub-Saharan Africa for comparison between models that incorporate age dependence and one that does not, and observe that age-dependent models consistently fitted the data better than the reference model. This highlights that including age dependence in the vector component of mosquito-borne disease models may be important to predict more reliably disease transmission dynamics. Further data and studies are needed to enable improved fitting, leading to more accurate and informative model predictions for the An. gambiae malaria vector as well as for other disease vectors. PMID:26030468

  14. Dental age estimation from the developmental stage of the third molars in Iranian population.

    PubMed

    Rai, Balwant; Kaur, Jasdeep; Jafarzadeh, Hamid

    2010-08-01

    A sharp increase in forensic age estimation of living persons has been observed in recent years. However, ethnic populations residing in different countries have been insufficiently analyzed. The aim of this study was to achieve a referral database and regression equations for dental age estimation of unaccompanied minors of Iran nationality. A total of 1200 orthopantomograms were collected from original Iran and equally divided in age categories between 10 and 27 years. On the radiographs, the developmental stage of the third molars was scored applying a Demirjian et al. scoring technique. Inter- and intra-observer reliabilities were tested using kappa statistics. Correlation between the scores of all four wisdom maxillary and mandibular third molars teeth and left/right symmetry were evaluated with spearman correlation coefficient. Student's t-test on asymmetry was performed and regression formulas were calculated. The present database was the first to assemble third molar developmental scores on radiographs of Iran individuals and provided more appropriate dental age estimation of unaccompanied Iran minors. To enhance the accuracy of forensic age estimates based on third molars mineralization, the use of population-specific standards is recommended.

  15. Quality of life in patients suffering from seborrheic dermatitis: influence of age, gender and education level.

    PubMed

    Szepietowski, Jacek C; Reich, Adam; Wesołowska-Szepietowska, Ewa; Baran, Eugeniusz

    2009-07-01

    Seborrheic dermatitis is a common inflammatory skin condition occurring mostly on the face, scalp and chest. Despite its high frequency, the impact of seborrheic dermatitis on patients' quality of life (QoL) has not been studied well so far. The objectives of this study were to analyse how seborrheic dermatitis affects the patients' QoL and which socio-economic factors could modulate QoL in these patients. A total of 3000 patients with seborrheic dermatitis and/or dandruff were enrolled into the study. All participants were divided into subgroups according to gender, age and education level. A specially designed questionnaire with demographic and clinical details of patients as well as Dermatology Life Quality Index (DLQI) was completed during a patient visit in an outpatient clinic. Data were collected by local dermatologists who were instructed regarding the inclusion and exclusion criteria and the questionnaires were sent back to us upon completion. The mean DLQI score for all patients was 6.92±5.34 points. Patients with dandruff had significantly better QoL than subjects with seborrheic dermatitis (5.34±4.67 points vs. 7.73±5.3 points, respectively; P<0.001) or individuals with dandruff plus seborrheic dermatitis (7.54±5.6 points, P<0.001). In addition, women, younger patients and subjects with higher educational level were more affected than the rest of the patients. Seborrheic dermatitis had significant, negative influence on patients' QoL. Observed discrepancies between subgroups could be explained by different roles played by different patient subgroups in the society. DLQI can be successfully used for the assessment of QoL in large populational studies. PMID:18793259

  16. Long-term survival after coronary bypass surgery. Comparison of various subsets of patients with general population.

    PubMed Central

    Greene, D G; Bunnell, I L; Arani, D T; Schimert, G; Lajos, T Z; Lee, A B; Tandon, R N; Zimdahl, W T; Bozer, J M; Kohn, R M; Visco, J P; Dean, D C; Smith, G L

    1981-01-01

    Life-table analysis consecutive cases of isolated coronary bypass surgery at the Buffalo Hospital between 1973 and 1977 showed an estimated survival of 94 per cent at five years, equal to that of an age- and sex-matched group of the US population. Subsets of these patients divided according to sex, age, number of vessels narrowed, number of segments grafted, history of myocardial infarction, ejection fraction, and presence of unstable angina have estimated survivals not statistically less in any of these subsets than that of matched cohorts of the general population. PMID:6971646

  17. Sympatric speciation in an age-structured population living on a lattice

    NASA Astrophysics Data System (ADS)

    Sousa, A. O.

    2004-06-01

    A square lattice is introduced into the Penna model for biological aging in order to study the evolution of diploid sexual populations under certain conditions when one single locus in the individual’s genome is considered as identifier of species. The simulation results show, after several generations, the flourishing and coexistence of two separate species in the same environment, i.e., one original species splits up into two on the same territory (sympatric speciation). As well, the mortalities obtained are in a good agreement with the Gompertz law of exponential increase of mortality with age.

  18. Population pharmacokinetics of levosimendan in patients with congestive heart failure

    PubMed Central

    Jonsson, E Niclas; Antila, Saila; McFadyen, Lynn; Lehtonen, Lasse; Karlsson, Mats O

    2003-01-01

    Aims The aim of this study was to characterize the population pharmacokinetics of levosimendan in patients with heart failure (NYHA grades III and IV) and its relationship to demographic factors, disease severity and concomitant use of digoxin and β-blocking agents. Methods Data from two efficacy studies with levosimendan administered by intravenous infusion were combined (190 patients in total). The data were analysed using a nonlinear mixed-effects modelling approach as implemented in the NONMEM program. The model development was done in three sequential steps. First the best structural model was determined (e.g. a one-, two- or three-compartment pharmacokinetic model). This was followed by the identification and incorporation of important covariates into the model. Lastly the stochastic part of the model was refined. Results A two-compartment model best described levosimendan pharmacokinetics. Clearance and the central volume of distribution were found to increase linearly with bodyweight. No other covariates, including concomitant use of digoxin and β-blocking agents, influenced the pharmacokinetics. In the final model, a 76-kg patient was estimated to have a clearance ± s.e. of 13.3 ± 0.4 l h−1 and a central volume of distribution of 16.8 ± 0.79 l. The interindividual variability was estimated to be 39% and 60% for clearance and central volume of distribution, respectively. Weight changed clearance by 1.5% [95% confidence interval (CI) 0.9%, 2.1%] and the central volume of distribution by 0.9% (95% CI 0.5%, 1.3%) per kg. Conclusions The population pharmacokinetics parameters of levosimendan in this patient group were comparable to those obtained by traditional methods in healthy volunteers and patients with mild heart failure. Bodyweight influenced the clearance and the central volume of distribution, which in practice is accounted for by weight adjusting doses. None of the other covariates, including digoxin and β-blocking agents, significantly

  19. Prevalence and Diagnostic Approach to Sleep Apnea in Hemodialysis Patients: A Population Study

    PubMed Central

    Forni Ogna, Valentina; Ogna, Adam; Pruijm, Menno; Bassi, Isabelle; Zuercher, Emilie; Halabi, Georges; Phan, Olivier; Bullani, Roberto; Teta, Daniel; Gauthier, Thierry; Cherpillod, Anne; Mathieu, Claudine; Mihalache, Alexandra; Cornette, Francoise; Haba-Rubio, José; Burnier, Michel; Heinzer, Raphaël

    2015-01-01

    Background. Previous observations found a high prevalence of obstructive sleep apnea (OSA) in the hemodialysis population, but the best diagnostic approach remains undefined. We assessed OSA prevalence and performance of available screening tools to propose a specific diagnostic algorithm. Methods. 104 patients from 6 Swiss hemodialysis centers underwent polygraphy and completed 3 OSA screening scores: STOP-BANG, Berlin's Questionnaire, and Adjusted Neck Circumference. The OSA predictors were identified on a derivation population and used to develop the diagnostic algorithm, which was validated on an independent population. Results. We found 56% OSA prevalence (AHI ≥ 15/h), which was largely underdiagnosed. Screening scores showed poor performance for OSA screening (ROC areas 0.538 [SE 0.093] to 0.655 [SE 0.083]). Age, neck circumference, and time on renal replacement therapy were the best predictors of OSA and were used to develop a screening algorithm, with higher discriminatory performance than classical screening tools (ROC area 0.831 [0.066]). Conclusions. Our study confirms the high OSA prevalence and highlights the low diagnosis rate of this treatable cardiovascular risk factor in the hemodialysis population. Considering the poor performance of OSA screening tools, we propose and validate a specific algorithm to identify hemodialysis patients at risk for OSA for whom further sleep investigations should be considered. PMID:26229952

  20. The cancer survival gap between elderly and middle-aged patients in Europe is widening.

    PubMed

    Quaglia, Alberto; Tavilla, Andrea; Shack, Lorraine; Brenner, Hermann; Janssen-Heijnen, Maryska; Allemani, Claudia; Colonna, Marc; Grande, Enrico; Grosclaude, Pascale; Vercelli, Marina

    2009-04-01

    The present study is aimed to compare survival and prognostic changes over time between elderly (70-84 years) and middle-aged cancer patients (55-69 years). We considered seven cancer sites (stomach, colon, breast, cervix and corpus uteri, ovary and prostate) and all cancers combined (but excluding prostate and non-melanoma skin cancers). Five-year relative survival was estimated for cohorts of patients diagnosed in 1988-1999 in a pool of 51 European populations covered by cancer registries. Furthermore, we applied the period-analysis method to more recent incidence data from 32 cancer registries to provide 1- and 5-year relative survival estimates for the period of follow-up 2000-2002. A significant survival improvement was observed from 1988 to 1999 for all cancers combined and for every cancer site, except cervical cancer. However, survival increased at a slower rate in the elderly, so that the gap between younger and older patients widened, particularly for prostate cancer in men and for all considered cancers except cervical cancer in women. For breast and prostate cancers, the increasing gap was likely attributable to a larger use of, respectively, mammographic screening and PSA test in middle-aged with respect to the elderly. In the period analysis of the most recent data, relative survival was much higher in middle-aged patients than in the elderly. The differences were higher for breast and gynaecological cancers, and for prostate cancer. Most of this age gap was due to a very large difference in survival after the 1st year following the diagnosis. Differences were much smaller for conditional 5-year relative survival among patients who had already survived the first year. The increase of survival in elderly men is encouraging but the lesser improvement in women and, in particular, the widening gap for breast cancer suggest that many barriers still delay access to care and that enhanced prevention and clinical management remain major issues.

  1. Arthroplasty Utilization in the United States is Predicted by Age-Specific Population Groups.

    PubMed

    Bashinskaya, Bronislava; Zimmerman, Ryan M; Walcott, Brian P; Antoci, Valentin

    2012-01-01

    Osteoarthritis is a common indication for hip and knee arthroplasty. An accurate assessment of current trends in healthcare utilization as they relate to arthroplasty may predict the needs of a growing elderly population in the United States. First, incidence data was queried from the United States Nationwide Inpatient Sample from 1993 to 2009. Patients undergoing total knee and hip arthroplasty were identified. Then, the United States Census Bureau was queried for population data from the same study period as well as to provide future projections. Arthroplasty followed linear regression models with the population group >64 years in both hip and knee groups. Projections for procedure incidence in the year 2050 based on these models were calculated to be 1,859,553 cases (hip) and 4,174,554 cases (knee). The need for hip and knee arthroplasty is expected to grow significantly in the upcoming years, given population growth predictions.

  2. Rates of stillbirth by gestational age and cause in Inuit and First Nations populations in Quebec

    PubMed Central

    Auger, Nathalie; Park, Alison L.; Zoungrana, Hamado; McHugh, Nancy Gros-Louis; Luo, Zhong-Cheng

    2013-01-01

    Background: Inuit and First Nations populations have higher rates of stillbirth than non-Aboriginal populations in Canada do, but little is known about the timing and cause of stillbirth in Aboriginal populations. We compared gestational age– and cause-specific stillbirth rates in Inuit and First Nations populations with the rates in the non-Aboriginal population in Quebec. Methods: Data included singleton stillbirths and live births at 24 or more gestational weeks among Quebec residents from 1981 to 2009. We calculated odds ratios (ORs), rate differences and 95% confidence intervals (CIs) for the retrospective cohort of Inuit and First Nations births relative to non-Aboriginal births using fetuses at risk (i.e., ongoing pregnancies) as denominators and adjusting for maternal characteristics. The main outcomes were stillbirth by gestational age (24–27, 28–36, ≥ 37 wk) and cause of death. Results: Rates of stillbirth per 1000 births were greater among Inuit (6.8) and First Nations (5.7) than among non-Aboriginal (3.6) residents. Relative to the non-Aboriginal population, the risk of stillbirth was greater at term (≥ 37 wk) than before term for both Inuit (OR 3.1, 95% CI 1.9 to 4.8) and First Nations (OR 2.6, 95% CI 2.1 to 3.3) populations. Causes most strongly associated with stillbirth were poor fetal growth, placental disorders and congenital anomalies among the Inuit, and hypertension and diabetes among the First Nations residents. Interpretation: Stillbirth rates in Aboriginal populations were particularly high at term gestation. Poor fetal growth, placental disorders and congenital anomalies were important causes of stillbirth among the Inuit, and diabetic and hypertensive complications were important causes in the First Nations population. Prevention may require improvements in pregnancy and obstetric care. PMID:23422443

  3. Gender difference in health and its determinants in the old-aged population in India.

    PubMed

    Dhak, Biplab

    2009-09-01

    This paper examines the gender differential in health and its socioeconomic and demographic determinants in the old-age population of India based on the National Sample Survey 60th round data collected in 2004. As in developed countries, older women in India report poorer self-reported health and experience greater immobility compared with men. Stepwise logistic regression analysis shows that the gender differential in health is linked to various socioeconomic and demographic variables and that the gender gap could be narrowed with appropriate policy intervention. Specifically, paying special attention towards improving the socioeconomic status of widowed/separated women could attenuate a substantial portion of the observed gender gap in the health of the old-age population. PMID:19563694

  4. Prevalence of aging population in the Middle East and its implications on cancer incidence and care

    PubMed Central

    Hajjar, R. R.; Atli, T.; Al-Mandhari, Z.; Oudrhiri, M.; Balducci, L.; Silbermann, M.

    2013-01-01

    The Middle Eastern population is aging rapidly, and as aging is the main risk factor for cancer, the incidence and prevalence of that disease are increasing among all the populations in the region. These developments represent huge challenges to national and community-based health services. At the current state of affairs, most Middle Eastern countries require the cooperation of international agencies in order to cope with such new challenges to their health systems. The focus and emphasis in facing these changing circumstances lie in the education and training of professionals, mainly physicians and nurses, at the primary, secondary and tertiary levels of health services. It is imperative that these training initiatives include clinical practice, with priority given to the creation of multidisciplinary teams both at the cancer centers and for home-based services. PMID:24001758

  5. Cancer Survivorship Issues: Life After Treatment and Implications for an Aging Population

    PubMed Central

    Rowland, Julia H.; Bellizzi, Keith M.

    2014-01-01

    The US population of cancer survivors age ≥ 65 years will continue to grow rapidly over the next few decades. This growth will be driven largely by the aging of the national population. With the diffusion of earlier detection and more effective therapies, the majority of these individuals can expect to live long term after diagnosis. This often vulnerable group of survivors poses significant challenges for both researchers and clinicians with regard to how best to document and address its unique health care needs. In this article, we briefly review the long-term and late-occurring effects of cancer and its treatment in older survivors, review information on current patterns of post-treatment care and the evolving guidelines for this care, and discuss opportunities for future research. PMID:25071099

  6. Age-specific breeding success in a wild mammalian population: selection, constraint, restraint and senescence.

    PubMed

    Dugdale, Hannah L; Pope, Lisa C; Newman, Chris; Macdonald, David W; Burke, Terry

    2011-08-01

    The Selection, Constraint, Restraint and Senescence Hypotheses predict how breeding success should vary with age. The Selection Hypothesis predicts between-individual variation arising from quality differences; the other hypotheses predict within-individual variation due to differing skills or physiological condition (Constraint), residual reproductive lifespan (Restraint), or somatic and reproductive investment (Senescence). Studies tend to focus on either the initial increase in breeding success or later decrease; however, both require consideration when unravelling the underlying evolutionary processes. Additionally, few studies present genetic fitness measures and rarely for both sexes. We therefore test these four hypotheses, which are not mutually exclusive, in a high-density population of European badgers Meles meles. Using an 18-year data set (including 22 microsatellite loci), we show an initial improvement in breeding success with age, followed by a later and steeper rate of reproductive senescence in male than in female badgers. Breeding success was skewed within age-classes, indicating the influence of factors other than age-class. This was partly attributable to selective appearance and disappearance of badgers (Selection Hypothesis). Individuals with a late age of last breeding showed a concave-down relationship between breeding success and experience (Constraint Hypothesis). There was no evidence of abrupt terminal effects; rather, individuals showed a concave-down relationship between breeding success and residual reproductive lifespan (Restraint Hypothesis), with an interaction with age of first breeding only in female badgers. Our results demonstrate the importance of investigating a comprehensive suite of factors in age-specific breeding success analyses, in both sexes, to fully understand evolutionary and population dynamics. PMID:21714821

  7. Comprehensive stellar population models and the disentanglement of age and metallicity effects

    NASA Technical Reports Server (NTRS)

    Worthey, Guy

    1994-01-01

    The construction of detailed models for intermediate and old stellar populations is described. Input parameters include metallicity (-2 less than (Fe/H) less than 0.5), single-burst age (between 1.5 and 17 Gyr), and initial mass function (IMF) exponent. Quantities output include broadband magnitudes, spectral energy distributions, surface brightness fluctuation magnitudes, and a suite of 21 absorption feature indices. The models are checked against a wide variety of available observations. Examinations of model output yield the following conclusions. (1) If the percentage change delta age/delta Z approximately equals 3/2 for two populations, they will appear almost identical in most indices. A few indices break this degeneracy by being either more abundance sensitive (Fe4668, Fe5015, Fe5709, and Fe5782) or more age sensitive (G4300, H beta, and presumably higher order Balmer lines) than usual. (2) Present uncertainties in stellar evolution are of the same magnitude as the effects of IMF and Y in the indices studied. (3) Changes in abundance ratios (like (Mg/Fe)) are predicted to be readily apparent in the spectra of old stellar populations. (4) The I-band flux of a stellar population is predicted to be nearly independent of metallicity and only modestly sensitive to age. The I band is therefore recommended for standard candle work or studies of M/L in galaxies. Other conclusions stem from this work. (1) Intercomparison of models and observations of two TiO indices seem to indicate variation of the (V/Ti) ratio among galaxies, but it is not clear how this observation ties into the standard picture of chemical enrichment. (2) Current estimates of (Fe/H) for the most metal-rich globulars that are based on integrated indices are probably slightly too high. (3) Colors of population models from different authors exhibit a substantial range. At solar metallicity and 13 Gyr, this range corresponds to an age error of roughly +/- 7 Gyr. Model colors from different authors

  8. The Critical Need to Promote Research of Aging and Aging-related Diseases to Improve Health and Longevity of the Elderly Population

    PubMed Central

    Jin, Kunlin; Simpkins, James W.; Ji, Xunming; Leis, Miriam; Stambler, Ilia

    2015-01-01

    Due to the aging of the global population and the derivative increase in aging-related non-communicable diseases and their economic burden, there is an urgent need to promote research on aging and aging-related diseases as a way to improve healthy and productive longevity for the elderly population. To accomplish this goal, we advocate the following policies: 1) Increasing funding for research and development specifically directed to ameliorate degenerative aging processes and to extend healthy and productive lifespan for the population; 2) Providing a set of incentives for commercial, academic, public and governmental organizations to foster engagement in such research and development; and 3) Establishing and expanding coordination and consultation structures, programs and institutions involved in aging-related research, development and education in academia, industry, public policy agencies and at governmental and supra-governmental levels. PMID:25657847

  9. LIPID PROFILE OF POLISH PRIMARY CARE PATIENTS AGED 35-55 YEARS LIVING IN THE DISTRICT OF PLESZEW.

    PubMed

    Hoffmann, Karolina; Matyjaszczyk, Piotr; Zaporowska-STACHOWIAK, Iwona; Kostrzewska, Magdalena; Piorunek, Tomasz; Minczykowskp, Andrzej; Bryl, Wieslaw

    2016-01-01

    In Poland, more than half of the adult population suffers from lipid disorders. Among the 18 million Polish people with hypercholesterolemia, over 10.8 million are unaware of this problem. To estimate the lipid profile of selected primary care patients in the district of Pleszew (Western Poland), general practitioners (GPs) recruited 681 patients aged 35-55 years in 2011. Fasting serum lipids were evaluated. We found statistically significant differences in all lipid parameters between all younger (35-45 years) and older (46-55 years) patients, between all female and male subjects, between women and men ages 35-45 years; in total cholesterol (TC), LDL-cholesterol (LDL-C) and triglycerides (TG) between younger and older female population; in HDL-cholesterol (HDL-C) and TG between women and men ages 46-55 years. Dyslipidemia, both, newly detected and previously treated, was detected in 591 patients (86.8%): 322 females (84.3%) and 269 males (90.0%). The highest percentage of lipid disorders was found in males aged 46-55 years (91.9%) and the lowest among women aged 35-45 years (78.0%). Age and gender differences in the prevalence of dyslipidemia proved of statistical importance. Among 155 patients on lipid-lowering therapy, only 28 subjects (18.1%) reached the target value of serum lipids. The prevalence of lipid disorders among primary care patients aged 35-55 years in the district of Pleszew was significantly high, and it was proved that dyslipidemia is statistically prominent in males and older patients. Polish healthcare professionals should make more efforts to improve the detection and treatment of lipid disorders. PMID:27180447

  10. Educating social workers to meet the challenge of an aging urban population: a promising model.

    PubMed

    Volland, Patricia J; Berkman, Barbara

    2004-12-01

    As Americans live longer, they will require more health and social services to address the onset of acute and chronic conditions. The persistent changes in health care delivery and the increasingly diverse older adult population in urban settings, coupled with the high expectation for families to be responsible for home care needs, challenge social workers, who work alongside physicians, nurses, and other health care professionals, to provide services effectively. Because social workers are becoming more essential, social work education must increase the numbers of social workers with the knowledge and skills necessary for practice in the current U.S. health, mental health, and social service systems, particularly in caring for the aging populations in urban settings. A New York Academy of Medicine study identified the need for increased synergy between the two components of graduate social work education: the field experience and classroom instruction. One educational model, the Practicum Partnership Program, which is designed to better integrate field and classroom, is being tested at six sites. Early results from over 300 graduates are encouraging, with evidence that students' knowledge and skills regarding aging adults have increased, their satisfaction with the experience was very high, and those who were trained reflect the diversity of the population of older adults. The early success of this program suggests that innovative educational models that expose graduate social work students to diverse populations across the continuum of care are possible. Such models will be essential for the nation to be successful in producing a social work labor force qualified to meet the challenge of an aging urban population.

  11. INTERMEDIATE-AGE STELLAR POPULATIONS IN CLASSICAL QUASI-STELLAR OBJECT HOST GALAXIES

    SciTech Connect

    Canalizo, Gabriela; Stockton, Alan E-mail: stockton@ifa.hawaii.edu

    2013-08-01

    Although mergers and starbursts are often invoked in the discussion of quasi-stellar object (QSO) activity in the context of galaxy evolution, several studies have questioned their importance or even their presence in QSO host galaxies. Accordingly, we are conducting a study of z {approx} 0.2 QSO host galaxies previously classified as passively evolving elliptical galaxies. We present deep Keck/LRIS spectroscopy of a sample of 15 hosts and model their stellar absorption spectra using stellar synthesis models. The high signal-to-noise ratio of our spectra allows us to break various degeneracies that arise from different combinations of models, varying metallicities, and contamination from QSO light. We find that none of the host spectra can be modeled by purely old stellar populations and that the majority of the hosts (14/15) have a substantial contribution from intermediate-age populations with ages ranging from 0.7 to 2.4 Gyr. An average host spectrum is strikingly well fit by a combination of an old population and a 2.1 (+0.5, -0.7) Gyr population. The morphologies of the host galaxies suggest that these aging starbursts were induced during the early stages of the mergers that resulted in the elliptical-shaped galaxies that we observe. The current active galactic nucleus activity likely corresponds to the late episodes of accretion predicted by numerical simulations, which occur near the end of the mergers, whereas earlier episodes may be more difficult to observe due to obscuration. Our off-axis observations prevent us from detecting any current star formation or young stellar populations that may be present in the central few kiloparsecs.

  12. Polymorphisms Associated with Age at Onset in Patients with Moderate-to-Severe Plaque Psoriasis.

    PubMed

    Prieto-Pérez, Rocío; Solano-López, Guillermo; Cabaleiro, Teresa; Román, Manuel; Ochoa, Dolores; Talegón, María; Baniandrés, Ofelia; López-Estebaranz, José Luis; de la Cueva, Pablo; Daudén, Esteban; Abad-Santos, Francisco

    2015-01-01

    Psoriasis is a chronic skin disease in which genetics play a major role. Although many genome-wide association studies have been performed in psoriasis, knowledge of the age at onset remains limited. Therefore, we analyzed 173 single-nucleotide polymorphisms in genes associated with psoriasis and other autoimmune diseases in patients with moderate-to-severe plaque psoriasis type I (early-onset, <40 years) or type II (late-onset, ≥40 years) and healthy controls. Moreover, we performed a comparison between patients with type I psoriasis and patients with type II psoriasis. Our comparison of a stratified population with type I psoriasis (n = 155) and healthy controls (N = 197) is the first to reveal a relationship between the CLMN, FBXL19, CCL4L, C17orf51, TYK2, IL13, SLC22A4, CDKAL1, and HLA-B/MICA genes. When we compared type I psoriasis with type II psoriasis (N = 36), we found a significant association between age at onset and the genes PSORS6, TNF-α, FCGR2A, TNFR1, CD226, HLA-C, TNFAIP3, and CCHCR1. Moreover, we replicated the association between rs12191877 (HLA-C) and type I psoriasis and between type I and type II psoriasis. Our findings highlight the role of genetics in age of onset of psoriasis. PMID:26613086

  13. Cluster analysis of polyphenol intake in a French middle-aged population (aged 35-64 years).

    PubMed

    Julia, Chantal; Touvier, Mathilde; Lassale, Camille; Fezeu, Léopold; Galan, Pilar; Hercberg, Serge; Kesse-Guyot, Emmanuelle

    2016-01-01

    Polyphenols have been suggested as protective factors for a range of chronic diseases. However, studying the impact of individual polyphenols on health is hindered by the intrinsic inter-correlations among polyphenols. Alternatively, studying foods rich in specific polyphenols fails to grasp the ubiquity of these components. Studying overall dietary patterns would allow for a more comprehensive description of polyphenol intakes in the population. Our objective was to identify clusters of dietary polyphenol intakes in a French middle-aged population (35-64 years old). Participants from the primary prevention trial SUpplementation en VItamines et Minéraux AntioXydants (SU.VI.MAX) study were included in the present cross-sectional study (n 6092; 57·8 % females; mean age 48·7 (sd 6·4) years). The fifty most consumed individual dietary polyphenols were divided into energy-adjusted tertiles and introduced in a multiple correspondence analysis (MCA), leading to comprehensive factors of dietary polyphenol intakes. The identified factors discriminating polyphenol intakes were used in a hierarchical clustering procedure. Four clusters were identified, corresponding broadly to clustered preferences for their respective food sources. Cluster 1 was characterised by high intakes of tea polyphenols. Cluster 2 was characterised by high intakes of wine polyphenols. Cluster 3 was characterised by high intakes of flavanones and flavones, corresponding to high consumption of fruit and vegetables, and more broadly to a healthier diet. Cluster 4 was characterised by high intakes of hydroxycinnamic acids, but was also associated with alcohol consumption and smoking. Profiles of polyphenol intakes allowed for the identification of meaningful combinations of polyphenol intakes in the diet. PMID:27547391

  14. Cluster analysis of polyphenol intake in a French middle-aged population (aged 35-64 years).

    PubMed

    Julia, Chantal; Touvier, Mathilde; Lassale, Camille; Fezeu, Léopold; Galan, Pilar; Hercberg, Serge; Kesse-Guyot, Emmanuelle

    2016-01-01

    Polyphenols have been suggested as protective factors for a range of chronic diseases. However, studying the impact of individual polyphenols on health is hindered by the intrinsic inter-correlations among polyphenols. Alternatively, studying foods rich in specific polyphenols fails to grasp the ubiquity of these components. Studying overall dietary patterns would allow for a more comprehensive description of polyphenol intakes in the population. Our objective was to identify clusters of dietary polyphenol intakes in a French middle-aged population (35-64 years old). Participants from the primary prevention trial SUpplementation en VItamines et Minéraux AntioXydants (SU.VI.MAX) study were included in the present cross-sectional study (n 6092; 57·8 % females; mean age 48·7 (sd 6·4) years). The fifty most consumed individual dietary polyphenols were divided into energy-adjusted tertiles and introduced in a multiple correspondence analysis (MCA), leading to comprehensive factors of dietary polyphenol intakes. The identified factors discriminating polyphenol intakes were used in a hierarchical clustering procedure. Four clusters were identified, corresponding broadly to clustered preferences for their respective food sources. Cluster 1 was characterised by high intakes of tea polyphenols. Cluster 2 was characterised by high intakes of wine polyphenols. Cluster 3 was characterised by high intakes of flavanones and flavones, corresponding to high consumption of fruit and vegetables, and more broadly to a healthier diet. Cluster 4 was characterised by high intakes of hydroxycinnamic acids, but was also associated with alcohol consumption and smoking. Profiles of polyphenol intakes allowed for the identification of meaningful combinations of polyphenol intakes in the diet.

  15. Estimation of lithium clearance from routine clinical data in Egyptian bipolar patients. A population pharmacokinetic approach.

    PubMed

    ElDesoky, E S; Kumar, V; Alorainy, M S; Hamdi, M M; Derendorf, H

    2008-12-01

    Population pharmacokinetics (PK) of lithium as a mood stabilizer was investigated in Egyptian patients with bipolar affective disorders (n = 50) of whom 31 were suffering from lithium toxicity. The mean (+/- SD) age and body weight of patients were 33 +/- 10 years and 67 +/- 3.6 kg, respectively. Patients selected were maintained on lithium carbonate controlled release tablets at doses of 400 mg/12 hours (n = 43) or 200 mg/12 hours (n = 7) respectively. In 19 patients who continued lithium therapy, 1 blood sample/patient was withdrawn for lithium level determination before the morning dose of the drug was given while for 31 patients who suffered from lithium-related toxicity and cessation of drug intake was therapeutically decided, a single blood was drawn at variable time (36, 48 or 72 h) following the last administered dose of the drug. The data was subjected to population PK analysis using NONMEM and a two-compartment model was used. Due to single point sparse data, not all parameters and their between subject variability (BSV) could be determined. Therefore, lithium clearance (CL) and BSV were estimated while other PK parameters were fixed using available literature information. First order (FO) estimation method was used in the analysis. Covariates were evaluated by univariate analysis using likelihood ratio test. The most significant covariate on lithium CL was found to be creatinine clearance (CrCL). The population CL of lithium in the final model was expressed as CLpop = 0.51 x (CrCL/105.3)0.44. The final population PK parameters estimates of lithium were: CL = 0.51 l/h with 12.7% BSV, V1 (Fixed) = 15.2 l, Q (Fixed) = 7.44 l/h, and V2 (Fixed) = 6.7 l. The mean value of lithium concentration at 12 hours as predicted by the final model in the patients with drug toxicity was 1.3 +/- 0.1 mmol/l versus 0.8 +/- 0.14 mmol/l in patients without toxic signs. External validation of the final model on another group of adult bipolar patients (n = 12) maintained on

  16. The development of universal health insurance coverage in Thailand: Challenges of population aging and informal economy.

    PubMed

    Hsu, Minchung; Huang, Xianguo; Yupho, Somrasri

    2015-11-01

    This paper quantitatively investigates the sustainability of the universal health insurance coverage (UHI) system in Thailand while taking into account the country's rapidly aging population and large informal labor sector. We examine the effects of population aging and informal employment across three tax options for financing the UHI. A modern dynamic general equilibrium framework is utilized to conduct policy experiments and welfare analysis. In the case of labor income tax being used to finance the cost of UHI, an additional 11-15% of labor tax will be required with the 2050 population age structure, compared with the 2005 benchmark economy. We also find that an expansion of income tax base to the informal sector can substantially alleviate the tax burden. Based on welfare comparisons across the alternative tax options, the labor income tax is the most preferred because the inequality between formal/informal sectors is large. If the informal sector cannot avoid labor income tax, capital tax will be preferred over labor and consumption taxes.

  17. The development of universal health insurance coverage in Thailand: Challenges of population aging and informal economy.

    PubMed

    Hsu, Minchung; Huang, Xianguo; Yupho, Somrasri

    2015-11-01

    This paper quantitatively investigates the sustainability of the universal health insurance coverage (UHI) system in Thailand while taking into account the country's rapidly aging population and large informal labor sector. We examine the effects of population aging and informal employment across three tax options for financing the UHI. A modern dynamic general equilibrium framework is utilized to conduct policy experiments and welfare analysis. In the case of labor income tax being used to finance the cost of UHI, an additional 11-15% of labor tax will be required with the 2050 population age structure, compared with the 2005 benchmark economy. We also find that an expansion of income tax base to the informal sector can substantially alleviate the tax burden. Based on welfare comparisons across the alternative tax options, the labor income tax is the most preferred because the inequality between formal/informal sectors is large. If the informal sector cannot avoid labor income tax, capital tax will be preferred over labor and consumption taxes. PMID:26452699

  18. Ages and metallicities for quiescent galaxies in the Shapley supercluster: driving parameters of the stellar populations

    NASA Astrophysics Data System (ADS)

    Smith, Russell J.; Lucey, John R.; Hudson, Michael J.

    2009-12-01

    We use high signal-to-noise spectroscopy for a sample of 232 quiescent galaxies in the Shapley supercluster, to investigate how their stellar populations depend on velocity dispersion (σ), luminosity and stellar mass. The sample spans a large range in velocity dispersion (30-300kms-1) and in luminosity (MR from -18.7 to -23.2). Estimates of age, total metallicity (Z/H) and α-element abundance ratio (α/Fe) were derived from absorption-line analysis, using single-burst models of Thomas and collaborators. Using the Rose CaII index, we conclude that recent star formation (frosting) events are not responsible for the intermediate ages observed in some of the galaxies. Age, Z/H and α/Fe are correlated positively with velocity dispersion, but we also find significant residual trends with luminosity: at given σ, the brighter galaxies are younger, less α-enriched and have higher Z/H. At face value, these results might suggest that the stellar populations depend on stellar mass as well as on velocity dispersion. However, we show that the observed trends can be reproduced by models in which the stellar populations depend systematically only on σ, and are independent of stellar mass M*. For age, the observed luminosity correlation arises because young galaxies are brighter, at fixed M*. For metallicity, the observed luminosity dependence arises because metal-rich galaxies, at fixed mass, tend also to be younger, and hence brighter. We find a good match to the observed luminosity correlations with age ~σ+0.40, Z/H~σ+0.35,α/Fe ~σ+0.20, where the slopes are close to those found when fitting traditional scaling relations. We conclude that the star formation and enrichment histories of galaxies are determined primarily by the depth of their gravitational potential wells. The observed residual correlations with luminosity do not imply a corresponding dependence on stellar mass.

  19. Population Pharmacokinetics of Benznidazole in Adult Patients with Chagas Disease

    PubMed Central

    Aldasoro, E.; Guerrero, L.; Posada, E.; Serret, N.; Mejía, T.; Urbina, J. A.; Gascón, J.

    2015-01-01

    The aim of the present study was to build a population pharmacokinetic (popPK) model to characterize benznidazole (BNZ) pharmacokinetics in adults with chronic Chagas disease. This study was a prospective, open-label, single-center clinical trial approved by the local ethics committee. Patients received BNZ at 2.5 mg/kg of body weight/12 h (Abarax, Elea Laboratory, Argentina) for 60 days. Plasma BNZ samples were taken several times during the study and analyzed by high-performance liquid chromatography with UV-visible detection (HPLC-UV). The popPK analysis was done with NONMEMv.7.3. Demographic and biological data were tested as covariates. Intraindividual, interoccasion, and residual variabilities were modeled. Internal and external validations were completed to assess the robustness of the model. Later on, simulations were performed to generate BNZ concentration-time course profiles for different dosage regimens. A total of 358 plasma BNZ concentrations from 39 patients were included in the analysis. A one-compartment PK model characterized by clearance (CL/F) and the apparent volume of distribution (V/F), with first-order absorption (Ka) and elimination, adequately described the data (CL/F, 1.73 liters/h; V/F, 89.6 liters; and Ka, 1.15 h−1). No covariates were found to be significant for CL/F and V/F. Internal and external validations of the final model showed adequate results. Data from simulations revealed that a dose of 2.5 mg/kg/12 h might lead to overexposure in most patients. A lower dose (2.5 mg/kg/24 h) was able to achieve trough BNZ plasma concentrations within the accepted therapeutic range of 3 to 6 mg/liter. In summary, we developed a population PK model for BNZ in adults with chronic Chagas disease. Dosing simulations showed that a BNZ dose of 2.5 mg/kg/24 h will adequately keep BNZ trough plasma concentrations within the recommended target range for the majority of patients. (This study has been registered at EudraCT under number 2011

  20. Sex differences in the treatment of patients with atrial fibrillation: population-based study in a local health district.

    PubMed

    Riesgo, Alba; Sant, Elisenda; Benito, Luisa; Hoyo, Jordi; Miró, Oscar; Mont, Lluís; Bragulat, Ernest; Coll-Vinent, Blanca

    2011-03-01

    Differences in the treatment of atrial fibrillation between men and women were investigated by using patients in a local health district as a reference population. The study included 688 patients (359 female) who presented with atrial fibrillation. Women were older, more frequently had heart failure, and were more often functionally dependent than men. With regards to the management of atrial fibrillation, women were prescribed digoxin more frequently than men, but underwent electrical cardioversion less often, were less frequently seen by a cardiologist, and understood less about their treatment. After stratifying the findings by age and adjusting for heart failure and the degree of functional dependence, it was observed that women aged over 85 years were prescribed digoxin more often than men, while women aged under 65 years underwent cardioversion less often than men. In conclusion, gender differences observed in the treatment of atrial fibrillation cannot be fully explained by differences in clinical characteristics between men and women in the population.

  1. Spatio-Temporal Variation in Age Structure and Abundance of the Endangered Snail Kite: Pooling across Regions Masks a Declining and Aging Population

    PubMed Central

    Kendall, William L.; Fletcher, Robert J.; Kitchens, Wiley M.

    2016-01-01

    While variation in age structure over time and space has long been considered important for population dynamics and conservation, reliable estimates of such spatio-temporal variation in age structure have been elusive for wild vertebrate populations. This limitation has arisen because of problems of imperfect detection, the potential for temporary emigration impacting assessments of age structure, and limited information on age. However, identifying patterns in age structure is important for making reliable predictions of both short- and long-term dynamics of populations of conservation concern. Using a multistate superpopulation estimator, we estimated region-specific abundance and age structure (the proportion of individuals within each age class) of a highly endangered population of snail kites for two separate regions in Florida over 17 years (1997–2013). We find that in the southern region of the snail kite—a region known to be critical for the long-term persistence of the species—the population has declined significantly since 1997, and during this time, it has increasingly become dominated by older snail kites (> 12 years old). In contrast, in the northern region—a region historically thought to serve primarily as drought refugia—the population has increased significantly since 2007 and age structure is more evenly distributed among age classes. Given that snail kites show senescence at approximately 13 years of age, where individuals suffer higher mortality rates and lower breeding rates, these results reveal an alarming trend for the southern region. Our work illustrates the importance of accounting for spatial structure when assessing changes in abundance and age distribution and the need for monitoring of age structure in imperiled species. PMID:27681854

  2. Risk and Prognosis of Bloodstream Infections among Patients on Chronic Hemodialysis: A Population-Based Cohort Study

    PubMed Central

    Skov Dalgaard, Lars; Nørgaard, Mette; Jespersen, Bente; Jensen-Fangel, Søren; Østergaard, Lars Jørgen; Schønheyder, Henrik Carl; Søgaard, Ole Schmeltz

    2015-01-01

    Background and Objectives Infections are common complications among patients on chronic hemodialysis. This population-based cohort study aims to estimate risk and case fatality of bloodstream infection among chronic hemodialysis patients. Methods In this population-based cohort study we identified residents with end-stage renal disease in Central and North Jutland, Denmark who had hemodialysis as first renal replacement therapy (hemodialysis patients) during 1995–2010. For each hemodialysis patient, we sampled 19 persons from the general population matched on age, gender, and municipality. Information on positive blood cultures was obtained from regional microbiology databases. All persons were observed from cohort entry until first episode of bloodstream infection, emigration, death, or end of hemodialysis treatment, whichever came first. Incidence-rates and incidence-rate ratios were computed and risk factors for bloodstream infection assessed by Poisson regression. Case fatality was compared by Cox regression. Results Among 1792 hemodialysis patients and 33 618 matched population controls, we identified 461 and 1126 first episodes of bloodstream infection, respectively. Incidence rates of first episode of bloodstream infection were 13.7 (95% confidence interval (CI), 12.5–15.0) per 100 person-years among hemodialysis patients and 0.53 (95% CI, 0.50–0.56) per 100 person-years among population controls. In hemodialysis patients, the most common causative microorganisms were Staphylococcus aureus (43.8%) and Escherichia coli (12.6%). The 30-day case fatality was similar among hemodialysis patients and population controls 16% (95% CI, 13%–20%) vs. 18% (95% CI, 15%–20%). Conclusions Hemodialysis patients have extraordinary high risk of bloodstream infection while short-term case fatality following is similar to that of population controls. PMID:25910221

  3. Impact of Age and Myopia on the Rate of Visual Field Progression in Glaucoma Patients

    PubMed Central

    Park, Hae-Young Lopilly; Hong, Kyung Euy; Park, Chan Kee

    2016-01-01

    Abstract Myopia is rapidly increasing in young populations and patients with glaucoma associated with myopia are reported to be young aged in East Asia. These young patients have a longer life expectancy, which increases their risk of end-of-life visual disabilities. There is a need to understand the clinical course of myopic glaucoma patients, which may be important for the care of these myopic populations. In this study, we evaluated the relationship between the age at presentation and the rate of glaucoma progression in the visual field (VF) according to the presence of myopia. The study was conducted as a prospective observational study including 179 patients with open-angle glaucoma who had undergone at least 5 VF examinations with a follow-up of at least 5 years. The progression rate of the mean deviation (MD) and the pattern standard deviation (PSD) are expressed as change in decibels (dB) per year. The slopes of the MD and PSD were calculated by linear regression analyses. Factors related to the slope of VF MD changes were analyzed with correlation and regression analyses. The slope of the linear fit line plotted against age at presentation and the rate of change in the VF MD was −0.026 (P < 0.001) in the myopic group and −0.008 (P = 0.167) in the nonmyopic group; the relationship was more prominent in the myopic group than the nonmyopic group. In the myopic group, age (β = −0.417; 95% confidence intervals (CI), −0.651 to −0.200; P = 0.050) and baseline untreated intraocular pressure (β = −0.179; 95% CI, −0.331 to −0.028; P = 0.022) were significantly related to the rate of change in the MD, which was only the presence of disc hemorrhage (β = −0.335; 95% CI, −0.568 to −0.018; P = 0.022) in the nonmyopic group. Age at presentation was significantly related to the rate of change in the VF in glaucomatous eyes with myopia compared to eyes without myopia. Older age was significantly related to the rate of

  4. Population Dynamics of Patients with Bacterial Resistance in Hospital Environment.

    PubMed

    Qu, Leilei; Pan, Qiuhui; Gao, Xubin; He, Mingfeng

    2016-01-01

    During the past decades, the increase of antibiotic resistance has become a major concern worldwide. The researchers found that superbugs with new type of resistance genes (NDM-1) have two aspects of transmission characteristics; the first is that the antibiotic resistance genes can horizontally transfer among bacteria, and the other is that the superbugs can spread between humans through direct contact. Based on these two transmission mechanisms, we study the dynamics of population in hospital environment where superbugs exist. In this paper, we build three mathematic models to illustrate the dynamics of patients with bacterial resistance in hospital environment. The models are analyzed using stability theory of differential equations. Positive equilibrium points of the system are investigated and their stability analysis is carried out. Moreover, the numerical simulation of the proposed model is also performed which supports the theoretical findings.

  5. Population Dynamics of Patients with Bacterial Resistance in Hospital Environment

    PubMed Central

    Qu, Leilei; Pan, Qiuhui; Gao, Xubin; He, Mingfeng

    2016-01-01

    During the past decades, the increase of antibiotic resistance has become a major concern worldwide. The researchers found that superbugs with new type of resistance genes (NDM-1) have two aspects of transmission characteristics; the first is that the antibiotic resistance genes can horizontally transfer among bacteria, and the other is that the superbugs can spread between humans through direct contact. Based on these two transmission mechanisms, we study the dynamics of population in hospital environment where superbugs exist. In this paper, we build three mathematic models to illustrate the dynamics of patients with bacterial resistance in hospital environment. The models are analyzed using stability theory of differential equations. Positive equilibrium points of the system are investigated and their stability analysis is carried out. Moreover, the numerical simulation of the proposed model is also performed which supports the theoretical findings. PMID:26904150

  6. Population Dynamics of Patients with Bacterial Resistance in Hospital Environment.

    PubMed

    Qu, Leilei; Pan, Qiuhui; Gao, Xubin; He, Mingfeng

    2016-01-01

    During the past decades, the increase of antibiotic resistance has become a major concern worldwide. The researchers found that superbugs with new type of resistance genes (NDM-1) have two aspects of transmission characteristics; the first is that the antibiotic resistance genes can horizontally transfer among bacteria, and the other is that the superbugs can spread between humans through direct contact. Based on these two transmission mechanisms, we study the dynamics of population in hospital environment where superbugs exist. In this paper, we build three mathematic models to illustrate the dynamics of patients with bacterial resistance in hospital environment. The models are analyzed using stability theory of differential equations. Positive equilibrium points of the system are investigated and their stability analysis is carried out. Moreover, the numerical simulation of the proposed model is also performed which supports the theoretical findings. PMID:26904150

  7. Rapid climate change did not cause population collapse at the end of the European Bronze Age.

    PubMed

    Armit, Ian; Swindles, Graeme T; Becker, Katharina; Plunkett, Gill; Blaauw, Maarten

    2014-12-01

    The impact of rapid climate change on contemporary human populations is of global concern. To contextualize our understanding of human responses to rapid climate change it is necessary to examine the archeological record during past climate transitions. One episode of abrupt climate change has been correlated with societal collapse at the end of the northwestern European Bronze Age. We apply new methods to interrogate archeological and paleoclimate data for this transition in Ireland at a higher level of precision than has previously been possible. We analyze archeological (14)C dates to demonstrate dramatic population collapse and present high-precision proxy climate data, analyzed through Bayesian methods, to provide evidence for a rapid climatic transition at ca. 750 calibrated years B.C. Our results demonstrate that this climatic downturn did not initiate population collapse and highlight the nondeterministic nature of human responses to past climate change.

  8. Fourth-Order Method for Numerical Integration of Age- and Size-Structured Population Models

    SciTech Connect

    Iannelli, M; Kostova, T; Milner, F A

    2008-01-08

    In many applications of age- and size-structured population models, there is an interest in obtaining good approximations of total population numbers rather than of their densities. Therefore, it is reasonable in such cases to solve numerically not the PDE model equations themselves, but rather their integral equivalents. For this purpose quadrature formulae are used in place of the integrals. Because quadratures can be designed with any order of accuracy, one can obtain numerical approximations of the solutions with very fast convergence. In this article, we present a general framework and a specific example of a fourth-order method based on composite Newton-Cotes quadratures for a size-structured population model.

  9. Rapid climate change did not cause population collapse at the end of the European Bronze Age

    PubMed Central

    Armit, Ian; Swindles, Graeme T.; Becker, Katharina; Plunkett, Gill; Blaauw, Maarten

    2014-01-01

    The impact of rapid climate change on contemporary human populations is of global concern. To contextualize our understanding of human responses to rapid climate change it is necessary to examine the archeological record during past climate transitions. One episode of abrupt climate change has been correlated with societal collapse at the end of the northwestern European Bronze Age. We apply new methods to interrogate archeological and paleoclimate data for this transition in Ireland at a higher level of precision than has previously been possible. We analyze archeological 14C dates to demonstrate dramatic population collapse and present high-precision proxy climate data, analyzed through Bayesian methods, to provide evidence for a rapid climatic transition at ca. 750 calibrated years B.C. Our results demonstrate that this climatic downturn did not initiate population collapse and highlight the nondeterministic nature of human responses to past climate change. PMID:25404290

  10. Rapid climate change did not cause population collapse at the end of the European Bronze Age.

    PubMed

    Armit, Ian; Swindles, Graeme T; Becker, Katharina; Plunkett, Gill; Blaauw, Maarten

    2014-12-01

    The impact of rapid climate change on contemporary human populations is of global concern. To contextualize our understanding of human responses to rapid climate change it is necessary to examine the archeological record during past climate transitions. One episode of abrupt climate change has been correlated with societal collapse at the end of the northwestern European Bronze Age. We apply new methods to interrogate archeological and paleoclimate data for this transition in Ireland at a higher level of precision than has previously been possible. We analyze archeological (14)C dates to demonstrate dramatic population collapse and present high-precision proxy climate data, analyzed through Bayesian methods, to provide evidence for a rapid climatic transition at ca. 750 calibrated years B.C. Our results demonstrate that this climatic downturn did not initiate population collapse and highlight the nondeterministic nature of human responses to past climate change. PMID:25404290

  11. The relative age effect in young French basketball players: a study on the whole population.

    PubMed

    Delorme, N; Raspaud, M

    2009-04-01

    The aim of this study is to test the presence of the relative age effect (RAE) and to examine height in an overall population of the young French basketball players from 7 to 18 years old, male (n=151 259) and female (n=107 101). For the boys as for the girls, the results show a statistically significant RAE in all age categories. The effect seems more pronounced during puberty. As far as the height is concerned, players born during quarters 1 and 2 are always significantly taller than those born during quarter 4, apart from the 17-year-old female players. These results require a new look at the methodology in the statistical calculation and the interpretation of RAE. A study wanting to give a precise measurement of this effect will have to take as the expected theoretical distribution the whole population of licensed players in the corresponding years, rather than one on the global population of the country. This will avoid the hasty conclusion that an asymmetric distribution of dates of birth of professional players would be due to RAE, whereas in reality it would be representative of one existing in the population of licensed players.

  12. Strategies for digital mammography interpretation in a clinical patient population.

    PubMed

    van den Biggelaar, Frank J H M; Kessels, Alphons G H; van Engelshoven, Jos M A; Flobbe, Karin

    2009-12-15

    Mammography is the basic imaging modality for early detection of breast cancer. The aim of this prospective study was to evaluate the impact of different mammogram reading strategies on the diagnostic yield in a consecutive patient population referred for digital mammography to a hospital. First, the effect of using computer-aided detection (CAD) software on the performance of mammogram readers was studied. Furthermore, the impact of employing technologists as either prereaders or double readers was assessed, as compared to the conventional strategy of single reading by a radiologist. Digital mammograms of 1,048 consecutive patients were evaluated by a radiologist and 3 technologists with and without the use of CAD software. ROC analysis was used to study the effects of the different strategies. In the conventional strategy, an overall area under the curve (AUC) of 0.92 was found, corresponding to a sensitivity of 84% and specificity of 94%. When applying CAD software, the AUCs were similar before and after CAD for all readers (mean of 0.95). Employing technologists in prereading and double reading of mammograms resulted in a mean AUC of 0.91 and 0.96, respectively. In the prereading strategy, the corresponding sensitivity and specificity were 81 and 96%; in the double reading strategy they were 96 and 79%, respectively. Concluding, in this clinical population, systematic application of CAD software by either radiologist or technologists failed to improve the diagnostic yield. Furthermore, employing technologists as double readers of mammograms was the most effective strategy in improving breast cancer detection in daily clinical practice. PMID:19672861

  13. Detrital Zircon U-Pb Age Populations in Time and Space in the Arctic Alaska Terrane

    NASA Astrophysics Data System (ADS)

    Moore, T. E.

    2010-12-01

    The Arctic Alaska Terrane (ATT) occupies the only margin of the Ameriasia Basin whose origin and position since Paleozoic time is incompletely known. To better understand its tectonic history, detrital zircon (DZ) U-Pb ages from about 75 samples of clastic strata were obtained from representative parts of the ATT in northern Alaska. The oldest known strata of the AAT are Neoproterozoic clastic rocks exposed in the northeastern Brooks Range. DZ dating of these rocks show that they contain abundant ~1.8 Ga zircons and subordinate populations that indicate derivation from the northwest part of Laurentia. Upper Neoproterozoic strata in the Brooks Range, in contrast, contain populations dominated by ~600 Ma zircons. The latter ages are similar to those in parts of the ATT outside of northern Alaska, including the Seward Peninsula, Chukotka, and Wrangel Island that are thought to have been derived from the Timanian orogen of northern Baltica. Similar DZ populations have also been obtained from Silurian sandstones of the Lisburne Peninsula, suggesting that much of the western and southern parts of AAT may have formed in or near northern Baltica. A third group of DZ ages were found in deformed clastic rocks that were deposited across large parts of the North Slope in the Silurian and/or Devonian and are also present in parautochthonous settings in the Brooks Range. These rocks typically are dominated by DZ ages of 390-470 Ma, and sometimes contain subordinate non-Laurentian populations of ~1.5 Ga. These DZ ages, the underlying rocks of probable Baltic and Laurentian affinity, and evidence of significant deformation indicate that the ATT may have been constructed by Caledonian tectonism in the Silurian and Devonian. Following Devonian deformation, Mississippian to Triassic platform strata of the Ellesmerian Sequence were deposited on a regional unconformity. DZ ages from these rocks appear to reflect the compositions of the sub-unconformity units and indicate that Timanian

  14. [Population structure of soil arthropod in different age Pinus massoniana plantations].

    PubMed

    Tan, Bo; Wu, Fu-zhong; Yang, Wan-qin; Zhang, Jian; Xu, Zhen-feng; Liu, Yang; Gou, Xiao-lin

    2013-04-01

    An investigation was conducted on the population structure of soil arthropod community in the 3-, 8-, 14-, 31-, and 40-years old Pinus massoniana plantations in the upper reaches of the Yangtze River in spring (May) and autumn (October), 2011, aimed to search for the scientific management of the plantation. A total of 4045 soil arthropods were collected, belonging to 57 families. Both the individual density and the taxonomic group number of the soil arthropod community decreased obviously with increasing soil depth, and this trend increased with increasing stand age. The dominant groups and ordinary groups of the soil arthropod community varied greatly with the stand age of P. massoniana plantation, and a significant difference (P<0.05) was observed in the individual density and taxonomic group number among different age P. massoniana plantations. In comparison with other stand age P. massoniana plantations, 3years old P. massoniana plantation had a significant difference in the structure and diversity of soil arthropod community, and the similarity index of the soil arthropod community was lower. The individual density, taxonomic group number, and diversity of soil arthropod community were the highest in 8-years old P. massoniana plantation, and then, decreased obviously with increasing stand age. It was suggested that the land fertility of the P. massoniana plantations could be degraded with increasing stand age, and it would be appropriate to make artificial regulation and restoration in 8-years old P. massoniana plantation.

  15. Effects of aging in catastrophe on the steady state and dynamics of a microtubule population

    NASA Astrophysics Data System (ADS)

    Jemseena, V.; Gopalakrishnan, Manoj

    2015-05-01

    Several independent observations have suggested that the catastrophe transition in microtubules is not a first-order process, as is usually assumed. Recent in vitro observations by Gardner et al. [M. K. Gardner et al., Cell 147, 1092 (2011), 10.1016/j.cell.2011.10.037] showed that microtubule catastrophe takes place via multiple steps and the frequency increases with the age of the filament. Here we investigate, via numerical simulations and mathematical calculations, some of the consequences of the age dependence of catastrophe on the dynamics of microtubules as a function of the aging rate, for two different models of aging: exponential growth, but saturating asymptotically, and purely linear growth. The boundary demarcating the steady-state and non-steady-state regimes in the dynamics is derived analytically in both cases. Numerical simulations, supported by analytical calculations in the linear model, show that aging leads to nonexponential length distributions in steady state. More importantly, oscillations ensue in microtubule length and velocity. The regularity of oscillations, as characterized by the negative dip in the autocorrelation function, is reduced by increasing the frequency of rescue events. Our study shows that the age dependence of catastrophe could function as an intrinsic mechanism to generate oscillatory dynamics in a microtubule population, distinct from hitherto identified ones.

  16. Hearing loss in an aging American population: extent, impact, and management.

    PubMed

    Bainbridge, Kathleen E; Wallhagen, Margaret I

    2014-01-01

    Despite contributing substantially to disability in the United States, age-related hearing loss is an underappreciated public health concern. Loss of hearing sensitivity has been documented in two-thirds of adults aged 70 years and older and has been associated with communication difficulties, lower health-related quality of life, and decreased physical and cognitive function. Management strategies for age-related hearing loss are costly, yet the indirect costs due to lost productivity among people with communication difficulties are also substantial and likely to grow. Hearing aids can improve health-related quality of life, but the majority of people with documented hearing loss do not report using them. Uncovering effective means to improve the utilization of hearing health care services is essential for meeting the hearing health care demands of our aging population. The importance of hearing for general well-being warrants an effort to enhance awareness among the general population of the indications of hearing loss and options for assistance. PMID:24641557

  17. Spain: Promoting the Welfare of Older Adults in the Context of Population Aging

    PubMed Central

    Serrano, Juan P.; Latorre, José M.; Gatz, Margaret

    2014-01-01

    Spain is one of the European countries with the most significant societal changes in the 21st century contributing to an aging population, in particular, high life expectancy coupled with low fertility, which will result in a doubling of the old-age dependency ratio. Demographic aging implies important challenges that affect the lives of people, families, the economy, public finances, and the reorganization of the health and social systems. Currently, the older population has become particularly vulnerable due to the economic crisis taking place in Spain, which has brought about the need for new policies and systems to protect older persons. The pension system is under the greatest threat in conjunction with possible changes in the national health care system. This report presents a general view of the main factors that surround and affect older adults in Spain, as well as policies developed by the government in response to the current and future situation. We highlight demographic predictions for the coming decades, quality-of-life indicators, situations of dependency, active aging policies, and the main research programs related to gerontology in Spain. PMID:24632624

  18. Spain: promoting the welfare of older adults in the context of population aging.

    PubMed

    Serrano, Juan P; Latorre, José M; Gatz, Margaret

    2014-10-01

    Spain is one of the European countries with the most significant societal changes in the 21st century contributing to an aging population, in particular, high life expectancy coupled with low fertility, which will result in a doubling of the old-age dependency ratio. Demographic aging implies important challenges that affect the lives of people, families, the economy, public finances, and the reorganization of the health and social systems. Currently, the older population has become particularly vulnerable due to the economic crisis taking place in Spain, which has brought about the need for new policies and systems to protect older persons. The pension system is under the greatest threat in conjunction with possible changes in the national health care system. This report presents a general view of the main factors that surround and affect older adults in Spain, as well as policies developed by the government in response to the current and future situation. We highlight demographic predictions for the coming decades, quality-of-life indicators, situations of dependency, active aging policies, and the main research programs related to gerontology in Spain.

  19. Uv Imaging of Intermediate-Age Magellanic Cloud Clusters: Hot Stellar Populations in Composite Stellar Systems

    NASA Astrophysics Data System (ADS)

    Freedman, Wendy

    1994-01-01

    Hot stars were first recognized to be an important component of galactic spheroids with early vacuum ultraviolet observations of ellipticals and spiral bulges that were made with OAO. Now, 20 years later, we still do not have a full understanding of the VUV evolution of intermediate and old age stellar populations. Using the WFPC2, we therefore propose to undertake an ultraviolet survey of a sample of star clusters spanning a range in age in the Large Magellanic Cloud. The objective of this investigation is to determine the nature of the hot stellar components in rich, intermediate-to-old age LMC clusters. Ground-based optical/IR studies suggest the presence of short-lived hot horizontal branch and post-asymptotic giant branch stars in these clusters but detailed characterizations of the stars require the ultraviolet capability of HST. In this effort we will be aided by the absence of red leaks in the WFPC2 Woods filter and very high angular resolution of the HST. Although old star clusters in the Galaxy and M31 are, and will be, the subjects of intense investigation by HST, OUR SURVEY WILL BE THE FIRST OF ITS KIND FOR POPULATIONS OF INTERMEDIATE AGE. Such systems are critical for interpreting the spectra and colors of high redshift galaxies, and will provide important support to these studies.

  20. Italian populations during the Copper Age: assessment of biological affinities through morphological dental traits.

    PubMed

    Vargiu, Rita; Cucina, Andrea; Coppa, Alfredo

    2009-08-01

    The Copper Age (3rd millennium BC) was characterized by considerable socioeconomic transformations and coincided with the discovery of metallurgy. In this study we reconstruct the peopling of Italy during this period on the basis of dental morphology traits. Dental remains from 41 sites throughout Italy were analyzed; only three of the sites (Laterza and two from Sicily) span from the late Copper Age to the early Bronze Age. To work with adequate samples, we pooled the collections into nine geographically and culturally homogeneous groups. Dental morphological traits were scored on 8,891 teeth from 1,302 individuals using the ASUDAS scale. The correlation between the mean measure of divergence and geographic distances (calculated as air distances) was computed. Multidimensional scaling with the minimum spanning tree and maximum-likelihood methods was applied to assess the relationships between groups. The results revealed a substantial genetic homogeneity among the populations throughout the Italian peninsula during the Copper Age with the exception of Sardinia, which tends to diverge from the continental samples. Phenetic and geographic distances correlate highly significantly only when the southern samples from Sicily and Laterza are removed from the analysis, which indicates that these groups may have experienced genetic admixture with external populations.

  1. Chronological age estimation based on third molar development in a Portuguese population.

    PubMed

    Caldas, Inês Morais; Júlio, Paula; Simões, Ricardo Jorge; Matos, Eduarda; Afonso, Américo; Magalhães, Teresa

    2011-03-01

    Third molar development was assessed using a sample of 1,131 orthopantomograms from a Portuguese population. The methodology applied was the eight stages (A-H) method described by Demirjian et al. The final sample was made of 739 orthopantomograms, 387 (52.5%) of which belonging to females; age ranged between 6.1 and 22.5 years old (mean age = 14.49, S.D. = 4.37). For each developmental stage, mean age, standard deviation, and minimal and maximal age was assessed; evaluation of the rate formation of each tooth, according to sex, was calculated and data distribution expressed in percentiles for each stage; the probability of an individual being 16 was also evaluated. The relationship between tooth development and chronological age had a statistical significance for all teeth and both sexes (p < 0.0001). The data described may provide reference for forensic application and agree with the thesis that each population need specific data.

  2. Age and metallicity effects in single stellar populations: application to M 31 clusters.

    NASA Astrophysics Data System (ADS)

    de Freitas Pacheco, J. A.

    1997-03-01

    We have recently calculated (Borges et al. 1995AJ....110.2408B) integrated metallicity indices for single stellar populations (SSP). Effects of age, metallicity and abundances were taken into account. In particular, the explicit dependence of the indices Mg_2_ and NaD respectively on the ratios [Mg/Fe] and [Na/Fe] was included in the calibration. We report in this work an application of those models to a sample of 12 globular clusters in M 31. A fitting procedure was used to obtain age, metallicity and the [Mg/Fe] ratio for each object, which best reproduce the data. The mean age of the sample is 15+/-2.8Gyr and the mean [Mg/Fe] ratio is 0.35+/-0.10. These values and the derived metallicity spread are comparable to those found in galactic counterparts.

  3. Dynamics of telomere length in different age groups in a Latvian population.

    PubMed

    Zole, Egija; Pliss, Liana; Ranka, Renate; Krumina, Astrida; Baumanis, Viesturs

    2013-12-01

    The shortening of telomeres with ageing is a well-documented observation; however, the reported number of nucleotides in telomeres varies between different laboratories and studies. Such variability is likely caused by ethnic differences between the populations studied. Until now, there were no studies that investigated the variability of telomere length in a senescent Latvian population of the most common mitochondrial haplogroups, defined as H (45%), U (25%), Y chromosomal N1c (40%) and R1a1 (40%). Telomere length was determined in 121 individuals in different age groups, including a control group containing individuals of 20-40 years old and groups of individuals between 60-70 years old, 71-80 years old, 81-90 years old, and above 90 years old. Telomere length was determined using the Southern blot telomeric restriction fragment assay (TRF). Decreased telomere length with ageing was confirmed, but a comparison of centenarians and individuals between 60-90 years of age did not demonstrate a significant difference in telomere length. However, significant variability in telomere length was observed in the control group, indicating probable rapid telomere shortening in some individuals that could lead up to development of health status decline appearing with ageing. Telomere length measured in mononuclear blood cells (MNC) was compared with the telomere length measured in whole peripheral white blood cells (WBC) using TRF. Telomere length in MNC was longer than in WBC for the control group with individuals 20 to 40 years old; in contrast, for the group of individuals aged 65 to 85 years old, measured telomere length was shorter in MNC when compared to WBC.

  4. Graphical and Demographic Synopsis of the Captive Cohort Method for Estimating Population Age Structure in the Wild

    PubMed Central

    Carey, James R.; Müller, Hans-Georg; Wang, Jane-Ling; Papadopoulos, Nikos; Diamantidis, Alexis; Kouloussis, Nikos

    2014-01-01

    The purpose of this paper is to complement the literature concerned with the captive cohort method for estimating age structure including (1) graphic techniques to visualize and thus better understand the underlying life table identity in which the age structure of a stationary population equals the time-to-death distribution of the individuals within it; (2) re-derive the basic model for estimating age structure in non-stationary population in demographic rather than statistical notation; and (3) describe a simplified method for estimating changes in the mean age of a wild population. PMID:22776134

  5. Prevalence of self-reported food allergy in different age groups of georgian population.

    PubMed

    Lomidze, N; Gotua, M

    2015-04-01

    Epidemiological studies in high income countries suggested that a big proportion of the population in Europe and America report adverse reactions to food. Self-reported prevalence of food allergy varied from 1.2% to 17% for milk, 0.2% to 7% for egg, 0% to 2% for peanuts and fish, 0% to 10% for shellfish, and 3% to 35% for any food. The aim of our study was to report the prevalence of self-reported food allergy in the different age groups of Georgian population and to reveal the most common self-reported food allergens. ISAAC phase III study methodology and questionnaires were used for data collection. Questions about food allergy were added to the survey and involved questions about self-reported food allergy. 6-7 years old 6140 children (response rate-94,5%) and 13-14 years old 5373 adolescents (response rate-86,9%) from two locations of Georgia, Tbilisi and Kutaisi were surveyed. 500 randomly assessed adults from Tbilisi aged 18 years and older were added later (response rate-97,6%). Findings revealed that self-reported food allergy among 6-7 years old age group and 13-14 years old age were almost the same (15,7% and 15,9% correspondingly) and slightly lower in adult population - 13,9%. Study revealed, that hen's egg was the commonest implicated food for 6-7 years age group, hazel nut - for 13-14 years old age group followed by hen's egg. Walnut and hazel nut were most reported foods for adult population. The findings also revealed that food allergy is one of the most important risk factor for symptoms associated with asthma (OR-3,05; 95%CI 2.50-3.74), rhinoconjunctivitis (OR-2,85; 95%CI 2.24-3.64) and eczema (OR-5,42; 95%CI 4.08-7.18) in childhood. The data has provided the first epidemiological information related to food allergy among children and adults in Georgia. Results should serve as baseline information for food allergy screening, diagnosis and treatment. Our findings can also inform the public health officials on the disease burden and may offer some

  6. Prevalence of self-reported food allergy in different age groups of georgian population.

    PubMed

    Lomidze, N; Gotua, M

    2015-04-01

    Epidemiological studies in high income countries suggested that a big proportion of the population in Europe and America report adverse reactions to food. Self-reported prevalence of food allergy varied from 1.2% to 17% for milk, 0.2% to 7% for egg, 0% to 2% for peanuts and fish, 0% to 10% for shellfish, and 3% to 35% for any food. The aim of our study was to report the prevalence of self-reported food allergy in the different age groups of Georgian population and to reveal the most common self-reported food allergens. ISAAC phase III study methodology and questionnaires were used for data collection. Questions about food allergy were added to the survey and involved questions about self-reported food allergy. 6-7 years old 6140 children (response rate-94,5%) and 13-14 years old 5373 adolescents (response rate-86,9%) from two locations of Georgia, Tbilisi and Kutaisi were surveyed. 500 randomly assessed adults from Tbilisi aged 18 years and older were added later (response rate-97,6%). Findings revealed that self-reported food allergy among 6-7 years old age group and 13-14 years old age were almost the same (15,7% and 15,9% correspondingly) and slightly lower in adult population - 13,9%. Study revealed, that hen's egg was the commonest implicated food for 6-7 years age group, hazel nut - for 13-14 years old age group followed by hen's egg. Walnut and hazel nut were most reported foods for adult population. The findings also revealed that food allergy is one of the most important risk factor for symptoms associated with asthma (OR-3,05; 95%CI 2.50-3.74), rhinoconjunctivitis (OR-2,85; 95%CI 2.24-3.64) and eczema (OR-5,42; 95%CI 4.08-7.18) in childhood. The data has provided the first epidemiological information related to food allergy among children and adults in Georgia. Results should serve as baseline information for food allergy screening, diagnosis and treatment. Our findings can also inform the public health officials on the disease burden and may offer some

  7. Age-Related Changes in Population of Stromal Precursor Cells in Hematopoietic and Lymphoid Organs.

    PubMed

    Gorskaya, Yulia F.; Latzinik, Natalia V.; Shuklina, Ekaterina U.; Nesterenko, Vladimir G.

    2000-07-01

    It is shown that the content of precursor cells of stromal tissue (CFC-F) in the hemopoietic and lymphoid organs of SAMP (rapidly-ageing mice) and SAMR mice (mice with a normal ageing rate) decreases as the animals grow older. However the decrease in the content of CFC-F in SAMP mice begins substantially earlier - in the age group of 9-11 months, while in the SAMR mice - only in the age group of 16-19 months. It was found that the age reduction of the number to an equal degree relates to the whole population of CFC-F, in particular both the fraction of weakly-linked CFC-F, which is isolated by means of mechanical disaggregation of the tissue, and the fraction which may only be isolated using trypsin. It is shown that the concentration of inducible osteogenic precursor cells (IOPC) in the spleen of guinea pigs does not change with age, but their content in that organ in old animals (2-3 years old) drops by two times. It was found that in elderly animals the mass of the ectopic osseous tissue, formed by the implantation of an osteoinductor (autologous epithelium of the urinary bladder) in a system open for entrance of cells, decreases by two times. After curettage of the medullary cavity of guinea pig tibia (i.e. under conditions of an increased demand for osteogenic cells) the mass of induced ectopic osseous tissue decreases by 4 times, which indicates to the possible functional relationship between the pool of determined and inducible osteogenic precursor cells. On the whole, the obtained data show that during ageing there is a reduction in the number of stromal precursor cells (CFC-F and IOPC), which form a specific microenvironment for hemopoietic and lymphoid organs, which is important to understand the role of these cells in the development of age pathologies, in particular senile osteoporosis. PMID:12687170

  8. Population Pharmacokinetics of Oral Baclofen in Pediatric Patients with Cerebral Palsy

    PubMed Central

    He, Yang; Brunstrom-Hernandez, Janice E.; Thio, Liu Lin; Lackey, Shellie; Gaebler-Spira, Deborah; Kuroda, Maxine M.; Stashinko, Elaine; Hoon, Alexander H.; Vargus-Adams, Jilda; Stevenson, Richard D.; Lowenhaupt, Stephanie; McLaughlin, John F.; Christensen, Ana; Dosa, Nienke P.; Butler, Maureen; Schwabe, Aloysia; Lopez, Christina; Roge, Desiree; Kennedy, Diane; Tilton, Ann; Krach, Linda E.; Lewandowski, Andrew; Dai, Hongying; Gaedigk, Andrea; Leeder, J. Steven; Jusko, William J.

    2014-01-01

    Objective To characterize the population pharmacokinetics (PK) of oral baclofen and assess impact of patient-specific covariates in children with cerebral palsy (CP) in order to support its clinical use. Subjects design Children (2-17 years of age) with CP received a dose of titrated oral baclofen from 2.5 mg 3 times a day to a maximum tolerated dose of up to 20 mg 4 times a day. PK sampling followed titration of 10-12 weeks. Serial R- and S-baclofen plasma concentrations were measured for up to 16 hours in 49 subjects. Population PK modeling was performed using NONMEM 7.1 (ICON PLC; Ellicott City, Maryland). Results R- and S-baclofen showed identical concentration-time profiles. Both baclofen enantiomers exhibited linear and dose/kg-proportional PK, and no sex differences were observed. Average baclofen terminal half-life was 4.5 hours. A 2-compartment PK model with linear elimination and transit absorption steps adequately described concentration-time profiles of both baclofen enantiomers. The mean population estimate of apparent clearance/F was 0.273 L/h/kg with 33.4% inter-individual variability (IIV), and the apparent volume of distribution (Vss/F) was 1.16 L/kg with 43.9% IIV. Delayed absorption was expressed by a mean transit time of 0.389 hours with 83.7% IIV. Body weight, a possible genetic factor, and age were determinants of apparent clearance in these children. Conclusion The PK of oral baclofen exhibited dose-proportionality and were adequately described by a 2-compartment model. Our population PK findings suggest that baclofen dosage can be based on body weight (2 mg/kg per day) and the current baclofen dose escalation strategy is appropriate in the treatment of children with CP older than 2 years of age. PMID:24607242

  9. High Risk of Depressive Disorders in Patients With Gout: A Nationwide Population-Based Cohort Study.

    PubMed

    Changchien, Te-Chang; Yen, Yung-Chieh; Lin, Cheng-Li; Lin, Ming-Chia; Liang, Ji-An; Kao, Chia-Hung

    2015-12-01

    Metabolic abnormalities are common in patients with depressive disorders. However, the relationship between gout and depression is unclear. We explored the causal relationship among gout, antigout medication, and the associated risk of incidental depressive disorders.In this nationwide cohort study, we sampled data from the National Health Insurance Research Database to recruit 34,050 patients with gout as the gout cohort and 68,100 controls (without gout) as the nongout cohort. Our primary endpoint was the diagnosis of depressive disorders during follow-up. The overall study population was followed up until depression diagnosis, withdrawal from the NHI program, or the end of the study. The differences in demographic and clinical characteristics between both cohorts were determined using the Chi-square test for categorical variables and the t-test for continuous variables. Cox proportional hazard regression models were used to examine the effect of gout on the risk of depression, represented using the hazard ratio with the 95% confidence interval.Patients with gout exhibited a higher risk of depressive disorders than controls did. The risk of depressive disorders increased with age and was higher in female patients and those with hypertension, stroke, and coronary artery disease. Nonsteroidal antiinflammatory drug and prednisolone use was associated with a reduced risk of depression. Patients with gout who had received antigout medication exhibited a reduced risk of depressive disorders compared with nongout patients.Our findings support that gout increases the risk of depressive disorders, and that antigout medication use reduces the risk.

  10. Survival of patients with mixed phenotype acute leukemias: A large population-based study.

    PubMed

    Shi, Runhua; Munker, Reinhold

    2015-06-01

    Little is known about the incidence and treatment outcome of patients with acute biphenotypic leukemias. The World Health Organization (WHO) established the term of acute leukemia of ambiguous phenotype in 2001 (revised in 2008) introducing the term of mixed phenotype acute leukemias. Using the database of the Surveillance, Epidemiology, and End Results registry (SEER), we identified 313 patients with mixed phenotype acute leukemias and compared them with 14,739 patients with acute lymphoblastic leukemia and 34,326 patients with acute myelogenous leukemias diagnosed between 2001 and 2011. As a further control group, 1777 patients were included who were not classified as myeloid, lymphoid or biphenotypic (other acute leukemias). The incidence of mixed phenotype acute leukemias is 0.35 cases/1,000,000 person-years. In a multivariate analysis, the prognosis depends strongly on age (as with other leukemias) and it has the worst outcome of all four types of leukemia. However, the prognosis has improved, comparing 2001-2005 with 2006-2011. We present the first comprehensive, population-based study of acute biphenotypic or mixed phenotype acute leukemias according to the WHO classification. Especially in older patients, the prognosis is unfavorable and new treatments should be investigated.

  11. Isotope and Patient Age Predict for PSA Spikes After Permanent Prostate Brachytherapy

    SciTech Connect

    Bostancic, Chelsea; Merrick, Gregory S. . E-mail: gmerrick@urologicresearchinstitute.org; Butler, Wayne M.; Wallner, Kent E.; Allen, Zachariah; Galbreath, Robert; Lief, Jonathan; Gutman, Sarah E.

    2007-08-01

    Purpose: To evaluate prostate-specific antigen (PSA) spikes after permanent prostate brachytherapy in low-risk patients. Methods and Materials: The study population consisted of 164 prostate cancer patients who were part of a prospective randomized trial comparing {sup 103}Pd and {sup 125}I for low-risk disease. Of the 164 patients, 61 (37.2%) received short-course androgen deprivation therapy. The median follow-up was 5.4 years. On average, 11.1 post-treatment PSA measurements were obtained per patient. Biochemical disease-free survival was defined as a PSA level of {<=}0.40 ng/mL after nadir. A PSA spike was defined as an increase of {>=}0.2 ng/mL, followed by a durable decline to prespike levels. Multiple parameters were evaluated as predictors for a PSA spike. Results: Of the 164 patients, 44 (26.9%) developed a PSA spike. Of the 46 hormone-naive {sup 125}I patients and 57 hormone-naive {sup 103}Pd patients, 21 (45.7%) and 8 (14.0%) developed a PSA spike. In the hormone-naive patients, the mean time between implantation and the spike was 22.6 months and 18.7 months for {sup 125}I and {sup 103}Pd, respectively. In patients receiving neoadjuvant androgen deprivation therapy, the incidence of spikes was comparable between isotopes ({sup 125}I 28.1% and {sup 103}Pd 20.7%). The incidence of spikes was substantially different in patients <65 years vs. {>=}65 years old (38.5% vs. 16.3%). On multivariate Cox regression analysis, patient age (p < 0.001) and isotope (p = 0.002) were significant predictors for spike. Conclusion: In low-risk prostate cancer, PSA spikes are most common in patients implanted with {sup 125}I and/or <65 years of age. Differences in isotope-related spikes are most pronounced in hormone-naive patients.

  12. Increased Risk of Osteoporosis in Patients With Peptic Ulcer Disease: A Nationwide Population-Based Study.

    PubMed

    Wu, Chieh-Hsin; Tung, Yi-Ching; Chai, Chee-Yin; Lu, Ying-Yi; Su, Yu-Feng; Tsai, Tai-Hsin; Kuo, Keng-Liang; Lin, Chih-Lung

    2016-04-01

    To investigate osteoporosis risk in patients with peptic ulcer disease (PUD) using a nationwide population-based dataset. This Taiwan National Health Insurance Research Database (NHIRD) analysis included 27,132 patients aged 18 years and older who had been diagnosed with PUD (International Classification of Diseases, Ninth Revision, Clinical Modification [ICD-9-CM] codes 531-534) during 1996 to 2010. The control group consisted of 27,132 randomly selected (age- and gender)-matched patients without PUD. The association between PUD and the risk of developing osteoporosis was estimated using a Cox proportional hazard regression model. During the follow-up period, osteoporosis was diagnosed in 2538 (9.35 %) patients in the PUD group and in 2259 (8.33 %) participants in the non-PUD group. After adjusting for covariates, osteoporosis risk was 1.85 times greater in the PUD group compared to the non-PUD group (13.99 vs 5.80 per 1000 person-years, respectively). Osteoporosis developed 1 year after PUD diagnosis. The 1-year follow-up period exhibited the highest significance between the 2 groups (hazard ratio [HR] = 63.44, 95% confidence interval [CI] = 28.19-142.74, P < 0.001). Osteoporosis risk was significantly higher in PUD patients with proton-pump-inhibitors (PPIs) use (HR = 1.17, 95% CI = 1.03-1.34) compared to PUD patients without PPIs use. This study revealed a significant association between PUD and subsequent risk of osteoporosis. Therefore, PUD patients, especially those treated with PPIs, should be evaluated for subsequent risk of osteoporosis to minimize the occurrence of adverse events.

  13. [Anesthesia for geriatric patients : Part 2: anesthetics, patient age and anesthesia management].

    PubMed

    Herminghaus, A; Löser, S; Wilhelm, W

    2012-04-01

    Part 2 of this review on geriatric anesthesia primarily describes the multiple influences of age on the pharmacokinetics and pharmacodynamics of different anesthetic agents and their impact on clinical practice. In the elderly the demand for opioids is reduced by almost 50% and with total intravenous anesthesia the dosages of propofol and remifentanil as well as recovery times are more determined by patient age than by body weight. As a result depth of anesthesia monitoring is recommended for geriatric patients to individually adjust the dosing to patients needs. With muscle relaxants both delayed onset of action and prolonged duration of drug effects must be considered with increasing age and as this may lead to respiratory complications, neuromuscular monitoring is highly recommended. The following measures appear to be beneficial for geriatric patients: thorough preoperative assessment, extended hemodynamic monitoring, use of short-acting anesthetics in individually adjusted doses best tailored by depth of anesthesia monitoring, intraoperative normotension, normothermia and normocapnia, complete neuromuscular recovery at the end of the procedure and well-planned postoperative pain management in order to reduce or avoid the use of opioids.

  14. Sex ratio at reproductive age: changes over the last century in the Italian population.

    PubMed

    Ulizzi, L; Astolfi, P; Zonta, L A

    2001-02-01

    The radical improvement in living conditions experienced in Italy during the last century caused a reduction in male extra-mortality during the prereproductive years. As a consequence, a progressive increase in the sex ratio at the beginning of the reproductive age (15-19 years) occurred, so that in recent times the sex ratio in the young adult population has approached the almost constant value of 1.06 observed at birth. We calculated that the sex composition would be the same in newborns and in young adults in about one generation: obviously, we have to assume that the sex differentials in mortality and migration are constant over time. The 1:1 equilibrium between sexes, which maximizes reproductive success, occurred in the 15-19 age group at the beginning of the century and shifted to the 30-35 age group in the 1990s. We compared the 1993-1995 sex ratios in different age groups in European Union countries and observed that in Italy as well as in other Mediterranean countries the numerical equality between sexes is reached at 30-35 years of age, while in north-central Europe it is reached later, approximately at the end of reproductive life.

  15. Suicide mortality of young, middle-aged and elderly males and females in Japan for the years 1953-96: time series analysis for the effects of unemployment, female labour force, young and aged population, primary industry and population density.

    PubMed

    Yamasaki, Akiko; Araki, Shunichi; Sakai, Ryoji; Yokoyama, Kazuhito; Voorhees, A Scott

    2008-12-01

    Effects of nine social life indicators on age-adjusted and age-specific annual suicide mortality of male and female Japanese population in the years 1953-96 were investigated by multiple regression analysis on time series data. Unemployment rate was significantly related to the age-adjusted mortality in both males and females. Also, female labour force participation was positively related to the male mortality; persons and 65 and above was inversely related to the male mortality. Results on the age-specific mortality indicated that: during the 44 yr, (1) unemployment significantly related with the mortality of young, middle-aged and elderly males and young females; (2) female labour force participation significantly related with the mortality of young and elderly males and young females; aged population significantly related with the mortality of middle-aged and elderly males; (4) young population significantly related with the mortality of young and middle-aged males and females; (5) divorce significantly related with the mortality of middle-aged and elderly males and young males and females; (6) persons employed in primary industries significantly related with the mortality in middle-aged males and young males and females; and (7) population density significantly related with the mortality of middle-aged males and young females.

  16. The cost of somatisation among the working‐age population in England for the year 2008–2009

    PubMed Central

    2010-01-01

    Medically unexplained symptoms are one of the most commonly encountered symptoms across all healthcare settings. They are also responsible for a large proportion of disability in the workforce and decreased quality of life. These patients represent an important clinical phenomenon with considerable direct and indirect economic consequences. This study aims to calculate the economic burden of somatisation among English adults in 2008–2009. Using existing literature, estimates of prevalence, healthcare use and disability were combined in order to calculate the annual cost of healthcare use and productivity loss associated with these patients in excess of non‐somatising patients. Based on the results of our analysis, the incremental health care cost incurred by somatising patients is estimated to be £3 billion. This represents approximately 10% of total NHS expenditure on these services for the working‐age population in 2008–2009. The cost of sickness absence and decreased quality of life associated with these patients amounts to over £14 billion. By highlighting the magnitude of this phenomenon at each level of the health system and the considerable impact of non‐healthcare costs, this study serves to draw attention to a group of patients who are frequently unrecognised or misdiagnosed by physicians who tend to repeatedly pursue organic possibilities through multiple tests, procedures and operations. As economic perspectives play an increasing role in healthcare planning, the reduction of health care use and improvement of functioning among this group of patients should be a major goal. In order to realise these goals, changed pathways and behaviour in primary and secondary care are needed, along with improved access to psychological therapy services. PMID:22477925

  17. Trends in Any and High-Dose Opioid Analgesic Receipt Among Aging Patients With and Without HIV

    PubMed Central

    Gordon, Kirsha; Edelman, E. Jennifer; Kerns, Robert D.; Crystal, Stephen; Dziura, James D.; Fiellin, Lynn E.; Gordon, Adam J.; Goulet, Joseph L.; Justice, Amy C.; Fiellin, David A.

    2016-01-01

    Harms of opioid analgesics, especially high-dose therapy among individuals with comorbidities and older age, are increasingly recognized. However, trends in opioid receipt among HIV-infected patients are not well characterized. We examined trends, from 1999 to 2010, in any and high-dose (≥120 mg/day) opioid receipt among patients with and without HIV, by age strata, controlling for demographic and clinical correlates. Of 127,216 patients, 64 % received at least one opioid prescription. Opioid receipt increased substantially among HIV-infected and uninfected patients over the study; high-dose therapy was more prevalent among HIV-infected patients. Trends in high-dose receipt stratified by three age groups revealed an increasing trend in each age strata, higher among HIV-infected patients. Correlates of any opioid receipt included HIV, PTSD and major depression. Correlates of high-dose receipt included HIV, PTSD, major depression and drug use disorders. These findings suggest a need for appropriate balance of risks and benefits, especially as these populations age. PMID:26384973

  18. Population pharmacokinetics of perphenazine in schizophrenia patients from CATIE: impact of race and smoking.

    PubMed

    Jin, Yuyan; Pollock, Bruce G; Coley, Kim; Miller, Del; Marder, Stephen R; Florian, Jeff; Schneider, Lon; Lieberman, Jeffrey; Kirshner, Margaret; Bies, Robert R

    2010-01-01

    The goal of the study was to characterize population pharmacokinetics (PPK) for perphenazine in patients with schizophrenia from the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE). Patients (n = 156) received 8 to 32 mg of perphenazine daily for 14 to 600 days for a total of 421 plasma concentrations measurements. Nonlinear mixed-effects modeling was used to determine PPK characteristics of perphenazine. One- and 2-compartment models with various random effect implementations and mixture distributions were evaluated. Objective function values and goodness-of-fit plots were used as model selection criteria. Age, weight, sex, race, smoking, and concomitant medications were evaluated as covariates. A 1-compartment linear model with proportional error best described the data. The population mean clearance and volume of distribution for perphenazine were 483 L/h and 18 200 L, respectively. Race and smoking status had significant impacts on perphenazine clearance estimates. In addition, the estimated population mean clearance was 48% higher in nonsmoking African Americans than in nonsmoking other races (512 L/h vs 346 L/h). Active smokers eliminated perphenazine 159 L/h faster than nonsmokers in each race. Clearances for smoking African Americans versus smokers in other races were 671 L/h versus 505 L/h, respectively.

  19. Tension-type headache in Parma's adult general population: a focus on age of onset.

    PubMed

    Taga, Arens; Russo, Marco; Manzoni, Gian C; Torelli, Paola

    2015-01-01

    In the present paper, we focus on the age of onset for tension-type headache in a population-based sample in the Parma, distinguishing its different subtypes and considering definite and probable diagnoses. Age of headache onset is a useful clinical feature for differential diagnosis between primary headaches and between primary and secondary headache forms. A total of 904 subjects representative of the Parma's adult general population were interviewed face to face by a physician from the Parma Headache Centre, using a validated questionnaire specially designed for the diagnosis of primary headaches according to the ICHD-II criteria. In the majority of subjects diagnosed with definite tension-type headache, age of onset was 39 years or less, while mean age of onset was 29.7 years (SD 16.3 years, range 5-79 years), the median being 25 years. Both infrequent and frequent episodic definite tension-type headache first occurred in the majority of cases in the second, third and fourth decades. Subjects with chronic definite tension-type headache reported a later onset in life (i.e. fourth, fifth and sixth decades). In our study, mean age of onset for probable tension-type headache was 23.7 years (SD 9.2 years, range 10-40 years) and the median was 22 years. In no case did we find significant gender differences. Our study results are similar to most of those reported in the literature. Further research needs to be done in the Italian epidemiological context, given the lack of literature reports on this topic.

  20. Population pharmacokinetic analysis of voriconazole and anidulafungin in adult patients with invasive aspergillosis.

    PubMed

    Liu, Ping; Mould, Diane R

    2014-08-01

    To assess the pharmacokinetics (PK) of voriconazole and anidulafungin in patients with invasive aspergillosis (IA) in comparison with other populations, sparse PK data were obtained for 305 adults from a prospective phase 3 study comparing voriconazole and anidulafungin in combination versus voriconazole monotherapy (voriconazole, 6 mg/kg intravenously [IV] every 12 h [q12h] for 24 h followed by 4 mg/kg IV q12h, switched to 300 mg orally q12h as appropriate; with placebo or anidulafungin IV, a 200-mg loading dose followed by 100 mg q24h). Voriconazole PK was described by a two-compartment model with first-order absorption and mixed linear and time-dependent nonlinear (Michaelis-Menten) elimination; anidulafungin PK was described by a two-compartment model with first-order elimination. For voriconazole, the normal inverse Wishart prior approach was implemented to stabilize the model. Compared to previous models, no new covariates were identified for voriconazole or anidulafungin. PK parameter estimates of voriconazole and anidulafungin are in agreement with those reported previously except for voriconazole clearance (the nonlinear clearance component became minimal). At a 4-mg/kg IV dose, voriconazole exposure tended to increase slightly as age, weight, or body mass index increased, but the difference was not considered clinically relevant. Estimated voriconazole exposures in IA patients at 4 mg/kg IV were higher than those reported for healthy adults (e.g., the average area under the curve over a 12-hour dosing interval [AUC0-12] at steady state was 46% higher); while it is not definitive, age and concomitant medications may impact this difference. Estimated anidulafungin exposures in IA patients were comparable to those reported for the general patient population. This study was approved by the appropriate institutional review boards or ethics committees and registered on ClinicalTrials.gov (NCT00531479). PMID:24913161

  1. Population pharmacokinetic analysis of voriconazole and anidulafungin in adult patients with invasive aspergillosis.

    PubMed

    Liu, Ping; Mould, Diane R

    2014-08-01

    To assess the pharmacokinetics (PK) of voriconazole and anidulafungin in patients with invasive aspergillosis (IA) in comparison with other populations, sparse PK data were obtained for 305 adults from a prospective phase 3 study comparing voriconazole and anidulafungin in combination versus voriconazole monotherapy (voriconazole, 6 mg/kg intravenously [IV] every 12 h [q12h] for 24 h followed by 4 mg/kg IV q12h, switched to 300 mg orally q12h as appropriate; with placebo or anidulafungin IV, a 200-mg loading dose followed by 100 mg q24h). Voriconazole PK was described by a two-compartment model with first-order absorption and mixed linear and time-dependent nonlinear (Michaelis-Menten) elimination; anidulafungin PK was described by a two-compartment model with first-order elimination. For voriconazole, the normal inverse Wishart prior approach was implemented to stabilize the model. Compared to previous models, no new covariates were identified for voriconazole or anidulafungin. PK parameter estimates of voriconazole and anidulafungin are in agreement with those reported previously except for voriconazole clearance (the nonlinear clearance component became minimal). At a 4-mg/kg IV dose, voriconazole exposure tended to increase slightly as age, weight, or body mass index increased, but the difference was not considered clinically relevant. Estimated voriconazole exposures in IA patients at 4 mg/kg IV were higher than those reported for healthy adults (e.g., the average area under the curve over a 12-hour dosing interval [AUC0-12] at steady state was 46% higher); while it is not definitive, age and concomitant medications may impact this difference. Estimated anidulafungin exposures in IA patients were comparable to those reported for the general patient population. This study was approved by the appropriate institutional review boards or ethics committees and registered on ClinicalTrials.gov (NCT00531479).

  2. Old-age pensions and population health: a global and cross-national perspective.

    PubMed

    Sjöberg, Ola

    2014-01-01

    Social security schemes can reduce poverty risk and increase resources available for individuals and families, and these schemes may therefore have an important role to play in population health in both high- and middle-income countries. This article analyses the linkage between effective coverage of old-age pension schemes and life expectancy in a sample of 93 high- and middle-income countries at the end of the twenty-first century. The analyses support the notion that social security schemes, and especially programmes with a universal approach, may have positive effects on population health, even after taking into account the effect of levels of economic development, income inequality and essential characteristics of health care systems. This article also demonstrates that there is no evident relationship between levels of economic development and social security legislation: historically, late industrialisers were often first in introducing major social security schemes, and today there is no clear cross-national relationship between levels of economic development and the proportion of the population covered by old-age pension schemes. PMID:24524644

  3. A synthetic circuit for selectively arresting daughter cells to create aging populations

    PubMed Central

    Afonso, Bruno; Silver, Pamela A.; Ajo-Franklin, Caroline M.

    2010-01-01

    The ability to engineer genetic programs governing cell fate will permit new safeguards for engineered organisms and will further the biological understanding of differentiation and aging. Here, we have designed, built and implemented a genetic device in the budding yeast Saccharomyces cerevisiae that controls cell-cycle progression selectively in daughter cells. The synthetic device was built in a modular fashion by combining timing elements that are coupled to the cell cycle, i.e. cell-cycle specific promoters and protein degradation domains, and an enzymatic domain which conditionally confers cell arrest. Thus, in the presence of a drug, the device is designed to arrest growth of only newly-divided daughter cells in the population. Indeed, while the engineered cells grow normally in the absence of drug, with the drug the engineered cells display reduced, linear growth on the population level. Fluorescence microscopy of single cells shows that the device induces cell arrest exclusively in daughter cells and radically shifts the age distribution of the resulting population towards older cells. This device, termed the ‘daughter arrester’, provides a blueprint for more advanced devices that mimic developmental processes by having control over cell growth and death. PMID:20150416

  4. A synthetic circuit for selectively arresting daughter cells to create aging populations.

    PubMed

    Afonso, Bruno; Silver, Pamela A; Ajo-Franklin, Caroline M

    2010-05-01

    The ability to engineer genetic programs governing cell fate will permit new safeguards for engineered organisms and will further the biological understanding of differentiation and aging. Here, we have designed, built and implemented a genetic device in the budding yeast Saccharomyces cerevisiae that controls cell-cycle progression selectively in daughter cells. The synthetic device was built in a modular fashion by combining timing elements that are coupled to the cell cycle, i.e. cell-cycle specific promoters and protein degradation domains, and an enzymatic domain which conditionally confers cell arrest. Thus, in the presence of a drug, the device is designed to arrest growth of only newly-divided daughter cells in the population. Indeed, while the engineered cells grow normally in the absence of drug, with the drug the engineered cells display reduced, linear growth on the population level. Fluorescence microscopy of single cells shows that the device induces cell arrest exclusively in daughter cells and radically shifts the age distribution of the resulting population towards older cells. This device, termed the 'daughter arrester', provides a blueprint for more advanced devices that mimic developmental processes by having control over cell growth and death.

  5. White noise and synchronization shaping the age structure of the human population

    NASA Astrophysics Data System (ADS)

    Cebrat, Stanislaw; Biecek, Przemyslaw; Bonkowska, Katarzyna; Kula, Mateusz

    2007-06-01

    We have modified the standard diploid Penna model of ageing in such a way that instead of threshold of defective loci resulting in genetic death of individuals, the fluctuation of environment and "personal" fluctuations of individuals were introduced. The sum of the both fluctuations describes the health status of the individual. While environmental fluctuations are the same for all individuals in the population, the personal component of fluctuations is composed of fluctuations corresponding to each physiological function (gene, genetic locus). It is rather accepted hypothesis that physiological parameters of any organism fluctuate highly nonlinearly. Transition to the synchronized behaviors could be a very strong diagnostic signal of the life threatening disorder. Thus, in our model, mutations of genes change the chaotic fluctuations representing the function of a wild gene to the synchronized signals generated by mutated genes. Genes are switched on chronologically, like in the standard Penna model. Accumulation of defective genes predicted by Medawar's theory of ageing leads to the replacement of uncorrelated white noise corresponding to the healthy organism by the correlated signals of defective functions. As a result we have got the age distribution of population corresponding to the human demographic data.

  6. RESEARCH PAPER: Old stellar population synthesis: new age and mass estimates for Mayall II = G1

    NASA Astrophysics Data System (ADS)

    Ma, Jun; de Grijs, Richard; Fan, Zhou; Rey, Soo-Chang; Wu, Zhen-Yu; Zhou, Xu; Wu, Jiang-Hua; Jiang, Zhao-Ji; Chen, Jian-Sheng; Lee, Kyungsook; Sohn, Sangmo Tony

    2009-06-01

    Mayall II = G1 is one of the most luminous globular clusters (GCs) in M31. Here, we determine its age and mass by comparing multicolor photometry with theoretical stellar population synthesis models. Based on far- and near-ultraviolet GALEX photometry, broad-band UBVRI, and infrared JHKS 2MASS data, we construct the most extensive spectral energy distribution of G1 to date, spanning the wavelength range from 1538 to 20 000 Å. A quantitative comparison with a variety of simple stellar population (SSP) models yields a mean age which is consistent with G1 being among the oldest building blocks of M31 and having formed within ~1.7 Gyr after the Big Bang. Irrespective of the SSP model or stellar initial mass function adopted, the resulting mass estimates (of order 107 Modot) indicate that G1 is one of the most massive GCs in the Local Group. However, we speculate that the cluster's exceptionally high mass suggests that it may not be a genuine GC. Our results also suggest that G1 may contain, on average, (1.65±0.63) × 102 Lodot far-ultraviolet-bright, hot, extreme horizontal-branch stars, depending on the adopted SSP model. In addition, we demonstrate that extensive multi-passband photometry coupled with SSP analysis enables one to obtain age estimates for old SSPs that have similar accuracies as those from integrated spectroscopy or resolved stellar photometry, provided that some of the free parameters can be constrained independently.

  7. Gene-drive into insect populations with age and spatial structure: a theoretical assessment.

    PubMed

    Huang, Yunxin; Lloyd, Alun L; Legros, Mathieu; Gould, Fred

    2011-05-01

    The potential benefits and risks of genetically engineered gene-drive systems for replacing wild pest strains with more benign strains must be assessed prior to any field releases. We develop a computer simulation model to assess the feasibility of using engineered underdominance constructs to drive transgenes into age- and spatially structured mosquito populations. Our practical criterion for success is the achievement of a transgene frequency of at least 0.80 within 3 years of release. The impacts of a number of parameters that may affect the success of gene-drive, such as the release area, release age, density-dependent larval survival, fitness cost of the engineered genes, and migration probability of adults, are examined. Results show that patchy release generally requires the release of fewer engineered insects to achieve success than central release. When the fitness cost is very low, central release covering 25% of the total area can be more effective than a completely uniform release over the whole area. This study demonstrates that to determine the best method of spatial release, and the total number of engineered insects that must be released, it is important to take into account the age and sex of the released insects and spatial structure of the population.

  8. The chronological age estimation of third molar mineralization of Han population in southwestern China.

    PubMed

    Qing, Maofeng; Qiu, Lihua; Gao, Zhi; Bhandari, Kishor

    2014-05-01

    The purpose of the study was to estimate the chronology of third molar mineralization in Han population of southwestern China and find its unique characteristics so that it would provide a reference in several legal cases like forensic age estimation. The study used Demirjian's staging method to study 2192 orthopantomograms of 984 male and 1208 female subjects aged between 8 and 25 years. The statistical data was analyzed by Student's t test and ANOVA. The conclusions of the study are: (1) The chronological mineralization age of third molars of Han population in Southwestern China is similar to the Turkish and the Japanese, was earlier than the Austrian and Han of South China, but later than the Spanish. (2) The mineralization timing of the third molars between two sides in maxilla or mandible has no significant differences in the same gender group. (3) There is no significant difference in mineralization of third molars between male and female, except for tooth 48 in Demirjian's stage E. (4) The mineralization of third molar in maxilla is earlier than mandible.

  9. Effect of Obesity on the Population Pharmacokinetics of Meropenem in Critically Ill Patients.

    PubMed

    Alobaid, Abdulaziz S; Wallis, Steven C; Jarrett, Paul; Starr, Therese; Stuart, Janine; Lassig-Smith, Melissa; Ordóñez Mejia, Jenny Lisette; Roberts, Michael S; Lipman, Jeffrey; Roberts, Jason A

    2016-08-01

    Severe pathophysiological changes in critical illness can lead to dramatically altered antimicrobial pharmacokinetics (PK). The additional effect of obesity on PK potentially increases the challenge for effective dosing. The aim of this prospective study was to describe the population PK of meropenem for a cohort of critically ill patients, including obese and morbidly obese patients. Critically ill patients prescribed meropenem were recruited into the following three body mass index (BMI) groups: nonobese (18.5 to 29.9 kg/m(2)), obese (30.0 to 39.9 kg/m(2)), and morbidly obese (≥40 kg/m(2)). Serial plasma samples were taken, and meropenem concentrations were determined using a validated chromatographic method. Population PK analysis and Monte Carlo dosing simulations were undertaken with Pmetrics. Nineteen critically ill patients with different BMI categories were enrolled. The patients' mean ± standard deviation (SD) age, weight, and BMI were 49 ± 15.9 years, 95 ± 22.0 kg, and 33 ± 7.0 kg/m(2), respectively. A two-compartment model described the data adequately. The mean ± SD parameter estimates for the final covariate model were as follows: clearance (CL), 15.5 ± 6.0 liters/h; volume of distribution in the central compartment (V1), 11.7 ± 5.8 liters; intercompartmental clearance from the central compartment to the peripheral compartment, 25.6 ± 35.1 liters h(-1); and intercompartmental clearance from the peripheral compartment to the central compartment, 8.32 ± 12.24 liters h(-1) Higher creatinine clearance (CLCR) was associated with a lower probability of target attainment, with BMI having little effect. Although obesity was found to be associated with an increased V1, dose adjustment based on CLCR appears to be more important than patient BMI. PMID:27185798

  10. An aging population and growing disease burden will require a large and specialized health care workforce by 2025.

    PubMed

    Dall, Timothy M; Gallo, Paul D; Chakrabarti, Ritasree; West, Terry; Semilla, April P; Storm, Michael V

    2013-11-01

    As the US population ages, the increasing prevalence of chronic disease and complex medical conditions will have profound implications for the future health care system. We projected future prevalence of selected diseases and health risk factors to model future demand for health care services for each person in a representative sample of the current and projected future population. Based on changing demographic characteristics and expanded medical coverage under the Affordable Care Act, we project that the demand for adult primary care services will grow by approximately 14 percent between 2013 and 2025. Vascular surgery has the highest projected demand growth (31 percent), followed by cardiology (20 percent) and neurological surgery, radiology, and general surgery (each 18 percent). Market indicators such as long wait times to obtain appointments suggest that the current supply of many specialists throughout the United States is inadequate to meet the current demand. Failure to train sufficient numbers and the correct mix of specialists could exacerbate already long wait times for appointments, reduce access to care for some of the nation's most vulnerable patients, and reduce patients' quality of life. PMID:24191094

  11. Gestational Age at Birth and 'Body-Mind' Health at 5 Years of Age: A Population Based Cohort Study.

    PubMed

    Cronin, Frances M; Segurado, Ricardo; McAuliffe, Fionnuala M; Kelleher, Cecily C; Tremblay, Richard E

    2016-01-01

    Numerous studies have identified the effects of prematurity on the neonate's physical health, however few studies have explored the effects of prematurity on both the physical and mental health of the child as they develop. Secondary analysis of data from the Millennium Cohort Study, a longitudinal study of infants (n = 18 818, born 2000-2002 in the United Kingdom) was performed. Effects of gestational age at birth on health outcomes at 5 years were measured using parental rating of their children's general health and severity of behavior problems. The association between parent's general health ratings and behavior problem ratings was low: 86% of those reporting serious behavior problems (5% of the sample, n = 764) rated their child as being in excellent, very good, or good health. Still, a gradient of increasing risk of poorer outcome with decreasing gestational age was observed for a composite health measure (poor/fair health and/or serious behavior problems), suggesting an association with prematurity for this composite assessment of health status. The greatest contribution to the childhood composite health measure at 5 years was for children born at 32-36 weeks gestation: population attributable fractions for having poor outcomes was 3.4% (Bonferroni-adjusted 95% confidence interval 1.1%-6.2%), compared to 1% (0.2-2.3) for birth at less than 32 weeks. Results suggest that preterm children, by school entry, are not only at high risk of physical health problems, but also of behavioral health problems. The recognition of, and response to comprehensive health and well-being outcomes related to prematurity are important in order to correctly plan and deliver adequate paediatric health services and policies. PMID:26975048

  12. Gestational Age at Birth and ‘Body-Mind’ Health at 5 Years of Age: A Population Based Cohort Study

    PubMed Central

    Segurado, Ricardo; McAuliffe, Fionnuala M.; Kelleher, Cecily C.

    2016-01-01

    Numerous studies have identified the effects of prematurity on the neonate’s physical health, however few studies have explored the effects of prematurity on both the physical and mental health of the child as they develop. Secondary analysis of data from the Millennium Cohort Study, a longitudinal study of infants (n = 18 818, born 2000–2002 in the United Kingdom) was performed. Effects of gestational age at birth on health outcomes at 5 years were measured using parental rating of their children’s general health and severity of behavior problems. The association between parent’s general health ratings and behavior problem ratings was low: 86% of those reporting serious behavior problems (5% of the sample, n = 764) rated their child as being in excellent, very good, or good health. Still, a gradient of increasing risk of poorer outcome with decreasing gestational age was observed for a composite health measure (poor/fair health and/or serious behavior problems), suggesting an association with prematurity for this composite assessment of health status. The greatest contribution to the childhood composite health measure at 5 years was for children born at 32–36 weeks gestation: population attributable fractions for having poor outcomes was 3.4% (Bonferroni-adjusted 95% confidence interval 1.1%–6.2%), compared to 1% (0.2–2.3) for birth at less than 32 weeks. Results suggest that preterm children, by school entry, are not only at high risk of physical health problems, but also of behavioral health problems. The recognition of, and response to comprehensive health and well-being outcomes related to prematurity are important in order to correctly plan and deliver adequate paediatric health services and policies. PMID:26975048

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

    PubMed Central

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

    2016-01-01

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

  14. Patients attended by palliative care teams: are they always comparable populations?

    PubMed

    Nabal, Maria; Barcons, Miquel; Moreno, Roberto; Busquets, Xavier; Trujillano, Javier J; Requena, Antonio

    2013-12-01

    Patients attended by palliative care teams: are they always comparable populations? To answer this question we have compared the basic epidemiological characteristics of patients attended by home palliative care teams (HPCT) in two autonomous regions of Spain. We carried out a coordinated analytical, observational and prospective study in two Spanish autonomous regions: Aragon and Catalonia. Data were kept during each home care visit according to patients' needs. Inclusion criteria were: advanced cancer, over 18 years old and first contact with a HPCT. The recruitment period was 6 months. Variables included were: Survival time (days), age, sex, primary disease and extension, place of residence. Functional and cognitive state, and co-morbidity. 10 signs/symptoms: asthenia, anorexia, cachexia, dysphagia, xerostomy, dyspnoea, oedemas, level of consciousness, presence of delirium, presence of pressure ulcers and some treatment data. Others variables considered were: responsible team, origin, destination when discharge, date and place of death, number of visits made and duration of monitoring. We developed a comparison between groups by Chi-squared test or the non-parametric Mann-Whitney U test and a survival analysis by Kaplan-Meier curves and the logrank test to determine differences between factors. The SPSS version 15.0 software package was used. 698 patients were included, 56.2% from Aragon and 43.8% from Catalonia. 60.3% were males, without differences between the regions. Characteristics relative to age, sex, place of residence and extension of oncological diseases were similar for both groups. We found significant differences between the two populations relative to survival time, co-morbidity, functional state, presence and intensity of a number of symptoms and the treatments, patient monitoring and the their destination after discharge. We can conclude that palliative care teams cover different profiles of patients with regard to their co-morbidity, functional

  15. Success of patient training in improving proficiency of eyedrop administration among various ophthalmic patient populations

    PubMed Central

    Feng, Alexander; O’Neill, John; Holt, Mitchell; Georgiadis, Catherine; Wright, Martha M; Montezuma, Sandra R

    2016-01-01

    Purpose The purpose of this study is to evaluate the success and usefulness of patient education in eyedrop self-administration technique via an educational handout and a short instructional video. Patients and methods We conducted a prospective study that included 34 patients who were self-administering ophthalmic drops. Of the total patients included, 12% had used drops for <12 months, and 88% had used drops for >12 months. Average age of patients in the study was 67 years, with an age range of 19–91 years. Of the total patients included, 82% had glaucoma, 6% had dry eyes, and 12% did not have a specific diagnosis. Subjects were video recorded and assessed by a trained observer on two occasions: at baseline and after they viewed a demonstrational video and handout. A maximum score of 15 points was awarded based on 15 criteria. A written self-assessment was administered at the end of each study. Results Pre- and post-teaching assessment scores improved significantly with education. Patients initially scored an average 2.53 points compared to a post-education score of 6.15 out of 15 points, demonstrating a 2.43 (P=0.008) factor of improvement. After education, 94% of patients versus 47% pre-teaching (P=0.0001) pulled down their lower eyelids. A total of 91% pre-teaching versus 59% post-teaching (P=0.0042) patients squeezed one drop into the lower fornix, 74% pre-teaching versus 26% post-teaching (P=0.0002) patients released the eyelid and closed the eye for 1 minute, and 56% pre-teaching versus 3% post-teaching (P=0.0001) patients applied nasal digital pressure on each eye. We found no significant difference in score changes between those who previously received education and those who had not (P=0.37). A total of 91% patients responded in a postassessment survey that they now feel more confident of their ability to self-administer eyedrops as their doctor prescribed and that the educational materials were responsible. Conclusion Participants demonstrated an

  16. Vatalanib population pharmacokinetics in patients with myelodysplastic syndrome: CALGB 10105 (Alliance)

    PubMed Central

    Wang, Xiaofeng; Owzar, Kouros; Gupta, Pankaj; Larson, Richard A; Mulkey, Flora; Miller, Antonius A; Lewis, Lionel D; Hurd, David; Vij, Ravi; Ratain, Mark J; Murry, Daryl J

    2014-01-01

    Aims Vatalanib is an oral anti-angiogenesis agent that inhibits vascular endothelial growth factor receptor tyrosine kinases, which in patients showed auto induction of metabolism and variability in pharmacokinetic (PK) disposition. The objective was to characterize the population PK and time-dependent change in vatalanib clearance and assess exposure–toxicity relationship in patients with myelodysplastic syndrome (MDS). Methods This was an open-label phase II study of vatalanib in MDS patients receiving 750–1250 mg once daily in 28-day cycles. Serial blood samples were obtained and plasma vatalanib concentrations measured by HPLC. Population PK analysis was performed using nonmem 7.2 with FO estimation since FOCE failed. The final model was evaluated using goodness-of-fit plots, bootstrap analysis, and visual predictive check. Results Pharmacokinetic data were complete for 137 patients (86 M, 51 F), of median age 70 years (range 20–91). A one-compartment model with lagged first-order absorption and time-dependent change in oral clearance was fitted to the vatalanib plasma concentration versus time data. The population means for pre-induction and post-induction oral clearance were 24.1 l h–1 (range: 9.6–45.5) and 54.9 l h–1 (range: 39.8–75.6), respectively. The apparent oral clearance increased 2.3-fold, (range: 1.7–4.1-fold) from first dose to steady state. Our data did not identify a significant relationship of the predefined covariates with vatalanib pharmacokinetics, although power to detect such a relationship was limited. Conclusions Vatalanib pharmacokinetics were highly variable and the extent of auto induction was not determined to correlate with any of the pre-defined covariates. PMID:24838014

  17. Antihypertensive treatment and control in a large primary care population of 21 167 patients.

    PubMed

    Qvarnström, M; Wettermark, B; Ljungman, C; Zarrinkoub, R; Hasselström, J; Manhem, K; Sundström, A; Kahan, T

    2011-08-01

    The efficacy of antihypertensive drug therapy is undisputed, but observational studies show that few patients reach a target blood pressure <140/90 mm Hg. However, there is limited data on the drug prescribing patterns and their effectiveness in real practice. This retrospective observational survey of electronic patient records extracted data from 24 Swedish primary health-care centres, with a combined registered population of 330 000 subjects. We included all patients > 30 years with a recorded diagnosis of hypertension who consulted the centres in 2005 or 2006 (n=21 167). Main outcome measures were systolic and diastolic blood pressures, and prescribed antihypertensive drug classes. Only 27% had a blood pressure <140/90 mm Hg. The number of prescribed drugs increased with age, except among the oldest (> 90 years). Only 29% of patients given monotherapy had a blood pressure <140/90 mm Hg. Women more often received diuretics (52 vs 42%), and less often angiotensin-converting enzyme inhibitors (22 vs 33%) and calcium channel blockers (26 vs 31%) than men. β-Blockers and diuretics were the most common drug classes prescribed, independent of comorbidity. In conclusion, one out of four primary care patients with hypertension reach target blood pressure. More frequent use of drug combinations may improve blood pressure control.

  18. Integrated population pharmacokinetics of etanercept in healthy subjects and in patients with rheumatoid arthritis and ankylosing spondylitis.

    PubMed

    Zhou, Simon Y; Shu, Cathye; Korth-Bradley, Joan; Raible, Donald; Palmisano, Maria; Wadjula, Joseph; Fatenejad, Saeed; Bjornsson, Thorir

    2011-06-01

    Etanercept pharmacokinetics in patients with rheumatoid arthritis (RA), ankylosing spondylitis (AS), and psoriasis were assessed separately with distinct models using population pharmacokinetics methods of limited precision. The different model structures and associated significant covariates identified by these earlier methods made it difficult to compare etanercept pharmacokinetics among disease groups. This integrated analysis aimed to establish a framework to evaluate previously established population pharmacokinetic models of etanercept, and to identify consistent and important demographic and disease factors that affected etanercept pharmacokinetics in a diverse population of healthy subjects and patients with RA and AS. In this integrated analysis, cumulative rich and sparse etanercept concentration data from 53 healthy volunteers, 212 patients with RA, and 346 patients with AS were examined and compared using nonlinear mixed effect methodology implemented the in NONMEM VI software package. A more precise estimation method (FOCEi) was employed and compared with the first-order method in population pharmacokinetics model building and evaluation. The integrated analysis found that an optimal population pharmacokinetics model with a 2-compartment structure adequately characterized etanercept pharmacokinetics in all subject groups. Health status or disease type did not significantly affect etanercept pharmacokinetics. In adult patients with RA and AS, age and body weight do not significantly affect etanercept pharmacokinetics. PMID:20852002

  19. Combining population and patient-specific characteristics for prostate segmentation on 3D CT images

    NASA Astrophysics Data System (ADS)

    Ma, Ling; Guo, Rongrong; Tian, Zhiqiang; Venkataraman, Rajesh; Sarkar, Saradwata; Liu, Xiabi; Tade, Funmilayo; Schuster, David M.; Fei, Baowei

    2016-03-01

    Prostate segmentation on CT images is a challenging task. In this paper, we explore the population and patient-specific characteristics for the segmentation of the prostate on CT images. Because population learning does not consider the inter-patient variations and because patient-specific learning may not perform well for different patients, we are combining the population and patient-specific information to improve segmentation performance. Specifically, we train a population model based on the population data and train a patient-specific model based on the manual segmentation on three slice of the new patient. We compute the similarity between the two models to explore the influence of applicable population knowledge on the specific patient. By combining the patient-specific knowledge with the influence, we can capture the population and patient-specific characteristics to calculate the probability of a pixel belonging to the prostate. Finally, we smooth the prostate surface according to the prostate-density value of the pixels in the distance transform image. We conducted the leave-one-out validation experiments on a set of CT volumes from 15 patients. Manual segmentation results from a radiologist serve as the gold standard for the evaluation. Experimental results show that our method achieved an average DSC of 85.1% as compared to the manual segmentation gold standard. This method outperformed the population learning method and the patient-specific learning approach alone. The CT segmentation method can have various applications in prostate cancer diagnosis and therapy.

  20. Combining Population and Patient-Specific Characteristics for Prostate Segmentation on 3D CT Images

    PubMed Central

    Ma, Ling; Guo, Rongrong; Tian, Zhiqiang; Venkataraman, Rajesh; Sarkar, Saradwata; Liu, Xiabi; Tade, Funmilayo; Schuster, David M.; Fei, Baowei

    2016-01-01

    Prostate segmentation on CT images is a challenging task. In this paper, we explore the population and patient-specific characteristics for the segmentation of the prostate on CT images. Because population learning does not consider the inter-patient variations and because patient-specific learning may not perform well for different patients, we are combining the population and patient-specific information to improve segmentation performance. Specifically, we train a population model based on the population data and train a patient-specific model based on the manual segmentation on three slice of the new patient. We compute the similarity between the two models to explore the influence of applicable population knowledge on the specific patient. By combining the patient-specific knowledge with the influence, we can capture the population and patient-specific characteristics to calculate the probability of a pixel belonging to the prostate. Finally, we smooth the prostate surface according to the prostate-density value of the pixels in the distance transform image. We conducted the leave-one-out validation experiments on a set of CT volumes from 15 patients. Manual segmentation results from a radiologist serve as the gold standard for the evaluation. Experimental results show that our method achieved an average DSC of 85.1% as compared to the manual segmentation gold standard. This method outperformed the population learning method and the patient-specific learning approach alone. The CT segmentation method can have various applications in prostate cancer diagnosis and therapy. PMID:27660382

  1. Increase in penguin populations during the Little Ice Age in the Ross Sea, Antarctica

    PubMed Central

    Hu, Qi-Hou; Sun, Li-Guang; Xie, Zhou-Qing; Emslie, Steven D.; Liu, Xiao-Dong

    2013-01-01

    Penguins are an important seabird species in Antarctica and are sensitive to climate and environmental changes. Previous studies indicated that penguin populations increased when the climate became warmer and decreased when it became colder in the maritime Antarctic. Here we determined organic markers in a sediment profile collected at Cape Bird, Ross Island, high Antarctic, and reconstructed the history of Adélie penguin colonies at this location over the past 700 years. The region transformed from a seal to a penguin habitat when the Little Ice Age (LIA; 1500–1800 AD) began. Penguins then became the dominant species. Penguin populations were the highest during ca. 1490 to 1670 AD, a cold period, which is contrary to previous results in other regions much farther north. Different responses to climate change may occur at low latitudes and high latitudes in the Antarctic, even if for same species. PMID:23969993

  2. Increase in penguin populations during the Little Ice Age in the Ross Sea, Antarctica.

    PubMed

    Hu, Qi-Hou; Sun, Li-Guang; Xie, Zhou-Qing; Emslie, Steven D; Liu, Xiao-Dong

    2013-01-01

    Penguins are an important seabird species in Antarctica and are sensitive to climate and environmental changes. Previous studies indicated that penguin populations increased when the climate became warmer and decreased when it became colder in the maritime Antarctic. Here we determined organic markers in a sediment profile collected at Cape Bird, Ross Island, high Antarctic, and reconstructed the history of Adélie penguin colonies at this location over the past 700 years. The region transformed from a seal to a penguin habitat when the Little Ice Age (LIA; 1500-1800 AD) began. Penguins then became the dominant species. Penguin populations were the highest during ca. 1490 to 1670 AD, a cold period, which is contrary to previous results in other regions much farther north. Different responses to climate change may occur at low latitudes and high latitudes in the Antarctic, even if for same species.

  3. Risk factors for depressed mood amongst a community dwelling older age population in England: cross-sectional survey data from the PRO-AGE study

    PubMed Central

    2014-01-01

    Background The Quality and Outcomes Framework in the United Kingdom (UK) National Health Service previously highlighted case finding of depression amongst patients with diabetes or coronary heart disease. However, depression in older people remains under-recognized. Comprehensive data for analyses of the association of depression in older age with other health and functional measures, and demographic factors from community populations within England, are lacking. Methods Secondary analyses of cross-sectional baseline survey data from the England arm of a randomised controlled trial of health risk appraisal for older people in Europe; PRO-AGE study. Data from 1085 community-dwelling non-disabled people aged 65 years or more from three group practices in suburban London contributed to this study. Depressed mood was ascertained from the 5-item Mental Health Inventory Screening test. Exploratory multivariable logistic regression was used to identify the strongest associations of depressed mood with a previous diagnosis of a specified physical/mental health condition, health and functional measures, and demographic factors. Results Depressed mood occurred in 14% (155/1085) of participants. A previous diagnoses of depression (OR 3.39; P < 0.001) and poor vision as determined from a Visual Function Questionnaire (OR 2.37; P = 0.001) were amongst the strongest factors associated with depressed mood that were independent of functional impairment, other co-morbidities, and demographic factors. A subgroup analyses on those without a previous diagnosis of depression also indicated that within this group, poor vision (OR 2.51; P = 0.002) was amongst the strongest independent factors associated with depressed mood. Conclusions Previous case-finding strategies in primary care focussed on heart disease and diabetes but health-related conditions other than coronary heart disease and diabetes are also associated with an increased risk for depression. Complex issues of

  4. A spatial age-structured model for describing sea lamprey (Petromyzon marinus) population dynamics

    USGS Publications Warehouse

    Robinson, Jason M.; Wilberg, Michael J.; Adams, Jean V.; Jones, Michael L.

    2013-01-01

    The control of invasive sea lampreys (Petromyzon marinus) presents large scale management challenges in the Laurentian Great Lakes. No modeling approach has been developed that describes spatial dynamics of lamprey populations. We developed and validated a spatial and age-structured model and applied it to a sea lamprey population in a large river in the Great Lakes basin. We considered 75 discrete spatial areas, included a stock-recruitment function, spatial recruitment patterns, natural mortality, chemical treatment mortality, and larval metamorphosis. Recruitment was variable, and an upstream shift in recruitment location was observed over time. From 1993–2011 recruitment, larval abundance, and the abundance of metamorphosing individuals decreased by 80, 84, and 86%, respectively. The model successfully identified areas of high larval abundance and showed that areas of low larval density contribute significantly to the population. Estimated treatment mortality was less than expected but had a large population-level impact. The results and general approach of this work have applications for sea lamprey control throughout the Great Lakes and for the restoration and conservation of native lamprey species globally.

  5. Age is not a limiting factor for brachytherapy for carcinoma of the node negative oral tongue in patients aged eighty or older

    PubMed Central

    2010-01-01

    Background To examine the role of brachytherapy for aged patients 80 or more in the trend of rapidly increasing number. Methods We examined the outcomes for elderly patients with node negative oral tongue cancer (T1-3N0M0) treated with brachytherapy. The 21 patients (2 T1, 14 T2, and 5 T3 cases) ranged in age from 80 to 89 years (median 81), and their cancer was pathologically confirmed. All patients underwent definitive radiation therapy, with low dose rate (LDR) Ra-226 brachytherapy (n = 4; median 70Gy), with Ir-192 (n = 12; 70Gy), with Au-198 (n = 1) or with high dose rate (HDR) Ir-192 brachytherapy (n = 4; 60 Gy). Eight patients also underwent external radiotherapy (median 30 Gy). The period of observation ranged from 13 months to 14 years (median 2.5 years). We selected 226 population matched younger counterpart from our medical chart. Results Definitive radiation therapy was completed for all 21 patients (100%), and acute grade 2-3 mucositis related to the therapy was tolerable. Local control (initial complete response) was attained in 19 of 21 patients (90%). The 2-year and 5-year local control rates were 91%, (100% for T1, 83% for T2 and 80% for T3 tumors after 2 years). These figures was not inferior to that of younger counterpart (82% at 5-year, n.s.). The cause-specific survival rate was 83% and the regional control rate 84% at the 2-years follow-up. However, 12 patients died because of intercurrent diseases or senility, resulting in overall survival rates of 55% at 2 years and 34% at 5 years. Conclusion Age is not a limiting factor for brachytherapy for appropriately selected elderly patients, and brachytherapy achieved good local control with acceptable morbidity. PMID:21143904

  6. Geographical gradient of mean age of dengue haemorrhagic fever patients in northern Thailand.

    PubMed

    Nagao, Y; Tawatsin, A; Thammapalo, S; Thavara, U

    2012-03-01

    Dengue haemorrhagic fever (DHF) is caused by dengue virus transmitted by Aedes mosquitoes; mean age of patients varies temporally and geographically. Variability in age of patients may be due to differences in transmission intensity or demographic structure. To compare these two hypotheses, the mean age of DHF patients from 90 districts in northern Thailand (1994-1996, 2002-2004) was regressed against (i) Aedes abundance or (ii) demographic variables (birthrate, average age) of the district. We also developed software to quantify direction and strength of geographical gradients of these variables. We found that, after adjusting for socioeconomics, climate, spatial autocorrelation, the mean age of patients was correlated only with Aedes abundance. The geographical gradient of mean age of patients originated from entomological, climate, and socioeconomic gradients. Vector abundance was a stronger determinant of mean age of patients than demographic variables, in northern Thailand.

  7. Large time behavior in a nonlinear age-dependent population dynamics problem with spatial diffusion.

    PubMed

    Langlais, M

    1988-01-01

    In this work we analyze the large time behavior in a nonlinear model of population dynamics with age-dependence and spatial diffusion. We show that when t----+ infinity either the solution of our problem goes to 0 or it stabilizes to a nontrivial stationary solution. We give two typical examples where the stationary solutions can be evaluated upon solving very simple partial differential equations. As a by-product of the extinction case we find a necessary condition for a nontrivial periodic solution to exist. Numerical computations not described below show a rapid stabilization.

  8. Mitochondrial variation and the risk of age-related macular degeneration across diverse populations.

    PubMed

    Restrepo, Nicole A; Mitchell, Sabrina L; Goodloe, Robert J; Murdock, Deborah G; Haines, Jonanthan L; Crawford, Dana C

    2015-01-01

    Substantial progress has been made in identifying susceptibility variants for age-related macular degeneration (AMD). The majority of research to identify genetic variants associated with AMD has focused on nuclear genetic variation. While there is some evidence that mitochondrial genetic variation contributes to AMD susceptibility, to date, these studies have been limited to populations of European descent resulting in a lack of data in diverse populations. A major goal of the Epidemiologic Architecture for Genes Linked to Environment (EAGLE) study is to describe the underlying genetic architecture of common, complex diseases across diverse populations. This present study sought to determine if mitochondrial genetic variation influences risk of AMD across diverse populations. We performed a genetic association study to investigate the contribution of mitochondrial DNA variation to AMD risk. We accessed samples from the National Health and Nutrition Examination Surveys, a U.S population-based, cross-sectional survey collected without regard to health status. AMD cases and controls were selected from the Third NHANES and NHANES 2007-2008 datasets which include non-Hispanic whites, non-Hispanic blacks, and Mexican Americans. AMD cases were defined as those > 60 years of age with early/late AMD, as determined by fundus photography. Targeted genotyping was performed for 63 mitochondrial SNPs and participants were then classified into mitochondrial haplogroups. We used logistic regression assuming a dominant genetic model adjusting for age, sex, body mass index, and smoking status (ever vs. never). Regressions and meta-analyses were performed for individual SNPs and mitochondrial haplogroups J, T, and U. We identified five SNPs associated with AMD in Mexican Americans at p < 0.05, including three located in the control region (mt16111, mt16362, and mt16319), one in MT-RNR2 (mt1736), and one in MT-ND4 (mt12007). No mitochondrial variant or haplogroup was significantly

  9. Urinary Stone Disease: Advancing Knowledge, Patient Care, and Population Health.

    PubMed

    Scales, Charles D; Tasian, Gregory E; Schwaderer, Andrew L; Goldfarb, David S; Star, Robert A; Kirkali, Ziya

    2016-07-01

    Expanding epidemiologic and physiologic data suggest that urinary stone disease is best conceptualized as a chronic metabolic condition punctuated by symptomatic, preventable stone events. These acute events herald substantial future chronic morbidity, including decreased bone mineral density, cardiovascular disease, and CKD. Urinary stone disease imposes a large and growing public health burden. In the United States, 1 in 11 individuals will experience a urinary stone in their lifetime. Given this high incidence and prevalence, urinary stone disease is one of the most expensive urologic conditions, with health care charges exceeding $10 billion annually. Patient care focuses on management of symptomatic stones rather than prevention; after three decades of innovation, procedural interventions are almost exclusively minimally invasive or noninvasive, and mortality is rare. Despite these advances, the prevalence of stone disease has nearly doubled over the past 15 years, likely secondary to dietary and health trends. The NIDDK recently convened a symposium to assess knowledge and treatment gaps to inform future urinary stone disease research. Reducing the public health burden of urinary stone disease will require key advances in understanding environmental, genetic, and other individual disease determinants; improving secondary prevention; and optimal population health strategies in an increasingly cost-conscious care environment. PMID:26964844

  10. New drugs and patient-centred end-points in old age: setting the wheels in motion.

    PubMed

    Mangoni, Arduino A; Pilotto, Alberto

    2016-01-01

    Older patients with various degrees of frailty and disability, a key population target of pharmacological interventions in acute and chronic disease states, are virtually neglected in pre-marketing studies assessing the efficacy and safety of investigational drugs. Moreover, aggressively pursuing established therapeutic targets in old age, e.g. blood pressure, serum glucose or cholesterol concentrations, is not necessarily associated with the beneficial effects, and the acceptable safety, reported in younger patient cohorts. Measures of self-reported health and functional status might represent additional, more meaningful, therapeutic end-points in the older population, particularly in patients with significant frailty and relatively short life expectancy, e.g. in the presence of cancer and/or neurodegenerative disease conditions. Strategies enhancing early knowledge about key pharmacological characteristics of investigational drugs targeting older adults are discussed, together with the rationale for incorporating non-traditional, patient-centred, end-points in this ever-increasing group. PMID:26455964

  11. Changes in sobriety in the Swedish population over three decades: age, period or cohort effects?

    PubMed Central

    Ahacic, Kozma; Kennison, Robert F; Kåreholt, Ingemar

    2012-01-01

    Aims This study aimed to examine age, cohort and period trends in alcohol abstinence. Design Two surveys, the Level of Living Survey collected in 1968, 1974, 1981, 1990 and 2000, and the Swedish Panel Study of the Oldest Old (SWEOLD) collected in 1992 and 2002, were studied with graphical depictions of cross-sectional and longitudinal data presented over time and over age. Cross-sectional 10-year age group differences, time-lag differences between waves and within-cohort differences between waves for 10-year birth cohorts were examined. Logistic regression models were applied to confirm the observed patterns. Setting The samples were representative of the Swedish population. Participants Participants ranged in age from 18 to 75 (n = 5000 per wave), and 77+ at later waves (n = 500). Measurements Alcohol abstinence was determined by asking ‘Do you ever drink wine, beer, or spirits?’, where a ‘no’ response indicated abstinence. Findings Decreases in abstinence rates were observed from 1968 to 2000/02. While cross-sectional analysis indicated increased abstinence with advancing age, the longitudinal analysis suggested otherwise. Inspection of cohort differences revealed little change within cohorts and large differences between cohorts; abstinence rates declined in later-born cohorts up to the 1940s birth cohorts; stability was observed in cohorts born since the 1940s. Logistic regression models indicated that neither age nor period were significant (P > 0.05) predictors of abstinence when cohort (P < 0.001) was included. Conclusion Decreasing proportions of total alcohol abstainers in Sweden from 1968 to 2000 appear to be attributable primarily to decreases in successive cohorts rather than drinkers becoming abstainers. PMID:22008293

  12. Damage from periorbital ageing to the multilayered structures and resilience of the skin in Chinese population

    PubMed Central

    Liao, Chuh-Kai; Tsai, Feng-Chou; Fong, Tsorng-Harn; Hu, Chien-Ming; Wei, Po-Li; Su, Ching-Hua

    2013-01-01

    Ageing dynamically disrupts the multilayered supporting components of the skin that are held together by cell adhesion molecules (CAMs). Skin specimens from 33 female Chinese patients undergoing lower blepharoplasty were divided into three age groups and examined by haematoxylin and eosin (H&E) staining, immunohistochemistry (IHC) and Elastica-van Gieson (EVG) stains, western blotting, surface electron microscopy (SEM) and biomechanical tension analysis. The SEM density (skin surface topology) showed a negative linear relationship with age. The triangular pattern of the skin surface in the younger group gradually broke down into quadrangular and irregular patterns in the older group. Collagens and elastic fibres in the dermis showed anisotropy and decreased density in the older groups compared with the younger group, especially in the papillary dermis. Anisotropy means that physical properties differ according to the direction of measurement. E-cadherin and integrin αv (whose functions are to bind epidermal and dermal elements respectively) increased and decreased, respectively, in the oldest group. Skin resilience decreased significantly in this group under repetitive stress. In conclusion, a loss of skin surface textures, integrin αv expressions, epidermal-dermal connections and dermal compactness led to the multilayered structure of the skin becoming separated. This in turn decreased resilience during ageing. These findings may therefore explain why aged skins cannot tolerate repetitive facial expressions, and why this action produces further dynamic wrinkles. PMID:23441675

  13. Evidence for different patterns of chemosensory alterations in the elderly population: impact of age versus dependency.

    PubMed

    Sulmont-Rossé, Claire; Maître, Isabelle; Amand, Marion; Symoneaux, Ronan; Van Wymelbeke, Virginie; Caumon, Elodie; Tavarès, Jérémy; Issanchou, Sylvie

    2015-03-01

    The present experiment aimed to explore the interindividual variability in chemosensory abilities among the elderly population. The chemosensory abilities of 559 subjects, aged from 65 to 99 years, were evaluated. Various categories of the elderly, including people who were living at home either without or with assistance, and people who were living in a nursing home, were interviewed. The results revealed that 43% of the sample presented well-preserved chemosensory abilities, whereas 21% of the participants presented a moderate impairment. Of the sample, 33% presented well-preserved olfactory abilities but strong impairment in gustatory abilities and 3% were nearly anosmic but remained able to perceive the salty taste, demonstrating that gustation and olfaction were not systematically damaged simultaneously. The results showed a link between the level of dependence (free living vs. living at home with help vs. nursing home) and chemosensory abilities, independently of the age effect. These results strengthen the hypothesis that the impairment of chemosensory abilities is not only an effect of age per se; rather, it is related to events that are associated with aging. Factors that lead to increased dependence (such as poor health) also lead to an impairment in chemosensory performance.

  14. Predicting successful aging in a population-based sample of georgia centenarians.

    PubMed

    Arnold, Jonathan; Dai, Jianliang; Nahapetyan, Lusine; Arte, Ankit; Johnson, Mary Ann; Hausman, Dorothy; Rodgers, Willard L; Hensley, Robert; Martin, Peter; Macdonald, Maurice; Davey, Adam; Siegler, Ilene C; Jazwinski, S Michal; Poon, Leonard W

    2010-01-01

    Used a population-based sample (Georgia Centenarian Study, GCS), to determine proportions of centenarians reaching 100 years as (1) survivors (43%) of chronic diseases first experienced between 0-80 years of age, (2) delayers (36%) with chronic diseases first experienced between 80-98 years of age, or (3) escapers (17%) with chronic diseases only at 98 years of age or older. Diseases fall into two morbidity profiles of 11 chronic diseases; one including cardiovascular disease, cancer, anemia, and osteoporosis, and another including dementia. Centenarians at risk for cancer in their lifetime tended to be escapers (73%), while those at risk for cardiovascular disease tended to be survivors (24%), delayers (39%), or escapers (32%). Approximately half (43%) of the centenarians did not experience dementia. Psychiatric disorders were positively associated with dementia, but prevalence of depression, anxiety, and psychoses did not differ significantly between centenarians and an octogenarian control group. However, centenarians were higher on the Geriatric Depression Scale (GDS) than octogenarians. Consistent with our model of developmental adaptation in aging, distal life events contribute to predicting survivorship outcome in which health status as survivor, delayer, or escaper appears as adaptation variables late in life. PMID:20885919

  15. [Factors associated with age at first intercourse: a population-based study].

    PubMed

    Hugo, Tairana Dias de Oliveira; Maier, Vanessa Teixeira; Jansen, Karen; Rodrigues, Cristine Eliane Gomes; Cruzeiro, Ana Laura Sicca; Ores, Liliane da Costa; Pinheiro, Ricardo Tavares; Silva, Ricardo; Souza, Luciano Dias de Mattos

    2011-11-01

    First sexual intercourse is considered an important event in young people's lives and has occurred at an increasingly early age. The aim of this study was to identify factors associated with early age at first intercourse in individuals 18 to 24 years of age in Pelotas, Rio Grande do Sul State, Brazil. This was a population-based cross-sectional study in a representative sample of 1,621 young people from August 2007 to December 2008. Subjects answered a questionnaire on health behaviors, including items related to their sexual lives. Cox regression was used to assess the association between early age at sexual initiation. After multivariate analysis, variables that are directly related to early sexual initiation were: male gender, low socioeconomic status, low schooling, divorced parents, living with a partner, not practicing a religion, smoking, drug use in the previous three months, and non-use of condoms during last intercourse. Considering the current social context, the study highlights the need for adequate sexual orientation with a preventive approach.

  16. Predicting successful aging in a population-based sample of georgia centenarians.

    PubMed

    Arnold, Jonathan; Dai, Jianliang; Nahapetyan, Lusine; Arte, Ankit; Johnson, Mary Ann; Hausman, Dorothy; Rodgers, Willard L; Hensley, Robert; Martin, Peter; Macdonald, Maurice; Davey, Adam; Siegler, Ilene C; Jazwinski, S Michal; Poon, Leonard W

    2010-01-01

    Used a population-based sample (Georgia Centenarian Study, GCS), to determine proportions of centenarians reaching 100 years as (1) survivors (43%) of chronic diseases first experienced between 0-80 years of age, (2) delayers (36%) with chronic diseases first experienced between 80-98 years of age, or (3) escapers (17%) with chronic diseases only at 98 years of age or older. Diseases fall into two morbidity profiles of 11 chronic diseases; one including cardiovascular disease, cancer, anemia, and osteoporosis, and another including dementia. Centenarians at risk for cancer in their lifetime tended to be escapers (73%), while those at risk for cardiovascular disease tended to be survivors (24%), delayers (39%), or escapers (32%). Approximately half (43%) of the centenarians did not experience dementia. Psychiatric disorders were positively associated with dementia, but prevalence of depression, anxiety, and psychoses did not differ significantly between centenarians and an octogenarian control group. However, centenarians were higher on the Geriatric Depression Scale (GDS) than octogenarians. Consistent with our model of developmental adaptation in aging, distal life events contribute to predicting survivorship outcome in which health status as survivor, delayer, or escaper appears as adaptation variables late in life.

  17. Shoulder disorders in female working-age population: a cross sectional study

    PubMed Central

    2014-01-01

    Background Musculoskeletal disorders (MSDs) are among the most common pathologies in the general population. However, research into the prevalence of upper arm MSDs is hampered by a lack of uniformity in case definition, and by the absence of a gold standard for measurement. Furthermore, some sectors of the population have benefited from extensive research whilst others have largely been ignored. Study Design: Cross-sectional study. Objectives: to investigate the prevalence of shoulder MSDs in a working age female population not exposed to specific occupational risk factors such as heavy and/or repetitive work, assessing the differences in prevalence recorded by using three different standard measurement tools. Methods 302 working aged women were enrolled in this study (age 20–55 years). Each subject underwent three different assessments: standardized questionnaires for symptoms and disability and the SF36 health survey, a clinical assessment performed by a blinded orthopaedic specialist, and an imaging assessment by means of ultrasound (US) and Magnetic Resonance (MR) if indicated. Results According to the questionnaire 77 subjects (25.5%) complained of shoulder pain whilst 225 (74.5%) were asymptomatic. According to the clinical examination, 31 subjects (10.3%) resulted positive, whereas 271 subjects (89.7%) had normal shoulders. According to the imaging findings, 26 subjects (8.6%) had alterations to the anatomical structures of the shoulder, whilst 276 subjects (91.4%) had no detectable abnormalities in either shoulder. In all assessments, the prevalence increased with age (p = 0.001). Conclusion Depending on the outcome measure used, the prevalence of reported MSDs of the shoulder varies considerably. There is a striking difference between the prevalence of subjective reported symptoms and the standardized clinical/imaging examinations. However, the results of all the assessments did concur in one aspect; there was a significant trend of increased

  18. Metabolomic markers reveal novel pathways of ageing and early development in human populations

    PubMed Central

    Menni, Cristina; Kastenmüller, Gabriella; Petersen, Ann Kristin; Bell, Jordana T; Psatha, Maria; Tsai, Pei-Chien; Gieger, Christian; Schulz, Holger; Erte, Idil; John, Sally; Brosnan, M Julia; Wilson, Scott G; Tsaprouni, Loukia; Lim, Ee Mun; Stuckey, Bronwyn; Deloukas, Panos; Mohney, Robert; Suhre, Karsten; Spector, Tim D; Valdes, Ana M

    2013-01-01

    Background Human ageing is a complex, multifactorial process and early developmental factors affect health outcomes in old age. Methods Metabolomic profiling on fasting blood was carried out in 6055 individuals from the UK. Stepwise regression was performed to identify a panel of independent metabolites which could be used as a surrogate for age. We also investigated the association with birthweight overall and within identical discordant twins and with genome-wide methylation levels. Results We identified a panel of 22 metabolites which combined are strongly correlated with age (R2 = 59%) and with age-related clinical traits independently of age. One particular metabolite, C-glycosyl tryptophan (C-glyTrp), correlated strongly with age (beta = 0.03, SE = 0.001, P = 7.0 × 10−157) and lung function (FEV1 beta = −0.04, SE = 0.008, P = 1.8 × 10−8 adjusted for age and confounders) and was replicated in an independent population (n = 887). C-glyTrp was also associated with bone mineral density (beta = −0.01, SE = 0.002, P = 1.9 × 10−6) and birthweight (beta = −0.06, SE = 0.01, P = 2.5 × 10−9). The difference in C-glyTrp levels explained 9.4% of the variance in the difference in birthweight between monozygotic twins. An epigenome-wide association study in 172 individuals identified three CpG-sites, associated with levels of C-glyTrp (P < 2 × 10−6). We replicated one CpG site in the promoter of the WDR85 gene in an independent sample of 350 individuals (beta = −0.20, SE = 0.04, P = 2.9 × 10−8). WDR85 is a regulator of translation elongation factor 2, essential for protein synthesis in eukaryotes. Conclusions Our data illustrate how metabolomic profiling linked with epigenetic studies can identify some key molecular mechanisms potentially determined in early development that produce long-term physiological changes influencing human health and ageing. PMID:23838602

  19. Total heart volume as a function of clinical and anthropometric parameters in a population of external beam radiation therapy patients

    NASA Astrophysics Data System (ADS)

    Nadège Ilembe Badouna, Audrey; Veres, Cristina; Haddy, Nadia; Bidault, François; Lefkopoulos, Dimitri; Chavaudra, Jean; Bridier, André; de Vathaire, Florent; Diallo, Ibrahima

    2012-01-01

    The aim of this paper was to determine anthropometric parameters leading to the least uncertain estimate of heart size when connecting a computational phantom to an external beam radiation therapy (EBRT) patient. From computed tomography images, we segmented the heart and calculated its total volume (THV) in a population of 270 EBRT patients of both sexes, aged 0.7-83 years. Our data were fitted using logistic growth functions. The patient age, height, weight, body mass index and body surface area (BSA) were used as explanatory variables. For both genders, good fits were obtained with both weight (R2 = 0.89 for males and 0.83 for females) and BSA (R2 = 0.90 for males and 0.84 for females). These results demonstrate that, among anthropometric parameters, weight plays an important role in predicting THV. These findings should be taken into account when assigning a computational phantom to a patient.

  20. Effectiveness of Chemoradiation for Head and Neck Cancer in an Older Patient Population

    SciTech Connect

    VanderWalde, Noam A.; Meyer, Anne Marie; Deal, Allison M.; Layton, J. Bradley; Liu, Huan; Carpenter, William R.; Weissler, Mark C.; Fleming, Mary E.; and others

    2014-05-01

    Purpose: The purpose of this study was to compare chemoradiation therapy (CRT) with radiation therapy (RT) only in an older patient population with head and neck squamous cell carcinoma (HNSCC). Methods and Materials: Using the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked database (1992-2007), we identified a retrospective cohort of nonmetastatic HNSCC patients and divided them into treatment groups. Comparisons were made between CRT and RT cohorts. Propensity scores for CRT were estimated from covariates associated with receipt of treatment using multivariable logistic regression. Standardized mortality ratio weights (SMRW) were created from the propensity scores and used to balance groups on measured confounders. Multivariable and SMR-weighted Cox proportional hazard models were used to estimate the hazard ratio (HR) of death for receipt of CRT versus RT among the whole group and for separate patient and tumor categories. Results: The final cohort of 10,599 patients was 68% male and 89% white. Median age was 74 years. Seventy-four percent were treated with RT, 26% were treated with CRT. Median follow-up points for CRT and RT survivors were 4.6 and 6.3 years, respectively. On multivariable analysis, HR for death with CRT was 1.13 (95% confidence interval [CI]: 1.07-1.20; P<.01). Using the SMRW model, the HR for death with CRT was 1.08 (95% CI: 1.02-1.15; P=.01). Conclusions: Although the addition of chemotherapy to radiation has proven efficacious in many randomized controlled trials, it may be less effective in an older patient population treated outside of a controlled trial setting.

  1. Radiotherapy and Survival in Prostate Cancer Patients: A Population-Based Study

    SciTech Connect

    Zhou, Esther H. Ellis, Rodney J.; Cherullo, Edward; Colussi, Valdir; Xu Fang; Chen Weidong; Gupta, Sanjay; Whalen, Christopher C.; Bodner, Donald; Resnick, Martin I.; Rimm, Alfred A.

    2009-01-01

    Purpose: To investigate the association of overall and disease-specific survival with the five standard treatment modalities for prostate cancer (CaP): radical prostatectomy (RP), brachytherapy (BT), external beam radiotherapy, androgen deprivation therapy, and no treatment (NT) within 6 months after CaP diagnosis. Methods and Materials: The study population included 10,179 men aged 65 years and older with incident CaP diagnosed between 1999 and 2001. Using the linked Ohio Cancer Incidence Surveillance System, Medicare, and death certificate files, overall and disease-specific survival through 2005 among the five clinically accepted therapies were analyzed. Results: Disease-specific survival rates were 92.3% and 23.9% for patients with localized vs. distant disease at 7 years, respectively. Controlling for age, race, comorbidities, stage, and Gleason score, results from the Cox multiple regression models indicated that the risk of CaP-specific death was significantly reduced in patients receiving RP or BT, compared with NT. For localized disease, compared with NT, in the monotherapy cohort, RP and BT were associated with reduced hazard ratios (HR) of 0.25 and 0.45 (95% confidence intervals 0.13-0.48 and 0.23-0.87, respectively), whereas in the combination therapy cohort, HR were 0.40 (0.17-0.94) and 0.46 (0.27-0.80), respectively. Conclusions: The present population-based study indicates that RP and BT are associated with improved survival outcomes. Further studies are warranted to improve clinical determinates in the selection of appropriate management of CaP and to improve predictive modeling for which patient subsets may benefit most from definitive therapy vs. conservative management and/or observation.

  2. Association of Metabolic Factors with Symptomatic Hand Osteoarthritis in the Chinese Han Population Aged 40 Years and above

    PubMed Central

    Wang, Fei; Shi, Lei; Xue, Qing-Yun

    2016-01-01

    Background: The relationship between hand osteoarthritis (HOA) and systemic metabolic factors is unclear. The aim of this study was to investigate the prevalence of systemic metabolic factors including obesity, hypertension, diabetes mellitus, and atherosclerosis in symptomatic patients with HOA and the association between these systemic metabolic factors and symptomatic HOA in the Chinese Han population aged 40 years and above. Methods: A cross-sectional survey was conducted on Chinese Han population aged 40 years and above in six centers in China. The sociodemographic features, lifestyle of the participants, and medical history of hypertension, diabetes mellitus, and atherosclerosis were collected. The cases with hand symptoms underwent anteroposterior radiographic examination of both hands to obtain a diagnosis. The correlations between systemic metabolic factors and symptomatic HOA were analyzed using Logistic regression analysis. Results: Overweight (39.3% vs. 30.5%, P < 0.001), hypertension (34.7% vs. 18.6%, P < 0.001), diabetes mellitus (11.2% vs. 3.3%, P < 0.001), and atherosclerosis (19.8% vs. 8.3%, P < 0.001) were more prevalent in symptomatic patients with HOA than those in the population without HOA. Overweight (odds ratio [OR] = 1.35, 95% confidence interval [CI]: 1.10–1.65, P = 0.005), hypertension (OR = 1.47, 95% CI: 1.18–1.83, P < 0.001), and diabetes mellitus (OR = 2.45, 95% CI: 1.74–3.45, P < 0.001) were associated with a higher prevalence of symptomatic HOA and the OR of symptomatic HOA significantly increased with the accumulated number of the three metabolic factors. Symptomatic HOA was associated with a higher prevalence of atherosclerosis (OR = 1.39, 95% CI: 1.05–1.85, P = 0.023). Conclusions: Overweight, hypertension, and diabetes mellitus were associated with a higher prevalence of HOA, showing cumulative effects. Atherosclerosis risk should be assessed in patients with HOA. PMID:27647188

  3. Risk of Cerebrovascular Events in Pneumoconiosis Patients: A Population-based Study, 1996-2011.

    PubMed

    Chuang, Chieh-Sen; Ho, Shang-Chang; Lin, Cheng-Li; Lin, Ming-Chia; Kao, Chia-Hung

    2016-03-01

    Pneumoconiosis is a parenchymal lung disease that develops through the inhalation of inorganic dust at work. Cerebrovascular and cardiovascular events are leading causes of mortality and adult disability worldwide. This retrospective cohort study investigated the association between pneumoconiosis, and cerebrovascular and cardiovascular events by using a nationwide population-based database in Taiwan. The data analyzed in this study was retrieved from the Taiwan National Health Insurance Research Database. We selected 6940 patients with pneumoconiosis from the database as our study cohort. Another 27,760 patients without pneumoconiosis were selected and matched with those with pneumoconiosis according to age and sex as the comparison cohort. We used univariate and multivariate Cox proportional-hazard regression analyses to determine the association between pneumoconiosis and the risk of cerebrovascular and cardiovascular events after adjusting for medical comorbidities. After adjustment for age, sex, and comorbidities, the patients with pneumoconiosis exhibited a significantly higher incidence of ischemic stroke (hazard ratio [HR] 1.14, 95% confidence interval [CI] 1.05-1.24) than did those without pneumoconiosis. The incidence of hemorrhagic stroke was higher, but not significant, in the pneumoconiosis patients (HR 1.20, 95% CI 0.99-1.46). No statistically significant differences were observed between the pneumoconiosis and nonpneumoconiosis groups in acute coronary syndrome (HR 1.10, 95% CI 0.95-1.26). The findings of this study reveal an association between pneumoconiosis and a higher risk of cerebrovascular events after adjustment for comorbidities. Healthcare providers should control the related risk factors for primary prevention of stroke in pneumoconiosis patients.

  4. Increasing opportunities for the productive engagement of older adults: a response to population aging.

    PubMed

    Gonzales, Ernest; Matz-Costa, Christina; Morrow-Howell, Nancy

    2015-04-01

    "Productive aging" puts forward the fundamental view that the capacity of older adults must be better developed and utilized in activities that make economic contributions to society-working, caregiving, volunteering. It is suggested that productive engagement can lead to multiple positive ends: offsetting fiscal strains of a larger older population, contributing to the betterment of families and civil society, and maintaining the health and economic security of older adults. Advocates claim that outdated social structures and discriminatory behaviors limit participation of older adults in these important social roles as well as prevent the optimization of outcomes for older adults, families, and society. We ask two important questions: (a) How can we shape policies and programs to optimally engage the growing resources of an aging population for the sake of society and older adults themselves? and (b) How can policies pertaining to productive engagement reduce health and economic disparities? We answer these questions by first describing the current state of engagement in each of the three productive activities and summarize some current policies and programs that affect engagement. Next we highlight challenges that cross-cut productive engagement. Finally, we provide policy recommendations to address these challenges. PMID:26035601

  5. [The evaluation of the retrograde memory in the Quebec population aged: PUB-40 and PUB-12].

    PubMed

    Langlois, Roxane; Joubert, Sven; Benoit, Sophie; Dostie, Valérie; Rouleau, Isabelle

    2015-09-01

    Memory assessment represents an important part of the clinical neuropsychologist's duties in a geriatric context. In fact, in Canada, about one-third of seniors report memory complaints, with different causes. Based on the underlying etiology, different components of memory may be affected in older adults. Nonautobiographical retrograde memory (public or semantic) is an important aspect of memory to assess; nevertheless, there is currently no reliable and standardized clinical tool to evaluate this aspect of memory in the elderly Quebecer population. The aims of this research were therefore: (1) to develop a protocol specifically aimed at assessing non-autobiographical retrograde memory in this population, the PUB-40; (2) to obtain reference data among 105 healthy subjects; and (3) to develop a short version based on the items which discriminated a group of 20 patients with amnestic Mild cognitive impairment (aMCI) from older healthy subjects.

  6. [Deficiencies and resources of working population in relation to age: a multidisciplinary approach].

    PubMed

    Volkoff, S

    2000-01-01

    The aging of the population as a whole and the later age at which young people start work are increasing the percentage of older employees. In situations where the working conditions are highly demanding, as in shiftwork, time-pressure jobs, and adaptation to modern technology or skill diversification, this demographic trend may cause serious problems. The way in which job constraints and demands are withstood at various ages should be considered in relation to health, which is often, whether implicitly or explicitly, a selection criterion in the work place. The connection between work and health can rarely be described by a single causal relationship and requires specific epidemiological methods. Moreover, a health problem linked to age can have a feedback effect on the manner in which a job is performed. While these problems do indeed arise in the areas of work and health, they are nonetheless usually symptoms of modifications that have taken place in the work activity itself. The ergonomic approach nevertheless allows us to improve our understanding of changes in work behavior as age increases, as experience is gained, and as skills are acquired. Men and women on the job are not passive spectators of the good or poor fit between the characteristics of their jobs and their own functional state. Consciously or unconsciously, they modify their operating modes (movements, work pace, posture, etc.), reduce their effort level in some subtasks, make more plans to avoid emergency situations, check the outcome of their actions so as to reduce errors that would be costly to correct, and adjust the distribution of tasks in cooperative and collective work situations. But these strategies can only be implemented if the work conditions and organization foster and promote them.

  7. Healthy Eating Habits among the Population of Serbia: Gender and Age Differences

    PubMed Central

    2015-01-01

    ABSTRACT The purpose of the study is to examine healthy eating habits of the population of Serbia through three dimensions: knowledge, problems, and feelings as well as to determine whether there are any differences between genders and among different age-groups. The research instrument was an Eating Habits Questionnaire (EHQ) which consisted of 35 items. There were 382 respondents involved in the study. The reliability and factor structure of the questionnaire were verified by using factor analysis. The results of MANOVA showed that there is a significant difference in the habits concerning healthy eating between men and women [F (3,378)=4.26, p=0.006; Wilks’ Lambda=0.97]. When the results for the dependent variables (knowledge, problems, and feelings) were considered separately, it was determined that there is no significant difference between men and women, which confirms the results of the t-test. The effect of age on the three dimensions of healthy eating habits was examined within three age-groups, by using ANOVA. The results showed that knowledge about healthy eating increases with age [F (2,379)=6.14, p=0.002] as well as positive feelings which occur as a result of healthy eating [F (2,379)=3.66, p=0.027]. Unlike ANOVA, MANOVA showed difference among the age-groups only when it came to the ‘knowledge’ variable. This study is important as it shows the current state of awareness on healthy eating habits in the researched populace and may be the basis for further research in this field in Serbia. PMID:25995724

  8. Healthy eating habits among the population of Serbia: gender and age differences.

    PubMed

    Jovičić, Ana Đ

    2015-03-01

    The purpose of the study is to examine healthy eating habits of the population of Serbia through three dimensions: knowledge, problems, and feelings as well as to determine whether there are any differences between genders and among different age-groups. The research instrument was an Eating Habits Questionnaire (EHQ) which consisted of 35 items. There were 382 respondents involved in the study. The reliability and factor structure of the questionnaire were verified by using factor analysis. The results of MANOVA showed that there is a significant difference in the habits concerning healthy eating between men and women [F (3,378)=4.26, p=0.006; Wilks' Lambda=0.97]. When the results for the dependent variables (knowledge, problems, and feelings) were considered separately, it was determined that there is no significant difference between men and women, which confirms the results of the t-test. The effect of age on the three dimensions of healthy eating habits was examined within three age-groups, by using ANOVA. The results showed that knowledge about healthy eating increases with age [F (2,379)=6.14, p=0.002] as well as positive feelings which occur as a result of healthy eating [F (2,379)=3.66, p=0.027]. Unlike ANOVA, MANOVA showed difference among the age-groups only when it came to the 'knowledge' variable. This study is important as it shows the current state of awareness on healthy eating habits in the researched populace and may be the basis for further research in this field in Serbia.

  9. Population pharmacokinetic model of canrenone after intravenous administration of potassium canrenoate to paediatric patients

    PubMed Central

    Suyagh, Maysa; Hawwa, Ahmed F; Collier, Paul S; Millership, Jeffrey S; Kole, Prashant; Millar, Muriel; Shields, Mike D; Halliday, Henry L; McElnay, James C

    2012-01-01

    AIMS To characterize the population pharmacokinetics of canrenone following administration of potassium canrenoate to paediatric patients. METHODS Data were collected prospectively from 23 paediatric patients (2 days to 10 years of age; median weight 4 kg, range 2.16–28.0 kg) who received intravenous potassium canrenoate (K-canrenoate) as part of their intensive care therapy for removal of retained fluids, e.g. in pulmonary oedema due to chronic lung disease and for the management of congestive heart failure. Plasma samples were analyzed by HPLC for determination of canrenone (the major metabolite and pharmacologically active moiety) and the data subjected to pharmacokinetic analysis using NONMEM. RESULTS A one compartment model best described the data. The only significant covariate was weight (WT). The final population models for canrenone clearance (CL/F) and volume of distribution (V/F) were CL/F (l h−1) = 11.4 × (WT/70.0)0.75 and V/F (l) = 374.2 × (WT/70) where WT is in kg. The values of CL/F and V/F in a 4 kg child would be 1.33 l h−1 and 21.4 l, respectively, resulting in an elimination half-life of 11.2 h. CONCLUSIONS The range of estimated CL/F in the study population was 0.67–7.38 l h−1. The data suggest that adjustment of K-canrenoate dosage according to body weight is appropriate in paediatric patients. PMID:22376078

  10. New Treatment Greatly Improves Prognosis for Patients with AMD (Age-Related Macular Degeneration)

    MedlinePlus

    ... turn JavaScript on. Feature: Age-related Macular Degeneration New Treatment Greatly Improves Prognosis for Patients with AMD ... Eye Institute Photo Courtesy of: NEI In a new study of nearly 650 people with age-related ...

  11. Continuous subcutaneous insulin infusion in diabetes: patient populations, safety, efficacy, and pharmacoeconomics

    PubMed Central

    Battelino, Tadej; Danne, Thomas; Hovorka, Roman; Jarosz‐Chobot, Przemyslawa; Renard, Eric

    2015-01-01

    Summary The level of glycaemic control necessary to achieve optimal short‐term and long‐term outcomes in subjects with type 1 diabetes mellitus (T1DM) typically requires intensified insulin therapy using multiple daily injections or continuous subcutaneous insulin infusion. For continuous subcutaneous insulin infusion, the insulins of choice are the rapid‐acting insulin analogues, insulin aspart, insulin lispro and insulin glulisine. The advantages of continuous subcutaneous insulin infusion over multiple daily injections in adult and paediatric populations with T1DM include superior glycaemic control, lower insulin requirements and better health‐related quality of life/patient satisfaction. An association between continuous subcutaneous insulin infusion and reduced hypoglycaemic risk is more consistent in children/adolescents than in adults. The use of continuous subcutaneous insulin infusion is widely recommended in both adult and paediatric T1DM populations but is limited in pregnant patients and those with type 2 diabetes mellitus. All available rapid‐acting insulin analogues are approved for use in adult, paediatric and pregnant populations. However, minimum patient age varies (insulin lispro: no minimum; insulin aspart: ≥2 years; insulin glulisine: ≥6 years) and experience in pregnancy ranges from extensive (insulin aspart, insulin lispro) to limited (insulin glulisine). Although more expensive than multiple daily injections, continuous subcutaneous insulin infusion is cost‐effective in selected patient groups. This comprehensive review focuses on the European situation and summarises evidence for the efficacy and safety of continuous subcutaneous insulin infusion, particularly when used with rapid‐acting insulin analogues, in adult, paediatric and pregnant populations. The review also discusses relevant European guidelines; reviews issues that surround use of this technology; summarises the effects of continuous subcutaneous insulin

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

    PubMed

    Kyzer; Ramadan; Avraham; Belavsky; Hopp; Chaimoff

    1996-08-01

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

  13. From major amputation to prosthetic outcome: a prospective study of 190 patients in a defined population.

    PubMed

    Johannesson, A; Larsson, G U; Oberg, T

    2004-04-01

    In this prospective study, the overall treatment and outcome of patients that underwent major lower limb amputation in a defined population is described. The study was performed over a five year period in the Health Care District of North-East Skåne, Sweden. Some 190 patients, permanent inhabitants of the Health Care District, underwent major lower limb amputation. Sixteen (16) of these patients had amputations before the study started and went through late second leg amputation during the period. One hundred and seventy four (174) patients had primary major amputation. Seventy nine (79) were men and 95 were women, with a median age of 81. The re-amputation rate was 17% although the primary knee preservation ratio was as high as 3.0:1. Rigid dressing was the standard method following trans-tibial amputation and was used for 5-7 days. ICEROSS silicone liner was used for compression therapy in 90% of all cases that resulted in delivery of a prosthesis. Prostheses were delivered to 43% of all patients with primary amputations. These patients spent a median of 13 days at the orthopaedic clinic. 55 days at the rehabilitation unit. Pressure casting was used as a standard method in the production of the prosthetic socket. ICEX carbon-fibre socket was used in 52%. New procedures, treatments and techniques were introduced, standardised and evaluated whilst the routines in the hospital were reorganised. In this way, a system has been implemented that better guarantees the outcome of the whole procedure and the service received by this category of patients. PMID:15171573

  14. The Risk of Chronic Pancreatitis in Patients with Psoriasis: A Population-Based Cohort Study

    PubMed Central

    Chiang, Yi-Ting; Huang, Weng-Foung; Tsai, Tsen-Fang

    2016-01-01

    Background Psoriasis is a chronic systemic inflammatory disorder, and studies have revealed its association with a variety of comorbidities. However, the risk of chronic pancreatitis (CP) in psoriasis has not been studied. This study aimed to investigate the risk of CP among patients with psoriasis. Methods Using the Taiwan National Health Insurance Research Database, this population-based cohort study enrolled 48430 patients with psoriasis and 193720 subjects without psoriasis. Stratified Cox proportional hazards models were used to compare the risks of CP between the patients with and without psoriasis. Results The incidence of CP was 0.61 per 1000 person-years in patients with psoriasis and 0.34 per 1000 person-years in controls during a mean 6.6-year follow-up period. Before adjustment, patients with psoriasis had a significantly higher risk of CP (crude hazard ratio (HR) = 1.81; 95% confidence interval (CI) = 1.53–2.15), and the risk remained significantly higher after adjustments for gender, age group, medications, and comorbidities (adjusted HR (aHR) = 1.76; 95% CI = 1.47–2.10). All psoriasis patient subgroups other than those with arthritis, including those with mild and severe psoriasis and those without arthritis, had significantly increased aHRs for CP, and the risk increased with increasing psoriasis severity. Psoriasis patients taking nonsteroidal anti-inflammatory drugs (aHR = 0.33; 95% CI = 0.22–0.49) and methotrexate (aHR = 0.28; 95% CI = 0.12–0.64) had a lower risk of developing CP after adjustments. Conclusions Psoriasis is associated with a significantly increased risk of CP. The results of our study call for more research to provide additional insight into the relationship between psoriasis and CP. PMID:27467265

  15. Influenza Vaccination Reduces Dementia Risk in Chronic Kidney Disease Patients: A Population-Based Cohort Study.

    PubMed

    Liu, Ju-Chi; Hsu, Yi-Ping; Kao, Pai-Feng; Hao, Wen-Rui; Liu, Shing-Hwa; Lin, Chao-Feng; Sung, Li-Chin; Wu, Szu-Yuan

    2016-03-01

    Taiwan has the highest prevalence of chronic kidney disease (CKD) worldwide. CKD, a manifestation of vascular diseases, is associated with a high risk of dementia. Here, we estimated the association between influenza vaccination and dementia risk in patients with CKD. Data from the National Health Insurance Research Database of Taiwan were used in this study. The study cohort included all patients diagnosed with CKD (according to International Classification of Disease, Ninth Revision, Clinical Modification codes) at healthcare facilities in Taiwan (n = 32,844) from January 1, 2000, to December 31, 2007. Each patient was followed up to assess dementia risk or protective factors: demographic characteristics of age and sex; comorbidities of diabetes, hypertension, dyslipidemia, cerebrovascular diseases, parkinsonism, epilepsy, substance and alcohol use disorders, mood disorder, anxiety disorder, psychotic disorder, and sleep disorder; urbanization level; monthly income; and statin, metformin, aspirin, and angiotensin-converting enzyme inhibitor (ACEI) use. A propensity score was derived using a logistic regression model for estimating the effect of vaccination by accounting for covariates that predict receiving the intervention (vaccine). A time-dependent Cox proportional hazard model was used to calculate the hazard ratios (HRs) of dementia among vaccinated and unvaccinated CKD patients. The study population comprised 11,943 eligible patients with CKD; 5745 (48%) received influenza vaccination and the remaining 6198 (52%) did not. The adjusted HRs (aHRs) of dementia decreased in vaccinated patients compared with those in unvaccinated patients (influenza season, noninfluenza season, and all seasons: aHRs = 0.68, 0.58, and 0.64; P < 0.0001, P < 0.0001, and P < 0.0001, respectively). In the sensitivity analysis, adjustments were made to estimate the association of age and sex; diabetes, dyslipidemia, hypertension, cerebrovascular diseases, anxiety

  16. Influenza Vaccination Reduces Dementia Risk in Chronic Kidney Disease Patients: A Population-Based Cohort Study.

    PubMed

    Liu, Ju-Chi; Hsu, Yi-Ping; Kao, Pai-Feng; Hao, Wen-Rui; Liu, Shing-Hwa; Lin, Chao-Feng; Sung, Li-Chin; Wu, Szu-Yuan

    2016-03-01

    Taiwan has the highest prevalence of chronic kidney disease (CKD) worldwide. CKD, a manifestation of vascular diseases, is associated with a high risk of dementia. Here, we estimated the association between influenza vaccination and dementia risk in patients with CKD. Data from the National Health Insurance Research Database of Taiwan were used in this study. The study cohort included all patients diagnosed with CKD (according to International Classification of Disease, Ninth Revision, Clinical Modification codes) at healthcare facilities in Taiwan (n = 32,844) from January 1, 2000, to December 31, 2007. Each patient was followed up to assess dementia risk or protective factors: demographic characteristics of age and sex; comorbidities of diabetes, hypertension, dyslipidemia, cerebrovascular diseases, parkinsonism, epilepsy, substance and alcohol use disorders, mood disorder, anxiety disorder, psychotic disorder, and sleep disorder; urbanization level; monthly income; and statin, metformin, aspirin, and angiotensin-converting enzyme inhibitor (ACEI) use. A propensity score was derived using a logistic regression model for estimating the effect of vaccination by accounting for covariates that predict receiving the intervention (vaccine). A time-dependent Cox proportional hazard model was used to calculate the hazard ratios (HRs) of dementia among vaccinated and unvaccinated CKD patients. The study population comprised 11,943 eligible patients with CKD; 5745 (48%) received influenza vaccination and the remaining 6198 (52%) did not. The adjusted HRs (aHRs) of dementia decreased in vaccinated patients compared with those in unvaccinated patients (influenza season, noninfluenza season, and all seasons: aHRs = 0.68, 0.58, and 0.64; P < 0.0001, P < 0.0001, and P < 0.0001, respectively). In the sensitivity analysis, adjustments were made to estimate the association of age and sex; diabetes, dyslipidemia, hypertension, cerebrovascular diseases, anxiety

  17. Psychotropic drugs and the risk of fractures in old age: a prospective population-based study

    PubMed Central

    2010-01-01

    Background There is evidence that the use of any psychotropic and the concomitant use of two or more benzodiazepines are related to an increased risk of fractures in old age. However, also controversial results exist. The aim was to describe associations between the use of a psychotropic drug, or the concomitant use of two or more of these drugs and the risk of fractures in a population aged 65 years or over. Methods This study was a part of a prospective longitudinal population-based study carried out in the municipality of Lieto, South-Western Finland. The objective was to describe gender-specific associations between the use of one psychotropic drug [benzodiazepine (BZD), antipsychotic (AP) or antidepressant (AD)] or the concomitant use of two or more psychotropic drugs and the risk of fractures in a population 65 years or over. Subjects were participants in the first wave of the Lieto study in 1990-1991, and they were followed up until the end of 1996. Information about fractures confirmed with radiology reports in 1,177 subjects (482 men and 695 women) during the follow-up was collected from medical records. Two follow-up periods (three and six years) were used, and previously found risk factors of fractures were adjusted as confounding factors separately for men and women. The Poisson regression model was used in the analyses. Results The concomitant use of two or more BZDs and the concomitant use of two or more APs were related to an increased risk of fractures during both follow-up periods after adjusting for confounding factors in men. No similar associations were found in women. Conclusions The concomitant use of several BZDs and that of several APs are associated with an increase in the risk of fractures in older men. Our findings show only risk relations. We cannot draw the conclusion that these drug combinations are causes of fractures. PMID:20602803

  18. Pseudosuccinea columella: age resistance to Calicophoron daubneyi infection in two snail populations

    PubMed Central

    Dar, Yasser; Rondelaud, Daniel; Vignoles, Philippe; Dreyfuss, Gilles

    2015-01-01

    Individual infections of Egyptian and French Pseudosuccinea columella with five miracidia of Calicophoron daubneyi were carried out to determine whether this lymnaeid was capable of sustaining larval development of this parasite. On day 42 post-exposure (at 23 °C), infected snails were only noted in groups of individuals measuring 1 or 2 mm in height at miracidial exposure. Snail survival in the 2-mm groups was significantly higher than that noted in the 1-mm snails, whatever the geographic origin of snail population. In contrast, prevalence of C. daubneyi infection was significantly greater in the 1-mm groups (15–20% versus 3.4–4.0% in the 2-mm snails). Low values were noted for the mean shell growth of infected snails at their death (3.1–4.0 mm) and the mean number of cercariae (<9 in the 1-mm groups, <19 in the 2-mm snails). No significant differences between snail populations and snails groups were noted for these last two parameters. Most infected snails died after a single cercarial shedding wave. Both populations of P. columella showed an age resistance to C. daubneyi infection and only juveniles measuring 2 mm or less in shell height at exposure can ensure larval development of this digenean up to cercarial shedding. PMID:25664810

  19. Geochemical record of high emperor penguin populations during the Little Ice Age at Amanda Bay, Antarctica.

    PubMed

    Huang, Tao; Yang, Lianjiao; Chu, Zhuding; Sun, Liguang; Yin, Xijie

    2016-09-15

    Emperor penguins (Aptenodytes forsteri) are sensitive to the Antarctic climate change because they breed on the fast sea ice. Studies of paleohistory for the emperor penguin are rare, due to the lack of archives on land. In this study, we obtained an emperor penguin ornithogenic sediment profile (PI) and performed geochronological, geochemical and stable isotope analyses on the sediments and feather remains. Two radiocarbon dates of penguin feathers in PI indicate that emperor penguins colonized Amanda Bay as early as CE 1540. By using the bio-elements (P, Se, Hg, Zn and Cd) in sediments and stable isotope values (δ(15)N and δ(13)C) in feathers, we inferred relative population size and dietary change of emperor penguins during the period of CE 1540-2008, respectively. An increase in population size with depleted N isotope ratios for emperor penguins on N island at Amanda Bay during the Little Ice Age (CE 1540-1866) was observed, suggesting that cold climate affected the penguin's breeding habitat, prey availability and thus their population and dietary composition.

  20. Geochemical record of high emperor penguin populations during the Little Ice Age at Amanda Bay, Antarctica.

    PubMed

    Huang, Tao; Yang, Lianjiao; Chu, Zhuding; Sun, Liguang; Yin, Xijie

    2016-09-15

    Emperor penguins (Aptenodytes forsteri) are sensitive to the Antarctic climate change because they breed on the fast sea ice. Studies of paleohistory for the emperor penguin are rare, due to the lack of archives on land. In this study, we obtained an emperor penguin ornithogenic sediment profile (PI) and performed geochronological, geochemical and stable isotope analyses on the sediments and feather remains. Two radiocarbon dates of penguin feathers in PI indicate that emperor penguins colonized Amanda Bay as early as CE 1540. By using the bio-elements (P, Se, Hg, Zn and Cd) in sediments and stable isotope values (δ(15)N and δ(13)C) in feathers, we inferred relative population size and dietary change of emperor penguins during the period of CE 1540-2008, respectively. An increase in population size with depleted N isotope ratios for emperor penguins on N island at Amanda Bay during the Little Ice Age (CE 1540-1866) was observed, suggesting that cold climate affected the penguin's breeding habitat, prey availability and thus their population and dietary composition. PMID:27261428

  1. Population aging and its impacts: strategies of the health-care system in Taipei.

    PubMed

    Lin, Ming-Hsien; Chou, Ming-Yueh; Liang, Chih-Kuang; Peng, Li-Ning; Chen, Liang-Kung

    2010-11-01

    Taiwan is one of the fastest aging countries in the world. As such, the government has developed various strategies to promote an age-friendly health-care system. Health services are supported by National Health Insurance (NHI), which insures over 97% of citizens and over 99% of health-care institutes. The current health-care system has difficulties in caring for older patients with multiple comorbidities, complex care needs, functional impairments, and post-acute care needs. Taipei, an international metropolis with a well-preserved tradition of filial piety in Chinese societies, has developed various strategies to overcome the aforementioned barriers to an age-friendly health-care system. These include an emphasis on general medical care and a holistic approach in all specialties, development of a geriatrics specialty training program, development of post-acute services, and strengthening of linkages between health and social care services. Despite achievements thus far, challenges still include creating a more extensive integration between medical specialties, promotion of an interdisciplinary care model across specialties and health-care settings, and integration of health and social care services. The experiences of Taipei in developing an age-friendly health-care service system may be a culturally appropriate model for other Chinese and Asian communities.

  2. The age associations of blood pressure, cholesterol and glucose: analysis of health examination surveys from international populations

    PubMed Central

    Pelizzari, Pamela M; Lin, John K; Cowan, Melanie J; Stevens, Gretchen A; Farzadfar, Farshad; Khang, Young-Ho; Lu, Yuan; Riley, Leanne M; Lim, Stephen S; Ezzati, Majid

    2014-01-01

    Background The age-association of cardiovascular disease (CVD) may be partially because its metabolic risk factors tend to rise with age. Few studies have analyzed age-associations of multiple metabolic risks in the same population, especially in nationally representative samples. We examined worldwide variations in the age associations of systolic blood pressure (SBP), total cholesterol (TC), and fasting plasma glucose (FPG). Methods and Results We used individual records from 83 nationally or sub-nationally representative health examination surveys in 52 countries to fit a linear model to risk factor data between ages 30-64 years for SBP and FPG, and between 30-54 years for TC. We report the cross-country variation of the slope and intercept of this relationship. We also assessed non-linear associations in older ages. Between 30 and 64 years of age, SBP increased by 1.7-11.6 mmHg per ten years of age and FPG increased by 0.8-20.4 mg/dL per ten years of age in different countries and in the two sexes. Between 30 and 54 years of age, TC increased by 0.2-22.4 mg/dL per ten years of age in different surveys and in the two sexes. For all risk factors and in most countries, risk factor levels rose more steeply among women than among men, especially for TC. On average, there was a flattening of age-SBP relationship in older ages; TC and FPG age associations reversed in older ages, leading to lower levels in older ages than in middle ages. Conclusions The rise with age of major metabolic CVD risk factors varies substantially across populations, especially for FPG and TC. TC rises more steeply in high-income countries and FPG in the Oceania countries, the Middle East, and the US. The SBP age association had no specific income or geographical pattern. PMID:22492580