Differences by age and sex in the sedentary time of adults in Scotland.

PubMed

Strain, Tessa; Kelly, Paul; Mutrie, Nanette; Fitzsimons, Claire

2018-04-01

Previous nationally-representative research in Scotland found a j-shaped relationship between age and leisure sedentary time (ST): a decrease from young to middle-age, before rising steeply in older-age. This study investigated the effects of age and sex on weekday (including work) ST for all adults and stratified by work-status, and on weekend day ST. Differences in the relative contributions of component behaviours were also investigated. Responses from 14,367 adult (≥16 years) 2012-14 Scottish Health Survey participants were analysed using linear regressions. We found no j-shaped relationship between age and weekday ST. Instead, only 16-24 year olds reported lower levels than those over 75 years (6.6 (95% CI: 6.3-6.9) compared to 7.4 (95% CI: 7.2-7.6) hours/day; p < 0001). The j-shape was only evident in the stratified analysis amongst women not in work, and for weekend day ST for all groups. For those in work, work ST accounted for 45% of weekday ST. Television/screen ST made up over half of leisure ST on weekdays and weekend days, regardless of sex, age, or work-status. These results challenge our understanding of how ST varies by age. Interventions to reduce ST should consider differences in the relative contributions of ST behaviours by age and work-status.

Nimble negotiators: How theory of mind (ToM) interconnects with persuasion skills in children with and without ToM delay.

PubMed

Peterson, Candida C; Slaughter, Virginia; Wellman, Henry M

2018-03-01

Persuasion is an essential social skill. Yet its development and underpinnings are poorly understood. In 2 studies, a total of 167 children aged 3 to 12 years took theory of mind (ToM) tests and participated in unscripted, seminaturalistic persuasive conversations. Children were typically developing (TD) or had deafness or autism spectrum disorder (ASD). High-level, informationally rich persuasive arguments increased with age in all groups in both studies, as did ToM. In both studies, ToM scores predicted persuasion skill over and above age, language ability, and deafness/ASD status. In Study 1, TD 8-year-olds outperformed age-matched deaf and autistic children in ToM but only equaled them in persuasive skill. Study 2 employed more challenging persuasion tasks and revealed superior persuasion performance by school-aged TD children compared with same-aged children with deafness or ASD. Deaf and ASD groups did better on Study 1's straightforward persuasion tasks than on Study 2's more challenging ones, whereas TD children rose to the added challenge without their persuasion performance suffering. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Using Laryngeal Electromyography to Differentiate Presbylarynges from Paresis

ERIC Educational Resources Information Center

Stager, Sheila V.; Bielamowicz, Steven A.

2010-01-01

Purpose: Differential diagnosis of patients over 64 years of age reporting hoarseness is challenging. Laryngeal electromyography (LEMG) was used to determine the status of the recurrent and superior laryngeal nerves. The authors hypothesized that individuals with hoarseness but normal LEMG would have measures similar to those of patients from…

Effects of 2 size classes of intratracheally administered airborne dust particles on primary and secondary specific antibody responses and body weight gain of broilers: a pilot study on the effects of naturally occurring dust.

PubMed

Lai, H T L; Nieuwland, M G B; Aarnink, A J A; Kemp, B; Parmentier, H K

2012-03-01

We studied the effects of a concurrent challenge on slow-growing broilers with 1) airborne particles of 2 sizes: fine dust (smaller than 2.5 microns) and coarse dust (between 2.5 and 10 microns) that were directly collected from a broiler house and 2) lipopolysaccharide on intratracheal immunizations with the specific antigen human serum albumin (HuSA) and measured primary and secondary systemic (total) antibody responses and (isotype-specific) IgM, IgG, and IgA responses at 3 and 7 wk of age. All treatments affected immune responses at several ages, heart morphology, and BW gain, albeit the latter only temporarily. Dust particles significantly decreased primary antibody (IgT and IgG) responses to HuSA at 3 wk of age but enhanced IgM responses to HuSA at 7 wk of age. Dust particles decreased secondary antibody responses to HuSA, albeit not significantly. All of the birds that were challenged with dust particles showed decreased BW gain after the primary but not after the secondary challenge. Relative heart weight was significantly decreased in birds challenged with coarse dust, fine dust, lipopolysaccharide, and HuSA at 3 wk of age, but not in birds challenged at 7 wk of age. Morphology (weight, width, and length) of hearts were also affected by the dust challenge at 3 wk of age. The present results indicate that airborne dust particles obtained from a broiler house when intratracheally administered at an early age affect specific humoral immune responsiveness and BW gain of broilers to simultaneously administered antigens differently than when administered at a later age. The hygienic status of broiler houses at a young age may be of importance for growth and immune responsiveness, and consequently, for vaccine efficacy and disease resistance in broilers. The consequences of our findings are discussed.

Challenges and New Opportunities for Clinical Nutrition Interventions in the Aged123

PubMed Central

Johnson, Mary Ann; Dwyer, Johanna T.; Jensen, Gordon L.; Miller, Joshua W.; Speakman, John R.; Starke-Reed, Pamela; Volpi, Elena

2011-01-01

Nutritional status plays a critical role in the prevention and management of many chronic health conditions that are common in the elderly and are likely to become more prevalent as the population ages. This paper highlights several aspects of nutrition that require additional basic science and clinical application research to improve the health and well-being of older adults. Topics addressed are selected demographic and health indices, the uncertain benefits of energy restriction in aged humans compared with other species, the impact of food insecurity on health, the relationship between dietary protein and sarcopenia, the prevention and management of obesity while maintaining muscle mass and functional status, and controversy regarding high intakes of folic acid. Research needs regarding the safety, efficacy, and application of clinical interventions related to these topics also are discussed. PMID:21270372

Fasting, but Not Aging, Dramatically Alters the Redox Status of Cysteine Residues on Proteins in Drosophila melanogaster

PubMed Central

Menger, Katja E.; James, Andrew M.; Cochemé, Helena M.; Harbour, Michael E.; Chouchani, Edward T.; Ding, Shujing; Fearnley, Ian M.; Partridge, Linda; Murphy, Michael P.

2015-01-01

Summary Altering the redox state of cysteine residues on protein surfaces is an important response to environmental challenges. Although aging and fasting alter many redox processes, the role of cysteine residues is uncertain. To address this, we used a redox proteomic technique, oxidative isotope-coded affinity tags (OxICAT), to assess cysteine-residue redox changes in Drosophila melanogaster during aging and fasting. This approach enabled us to simultaneously identify and quantify the redox state of several hundred cysteine residues in vivo. Cysteine residues within young flies had a bimodal distribution with peaks at ∼10% and ∼85% reversibly oxidized. Surprisingly, these cysteine residues did not become more oxidized with age. In contrast, 24 hr of fasting dramatically oxidized cysteine residues that were reduced under fed conditions while also reducing cysteine residues that were initially oxidized. We conclude that fasting, but not aging, dramatically alters cysteine-residue redox status in D. melanogaster. PMID:26095360

Cryptosporidiosis: Environmental, therapeutic, and preventive challenges

PubMed Central

Collinet-Adler, Stefan; Ward, Honorine D.

2014-01-01

Cryptosporidium spp. are responsible for endemic and epidemic disease worldwide. Clinical manifestations may include acute, persistent, or chronic diarrhea, biliary, and pulmonary disease. Disease severity ranges from asymptomatic or mild to severe, intractable diarrhea with wasting depending on immune status, nutrition, and age. Transmission is fecal-oral with both human and animal reservoirs. Disease is often self limited in healthy individuals, but therapy remains a challenge in the immune-compromised. Prevention currently depends on appropriate hygiene and proper water management and treatment. PMID:20521158

Depression, disability and functional status among community-dwelling older adults in South Africa: evidence from the first South African National Income Dynamics Study.

PubMed

Tomita, Andrew; Burns, Jonathan K

2013-12-01

This study examined the relationship between depression and functional status among a community-dwelling older population of 65 years and older in South Africa. Data from the first wave of the South African National Income Dynamics Study were used, this being the first longitudinal panel survey of a nationally representative sample of households. The study focused on the data for resident adults 65 years and older (n = 1,429). Depression was assessed using the 10-item version of the Center for Epidemiologic Studies Depression Scale. Functional status, pertaining to both difficulty and dependence in activities of daily living (ADL), instrumental activities of daily living (IADL), and physical functioning and mobility (PFM), were assessed using 11 items. Functional challenges were generally higher in the older age group. There was a significant association between depression and functional dependence in ADL (adjusted OR = 2.57 [CI: 1.03-6.41]), IADL (adjusted OR = 2.76 [CI: 1.89-4.04]), and PFM (adjusted OR = 1.66 [CI: 1.18-2.33]), but the relationship between depression and functional status, particularly PFM, appeared weaker in older age. The relationship between depression symptoms and function is complex. Functional characteristics between older and younger old populations are diverse, and caution is indicated against overgeneralizing the challenges related to depression and function among this target population. Copyright © 2013 John Wiley & Sons, Ltd.

Depression, disability and functional status among community dwelling older adults in South Africa: Evidence from the first South African National Income Dynamics Study

PubMed Central

Tomita, Andrew; Burns, Jonathan K

2013-01-01

Objectives This study examined the relationship between depression and functional status among a community-dwelling elderly population of 65 years and older in South Africa. Method Data from the first wave of the South African National Income Dynamics Study (SA-NIDS) was used, this being the first longitudinal panel survey of a nationally representative sample of households. The study focused on the data for resident adults 65 years and older (n=1,429). Depression was assessed using the 10-item version of the Center for Epidemiologic Studies Depression Scale (CES-D). Functional status, pertaining to both difficulty and dependency in activities of daily living (ADL), instrumental activities of daily living (IADL), and physical functioning and mobility (PFM), were assessed using 11 items. Results Functional challenges were generally higher in the older age group. There was a significant association between depression and functional dependency in ADL (adjusted OR=2.57 [CI: 1.03-6.41]), IADL (adjusted OR=2.76 [CI: 1.89-4.04]) and PFM (adjusted OR=1.66 [CI: 1.18-2.33]) but the relationship between depression and functional status, particularly PFM, appeared weaker in older age. Conclusion The relationship between depression symptoms and function is complex. Functional characteristics between older and younger older populations are diverse, and caution is indicated against overgeneralizing the challenges related to depression and function among this target population. PMID:23512338

Psychology and Aging: The First 20 Years

PubMed Central

Zacks, Rose T.; Blanchard-Fields, Fredda; Haley, William E.

2006-01-01

This article provides a review of the first 20 years of Psychology and Aging, the American Psychological Association’s first and only scholarly journal devoted to the topic of aging. The authors briefly summarize its history, its contributions to the study of aging, and its broader status as a scholarly publication. One theme highlighted in our review is the diversity of content in the journal throughout its history. Another is the strong impact that articles published in the journal have had on both basic and applied topics in aging. Efforts to encompass the breadth of topics and methodologies in aging research while retaining excellent quality remain the exciting but essential challenge for Psychology and Aging. PMID:16594786

A 6-year Follow-up survey of health status in middle-aged women with Turner syndrome.

PubMed

Fjermestad, Krister W; Naess, Eva E; Bahr, David; Gravholt, Claus H

2016-09-01

Studies suggest younger women with Turner syndrome (TS) have good quality of life. Less is known about everyday functioning in adults with TS. In a 6-year follow-up study, multiple areas of functioning were compared between TS women and controls. Women with TS and controls were mailed a self-report survey 6 years after a baseline study. Fifty-seven women with TS (M age 40·6 ± 11·1 years) and 101 controls (M age 38·8 ± 10·6 years, ns) responded. Measures of background information, experienced life strain and presence/impact of health conditions were developed for this study. The QPS Nordic measured perceived workload challenges. The LiSat-9 measured life satisfaction. The Rosenberg Self-Esteem Scale measured self-esteem. More TS women lived alone, fewer had biological children, and more had adoptive children. TS women reported fewer sex partners and less sexual confidence. Controls had higher education. There was no difference in employment status. More TS women received disability pensions. TS women reported their work as more physically challenging, less positively challenging and requiring less knowledge skills. TS women experienced more life strain in school, adolescence and late working life. Controls reported higher overall life satisfaction, with no difference between samples on specific domains. TS women reported lower self-esteem. For TS women only, physical health at baseline predicted length of education and mental health at baseline predicted self-esteem. Women with TS face more challenges than controls on several domains of functioning. Early physical and mental health may influence later educational achievement and self-esteem for women with TS. © 2016 John Wiley & Sons Ltd.

Nutrition Needs Assessment of Young Special Olympics Participants

ERIC Educational Resources Information Center

Gibson, Jennifer C.; Temple, Viviene A.; Anholt, Jane P.; Gaul, Catherine A.

2011-01-01

Background: Children with intellectual disability (ID) are at increased risk for obesity and nutrition-related health concerns, yet there is a paucity of data describing their nutrition status. The purpose of this study was to evaluate nutritional challenges of young participants (2-10 years of age) enrolled in Special Olympics Canada (SOC)…

Stunting and weight statuses of adolescents differ between public and private schools in urban Gambia.

PubMed

Juwara, Alimatou; Huang, Nicole; Chien, Li-Ying; Chen, Hsin-Jen

2016-07-01

This study assessed the disparity in nutritional status of adolescents between public and private schools in urban Gambia. This is a school-based cross-sectional study in six private and six public upper basic schools in urban Gambia. This study recruited 491 students from public and 469 students from private schools (13-15 years of age). The prevalence of stunting (WHO height-for-age Z < -2SD) was 13.4 % for public school students and 4.5 % for private schools. After adjustment for children's sex, age, and family socioeconomic status, the differences in prevalence of stunting and underweight were significant between public and private schools. Private school students are more likely to be overweight/obese (WHO BMI-for-age Z > +1SD) (OR = 2.85, 95 % CI 1.55-5.22), but less likely to be thin (BMI-for-age Z < -2SD) (OR = 0.61 [0.39-0.96]), compared to public school students. Children from lower income families had lower odds for overweight/obese than normal weight, compared to those from higher income families (OR = 0.34 [0.15-0.76]). Public and private schools in urban regions of the Gambia may face different nutritional challenges due to differences in school environment and resources.

Refractive Status and Prevalence of Refractive Errors in Suburban School-age Children

PubMed Central

Pi, Lian-Hong; Chen, Lin; Liu, Qin; Ke, Ning; Fang, Jing; Zhang, Shu; Xiao, Jun; Ye, Wei-Jiang; Xiong, Yan; Shi, Hui; Yin, Zheng-Qin

2010-01-01

Objective: This study investigated the distribution pattern of refractive status and prevalence of refractive errors in school-age children in Western China to determine the possible environmental factors. Methods: A random sampling strategy in geographically defined clusters was used to identify children aged 6-15 years in Yongchuan, a socio-economically representative area in Western China. We carried out a door-to-door survey and actual eye examinations, including visual acuity measurements, stereopsis examination, anterior segment and eyeball movements, fundus examinations, and cycloplegic retinoscopy with 1% cyclopentolate. Results: A total of 3469 children living in 2552 households were selected, and 3070 were examined. The distributions of refractive status were positively-skewed for 6-8-year-olds, and negatively-skewed for 9-12 and 13-15-year-olds. The prevalence of hyperopia (≥+2.00 D spherical equivalent [SE]), myopia (≤-0.50 D SE), and astigmatism (≥1.00 diopter of cylinder [DC]) were 3.26%, 13.75%, and 3.75%, respectively. As children's ages increased, the prevalence rate of hyperopia decreased (P<0.001) and that of myopia increased significantly (P<0.001). Children in academically challenging schools had a higher risk of myopia (P<0.001) and astigmatism (≥1.00DC, P =0.04) than those in regular schools. Conclusion: The distribution of refractive status changes gradually from positively-skewed to negatively-skewed distributions as age increases, with 9-year-old being the critical age for the changes. Environmental factors and study intensity influence the occurrence and development of myopia. PMID:20975844

Stress appraisals and cellular aging: A key role for anticipatory threat in the relationship between psychological stress and telomere length

PubMed Central

O’Donovan, Aoife; Tomiyama, A. Janet; Lin, Jue; Puterman, Eli; Adler, Nancy E.; Kemeny, Margaret; Wolkowitz, Owen M.; Blackburn, Elizabeth H.; Epel, Elissa S.

2012-01-01

Chronic psychological stressis a risk factor formultiple diseases of aging. Accelerated cellular aging as indexed by short telomere length has emerged as a potential common biological mechanism linking various forms of psychological stress and diseases of aging. Stress appraisals determine the degree and type of biological stress responses and altered stress appraisals may be a common psychological mechanism linking psychological stress and diseases of aging. However, no previous studies have examined the relationship between stress appraisals and telomere length. We exposed chronically stressed female caregivers and non-caregiving controls (N= 50; M age = 62.14±6.10) to a standardized acute laboratory stressor and measured their anticipatory and retrospective threat and challenge appraisals of the stressor. We hypothesized that threat and challenge appraisals would be associated with shorter and longer telomere length respectively, and that chronic care giving stress would influence telomere length through altered stress appraisals. Higher anticipatory threat appraisals were associated with shorter age-adjusted telomere length (β = −.32, p = .03), but challenge appraisals and retrospective threat appraisals showed no independent association with telomere length. Caregivers reported significantly higher anticipatory (β = −.36, p = .006)and retrospective (β = −.29, p = .03) threat appraisals than controls, but similar challenge appraisals. Although there was no significant main effect of caregiver status on telomere length, care giving had a significant indirect effect on telomere length through anticipatory threat appraisals. Exaggerated anticipatory threat appraisals may be a common and modifiable psychological mechanism of psychological stress effects on cellular aging. PMID:22293459

Age-related trajectories of social cognition in youth at clinical high risk for psychosis: An exploratory study.

PubMed

Davidson, Charlie A; Piskulic, Danijela; Addington, Jean; Cadenhead, Kristen S; Cannon, Tyrone D; Cornblatt, Barbara A; McGlashan, Thomas H; Perkins, Diana O; Seidman, Larry J; Tsuang, Ming T; Walker, Elaine F; Bearden, Carrie E; Mathalon, Daniel H; Woods, Scott W; Johannesen, Jason K

2018-05-08

Clinical high risk (CHR) status is characterized by impairments in social cognition, but questions remain concerning their stability over development. In cross-sectional analysis of a large naturalistic sample, the current study examined whether those at CHR status show deviant trajectories for age-related change in social cognitive ability, and whether these trajectories are influenced by treatment history. Emotion perception (EP) and theory of mind (ToM) were assessed in 675 CHR and 263 healthy comparison (HC) participants aged 12-35. Age effects in CHR were modeled against HC age-expected performance. Prior medication status was tested for interactions with age. CHR exhibited normal age trajectory for EP, but significantly lower slopes for ToM from age 17 onward. This effect was specific to stimuli exhibiting sarcasm and not to detection of lies. When treatment history was included in the model, age-trajectory appeared normal in CHR subjects previously prescribed both antipsychotics and antidepressant medication, although the blunted trajectory still characterized 80% of the sample. Cross-sectional analyses suggested that blunting of ToM in CHR develops in adolescence, while EP abilities were diminished evenly across the age range. Exploratory analyses of treatment history suggested that ToM was not affected, however, in CHRs with lifetime histories of both antipsychotic and antidepressant medications. Reduction in age-expected ToM ability may impair the ability of individuals at CHR to meet social developmental challenges in adolescence. Medication effects on social cognition deserve further study. Copyright © 2018. Published by Elsevier B.V.

Physical independence and mortality at the extreme limit of life span: supercentenarians study in Japan.

PubMed

Arai, Yasumichi; Inagaki, Hiroki; Takayama, Michiyo; Abe, Yukiko; Saito, Yasuhiko; Takebayashi, Toru; Gondo, Yasuyuki; Hirose, Nobuyoshi

2014-04-01

Prevention of disability is a major challenge in aging populations; however, the extent to which physical independence can be maintained toward the limit of human life span remains to be determined. We examined the health and functional status of 642 centenarians: 207 younger centenarians (age: 100-104 years), 351 semi-supercentenarians (age: 105-109 years), and 84 supercentenarians (age: >110 years). All-cause mortality was followed by means of an annual telephone or mailed survey. Age-specific disability patterns revealed that the older the age group, the higher the proportion of those manifesting independence in activities of daily living at any given age of entry. Multiple logistic regression analysis identified male gender and better cognitive function as consistent determinants of physical independence across all age categories. In a longitudinal analysis, better physical function was significantly associated with survival advantage until the age of 110. However, mortality beyond that age was predicted neither by functional status nor biomedical measurements, indicating alternative trajectories of mortality at the highest ages. These findings suggest that maintaining physical independence is a key feature of survival into extreme old age. Future studies illuminating genetic and environmental underpinnings of supercentenarians' phenotypes will provide invaluable opportunities not only to improve preventive strategies but also to test the central hypotheses of human aging.

Assessment of oral health parameters among students attending special schools of Mangalore city.

PubMed

Peter, Tom; Cherian, Deepthi Anna; Peter, Tim

2017-01-01

The aim of the study was to assess the oral health status and treatment needs and correlation between dental caries susceptibility and salivary pH, buffering capacity and total antioxidant capacity among students attending special schools of Mangalore city. In this study 361 subjects in the age range of 12-18 years were divided into normal ( n = 84), physically challenged ( n = 68), and mentally challenged ( n = 209) groups. Their oral health status and treatment needs were recorded using the modified WHO oral health assessment proforma. Saliva was collected to estimate the salivary parameters. Statistical analysis was done using Statistical Package for Social Sciences version 17. Chicago. On examining, the dentition status of the study subjects, the mean number of decayed teeth was 1.57 for the normal, 2.54 for the physically challenged and 4.41 for the mentally challenged study subjects. These results were highly statistically significant ( P < 0.001). The treatment needs of the study subjects revealed that the mean number of teeth requiring pulp care and restoration were 1 for the normal, 0.12 for the physically challenged, and 1.21 for the mentally challenged study subjects. These results were highly statistically significant ( P < 0.001). The mean salivary pH and buffering capacity were found to be lowest among the mentally challenged subjects. Physically challenged group had the lowest mean total antioxidant capacity among the study subjects. Among the study subjects, normal students had the highest mean salivary pH, buffering capacity, and total antioxidant capacity. These results were highly statistically significant ( P < 0.001). This better dentition status of the normal compared to the physically and mentally challenged study subjects could be due to their improved quality of oral health practices. The difference in the treatment needs could be due to the higher prevalence of untreated dental caries and also due to the neglected oral health care among the mentally challenged study subjects. The salivary pH and buffering capacity were comparatively lower among the physically and mentally challenged study subjects which could contribute to their increased caries experience compared to the normal study subjects. However, further studies are needed to establish a more conclusive result on the total anti-oxidant capacity of the saliva and dental caries.

Early-pregnancy maternal vitamin D status and maternal hyperglycaemia.

PubMed

Tomedi, L E; Simhan, H N; Bodnar, L M

2013-09-01

To estimate the association between serum 25-hydroxyvitamin D concentrations and maternal hyperglycaemia (post-load glucose concentration ≥ 7.5 mmol/l). Pregnant women (n = 429; 61% black, 36% obese, 45% smokers) enrolled in a cohort study at <16 weeks gestation. Non-fasting blood samples were assayed for serum 25-hydroxyvitamin D at enrolment. At 24-28 weeks gestation, maternal hyperglycaemia was determined using a 50-g 1-h oral glucose challenge test. A total of 67% of women had 25-hydroxyvitamin D concentrations < 50 nmol/l and 11% had maternal hyperglycaemia. Among smokers, each 23-nmol/l increase in serum 25-hydroxyvitamin D was associated with a reduction in the odds of maternal hyperglycaemia [odds ratio: 0.30 (95% CI: 0.13, 0.68)] after adjustment for parity, race/ethnicity, age, pre-pregnancy BMI, marital status, income, family history of diabetes, and gestational age of gestational diabetes mellitus screening. Among non-smokers, we found no association between early pregnancy vitamin D status and maternal hyperglycaemia. Smoking status may modify the relationship between poor maternal vitamin D status and maternal hyperglycaemia. © 2013 The Authors. Diabetic Medicine © 2013 Diabetes UK.

¿Y ahora qué? Anticipated immigration status barriers and Latina/o high school students' future expectations.

PubMed

McWhirter, Ellen Hawley; Ramos, Karina; Medina, Cynthia

2013-07-01

Latina/o high school students without documentation face a challenging situation when they graduate from high school, with pathways to work and postsecondary education stymied by their immigration status. We examined the effects of anticipated barriers associated with immigration status, age, and sex on the dependent variables of vocational outcome expectations, anticipated external and internal barriers, and postsecondary schooling plans in a sample of 475 Latina/o high school students. Findings include that students anticipating immigration status problems had lower vocational outcome expectations and anticipated more external barriers to pursuing their postsecondary plans. Latina girls and older high school students anticipating immigration status problems were more likely to plan to attend 2-year rather than 4-year colleges, and less likely to plan on postsecondary education, respectively. Implications for practice, policy, and research are discussed. PsycINFO Database Record (c) 2013 APA, all rights reserved.

'We just do the dirty work': dealing with incontinence, courtesy stigma and the low occupational status of carework in long-term aged care facilities.

PubMed

Ostaszkiewicz, Joan; O'Connell, Beverly; Dunning, Trisha

2016-09-01

To systematically examine, describe and explain how continence care was determined, delivered and communicated in Australian long aged care facilities. Incontinence is a highly stigmatising condition that affects a disproportionally large number of people living in long-term aged care facilities. Its day-to-day management is mainly undertaken by careworkers. We conducted a Grounded theory study to explore how continence care was determined, delivered and communicated in long-term aged care facilities. This paper presents one finding, i.e. how careworkers in long-term aged care facilities deal with the stigma, devaluation and the aesthetically unpleasant aspects of their work. Grounded theory. Eighty-eight hours of field observations in two long-term aged care facilities in Australia. In addition, in-depth interviews with 18 nurses and careworkers who had experience of providing, supervising or assessment of continence care in any long-term aged care facility in Australia. Occupational exposure to incontinence contributes to the low occupational status of carework in long-term aged care facilities, and continence care is a symbolic marker for inequalities within the facility, the nursing profession and society at large. Careworkers' affective and behavioural responses are characterised by: (1) accommodating the context; (2) dissociating oneself; (3) distancing oneself and (4) attempting to elevate one's role status. The theory extends current understandings about the links between incontinence, continence care, courtesy stigma, emotional labour and the low occupational status of carework in long-term aged care facilities. This study provides insights into the ways in which tacit beliefs and values about incontinence, cleanliness and contamination may affect the social organisation and delivery of care in long-term aged care facilities. Nurse leaders should challenge the stigma and devaluation of carework and careworkers, and reframe carework as 'dignity work'. © 2016 John Wiley & Sons Ltd.

An accurate, simple prognostic model consisting of age, JAK2, CALR, and MPL mutation status for patients with primary myelofibrosis.

PubMed

Rozovski, Uri; Verstovsek, Srdan; Manshouri, Taghi; Dembitz, Vilma; Bozinovic, Ksenija; Newberry, Kate; Zhang, Ying; Bove, Joseph E; Pierce, Sherry; Kantarjian, Hagop; Estrov, Zeev

2017-01-01

In most patients with primary myelofibrosis, one of three mutually exclusive somatic mutations is detected. In approximately 60% of patients, the Janus kinase 2 gene is mutated, in 20%, the calreticulin gene is mutated, and in 5%, the myeloproliferative leukemia virus gene is mutated. Although patients with mutated calreticulin or myeloproliferative leukemia genes have a favorable outcome, and those with none of these mutations have an unfavorable outcome, prognostication based on mutation status is challenging due to the heterogeneous survival of patients with mutated Janus kinase 2. To develop a prognostic model based on mutation status, we screened primary myelofibrosis patients seen at the MD Anderson Cancer Center, Houston, USA, between 2000 and 2013 for the presence of Janus kinase 2, calreticulin, and myeloproliferative leukemia mutations. Of 344 primary myelofibrosis patients, Janus kinase 2 V617F was detected in 226 (66%), calreticulin mutation in 43 (12%), and myeloproliferative leukemia mutation in 16 (5%); 59 patients (17%) were triple-negatives. A 50% cut-off dichotomized Janus kinase 2-mutated patients into those with high Janus kinase 2 V617F allele burden and favorable survival and those with low Janus kinase 2 V617F allele burden and unfavorable survival. Patients with a favorable mutation status (high Janus kinase 2 V617F allele burden/myeloproliferative leukemia/calreticulin mutation) and aged 65 years or under had a median survival of 126 months. Patients with one risk factor (low Janus kinase 2 V617F allele burden/triple-negative or age >65 years) had an intermediate survival duration, and patients aged over 65 years with an adverse mutation status (low Janus kinase 2 V617F allele burden or triple-negative) had a median survival of only 35 months. Our simple and easily applied age- and mutation status-based scoring system accurately predicted the survival of patients with primary myelofibrosis. Copyright© Ferrata Storti Foundation.

Securing and sustaining employment: concerns of HIV patients in Singapore.

PubMed

Tan, Si Ying; Ow Yong, Lai Meng; Foong, Jasmin Yuet Ee; Wong, Nicole Huay Sze; Chew, Li Ling; Koh, Yin Ling

2013-01-01

Employment sustainability is one of the most pressing issues inflicting people living with HIV (PLHIV). A qualitative approach was used to elucidate the perceived challenges in sustaining their employment and the perceived barriers in re-entering the workforce for HIV patients. In-depth interviews were conducted with 16 patients from an acute hospital in Singapore. The main challenges raised in sustaining employment were: (1) ability to ensure secrecy of diagnosis from employers, (2) ability to secure financial resources for treatment and sustenance, (3) ability to ensure stable health to meet job requirements, (4) ability to cognitively sit with the concerns of uncertainty and limitations in career, and (5) ability to work through discriminatory workplace practices. The perceived barriers in gaining workforce re-entry were: (1) fear of pre-employment medical screening and potential discriminatory practices at workplace, (2) concerns over health (frequent hospital admissions, physical weakness, and existing medical co-morbidities), and (3) psychosocial challenges (unstable accommodation, older age, financial issues, and trade skills limitation). The overarching factor that influences the success of sustaining and securing an employment among HIV patients is secrecy of the diagnosis. The individuals' health status, financial status and access to healthcare, and other psychosocial challenges further compound the issue.

Frail Elders in an Urban District Setting in Malaysia: Multidimensional Frailty and Its Correlates.

PubMed

Sathasivam, Jeyanthini; Kamaruzzaman, Shahrul Bahyah; Hairi, Farizah; Ng, Chiu Wan; Chinna, Karuthan

2015-11-01

In the past decade, the population in Malaysia has been rapidly ageing. This poses new challenges and issues that threaten the ability of the elderly to independently age in place. A multistage cross-sectional study on 789 community-dwelling elderly individuals aged 60 years and above was conducted in an urban district in Malaysia to assess the geriatric syndrome of frailty. Using a multidimensional frailty index, we detected 67.7% prefrail and 5.7% frail elders. Cognitive status was a significant correlate for frailty status among the respondents as well as those who perceived their health status as very poor or quite poor; but self-rated health was no longer significant when controlled for sociodemographic variables. Lower-body weakness and history of falls were associated with increasing frailty levels, and this association persisted in the multivariate model. This study offers support that physical disability, falls, and cognition are important determinants for frailty. This initial work on frailty among urban elders in Malaysia provides important correlations and identifies potential risk factors that can form the basis of information for targeted preventive measures for this vulnerable group in their prefrail state. © 2015 APJPH.

Revitalizing the Field of Educational Foundations and PK-20 Educators' Commitment to Social Justice and Issues of Equity in an Age of Neoliberalism

ERIC Educational Resources Information Center

Hartlep, Nicholas D.; Porfilio, Bradley J.

2015-01-01

In this article, we situate the imminent extinction of educational foundations within larger macro contexts, including the corporate control of knowledge production, the marginalization of critical academics who challenge the social, economic, and political status quos, and the global (United States in particular) economic recession. We also…

Perspectives on the Current Status of and Emerging Policy Issues for Church-Related Colleges and Universities. AGB Occasional Paper No. 8.

ERIC Educational Resources Information Center

McInnes, William

1991-01-01

This paper explores the interaction between church-related institutions and the way in which they shape society and are shaped in turn by the environment in which they operate. Like all schools they face operational challenges such as improving educational quality, promoting greater cultural diversity, coping with aging individuals and…

The Imperatives of Challenges for Africa in the Knowledge Age: Status and Role of National Information Policy.

ERIC Educational Resources Information Center

Oladele, Benedict A.

In principle, the emergence of National Information Policy (NIP) as a framework for developing information resources and institutions was welcomed by most countries in Africa with a messianic zeal. However, most of these countries, particularly those in the Sub-Sahara region, were unable to correspondingly match their zeal with concrete efforts…

Breaking down "Healthism": Barriers to Health and Fitness as Identified by Immigrant Youth in St. John's, NL, Canada

ERIC Educational Resources Information Center

Shea, Jennifer M.; Beausoleil, Natalie

2012-01-01

In this article, we challenge dominant health and fitness discourses which stress individual responsibility in the attainment of these statuses. We examine the results of an empirical study exploring how a group of 15 Canadian immigrant youth, aged 12-17, discursively construct notions of health and fitness. Qualitative data were collected through…

HSR Aerodynamic Performance Status and Challenges

NASA Technical Reports Server (NTRS)

Gilbert, William P.; Antani, Tony; Ball, Doug; Calloway, Robert L.; Snyder, Phil

1999-01-01

This paper describes HSR (High Speed Research) Aerodynamic Performance Status and Challenges. The topics include: 1) Aero impact on HSR; 2) Goals and Targets; 3) Progress and Status; and 4) Remaining Challenges. This paper is presented in viewgraph form.

Lesbian, Gay, and Heterosexual Adoptive Parents' Experiences in Preschool Environments

PubMed Central

Goldberg, Abbie E.

2014-01-01

Little research has examined the school experiences of lesbian/gay (LG) parent families or adoptive parent families. The current exploratory study examined the experiences of 79 lesbian, 75 gay male, and 112 heterosexual adoptive parents of preschool-age children with respect to their (a) level of disclosure regarding their LG parent and adoptive family status at their children's schools; (b) perceived challenges in navigating the preschool environment and advocating on behalf of their children and families; and (c) recommendations to teachers and schools about how to create affirming school environments with respect to family structure, adoption, and race/ethnicity. Findings revealed that the majority of parents were open about their LG and adoptive family status, and had not encountered challenges related to family diversity. Those parents who did experience challenges tended to describe implicit forms of marginalization, such as insensitive language and school assignments. Recommendations for teachers included discussing and reading books about diverse families, tailoring assignments to meet the needs of diverse families, and offering school community-building activities and events to help bridge differences across families. PMID:25414543

Lesbian, Gay, and Heterosexual Adoptive Parents' Experiences in Preschool Environments.

PubMed

Goldberg, Abbie E

2014-01-01

Little research has examined the school experiences of lesbian/gay (LG) parent families or adoptive parent families. The current exploratory study examined the experiences of 79 lesbian, 75 gay male, and 112 heterosexual adoptive parents of preschool-age children with respect to their (a) level of disclosure regarding their LG parent and adoptive family status at their children's schools; (b) perceived challenges in navigating the preschool environment and advocating on behalf of their children and families; and (c) recommendations to teachers and schools about how to create affirming school environments with respect to family structure, adoption, and race/ethnicity. Findings revealed that the majority of parents were open about their LG and adoptive family status, and had not encountered challenges related to family diversity. Those parents who did experience challenges tended to describe implicit forms of marginalization, such as insensitive language and school assignments. Recommendations for teachers included discussing and reading books about diverse families, tailoring assignments to meet the needs of diverse families, and offering school community-building activities and events to help bridge differences across families.

Aging in Puerto Rico: A Comparison of Health Status Among Island Puerto Rican and Mainland U.S. Older Adults.

PubMed

Pérez, Catherine; Ailshire, Jennifer A

2017-06-01

To characterize the health status of older island Puerto Ricans, a segment of the U.S. population that has been largely overlooked in aging research. Data from the 2002 Puerto Rican Elderly Health Conditions Project and the 2002 Health and Retirement Study are used to examine differences in disease, disability, and self-rated health among island Puerto Ricans and the mainland U.S.-born older adult population. Differences are further examined by gender. Island Puerto Ricans were less likely to have heart disease, stroke, lung disease, cancer, activities of daily living (ADL) limitations, and poor self-rated health, but more likely to have hypertension and diabetes. Island Puerto Rican women had worse health relative to island Puerto Rican men. Recent challenges in the funding and provision of health care in Puerto Rico are worrisome given the large number of aging island adults, many of whom have hypertension and diabetes, two conditions that require long-term medical care.

[Retired physicians in Hungary - nationwide, representative study].

PubMed

Győrffy, Zsuzsa; Szél, Zsuzsanna; Girasek, Edmond

2016-10-01

The aging population and the aging physician society is an important challenge of the New Millenium. Despite this, very few publications are dealing with the older generations' physical and mental well-being, quality of life and working conditions. The aim of this study was to describe the retired physicians populations' (n = 2112) demographic data, work status, income and health status. Data of this representative, cross-sectional epidemiological study was obtained from online and paper-based questionnaires completed by 2112 retired physicians. The retired physicians' average age is 72 years, nearly two-thirds of the respondents retired after 35-45 years of service. Currently, nearly 60% are working, almost a quarter of them more than 40 hours per week. 35% of the respondents' income is below HUF 150,000. On this issue, significant differences emerge between female doctors and their male colleagues. The employment data of the results is consistent with the international trend, but the gender perspectives has unique significance in the international literature. Orv. Hetil., 2016, 157(43), 1729-1736.

Neurocognitive markers of cognitive impairment: exploring the roles of speed and inconsistency.

PubMed

Dixon, Roger A; Garrett, Douglas D; Lentz, Tanya L; MacDonald, Stuart W S; Strauss, Esther; Hultsch, David F

2007-05-01

A well-known challenge for research in the cognitive neuropsychology of aging is to distinguish between the deficits and changes associated with normal aging and those indicative of early cognitive impairment. In a series of 2 studies, the authors explored whether 2 neurocognitive markers, speed (mean level) and inconsistency (intraindividual variability), distinguished between age groups (64-73 and 74-90+ years) and cognitive status groups (nonimpaired, mildly impaired, and moderately impaired). Study 1 (n = 416) showed that both level and inconsistency distinguished between the age and 2 cognitive status (not impaired, mildly impaired) groups, with a modest tendency for inconsistency to predict group membership over and above mean level. Study 2 (n = 304) replicated these results but extended them because of the qualifying effects associated with the unique moderately impaired oldest group. Specifically, not only were the groups more firmly distinguished by both indicators of speed, but evidence for the differential contribution of performance inconsistency was stronger. Neurocognitive markers of speed and inconsistency may be leading indicators of emerging cognitive impairment. (c) 2007 APA, all rights reserved

Evaluating Cancer Patients' Expectations and Barriers Toward Traditional Chinese Medicine Utilization in China: A Patient-Support Group-Based Cross-Sectional Survey.

PubMed

Sun, Lingyun; Mao, Jun J; Vertosick, Emily; Seluzicki, Christina; Yang, Yufei

2018-06-01

Traditional Chinese medicine (TCM) is widely used among Chinese cancer patients. However, little is known about Chinese patients' expectations and barriers toward using TCM for cancer. We conducted a cross-sectional survey within a patient-support group, the Beijing Anti-Cancer Association. We measured the outcome, Chinese cancer survivors' expectations and barriers toward TCM utilization, using a modified version of ABCAM (Attitudes and Beliefs towards Complementary and Alternative Medicine), the ABTCM (Attitudes and Beliefs towards Traditional Chinese Medicine). We used multivariate models to evaluate the impact of socioeconomic status and clinical factors on their expectations and barriers (including treatment concerns and logistical challenges domain) toward TCM. Among 590 participants, most patients expected TCM to boost their immune system (96%), improve their physical health (96%), and reduce symptoms (94%). Many had logistical challenges (difficulty decocting herbs (58%) and finding a good TCM physician (55%)). A few were concerned that TCM might interfere with conventional treatments (7.6%), and that many TCM treatments are not based on scientific research (9.1%). In the multivariable regression model, age ≤60 years was independently associated with higher expectation score ( P = .031). Age ≤60 years (coefficient 5.0, P = .003) and localized disease (coefficient 9.5, P = .001) were both associated with higher treatment concerns. Active employment status (coefficient 9.0, P = .008) and localized disease (coefficient 7.5, P = .030) were related to more logistical challenges. Age and cancer stage were related to Chinese cancer patients' perceived expectations and barriers toward TCM use. Understanding these attitudes is important for reshaping the role that TCM plays in China's patient-centered comprehensive cancer care model.

Educational and social competencies at 8 years in children with threshold retinopathy of prematurity in the CRYO-ROP multicenter study.

PubMed

Msall, Michael E; Phelps, Dale L; Hardy, Robert J; Dobson, Velma; Quinn, Graham E; Summers, C Gail; Tremont, Michelle R

2004-04-01

To describe the educational status and special education services at 8 years among children who had threshold retinopathy of prematurity (ROP). A prospective study was conducted of a cohort of children who had birth weight of <1251 g and threshold ROP in the Cryotherapy for Retinopathy of Prematurity multicenter study. At age 5.5 years, visual status, functional skills, and social information were obtained. At 8 years, special education classes, developmental disabilities, rehabilitation therapies, and academic and social competencies were determined by questionnaire. Visual status was considered favorable/unfavorable on the basis of the better eye. Of 255 survivors, 216 (85%) were evaluated at both 5.5 and 8 years. Major impairments were significantly more prevalent in children with unfavorable versus favorable visual status: cerebral palsy (39% vs 16%), developmental disability (57% vs 22%), autism (9% vs 1%), and epilepsy (23% vs 3%). Special education services (63% vs 27%), below-grade-level academic performance (84% vs 48%), and school-based rehabilitation services were significantly less common in children with favorable visual status. Favorable visual status, favorable functional ratings at 5.5 years, markers of higher socioeconomic status, and nonblack race were associated with significantly lower rates of both special education placement and below-grade-level academic performance at age 8. On multivariate logistic regression, only favorable visual status and functional status remained significant predictors for decreasing special education placement. Threshold ROP is associated with high rates of developmental, educational, and social challenges in middle childhood; preserved vision was associated with a clear advantage, with more than half of the children with favorable visual status performing at grade level.

Parental HIV disclosure in Burkina Faso: experiences and challenges in the era of HAART.

PubMed

Tiendrebeogo, Georges; Hejoaka, Fabienne; Belem, Edwige Mireille; Compaoré, Pascal Louis Germain; Wolmarans, Liezel; Soubeiga, André; Ouangraoua, Nathalie

2013-07-01

Increasingly parents living with HIV will have to confront the dilemmas of concealing their lifelong treatment or disclosing to their children exposed to their daily treatment practices. However, limited data are available regarding parental HIV disclosure to children in Burkina Faso. Do parents on antiretroviral therapy disclose their HIV status to their children? What drives them? How do they proceed and how do children respond? We conducted in-depth interviews with 63 parents of children aged seven and above where the parents had been in treatment for more than 3 years in two major cities of Burkina Faso. Interviews addressed parental disclosure and the children's role in their parents' treatment. The rate of parental HIV status disclosure is as high as that of non-disclosure. Factors associated with parental disclosure include female sex, parent's older age, parent's marital history and number of children. After adjustment, it appears that the only factor remaining associated with parental disclosure was the female gender of the parent. In most of the cases, children suspected, and among non-disclosers many believed their children already knew without formal disclosure. Age of the children and history of divorce or widowhood were associated with parental disclosure. Most parents believed children do not have the necessary emotional skills to understand or that they cannot keep a secret. However, parents who disclosed to their children did not experience blame nor was their secret revealed. Rather, children became treatment supporters. Challenges to parental HIV disclosure to children are neither essential nor specific since disclosure to adults is already difficult because of perceived risk of public disclosure and subsequent stigma. However, whether aware or not of their parents' HIV-positive status, children contribute positively to the care of parents living with HIV. Perceptions about children's vulnerability and will to protect them against stigma lead parents to delay disclosure and not to overwhelm them with their experience of living with HIV. Finally, without institutional counselling support, disclosure to children remains a challenge for both parents and children, which suggests a need for rethinking of current counselling practices.

Knowledge and disclosure of HIV status among adolescents and young adults attending an adolescent HIV clinic in Accra, Ghana.

PubMed

Kenu, Ernest; Obo-Akwa, Adjoa; Nuamah, Gladys B; Brefo, Anita; Sam, Miriam; Lartey, Margaret

2014-11-26

In Ghana it is estimated that 1.2% of HIV infections occur in young people aged 15-24 but the representation in our clinics is small. Adherence to treatment, appointment keeping and knowledge of HIV status remains a challenge. Disclosure has been shown to result in better adherence to therapy, good clinical outcomes, psychological adjustment and reduction in the risk of HIV transmission when the young person becomes sexually active. A baseline study was conducted to ascertain if adolescents and young adults knew their HIV status and their knowledge on HIV. Informed consent and assent were obtained from willing participants. Self-administered questionnaires on general knowledge of HIV, HIV treatment and disclosure were collected and analyzed. Thirty-four young persons participated in the study. The mean age was 16.9±SD 2.5 and 62% (21/32) were female. All of them were still in school. Eighty-five percent were aware that young people their age could fall sick, 91% had heard of HIV, 70% knew someone with HIV and 45% thought that adolescents were not at risk of HIV. On modes of HIV transmission, 66.7% knew HIV was transmitted through sex and 63.6% knew about mother to child transmission. Fifty three percent (18/34) knew their HIV status, 50% (17/34) were on antiretroviral and 35% (6/17) of them admitted to missing ARV doses. One person who said he was HIV negative and another who did not know his status were both on ARVs. Disclosure of HIV status to adolescents and young people is dependent on a complex mix of factors and most practitioners recommend an age and developmentally appropriate disclosure. Thus it is highly individualized. The knowledge and awareness of HIV was 91% compared to 97% of adults in the most recent Ghana Demographic and Health Survey however only about two thirds had acceptable in depth knowledge on HIV. Only half knew their HIV status which was not the best considering their ages. There is the need to strengthen education to young persons with HIV, support adhere to ARVs for better outcomes and assist care givers to disclose HIV status to them.

Education Mitigates the Relationship of Stress and Mental Disorders Among Rural Indian Women.

PubMed

Fahey, Nisha; Soni, Apurv; Allison, Jeroan; Vankar, Jagdish; Prabhakaran, Anusha; Moore Simas, Tiffany A; Byatt, Nancy; Phatak, Ajay; O'Keefe, Eileen; Nimbalkar, Somashekhar

Common mental disorders (CMD) are a constellation of mental health conditions that include depression, anxiety, and other related nonpsychotic affective disorders. Qualitative explanatory models of mental health among reproductive-aged women in India reveal that distress is strongly associated with CMD. The relationship of perceived stress and CMD might be attenuated or exacerbated based on an individual's sociodemographic characteristics. To screen for Common Mental Disorders (CMD) among reproductive-aged women from rural western India and explore how the relationship between perceived stress and CMD screening status varies by sociodemographic characteristics. Cross-sectional survey of 700 women from rural Gujarat, India. CMD screening status was assessed using Self-Reported Questionnaire 20 (SRQ-20). Factors associated with CMD screening status were evaluated using multivariable logistic regression. Effect modification for the relationship of perceived stress and CMD screening status was assessed using interaction terms and interpreted in terms of predicted probabilities. The analytic cohort included 663 women, with roughly 1 in 4 screening positive for CMD (157, 23.7%). Poor income, low education, food insecurity, and recurrent thoughts after traumatic events were associated with increased risk of positive CMD screen. Perceived stress was closely associated with CMD screening status. Higher education attenuated the relationship between high levels of stress and CMD screening status (82.3%, 88.8%, 32.9%; P value for trend: 0.03). Increasing income and age attenuated the link between moderate stress and CMD. Our findings suggest a high burden of possible CMD among reproductive-aged women from rural western India. Higher education might mitigate the association between elevated stress and CMD. Future efforts to improve mental health in rural India should focus on preventing CMD by enhancing rural women's self-efficacy and problem-solving capabilities to overcome challenging life events and stressors, thereby reducing the risk of CMD. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

Medical challenges at the end of the first ten decades of life.

PubMed

Münzer, Thomas

2017-07-11

Demographic changes worldwide challenge the healthcare system. Advanced age is associated with a number of biological alterations that, together with concomitant comorbidities, increase the risk for functional decline by inducing functional disintegration. In this concept frailty and sarcopenia play an important role. Consequently the preservation of muscle mass and function are prominent targets of medicine in old age. In order to professionally care for persons in their last years of life several other factors influencing medical decisions regarding diagnostic and treatments are important. These factors concern the life expectancy, the person`s functional status the physicians involved in care and the family system. Balancing between over- and undertreatment in very old patients can be optimised by a goal-oriented decision making approach. Very old persons with poor decision making capacity might benefit from decisions made in a team. To be able to manage the challenges associated with the last decade of life, we need physicians who have the knowledge, the appropriate attitude towards frail old patients and the skills to communicate with different groups involved in care. Ideally old age medicine should become an integrative part of a unified national medical curriculum.

Fecal Near Infrared Spectroscopy to Discriminate Physiological Status in Giant Pandas

PubMed Central

Wiedower, Erin E.; Kouba, Andrew J.; Vance, Carrie K.; Hansen, Rachel L.; Tolleson, Douglas R.

2012-01-01

Giant panda (Ailuropoda melanoleuca) monitoring and research often require accurate estimates of population size and density. However, obtaining these estimates has been challenging. Innovative technologies, such as fecal near infrared reflectance spectroscopy (FNIRS), may be used to differentiate between sex, age class, and reproductive status as has been shown for several other species. The objective of this study was to determine if FNIRS could be similarly used for giant panda physiological discriminations. Based on samples from captive animals in four U.S. zoos, FNIRS calibrations correctly identified 78% of samples from adult males, 81% from adult females, 85% from adults, 89% from juveniles, 75% from pregnant and 70% from non-pregnant females. However, diet had an impact on the success of the calibrations. When diet was controlled for plant part such that “leaf only” feces were evaluated, FNIRS calibrations correctly identified 93% of samples from adult males and 95% from adult females. These data show that FNIRS has the potential to differentiate between the sex, age class, and reproductive status in the giant panda and may be applicable for surveying wild populations. PMID:22719982

Child's Challenging Behaviour Scale, Version 2 (CCBS-2): Psychometric Evaluation With Young Children.

PubMed

Bourke-Taylor, Helen; Pallant, Julie; Cordier, Reinie

In this article, we evaluate psychometric properties of the Child's Challenging Behaviour Scale, Version 2 (CCBS-2) with mothers of young, typically developing children. A cross-sectional mail survey with Australian mothers (N = 337) included the CCBS-2, the Depression Anxiety Stress Scales, and the Parents' Evaluation of Developmental Status scale. Internal consistency was good, and no gender differences in CCBS-2 scores were significant. Significant results included differences between CCBS-2 scores: among children grouped according to age, among children grouped according to pre- and post-school entry, among mothers grouped according to extent of any symptom type, and between this sample and a previously collected age-matched sample of children with disabilities. Of the properties tested, results support sound psychometrics. The CCBS-2 can be used to differentiate children according to age, school entry, and disability as well as to identify families for potential services in behavior management and mental health. Copyright © 2017 by the American Occupational Therapy Association, Inc.

Ageing alters the impact of nutrition on immune function.

PubMed

Yaqoob, Parveen

2017-08-01

Immunosenescence during ageing is a major challenge which weakens the ability of older individuals to respond to infection or vaccination. There has been much interest in dietary strategies to improve immunity in older people, but there is an assumption that modulation of the immune response in older people will be based on the same principles as for younger adults. Recent evidence suggests that ageing fundamentally alters the impact of nutrition on immune function. As a result, interpretation of data from studies investigating the impact of diet on immune function is highly dependent on subject age. Study design is critically important when investigating the efficacy of dietary components, and most studies involving older people include rigorous inclusion/exclusion criteria based on medical history, laboratory tests, general health status and often nutritional status. However, immunological status is rarely accounted for, but can vary significantly, even amongst healthy older people. There are several clear examples of age-related changes in immune cell composition, phenotype and/or function, which can directly alter the outcome of an intervention. This review uses two case studies to illustrate how the effects of n-3 PUFA and probiotics differ markedly in young v. older subjects. Evidence from both suggests that baseline differences in immunosenescence influence the outcome of an intervention, highlighting the need for detailed immunological characterisation of subjects prior to interventions. Finally, future work elucidating alterations in metabolic regulation within cells of the immune system as a result of ageing may be important in understanding the impact of diet on immune function in older people.

Attachment status and salivary cortisol in a normal day and during simulated interpersonal stress in young men.

PubMed

Rifkin-Graboi, Anne

2008-05-01

Attachment insecurity, as assessed via the adult attachment interview (AAI), may be expected to relate to basal hypothalamic-pituitary-adrenal (HPA) activity because it is retrodictive of stressful early experiences, which may influence HPA development. In addition, because AAI insecurity may reflect limitations on concurrent cognitive, emotional, and behavioral strategies for managing interpersonal distress, insecurity may also relate to cortisol reactivity specifically during inter-personal challenges. Nevertheless, only two studies have examined associations between AAI insecurity and cortisol, and in total only eight non-clinical men were included. To expand upon past research, the current study focused on college aged men and examined relations between attachment status (via categories and continuous scores) and cortisol levels during daily life and during interpersonal laboratory challenges, wherein subjects were asked to visualize and respond to hypothetical situations concerning loss, separation, and abandonment. Unlike prior research, salivary cortisol was measured during cognitive challenges (e.g. non-autobiographical memory tests), so as to inform questions concerning the specificity of effects. Contrary to expectations, only limited evidence suggested a relation between insecurity and basal HPA functioning. However, in keeping with expectations, associations between insecurity, and in particular dismissing idealization, and comparatively higher cortisol values following interpersonal challenges were observed.

Rise in childhood obesity with persistently high rates of undernutrition among urban school-aged Indo-Asian children.

PubMed

Jafar, T H; Qadri, Z; Islam, M; Hatcher, J; Bhutta, Z A; Chaturvedi, N

2008-05-01

Childhood obesity is an emerging global public health challenge. Evidence for the transition in nutrition in Indo-Asian developing countries is lacking. We conducted these analyses to determine the trends in nutritional status of school-aged children in urban Pakistan. Data on the nutritional status of children aged 5 to 14 years from two independent population-based representative surveys, the urban component of the National Health Survey of Pakistan (NHSP; 1990-1994) and the Karachi survey (2004-2005), were analysed. Using normative data from children in the United States as the reference, trends for age- and gender-standardised prevalence (95% CI) of underweight (more than 2 SD below the weight-for-age reference), stunted (more than 2 SD below the height-for-age reference) and overweight and obese (body mass index (BMI) 85(th) percentile or greater) children were compared for the two surveys. The association between physical activity and being overweight or obese was analysed in the Karachi survey using logistical regression analysis. 2074 children were included in the urban NHSP and 1675 in the Karachi survey. The prevalence of underweight children was 29.7% versus 27.3% (p = 0.12), stunting was 16.7% versus 14.3% (p = 0.05), and prevalence of overweight and obese children was 3.0 versus 5.7 (p<0.001) in the NHSP and Karachi surveys, respectively. Physical activity was inversely correlated with being overweight or obese (odds ratio, 95% CI, 0.51, 0.32-0.80 for those who engaged in more than 30 minutes of physical activity versus those engaged in less than 30 minutes' activity). Our study highlights the challenge faced by Pakistani school-aged children. There has been a rapid rise in the number of overweight and obese children despite a persistently high burden of undernutrition. Focus on prevention of obesity in children must include strategies for promoting physical activity.

Rise in childhood obesity with persistently high rates of undernutrition among urban school-aged Indo-Asian children

PubMed Central

Jafar, T H; Qadri, Z; Islam, M; Hatcher, J; Bhutta, Z A; Chaturvedi, N

2008-01-01

Background: Childhood obesity is an emerging global public health challenge. Evidence for the transition in nutrition in Indo-Asian developing countries is lacking. We conducted these analyses to determine the trends in nutritional status of school-aged children in urban Pakistan. Methods: Data on the nutritional status of children aged 5 to 14 years from two independent population-based representative surveys, the urban component of the National Health Survey of Pakistan (NHSP; 1990–1994) and the Karachi survey (2004–2005), were analysed. Using normative data from children in the United States as the reference, trends for age- and gender-standardised prevalence (95% CI) of underweight (more than 2 SD below the weight-for-age reference), stunted (more than 2 SD below the height-for-age reference) and overweight and obese (body mass index (BMI) 85th percentile or greater) children were compared for the two surveys. The association between physical activity and being overweight or obese was analysed in the Karachi survey using logistical regression analysis. Results: 2074 children were included in the urban NHSP and 1675 in the Karachi survey. The prevalence of underweight children was 29.7% versus 27.3% (p = 0.12), stunting was 16.7% versus 14.3% (p = 0.05), and prevalence of overweight and obese children was 3.0 versus 5.7 (p<0.001) in the NHSP and Karachi surveys, respectively. Physical activity was inversely correlated with being overweight or obese (odds ratio, 95% CI, 0.51, 0.32–0.80 for those who engaged in more than 30 minutes of physical activity versus those engaged in less than 30 minutes’ activity). Conclusions: Our study highlights the challenge faced by Pakistani school-aged children. There has been a rapid rise in the number of overweight and obsese children despite a persistently high burden of undernutrition. Focus on prevention of obesity in children must include strategies for promoting physical activity. PMID:17942586

The emerging phenotype of long-term survivors with infantile Pompe disease

PubMed Central

Prater, Sean N.; Banugaria, Suhrad G.; DeArmey, Stephanie M.; Botha, Eleanor G.; Stege, Erin M.; Case, Laura E.; Jones, Harrison N.; Phornphutkul, Chanika; Wang, Raymond Y.; Young, Sarah P.; Kishnani, Priya S.

2013-01-01

Purpose Enzyme replacement therapy with alglucosidase alfa for infantile Pompe disease has improved survival creating new management challenges. We describe an emerging phenotype in a retrospective review of long-term survivors. Methods Inclusion criteria included ventilator-free status and age ≤6 months at treatment initiation, and survival to age ≥5 years. Clinical outcome measures included invasive ventilator-free survival and parameters for cardiac, pulmonary, musculoskeletal, gross motor and ambulatory status; growth; speech, hearing, and swallowing; and gastrointestinal and nutritional status. Results Eleven of 17 patients met study criteria. All were cross-reactive immunologic material-positive, alive, and invasive ventilator-free at most recent assessment, with a median age of 8.0 years (range: 5.4 to 12.0 years). All had marked improvements in cardiac parameters. Commonly present were gross motor weakness, motor speech deficits, sensorineural and/or conductive hearing loss, osteopenia, gastroesophageal reflux disease, and dysphagia with aspiration risk. Seven of 11 patients were independently ambulatory and four required the use of assistive ambulatory devices. All long-term survivors had low or undetectable anti-alglucosidase alfa antibody titers. Conclusions Long-term survivors exhibited sustained improvements in cardiac parameters and gross motor function. Residual muscle weakness, hearing loss, risk for arrhythmias, hypernasal speech, dysphagia with risk for aspiration, and osteopenia were commonly observed findings. PMID:22538254

The association between glucose challenge test level and fetal nutritional status.

PubMed

Leng, J Junhong; Liu, Gongshu; Wang, Jing; Li, Weiqin; Liu, Huihuan; She, Ye; Liu, Jian

2014-03-01

To examine the relationship between maternal glucose challenge test (GCT) levels and fetal nutritional status index (FNSI: a ratio of child's birth weight (kg) over squared maternal height (m(2)). A total of 2193 women from the Beichen district, Tianjin, China, who had 50 g GCT at gestational age 24-28 weeks, gave a full-term singleton birth between June 2011 and October 2012, and with both maternal height and birth weight measures are included in this report. Approximately 28.0% of women had a GCT ≥ 7.8 mmol/L. The newborns of mothers with a GCT ≥ 7.8 mmol/L had significantly higher level of FNSI ([kg/m(2)], boys: 1.336 versus 1.296, p < 0.001; girls: 1.312 versus 1.268, p < 0.0001). Logistic regression results, after adjustment for maternal age, residence, education, nationality, history of disease and reproduction, insurance and gestational age, indicated that every unit increase in FNSI was associated with approximately threefold higher odds (OR [95% CI]: 3.6 [1.5, 8.9]) of being in GCT ≥ 7.8 mmol/L for women giving birth as boys and fivefold higher odds (5.9 [2.5, 14.1]) for giving birth as girls. Women with a GCT ≥ 7.8 mmol/L have babies with a higher FNSI, suggesting that these infants may be overnourished before birth and may increase cardiovascular risk in their future.

Evaluation of smoking status identification using electronic health records and open-text information in a large mental health case register.

PubMed

Wu, Chia-Yi; Chang, Chin-Kuo; Robson, Debbie; Jackson, Richard; Chen, Shaw-Ji; Hayes, Richard D; Stewart, Robert

2013-01-01

High smoking prevalence is a major public health concern for people with mental disorders. Improved monitoring could be facilitated through electronic health record (EHR) databases. We evaluated whether EHR information held in structured fields might be usefully supplemented by open-text information. The prevalence and correlates of EHR-derived current smoking in people with severe mental illness were also investigated. All cases had been referred to a secondary mental health service between 2008-2011 and received a diagnosis of schizophreniform or bipolar disorder. The study focused on those aged over 15 years who had received active care from the mental health service for at least a year (N=1,555). The 'CRIS-IE-Smoking' application used General Architecture for Text Engineering (GATE) natural language processing software to extract smoking status information from open-text fields. A combination of CRIS-IE-Smoking with data from structured fields was evaluated for coverage and the prevalence and demographic correlates of current smoking were analysed. Proportions of patients with recorded smoking status increased from 11.6% to 64.0% through supplementing structured fields with CRIS-IE-Smoking data. The prevalence of current smoking was 59.6% in these 995 cases for whom this information was available. After adjustment, younger age (below 65 years), male sex, and non-cohabiting status were associated with current smoking status. A natural language processing application substantially improved routine EHR data on smoking status above structured fields alone and could thus be helpful in improving monitoring of this lifestyle behaviour. However, limited information on smoking status remained a challenge.

Nutritional status in pregnant adolescents: a systematic review of biochemical markers.

PubMed

Moran, Victoria Hall

2007-04-01

Adolescent pregnancy is a major public health challenge for many industrialized countries and is associated with significant medical, nutritional, social and economic risk for mothers and their infants. Despite this, relatively little is known about the nutritional status of this population. The aim of this paper was to conduct a systematic review of the current evidence relating to the biochemical markers of nutritional status of pregnant adolescents living in industrialized countries. Six papers were identified that fulfilled the inclusion criteria, the majority of which were conducted in the United States. The studies were of variable quality and most failed to control for potential confounders which may have strongly influenced the findings. Due to limited research, conclusions cannot be drawn about the zinc and calcium status of pregnant adolescents, and data on folate and vitamin B(12) status appeared conflicting. There was some consensus among studies, however, to suggest that indicators of anaemia and iron status were compromised in pregnant adolescents, particularly during the third trimester of pregnancy. Chronological age did not appear to influence nutritional status, although there was some evidence to suggest that increasing gynaecologic age may positively influence plasma ferritin levels. Current research is limited by sampling and measurement bias, and research is urgently required to address these limitations. Further consideration should also be made of the influence of the role of socio-economic support on pregnant adolescents' nutritional status. The achievement of improved nutrition in pregnancy among adolescents requires multidisciplinary collaborations of adolescent healthcare providers, academics, professional organizations, policymakers, industry and service users. Only once this is achieved can adolescent nutrition, and adolescent nutrition in pregnancy, be significantly and sustainably optimized.

Education and employment status of children and adults with thalassemia in North America.

PubMed

Pakbaz, Zahra; Treadwell, Marsha; Kim, Hae-Young; Trachtenberg, Felicia; Parmar, Nagina; Kwiatkowski, Janet L; Cunningham, Melody J; Martin, Marie; Sweeters, Nancy; Neufeld, Ellis J; Giardina, Patricia J; Olivieri, Nancy; Yamashita, Robert C; Vichinsky, Elliott

2010-10-01

Advances in the management of thalassemia have resulted in increased life expectancy and new challenges. We conducted the first survey of education and employment status of people with thalassemia in North America. A total of 633 patients (349 adults and 284 school age children) enrolled in the Thalassemia Clinical Research Network (TCRN) registry in Canada and the U.S. were included in the data analysis. Predictors considered for analysis were age, gender, race/ethnicity, site of treatment (Canada vs. United States), transfusion and chelation status, serum ferritin, and clinical complications. Seventy percent of adults were employed of which 67% reported working full-time. Sixty percent had a college degree and 14% had achieved some post-college education. Eighty-two percent of school age children were at expected grade level. In a multivariate analysis for adults, Whites (OR = 2.76, 95% CI: 1.50-5.06) were more likely to be employed compared to Asians. Higher education in adults was associated with older age (OR = 1.67, 95% CI: 1.29-2.15), female gender (OR = 2.08, 95% CI: 1.32-3.23) and absence of lung disease (OR = 14.3, 95% CI: 2.04-100). Younger children (OR = 5.7 for 10-year increments, 95% CI: 2.0-16.7) and Canadian patients (OR = 5.6, 95% CI: 1.5-20) were more likely to be at the expected education level. Neither transfusion nor chelation was associated with lower employment or educational achievement. Individuals with thalassemia in North America can achieve higher education; however, full-time employment remains a problem. Transfusion and chelation do not affect employment or education status of this patient population. Copyright 2010 Wiley-Liss, Inc.

Prevalence and Determinants of Premature Menopause among Indian Women: Issues and Challenges Ahead.

PubMed

Jungari, Suresh Banayya; Chauhan, Bal Govind

2017-05-01

Premature menopause refers to the occurrence of menopause in women less than 40 years of age. This heterogeneous disorder affects 1 percent and 0.1 percent of women less than 40 and 30 years of age, respectively. The study reported in this article attempts to understand the prevalence and determinants of premature menopause among Indian women by studying the effects of various socioeconomic indicators, such as age, education, wealth index, rural-urban settlement, work status, religion, and caste, on women. The study analyzed the National Family Health Survey-3, which is equivalent to the Demographic Health Survey in India. Bivariate and logistic regression analyses were performed to tease out the determinants of premature menopause. Results indicate that the percentage of premature menopause is very high (5.5 percent) among Indian women. Among Indian states, Andhra Pradesh women have the highest percentage of premature menopause (14.6 percent). Smoking and the nutritional status of women are strongly associated with early menopause. Furthermore, women living in rural areas and using tobacco are at a greater risk of premature menopause. © 2017 National Association of Social Workers.

The determinants of fat intake in a multi-ethnic New Zealand population. Fletcher Challenge--University of Auckland Heart and Health Study Management Committee.

PubMed

Swinburn, B A; Walter, L; Ricketts, H; Whitlock, G; Law, B; Norton, R; Jackson, R; MacMahon, S

1998-06-01

The New Zealand diet is high in total and saturated fat and this is likely to be contributing to the increasing prevalence of obesity and relatively high rates of coronary heart disease in New Zealand. The identification of subgroups with a high-fat intake will enable nutrition-related public health strategies to be better targeted. Subjects from two surveys were included in the study: 7574 employees from a large multinational workforce survey and 2447 people aged 35-84 years selected from a stratified random sample of the electoral roll in central Auckland. Fat and saturated fat intake were assessed by short questionnaire which gave a dietary fat habits (DFH) score and supplemented by a six-item food frequency questionnaire. The DFH scores were higher in males than in females at all ages, and there was an inverse relationship with age which was stronger for males. Age-adjusted scores showed significantly higher DFH scores for Maori than for Europeans. Lower socioeconomic status was associated with higher DFH scores in males. Current smoking and heavy drinking (in males) were associated with significantly higher DFH scores after controlling for socioeconomic status. The results of the limited food frequency questionnaire supported the trends in DFH scores. The subgroups with high total and saturated fat intakes which should be a priority for public health action are young and middle-aged males, Maori and lower socioeconomic status males. The clustering of high-fat intake with smoking and heavy drinking should be considered when developing preventative strategies.

Living with Genetic Risk: Effect on Adolescent Self-Concept

PubMed Central

McConkie-Rosell, Allyn; Spiridigliozzi, Gail A.; Melvin, Elizabeth; Dawson, Deborah V.; Lachiewicz, Ave M.

2009-01-01

The purpose of this study is to describe the interplay of adolescent girls’ self-concept, coping behaviors, and adjustment associated with knowledge of genetic risk for fragile X syndrome. We will report here findings on self concept. Using a multi-group cross-sectional design this study focused on girls ages 14–25 years from families previously diagnosed with fragile X syndrome, who knew they were 1) carriers (n = 20; mean age 18.35 years s.d. 2.5), or 2) noncarriers (n =18; mean age 17.78 years s.d. 2.69), or 3) at-risk to be carriers (n = 15; mean age 17.87 s.d. 3.18). The girls completed the Tennessee Self Concept Scale (TSCS:2), a visual analog scale, and a guided interview. Total and all subscale scores on the TSCS:2 were in the normal range for all three groups. However, threats to self concept were found in personal self (physical self, genetic identity, and parental role), social self, and family self (family genetic identity) as they specifically related to the meaning of genetic information and varied based on risk status. Our findings suggest that risk information itself is threatening and for some girls, may be as threatening as learning one is a carrier. Certainty related to genetic risk status appears to make a positive difference for some girls by allowing them the opportunity to face the challenge of their genetic risk status and to begin to consider the meaning of this information. PMID:18200514

Practical Application of Linear Growth Measurements in Clinical Research in Low- and Middle-Income Countries

PubMed Central

Wit, Jan M.; Himes, John H.; van Buuren, Stef; Denno, Donna M.; Suchdev, Parminder S.

2017-01-01

Background/Aims Childhood stunting is a prevalent problem in low- and middle-income countries and is associated with long-term adverse neurodevelopment and health outcomes. In this review, we define indicators of growth, discuss key challenges in their analysis and application, and offer suggestions for indicator selection in clinical research contexts. Methods Critical review of the literature. Results Linear growth is commonly expressed as length-for-age or height-for-age z-score (HAZ) in comparison to normative growth standards. Conditional HAZ corrects for regression to the mean where growth changes relate to previous status. In longitudinal studies, growth can be expressed as ΔHAZ at 2 time points. Multilevel modeling is preferable when more measurements per individual child are available over time. Height velocity z-score reference standards are available for children under the age of 2 years. Adjusting for covariates or confounders (e.g., birth weight, gestational age, sex, parental height, maternal education, socioeconomic status) is recommended in growth analyses. Conclusion The most suitable indicator(s) for linear growth can be selected based on the number of available measurements per child and the child's age. By following a step-by-step algorithm, growth analyses can be precisely and accurately performed to allow for improved comparability within and between studies. PMID:28196362

Activities of daily living, instrumental activities for daily living and predictors of functional capacity of older men in Jamaica

PubMed Central

Bourne, Paul Andrew

2009-01-01

Background: An extensive search of the literature found no studies that have examined functional capacity [Activities of Daily Living (ADL) and Instrumental Activities for Daily Living (I) ADL)] of Jamaican older men as well as factors that determine their functional capacity. Aims: The current study examines 1) ADL, 2) (I) ADL), 3) self-reported health status, 4) functional capacity, and 5) factors that determine functional capacity of older men. Methods and Method: Stratified multistage probability sampling technique was used to draw a sample of 2,000 55+ year men. A132-item questionnaire was used to collect the data. Descriptive statistics provide background information on the sample, cross tabulations were used to examine non-metric variables and logistic regression provides a model of predictors of functional capacity. Result: Fifty-five percent of sample indicated good current health status. Four percent was mostly satisfied with life; 21.7% had moderate dependence; 77.1% had high dependence (i.e. independence); 1.2% had low dependence; 21.9% were ages 75 years and older; 35.6% were ages 65 to 74 years and 42.6% reported ages 55 to 64 years. Functional capacity can be determined by church attendance (β=0.245; 95% CI: 0.264, 1.291); social support (β=0.129; 95% CI: 0.129, 0.258), area of residence (β=-0.060; 95% CI: -0.427, -0.061) and lastly by age of respondents. Conclusion: Ageing in explains deterioration in their (I) ADL, suggesting the challenges of ageing men's independence. More rural men were rarely satisfied with life; but more of them had a greater functional capacity than urban men. Depression was found to negatively relate to functional capacity, and church attendees had a greater functional status than non-attendees. PMID:22666693

La atencion preescolar en Chile: desafios para la redemocratizacion (Preschool Care in Chile: Challenges for Redemocratization. Discussion Paper No. 13).

ERIC Educational Resources Information Center

Filp, Johanna; Undurrage, Consuelo

This paper examines the current status of programs for preschool children in Chile. Section 1 of the paper provides an overview of the situation of preschool children in Chile. The country's population includes more than 1.6 million children between the ages of 0 and 5 years 11 months, and in urban areas, 18.4 percent of children between the ages…

Nutritional Strategies Facing an Older Demographic: The Nutrition UP 65 Study Protocol

PubMed Central

2016-01-01

Background The population of Portugal is aging. The lack of data on older adults’ nutritional status and the lack of nutrition knowledge amongst health professionals, caregivers, and older adults themselves, remains a challenge. Objective The Nutrition UP 65 study aims to reduce nutritional inequalities in the older Portuguese adult population and improve knowledge regarding older Portuguese adults’ nutritional status, specifically relating to undernutrition, obesity, sarcopenia, frailty, hydration, sodium, and vitamin D statuses. Methods A representative sample of older Portuguese adults was selected. Sociodemographic, lifestyle, anthropometric, functional, and clinical data were collected. Sodium excretion, hydration, and vitamin D statuses were assessed. Results Data collection (n=1500) took place between December, 2015 and June, 2016. Results will be disseminated in national and international scientific journals, and via Portuguese media. Conclusions Nutrition UP 65 results will provide evidence for the design and implementation of effective preventive public health strategies regarding the elderly. These insights may represent relevant health gains and costs savings. PMID:27628097

Triglycerides and carotid intima-media thickness in ischemic stroke patients.

PubMed

Batluk, Jana; Leonards, Christopher O; Grittner, Ulrike; Lange, Kristin Sophie; Schreiber, Stephan J; Endres, Matthias; Ebinger, Martin

2015-11-01

Common carotid artery intima-media thickness (CCA-IMT) is an established marker for atherosclerosis. The role of triglycerides in CCA-IMT remains controversial. We sought to determine if elevated fasting and post-challenge triglycerides are associated with CCA-IMT. All acute ischemic stroke patients who participated in the Berlin "Cream & Sugar" study in the Charité Virchow and Charité Mitte Campuses between January 2009 and January 2014 and underwent carotid artery ultrasound studies were eligible for inclusion. A combined oral glucose and triglyceride tolerance test was performed 3-7 days after first ever ischemic stroke. Patients were classified according to triglyceride metabolism-namely, (1) patients reaching a maximum triglyceride levels 3 h post-challenge ("fast metabolizers," n = 37), (2) patients with increasing triglycerides 4 (medium metabolizers, n = 64), and (3) 5 h post-challenge ("slow metabolizers," n = 44; 13 missing). We included 158 patients (34% female; mean age 63 years, SD 14). Absolute non-fasting triglyceride levels were positively associated with CCA-IMT. A final multiple regression model revealed that older age, more severe strokes, and higher levels of fasting triglycerides were significantly and independently associated with higher mean CCA-IMT. Older age, higher waist-to-hip ratio, and higher levels of thyroid-stimulating hormone were independently associated with higher maximum CCA-IMT. Fasting triglycerides but not post-challenge triglycerides associate with CCA-IMT. An oral fat challenge may not add information on atherosclerotic status in ischemic stroke patients. The Berlin "Cream & Sugar" study is registered with EudraCT (2009-010356-97) and clinicaltrials.gov (NCT 01378468). Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

The multidimensional background of malnutrition among rural older individuals in Bangladesh--a challenge for the Millennium Development Goal.

PubMed

Ferdous, Tamanna; Kabir, Zarina Nahar; Wahlin, Ake; Streatfield, Kim; Cederholm, Tommy

2009-12-01

To investigate the associations and relative impact of illness, socio-economic and social indicators for nutritional status among elderly persons in rural Bangladesh. A multidisciplinary, cross-sectional study employing home interviews to collect information on demographic, socio-economic and social status; clinical examination to classify medical diagnoses; and Mini Nutritional Assessment (MNA) to assess the nutritional status of each participant. Matlab, Bangladesh. A total of 625 randomly selected individuals (>or=60 years of age) participated in home interviews and 473 underwent clinical examination. Complete information on nutritional status was available for 457 individuals, median age 68 years, 55 % women. Twenty-six per cent of the elderly participants were undernourished and 62 % were at risk of malnutrition according to MNA. More than three-quarters of the participants had acute infections, 66 % suffered from chronic illnesses, 36 % had sensory impairments and 81 % were suffering from gastrointestinal disorders. Acute infections (P < 0.001), gastrointestinal disorders (P < 0.01), depressive symptoms (P < 0.001) and impaired cognitive function (P < 0.01) were significantly and independently associated with poorer nutritional status. Moreover, female gender (P < 0.05), having no income (P < 0.01), being illiterate (P < 0.01) and not receiving regular financial support (P < 0.05) were also independently associated with poor nutritional status. Malnutrition among elderly people in rural Bangladesh is associated with female gender, medical, psychological, socio-economic and social indicators. A multidimensional approach is probably needed to reduce undernutrition in older populations in low-income countries like Bangladesh.

Recruitment methods in a clinical trial of provoked vulvodynia: Predictors of enrollment.

PubMed

Bachour, Candi C; Bachmann, Gloria A; Foster, David C; Wan, Jim Y; Rawlinson, Leslie A; Brown, Candace S

2017-02-01

Successful recruitment in clinical trials for chronic pain conditions is challenging, especially in women with provoked vulvodynia due to reluctance in discussing pain associated with sexual intercourse. The most successful recruitment methods and the characteristics of women reached with these methods are unknown. To compare the effectiveness and efficiency of four recruitment methods and to determine socioeconomic predictors for successful enrollment in a National Institutes of Health-sponsored multicenter clinical trial evaluating a gabapentin intervention in women with provoked vulvodynia. Recruitment methods utilized mass mailing, media, clinician referrals and community outreach. Effectiveness (number of participants enrolled) and efficiency (proportion screened who enrolled) were determined. Socioeconomic variables including race, educational level, annual household income, relationship status, age, menopausal status and employment status were also evaluated regarding which recruitment strategies were best at targeting specific cohorts. Of 868 potential study participants, 219 were enrolled. The most effective recruitment method in enrolling participants was mass mailing ( p < 0.001). There were no statistically significant differences in efficiency between recruitment methods ( p = 0.11). Relative to clinician referral, black women were 13 times as likely to be enrolled through mass mailing (adjusted odds ratio 12.5, 95% confidence interval, 3.6-43.1) as white women. There were no differences in enrollment according to educational level, annual income, relationship status, age, menopausal status, or employment status and recruitment method. In this clinical trial, mass mailing was the most effective recruitment method. Race of participants enrolled in a provoked vulvodynia trial was related to the recruitment method.

Evaluation of Smoking Status Identification Using Electronic Health Records and Open-Text Information in a Large Mental Health Case Register

PubMed Central

Wu, Chia-Yi; Chang, Chin-Kuo; Robson, Debbie; Jackson, Richard; Chen, Shaw-Ji; Hayes, Richard D.; Stewart, Robert

2013-01-01

Background High smoking prevalence is a major public health concern for people with mental disorders. Improved monitoring could be facilitated through electronic health record (EHR) databases. We evaluated whether EHR information held in structured fields might be usefully supplemented by open-text information. The prevalence and correlates of EHR-derived current smoking in people with severe mental illness were also investigated. Methods All cases had been referred to a secondary mental health service between 2008-2011 and received a diagnosis of schizophreniform or bipolar disorder. The study focused on those aged over 15 years who had received active care from the mental health service for at least a year (N=1,555). The ‘CRIS-IE-Smoking’ application used General Architecture for Text Engineering (GATE) natural language processing software to extract smoking status information from open-text fields. A combination of CRIS-IE-Smoking with data from structured fields was evaluated for coverage and the prevalence and demographic correlates of current smoking were analysed. Results Proportions of patients with recorded smoking status increased from 11.6% to 64.0% through supplementing structured fields with CRIS-IE-Smoking data. The prevalence of current smoking was 59.6% in these 995 cases for whom this information was available. After adjustment, younger age (below 65 years), male sex, and non-cohabiting status were associated with current smoking status. Conclusions A natural language processing application substantially improved routine EHR data on smoking status above structured fields alone and could thus be helpful in improving monitoring of this lifestyle behaviour. However, limited information on smoking status remained a challenge. PMID:24069288

Iron status in pregnant women and women of reproductive age in Europe.

PubMed

Milman, Nils; Taylor, Christine L; Merkel, Joyce; Brannon, Patsy M

2017-12-01

Understanding the iron status in pregnant women in Europe provides a foundation for considering the role of iron screening and supplementation. However, available reports and studies have used different approaches that challenge the devising of overall summaries. Moreover, data on pregnant women are limited, and thus, data on women of reproductive age provide useful background information including baseline iron stores in pregnant women. This review considered data that are available from >15 European countries including national surveys and relevant clinical studies. In European women of reproductive age, median or geometric mean serum ferritin (SF) concentrations were estimated at 26-38 μg/L. Approximately 40-55% of this population had small or depleted iron stores (i.e., SF concentration ≤30 μg/L), and 45-60% of this population had apparently replete iron stores. The prevalence of iron deficiency (ID) and iron deficiency anemia (IDA) was 10-32% and 2-5%, respectively, depending on the cutoffs used. Approximately 20-35% of European women of reproductive age had sufficient iron stores (SF concentration >70 μg/L) to complete a pregnancy without supplementary iron. During pregnancy, European women in controlled supplementation trials who were not receiving iron supplements displayed increasing prevalences of ID and IDA during pregnancy, which peaked in the middle to late third trimester. Available evidence has suggested that, in gestational weeks 32-39, the median or geometric mean SF concentrations were 6-21 μg/L, and prevalences of ID and IDA were 28-85% and 21-35%, respectively. Women who were taking iron supplements had higher iron status and lower prevalences of ID and IDA, which were dependent on the dose of iron and compliance. The data suggest that, in Europe, the iron status of reproductive-aged women varies by region and worsens in pregnancy without iron supplementation. © 2017 American Society for Nutrition.

Assignment of cytomegalovirus infection status in infants awaiting solid organ transplant: Viral detection methods as adjuncts to serology.

PubMed

Burton, Catherine E; Dragan, Tatiana; Mabilangan, Curtis A; O'Brien, Sheila F; Fearon, Margaret; Scalia, Vito; Preiksaitis, Jutta K

2018-05-24

Assignment of CMV infection status in infants awaiting SOT is challenging as passive maternal antibody can lead to false-positive serology. Since 2000, our protocol has recommended sending throat and urine samples for CMV viral detection, culture, or NAAT, for CMV-seropositive infants <18 months awaiting SOT. We reviewed pretransplant CMV serology for 152 infants and, for CMV seropositives, examined relationships between CMV IgG OD values, age, and CMV viral detection to explore time to clearance of maternal CMV IgG and evaluate viral detection in assignment of pretransplant CMV infection status. The proportion of CMV-seropositive infants decreased from 52% in infants 0-6 months of age to 28% in those 12-18 months. Among CMV-seropositive infants, median OD was significantly higher in the 6- to 12- and 12- to 18-month groups compared to the 0- to 6-month group. Distribution of OD by age group suggested that maternal antibody cleared before 12 months. Of 59 eligible CMV-seropositive infants, 49 (83%) had CMV viral detection studies and 18 of 49 (36.7%) had detectable CMV: 9 of 30 (30.0%) infants 0-6 months, 7 of 15 (46.7%) infants 6-12 months, and 2 of 4 (50.0%) infants 12-18 months. CMV viral detection studies are useful to confirm positive CMV infection status in CMV-seropositive infants awaiting SOT. Maternal CMV IgG likely clears before 12 months. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Impact of elimination diets on growth and nutritional status in children with multiple food allergies.

PubMed

Berry, Melissa J; Adams, Jennifer; Voutilainen, Helena; Feustel, Paul J; Celestin, Jocelyn; Järvinen, Kirsi M

2015-03-01

Impairment of growth has been reported in food-allergic children. It is not known whether this is related to the extent of food allergies. We sought to compare growth, nutritional status, and nutrient intake in children with food allergy either avoiding cow's milk or avoiding cow's milk and wheat, which are staples of the diet in young children. Infants and young children with challenge-proven allergy were recruited to this prospective study. They were strictly avoiding their allergic food triggers, either cow's milk, or cow's milk and wheat. They were counseled by a dietitian specialized in food allergies on food avoidance diets and nutritionally adequate supplementation at regular intervals. A 3-day food diary was kept. Children's height, weight, and laboratory data for nutritional parameters were monitored at 8-month intervals. A total of 18 patients avoiding milk and 28 patients avoiding milk and wheat were evaluated at an average of 12, 21, and 28 months of age. During the follow-up, the markers of nutritional status, nutrient intake or height for age, and weight for height were comparable between the two groups, although the means for anthropometric measures were below the average for age in both groups. The extent of food elimination diet has no impact on growth or nutritional status of food-allergic children, when diet is adequately supplemented. Close physician and dietitian follow-up are essential for food-allergic children when avoiding one or more foods, which are staples of the diet. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

The prevalence of underweight, overweight, obesity and associated risk factors among school-going adolescents in seven African countries.

PubMed

Manyanga, Taru; El-Sayed, Hesham; Doku, David Teye; Randall, Jason R

2014-08-28

The burden caused by the coexistence of obesity and underweight in Low and Middle Income Countries is a challenge to public health. While prevalence of underweight among youth has been well documented in these countries, overweight, obesity and their associated risk factors are not well understood unlike in high income countries. Cross-sectional data from the Global School-based Student Health Survey (GSHS) conducted in seven African countries were used for this study. The survey used a clustered design to obtain a representative sample (n = 23496) from randomly selected schools. 53.6% of the sample was male, and participants ranged in age from 11-17 years old. Body Mass Index (BMI) was calculated using age and sex adjusted self-reported heights and weights. Classification of weight status was based on the 2007 World Health Organization growth charts (BMI-for-age and sex). Multivariable Logistic Regression reporting Odds Ratios was used to assess potential risk factors on BMI, adjusting for age, sex, and country. Statistical analyses were performed with Stata with an alpha of 0.05 and reporting 95% confidence intervals. Unadjusted rates of being underweight varied from 12.6% (Egypt) to 31.9% (Djibouti), while being overweight ranged from 8.7% (Ghana) to 31.4% (Egypt). Obesity rates ranged from 0.6% (Benin) to 9.3% (Egypt). Females had a higher overweight prevalence for every age group in five of the countries, exceptions being Egypt and Malawi. Overall, being overweight was more prevalent among younger (≤12) adolescents and decreased with age. Males had a higher prevalence of being underweight than females for every country. There was a tendency for the prevalence of being underweight to increase starting in the early teens and decrease between ages 15 and 16. Most of the potential risk factors captured by the GSHS were not significantly associated with weight status. The prevalence of both overweight and underweight was relatively high, demonstrating the existence of the double burden of malnutrition among adolescents in developing countries. Several factors were not associated with weight status suggesting the need to explore other potential risk factors for overweight and underweight, including genetic factors and socioeconomic status.

Sepsis in Older Adults.

PubMed

Rowe, Theresa A; McKoy, June M

2017-12-01

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

[Current situation and reflection on the prevention and treatment of burns in the elderly].

PubMed

Zhang, J P; Huang, Y S

2017-09-20

With ageing of the population, it is estimated that the percentage of old people aged above 65 years old will be approached to 30% in China by 2035. This presents a considerable challenge to geriatric burn treatment, as elderly burn patients have more serious injuries, longer hospital lengths of stay, and higher rates of complications and mortality. In this article, we analyze the current status of burns in the elderly in China and the factors contributing to the outcome of the elderly, and put forward therapeutic strategies so as to improve the level of prevention and treatment of burns in the elderly.

Stereotactic Radiosurgery and Hypofractionated Radiotherapy for Glioblastoma.

PubMed

Shah, Jennifer L; Li, Gordon; Shaffer, Jenny L; Azoulay, Melissa I; Gibbs, Iris C; Nagpal, Seema; Soltys, Scott G

2018-01-01

Glioblastoma is the most common primary brain tumor in adults. Standard therapy depends on patient age and performance status but principally involves surgical resection followed by a 6-wk course of radiation therapy given concurrently with temozolomide chemotherapy. Despite such treatment, prognosis remains poor, with a median survival of 16 mo. Challenges in achieving local control, maintaining quality of life, and limiting toxicity plague treatment strategies for this disease. Radiotherapy dose intensification through hypofractionation and stereotactic radiosurgery is a promising strategy that has been explored to meet these challenges. We review the use of hypofractionated radiotherapy and stereotactic radiosurgery for patients with newly diagnosed and recurrent glioblastoma. Copyright © 2017 by the Congress of Neurological Surgeons.

Walk the Talk: Characterizing Mobility in Older Adults Living on Low Income.

PubMed

Chudyk, Anna M; Sims-Gould, Joanie; Ashe, Maureen C; Winters, Meghan; McKay, Heather A

2017-06-01

We provide an in-depth description of the mobility (capacity and enacted function, i.e., physical activity and travel behaviour) of community-dwelling older adults of low socioeconomic status. Participants [n = 161, mean age (range) = 74 (65-96) years] completed interviewer-administered questionnaires and objective measures of mobility. Our findings did not generally indicate that older adults of low socioeconomic status have a reduced capacity to be mobile. Participants presented with positive profiles across physical, psychosocial, and social environment domains that influence the capacity to be mobile. They also made a high proportion of trips by foot, although these did not together serve to meet physical activity guidelines for most. We challenge future researchers to focus on innovative strategies to recruit this difficult-to-access population, to consider the influence of socioeconomic status across the lifespan, and the role of behaviour-driven agency when investigating the association between the person, environment, and older adult mobility.

Achilles lengthening/posterior tibial tenotomy with immediate weightbearing for patients with significant comorbidities.

PubMed

Redfern, John C; Thordarson, David B

2008-03-01

Fixed equinovarus deformities can be challenging to treat especially in medically debilitated patients. The purpose of this study was to evaluate Achilles lengthening with posterior tibial tenotomy and immediate weightbearing in this difficult group of patients. Thirteen extremities in 10 patients underwent Achilles lengthening and posterior tibial tenotomy for fixed equinovarus deformities with significant medical comorbidities. Pre- and postoperative ambulatory status and deformities were noted. Average age at the time of surgery was 65 with an average duration of deformity 6.3 years. The average equinus corrected from 26 degrees to 1.2 degrees and the average varus deformity improved from -8.5 degrees to 2.7 degrees. All patients except one who was wheelchair-bound had a significant improvement in ambulatory status. Achilles lengthening with posterior tibial tenotomy allowed for immediate postoperative weightbearing with improvement in deformity and ambulatory status in this complicated patient group.

The decay of Redox-stress Response Capacity is a substantive characteristic of aging: Revising the redox theory of aging.

PubMed

Meng, Jiao; Lv, Zhenyu; Qiao, Xinhua; Li, Xiaopeng; Li, Yazi; Zhang, Yuying; Chen, Chang

2017-04-01

Aging is tightly associated with redox events. The free radical theory of aging indicates that redox imbalance may be an important factor in the aging process. Most studies about redox and aging focused on the static status of oxidative stress levels, there has been little research investigating differential responses to redox challenge during aging. In this study, we used Caenorhabditis elegans and human fibroblasts as models to compare differential responses to oxidative stress challenge in young and old individuals. In response to paraquat stress, young individuals generated more ROS and activated signaling pathways including p-ERK, p-AKT and p-AMPKα/β. After the initial response, young individuals then promoted NRF2 translocation and induced additional antioxidant enzymes and higher expression of phase II enzymes, including SOD, CAT, GPX, HO-1, GSTP-1and others, to maintain redox homeostasis. Moreover, young individuals also demonstrated a better ability to degrade damaged proteins by up-regulating the expression of chaperones and improving proteasome activity. Based on these data, we propose a new concept "Redox-stress Response Capacity (RRC)", which suggests cells or organisms are capable of generating dynamic redox responses to activate cellular signaling and maintain cellular homeostasis. The decay of RRC is the substantive characteristic of aging, which gives a new understand of the redox theory of aging. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.

Mutation status of the mediator complex subunit 12 (MED12) in uterine leiomyomas and concurrent/metachronous multifocal peritoneal smooth muscle nodules (leiomyomatosis peritonealis disseminata).

PubMed

Rieker, Ralf J; Agaimy, Abbas; Moskalev, Evgeny A; Hebele, Simone; Hein, Alexander; Mehlhorn, Grit; Beckmann, Matthias W; Hartmann, Arndt; Haller, Florian

2013-06-01

The pathogenesis and classification of multicentric smooth muscle tumours with benign appearance and concurrent/metachronous uterine and peritoneal involvement is controversial and may on occasion be diagnostically challenging. Leiomyomatosis peritonealis disseminata (LPD) is a rare condition affecting women of reproductive age, characterised by the occurrence of multiple small peritoneal smooth muscle nodules with bland histology. We investigated a total of 12 uterine and seven concurrent/metachronous peritoneal smooth muscle nodules with benign appearance from two females for mutations in the mediator complex subunit 12 (MED12), which has recently been identified as the most frequent genetic aberration in uterine leiomyomas. The first case harboured different MED12 mutations in the peritoneal nodules. Mutational status of peritoneal nodules was discordant with that of the uterine leiomyomas. The second case displayed the same MED12 mutation in all five peritoneal nodules, but this mutation was not detected in her current uterine leiomyomas. Our results suggest that smooth muscle neoplasms with benign appearance of the primary and secondary müllerian system share a similar genetic background of MED12 mutation in combination with oestrogen dependency. Analysis of MED12 mutation status might be a valuable adjunct tool for the future classification of these sometimes diagnostically challenging multicentric tumours.

Direct seeding southern pines: history and status of a technique developed for restoring cutover forests

Treesearch

J.P. Barnett

2014-01-01

Early in the 20th century the deforestation resulting from the “golden-age of lumbering” left millions of acres of forest land in the need for reforestation. The challenge was so extreme that foresters of the early 1930s estimated that it would take 900 to 1,000 years at the then rate of planting to reforest the denuded forest land that occurred throughout the Nation....

Pattern, challenges and correlates of condom use among Nigerians living with HIV infection

PubMed Central

Ayoola, Oladele David; Victoria, Gab-Okafor Chidinma; Bamidele, Oke; Olufela, Kalejaiye Olufunto; Oluwatosin, Somefun Esther; Mbaneifo, Ezeobi Paschal; Titilola, Gbajabiamila; Adagu, Adu Rosemary; Ifeanyi, Onwujekwe Dan; Harry, Ohwodo; Oluwatosin, Odubela; Nonyelum, Odunukwe Nkiru; Nkiruka, David; Chukwujekwu, Ezechi Oliver

2014-01-01

Objective To determine the pattern, challenges and correlates of condom use among Nigerians living with HIV Infection. Methods A cross sectional questionnaire study among HIV positive adults attending an HIV treatment centre in Lagos, Nigeria. Data entry and analysis were done with Epi-info version 3.5.1. Results The mean age of respondents was 35 (SD=7.7; range: 17-58 years) and mean age at sexual debut was 20 years old (range: 7-37 years). Majority were women (66.6%), had at least secondary school education(91.1%), married (68.2%)), on ART (50.7%) and knew their partners HIV status(60.9%). The rate of condom use at last sex act was 65.9%, but only 48.8% used condom consistently. Factors associated with condom use were male gender (OR=2.43, CI=1.35-4.33, P=0.002), less than secondary school education (OR=3.12, CI=1.04-9.28, P=0.05) and Not knowing partner's HIV status (OR=1.90, CI=1.04-3.80, P=0.04). Refusal to use condom (28.4%) were as a result of pregnancy intention, undesirability of condom in marriage and decreased sexual pleasure. Conclusion There is low consistent condom use rate of 48.8% among this cohort despite their exposure to behavioural change messages. A review of the present counselling strategy and combination prevention is therefore advocated. PMID:25183080

Signed language working memory capacity of signed language interpreters and deaf signers.

PubMed

Wang, Jihong; Napier, Jemina

2013-04-01

This study investigated the effects of hearing status and age of signed language acquisition on signed language working memory capacity. Professional Auslan (Australian sign language)/English interpreters (hearing native signers and hearing nonnative signers) and deaf Auslan signers (deaf native signers and deaf nonnative signers) completed an Auslan working memory (WM) span task. The results revealed that the hearing signers (i.e., the professional interpreters) significantly outperformed the deaf signers on the Auslan WM span task. However, the results showed no significant differences between the native signers and the nonnative signers in their Auslan working memory capacity. Furthermore, there was no significant interaction between hearing status and age of signed language acquisition. Additionally, the study found no significant differences between the deaf native signers (adults) and the deaf nonnative signers (adults) in their Auslan working memory capacity. The findings are discussed in relation to the participants' memory strategies and their early language experience. The findings present challenges for WM theories.

Family Commitment and Work Characteristics among Pharmacists

PubMed Central

Gubbins, Paul O.; Ragland, Denise; Castleberry, Ashley N.; Payakachat, Nalin

2015-01-01

Factors associated with family commitment among pharmacists in the south central U.S. are explored. In 2010, a cross-sectional mailed self-administered 70 item survey of 363 active licensed pharmacists was conducted. This analysis includes only 269 (74%) participants who reported being married. Outcome measures were family commitment (need for family commitment, spouse’s family commitment), work-related characteristics (work challenge, stress, workload, flexibility of work schedule), and job and career satisfaction. Married participants’ mean age was 48 (SD = 18) years; the male to female ratio was 1:1; 73% worked in retail settings and 199 (74%) completed the family commitment questions. Females reported a higher need for family commitment than males (p = 0.02) but there was no significant difference in satisfaction with the commitment. Work challenge and work load were significantly associated with higher need for family commitment (p < 0.01), when controlled for age, gender, number of dependents, work status, and practice setting. Higher work challenge was associated with higher career satisfaction. Higher job related stress was associated with lower job satisfaction. High work challenge and work load may negatively impact family function since married pharmacists would need higher family commitment from their counterparts. The impact of work-family interactions on pharmacy career satisfaction should be further investigated. PMID:28975924

Family Commitment and Work Characteristics among Pharmacists.

PubMed

Gubbins, Paul O; Ragland, Denise; Castleberry, Ashley N; Payakachat, Nalin

2015-12-17

Factors associated with family commitment among pharmacists in the south central U.S. are explored. In 2010, a cross-sectional mailed self-administered 70 item survey of 363 active licensed pharmacists was conducted. This analysis includes only 269 (74%) participants who reported being married. Outcome measures were family commitment (need for family commitment, spouse's family commitment), work-related characteristics (work challenge, stress, workload, flexibility of work schedule), and job and career satisfaction. Married participants' mean age was 48 (SD = 18) years; the male to female ratio was 1:1; 73% worked in retail settings and 199 (74%) completed the family commitment questions. Females reported a higher need for family commitment than males ( p = 0.02) but there was no significant difference in satisfaction with the commitment. Work challenge and work load were significantly associated with higher need for family commitment ( p < 0.01), when controlled for age, gender, number of dependents, work status, and practice setting. Higher work challenge was associated with higher career satisfaction. Higher job related stress was associated with lower job satisfaction. High work challenge and work load may negatively impact family function since married pharmacists would need higher family commitment from their counterparts. The impact of work-family interactions on pharmacy career satisfaction should be further investigated.

Hidden Breast Cancer Disparities in Asian Women: Disaggregating Incidence Rates by Ethnicity and Migrant Status

PubMed Central

Quach, Thu; Horn-Ross, Pamela L.; Pham, Jane T.; Cockburn, Myles; Chang, Ellen T.; Keegan, Theresa H. M.; Glaser, Sally L.; Clarke, Christina A.

2010-01-01

Objectives. We estimated trends in breast cancer incidence rates for specific Asian populations in California to determine if disparities exist by immigrant status and age. Methods. To calculate rates by ethnicity and immigrant status, we obtained data for 1998 through 2004 cancer diagnoses from the California Cancer Registry and imputed immigrant status from Social Security Numbers for the 26% of cases with missing birthplace information. Population estimates were obtained from the 1990 and 2000 US Censuses. Results. Breast cancer rates were higher among US- than among foreign-born Chinese (incidence rate ratio [IRR] = 1.84; 95% confidence interval [CI] = 1.72, 1.96) and Filipina women (IRR = 1.32; 95% CI = 1.20, 1.44), but similar between US- and foreign-born Japanese women. US-born Chinese and Filipina women who were younger than 55 years had higher rates than did White women of the same age. Rates increased over time in most groups, as high as 4% per year among foreign-born Korean and US-born Filipina women. From 2000–2004, the rate among US-born Filipina women exceeded that of White women. Conclusions. These findings challenge the notion that breast cancer rates are uniformly low across Asians and therefore suggest a need for increased awareness, targeted cancer control, and research to better understand underlying factors. PMID:20147696

"When am I going to stop taking the drug?" Enablers, barriers and processes of disclosure of HIV status by caregivers to adolescents in a rural district in Zambia.

PubMed

Mweemba, Mable; Musheke, Maurice M; Michelo, Charles; Halwiindi, Hikabasa; Mweemba, Oliver; Zulu, Joseph M

2015-10-07

Disclosure of adolescents' own HIV status by caregivers is not only challenging but low. The reasons for this remain unclear despite efforts to examine and seek to understand disclosure patterns or factors that may either facilitate or inhibit this disclosure. This study explored the enablers, barriers and processes of disclosure of HIV status to adolescents by their caregivers in Kafue district of Zambia. A case study method was used to understand factors that facilitate or inhibit caregiver's ability to disclose the HIV status of adolescents aged 10-15 years. Data collected through in-depth interviews with 30 caregivers as well as 6 key informants were analysed using thematic analysis. Overall, 17 out of 30 (56.7 %) caregivers had informed the adolescents about their HIV status. Reasons for disclosing of the HIV status included inquiries by adolescents as to why they were taking medication, threats by adolescents not to take HIV medication, desire to promote treatment self-efficacy amongst adolescents as well as facilitating adoption of safe sexual behaviour among adolescents. The disclosure processes were conducted either at the home or at the clinic. Enabling factors for HIV disclosure were adolescents' knowledge of HIV and caregivers' knowledge of and experience with HIV programs. Barriers to disclosure of HIV status included fear of psychological trauma for the adolescents, perceived inability of adolescents to keep their HIV status confidential which could attract HIV stigmatisation for the family, and caregivers', fear of being blamed by the adolescents for the infection, limited disclosure skills by caregivers as well as negative attitude by some HIV counsellors. Despite challenges associated with disclosure of adolescents' own HIV status by caregivers, environments that facilitate this process exist and can be strengthened. Promoting HIV disclosure requires in-depth and context-specific understanding of the factors that enable and undermine this process. Limitations in this understanding may have played critical roles in past strategic implementation of locally driven and relevant interventions to improve disclosure of HIV status by caregivers to adolescents in Zambia.

17-Year Outcome of Preterm Infants with Diverse Neonatal Morbidities: Part 1, Impact on Physical, Neurological, and Psychological Health Status

PubMed Central

Sullivan, Mary C.; Msall, Michael E.; Miller, Robin J.

2012-01-01

Purpose The purpose of this study was to comprehensively examine physical, neurological, and psychological health in a U.S. sample of 180 infants at age 17. Design & Methods The World Health Organization International Classification of Functioning, Disability and Health model framed the health-related domains and contextual factors. Assessments included growth, chronic conditions, neurological status, and psychological health. Results Physical health, growth, and neurological outcomes were poorer in the preterm groups. Minor neurological impairment was related to integrative function. Preterm survivors reported higher rates of depression, anxiety, and inattention/hyperactivity. Practice Implications Complex health challenges confront preterm survivors at late adolescence suggesting the necessity of continued health surveillance. PMID:22734876

22 CFR 9.8 - Classification challenges.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 22 Foreign Relations 1 2012-04-01 2012-04-01 false Classification challenges. 9.8 Section 9.8 Foreign Relations DEPARTMENT OF STATE GENERAL SECURITY INFORMATION REGULATIONS § 9.8 Classification... classification status is improper are expected and encouraged to challenge the classification status of the...

22 CFR 9.8 - Classification challenges.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 22 Foreign Relations 1 2013-04-01 2013-04-01 false Classification challenges. 9.8 Section 9.8 Foreign Relations DEPARTMENT OF STATE GENERAL SECURITY INFORMATION REGULATIONS § 9.8 Classification... classification status is improper are expected and encouraged to challenge the classification status of the...

22 CFR 9.8 - Classification challenges.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 22 Foreign Relations 1 2014-04-01 2014-04-01 false Classification challenges. 9.8 Section 9.8 Foreign Relations DEPARTMENT OF STATE GENERAL SECURITY INFORMATION REGULATIONS § 9.8 Classification... classification status is improper are expected and encouraged to challenge the classification status of the...

22 CFR 9.8 - Classification challenges.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Classification challenges. 9.8 Section 9.8 Foreign Relations DEPARTMENT OF STATE GENERAL SECURITY INFORMATION REGULATIONS § 9.8 Classification... classification status is improper are expected and encouraged to challenge the classification status of the...

22 CFR 9.8 - Classification challenges.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 22 Foreign Relations 1 2011-04-01 2011-04-01 false Classification challenges. 9.8 Section 9.8 Foreign Relations DEPARTMENT OF STATE GENERAL SECURITY INFORMATION REGULATIONS § 9.8 Classification... classification status is improper are expected and encouraged to challenge the classification status of the...

Prediction of developmental performance in preterm infants at two years of corrected age: contribution of the neurological assessment at term age.

PubMed

Simard, Marie-Noëlle; Lambert, Jean; Lachance, Christian; Audibert, François; Gosselin, Julie

2011-12-01

The population of preterm infants is increasing and resources available for follow-up are limited. Early markers are needed to identify children who will show major as well as more subtle neurodevelopmental impairments. Such a challenge could be achieved with the Amiel-Tison Neurological Assessment at Term (ATNAT). This study assesses the usefulness of the ATNAT in the prediction of developmental problems at two years of corrected age (CA) in infants born between 29 and 37 weeks of gestation. Inclusion criteria were: gestational age between 29(0/7) and 36(6/7) weeks inclusively, birth weight below 2500g and minimal 24-hour stay in the Neonatal Intensive Care Unit of Sainte-Justine Hospital. A sample of 147 was prospectively recruited and assessed at two ages: at term with the ATNAT and at 24months CA with Bayley Scales of Infant Development-II. No major impairment such as cerebral palsy and no neurosensory impairment were observed. Developmental delay defined by an index<70 on the mental or psychomotor scale was reported respectively in 6.2% and 5.4% of the cohort. Significant differences in mental, psychomotor and behavioral performances were found according to neurological status. Neurological status was the only variable to enter the predictive model for psychomotor and behavioral indexes. Gender and neurological status remained in the predictive model for mental performance. This study supports the inclusion of the ATNAT among the eligibility criteria for systematic neurodevelopmental surveillance as it allows early identification of infants at higher risk of low developmental performances at 24months CA. Copyright © 2011 Elsevier Ltd. All rights reserved.

Changing dentate status of adults, use of dental health services, and achievement of national dental health goals in Denmark by the year 2000.

PubMed

Petersen, Poul Erik; Kjøller, Mette; Christensen, Lisa Bøge; Krustrup, Ulla

2004-01-01

This study analyzes the current profile of dentate status and use of dental health services among adults in Denmark at the turn of the millennium, assesses the impact on dentate status of sociodemographic factors and use of dental health services in adulthood and in childhood, and highlights the changes over time in dental health conditions among adults. Finally, the intention of the study was to evaluate the Danish dental health care system's level of achievement of the official goals for the year 2000 as formulated by the World Health Organization and the National Board of Health. The subjects of this study included a national representative sample of 16,690 Danish citizens aged 16 years and older (response rate=74.2%). A subsample (n=3,818) took part in a survey of dental care habits in childhood and prevalence of removable dentures; 66 percent of persons selected responded. Personal interviews were used to collect information on dentate status, use of dental health services and living conditions; data on dental care habits in childhood and prevalence of removable dentures were collected by self-administered questionnaires. In all, 8 percent of interviewed persons were edentulous, while 80 percent had 20 or more natural teeth. At age 65-74 years, 27 percent were edentulous and 40 percent had 20 teeth or more; 58 percent wore removable dentures. Dentate status and prevalence of dentures were highly related to educational background and income, particularly for older age groups. Among persons interviewed, 80 percent paid regular dental visits and visits were most frequent among persons of high education and income. At age 35-44 years 95 percent had participated in regular dental care in childhood compared to 49 percent of 65-74-year-olds. Multivariate analyses revealed that sociobehavioral factors had significant effects on dentate status. Compared to similar studies carried out in 1987 and 1994, the present survey indicates a positive trend of improved dentate status in adult Danes in general and regular use of dental health services increased considerably over time. The WHO goals for better dental health by the year 2000 were achieved for 35-44-year-olds, whereas the goal of more people with functional dentitions at age 65 years or older was not achieved. It remains a challenge to the Danish dental health system to help even out the social inequalities in dental health.

Perception of care and barriers to treatment in individuals with diabetic retinopathy in India: 11-city 9-state study.

PubMed

Shukla, Rajan; Gudlavalleti, Murthy V S; Bandyopadhyay, Souvik; Anchala, Raghupathy; Gudlavalleti, Aashrai Sai Venkat; Jotheeswaran, A T; Ramachandra, Srikrishna S; Singh, Vivek; Vashist, Praveen; Allagh, Komal; Ballabh, Hira Pant; Gilbert, Clare E

2016-04-01

Diabetic retinopathy is a leading cause of visual impairment. Low awareness about the disease and inequitable distribution of care are major challenges in India. Assess perception of care and challenges faced in availing care among diabetics. The cross-sectional, hospital based survey was conducted in eleven cities. In each city, public and private providers of eye-care were identified. Both multispecialty and standalone facilities were included. Specially designed semi-open ended questionnaires were administered to the clients. 376 diabetics were interviewed in the eye clinics, of whom 62.8% (236) were selected from facilities in cities with a population of 7 million or more. The mean duration of known diabetes was 11.1 (±7.7) years. Half the respondents understood the meaning of adequate glycemic control and 45% reported that they had visual loss when they first presented to an eye facility. Facilities in smaller cities and those with higher educational status were found to be statistically significant predictors of self-reported good/adequate control of diabetes. The correct awareness of glycemic control was significantly high among attending privately-funded facilities and higher educational status. Self-monitoring of glycemic status at home was significantly associated with respondents from larger cities, privately-funded facilities, those who were better educated and reported longer duration of diabetes. Duration of diabetes (41%), poor glycemic control (39.4%) and age (20.7%) were identified as the leading causes of DR. The commonest challenges faced were lifestyle/behavior related. The findings have significant implications for the organization of diabetes services in India.

The Rationality/Emotional Defensiveness Scale--I. Internal structure and stability.

PubMed

Swan, G E; Carmelli, D; Dame, A; Rosenman, R H; Spielberger, C D

1991-01-01

In a 10-year prospective study, Grossarth-Maticek and colleagues reported that the tendency to repress and/or deny emotions was strongly predictive of cancer mortality. The method used to assess repression/denial was modified recently by Spielberger to form the Rationality/Emotional Defensiveness (R/ED) Scale. The present study investigates the psychometric properties of the R/ED Scale in 1236 male (mean age = 71.8 yr) and 863 female (mean age = 68.5 yr) participants in a 27-year follow-up of the Western Collaborative Group Study. Analyses revealed high interitem consistency (Cronbach's alpha = 0.77 and 0.78 for men and women, respectively) and two independent and stable factors that we labeled 'Anti-emotionality' (27% of total variance) and 'Rationality' (21% of total variance). Excluding cancer subjects, significant gender differences were observed for individual items, total R/ED score, and the two subscales. Comparisons of the 159 male cancer patients and the 175 female cancer patients with the corresponding noncancer subjects suggest possible gender x cancer status and age x cancer status interactions. These results challenge Grossarth-Maticek's assertion that rationality/anti-emotionality is a unidimensional construct and indicate the need to take into account the effect of age and gender on the presence of these psychological constructs.

Comparison of diagnostic validity of mannitol and methacholine challenges and relationship to clinical status and airway inflammation in steroid-naïve asthmatic patients.

PubMed

Porpodis, Konstantinos; Domvri, Kalliopi; Kontakiotis, Theodoros; Fouka, Evangelia; Kontakioti, Eirini; Zarogoulidis, Konstantinos; Papakosta, Despina

2017-06-01

The purpose of this study was to demonstrate and compare the diagnostic validity of two bronchial challenges and to investigate their correlation with patient clinical status, atopy and inflammation markers. Eighty-eight patients, 47 women and 41 men, mean age 38.56 ± 16.73 years who presented with asthma related symptoms and were not on any anti-asthma medication, were challenged with mannitol and methacholine on separate days. Medical history regarding asthmatic symptoms, physical examination, skin prick tests and FeNO levels were also assessed. The clinical diagnosis of asthma was based on bronchodilator reversibility test. Sixty-seven patients were diagnosed with asthma and 21 without asthma. Both methacholine (P < 0.014) and mannitol (P < 0.000) challenges were significant in diagnosing asthma. The positive/negative predictive value was 93.33%/41.86% for methacholine, 97.72%/45.45% for mannitol and 97.05%/45.45%. for both methods assessed together. Worthy of note that 22% of asthmatics had both tests negative. There was a negative correlation between PC20 of methacholine and the FeNO level P < 0.001, and positive with the PD15 of mannitol P < 0.001 and the pre-test FEV 1 % pred P < 0.005, whereas PD15 of mannitol was negatively correlated with the FeNO level P < 0.001. Furthermore, dyspnea was the only asthmatic symptom associated with FeNO level P < 0.035 and the positivity of mannitol P < 0.014 and methacholine P < 0.04. Both challenge tests were equivalent in diagnosing asthma. Nevertheless, specificity appeared to be slightly higher in mannitol challenge.

What will my child's future hold? phenotypes of intellectual development in 2-8-year-olds with autism spectrum disorder.

PubMed

Solomon, Marjorie; Iosif, Ana-Maria; Reinhardt, Vanessa P; Libero, Lauren E; Nordahl, Christine W; Ozonoff, Sally; Rogers, Sally J; Amaral, David G

2018-01-01

We examined phenotypes of autism spectrum disorder (ASD) based on trajectories of intellectual development from early (ages 2-3 ½) to middle (ages 5-8) childhood in a recent clinically ascertained cohort. Participants included 102 children (82 males) initially diagnosed with ASD from the Autism Phenome Project longitudinal sample. Latent class growth analysis was used to identify distinct IQ trajectories. Baseline and developmental course differences among groups were assessed using univariate techniques and repeated measures regression models, respectively. A four class model best represented the data. Using the highest posterior probability, participants were assigned to High Challenges (25.5%), Stable Low (17.6%), Changers (35.3%), and Lesser Challenges (21.6%) groups. The High Challenges and Stable Low groups exhibited persistently low IQ, although, the High Challenges group experienced declines while the Stable Low group's scores remained more constant. Changers showed IQ improvement of > 2 standard deviations. The Lesser Challenges group had IQs in the average range at both times that were about 1 standard deviation higher at T2. In summation, 75% of the participants experienced some relative improvements in intellectual and/or other areas of functioning between ages 2 and 8 years. The Changers group demonstrated the most significant IQ change that was accompanied by adaptive communication improvement and declining externalizing symptoms. Only the Lesser Challenges group showed a significant reduction in ASD symptom severity, such that by age 8, 14% of them no longer met ADOS-2 criteria for ASD. All groups showed reductions in internalizing symptoms. Intervention history was not associated with group status. Autism Res 2018, 11: 121-132. © 2017 International Society for Autism Research, Wiley Periodicals, Inc. We examined how the IQs of children with autism spectrum disorder change between ages 2 and 8, and identified four patterns. Two groups exhibited persistently lower IQs. One group showed IQ increases of greater than 30 points with improved communicate abilities and declining disruptive behaviors. The final group had IQs in the average or better range at both time points, and 14% of them lost their diagnoses. Over half of the children experienced improved intellectual functioning between ages 2 and 8, whereas about 25% showed declines. Findings were not associated with intervention history. © 2017 International Society for Autism Research, Wiley Periodicals, Inc.

Children with cow's milk allergy following an elimination diet had normal growth but relatively low plasma leptin at age two.

PubMed

Dong, Ping; Feng, Jing-Jing; Yan, Dong-Yong; Lyu, Yu-Jing; Xu, Xiu

2018-02-20

To assess nutrient intake, growth and nutritional status of infants with cow's milk allergy (CMA) who follow a therapeutic elimination diet since the first few months of life. Sixty infants younger than four months of age with challenge-proven CMA and 60 healthy age-matched children were investigated. Anthropometric and body composition (BC) were assessed up to 24 months. Dietary intake was recorded by the parents for three consecutive days before visits at 6, 12, 18 and 24 months. Blood albumin, prealbumin, retinol binding protein and metabolic-related hormones were examined at 24 months. The average age at enrolment was 2.9 ± 1.0 months. At the end of the follow-up, there were no differences in daily milk consumption, nutrient intake, weight and height z scores or BC measures between the groups; however, the plasma leptin level was lower in infants with CMA (1.67 ± 1.03 vs 2.05 ± 1.48) (ng/mL) (p < 0.05) compared to healthy children. Children with CMA who followed an elimination diet could achieve a normal nutritional status, except for relatively lower plasma leptin levels, at the age of 2. Further studies with larger cohorts and research on the long-term consequences of these early differences are needed. ©2018 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

Sociodemographic Characteristics and Health Profile of the Elderly Seeking Health Care in Kampala, Uganda

PubMed Central

Söderberg, Martin; Midlöv, Patrik; Ajambo, Aidah; Nakasujja, Noeline

2018-01-01

Aging entails health challenges globally, but pertinent data from low-income countries like Uganda remains scarce. A cross-sectional study was carried out at Mulago National Referral Hospital in Kampala, among 134 patients (38% men and 62% women) aged ≥60 years. Data was collected on sociodemographic characteristics, medical disorders, cognitive function, hearing handicap, and functional status, that is, Basic Activities of Daily Living (BADL) and Instrumental Activities of Daily Living (IADL). The participants had high independency in BADL (89%) and IADL (75%). The most common medical conditions were bone/joint pain (35%), hypertension (24%), and visual problems (20%). More women (54%) than men (37%) reported bone and joint pain. The majority (80%) of the participants did not report any hearing handicap, and half (54%) did not have any cognitive impairment. Dependency in IADL was associated with advanced age, being female, and being financially dependent, and the risk of having a hearing handicap was higher among those above the median age (68 years). In adjusted models, the effects remained similar although statistical significance was only achieved for advanced age versus dependency in IADL (RR: 2.38, 95% CI: 1.12–5.08) and hearing handicap (RR: 2.67, 95% CI: 1.17–6.12). Thus, socioeconomic status and gender are relevant aspects when attempting to understand the health profile of the elderly in Kampala, Uganda. PMID:29861722

Sociodemographic Characteristics and Health Profile of the Elderly Seeking Health Care in Kampala, Uganda.

PubMed

Nawagi, Faith; Söderberg, Martin; Berggren, Vanja; Midlöv, Patrik; Ajambo, Aidah; Nakasujja, Noeline

2018-01-01

Aging entails health challenges globally, but pertinent data from low-income countries like Uganda remains scarce. A cross-sectional study was carried out at Mulago National Referral Hospital in Kampala, among 134 patients (38% men and 62% women) aged ≥60 years. Data was collected on sociodemographic characteristics, medical disorders, cognitive function, hearing handicap, and functional status, that is, Basic Activities of Daily Living (BADL) and Instrumental Activities of Daily Living (IADL). The participants had high independency in BADL (89%) and IADL (75%). The most common medical conditions were bone/joint pain (35%), hypertension (24%), and visual problems (20%). More women (54%) than men (37%) reported bone and joint pain. The majority (80%) of the participants did not report any hearing handicap, and half (54%) did not have any cognitive impairment. Dependency in IADL was associated with advanced age, being female, and being financially dependent, and the risk of having a hearing handicap was higher among those above the median age (68 years). In adjusted models, the effects remained similar although statistical significance was only achieved for advanced age versus dependency in IADL (RR: 2.38, 95% CI: 1.12-5.08) and hearing handicap (RR: 2.67, 95% CI: 1.17-6.12). Thus, socioeconomic status and gender are relevant aspects when attempting to understand the health profile of the elderly in Kampala, Uganda.

Nutritional status of children under 5 years of age in Brazil: evidence of nutritional epidemiological polarisation.

PubMed

Pereira, Ingrid Freitas da Silva; Andrade, Lára de Melo Barbosa; Spyrides, Maria Helena Constatino; Lyra, Clélia de Oliveira

2017-10-01

The objective of this study was to evaluate the nutritional status of children under 5 years of age in Brazil in 2009 and its association with social and demographic factors. Data from the Household Budget Survey (Pesquisa de Orçamento Familiar - POF 2008-2009) were used, in which the nutritional profile was evaluated according to the weight-for-age (W/A), height-for-age (H/A) and weight-for-height (W/H) indices (n = 14,569). The association was estimated by applying the Pearson association test, a logistic regression and a correspondence analysis. The correspondence analysis showed a higher association of thinness with children in the North and Northeast regions, in families with lower levels of income and in those of black colour/race. Overweight and obesity had a stronger relationship with children living in the South, Southeast and Central-West, in males, in those from urban areas, in those of Caucasian colour/race, in those aged 3 years and in those from families with intermediate income ranges. Overweight and obesity showed a heterogeneous spatial distribution amongst Brazilian states. A nutritional epidemiological polarisation that presents a major challenge for public health is indicated: we must reduce nutritional deficiencies and promote healthy eating habits from childhood to improve the nutritional and epidemiological profiles and mortality of the population.

Personal growth and the transition to grandfatherhood.

PubMed

Taubman-Ben-ari, Orit; Findler, Liora; Ben Shlomo, Shirley

2012-01-01

The study examined personal growth among new grandfathers (n = 101, age 45-67), 2 to 24 months after the birth of their first grandchild. Specifically, it investigated the contribution of internal resources (self-esteem), perceived characteristics of the situation (grandparenthood distress and cognitive appraisals of threat, challenge, and self-efficacy), and external resources (perceived marital relationship) to the experience of growth. Associations with several background variables, including age, education, health and economic status, grandchild's age, and frequency of grandfather-grandchild meetings, were also examined. The results showed that lower internal resources, a positive assessment of the situation, and lower education were most closely associated with a higher experience of growth in first-time grandfathers. The discussion relates to the uniqueness of focusing on grandfathers and the potential for personal growth in this new family role.

Microglia of the Aged Brain: Primed to be Activated and Resistant to Regulation

PubMed Central

Norden, Diana M.; Godbout, Jonathan P.

2012-01-01

Innate immunity within the central nervous system (CNS) is primarily provided by resident microglia. Microglia are pivotal in immune surveillance and also facilitate the coordinated responses between the immune system and the brain. For example, microglia interpret and propagate inflammatory signals that are initiated in the periphery. This transient microglial activation helps mount the appropriate physiological and behavioral response following peripheral infection. With normal aging, however, microglia develop a more inflammatory phenotype. For instance, in several models of aging there are increased pro-inflammatory cytokines in the brain and increased expression of inflammatory receptors on microglia. This increased inflammatory status of microglia with aging is referred to as primed, reactive, or sensitized. A modest increase in the inflammatory profile of the CNS and altered microglial function in aging has behavioral and cognitive consequences. Nonetheless, there are major differences in microglial biology between young and old age when the immune system is challenged and microglia are activated. In this context, microglial activation is amplified and prolonged in the aged brain compared to adults. The cause of this amplified microglial activation may be related to impairments in several key regulatory systems with age that make it more difficult to resolve microglial activation. The consequences of impaired regulation and microglial hyper-activation following immune challenge are exaggerated neuroinflammation, sickness behavior, depressive-like behavior and cognitive deficits. Therefore the purpose of this review is to discuss the current understanding of age-associated microglial priming, consequences of priming and reactivity, and the impairments in regulatory systems that may underlie these age-related deficits. PMID:23039106

Greek Immigrants in Australia: Implications for Culturally Sensitive Practice.

PubMed

Georgiades, Savvas Daniel

2015-10-01

This exploratory research examined adjustment challenges, resiliencies, attitudes, emotional health, economic stability, criminal involvement, victimization and service experiences, and some cultural propensities of Greek Immigrants (GIs) in Australia using a convenient multi-generational sample (n = 123; response rate = .5). Data were collected via surveys, telephone, and personal-interviews in four major Australian cities. Among other things, the study revealed that Greek identity and cultural customs are often significant to first generation GIs. Adjustment challenges upon entry include primarily language, housing, and transportation difficulties, nostalgia for relatives and the motherland, unfamiliarity with socio-cultural systems, unemployment, money challenges, and lack of friendships. Christian faith, the extended family, family values and traditions, cultural pride for ancient Greek achievements, and a hard 'work ethic' are notable resiliencies that support GIs in their struggles and solidify their pursuit for happiness and success. Financial concerns, aging, and nostalgia for relatives and the motherland were the primary causes of socio-emotional instability. Attitudinal differences in the respondents based on age, gender, and socio-economic status, cross-cultural comparisons, and recommendations for culturally-sensitive practice with GIs are analyzed and methodological limitations illuminated. Future research needs in the field are also highlighted.

Psychosocial characteristics of nonoffending mothers of sexually abused girls: findings from a prospective, multigenerational study.

PubMed

Kim, Kihyun; Noll, Jennie G; Putnam, Frank W; Trickett, Penelope K

2007-11-01

This study examined psychosocial characteristics of nonoffending mothers of sexually abused girls. The sample consisted of 72 ethnically diverse mothers of sexually abused girls aged 6 to 16 years, and 55 mothers of girls who were demographically similar with the abused girls on age, socioeconomic status, and family constellation. The variables examined included measures of the mothers' childhood developmental histories and current functioning (e.g., depression, parenting), as well as their current family environment. The specific questions addressed were (a) whether mothers of sexually abused girls could be distinguished from mothers of comparison girls on various psychosocial characteristics and (b) whether three subgroups of mothers (i.e., mother and daughter sexually abused, daughter-only abused, neither mother nor daughter abused) would exhibit different patterns of psychosocial characteristics. Results show that nonoffending mothers of sexually abused girls may confront considerable psychosocial challenges following the disclosure of their daughters' sexual abuse and that mother's own childhood abuse experiences may be an important factor to understand these challenges.

Management of type 2 diabetes mellitus: adherence challenges in environments of low socio-economic status.

PubMed

Steyl, Tania; Phillips, Julie

2014-11-06

The efficacy of treatment for clients with diabetes is highly dependent on the individual's ability to manage the disease. Several constraints, such as poverty, illiteracy and insufficient resources (finances and specialised healthcare professionals), especially communities of low socio-economic status, could influence clients' ability to manage their disease. The main aim of this study was to outline the obstacles encountered by individuals with type 2 diabetes mellitus from an urban community with regard to management of their disease. The study was conducted at a primary health care facility in the Western Cape, South Africa. Ethical clearance was obtained from all relevant authorities. Eight (8) conveniently selected clients with type 2 diabetes mellitus per participating community healthcare centre (six approved centres in total) were invited to take part in focus group discussions. Twenty six clients, 15 females and 11 males, with a mean age of 58.92 years (SD = 7.33), agreed to participate. Audiotaped data were transcribed verbatim followed by content analysis and identification of themes. Themes that emerged were challenges with: a healthy eating plan, physical activity, financial constraints, other people's understanding of the disease, and service received at the community healthcare centre. Verbatim quotes were used to exemplify the themes. Clients with type 2 diabetes mellitus experienced several challenges in the management of their disease. These challenges should be addressed to assist with better glycaemic control and to curb the emergence of diabetic complications and their attendant cost implications.

Abidjan: new challenges. UNAIDS focus.

PubMed

1998-03-01

This article focuses on the challenges as a result of the AIDS epidemic in Africa. Updated surveillance uncovers 16,000 new infections a day and 30 million people are now living with HIV/AIDS. In addition, 1 in 100 adults in the 15-49 age group are infected with HIV and only 1 in 10 infected persons are aware of their HIV status. At the 10th International Conference on AIDS and Sexually Transmitted Diseases in Africa in 1997, Dr. Peter Piot, Executive Director of the Joint UN Program on HIV/AIDS, drew attention to the importance of unmasking what is in many places still an invisible epidemic. Dr. Piot said that the alarming situation calls for an unprecedented global effort. In conclusion, Dr. Piot issued these challenges of: breaking the silence, focusing on the next generation, making AIDS a development issue, and ensuring solidarity to help Africa scale up its response to the epidemic.

Challenging gender stereotypes: resistance and exclusion.

PubMed

Mulvey, Kelly Lynn; Killen, Melanie

2015-01-01

The likelihood of resisting gender-stereotypic peer group norms, along with expectations about personal resistance, was investigated in 9- to 10-year-olds and 13- to 14-year-olds (N = 292). Participants were told about a stereotype conforming group (boys playing football; girls doing ballet) and a stereotype nonconforming group (boys doing ballet; girls playing football). Contrary to expectations from gender-stereotyping research, participants stated that they would personally resist gender-stereotypic norms, and more so than they would expect their peers to resist. However, expecting peers to resist declined with age. Participants expected that exclusion from the group was a consequence for challenging the peer group, and understood the asymmetrical status of gender stereotypes with an expectation that it would be more difficult for boys to challenge stereotypes than for girls. © 2014 The Authors. Child Development © 2014 Society for Research in Child Development, Inc.

Bacillus amyloliquefaciens supplementation alleviates immunological stress in lipopolysaccharide-challenged broilers at early age.

PubMed

Li, Y; Zhang, H; Chen, Y P; Yang, M X; Zhang, L L; Lu, Z X; Zhou, Y M; Wang, T

2015-07-01

This study was conducted to investigate the effect of Bacillus amyloliquefaciens ( BA: ) on the immune function of broilers challenged with lipopolysaccharide ( LPS: ). 192 one-day-old male Arbor Acre broiler chickens were randomly distributed into four treatments: 1) broilers fed a basal diet; 2) broilers fed a basal diet supplemented with BA; 3) LPS-challenged broilers fed a basal diet; and 4) LPS-challenged broilers fed a basal diet supplemented with BA. Each treatment consisted of six replicates with eight broilers per replicate. Broilers were intraperitoneally injected with either 500 μg LPS per kg body weight or sterile saline at 16, 18 and 20 d of age. LPS decreased the average daily gain ( ADG: , P = 0.001) and average daily feed intake (P = 0.001). The decreased ADG (P = 0.009) and increased feed conversion ratio (P = 0.047) in LPS-challenged broilers were alleviated by BA. LPS increased the relative spleen weight (P = 0.001). Relative spleen (P = 0.014) and bursa (P = 0.024) weights in the LPS-challenged broilers were reduced by BA. LPS increased white blood cell ( WBC: ) numbers (P = 0.001). However, the WBC numbers (P = 0.042) and the ratio of lymphocytes to WBC (P = 0.020) in LPS-challenged broilers were decreased with BA treatment. LPS decreased plasma lysozyme activity (P = 0.001), but increased concentrations of plasma corticosterone (P = 0.012) and IL-2 (P = 0.020). In contrast, BA increased lysozyme activity in plasma (P = 0.040). LPS increased mRNA abundances of splenic toll-like receptor 4 (P = 0.046), interferon γ (P = 0.008), IL-1β (P = 0.045) and IL-6, (P = 0.006). IL-2 (P = 0.014) and IL-6 (P = 0.074) mRNA abundances in LPS-challenged broilers were reduced by BA, although BA had an opposite effect for IL-10 mRNA expression in those broilers (P = 0.004). In conclusion, BA supplementation could partially alleviate the compromised growth performance and immune status of broilers under immune stress induced by LPS challenge at early age. © 2015 Poultry Science Association Inc.

Social determinants of self-reported health in women and men: understanding the role of gender in population health.

PubMed

Hosseinpoor, Ahmad Reza; Stewart Williams, Jennifer; Amin, Avni; Araujo de Carvalho, Islene; Beard, John; Boerma, Ties; Kowal, Paul; Naidoo, Nirmala; Chatterji, Somnath

2012-01-01

Women and men share similar health challenges yet women report poorer health. The study investigates the social determinants of self-reported health in women and men, and male-female differences in health. Data on 103154 men and 125728 women were analysed from 57 countries in the World Health Survey 2002-2004. Item Response Theory was used to construct a composite measure of health. Associations between health and determinants were assessed using multivariate linear regression. Blinder-Oaxaca decomposition partitioned the inequality in health between women and men into an "explained" component that arises because men and women differ in social and economic characteristics, and an "unexplained" component due to the differential effects of these characteristics. Decomposition was repeated for 18 countries in the World Health Organization (WHO) African region and 19 countries in the WHO European region. Women's health was significantly lower than men's. Health was associated with education, household economic status, employment, and marital status after controlling for age. In the pooled analysis decomposition showed that 30% of the inequality was "explained", of which almost 75% came from employment, education, marital status. The differential effects of being in paid employment increased the inequality. When countries in Africa and Europe were compared, the "explained" component (31% and 39% respectively) was largely attributed to the social determinants in the African countries and to women's longevity in the European countries. Being in paid employment had a greater positive effect on the health of males in both regions. Ways in which age and the social determinants contribute to the poorer health status of women compared with men varies between groups of countries. This study highlights the need for action to address social structures, institutional discrimination and harmful gender norms and roles that differently influence health with ageing.

Community Disclosure by People Living With HIV in Rural China.

PubMed

Lan, Chiao-Wen; Li, Li; Lin, Chunqing; Feng, Nan; Ji, Guoping

2016-08-01

The decision to disclose HIV serostatus is a complex and a challenging task because of potential stigma, blame, and fear associated with HIV infection. Despite continued research on HIV disclosure, literature on HIV disclosure to community is still scarce. The purpose of the study is to describe patterns of HIV status disclosure to community members in a sample of HIV-infected men and women in rural China. This study used the baseline data of a randomized controlled intervention trial for HIV-affected families in China. The data was collected between late 2011 to early 2013. In addition to demographic and HIV-related clinical characteristics, we collected the extent of HIV disclosure to members within the community. We first calculated descriptive statistics and frequencies to describe the demographics of the sample. We then compared the extents of HIV disclosure to different community members. We performed chi-square tests to determine whether the demographic and socioeconomic variables were associated with the extent of HIV disclosure to community. A total of 522 PLH were included in the study. The results show that age and family income are associated with the extent of disclosure of HIV status to members within the community, including neighbor, village leaders, people in the village, and coworkers. More disclosures were found among older age groups. People with less family income tend to disclose more to the community than those with higher family income. There is a need to explore the association of HIV disclosure to the community to help realize the public health and personal implications of disclosure. Our results underscore the potential benefits of age and socioeconomic status-specific interventions in the efforts to dispel barriers to HIV status disclosure to the community.

Globalization and health: a critical appraisal.

PubMed

Swende, T Z; Sokpo, J; Tamen, F I

2008-01-01

Health has long been recognized as a central feature of development. Globalization tends to be understood as a process of economic integration, but it implies more. It entails openness to trade, ideas, investment, people and culture all of which impact health. Review of relevant literature on globalization and health obtained from texts and Pubmed search. Globalization affects health positively and negatively simultaneously, depending on such factors as geographical location, sex, age, ethnic origin, educational level and socioeconomic status. The challenge remains how to make globalization work for health and to use health to foster better forms of globalization. The health community must brace up to the challenge of engaging in the globalization debate with a view to promoting better health for us all.

Introducing Computed Tomography Standards for Age Estimation of Modern Australian Subadults Using Postnatal Ossification Timings of Select Cranial and Cervical Sites(.).

PubMed

Lottering, Nicolene; MacGregor, Donna M; Alston, Clair L; Watson, Debbie; Gregory, Laura S

2016-01-01

Contemporary, population-specific ossification timings of the cranium are lacking in current literature due to challenges in obtaining large repositories of documented subadult material, forcing Australian practitioners to rely on North American, arguably antiquated reference standards for age estimation. This study assessed the temporal pattern of ossification of the cranium and provides recalibrated probabilistic information for age estimation of modern Australian children. Fusion status of the occipital and frontal bones, atlas, and axis was scored using a modified two- to four-tier system from cranial/cervical DICOM datasets of 585 children aged birth to 10 years. Transition analysis was applied to elucidate maximum-likelihood estimates between consecutive fusion stages, in conjunction with Bayesian statistics to calculate credible intervals for age estimation. Results demonstrate significant sex differences in skeletal maturation (p < 0.05) and earlier timings in comparison with major literary sources, underscoring the requisite of updated standards for age estimation of modern individuals. © 2015 American Academy of Forensic Sciences.

Prevalence of, and barriers to the disclosure of HIV status to infected children and adolescents in a district of Ghana.

PubMed

Gyamfi, Eric; Okyere, Paul; Enoch, Acheampong; Appiah-Brempong, Emmanuel

2017-04-08

Globally there are about 3.3million children under the age of 15 years living with HIV. Of this number, 88% live in sub-Saharan Africa. In Ghana, an estimated 33,000 children were said to be living with the HIV infection in 2012. Lack of disclosure adversely affects the well-being of the child, including access to paediatric HIV treatment and care and adherence to treatment. However, the greatest psychosocial challenges that parents and caregivers of HIV-infected children face is disclosure of HIV status to their infected children. This study sought to determine the prevalence of and the barriers to the disclosure of HIV status to infected children and adolescents in Lower Manya-Krobo District in Ghana. A cross sectional study with a sample of 118 caregivers of HIV infected children and adolescents aged 4-19 years attending three HIV clinics in the Lower Manya Krobo District, and 10 key informants comprising of healthcare workers and HIV volunteer workers involved in the provision of care to infected children and their families. The prevalence of disclosure was higher. Main barriers to disclosure identified in this study included age of child, perceived cause of HIV, stigma attached to HIV, child's inability to keep diagnosis to self and fear of psychological harm to child. There is the need for the Ghana Health Service in conjunction with the Ghana Aids Commission and the National Aids Control Programme to develop comprehensive context-based disclosure guidelines.

Factors associated with frailty in chronically ill older adults.

PubMed

Hackstaff, Lynn

2009-01-01

An ex post facto analysis of a secondary dataset examined relationships between physical frailty, depression, and the self-perceived domains of health status and quality-of-life in older adults. The randomized sample included 992 community-dwelling, chronically ill, and functionally impaired adults age 65 and older who received care from a Southern California Kaiser Permanente medical center between 1998 and 2002. Physical frailty represents a level of physiologic vulnerability and functional loss that results in dependence on others for basic, daily living needs (Fried et al., 2001). The purpose of the study was to identify possible intervention junctures related to self-efficacy of older adults in order to help optimize their functionality. Multivariate correlation analyses showed statistically significant positive correlations between frailty level and depression (r = .18; p = < .05), number of medical conditions (r = .09; p = < .05), and self-rated quality-of-life (r = .24; p = < .05). Frailty level showed a statistically significant negative correlation with self-perceived health status (r = -.25; p = < .05). Notably, no statistically significant correlation was found between age and frailty level (r = -.03; p = < .05). In linear regression, self-perceived health status had a partial variance with frailty level (part r = -.18). The significant correlations found support further research to identify interventions to help vulnerable, older adults challenge self-perceived capabilities so that they may achieve optimum functionality through increased physical activity earlier on, and increased self-efficacy to support successful adaptation to aging-related losses.

Participation in policy discourse: new form of exclusion for seniors with disabilities?

PubMed

Raymond, Émilie; Grenier, Amanda

2013-06-01

Recent discourses on aging emphasize the value of older people's social participation. How participation is defined in policy, however, may not correspond with seniors' realities. This article reports on the results of a critical discourse analysis conducted on aging policy in Quebec between 2005 and 2011. Results indicate that participation definitions can be problematic recommendations, standards, and expectations. Over time, participation increasingly came to be defined as productivity. The participation context also changed from collective responsibility to community adjustment and personal choice. Finally, policy texts reflected a polarization between activity and a loss of autonomy that linked participation with health status. Results suggest that, although innovative in the Canadian context, articulation of participation in Quebec's recent policies on aging lacks the politics from which to discuss difference, otherness, and access to participative opportunities. The case of older people's aging with disabilities illustrates the challenges of the new participatory agenda.

Predicting and detecting adverse drug reactions in old age: challenges and opportunities.

PubMed

Mangoni, Arduino A

2012-05-01

Increased, often inappropriate, drug exposure, pharmacokinetic and pharmacodynamic changes, reduced homeostatic reserve and frailty increase the risk of adverse drug reactions (ADRs) in the older population, thereby imposing a significant public health burden. Predicting and diagnosing ADRs in old age presents significant challenges for the clinician, even when specific risk scoring systems are available. The picture is further compounded by the potential adverse impact of several drugs on more 'global' health indicators, for example, physical function and independence, and the fragmentation of care (e.g., increased number of treating doctors and care transitions) experienced by older patients during their clinical journey. The current knowledge of drug safety in old age is also curtailed by the lack of efficacy and safety data from pre-marketing studies. Moreover, little consideration is given to individual patients' experiences and reporting of specific ADRs, particularly in the presence of cognitive impairment. Pending additional data on these issues, the close review and monitoring of individual patients' drug prescribing, clinical status and biochemical parameters remain essential to predict and detect ADRs in old age. Recently developed strategies, for example, medication reconciliation and trigger tool methodology, have the potential for ADRs risk mitigation in this population. However, more information is required on their efficacy and applicability in different healthcare settings.

Age-related effect of aerobic exercise training on antioxidant and oxidative markers in the liver challenged by doxorubicin in rats.

PubMed

Ahmadian, Mehdi; Dabidi Roshan, Valiollah; Leicht, Anthony S

2018-05-16

The aims of the current study were to investigate the oxidant and antioxidant status of liver tissue challenged by doxorubicin and to examine the possible protective effects of aerobic exercise on doxorubicin-induced oxidative stress. Seventy-two rats were divided into three age groups (Young, Adult, and Elderly) with three treatment subgroups consisting of eight rats per age group: doxorubicin, aerobic exercise + doxorubicin, and aerobic exercise + saline. The experimental groups performed regular treadmill running for 3 weeks. Doxorubicin was administered by i.p. injection at a dosage of 20 mg kg -1 while the aerobic exercise + saline group received saline of a comparable volume. Heat shock protein 70, malondialdehyde, glutathione peroxidase, and protein carbonyl were determined from the liver homogenates following the intervention period. Treatment with doxorubicin induced hepatotoxicity in all groups with lower values of oxidative stress in young compared with the older groups. The inclusion of aerobic exercise training significantly increased heat shock protein 70 and antioxidant enzyme levels (glutathione peroxidase) whereas it decreased oxidative stress biomarkers (malondialdehyde and protein carbonyl) for all age groups. These results suggest that aerobic exercise training may be a potential, non-drug strategy to modulate doxorubicin-induced hepatotoxicity through its positive impact on antioxidant levels and oxidative stress biomarkers.

Nutritional and developmental status among 6- to 8-month-old children in southwestern Uganda: a cross-sectional study.

PubMed

Muhoozi, Grace K M; Atukunda, Prudence; Mwadime, Robert; Iversen, Per Ole; Westerberg, Ane C

2016-01-01

Undernutrition continues to pose challenges to Uganda's children, but there is limited knowledge on its association with physical and intellectual development. In this cross-sectional study, we assessed the nutritional status and milestone development of 6- to 8-month-old children and associated factors in two districts of southwestern Uganda. Five hundred and twelve households with mother-infant (6-8 months) pairs were randomly sampled. Data about background variables (e.g. household characteristics, poverty likelihood, and child dietary diversity scores (CDDS)) were collected using questionnaires. Bayley Scales of Infant and Toddler Development (BSID III) and Ages and Stages questionnaires (ASQ) were used to collect data on child development. Anthropometric measures were used to determine z-scores for weight-for-age (WAZ), length-for-age (LAZ), weight-for-length (WLZ), head circumference (HCZ), and mid-upper arm circumference. Chi-square tests, correlation coefficients, and linear regression analyses were used to relate background variables, nutritional status indicators, and infant development. The prevalence of underweight, stunting, and wasting was 12.1, 24.6, and 4.7%, respectively. Household head education, gender, sanitation, household size, maternal age and education, birth order, poverty likelihood, and CDDS were associated (p<0.05) with WAZ, LAZ, and WLZ. Regression analysis showed that gender, sanitation, CDDS, and likelihood to be below the poverty line were predictors (p<0.05) of undernutrition. BSID III indicated development delay of 1.3% in cognitive and language, and 1.6% in motor development. The ASQ indicated delayed development of 24, 9.1, 25.2, 12.2, and 15.1% in communication, fine motor, gross motor, problem solving, and personal social ability, respectively. All nutritional status indicators except HCZ were positively and significantly associated with development domains. WAZ was the main predictor for all development domains. Undernutrition among infants living in impoverished rural Uganda was associated with household sanitation, poverty, and low dietary diversity. Development domains were positively and significantly associated with nutritional status. Nutritional interventions might add value to improvement of child growth and development.

Nutritional and developmental status among 6- to 8-month-old children in southwestern Uganda: a cross-sectional study

PubMed Central

Muhoozi, Grace K. M.; Atukunda, Prudence; Mwadime, Robert; Iversen, Per Ole; Westerberg, Ane C.

2016-01-01

Background Undernutrition continues to pose challenges to Uganda's children, but there is limited knowledge on its association with physical and intellectual development. Objective In this cross-sectional study, we assessed the nutritional status and milestone development of 6- to 8-month-old children and associated factors in two districts of southwestern Uganda. Design Five hundred and twelve households with mother–infant (6–8 months) pairs were randomly sampled. Data about background variables (e.g. household characteristics, poverty likelihood, and child dietary diversity scores (CDDS)) were collected using questionnaires. Bayley Scales of Infant and Toddler Development (BSID III) and Ages and Stages questionnaires (ASQ) were used to collect data on child development. Anthropometric measures were used to determine z-scores for weight-for-age (WAZ), length-for-age (LAZ), weight-for-length (WLZ), head circumference (HCZ), and mid-upper arm circumference. Chi-square tests, correlation coefficients, and linear regression analyses were used to relate background variables, nutritional status indicators, and infant development. Results The prevalence of underweight, stunting, and wasting was 12.1, 24.6, and 4.7%, respectively. Household head education, gender, sanitation, household size, maternal age and education, birth order, poverty likelihood, and CDDS were associated (p<0.05) with WAZ, LAZ, and WLZ. Regression analysis showed that gender, sanitation, CDDS, and likelihood to be below the poverty line were predictors (p<0.05) of undernutrition. BSID III indicated development delay of 1.3% in cognitive and language, and 1.6% in motor development. The ASQ indicated delayed development of 24, 9.1, 25.2, 12.2, and 15.1% in communication, fine motor, gross motor, problem solving, and personal social ability, respectively. All nutritional status indicators except HCZ were positively and significantly associated with development domains. WAZ was the main predictor for all development domains. Conclusion Undernutrition among infants living in impoverished rural Uganda was associated with household sanitation, poverty, and low dietary diversity. Development domains were positively and significantly associated with nutritional status. Nutritional interventions might add value to improvement of child growth and development. PMID:27238555

Socioeconomic status and age at menarche in indigenous and non-indigenous Chilean adolescents.

PubMed

Amigo, Hugo; Vásquez, Sofía; Bustos, Patricia; Ortiz, Guillermo; Lara, Macarena

2012-05-01

The objective was to analyze the relationship between socioeconomic status and age at menarche among indigenous and non-indigenous girls in the Araucanía Region of Chile, controlling for nutritional status and mother's age at menarche. A total of 8,624 randomly selected girls from 168 schools were screened, resulting in the selection of 207 indigenous and 200 non-indigenous girls who had recently experienced menarche. Age at menarche was 149.6 ± 10.7 months in the indigenous group and 146.6 ± 10.8 months in the non-indigenous group. Among the non-indigenous, the analysis showed no significant association between age at menarche and socioeconomic status. In the indigenous group, age at menarche among girls with low socioeconomic status was 5.4 months later than among those with higher socioeconomic status. There were no differences in nutritional status according to socioeconomic level. Obesity was associated with earlier menarche. Menarche occurred earlier than in previous generations. An inverse relationship between socioeconomic status and age at menarche was seen in the indigenous group only; low socioeconomic status was associated with delayed menarche, regardless of nutritional status or mother's age at menarche.

Vascular robustness: The missing parameter in cardiovascular risk prediction.

PubMed

Kraushaar, Lutz E; Dressel, Alexander; Maßmann, Alexander

2018-03-01

Undetected high risk for premature death of cardiovascular disease (CVD) among individuals with low-to-moderate risk factor scores is an acknowledged obstacle to CVD prevention. The vasculature's functional robustness against risk factor derailment may serve as a novel discriminator of mortality risk under similar risk factor loads. To test this assumption, we hypothesized that the expected inverse robustness-mortality association is verifiable as a significant trend along the age spectrum of risk factor-challenged cohorts. This is a retrospective cohort study of 372 adults (mean age 56.1 years, range 21-92; 45% female) with a variety of CV risk factors. An arterial model (VascAssist 2, iSYMED GmbH, Germany) was used to derive global parameters of arterial function from non-invasively acquired pulse pressure waves. Participants were stratified by health status: apparently healthy (AH; n = 221); with hypertension and/or hypercholesterolemia (CC; n = 61); with history of CV event(s) (CVE; n = 90). Multivariate linear regression was used to derive a robustness score which was calibrated against the CVD mortality hazard rate of a sub-cohort of the LURIC study (n = 1369; mean age 59.1 years, range 20-75; 37% female). Robustness correlated linearly with calendar age in CC (F(1, 59) = 10.42; p  < 0.01) and CVE (F(1, 88) = 40.34; p  < 0.0001) but not in the AH strata, supporting the hypothesis of preferential elimination of less robust individuals along the aging trajectory under risk factor challenges. Vascular robustness may serve as a biomarker of vulnerability to CVD risk factor challenges, prognosticating otherwise undetectable elevated risk for premature CVD mortality.

Socioeconomic status and prevalence of self-reported diabetes among adults in Tehran: results from a large population-based cross-sectional study (Urban HEART-2).

PubMed

Asadi-Lari, M; Khosravi, A; Nedjat, S; Mansournia, M A; Majdzadeh, R; Mohammad, K; Vaez-Mahdavi, M R; Faghihzadeh, S; Haeri Mehrizi, A A; Cheraghian, B

2016-05-01

Diabetes mellitus is an important public health challenge worldwide. The prevalence of type 2 diabetes varies across countries. The aim of this study is to estimate the prevalence of type 2 diabetes and to determine related factors including socioeconomic factors in a large random sample of Tehran population in 2011. In this cross-sectional study, 91,814 individuals aged over 20 years were selected randomly based on a multistage, cluster sampling. All participants were interviewed by trained personnel using standard questionnaires. Prevalence and Townsend deprivation indexes were calculated. Principal component analysis (PCA) was used to construct wealth index. Logistic regression model was used in multivariate analysis. The estimated prevalence of self-reported diabetes was 4.98 % overall, 4.76 %in men and 5.19 % in women (P < 0.003). In multivariate analysis, age, marital status (married and divorced/widow) and BMI were positively associated with the prevalence of self-reported diabetes. Of the socioeconomic variables, educational level and wealth status were negatively and Townsend Index was positively associated with diabetes. Our study findings highlight low reported prevalence of diabetes among adults in Tehran. Subjects with low socioeconomic status (SES) had a higher prevalence of type 2 diabetes. Weight gain and obesity were the most important risk factors associated with type 2 diabetes. Wealth index and educational level were better socioeconomic indicators for presenting the inequality in diabetes prevalence in relation to Townsend deprivation index.

The Amagugu Intervention: A Conceptual Framework for Increasing HIV Disclosure and Parent-Led Communication about Health among HIV-Infected Parents with HIV-Uninfected Primary School-Aged Children

PubMed Central

Rochat, Tamsen J.; Mitchell, Joanie; Stein, Alan; Mkwanazi, Ntombizodumo Brilliant; Bland, Ruth M.

2016-01-01

Advances in access to HIV prevention and treatment have reduced vertical transmission of HIV, with most children born to HIV-infected parents being HIV-uninfected themselves. A major challenge that HIV-infected parents face is disclosure of their HIV status to their predominantly HIV-uninfected children. Their children enter middle childhood and early adolescence facing many challenges associated with parental illness and hospitalization, often exacerbated by stigma and a lack of access to health education and support. Increasingly, evidence suggests that primary school-aged children have the developmental capacity to grasp concepts of health and illness, including HIV, and that in the absence of parent-led communication and education about these issues, HIV-exposed children may be at increased risk of psychological and social problems. The Amagugu intervention is a six-session home-based intervention, delivered by lay counselors, which aims to increase parenting capacity to disclose their HIV status and offer health education to their primary school-aged children. The intervention includes information and activities on disclosure, health care engagement, and custody planning. An uncontrolled pre–post-evaluation study with 281 families showed that the intervention was feasible, acceptable, and effective in increasing maternal disclosure. The aim of this paper is to describe the conceptual model of the Amagugu intervention, as developed post-evaluation, showing the proposed pathways of risk that Amagugu aims to disrupt through its intervention targets, mechanisms, and activities; and to present a summary of results from the large-scale evaluation study of Amagugu to demonstrate the acceptability and feasibility of the intervention model. This relatively low-intensity home-based intervention led to: increased HIV disclosure to children, improvements in mental health for mother and child, and improved health care engagement and custody planning for the child. The intervention model demonstrates the potential for disclosure interventions to include pre-adolescent HIV education and prevention for primary school-aged children. PMID:27630981

Dental prosthetic status and prosthetic needs of institutionalised elderly population in oldage homes of jabalpur city, madhya pradesh, India.

PubMed

Deogade, Suryakant C; Vinay, S; Naidu, Sonal

2013-12-01

Oral disorders are cumulative throughout life and hence unfavourable outcomes are likely to be greatest among the elderly. A descriptive cross-sectional study was conducted among institutionalized geriatric population in old-age homes of Jabalpur city, Madhya Pradesh, to assess their prosthetic status and prosthetic needs. A cross-sectional survey was conducted in all the four old-age homes of Jabalpur city, Madhya Pradesh state, India. All residents aged 60 years and above formed the study population. The recording of prosthetic status and prosthetic needs was carried out according to the World Health Organisation (WHO) Oral Health Assessment Form (1997). A total of 224 individuals were included in the study of which 123 were females and 101 were males. Seventy five percent of the females and 55 % of the males had no prostheses in their upper arch and 61 % of the females and 76 % of the males had no prostheses in their lower arch. More number of males presented with 'Bridges' in their upper arch when compared to females (P value = 0.006). Highest prosthetic need in males was multi-unit prosthesis (42 % in upper arch and 41 % in lower arch) whereas, females' required full prosthesis (39 % in both the upper arch and lower arches). Ageing presents some formidable challenges, particularly with the institutionalised. This study clearly demonstrates a high insufficiency of prosthetic care among the institutionalized elderly population. Any preparation towards the provision of oral health care should not be limited to treatment alone but, more importantly focus on empowering this elderly community with information and education programmes.

Perception of care and barriers to treatment in individuals with diabetic retinopathy in India: 11-city 9-state study

PubMed Central

Shukla, Rajan; Gudlavalleti, Murthy V. S.; Bandyopadhyay, Souvik; Anchala, Raghupathy; Gudlavalleti, Aashrai Sai Venkat; Jotheeswaran, A. T.; Ramachandra, Srikrishna S.; Singh, Vivek; Vashist, Praveen; Allagh, Komal; Ballabh, Hira Pant; Gilbert, Clare E.

2016-01-01

Background: Diabetic retinopathy is a leading cause of visual impairment. Low awareness about the disease and inequitable distribution of care are major challenges in India. Objectives: Assess perception of care and challenges faced in availing care among diabetics. Materials and Methods: The cross-sectional, hospital based survey was conducted in eleven cities. In each city, public and private providers of eye-care were identified. Both multispecialty and standalone facilities were included. Specially designed semi-open ended questionnaires were administered to the clients. Results: 376 diabetics were interviewed in the eye clinics, of whom 62.8% (236) were selected from facilities in cities with a population of 7 million or more. The mean duration of known diabetes was 11.1 (±7.7) years. Half the respondents understood the meaning of adequate glycemic control and 45% reported that they had visual loss when they first presented to an eye facility. Facilities in smaller cities and those with higher educational status were found to be statistically significant predictors of self-reported good/adequate control of diabetes. The correct awareness of glycemic control was significantly high among attending privately-funded facilities and higher educational status. Self-monitoring of glycemic status at home was significantly associated with respondents from larger cities, privately-funded facilities, those who were better educated and reported longer duration of diabetes. Duration of diabetes (41%), poor glycemic control (39.4%) and age (20.7%) were identified as the leading causes of DR. The commonest challenges faced were lifestyle/behavior related. Conclusions: The findings have significant implications for the organization of diabetes services in India. PMID:27144135

Employment among older workers and inequality of gender and education: evidence from a Taiwanese national survey.

PubMed

Lu, Luo

2010-01-01

The aim of this research was twofold: to examine the prevalence of employment and under-employment among Taiwanese older workers (aged 50 and above), and to explore personal correlates of their employment status, in particular gender and education. Using a national representative sample, we found that: 1) a rather substantial percentage of people continued to work well into their older years; 2) the underemployment rates were substantial in the older age, and less-educated workers and women were more at risk; and 3) multivariate analysis confirmed that age, gender, personal health, spousal health, and family income were significant predictors of continued employment after age 50. Gender and education were also significantly related to the risk of under-employment. Our results highlight the importance and urgency of more concerted research to inform public labor policies, especially in an aging developing society where older workers are faced with a double challenge of economic and societal restructuring.

Does Farming Have an Effect on Health Status? A Comparison Study in West Greece

PubMed Central

Demos, Konstantinos; Sazakli, Eleni; Jelastopulu, Eleni; Charokopos, Nikolaos; Ellul, John; Leotsinidis, Michalis

2013-01-01

Investigating the health status of agricultural workers is a challenging goal. Contradictory outcomes concerning farmers’ health are reported in the literature. In this cross-sectional study, certain clinical and neurobehavioral health outcomes were compared between farmers and non-farmers living in the same rural area. Farmers (328) and non-farmers (347), matched per age and sex, were selected randomly in an agricultural area in West Greece. Both groups underwent haematological and biochemical examinations and were administered two neurobehavioral tests, namely the Mini-Mental State Examination (MMSE) and the Montgomery-Åsberg Depression Rating Scale (MADRS). Sociodemographic, personal medical, nutritional and lifestyle data were recorded. According to personal statements, farmers suffered from hypertension, cardiovascular, orthopaedic and ENT problems in higher frequency. Haematocrit, haemoglobin and serum cholinesterase’s activity were found to be lower among farmers. Lower prevalence of hypertension and better performances on MMSE and MADRS tests were recorded in young farmers in relation to young non-farmers, while these findings were reversed in older ages. Odds Ratios were calculated through multivariate logistic regression models. Factors affecting these impairments remain to be clarified. PMID:23442558

Does farming have an effect on health status? A comparison study in west Greece.

PubMed

Demos, Konstantinos; Sazakli, Eleni; Jelastopulu, Eleni; Charokopos, Nikolaos; Ellul, John; Leotsinidis, Michalis

2013-02-26

Investigating the health status of agricultural workers is a challenging goal. Contradictory outcomes concerning farmers' health are reported in the literature. In this cross-sectional study, certain clinical and neurobehavioral health outcomes were compared between farmers and non-farmers living in the same rural area. Farmers (328) and non-farmers (347), matched per age and sex, were selected randomly in an agricultural area in West Greece. Both groups underwent haematological and biochemical examinations and were administered two neurobehavioral tests, namely the Mini-Mental State Examination (MMSE) and the Montgomery-Åsberg Depression Rating Scale (MADRS). Sociodemographic, personal medical, nutritional and lifestyle data were recorded. According to personal statements, farmers suffered from hypertension, cardiovascular, orthopaedic and ENT problems in higher frequency. Haematocrit, haemoglobin and serum cholinesterase's activity were found to be lower among farmers. Lower prevalence of hypertension and better performances on MMSE and MADRS tests were recorded in young farmers in relation to young non-farmers, while these findings were reversed in older ages. Odds Ratios were calculated through multivariate logistic regression models. Factors affecting these impairments remain to be clarified.

Aging, Nutritional Status and Health.

PubMed

Leslie, Wilma; Hankey, Catherine

2015-07-30

The older population is increasing worldwide and in many countries older people will outnumber younger people in the near future. This projected growth in the older population has the potential to place significant burdens on healthcare and support services. Meeting the diet and nutrition needs of older people is therefore crucial for the maintenance of health, functional independence and quality of life. While many older adults remain healthy and eat well those in poorer health may experience difficulties in meeting their nutritional needs. Malnutrition, encompassing both under and over nutrition increases health risks in the older population. More recently the increase in obesity, and in turn the incidence of chronic disease in older adults, now justifies weight management interventions in obese older adults. This growing population group is becoming increasingly diverse in their nutritional requirements. Micro-nutrient status may fluctuate and shortfalls in vitamin D, iron and a number of other nutrients are relatively common and can impact on well-being and quality of life. Aging presents a number of challenges for the maintenance of good nutritional health in older adults.

Age at adiposity rebound and body mass index trajectory from early childhood to adolescence; differences by breastfeeding and maternal immigration background.

PubMed

Besharat Pour, M; Bergström, A; Bottai, M; Magnusson, J; Kull, I; Moradi, T

2017-02-01

This paper aims to assess association between breastfeeding and maternal immigration background and body mass index development trajectories from age 2 to 16 years. A cohort of children born in Stockholm during 1994 to 1996 was followed from age 2 to 16 years with repeated measurement of height and weight at eight time points (n = 2278). Children were categorized into groups by breastfeeding status during the first 6 months of life and maternal immigration background. Body mass index (BMI) trajectories and age at adiposity rebound were estimated using mixed-effects linear models. Body mass index trajectories were different by breastfeeding and maternal immigration status (P-value < 0.0001). Compared with exclusively breastfed counterparts, never/short breastfed children of Swedish mothers had a higher BMI trajectory, whereas never/short breastfed children of immigrant mothers followed a lower BMI trajectory. Ages at adiposity rebound were earlier for higher BMI trajectories regardless of maternal immigration background. Differences in BMI trajectories between offspring of immigrant and of Swedish mothers suggest a lack of beneficial association between breastfeeding and long-term BMI development among children of immigrant mothers. Given the relation between long-term BMI development and risk of overweight/obesity, these differences challenge the notion that exclusive breastfeeding is always beneficial for children's BMI development and subsequent risk of overweight/obesity. © 2016 World Obesity Federation.

Gender and sex differences in job status and hypertension.

PubMed

Clougherty, Jane E; Eisen, Ellen A; Slade, Martin D; Kawachi, Ichiro; Cullen, Mark R

2011-01-01

Studies have shown greater health risks associated with blue-collar manufacturing employment for women than men. It remains challenging, however, to distinguish gendered job status (affected by family composition and other personal characteristics) from sex-linked biological differences influencing physiological response to workplace physical hazards. We examined the effects of hourly (blue-collar) status on incident hypertension among men and women, using health claims data for 14, 618 white- and blue-collar aluminium manufacturing employees in eight US states. To explore gender differences in job status, we developed sex-stratified propensity score models identifying key socioeconomic predictors of hourly status for men and women. To examine the effects of hourly employment on hypertension risk, after adjusting for gender differences in job status, we applied time-weighted logistic regression models, stratified by propensity score, with additional adjustment for socioeconomic confounders. Family structure (partnership, parity) influenced job status for both sexes; single mothers were more likely to hold hourly jobs (OR 2.02; 95% CI 1.37 to 2.97) and partnered men with children less likely (OR 0.68; 95% CI 0.56 to 0.83). Education, age at hire and race influenced job status for both sexes. The effect of hourly status on hypertension was significant only among women predicted to be hourly (OR 1.78; 95% CI 1.34 to 2.35). Our results indicate significant risks of hypertension associated with hourly status for women, possibly exacerbated by sociodemographic factors predicting hourly status (eg, single parenthood, low education). Greater attention to gender differences in job status, and finer exploration of sex-linked biological differences influencing responsivity to workplace exposures, is warranted.

Health status and coping strategies among older parent-carers of adults with intellectual disabilities in an Australian sample.

PubMed

Llewellyn, Gwynnyth; McConnell, David; Gething, Lindsay; Cant, Rosemary; Kendig, Hal

2010-01-01

Older parent-carers in Australia are the subject of increasing policy and practice attention due to concerns about their ongoing ability to care in the light of their own ageing and the ageing of their adult son or daughter. This paper examines health status and the coping strategies of a group of older Australian parents caring for an adult son or daughter with intellectual disabilities. Health status using the SF-12 (Ware, Snow, Kosinski, & Gandek, 1993), caring stress using the CADI (Nolan, Grant, & Keady, 1998), and coping strategies using the CAMI (Nolan et al., 1998) were assessed in 64 older parent-carers of adults with intellectual disabilities. The self-reported health status of this sample of older parent-carers did not differ significantly from Australian population norms, with one exception. That is, the younger parent-carers in the sample (55-64 years) reported significantly poorer mental health. Better health was associated with having a partner, a larger and close support network of family, friends and neighbours, and a lower care-load. Overall, the study participants identified both satisfaction as well as stress associated with caring, a finding that runs counter to the common perception that being a carer is overwhelmingly burdensome. Common sources of stress were feeling helpless or not in control, and poor professional support. Analysis of older parent-carers coping strategies suggests that self-reliance, whether by choice or necessity, was the norm. The health status of older parent-carers may present less cause for concern than anecdotal reports suggest. That said, the strong self-reliance particularly of the older carers presents a challenge to service providers seeking to engage those whose situation appears to warrant support from the service system. Copyright © 2010 Elsevier Ltd. All rights reserved.

The vitamin D status and its effects on life quality among the elderly in Jinan, China.

PubMed

Feng, Xiaoyu; Guo, Tao; Wang, Yan; Kang, Donghong; Che, Xuanqiang; Zhang, Hongmei; Cao, Wei; Wang, Ping

2016-01-01

A challenge for researchers is that vitamin D has many functions in the body, and vitamin D status across the world is not optimistic. There was little data regarding insufficient vitamin D status and its adverse effect on health of elderly Chinese people. So we selected 686 subjects (310 men and 376 women) aged 60-89 years to explore the correlation between vitamin D status and their life quality in a community-based osteoporosis prevention study at Qianfoshan Hospital of Shandong University from 2009 to 2010. All subjects were divided into three groups: vitamin D adequacy [serum 25(OH)D ≧ 75 nmol/L], hypovitaminosis D (50-74.9 nmol/L), and vitamin D insufficiency (<50 nmol/L). Participants were requested to complete SF-36 health survey. The regression models were used to evaluate respectively the association between 25(OH)D levels and parameters of SF-36. As a result, serum 25(OH)D levels were 58.60 nmol/L in male [95% confidence interval (95% CI): 56.7-60.5 nmol/L] and 54.17 nmol/L in female (95% CI: 52.8-55.8 nmol/L). Vitamin D adequacy was in 19.4% of male and 14.4% of female. With aging, proportions of insufficient vitamin D increased significantly in male (P=0.004), and in female (P<0.001). The elderly with hypovitaminosis D got lower scores than that with vitamin D adequacy (almost P<0.01). Regression analysis showed that vitamin D appeared a positive association with parameters of SF-36 (almost P<0.001). In conclusion, vitamin D status in the elderly was severely inadequate, which decreased their life quality and cause adverse effect on their health. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Variation in Subjective Aging by Sexual Minority Status.

PubMed

Barrett, Anne; Barbee, Harry

2017-06-01

The past few decades have seen increased scholarly attention to gay and lesbian individuals' aging experiences; however, few studies examine differences in subjective aging by sexual minority status. We identify four perspectives on the association between sexual minority status and subjective aging-double jeopardy, crisis competence, gender interactive, and limited salience perspectives. We examine each perspective's predictions using data from the first wave of Midlife in the United States (1995-1996; MIDUS). Ordinary least square regression models reveal strongest support for the limited salience perspective, suggesting that sexual minority status has weaker effects on subjective aging than do other social factors, such as age, health, and gender. However, some results provide support for the gender interactive perspective, positing that the effect of sexual minority status on subjective aging varies by gender. Our study provides an organizational framework of theoretical perspectives that can guide further examinations of variation in aging experiences by sexual minority status.

Workshop--E-leaks: the privacy of health information in the age of electronic information.

PubMed

Vonn, Michael; Lang, Renée; Perras, Maude

2011-10-01

This workshop examined some of the new challenges to health-related privacy emerging as a result of the proliferation of electronic communications and data storage, including through social media, electronic health records and ready access to personal information on the internet. The right to privacy is a human right. As such, protecting privacy and enforcing the duty of confidentiality regarding health information are fundamental to treating people with autonomy, dignity and respect. For people living with HIV, unauthorized disclosure of their status can lead to discrimination and breaches of other human rights. While this is not new, in this information age a new breed of privacy violation is emerging and our legal protections are not necessarily keeping pace.

Extrapulmonary involvement in pediatric tuberculosis.

PubMed

Kritsaneepaiboon, Supika; Andres, Mariaem M; Tatco, Vincent R; Lim, Cielo Consuelo Q; Concepcion, Nathan David P

2017-09-01

Tuberculosis in childhood is clinically challenging, but it is a preventable and treatable disease. Risk factors depend on age and immunity status. The most common form of pediatric tuberculosis is pulmonary disease, which comprises more than half of the cases. Other forms make up the extrapulmonary tuberculosis that involves infection of the lymph nodes, central nervous system, gastrointestinal system, hepatobiliary tree, and renal and musculoskeletal systems. Knowledge of the imaging characteristics of pediatric tuberculosis provides clues to diagnosis. This article aims to review the imaging characteristics of common sites for extrapulmonary tuberculous involvement in children.

Management of type 2 diabetes mellitus: Adherence challenges in environments of low socio-economic status

PubMed Central

Phillips, Julie

2014-01-01

Abstract Background The efficacy of treatment for clients with diabetes is highly dependent on the individual's ability to manage the disease. Several constraints, such as poverty, illiteracy and insufficient resources (finances and specialised healthcare professionals), especially communities of low socio-economic status, could influence clients’ ability to manage their disease. Aim The main aim of this study was to outline the obstacles encountered by individuals with type 2 diabetes mellitus from an urban community with regard to management of their disease. Setting The study was conducted at a primary health care facility in the Western Cape, South Africa. Methods Ethical clearance was obtained from all relevant authorities. Eight (8) conveniently selected clients with type 2 diabetes mellitus per participating community healthcare centre (six approved centres in total) were invited to take part in focus group discussions. Twenty six clients, 15 females and 11 males, with a mean age of 58.92 years (SD = 7.33), agreed to participate. Audiotaped data were transcribed verbatim followed by content analysis and identification of themes. Results Themes that emerged were challenges with: a healthy eating plan, physical activity, financial constraints, other people's understanding of the disease, and service received at the community healthcare centre. Verbatim quotes were used to exemplify the themes. Conclusion Clients with type 2 diabetes mellitus experienced several challenges in the management of their disease. These challenges should be addressed to assist with better glycaemic control and to curb the emergence of diabetic complications and their attendant cost implications. PMID:26245413

Economic abuse between intimate partners in Australia: prevalence, health status, disability and financial stress.

PubMed

Kutin, Jozica; Russell, Roslyn; Reid, Mike

2017-06-01

Economic abuse is a form of domestic violence that has a significant impact on the health and financial wellbeing of victims, but is understudied. This study determined the lifetime prevalence of economic abuse in Australia by age and gender, and the associated risk factors. The 2012 ABS Personal Safety Survey was used, involving a cross-sectional population survey of 17,050 randomly selected adults using face-to-face interviews. The survey-weighted prevalence of economic abuse was calculated and analysed by age and gender. Logistic regression was used to adjust odds ratios for possible confounding between variables. The lifetime prevalence of economic abuse in the whole sample was 11.5%. Women in all age groups were more likely to experience economic abuse (15.7%) compared to men (7.1%). Disability, health and financial stress status were significant markers of economic abuse. For women, financial stress and disability were important markers of economic abuse. However, prevalence rates were influenced by the measures used and victims' awareness of the abuse, which presents a challenge for screening and monitoring. Implications for public health: Social, health and financial services need to be aware of and screen for the warning signs of this largely hidden form of domestic violence. © 2017 The Authors.

Watson for Oncology and breast cancer treatment recommendations: agreement with an expert multidisciplinary tumor board.

PubMed

Somashekhar, S P; Sepúlveda, M-J; Puglielli, S; Norden, A D; Shortliffe, E H; Rohit Kumar, C; Rauthan, A; Arun Kumar, N; Patil, P; Rhee, K; Ramya, Y

2018-02-01

Breast cancer oncologists are challenged to personalize care with rapidly changing scientific evidence, drug approvals, and treatment guidelines. Artificial intelligence (AI) clinical decision-support systems (CDSSs) have the potential to help address this challenge. We report here the results of examining the level of agreement (concordance) between treatment recommendations made by the AI CDSS Watson for Oncology (WFO) and a multidisciplinary tumor board for breast cancer. Treatment recommendations were provided for 638 breast cancers between 2014 and 2016 at the Manipal Comprehensive Cancer Center, Bengaluru, India. WFO provided treatment recommendations for the identical cases in 2016. A blinded second review was carried out by the center's tumor board in 2016 for all cases in which there was not agreement, to account for treatments and guidelines not available before 2016. Treatment recommendations were considered concordant if the tumor board recommendations were designated 'recommended' or 'for consideration' by WFO. Treatment concordance between WFO and the multidisciplinary tumor board occurred in 93% of breast cancer cases. Subgroup analysis found that patients with stage I or IV disease were less likely to be concordant than patients with stage II or III disease. Increasing age was found to have a major impact on concordance. Concordance declined significantly (P ≤ 0.02; P < 0.001) in all age groups compared with patients <45 years of age, except for the age group 55-64 years. Receptor status was not found to affect concordance. Treatment recommendations made by WFO and the tumor board were highly concordant for breast cancer cases examined. Breast cancer stage and patient age had significant influence on concordance, while receptor status alone did not. This study demonstrates that the AI clinical decision-support system WFO may be a helpful tool for breast cancer treatment decision making, especially at centers where expert breast cancer resources are limited. © The Author(s) 2018. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Parenthood and host resistance to the common cold.

PubMed

Sneed, Rodlescia S; Cohen, Sheldon; Turner, Ronald B; Doyle, William J

2012-01-01

To determine whether parenthood predicts host resistance to the common cold among healthy volunteers experimentally exposed to a common cold virus. Participants were 795 healthy volunteers (age range = 18-55 years) enrolled in one of three viral-challenge studies conducted from 1993 to 2004. After reporting parenthood status, participants were quarantined, administered nasal drops containing one of four common cold viruses, and monitored for the development of a clinical cold (infection in the presence of objective signs of illness) on the day before and for 5 to 6 days after exposure. All analyses included controls for immunity to the experimental virus (prechallenge specific antibody titers), viral strain, season, age, sex, race/ethnicity, marital status, body mass, study, employment status, and education. Parents were less likely to develop colds than nonparents were (odds ratio [OR] = 0.48, 95% confidence interval [CI] = 0.31-0.73). This was true for both parents with one to two children (OR = 0.52, 95% CI = 0.33-0.83) and three or more children (OR = 0.39, 95% CI = 0.22-0.70). Parenthood was associated with a decreased risk of colds for both those with at least one child living at home (OR = 0.46, 95% CI = 0.24-0.87) and those whose children all lived away from home (OR = 0.27, 95% CI = 0.12-0.60). The relationship between parenthood and colds was not observed in parents aged 18 to 24 years but was pronounced among older parents. Parenthood was associated with greater host resistance to common cold viruses.

Socio-economic, clinical and biological risk factors for mother - to - child transmission of HIV-1 in Muhima health centre (Rwanda): a prospective cohort study.

PubMed

Bucagu, Maurice; Bizimana, Jean de Dieu; Muganda, John; Humblet, Claire Perrine

2013-02-28

Three decades since the first HIV-1 infected patients in Rwanda were identified in 1983; the Acquired Immunodeficiency Syndrome epidemic has had a devastating history and is still a major public health challenge in the country. This study was aimed at assessing socioeconomic, clinical and biological risk factors for mother - to - child transmission of HIV- in Muhima health centre (Kigali/Rwanda). The prospective cohort study was conducted at Muhima Health centre (Kigali/Rwanda).During the study period (May 2007 - April 2010), of 8,669 pregnant women who attended antenatal visits and screened for HIV-1, 736 tested HIV-1 positive and among them 700 were eligible study participants. Hemoglobin, CD4 count and viral load tests were performed for participant mothers and HIV-1 testing using DNA PCR technique for infants.Follow up data for eligible mother-infant pairs were obtained from women themselves and log books in Muhima health centre and maternity, using a structured questionnaire.Predictors of mother-to-child transmission of HIV-1 were assessed by multivariable logistic regression analysis. Among the 679 exposed and followed-up infants, HIV-1 status was significantly associated with disclosure of HIV status to partner both at 6 weeks of age (non-disclosure of HIV status, adjusted odds ratio [AOR] 4.68, CI 1.39 to 15.77, p < 0.05; compared to disclosure) and at 6 months of age (non-disclosure of HIV status, AOR, 3.41, CI 1.09 to 10.65, p < 0.05, compared to disclosure).A significant association between mother's viral load (HIV-1 RNA) and infant HIV-1 status was found both at 6 weeks of age (> = 1000 copies/ml, AOR 7.30, CI 2.65 to 20.08, p < 0.01, compared to <1000 copies/ml) and at 6 months of age (> = 1000 copies/ml, AOR 4.60, CI 1.84 to 11.49, p < 0.01, compared to <1000 copies/ml). In this study, the most relevant factors independently associated with increased risk of mother - to - child transmission of HIV-1 included non-disclosure of HIV status to partner and high HIV-1 RNA. Members of this cohort also showed socioeconomic inequalities, with unmarried status carrying higher risk of undisclosed HIV status. The monitoring of maternal HIV-1 RNA level might be considered as a routinely used test to assess the risk of transmission with the goal of achieving viral suppression as critical for elimination of pediatric HIV, particularly in breastfeeding populations.

Ethical challenges in resuscitation.

PubMed

Mentzelopoulos, Spyros D; Slowther, Anne-Marie; Fritz, Zoe; Sandroni, Claudio; Xanthos, Theodoros; Callaway, Clifton; Perkins, Gavin D; Newgard, Craig; Ischaki, Eleni; Greif, Robert; Kompanje, Erwin; Bossaert, Leo

2018-06-01

A rapidly evolving resuscitation science provides more effective treatments to an aging population with multiple comorbidites. Concurrently, emergency care has become patient-centered. This review aims to describe challenges associated with the application of key principles of bioethics in resuscitation and post-resuscitation care; propose actions to address these challenges; and highlight the need for evidence-based ethics and consensus on ethical principles interpretation. Following agreement on the article's outline, subgroups of 2-3 authors provided narrative reviews of ethical issues concerning autonomy and honesty, beneficence/nonmaleficence and dignity, justice, specific practices/circumstances such as family presence during resuscitation, and emergency research. Proposals for addressing ethical challenges were also offered. Respect for patient autonomy can be realized through honest provision of information, shared decision-making, and advance directives/care planning. Essential prerequisites comprise public and specific healthcare professionals' education, appropriate regulatory provisions, and allocation of adequate resources. Regarding beneficence/nonmaleficence, resuscitation should benefit patients, while avoiding harm from futile interventions; pertinent practice should be based on neurological prognostication and patient/family-reported outcomes. Regarding dignity, aggressive life-sustaining treatments against patients preferences should be avoided. Contrary to the principle of justice, resuscitation quality may be affected by race/income status, age, ethnicity, comorbidity, and location (urban versus rural or country-specific/region-specific). Current evidence supports family presence during resuscitation. Regarding emergency research, autonomy should be respected without hindering scientific progress; furthermore, transparency of research conduct should be promoted and funding increased. Major ethical challenges in resuscitation science need to be addressed through complex/resource-demanding interventions. Such actions require support by ongoing/future research.

Systems vaccinology: Probing humanity’s diverse immune systems with vaccines

PubMed Central

Pulendran, Bali

2014-01-01

Homo sapiens are genetically diverse, but dramatic demographic and socioeconomic changes during the past century have created further diversification with respect to age, nutritional status, and the incidence of associated chronic inflammatory disorders and chronic infections. These shifting demographics pose new challenges for vaccination, as emerging evidence suggests that age, the metabolic state, and chronic infections can exert major influences on the immune system. Thus, a key public health challenge is learning how to reprogram suboptimal immune systems to induce effective vaccine immunity. Recent advances have applied systems biological analysis to define molecular signatures induced early after vaccination that correlate with and predict the later adaptive immune responses in humans. Such “systems vaccinology” approaches offer an integrated picture of the molecular networks driving vaccine immunity, and are beginning to yield novel insights about the immune system. Here we discuss the promise of systems vaccinology in probing humanity’s diverse immune systems, and in delineating the impact of genes, the environment, and the microbiome on protective immunity induced by vaccination. Such insights will be critical in reengineering suboptimal immune systems in immunocompromised populations. PMID:25136102

Systems vaccinology: probing humanity's diverse immune systems with vaccines.

PubMed

Pulendran, Bali

2014-08-26

Homo sapiens are genetically diverse, but dramatic demographic and socioeconomic changes during the past century have created further diversification with respect to age, nutritional status, and the incidence of associated chronic inflammatory disorders and chronic infections. These shifting demographics pose new challenges for vaccination, as emerging evidence suggests that age, the metabolic state, and chronic infections can exert major influences on the immune system. Thus, a key public health challenge is learning how to reprogram suboptimal immune systems to induce effective vaccine immunity. Recent advances have applied systems biological analysis to define molecular signatures induced early after vaccination that correlate with and predict the later adaptive immune responses in humans. Such "systems vaccinology" approaches offer an integrated picture of the molecular networks driving vaccine immunity, and are beginning to yield novel insights about the immune system. Here we discuss the promise of systems vaccinology in probing humanity's diverse immune systems, and in delineating the impact of genes, the environment, and the microbiome on protective immunity induced by vaccination. Such insights will be critical in reengineering suboptimal immune systems in immunocompromised populations.

A Case–Control Study of Socio-Economic and Nutritional Characteristics as Determinants of Dental Caries in Different Age Groups, Considered as Public Health Problem: Data from NHANES 2013–2014

PubMed Central

Chávez-Lamas, Nubia M.; Gracia-Cortés, Ma. del Carmen; Moreno-Báez, Arturo; Arceo-Olague, Jose G.; Galván-Tejada, Jorge I.

2018-01-01

One of the principal conditions that affects oral health worldwide is dental caries, occurring in about 90% of the global population. This pathology has been considered a challenge because of its high prevalence, besides being a chronic but preventable disease which can be caused by a series of different demographic, dietary, among others. Based on this problem, in this research a demographic and dietary features analysis is performed for the classification of subjects according to their oral health status based on caries, according to the age group where the population belongs, using as feature selector a technique based on fast backward selection (FBS) approach for the development of three predictive models, one for each age range (group 1: 10–19; group 2: 20–59; group 3: 60 or more years old). As validation, a net reclassification improvement (NRI), AUC, ROC, and OR values are used to evaluate their classification accuracy. We analyzed 189 demographic and dietary features from National Health and Nutrition Examination Survey (NHANES) 2013–2014. Each model obtained statistically significant results for most features and narrow OR confidence intervals. Age group 2 obtained a mean NRI = −0.080 and AUC = 0.933; age group 3 obtained a mean NRI = −0.024 and AUC = 0.787; and age group 4 obtained a mean NRI = −0.129 and AUC = 0.735. Based on these results, it is concluded that these specific demographic and dietary features are significant determinants for estimating the oral health status in patients based on their likelihood of developing caries, and the age group could imply different risk factors for subjects. PMID:29748513

A Case⁻Control Study of Socio-Economic and Nutritional Characteristics as Determinants of Dental Caries in Different Age Groups, Considered as Public Health Problem: Data from NHANES 2013⁻2014.

PubMed

Zanella-Calzada, Laura A; Galván-Tejada, Carlos E; Chávez-Lamas, Nubia M; Gracia-Cortés, Ma Del Carmen; Moreno-Báez, Arturo; Arceo-Olague, Jose G; Celaya-Padilla, Jose M; Galván-Tejada, Jorge I; Gamboa-Rosales, Hamurabi

2018-05-10

One of the principal conditions that affects oral health worldwide is dental caries, occurring in about 90% of the global population. This pathology has been considered a challenge because of its high prevalence, besides being a chronic but preventable disease which can be caused by a series of different demographic, dietary" among others. Based on this problem, in this research a demographic and dietary features analysis is performed for the classification of subjects according to their oral health status based on caries, according to the age group where the population belongs, using as feature selector a technique based on fast backward selection (FBS) approach for the development of three predictive models, one for each age range (group 1: 10⁻19; group 2: 20⁻59; group 3: 60 or more years old). As validation, a net reclassification improvement (NRI), AUC, ROC, and OR values are used to evaluate their classification accuracy. We analyzed 189 demographic and dietary features from National Health and Nutrition Examination Survey (NHANES) 2013⁻2014. Each model obtained statistically significant results for most features and narrow OR confidence intervals. Age group 2 obtained a mean NRI = -0.080 and AUC = 0.933; age group 3 obtained a mean NRI = -0.024 and AUC = 0.787; and age group 4 obtained a mean NRI = -0.129 and AUC = 0.735. Based on these results, it is concluded that these specific demographic and dietary features are significant determinants for estimating the oral health status in patients based on their likelihood of developing caries, and the age group could imply different risk factors for subjects.

Disclosure of Positive BRCA1/2-Mutation Status in Young Couples: The Journey From Uncertainty to Bonding Through Partner Support

PubMed Central

Hoskins, Lindsey M.; Roy, Kevin; Peters, June A.; Loud, Jennifer T.; Greene, Mark H.

2011-01-01

BRCA1/2-positive women who learn their mutation status early in the life-course face unique challenges related to navigating the tasks of young adulthood. Using qualitative methods and grounded theory, the authors analyzed in-depth interviews with 11 women aged 26 to 35 who learned their mutation status before marriage. Their narratives illustrate the complexity of relationship formation, and highlight the potential for relationship-bonding and intimacy-building in the course of sharing mutation information. Disclosing BRCA mutation status to dating partners is often preceded by feelings of fear and anxiety, yet many participants reported that doing so has positive effects on relationships. Partners’ abilities to respond with interest, empathy, and affection are associated with in creased future intimacy, consistent with generally accepted principles within the family/couple systems field. Individual cancer risk perception and familial cancer experiences may affect the disclosure experience, which can be understood via Attachment Theory. Our findings provide clinical insight, identify new areas for research, and suggest ways to assist this unique population in their adjustment to being BRCA mutation-positive. PMID:25132793

Dreams deferred: Contextualizing the health and psychosocial needs of undocumented Asian and Pacific Islander young adults in Northern California.

PubMed

Sudhinaraset, May; Ling, Irving; To, Tu My; Melo, Jason; Quach, Thu

2017-07-01

There are currently 1.5 million undocumented Asians and Pacific Islanders (APIs) in the US. Undocumented API young adults, in particular, come of age in a challenging political and social climate, but little is known about their health outcomes. To our knowledge, this is the first study to assess the psychosocial needs and health status of API undocumented young adults. Guided by social capital theory, this qualitative study describes the social context of API undocumented young adults (ages 18-31), including community and government perceptions, and how social relationships influence health. This study was conducted in Northern California and included four focus group discussions (FGDs) and 24 in-depth interviews (IDIs), with 32 unique participants total. FGDs used purposeful sampling by gender (two male and two female discussions) and education status (in school and out-of-school). Findings suggest low bonding and bridging social capital. Results indicate that community distrust is high, even within the API community, due to high levels of exploitation, discrimination, and threats of deportation. Participants described how documentation status is a barrier in accessing health services, particularly mental health and sexual and reproductive health services. This study identifies trusted community groups and discusses recommendations for future research, programs, and policies. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Implementing primary health care-based PMTCT interventions: operational perspectives from Muhima cohort analysis (Rwanda)

PubMed Central

Bucagu, Maurice; Muganda, John

2014-01-01

Introduction In countries with high burden of HIV, major programmatic challenges have been identified to preventing new infections among children and scaling up of treatment for pregnant mothers. We initiated this study to examine operational approaches that were used to enhance implementation of PMTCT interventions in Muhima health Centre (Kigali/Rwanda) from 2007 to 2010. Methods The prospective cohort study was conducted at Muhima health centre. A sample size of 656 was the minimum number required for the study. The main outcome was cumulative incidence of mother - to - child transmission of HIV-1 measured at 6 weeks of life among live born children. Results Among the 679 live born babies and followed up in this study, the overall cumulative rate of HIV-1 mother - to - child transmission observed was 3.2% at 6 weeks of age after birth. Disclosure of HIV status to partner was significantly associated with HIV-1 status of infants at 6 weeks of age (non-disclosure of HIV status adjusted odds ratio [AOR] 4.68, CI 1.39 to 15.77, p. Conclusion The Muhima type of decentralized health facility offered an appropriate platform for implementation of PMTCT interventions, with the following operational features: family - centered approach; integrated service delivery for PMTCT/MCH interventions, task shifting; subsidized membership fees for people living with HIV, allowing for access to the community-based health insurance benefits. PMID:26113893

First trimester prediction of maternal glycemic status.

PubMed

Gabbay-Benziv, Rinat; Doyle, Lauren E; Blitzer, Miriam; Baschat, Ahmet A

2015-05-01

To predict gestational diabetes mellitus (GDM) or normoglycemic status using first trimester maternal characteristics. We used data from a prospective cohort study. First trimester maternal characteristics were compared between women with and without GDM. Association of these variables with sugar values at glucose challenge test (GCT) and subsequent GDM was tested to identify key parameters. A predictive algorithm for GDM was developed and receiver operating characteristics (ROC) statistics was used to derive the optimal risk score. We defined normoglycemic state, when GCT and all four sugar values at oral glucose tolerance test, whenever obtained, were normal. Using same statistical approach, we developed an algorithm to predict the normoglycemic state. Maternal age, race, prior GDM, first trimester BMI, and systolic blood pressure (SBP) were all significantly associated with GDM. Age, BMI, and SBP were also associated with GCT values. The logistic regression analysis constructed equation and the calculated risk score yielded sensitivity, specificity, positive predictive value, and negative predictive value of 85%, 62%, 13.8%, and 98.3% for a cut-off value of 0.042, respectively (ROC-AUC - area under the curve 0.819, CI - confidence interval 0.769-0.868). The model constructed for normoglycemia prediction demonstrated lower performance (ROC-AUC 0.707, CI 0.668-0.746). GDM prediction can be achieved during the first trimester encounter by integration of maternal characteristics and basic measurements while normoglycemic status prediction is less effective.

Evaluating emotional sensitivity and tolerance factors in the prediction of panic-relevant responding to a biological challenge.

PubMed

Kutz, Amanda; Marshall, Erin; Bernstein, Amit; Zvolensky, Michael J

2010-01-01

The current study investigated anxiety sensitivity, distress tolerance (Simons & Gaher, 2005), and discomfort intolerance (Schmidt, Richey, Cromer, & Buckner, 2007) in relation to panic-relevant responding (i.e., panic attack symptoms and panic-relevant cognitions) to a 10% carbon dioxide enriched air challenge. Participants were 216 adults (52.6% female; M(age)=22.4, SD=9.0). A series of hierarchical multiple regressions was conducted with covariates of negative affectivity and past year panic attack history in step one of the model, and anxiety sensitivity, discomfort intolerance, and distress tolerance entered simultaneously into step two. Results indicated that anxiety sensitivity, but not distress tolerance or discomfort intolerance, was significantly incrementally predictive of physical panic attack symptoms and cognitive panic attack symptoms. Additionally, anxiety sensitivity was significantly predictive of variance in panic attack status during the challenge. These findings emphasize the important, unique role of anxiety sensitivity in predicting risk for panic psychopathology, even when considered in the context of other theoretically relevant emotion vulnerability variables.

Health-related quality of life among long-term rectal cancer survivors with an ostomy: manifestations by sex.

PubMed

Krouse, Robert S; Herrinton, Lisa J; Grant, Marcia; Wendel, Christopher S; Green, Sylvan B; Mohler, M Jane; Baldwin, Carol M; McMullen, Carmit K; Rawl, Susan M; Matayoshi, Eric; Coons, Stephen Joel; Hornbrook, Mark C

2009-10-01

Intestinal stomas can pose significant challenges for long-term (> or = 5 years) rectal cancer (RC) survivors. Specifying common challenges and sociodemographic or clinical differences will further the development of tailored interventions to improve health-related quality of life (HRQOL). This was a matched cross-sectional study of long-term RC survivors conducted in three Kaiser Permanente regions. The mailed questionnaire included the modified City of Hope Quality of Life-Ostomy (mCOH-QOL-Ostomy) and Medical Outcomes Study 36-Item Short-Form Health Survey, version 2 (SF-36v2). Groups surveyed were permanent ostomates (cases) and those who did not require an ostomy (controls). RC survivors were matched on sex, age, and time since diagnosis. Comparisons between groups used regression analysis with adjustment for age, comorbidity score, history of radiation therapy, income, and work status. Response rate was 54% (491 of 909). Cases and controls had similar demographic characteristics. On the basis of the mCOH-QOL-Ostomy, both male and female cases had significantly worse social well-being compared with controls, while only female cases reported significantly worse overall HRQOL and psychological well-being. For younger females (< age 75 years), ostomy had a greater impact on physical well-being compared with older females. Based on the SF-36v2, statistically significant and meaningful differences between female cases and controls were observed for seven of the eight scales and on the physical and mental component summary scores. Men and women report a different profile of challenges, suggesting the need for targeted or sex-specific interventions to improve HRQOL in this population. This may include focus on physical HRQOL for female ostomy survivors younger than age 75.

Health-Related Quality of Life Among Long-Term Rectal Cancer Survivors With an Ostomy: Manifestations by Sex

PubMed Central

Krouse, Robert S.; Herrinton, Lisa J.; Grant, Marcia; Wendel, Christopher S.; Green, Sylvan B.; Mohler, M. Jane; Baldwin, Carol M.; McMullen, Carmit K.; Rawl, Susan M.; Matayoshi, Eric; Coons, Stephen Joel; Hornbrook, Mark C.

2009-01-01

Purpose Intestinal stomas can pose significant challenges for long-term (≥ 5 years) rectal cancer (RC) survivors. Specifying common challenges and sociodemographic or clinical differences will further the development of tailored interventions to improve health-related quality of life (HRQOL). Patients and Methods This was a matched cross-sectional study of long-term RC survivors conducted in three Kaiser Permanente regions. The mailed questionnaire included the modified City of Hope Quality of Life-Ostomy (mCOH-QOL-Ostomy) and Medical Outcomes Study 36-Item Short-Form Health Survey, version 2 (SF-36v2). Groups surveyed were permanent ostomates (cases) and those who did not require an ostomy (controls). RC survivors were matched on sex, age, and time since diagnosis. Comparisons between groups used regression analysis with adjustment for age, comorbidity score, history of radiation therapy, income, and work status. Results Response rate was 54% (491 of 909). Cases and controls had similar demographic characteristics. On the basis of the mCOH-QOL-Ostomy, both male and female cases had significantly worse social well-being compared with controls, while only female cases reported significantly worse overall HRQOL and psychological well-being. For younger females (< age 75 years), ostomy had a greater impact on physical well-being compared with older females. Based on the SF-36v2, statistically significant and meaningful differences between female cases and controls were observed for seven of the eight scales and on the physical and mental component summary scores. Conclusion Men and women report a different profile of challenges, suggesting the need for targeted or sex-specific interventions to improve HRQOL in this population. This may include focus on physical HRQOL for female ostomy survivors younger than age 75. PMID:19720920

Comprehensive taxonomy and worldwide trends in pharmaceutical policies in relation to country income status.

PubMed

Maniadakis, N; Kourlaba, G; Shen, J; Holtorf, A

2017-05-25

Rapidly evolving socioeconomic and technological trends make it challenging to improve access, effectiveness and efficiency in the use of pharmaceuticals. This paper identifies and systematically classifies the prevailing pharmaceutical policies worldwide in relation to a country's income status. A literature search was undertaken to identify and taxonomize prevailing policies worldwide. Countries that apply those policies and those that do not were then grouped by income status. Pharmaceutical policies are linked to a country's socioeconomics. Developed countries have universal coverage and control pharmaceuticals with external and internal price referencing systems, and indirect price-cost controls; they carry out health technology assessments and demand utilization controls. Price-volume and risk-sharing agreements are also evolving. Developing countries are underperforming in terms of coverage and they rely mostly on restrictive state controls to regulate prices and expenditure. There are significant disparities worldwide in the access to pharmaceuticals, their use, and the reimbursement of costs. The challenge in high-income countries is to maintain access to care whilst dealing with trends in technology and aging. Essential drugs should be available to all; however, many low- and middle-income countries still provide most of their population with only poor access to medicines. As economies grow, there should be greater investment in pharmaceutical care, looking to the policies of high-income countries to increase efficiency. Pharmaceutical companies could also develop special access schemes with low prices to facilitate coverage in low-income countries.

Symposium 6: Young people, artificial nutrition and transitional care. The nutritional challenges of the young adult with cystic fibrosis: transition.

PubMed

Morton, Alison M

2009-11-01

Cystic fibrosis (CF) is a complex multisystem disorder affecting mainly the gastrointestinal tract and respiratory system. Intestinal malabsorption occurs in approximately 90% of patients. In the past, malnutrition was an inevitable consequence of disease progression, leading to poor growth, impaired respiratory muscle function, decreased exercise tolerance and immunological impairment. A positive association between body weight and height and survival has been widely reported. The energy requirements of patients with CF vary widely and generally increase with age and disease severity. For many young adults requirements will be 120-150% of the age-related estimated average requirement. To meet these energy needs patients are encouraged to eat a high-fat high-energy diet with appropriate pancreatic enzyme supplements. Many patients are unable to achieve an adequate intake as a result of a variety of factors including chronic poor appetite, infection-related anorexia, gastro-oesophageal reflux and abdominal pain. Oral energy supplements and enteral tube feeding are widely used. Nutritional support has been shown to improve nutritional status and stabilise or slow the rate of decline in lung function. With such emphasis on nutritional intake and nutritional status throughout life, poor adherence to therapies and issues relating to body image are emerging. The median survival of patients with CF is increasing. CF is now considered a life-limiting disease of adulthood rather than a terminal childhood illness. With increased longevity new challenges are emerging that include the transition of young adults with CF to adult services, CF-related diabetes, disordered eating, osteoporosis, liver disease and transplantation.

The AGING Initiative experience: a call for sustained support for team science networks.

PubMed

Garg, Tullika; Anzuoni, Kathryn; Landyn, Valentina; Hajduk, Alexandra; Waring, Stephen; Hanson, Leah R; Whitson, Heather E

2018-05-18

Team science, defined as collaborative research efforts that leverage the expertise of diverse disciplines, is recognised as a critical means to address complex healthcare challenges, but the practical implementation of team science can be difficult. Our objective is to describe the barriers, solutions and lessons learned from our team science experience as applied to the complex and growing challenge of multiple chronic conditions (MCC). MCC is the presence of two or more chronic conditions that have a collective adverse effect on health status, function or quality of life, and that require complex healthcare management, decision-making or coordination. Due to the increasing impact on the United States society, MCC research has been identified as a high priority research area by multiple federal agencies. In response to this need, two national research entities, the Healthcare Systems Research Network (HCSRN) and the Claude D. Pepper Older Americans Independence Centers (OAIC), formed the Advancing Geriatrics Infrastructure and Network Growth (AGING) Initiative to build nationwide capacity for MCC team science. This article describes the structure, lessons learned and initial outcomes of the AGING Initiative. We call for funding mechanisms to sustain infrastructures that have demonstrated success in fostering team science and innovation in translating findings to policy change necessary to solve complex problems in healthcare.

Women's status and family planning: results from a focus group survey.

PubMed

Gu, B; Xie, Z

1994-02-01

Focus group discussions were conducted in China's Pingluo County, Ningxia Hui Autonomous Region, and Sihui County, Guangdong Province among reproductive age women with only daughters, mothers-in-law, unmarried women aged 23 years and older, and women business persons and cadres. The topic of discussion was the status of women, gender differences in employment, education, marriage, family life, childbearing, and elderly care in counties that have above average fertility rates. There were also several groups of men, mixed gender groups with husbands working away from home, local family planning workers, and rural intellectuals. The findings showed that there is more access to education for girls and a higher employment rate for young women. Daughters receive education to the highest level affordable. Enrollments are equal for boys and girls. Women's employment is not challenged by husbands, and work is available in a variety of locations. Business ownership and operation is encouraged. By middle age, women generally do not work in enterprises, but at home or on contracted farmland. Equal rights within the family are generally accepted. Husbands turn over their salary to wives for family expenses. Girls receive the same care after birth as boys. Women's status is improving. Improvements in social status have also involved sacrifices. Women complained that the workload on the farm has increased with adult males away working in cities. Women bear the burden of family planning, including in some cases side effects from oral pills and recovery from sterilizations. One women remarked that there were burdens in bearing children, taking oral pills, having IUD insertions, and having induced abortions; men should bear 50% of the responsibility. The burden of women without sons is harder, and women may also feel inferior as the last in their family line. One family with 6 daughters accepted the fine of RMB 7000 yuan for having another child, which turned out to be a son. One commented that even a stupid son is better than a daughter. Many with only daughters have not tried for a son because the fine was too expensive. Support in old age was a reason for desiring sons. There were positive opinions expressed about family planning. Economic gains for women were considered important in raising women's status.

Reactor antineutrino fluxes – Status and challenges

DOE PAGES

Huber, Patrick

2016-04-22

Here, we describe the current understanding of reactor antineutrino fluxes and point out some recent developments. This is not intended to be a complete review of this vast topic but merely a selection of observations and remarks, which despite their incompleteness, will highlight the status and the challenges of this field.

Current status and challenges in developing Ni phytomining: An agronomic perspective

USDA-ARS?s Scientific Manuscript database

This review examines the current status, progress and challenges in Ni phytomining agronomy undertaken since the first field trial two decades ago. To date, over 400 Ni hyperaccumulators have been documented (of which >30% are in Cuba) including approximately 50 species with potential for use in Ni ...

Assessment of nutritional status and meal-related situations among patients with chronic obstructive pulmonary disease in Primary health care - obese patients; a challenge for the future.

PubMed

Odencrants, Sigrid; Theander, Kersti

2013-04-01

To describe nutritional status, meal related situations, food habits and food preferences of patients with chronic obstructive pulmonary disease (COPD) in a Primary health care (PHC) setting. To date, guidelines have mainly focused on underweight patients with COPD, as a low body mass index (BMI) is a risk factor for mortality. However, in recent years there has been an increase in the number of overweight patients with COPD, and therefore nutritional management must be developed to cover problems related to both under and overweight. Descriptive. One hundred and three patients from PHC centres representing COPD stages 2 and 3 were included. The Mini Nutritional Assessment (MNA) was used to collect nutritional status data while semi-structured interviews provided information on food and meal related situations. Mean age was 69 (± 5)years and 45% were women. Among all patients mean BMI was 27 and 14% had a BMI ≤ 21 kg/m(2) . More women (31%) than men (26%) had a BMI ≥ 30 kg/m(2) . According to the MNA screening score, 86% of the patients were assessed as normal or not at risk of malnutrition. The total MNA assessment score revealed that 10 patients were at risk of malnutrition or malnourishment. Problems with meal related situations were mostly associated with eating, and only a small number reported difficulties with shopping or preparing food. In PHC, more patients with COPD were obese than malnourished and their self-reported nutritional status was not always accurate. It is challenging to identify the patient's nutritional status, individualize nutritional care and educate obese patients with COPD at PHC centres. It is necessary to develop screening instruments to assess the risk of both obesity and malnutrition. © 2012 Blackwell Publishing Ltd.

Cognitive function in older adults according to current socioeconomic status.

PubMed

Zhang, Michael; Gale, Shawn D; Erickson, Lance D; Brown, Bruce L; Woody, Parker; Hedges, Dawson W

2015-01-01

Cognitive function may be influenced by education, socioeconomic status, sex, and health status. Furthermore, aging interacts with these factors to influence cognition and dementia risk in late life. Factors that may increase or decrease successful cognitive aging are of critical importance, particularly if they are modifiable. The purpose of this study was to determine if economic status in late life is associated with cognition independent of socioeconomic status in early life. Cross-sectional demographic, socioeconomic, and cognitive function data were obtained in 2592 older adults (average age 71.6 years) from the Center for Disease Control's National Health and Nutrition Examination Survey (NHANES) and analyzed with linear regression modeling. Cognitive function, as measured with a test of processing speed, was significantly associated with poverty index scores after adjusting for educational attainment as an estimate of childhood socioeconomic status, ethnic background, age, health status, and sex (P < 0.001). Our findings suggest that current economic status is independently associated with cognitive function in adults over age 60 years.

Processes Linking Weight Status and Self-Concept Among Girls From Ages 5 to 7 Years

PubMed Central

Davison, Kirsten Krahnstoever; Birch, Leann Lipps

2008-01-01

This study assessed the relationship between girls’ weight status and self-concept and examined peer teasing and parent criticism as potential mediators of this relationship. Data were collected for 182 girls and their parents when the girls were 5 and 7 years old. At each age, girls’ body mass index, self-concept, peer weight-related teasing (child report), and parents’ criticism of girls’ weight status (spouse report) were assessed. At ages 5 and 7, girls who were more overweight reported lower self-concept. Peer teasing and parent criticism mediated the relationship between weight status and self-concept at age 7, but not at age 5. In addition, the duration and timing of parent criticism across ages 5 and 7 mediated the association between girls’ weight status at age 5 and perceived peer acceptance at age 7. PMID:12220051

Social Determinants of Self-Reported Health in Women and Men: Understanding the Role of Gender in Population Health

PubMed Central

Hosseinpoor, Ahmad Reza; Stewart Williams, Jennifer; Amin, Avni; Araujo de Carvalho, Islene; Beard, John; Boerma, Ties; Kowal, Paul; Naidoo, Nirmala; Chatterji, Somnath

2012-01-01

Background Women and men share similar health challenges yet women report poorer health. The study investigates the social determinants of self-reported health in women and men, and male-female differences in health. Methods Data on 103154 men and 125728 women were analysed from 57 countries in the World Health Survey 2002–2004. Item Response Theory was used to construct a composite measure of health. Associations between health and determinants were assessed using multivariate linear regression. Blinder-Oaxaca decomposition partitioned the inequality in health between women and men into an “explained" component that arises because men and women differ in social and economic characteristics, and an “unexplained" component due to the differential effects of these characteristics. Decomposition was repeated for 18 countries in the World Health Organization (WHO) African region and 19 countries in the WHO European region. Results Women's health was significantly lower than men's. Health was associated with education, household economic status, employment, and marital status after controlling for age. In the pooled analysis decomposition showed that 30% of the inequality was “explained", of which almost 75% came from employment, education, marital status. The differential effects of being in paid employment increased the inequality. When countries in Africa and Europe were compared, the “explained" component (31% and 39% respectively) was largely attributed to the social determinants in the African countries and to women's longevity in the European countries. Being in paid employment had a greater positive effect on the health of males in both regions. Conclusions Ways in which age and the social determinants contribute to the poorer health status of women compared with men varies between groups of countries. This study highlights the need for action to address social structures, institutional discrimination and harmful gender norms and roles that differently influence health with ageing. PMID:22514667

Changing demographics of visceral leishmaniasis in northeast Brazil: Lessons for the future

PubMed Central

Lima, Iraci Duarte; Lima, Adila L. M.; Mendes-Aguiar, Carolina de Oliveira; Coutinho, José F. V.; Wilson, Mary E.; Pearson, Richard D.

2018-01-01

Background Visceral leishmaniasis (VL) caused by Leishmania infantum became a disease of urban areas in Brazil in the last 30 years and there has been an increase in asymptomatic L. infantum infection with these areas. Methodology/Principal findings A retrospective study of human VL was performed in the state of Rio Grande do Norte, Brazil, for the period of 1990–2014. The data were divided into five-time periods. For all VL cases, data on sex, age, nutritional status and childhood vaccination were collected. Geographic information system tools and statistical models were used to analyze the dispersion of human VL. The mean annual incidence of VL was 4.6 cases/100,000 inhabitants, with total 3,252 cases reported. The lethality rate was 6.4%. Over time the annual incidence of VL decreased in the 0–4 years (p<0.0001) and 5–9 (p <0.0001) age groups, but increased in ages 20–39 (p<0.001) and >40 years (p<0.0001). VL occurred more often in males (β2 = 2.5; p<0.0001). The decreased incidence of VL in children was associated with improved nutritional status and childhood immunizations including measles, poliomyelitis, BCG, and hepatitis B. Human VL correlated temporally and geographically with canine L. infantum infection (p = 0.002, R2 = 0.438), with rainfall and with Lutzomyia longipalpis density (r = 0.762). Overall, the incidence of VL decreased, while VL-AIDS increased, especially between 2010–2014. VL was more frequently found in areas that lacked urban infrastructure, detected by lack of garbage collection and sewers, whereas HIV infection was associated with higher levels of schooling and evidence of higher socioeconomic status. Conclusion/Significance The demographics of VL in northeastern Brazil have changed. Disease incidence has decreased in children and increased in adults. They were associated with improvements in nutrition, socioeconomic status and immunization rates. Concurrent VL-AIDS poses a serious challenge for the future. PMID:29509765

Nutritional Status and Age at Menarche on Female Students of Junior High School

ERIC Educational Resources Information Center

Juliyatmi, Rihul Husnul; Handayani, Lina

2015-01-01

Menarche is the first menstrual period as one of the sign of puberty. There are many factors may affect the age at menarche such as nutritional status, genetic, environmental conditions, socioeconomic status, and education. The purpose of this research is to determine the relationship between nutritional status and age of menarche on female…

Evaluating the physiological reserves of older patients with cancer: the value of potential biomarkers of aging?

PubMed

Pallis, Athanasios G; Hatse, Sigrid; Brouwers, Barbara; Pawelec, Graham; Falandry, Claire; Wedding, Ulrich; Lago, Lissandra Dal; Repetto, Lazzaro; Ring, Alistair; Wildiers, Hans

2014-04-01

Aging of an individual entails a progressive decline of functional reserves and loss of homeostasis that eventually lead to mortality. This process is highly individualized and is influenced by multiple genetic, epigenetic and environmental factors. This individualization and the diversity of factors influencing aging result in a significant heterogeneity among people with the same chronological age, representing a major challenge in daily oncology practice. Thus, many factors other than mere chronological age will contribute to treatment tolerance and outcome in the older patients with cancer. Clinical/comprehensive geriatric assessment can provide information on the general health status of individuals, but is far from perfect as a prognostic/predictive tool for individual patients. On the other hand, aging can also be assessed in terms of biological changes in certain tissues like the blood compartment which result from adaptive alterations due to past history of exposures, as well as intrinsic aging processes. There are major signs of 'aging' in lymphocytes (e.g. lymphocyte subset distribution, telomere length, p16INK4A expression), and also in (inflammatory) cytokine expression and gene expression patterns. These result from a combination of the above two processes, overlaying genetic predispositions which contribute significantly to the aging phenotype. These potential "aging biomarkers" might provide additional prognostic/predictive information supplementing clinical evaluation. The purpose of the current paper is to describe the most relevant potential "aging biomarkers" (markers that indicate the biological functional age of patients) which focus on the biological background, the (limited) available clinical data, and technical challenges. Despite their great potential interest, there is a need for much more (validated) clinical data before these biomarkers could be used in a routine clinical setting. This manuscript tries to provide a guideline on how these markers can be integrated in future research aimed at providing such data. © 2013.

The challenge of comprehensively mapping children's health in a nation-wide health survey: design of the German KiGGS-Study.

PubMed

Kurth, Bärbel-Maria; Kamtsiuris, Panagiotis; Hölling, Heike; Schlaud, Martin; Dölle, Rüdiger; Ellert, Ute; Kahl, Heidrun; Knopf, Hiltraud; Lange, Michael; Mensink, Gert Bm; Neuhauser, Hannelore; Rosario, Angelika Schaffrath; Scheidt-Nave, Christa; Schenk, Liane; Schlack, Robert; Stolzenberg, Heribert; Thamm, Michael; Thierfelder, Wulf; Wolf, Ute

2008-06-04

From May 2003 to May 2006, the Robert Koch Institute conducted the German Health Interview and Examination Survey for Children and Adolescents (KiGGS). Aim of this first nationwide interview and examination survey was to collect comprehensive data on the health status of children and adolescents aged 0 to 17 years. Participants were enrolled in two steps: first, 167 study locations (sample points) were chosen; second, subjects were randomly selected from the official registers of local residents. The survey involved questionnaires filled in by parents and parallel questionnaires for children aged 11 years and older, physical examinations and tests, and a computer assisted personal interview performed by study physicians. A wide range of blood and urine testing was carried out at central laboratories. A total of 17 641 children and adolescents were surveyed - 8985 boys and 8656 girls. The proportion of sample neutral drop-outs was 5.3%. The response rate was 66.6%. The response rate showed little variation between age groups and sexes, but marked variation between resident aliens and Germans, between inhabitants of cities with a population of 100 000 or more and sample points with fewer inhabitants, as well as between the old West German states and the former East German states. By analysing the short non-responder questionnaires it was proven that the collected data give comprehensive and nationally representative evidence on the health status of children and adolescents aged 0 to 17 years.

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

PubMed Central

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

2017-01-01

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

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

PubMed

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

2017-01-01

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

Marital breakup in later adulthood and self-rated health: a cross-sectional survey in Switzerland.

PubMed

Knöpfli, Bina; Cullati, Stéphane; Courvoisier, Delphine S; Burton-Jeangros, Claudine; Perrig-Chiello, Pasqualina

2016-04-01

This research examines the impact of relationship status on self-rated health (SRH) by taking into account intrapersonal and social resources. Data stem from a Swiss-based survey of 1355 participants aged 40-65 years. Three groups are compared: continuously married (n = 399), single divorcees (n = 532) and repartnered divorcees (n = 424). Linear regression models are used to examine the predictive role of relationship status on SRH and to investigate the moderating role of intrapersonal and social resources on SRH. Single divorcees show the lowest SRH scores, whereas their repartnered counterparts reported scores comparable to the continuously married-even after controlling for socio-demographic and economic variables. Although single divorcees reported higher levels of loneliness and agreeableness in addition to lower levels of resilience when compared with the other groups, none of these variables had a significant moderation effect on SRH. Our results underscore the positive effect of relationship status on SRH, and contribute new insights on the impact of later-life divorce. Given the growing number of divorcees, related public health challenges are likely to increase.

The challenge of comorbidity in clinical trials for multiple sclerosis.

PubMed

Marrie, Ruth Ann; Miller, Aaron; Sormani, Maria Pia; Thompson, Alan; Waubant, Emmanuelle; Trojano, Maria; O'Connor, Paul; Reingold, Stephen; Cohen, Jeffrey A

2016-04-12

We aimed to provide recommendations for addressing comorbidity in clinical trial design and conduct in multiple sclerosis (MS). We held an international workshop, informed by a systematic review of the incidence and prevalence of comorbidity in MS and an international survey about research priorities for studying comorbidity including their relation to clinical trials in MS. We recommend establishing age- and sex-specific incidence estimates for comorbidities in the MS population, including those that commonly raise concern in clinical trials of immunomodulatory agents; shifting phase III clinical trials of new therapies from explanatory to more pragmatic trials; describing comorbidity status of the enrolled population in publications reporting clinical trials; evaluating treatment response, tolerability, and safety in clinical trials according to comorbidity status; and considering comorbidity status in the design of pharmacovigilance strategies. Our recommendations will help address knowledge gaps regarding comorbidity that interfere with the ability to interpret safety in monitored trials and will enhance the generalizability of findings from clinical trials to "real world" settings where the MS population commonly has comorbid conditions. © 2016 American Academy of Neurology.

The challenge of comorbidity in clinical trials for multiple sclerosis

PubMed Central

Miller, Aaron; Sormani, Maria Pia; Thompson, Alan; Waubant, Emmanuelle; Trojano, Maria; O'Connor, Paul; Reingold, Stephen; Cohen, Jeffrey A.

2016-01-01

Objective: We aimed to provide recommendations for addressing comorbidity in clinical trial design and conduct in multiple sclerosis (MS). Methods: We held an international workshop, informed by a systematic review of the incidence and prevalence of comorbidity in MS and an international survey about research priorities for studying comorbidity including their relation to clinical trials in MS. Results: We recommend establishing age- and sex-specific incidence estimates for comorbidities in the MS population, including those that commonly raise concern in clinical trials of immunomodulatory agents; shifting phase III clinical trials of new therapies from explanatory to more pragmatic trials; describing comorbidity status of the enrolled population in publications reporting clinical trials; evaluating treatment response, tolerability, and safety in clinical trials according to comorbidity status; and considering comorbidity status in the design of pharmacovigilance strategies. Conclusion: Our recommendations will help address knowledge gaps regarding comorbidity that interfere with the ability to interpret safety in monitored trials and will enhance the generalizability of findings from clinical trials to “real world” settings where the MS population commonly has comorbid conditions. PMID:26888986

Twenty-year follow-up of children with and without speech-language impairments: family, educational, occupational, and quality of life outcomes.

PubMed

Johnson, Carla J; Beitchman, Joseph H; Brownlie, E B

2010-02-01

Parents, professionals, and policy makers need information on the long-term prognosis for children with communication disorders. Our primary purpose in this report was to help fill this gap by profiling the family, educational, occupational, and quality of life outcomes of young adults at 25 years of age (N = 244) from the Ottawa Language Study, a 20-year, prospective, longitudinal study of a community sample of individuals with (n = 112) and without (n = 132) a history of early speech and/or language impairments. A secondary purpose of this report was to use data from earlier phases of the study to predict important, real-life outcomes at age 25. Participants were initially identified at age 5 and subsequently followed at 12, 19, and 25 years of age. Direct assessments were conducted at all 4 time periods in multiple domains (demographic, communicative, cognitive, academic, behavioral, and psychosocial). At age 25, young adults with a history of language impairments showed poorer outcomes in multiple objective domains (communication, cognitive/academic, educational attainment, and occupational status) than their peers without early communication impairments and those with early speech-only impairments. However, those with language impairments did not differ in subjective perceptions of their quality of life from those in the other 2 groups. Objective outcomes at age 25 were predicted differentially by various combinations of multiple, interrelated risk factors, including poor language and reading skills, low family socioeconomic status, low performance IQ, and child behavior problems. Subjective well-being, however, was primarily associated with strong social networks of family, friends, and others. This information on the natural history of communication disorders may be useful in answering parents' questions, anticipating challenges that children with language disorders might encounter, and planning services to address those issues.

Examining the association between race, ethnicity, and health status: do assets matter?

PubMed

Boyas, Javier; Shobe, Marcia A; Hannam, Holly M

2009-10-01

The current study employs data from the 2004 Immigration and Intergenerational Mobility in Metropolitan Los Angeles (IIMMLA) study to examine the degree to which observed differences in self-reported health status between African Americans, Asians, Latinos, and non-Hispanic Whites in the United States can be attributed to differences in various indicators of socioeconomic status. Results of the multinomial logistic regression techniques suggest that socioeconomic indicators had varying significant effects in predicting self-reported health status among all racial and ethnic groups. Among African Americans, homeownership, income, and age played a significant role. Among Asian Americans, only income and age significantly predicted health status. Among Latinos, income, having a checking account, and age significantly shaped health status, while education, age, and homeownership significantly predicted health status among non-Hispanic Whites.

Home fire safety beliefs and practices in homes of urban older adults.

PubMed

Coty, Mary-Beth; McCammon, Colette; Lehna, Carlee; Twyman, Stephanie; Fahey, Erin

2015-01-01

The purpose of this study is to examine factors influencing urban older adults and develop a thematic analysis of how these factors affect seniors' home fire safety (HFS) beliefs and practices. This was a focused ethnography using participant observation and semi-structured interviews. Additionally, public housing records, cognitive functioning, and general health status were assessed. Individual interviews were transcribed verbatim using a constant comparative analysis. Eight seniors participated in the study. Two main themes described older adults' HFS while aging in place: the risk associated with the living environment and the journey associated with maintaining independence. All participants experienced HFS challenges such as limited mobility and financial constraints. Participants' general health and cognitive status additionally influenced their ability to maintain HFS. The findings suggest that urban seniors may have diverse HFS environment risks compared with the general population, highlighting the need for older adult focused HFS interventions. Copyright © 2015 Elsevier Inc. All rights reserved.

Brain metastasis and treatment

PubMed Central

Ahluwalia, Manmeet S.; Vogelbaum, Michael V.; Chao, Samuel T.

2014-01-01

Despite major therapeutic advances in the management of patients with systemic malignancies, management of brain metastases remains a significant challenge. These patients often require multidisciplinary care that includes surgical resection, radiation therapy, chemotherapy, and targeted therapies. Complex decisions about the sequencing of therapies to control extracranial and intracranial disease require input from neurosurgeons, radiation oncologists, and medical/neuro-oncologists. With advances in understanding of the biology of brain metastases, molecularly defined disease subsets and the advent of targeted therapy as well as immunotherapeutic agents offer promise. Future care of these patients will entail tailoring treatment based on host (performance status and age) and tumor (molecular cytogenetic characteristics, number of metastases, and extracranial disease status) factors. Considerable work involving preclinical models and better clinical trial designs that focus not only on effective control of tumor but also on quality of life and neurocognition needs to be done to improve the outcome of these patients. PMID:25580268

Postoperative Refractive Errors Following Pediatric Cataract Extraction with Intraocular Lens Implantation.

PubMed

Indaram, Maanasa; VanderVeen, Deborah K

2018-01-01

Advances in surgical techniques allow implantation of intraocular lenses (IOL) with cataract extraction, even in young children. However, there are several challenges unique to the pediatric population that result in greater degrees of postoperative refractive error compared to adults. Literature review of the techniques and outcomes of pediatric cataract surgery with IOL implantation. Pediatric cataract surgery is associated with several sources of postoperative refractive error. These include planned refractive error based on age or fellow eye status, loss of accommodation, and unexpected refractive errors due to inaccuracies in biometry technique, use of IOL power formulas based on adult normative values, and late refractive changes due to unpredictable eye growth. Several factors can preclude the achievement of optimal refractive status following pediatric cataract extraction with IOL implantation. There is a need for new technology to reduce postoperative refractive surprises and address refractive adjustment in a growing eye.

Exploring the self-compassion of health-care social workers: How do they fare?

PubMed

Lianekhammy, Joann; Miller, J Jay; Lee, Jacquelyn; Pope, Natalie; Barnhart, Sheila; Grise-Owens, Erlene

2018-05-03

Indubitably, the challenges facing health-care social workers are becoming increasingly complex. Whilst these problematic professional circumstances compound the need for self-compassion among health-care social workers, few studies, if any, have explicitly examined self-compassion among this practitioner group. This cross-sectional study explored self-compassion among a sample of practitioners (N = 138) in one southeastern state. Results indicate that health-care social workers in this sample engage in self-compassion only moderately. Further, occupational and demographic/life characteristics (e.g., age, years practicing social work, average hours worked per week, health status, and relationship status, among others) are able to predict self-compassion scores. After a terse review of relevant literature, this paper will explicate findings from this study, discuss relevant points derived from said findings, and identify salient implication for health-care social work praxis.

Definition of Unfit for Standard Acute Myeloid Leukemia Therapy.

PubMed

Klepin, Heidi D

2016-12-01

Determining who is fit or unfit for standard treatments among older adults with acute myeloid leukemia (AML) remains a challenge. However, available evidence can provide guidance on strategies to assess and categorize fitness. Evidence is strongest to guide identification of "frail" older adults at the time of diagnosis based on performance status, physical function, and comorbidity. Many older adults, with adequate performance status and comorbidity burden, however, may be better characterized as "vulnerable". These patients have subclinical impairments that limit resilience when stressed with intensive therapies. More sensitive assessment strategies are needed to differentiate fit and vulnerable older adults regardless of chronologic age. Research is ongoing to identify tools and approaches, such as geriatric assessment, that can enhance characterization of fitness for AML therapies. This review will highlight available evidence for assessment of fitness among older adults with AML and discuss implications for practice and research.

Weight and skin colour as predictors of vitamin D status: results of an epidemiological investigation using nationally representative data.

PubMed

Rajan, Sonali; Weishaar, Tom; Keller, Bryan

2017-07-01

Current US dietary recommendations for vitamin D vary by age. Recent research suggests that body weight and skin colour are also major determinants of vitamin D status. The objective of the present epidemiological investigation was to clarify the role of age as a predictor of vitamin D status, while accounting for body weight and skin colour, among a nationally representative sample. We calculated the mean serum 25-hydroxyvitamin D levels for the US population by age and weight, as well as by weight and race/ethnicity group. Multiple regression analyses were utilized to evaluate age and weight as predictors of vitamin D status: serum 25-hydroxyvitamin D levels with age alone, age and body weight, and age, body weight and their two-way interaction were modelled for the entire sample and each age subgroup. Graphical data were developed using B-spline non-linear regression. National Health and Nutrition Examination Survey (31 934 unweighted cases). Individuals aged 1 year and older. There were highly significant differences in mean vitamin D status among US residents by weight and skin colour, with those having darker skin colour or higher body weight having worse vitamin D status. Although a significant factor, the impact of age on vitamin D status was notably less than the impact of body weight. Vitamin D status varied predominantly by body weight and skin colour. Recommendations by nutritionists for diet and supplementation needs should take this into account if vitamin D-related health disparities are to be meaningfully reduced across the USA.

The Use of Data Analytics to Build an Australian Context-Sensitive Health Informatics Framework for Consumer-Directed Community Aged Care.

PubMed

Georgiou, Andrew; Jorgensen, Mikaela; Siette, Joyce; Westbrook, Johanna I

2017-01-01

The challenge of providing services that meet the growing needs of an ageing population is one confronted by communities across Australia and internationally. The aim of this study was to: a) undertake semi-structured interviews and focus groups across a sample of service and technical staff to identify the interconnection between communication, information, work practices and performance; and b) carry out a comprehensive review of existing data sources to identify the data linkages required to identify and monitor performance across different dimensions of the quality of aged care spectrum. The results from this study provided empirical evidence of the interconnection between communication, information, work practices and performance; and highlighted numerous potential data linkages which can be used to monitor performance across different dimensions of aged care. These included: the uptake and utilisation of community care services, community aged care client interactions and transitions (with hospitals and other health care providers), and quality of life measures (e.g., health and safety status, symptoms of depression and anxiety, social integration and mortality rates).

Parental health literacy and its impact on patient care.

PubMed

Scotten, Mitzi

2015-03-01

The process of navigating through the modern American health care system is becoming progressively challenging. The range of tasks being asked of patients in the digital age is vast and complex and includes completing intricate insurance applications, signing complex consent forms, and translating medical data and prescription medication directions. Nearly 9 out of 10 adults have difficulty using the everyday health information that is routinely offered by medical providers. Mounting evidence now supports a growing awareness that general health literacy is the greatest individual factor affecting a person's health status. Copyright © 2015 Elsevier Inc. All rights reserved.

Dysphagia in the Older Patient.

PubMed

Nawaz, Samia; Tulunay-Ugur, Ozlem E

2018-05-17

Dysphagia in older adults is a challenging problem and necessitates a team approach. The key to effective management is recognition. Patients tend to dismiss their symptoms as normal aging; therefore, early diagnosis depends on the diligence of the primary care doctors. No diagnostic technique can replace the benefits of a thorough history, with a detailed understanding of nutritional status and aspiration risk. Although one of the main goals in management is to ensure safe swallowing, the impact of a nonoral diet on the quality of life of patients should not be underestimated. Copyright © 2018 Elsevier Inc. All rights reserved.

Gender and sex differences in job status and hypertension

PubMed Central

Clougherty, Jane E.; Eisen, Ellen A.; Slade, Martin D.; Kawachi, Ichiro; Cullen, Mark R.

2013-01-01

Objectives Studies have shown greater health risks associated with blue-collar manufacturing employment for women than men. It remains challenging, however, to distinguish cultural gendered factors influencing employment decisions (e.g., expected work roles, family responsibilities) from sex-linked biological differences shaping physiological response to workplace physical hazards. Methods We examined effects of hourly (blue-collar) status on incident hypertension among men and women, using health claims data for 14,618 white- and blue-collar aluminum manufacturing employees in eight U.S. states. To explore gender differences in job status, we developed sex-stratified propensity score models identifying key socioeconomic predictors of hourly status for men and women. To examine effects of hourly employment on hypertension risk, after adjusting for gender differences in job placement, we applied time-weighted logistic regression models, stratified by propensity score, with additional adjustment for socioeconomic confounders. Results Family structure (partnership, parity) influenced job status for both sexes; single mothers were more likely to hold hourly jobs (OR = 2.02 (95% CI = 1.37–2.97)), partnered men with children less likely (OR = 0.68 (0.56–0.83)). Education, age at hire, and race influenced job placement for both sexes. The effect of hourly status on hypertension was significant only among women predicted to be hourly (OR = 1.78 (1.34 – 2.35)). Conclusions Our results indicate significant risks of hypertension associated with hourly status for women, possibly exacerbated by sociodemographic factors predicting hourly status (e.g., single parenthood, low education). Greater attention to gender differences in job status, workplace stressors, and health risks associated with hourly work, is warranted. PMID:20864467

Prevalence of Sarcopenia and Its Association with Socioeconomic Status among the Elderly in Tehran.

PubMed

Dorosty, Ahmadreza; Arero, Godana; Chamar, Maryam; Tavakoli, Sogand

2016-07-01

Sarcopenia is a syndrome characterized by progressive and generalized loss of skeletal muscle mass and strength. It imposes significant costs on health care systems. Socioeconomic status is also the root cause of healthy challenges among the elderly. Therefore, investigating the association between sarcopenia and socioeconomic status is very important to improve healthy ageing of the elderly. The aim of this study was to investigate the prevalence of sarcopenia and its association with socioeconomic status among the elderly in Tehran. Cross-sectional and case-control studies were conducted from August 2014-July 2015 among 310 men and 334 women elderly (60 and over years old) in Tehran health centers. Randomization, restriction and matching were setting during study design to minimize selection bias. Then study participants were recruited via phone call. Participants' phone numbers were already recorded in a telephone book electronically. When there were two elderly people in the same house, only one person was invited randomly. Association between sarcopenia and socio-economic status was analyzed by SPSS version 22. The overall prevalence of sarcopenia in the elderly was 16.5%. Prevalenceamong the low-income elderly was relatively higher than (20.5%) that among those with middle income status (18.2%) while in the higher income, the proportion of sarcopenia was very low (12.8%). The findings indicated that 339(52.6%) were in low-income status, 304(47.1%) were in middle-income status and 1(.2%) in high-income class. There was a significant association between socioeconomic status and sarcopenia (P-value <0.001). The odd risk of sarcopenia was 0.97 times more likely higher in low socioeconomic class than those who were in middle and high income classes.

Climate Variability and Inter-Provincial Migration in South America, 1970-2011

PubMed Central

Thiede, Brian; Gray, Clark; Mueller, Valerie

2016-01-01

We examine the effect of climate variability on human migration in South America. Our analyses draw on over 21 million observations of adults aged 15-40 from 25 censuses conducted in eight South American countries. Addressing limitations associated with methodological diversity among prior studies, we apply a common analytic approach and uniform definitions of migration and climate across all countries. We estimate the effects of climate variability on migration overall and also investigate heterogeneity across sex, age, and socioeconomic groups, across countries, and across historical climate conditions. We also disaggregate migration by the rural/urban status of destination. We find that exposure to monthly temperature shocks has the most consistent effects on migration relative to monthly rainfall shocks and gradual changes in climate over multi-year periods. We also find evidence of heterogeneity across demographic groups and countries. Analyses that disaggregate migration by the rural/urban status of destination suggest that much of the climate-related inter-province migration is directed toward urban areas. Overall, our results underscore the complexity of environment-migration linkages and challenge simplistic narratives that envision a linear and monolithic migratory response to changing climates. PMID:28413264

Climate Variability and Inter-Provincial Migration in South America, 1970-2011.

PubMed

Thiede, Brian; Gray, Clark; Mueller, Valerie

2016-11-01

We examine the effect of climate variability on human migration in South America. Our analyses draw on over 21 million observations of adults aged 15-40 from 25 censuses conducted in eight South American countries. Addressing limitations associated with methodological diversity among prior studies, we apply a common analytic approach and uniform definitions of migration and climate across all countries. We estimate the effects of climate variability on migration overall and also investigate heterogeneity across sex, age, and socioeconomic groups, across countries, and across historical climate conditions. We also disaggregate migration by the rural/urban status of destination. We find that exposure to monthly temperature shocks has the most consistent effects on migration relative to monthly rainfall shocks and gradual changes in climate over multi-year periods. We also find evidence of heterogeneity across demographic groups and countries. Analyses that disaggregate migration by the rural/urban status of destination suggest that much of the climate-related inter-province migration is directed toward urban areas. Overall, our results underscore the complexity of environment-migration linkages and challenge simplistic narratives that envision a linear and monolithic migratory response to changing climates.

Fail or flourish? Cognitive appraisal moderates the effect of solo status on performance.

PubMed

White, Judith B

2008-09-01

When everyone in a group shares a common social identity except one individual, the one who is different from the majority has solo status. Solo status increases one's visibility and performance pressure, which may result in stress. Stress has divergent effects on performance, and individuals' response to stressful situations is predicted by their cognitive appraisal (challenge or threat) of the situation. Two experiments test the hypothesis that cognitive appraisal moderates the effect of solo status on performance. Experiment 1 finds that at relatively high appraisal levels (resources exceed demands), solo status improves men's and women's performance; at relatively low appraisal levels, solo status hurts performance. Experiment 2 replicates this effect for solo status based on minimal group assignment. Results suggest that for individuals who feel challenged and not threatened by their work, it may help to be a solo.

Relative Association of Multi-Level Supportive Environments on Poor Health among Older Adults

PubMed Central

Mier, Nelda; Ory, Marcia G.; Towne, Samuel D.; Smith, Matthew Lee

2017-01-01

Background: The aging of the United States population poses significant challenges to American healthcare and informal caregiving systems. Additional research is needed to understand how health promotion programs and policies based on a socio-ecological perspective impact the health and well-being of older persons. The purpose of this study was to investigate personal characteristics and supportive environments associated with poor health among older individuals aged 65 and over. Methods: This study used a cross-sectional design and was guided by a conceptual framework developed by the authors to depict the relationship between personal characteristics and environments associated with poor health status. Environment types included in this study were family, home, financial, neighborhood, and healthcare. The sample was comprised of 1319 adults aged 65 years and older residing in Central Texas. From a random selection of households, participants were administered a mail-based survey created by a community collaborative effort. Descriptive statistics and three binary logistic regression models were fitted to examine associations with poor health status (i.e., physical, mental, and combined physical/mental). Results: Two personal characteristics (number of chronic conditions and educational level) were consistently related (p < 0.05) to health outcomes. Supportive family, home, financial, neighborhood, and health care environmental factors were shown to be related (p < 0.05) to various aspects of physical or mental health outcomes. Conclusions: Multidimensional factors including personal characteristics and protective environments are related to health status among older individuals. The unique roles of each environment can help inform public health interventions to create and enhance support for older adults to engage in healthful activities and improve their physical and mental health. PMID:28383513

32 CFR 2001.14 - Classification challenges.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 32 National Defense 6 2013-07-01 2013-07-01 false Classification challenges. 2001.14 Section 2001... Classification § 2001.14 Classification challenges. (a) Challenging classification. Authorized holders, including authorized holders outside the classifying agency, who want to challenge the classification status of...

32 CFR 2001.14 - Classification challenges.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 32 National Defense 6 2014-07-01 2014-07-01 false Classification challenges. 2001.14 Section 2001... Classification § 2001.14 Classification challenges. (a) Challenging classification. Authorized holders, including authorized holders outside the classifying agency, who want to challenge the classification status of...

32 CFR 2001.14 - Classification challenges.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 32 National Defense 6 2012-07-01 2012-07-01 false Classification challenges. 2001.14 Section 2001... Classification § 2001.14 Classification challenges. (a) Challenging classification. Authorized holders, including authorized holders outside the classifying agency, who want to challenge the classification status of...

32 CFR 2001.14 - Classification challenges.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 32 National Defense 6 2011-07-01 2011-07-01 false Classification challenges. 2001.14 Section 2001... Classification § 2001.14 Classification challenges. (a) Challenging classification. Authorized holders, including authorized holders outside the classifying agency, who want to challenge the classification status of...

Physiological frailty index (PFI): quantitative in-life estimate of individual biological age in mice.

PubMed

Antoch, Marina P; Wrobel, Michelle; Kuropatwinski, Karen K; Gitlin, Ilya; Leonova, Katerina I; Toshkov, Ilia; Gleiberman, Anatoli S; Hutson, Alan D; Chernova, Olga B; Gudkov, Andrei V

2017-03-19

The development of healthspan-extending pharmaceuticals requires quantitative estimation of age-related progressive physiological decline. In humans, individual health status can be quantitatively assessed by means of a frailty index (FI), a parameter which reflects the scale of accumulation of age-related deficits. However, adaptation of this methodology to animal models is a challenging task since it includes multiple subjective parameters. Here we report a development of a quantitative non-invasive procedure to estimate biological age of an individual animal by creating physiological frailty index (PFI). We demonstrated the dynamics of PFI increase during chronological aging of male and female NIH Swiss mice. We also demonstrated acceleration of growth of PFI in animals placed on a high fat diet, reflecting aging acceleration by obesity and provide a tool for its quantitative assessment. Additionally, we showed that PFI could reveal anti-aging effect of mTOR inhibitor rapatar (bioavailable formulation of rapamycin) prior to registration of its effects on longevity. PFI revealed substantial sex-related differences in normal chronological aging and in the efficacy of detrimental (high fat diet) or beneficial (rapatar) aging modulatory factors. Together, these data introduce PFI as a reliable, non-invasive, quantitative tool suitable for testing potential anti-aging pharmaceuticals in pre-clinical studies.

WOMEN'S EMPOWERMENT AND GENDER INEQUALITY IN ADOLESCENT NUTRITIONAL STATUS: EVIDENCE FROM THE INDONESIAN FAMILY LIFE SURVEY.

PubMed

Kunto, Yohanes Sondang; Bras, Hilde

2017-11-23

In contrast to the extensive knowledge on the association between women's empowerment and the nutritional status of children under the age of five, relatively little is known about the influence of women's empowerment on adolescents' nutritional status. This study aimed to assess the association between women's empowerment and gender inequalities in adolescent nutritional status. Data were from the Indonesian Family Life Survey (IFLS) covering the period 1997 to 2015, and consisted of 16,683 observations from 13,396 adolescents between the ages of 10 and 19 years born in 6781 families. Three indicators of women's empowerment were used: mother's education, mother's bargaining power and mother's working status. Multivariate linear regression with robust standard errors was used to examine whether and how these indicators of women's empowerment influenced adolescent nutritional status. Interaction terms were added to analyse how the association between women's empowerment and adolescent nutritional status differed by gender. The results showed that mother's education and mother's working status were significantly associated with adolescent nutritional status, particularly with height-for-age. Adolescents of well-educated mothers had a higher height-for-age while those who were raised by mothers with a blue-collar job had a lower height-for-age. Although no gender differences were found for height-for-age, gender differences for BMI-for-age were obvious, with boys having a lower BMI-for-age than girls. Interactions between indicators of mother's empowerment and gender showed that the gender gap in BMI-for-age was smaller for adolescents of more educated mothers. However, further analyses of food consumption patterns showed that boys whose mothers were more educated consumed more fast food and had higher instant noodle consumption than girls, thus suggesting gender bias in new disguise.

47 CFR 101.1309 - Regulatory status.

Code of Federal Regulations, 2010 CFR

2010-10-01

... party may challenge the regulatory status granted an MAS licensee. System License Requirements ... 47 Telecommunication 5 2010-10-01 2010-10-01 false Regulatory status. 101.1309 Section 101.1309... SERVICES Multiple Address Systems General Provisions § 101.1309 Regulatory status. (a) The Commission will...

Association Between Nutritional Status and Quality of Life in (Pre) Frail Community-Dwelling Older Persons.

PubMed

Luger, E; Haider, S; Kapan, A; Schindler, K; Lackinger, C; Dorner, T E

2016-01-01

BACKGROUND: For developed countries, healthy aging is one of the challenges and the number of healthy life years and especially the quality of life (QoL) are important. OBJECTIVE: This study aimed to assess the association between nutritional status and different domains of QoL in (pre)frail community-dwelling elders. DESIGN: Baseline data from persons, who participated in a 12-week nutritional and physical training intervention program, conducted from September 2013 - July 2015. Setting: (Pre)frail community-dwelling elders living in Vienna, Austria. PARTICIPANTS: A total of 83 older persons living at home, 12 men and 71 women (86%) aged 65 to 98 years. Measurements: Structured interviews were conducted at participants’ homes. Mini Nutritional Assessment® long-form (MNA®-LF) was used to investigate the nutritional status. The QoL domains were assessed with the World Health Organization Quality of Life questionnaires. Simple and multiple linear regression analyses were performed to evaluate the association between nutritional status and QoL domains, adjusted for possible confounders. RESULTS: 45% of the participants were at risk of malnutrition and 3% were malnourished. Compared to normal nourished people, persons who had an impaired nutritional status, significantly differed in the QoL domain ‘autonomy’ with mean (SD) scores of 50.0 (14.9) vs. 57.3 (13.7); p=0.022 and in the QoL domain ‘social participation’ with scores of 40.1 (13.6) vs. 47.0 (11.2); p=0.014, respectively. According to linear regression analyses, the MNA®-LF score was significantly associated with ‘overall QoL’ (β=0.26; p=0.016) and the QoL domains ‘physical health’ (β=0.23; p=0.036), ‘autonomy’ (β=0.27; p=0.015), and ‘social participation’ (β=0.28; p=0.013).CONCLUSIONS: There was a significant association between nutritional status and QoL in elderly (pre)frail community-dwelling people, in particular for the QoL domains ‘autonomy’ and ‘social participation’. However, it remains unclear whether malnutrition was the cause or the consequence, or it was mediated through a third possible factor e.g. the functional status.

Clinical decision making in seizures and status epilepticus.

PubMed

Teran, Felipe; Harper-Kirksey, Katrina; Jagoda, Andy

2015-01-01

Seizures and status epilepticus are frequent neurologic emergencies in the emergency department, accounting for 1% of all emergency department visits. The management of this time-sensitive and potentially life-threatening condition is challenging for both prehospital providers and emergency clinicians. The approach to seizing patients begins with differentiating seizure activity from mimics and follows with identifying potential secondary etiologies, such as alcohol-related seizures. The approach to the patient in status epilepticus and the patient with nonconvulsive status epilepticus constitutes a special clinical challenge. This review summarizes the best available evidence and recommendations regarding diagnosis and resuscitation of the seizing patient in the emergency setting.

Impact of Sex and Menopausal Status on Episodic Memory Circuitry in Early Midlife.

PubMed

Jacobs, Emily G; Weiss, Blair K; Makris, Nikos; Whitfield-Gabrieli, Sue; Buka, Stephen L; Klibanski, Anne; Goldstein, Jill M

2016-09-28

Cognitive neuroscience of aging studies traditionally target participants age 65 and older. However, epidemiological surveys show that many women report increased forgetfulness earlier in the aging process, as they transition to menopause. In this population-based fMRI study, we stepped back by over a decade to characterize the changes in memory circuitry that occur in early midlife, as a function of sex and women's reproductive stage. Participants (N = 200; age range, 45-55) performed a verbal encoding task during fMRI scanning. Reproductive histories and serologic evaluations were used to determine menopausal status. Results revealed a pronounced impact of reproductive stage on task-evoked hippocampal responses, despite minimal difference in chronological age. Next, we examined the impact of sex and reproductive stage on functional connectivity across task-related brain regions. Postmenopausal women showed enhanced bilateral hippocampal connectivity relative to premenopausal and perimenopausal women. Across women, lower 17β-estradiol concentrations were related to more pronounced alterations in hippocampal connectivity and poorer performance on a subsequent memory retrieval task, strongly implicating sex steroids in the regulation of this circuitry. Finally, subgroup analyses revealed that high-performing postmenopausal women (relative to low and middle performers) exhibited a pattern of brain activity akin to premenopausal women. Together, these findings underscore the importance of considering reproductive stage, not simply chronological age, to identify neuronal and cognitive changes that unfold in the middle decades of life. In keeping with preclinical studies, these human findings suggest that the decline in ovarian estradiol production during menopause plays a significant role in shaping memory circuitry. Maintaining intact memory function with age is one of the greatest public health challenges of our time, and women have an increased risk for memory disorders relative to men later in life. We studied adults early in the aging process, as women transition into menopause, to identify neuronal and cognitive changes that unfold in the middle decades of life. Results demonstrate regional and network-level differences in memory encoding-related activity as a function of women's reproductive stage, independent of chronological age. Analyzing data without regard to sex or menopausal status obscured group differences in circuit-level neural strategies associated with successful memory retrieval. These findings suggest that early changes in memory circuitry are evident decades before the age range traditionally targeted by cognitive neuroscience of aging studies. Copyright © 2016 the authors 0270-6474/16/3610163-11$15.00/0.

Hepatitis B Virus Infection in Tanzania: Current Status and Challenges

PubMed Central

Bakshi, Fatma A.; Jaka, Hyasinta

2018-01-01

Hepatitis B is one of the most common infectious diseases in the world with high prevalence in most of sub-Saharan Africa countries. The complexity in its diagnosis and treatment poses a significant management challenge in the resource-limited settings including Tanzania, where most of the tests and drugs are either unavailable or unaffordable. This mini review aims at demonstrating the current status of the disease in the country and discussing the concomitant challenges in diagnosis, treatment, and prevention. PMID:29666656

Early-life Socio-economic Status and Adult Health: The Role of Positive Affect.

PubMed

Murdock, Kyle W; LeRoy, Angie S; Fagundes, Christopher P

2017-08-01

The aim of this paper is to develop a further understanding of the relationship between early-life socio-economic status (SES) and adult health disparities. This was accomplished through evaluation of state indicators of positive and negative affect as mechanisms through which early-life SES was associated with susceptibility to a rhinovirus (i.e. the common cold). Analyses were conducted among 286 adults in a viral challenge study in which participants were exposed to a rhinovirus via nasal drops and cold symptoms were evaluated over a period of 5 days. Participant age, body mass index, sex, education, ethnicity, pre-challenge virus-specific antibody titres and subjective adult SES, along with virus type and season of participation, were included as covariates. Early-life SES was associated with cold incidence through state positive affect, but not state negative affect. In addition, contrast analysis indicated that the indirect effect through state positive affect was stronger than the indirect effect through state negative affect. Findings provide further support for early-life SES being an important variable associated with adult health, and that state self-reported positive affect may be an underlying mechanism associated with susceptibility to rhinoviruses. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Associations among physical activity, diet quality, and weight status in US adults.

PubMed

Pate, Russell R; Taverno Ross, Sharon E; Liese, Angela D; Dowda, Marsha

2015-04-01

Nearly 70% of adult Americans are overweight or obese, but the associations between physical activity, diet quality, and weight status have not been examined in a representative sample of US adults. The purpose of this study was to examine the associations among moderate-to-vigorous physical activity (MVPA), diet quality, and weight status within and across age groups in US adults. Participants included 2587 men and 2412 women age 20 to ≥70 yr from the National Health and Nutrition Examination Survey 2003-2004 and 2005-2006. Physical activity was measured by accelerometry. Diet quality was assessed with overall Healthy Eating Index-2005 scores. Measures of weight status, body mass index (BMI), and waist circumference were assessed using standard National Health and Nutrition Examination Survey protocols. Across age groups, MVPA was lower in the older age groups for both men and women, whereas diet quality was higher (P < 0.001). BMI and waist circumference were also higher in the older age groups (P < 0.05). Within age groups, MVPA was inversely associated with BMI and waist circumference for men and women in nearly every age group (P < 0.05). Diet quality was inversely associated with the weight status variables only in men age 30-39, 40-49 (BMI only), and 50-59 yr and women age 50-59 yr (P < 0.05). We observed clear age-related trends for measures of weight status, physical activity, and diet quality in US men and women. MVPA was very consistently related to weight status in both genders. The relation between diet quality and weight status was less consistent. These findings provide support for public health efforts to prevent obesity by promoting increased physical activity in adult Americans.

Associations among Physical Activity, Diet Quality, and Weight Status in U.S. Adults

PubMed Central

Pate, Russell R.; Taverno Ross, Sharon E.; Liese, Angela D.; Dowda, Marsha

2015-01-01

Purpose Nearly 70% of adult Americans are overweight or obese, but the associations between physical activity, diet quality, and weight status have not been examined in a representative sample of U.S. adults. The purpose of this study was to examine the associations among moderate-to-vigorous physical activity (MVPA), diet quality, and weight status within and across age groups in U.S. adults. Methods Participants included 2,587 men and 2,412 women ages 20 to ≥70 years from the National Health and Nutrition Examination Survey (NHANES) 2003–2004 and 2005–2006. Physical activity was measured by accelerometry. Diet quality was assessed with overall Healthy Eating Index-2005 scores. Measures of weight status, BMI and waist circumference, were assessed using standard NHANES protocols. Results Across age groups, MVPA was lower in the older age groups for both men and women while diet quality was higher (P<.001). BMI and waist circumference were also higher in the older age groups (P<0.05). Within age groups, MVPA was inversely associated with BMI and waist circumference for men and women in nearly every age group (P<0.05). Diet quality was inversely associated with the weight status variables only in men ages 30–39, 40–49 (BMI only), and 50–59 years, and women ages 50–59 years (P<0.05). Conclusions We observed clear age-related trends for measures of weight status, physical activity, and diet quality in U.S. men and women. MVPA was very consistently related to weight status in both genders. The relationship between diet quality and weight status was less consistent. These findings provide support for public health efforts to prevent obesity by promoting increased physical activity in adult Americans. PMID:25058328

Parental perception of child’s weight status and subsequent BMIz change: the KOALA birth cohort study

PubMed Central

2014-01-01

Background Parents often fail to correctly perceive their children’s weight status, but no studies have examined the association between parental weight status perception and longitudinal BMIz change (BMI standardized to a reference population) at various ages. We investigated whether parents are able to accurately perceive their child’s weight status at age 5. We also investigated predictors of accurate weight status perception. Finally, we investigated the predictive value of accurate weight status perception in explaining children’s longitudinal weight development up to the age of 9, in children who were overweight at the age of 5. Methods We used longitudinal data from the KOALA Birth Cohort Study. At the child’s age of 5 years, parents filled out a questionnaire regarding child and parent characteristics and their perception of their child’s weight status. We calculated the children’s actual weight status from parental reports of weight and height at ages 2, 5, 6, 7, 8, and 9 years. Regression analyses were used to identify factors predicting which parents accurately perceived their child’s weight status. Finally, regression analyses were used to predict subsequent longitudinal BMIz change in overweight children. Results Eighty-five percent of the parents of overweight children underestimated their child’s weight status at age 5. The child’s BMIz at age 2 and 5 were significant positive predictors of accurate weight status perception (vs. underestimation) in normal weight and overweight children. Accurate weight status perception was a predictor of higher future BMI in overweight children, corrected for actual BMI at baseline. Conclusions Children of parents who accurately perceived their child’s weight status had a higher BMI over time, probably making it easier for parents to correctly perceive their child’s overweight. Parental awareness of the child’s overweight as such may not be sufficient for subsequent weight management by the parents, implying that parents who recognize their child’s overweight may not be able or willing to adequately manage the overweight. PMID:24678601

Job loss, retirement and the mental health of older Americans.

PubMed

Mandal, Bidisha; Roe, Brian

2008-12-01

Millions of older individuals cope with physical limitations, cognitive changes, and various losses such as bereavement that are commonly associated with aging. Given increased vulnerability to various health problems during aging, work displacement might exacerbate these due to additional distress and to possible changes in medical coverage. Older Americans are of increasing interest to researchers and policymakers due to the sheer size of the Baby Boom cohort, which is approaching retirement age, and due to the general decline in job security in the U.S. labor market. This research compares and contrasts the effect of involuntary job loss and retirement on the mental health of older Americans. Furthermore, it examines the impact of re-employment on the depressive symptoms. There are two fundamental empirical challenges in isolating the effect of employment status on mental health. The first is to control for unobserved heterogeneity--all latent factors that could impact mental health so as to establish the correct magnitude of the effect of employment status. The second challenge is to verify the direction of causality. First difference models are used to control for latent effects and a two-stage least squares regression is used to account for reverse causality. We find that involuntary job loss worsens mental health, and re-employment recaptures the past mental health status. Retirement is found to improve mental health of older Americans. With the use of longitudinal data from the Health and Retirement Study surveys and the adoption of proper measures to control for the possibility of reverse causality, this study provides strong evidence of elevating depressive symptoms with involuntary job displacement even after controlling for other late-life events. Women suffer from greater distress levels than men after job loss due to business closure or lay-off. However, women also exhibit better psychological well-being than men following retirement. The present study is the first to report that the re-employment of involuntary job-loss sufferers leads to a recapturing of past mental health status. Additionally, we find that re-entering the labor force is psychologically beneficial to retirees as well. It is well established that out-of-pocket expenditures on all forms of health care for seniors with self-diagnosed depression significantly exceeds expenditures for seniors with other common ailments such as hypertension and arthritis in the U.S. Thus, our research suggests that re-employment of older Americans displaced from the labor force will be cost-effective with regard to personal mental health outcomes. That re-employment of involuntary job loss sufferers leads to a recapturing of past mental health status illuminates one potential policy trade off - increased resources dedicated to job training and placement for older U.S. workers could reap benefits with regard to reduced private and public mental health expenditures. Further research could more clearly assess the degree to which the mental health benefits of employment among older Americans would warrant the expansion of job training and employment programs aimed at this group.

Patient-Reported Outcome Measures (PROM) as A Preoperative Assessment Tool.

PubMed

Kim, Sunghye; Duncan, Pamela W; Groban, Leanne; Segal, Hannah; Abbott, Rica Moonyeen; Williamson, Jeff D

2017-11-28

Patient-reported outcomes (PRO) on functional, social, and behavioral factors might be important preoperative predictors of postoperative outcomes. We conducted a literature review to explore associations of preoperative depression, socioeconomic status, social support, functional status/frailty, cognitive status, self-management skills, health literacy, and nutritional status with surgical outcomes. Two electronic data bases, including PubMed and Google Scholar, were searched linking either depression, socioeconomic status, social support, functional status/frailty, cognitive status, self-management skills, health literacy, or nutritional status with surgery, postoperative complications, or perioperative period within the past 2 decades. Preoperative depression has been linked to postoperative delirium, complications, persistent pain, longer lengths of stay, and mortality. Socioeconomic status associates with overall and cancer-free survival. Low socioeconomic status has also been connected to medication non- compliance. Social support can predict overall and cancer- free survival, as well as physical, social and emotional quality of life. Poor functional status and frailty have been related to postoperative complications, longer lengths of stay, post-discharge institutionalization, and higher costs. Preoperative cognitive impairment also associates with self-medication management errors, postoperative cognitive impairment, delirium, complications and mortality. In addition, a greater tendency for reduced adherence to preoperative medication instructions has been linked to health illiteracy. Preoperative malnutrition is prevalent and associates with postoperative morbidity. Efficient and effective assessments of social and behavioral determinants of health, functional status, health literacy, patient's perception of health, and preferences for self-management may improve postoperative management and surgical outcomes, particularly among vulnerable patients undergoing elective surgery who might have subtle physical, social, or psychological deficits or challenges, otherwise missed upon routine evaluation. Patient Reported Outcome Measures (PROMs) can be used to effectively and efficiently collect these factors in the preoperative period, thereby identifying areas that can be intervened preemptively. (Partially Funded by the National Institute on Aging and the Wake Forest University Claude D. Pepper Older Americans Independence Center.).

Higher-status occupations and breast cancer: a life-course stress approach.

PubMed

Pudrovska, Tetyana; Carr, Deborah; McFarland, Michael; Collins, Caitlyn

2013-07-01

Using the 1957-2011 data from 3682 White non-Hispanic women (297 incident breast cancer cases) in the Wisconsin Longitudinal Study, United States, we explore the effect of occupation in 1975 (at age 36) on breast cancer incidence up to age 72. Our study is motivated by the paradoxical association between higher-status occupations and elevated breast cancer risk, which presents a challenge to the consistent health advantage of higher social class. We found that women in professional occupations had 72122% and women in managerial occupations had 57-89% higher risk of a breast cancer diagnosis than housewives and women in lower-status occupations. We explored an estrogen-related pathway (reproductive history, health behaviors, and life-course estrogen cycle) as well as a social stress pathway (occupational experiences) as potential explanations for the effect of higher-status occupations. The elevated risk of breast cancer among professional women was partly explained by estrogen-related variables but remained large and statistically significant. The association between managerial occupations and breast cancer incidence was fully explained by job authority defined as control over others' work. Exercising job authority was related to higher breast cancer risk (HR = 1.57, 95% CI: 1.12, 2.18), especially with longer duration of holding the professional/managerial job. We suggest that the assertion of job authority by women in the 1970s involved stressful interpersonal experiences that may have promoted breast cancer development via prolonged dysregulation of the glucocorticoid system and exposure of the breast tissue to adverse effects of chronically elevated cortisol. Our study emphasizes complex biosocial pathways through which women's gendered occupational experiences become embodied and drive forward physiological repercussions. Copyright © 2013 Elsevier Ltd. All rights reserved.

Higher-Status Occupations and Breast Cancer: A Life-Course Stress Approach

PubMed Central

Pudrovska, Tetyana; Carr, Deborah; McFarland, Michael; Collins, Caitlyn

2013-01-01

Using the 1957-2011 data from 3,682 White non-Hispanic women (297 incident breast cancer cases) in the Wisconsin Longitudinal Study, United States, we explore the effect of occupation in 1975 (at age 36) on breast cancer incidence up to age 72. Our study is motivated by the paradoxical association between higher-status occupations and elevated breast cancer risk, which presents a challenge to the consistent health advantage of higher social class. We found that women in professional occupations had 72%-122% and women in managerial occupations had 57%-89% higher risk of a breast cancer diagnosis than housewives and women in lower-status occupations. We explored an estrogen-related pathway (reproductive history, health behaviors, and life-course estrogen cycle) as well as a social stress pathway (occupational experiences) as potential explanations for the effect of higher-status occupations. The elevated risk of breast cancer among professional women was partly explained by estrogen-related variables but remained large and statistically significant. The association between managerial occupations and breast cancer incidence was fully explained by job authority defined as control over others’ work. Exercising job authority was related to higher breast cancer risk (HR = 1.57, 95% CI: 1.12, 2.18), especially with longer duration of holding the professional/managerial job. We suggest that the assertion of job authority by women in the 1970s involved stressful interpersonal experiences that may have promoted breast cancer development via prolonged dysregulation of the glucocorticoid system and exposure of the breast tissue to adverse effects of chronically elevated cortisol. Our study emphasizes complex biosocial pathways through which women’s gendered occupational experiences become embodied and drive forward physiological repercussions. PMID:23726216

Modifying Status Effects in Diverse Student Groups in New Zealand Tertiary Institutions: Elizabeth Cohen's Legacy for Teacher Education

ERIC Educational Resources Information Center

Baker, Trish; Clark, Jill

2017-01-01

New Zealand tertiary classrooms are a mix of New Zealand's ethnically diverse domestic students and predominantly Asian international students. This multicultural diversity, while having potential to enhance educational experience, brings challenges for teachers in the use of cooperative learning. A major challenge is status inequality in diverse…

CHILDREN’S UNION STATUS AND CONTACT WITH MOTHERS: A CROSS-NATIONAL STUDY

PubMed Central

Yahirun, Jenjira J.; Hamplová, Dana

2015-01-01

BACKGROUND In North America and Europe, population aging challenges the institutions responsible for elder care. In these environments, older individuals rely on offspring to provide social, instrumental and financial support. However, reliance on offspring, and offspring’s provision of support, depend on several factors. OBJECTIVE In this paper, we examine how offspring’s union status is associated with maternal contact and distinguish between offspring who are married, cohabiting or single. METHODS We use data from the U.S. Health and Retirement Survey and the Survey of Health, Aging, and Retirement in Europe to compare the association between adult children’s union status and contact with mothers. Our sample consists of 9,779 mothers and 20,795 of their adult children across 15 countries. We employ multi-level analyses to account for variation in contact across and within family units and country contexts. RESULTS We find that across all countries, cohabiting offspring have the least contact with mothers compared to married or single offspring. However, the effects of marriage are not universal and vary greatly across countries. In some countries, marriage is associated with less contact with mothers; in others, marriage binds generations together and intergenerational contact is greater than when offspring are single. Differences between married and cohabiting offspring also vary across contexts. We interpret these findings in light of cross-national variation in norms of parental obligations, public support for the elderly and kin relationships in weak versus strong family systems. PMID:26664290

Taking it one day at a time: African American women aging with HIV and co-morbidities.

PubMed

Warren-Jeanpiere, Lari; Dillaway, Heather; Hamilton, Pilar; Young, Mary; Goparaju, Lakshmi

2014-07-01

Self-managing HIV/AIDS presents challenges for anyone infected. These challenges may be further complicated for older HIV-infected African American women who acquired the disease at younger ages and now have co-morbidities. Little is known regarding how women's age identity, social responsibilities, co-morbidities, and romantic relationship status influence their HIV self-management. Five focus groups were conducted in Washington DC, with HIV-positive African American women aged 52-65. Topics included HIV and co-morbidity self-management, social support needs, medication adherence, and future plans for old age. A constant comparison approach was applied during data analysis. Co-morbidities, including diabetes and hypertension, were perceived to be more difficult to self-manage than HIV. This difficulty was not attributed to aging but to daily struggles such as lack of income and/or health insurance, an inflexible work schedule, and loneliness. Social responsibilities, including caring for family, positively impacted participants' ability to self-manage HIV by serving as motivation to stay healthy in order to continue to help family members. In contrast, inflexible work schedules negatively impacted women's ability to sustain medication adherence. Overall, this study demonstrates that HIV and co-morbidity self-management are inextricably linked. We can no longer afford to view engagement in HIV care as a single-disease issue and hope to attain optimal health and well-being in our HIV-affected populations. Optimal HIV self-management must be framed within a larger context that simultaneously addresses HIV and co-morbidities, while considering how social and cultural factors uniquely intersect to influence older African American women's self-management strategies.

Maternal and child nutrition in Sub-Saharan Africa: challenges and interventions.

PubMed

Lartey, Anna

2008-02-01

Women of child-bearing age (especially pregnant and lactating women), infants and young children are in the most nutritionally-vulnerable stages of the life cycle. Maternal malnutrition is a major predisposing factor for morbidity and mortality among African women. The causes include inadequate food intake, poor nutritional quality of diets, frequent infections and short inter-pregnancy intervals. Evidence for maternal malnutrition is provided by the fact that between 5 and 20% of African women have a low BMI as a result of chronic hunger. Across the continent the prevalence of anaemia ranges from 21 to 80%, with similarly high values for both vitamin A and Zn deficiency levels. Another challenge is the high rates of HIV infection, which compromise maternal nutritional status. The consequences of poor maternal nutritional status are reflected in low pregnancy weight gain and high infant and maternal morbidity and mortality. Suboptimal infant feeding practices, poor quality of complementary foods, frequent infections and micronutrient deficiencies have largely contributed to the high mortality among infants and young children in the region. Feeding children whose mothers are infected with HIV continues to remain an issue requiring urgent attention. There are successful interventions to improve the nutrition of mothers, infants and young children, which will be addressed. Interventions to improve the nutrition of infants and young children, particularly in relation to the improvement of micronutrient intakes of young children, will be discussed. The recent release by WHO of new international growth standards for assessing the growth and nutritional status of children provides the tool for early detection of growth faltering and for appropriate intervention.

Is There Evidence for Systematic Upcoding of ASA Physical Status Coincident with Payer Incentives? A Regression Discontinuity Analysis of the National Anesthesia Clinical Outcomes Registry.

PubMed

Schonberger, Robert B; Dutton, Richard P; Dai, Feng

2016-01-01

Modifications in physician billing patterns have been shown to occur in response to payer incentives, but the phenomenon remains largely unexplored in billing for anesthesia services. Within the field of anesthesiology, Medicare's policy not to provide additional reimbursement for higher ASA physical status scores contrasts with the practices of most private payers, and this pattern of reimbursement introduces a change in billing incentives once patients attain Medicare eligibility. We hypothesized that, coincident with the onset of widespread Medicare eligibility at age 65 years, a discontinuity in reported ASA physical status scores would be observed after controlling for the underlying trend of increasing ASA physical status scores with age. This phenomenon would manifest as a pattern of upcoding of ASA physical status scores for patients younger than 65 years that would become less common in patients age 65 years and older. Using data on age, sex, ASA physical status scores, and type of surgery from the National Anesthesia Clinical Outcomes Registry, we used a quasi-experimental regression discontinuity design to analyze whether there was evidence for a discontinuity in reported ASA physical status scores occurring at age 65 years for the nondeferrable anesthesia services accompanying hip, femur, or lower leg fracture repair. A total of 49,850 records were analyzed. In models designed to detect regression discontinuity at 65 years of age, neither the binary variable "age ≥ 65" nor the interaction term of age × age ≥ 65 was a statistically significant predictor of the outcome of ASA physical status score. The statistical inference was unchanged when ASA physical status scores were reclassified as a binary outcome (I-II vs III-V) and when different bandwidths around age 65 years were used. To test the validity of our study design for detecting regression discontinuity, simulations of the occurrence of deliberate upcoding of ASA physical status scores demonstrated the ability to detect deliberate upcoding occurring at rates exceeding 2% of eligible cases of patients younger than 65 years. We found no evidence for a significant discontinuity in the pattern of ASA physical status scores coincident with Medicare eligibility at age 65 years for the nondeferrable conditions of hip, femur, or lower leg fracture repair. Our data do not support the presence of fraudulent ASA physical status scoring among National Anesthesia Clinical Outcomes Registry contributors. If deliberate upcoding of ASA physical status scores is present in our data, the behavior is either too rare or too insensitive to the removal of payer incentives at age 65 years to be evident in the present analysis.

Intrapersonal, social and physical environmental determinants of moderate-to-vigorous physical activity in working-age women: a systematic review protocol.

PubMed

Prince, Stephanie A; Reed, Jennifer L; Nerenberg, Kara A; Kristjansson, Elizabeth A; Hiremath, Swapnil; Adamo, Kristi B; Tulloch, Heather E; Mullen, Kerri-Anne; Fodor, J George; Wright, Erica; Reid, Robert D

2014-11-04

The majority of North American adult females do not meet current physical activity recommendations (150 min of moderate-to-vigorous intensity physical activity (MVPA) per week accrued in ≥10 min bouts) ultimately placing themselves at increased risk of morbidity and mortality. Working-age females face particular challenges in meeting physical activity recommendations as they have multiple demands, including occupational, family and social demands. To develop effective interventions to increase MVPA among working-age females, it is necessary to identify and understand the strongest modifiable determinants influencing these behaviours. Therefore, the objective of this systematic review is to examine the available evidence to identify intrapersonal, social and environmental determinants of MVPA among working-age females. Six electronic databases will be searched to identify all prospective cohort studies that report on intrapersonal, social and/or environmental determinants of MVPA in working-age females. Grey literature sources including theses, published conference abstracts and websites from relevant organizations will also be included. Articles that report on intrapersonal (e.g. health status, self-efficacy, socio-economic status (SES), stress, depression), social environmental (e.g. crime, safety, area SES, social support, climate and capital, policies), and environmental (e.g. weather, workplace, home, neighbourhood, recreation environment, active transportation) determinants of MVPA in a working-age (mean age 18-65 years) female population will be included. Risk of bias will be assessed within and across all included studies using the Tool to Assess Risk of Bias in Cohort Studies and the Grades of Recommendation, Assessment, Development and Evaluation approach. Harvest plots will be used to synthesize results across all determinants, and meta-analyses will be conducted where possible among studies with sufficient homogeneity. This review will provide a comprehensive examination of evidence in this field and will serve to highlight gaps for future research on the determinants of MVPA in working-age females and ultimately inform intervention design. CRD42014009750.

A reconceptualization of age stratification in China.

PubMed

Yin, P; Lai, K H

1983-09-01

Using the concepts of age stratification theory--age effect, cohort effect, and subcohort differences--this paper provides a new perspective on age stratification in China. Currently, the literature suggests that the status of elderly people declined after the Communist Revolution and will further decline with modernization. We discuss the problems with this perspective and argue, instead, that the status of elderly adults did not decline for the majority of the aged during the Maoist years. Rather, the most important change in the age stratification system during the Maoist years was the change in the criterion of age stratification--from age differences to cohort and subcohort differences. Furthermore, the subcohort of elderly adults who suffered the most status decline during the Maoist years--the bourgeoisie--may actually enjoy an increase in status with the recent modernization impetus. Research suggestions from this new perspective are discussed.

Going solo: Findings from a survey of women aging without a partner and who do not have children.

PubMed

Hafford-Letchfield, Trish; Lambert, Nicky; Long, Ellouise; Brady, Dominique

2017-01-01

Greater longevity in the UK population has led to the increasing diversity of women experiencing aging in a multitude of ways. Internationally, gender inequalities in aging are still relatively invisible within both government policy and everyday life for particular groups of women. This article explores the concept of women growing older "solo"-by which we mean women who find themselves nonpartnered and aging without children as they move into later life. We report on the findings from a mixed-methods survey of 76 solo women in the UK aged 50 years and over, used to provide a broader overview of the issues and challenges they face as they move into later life. Qualitative data from the survey captured respondents' perspectives about the links between their relationships status and well-being in later life and highlighted specific cumulative disadvantages emerging for some women as a result of their solo lifestyles. We discuss two key themes that were identified, "solo-loneliness" and "meaningful futures," in conjunction with the relevant literature and make suggestions for future research within gender and aging studies that could enhance more positive approaches to solo lifestyles.

Individual differences in the activity of the hypothalamic pituitary adrenal axis: Relations to age and cumulative risk in early childhood.

PubMed

Holochwost, Steven J; Gariépy, Jean-Louis; Mills-Koonce, W Roger; Propper, Cathi B; Kolacz, Jacek; Granger, Douglas A

2017-07-01

This study examined individual differences in the function of the hypothalamic-pituitary-adrenal (HPA) axis with regard to age and cumulative risk during challenging laboratory tasks administered at 6, 12, 24, and 36 months. Saliva samples were collected from a majority-minority sample of N=185 children (57% African American, 50% female) prior to and following these tasks and later assayed for cortisol. Cumulative distal risk was indexed via a composite of maternal marital status, maternal education, income-to-needs ratio, the number of children in the household, and maternal age at childbirth. Probing of hierarchical models in which cortisol levels and age were nested within child revealed significant differences in cortisol as a function of both age and cumulative risk, such that children exposed to high levels of risk exhibited higher levels of cortisol both within and across age. These results highlight the sensitivity of the HPA axis to environmental context at the level of the individual, even as that sensitivity is manifest against the background of species-typical biological development. Copyright © 2017 Elsevier Ltd. All rights reserved.

An interferon inducing porcine reproductive and respiratory syndrome virus vaccine candidate elicits protection against challenge with the heterologous virulent type 2 strain VR-2385 in pigs.

PubMed

Fontanella, Eve; Ma, Zexu; Zhang, Yanjin; de Castro, Alessandra M M G; Shen, Huigang; Halbur, Patrick G; Opriessnig, Tanja

2017-01-03

Achieving consistent protection by vaccinating pigs against porcine reproductive and respiratory syndrome virus (PRRSV) remains difficult. Recently, an interferon-inducing PRRSV vaccine candidate strain A2MC2 was demonstrated to be attenuated and induced neutralizing antibodies. The objective of this study was to determine the efficacy of passage 90 of A2MC2 (A2P90) to protect pigs against challenge with moderately virulent PRRSV strain VR-2385 (92.3% nucleic acid identity with A2MC2) and highly virulent atypical PRRSV MN184 (84.5% nucleic acid identity with A2MC2). Forty 3-week old pigs were randomly assigned to five groups including a NEG-CONTROL group (non-vaccinated, non-challenged), VAC-VR2385 (vaccinated, challenged with strain VR-2385), VR2385 (challenged with strain VR-2385), VAC-MN184 (vaccinated, challenged with strain MN184) and a MN184 group (challenged with MN184 virus). Vaccination was done at 3weeks of age followed by challenge at 8weeks of age. No viremia was detectable in any of the vaccinated pigs; however, by the time of challenge, 15/16 vaccinated pigs had seroconverted based on ELISA and had neutralizing antibodies against a homologous strain with titers ranging from 8 to 128. Infection with VR-2385 resulted in mild-to-moderate clinical disease and lesions. For VR-2385 infected pigs, vaccination significantly lowered PRRSV viremia and nasal shedding by 9days post challenge (dpc), significantly reduced macroscopic lung lesions, and significantly increased the average daily weight gain compared to the non-vaccinated pigs. Infection with MN184 resulted in moderate-to-severe clinical disease and lesions regardless of vaccination status; however, vaccinated pigs had significantly less nasal shedding by dpc 5 compared to non-vaccinated pigs. Under the study conditions, the A2P90 vaccine strain was attenuated without detectable shedding, improved weight gain, and offered protection to the pigs challenged with VR-2385 by reduction of virus load and macroscopic lung lesions. Further work is needed to investigate different vaccination and challenge protocols, including routes, doses, timing and strains. Copyright © 2016 Elsevier Ltd. All rights reserved.

Healthy aging persons and their brains: promoting resilience through creative engagement.

PubMed

McFadden, Susan H; Basting, Anne D

2010-02-01

Creative engagement, as an expression of and a support for resilience, may have a neuroprotective effect among older adults, contributing to retention of cognitive capacity. Recent research on creative activities shows that they strengthen social networks and give persons a sense of control; both outcomes have been associated with brain health. The authors cite evidence suggesting that positive social interactions can nurture resilience and creative engagement among older persons, including those living with dementia. The motivational, attentional, affective, and social components of creative activities combine to offer older persons meaningful opportunities to express and strengthen their resilience, regardless of their cognitive status, despite the biopsychosocial challenges of aging. The article addresses implications for future research, clinical practice, and public policy, and suggests how gaps in current research on resilience and creativity might be addressed.

National survey of the Portuguese elderly nutritional status: study protocol.

PubMed

Madeira, Teresa; Peixoto-Plácido, Catarina; Goulão, Beatriz; Mendonça, Nuno; Alarcão, Violeta; Santos, Nuno; de Oliveira, Rita Machado; Yngve, Agneta; Bye, Asta; Bergland, Astrid; Lopes, Carla; Nicola, Paulo; Santos, Osvaldo; Clara, João Gorjão

2016-07-16

Worldwide we are facing a serious demographic challenge due to the dramatic growth of the population over 60 years. It is expected that the proportion of this population will nearly double from 12 to 22 %, between 2015 and 2050. This demographic shift comes with major health and socio-economic concerns. Nutrition is a fundamental determinant of both health and disease and its role in extending a healthy lifespan is the object of considerable research. Notably, malnutrition is one of the main threats to health and quality of life among the elderly. Therefore, knowledge about nutritional status among the elderly is essential for the promotion and maintenance of healthy ageing and to support the development of health protection policies and equity in elderly health care. This is a nationwide nutrition survey of the Portuguese population over 65 years old, with data collection through face-to-face interviews. A representative and random sample of community dwelling elderly and nursing homes residents will be obtained by multistage sampling stratified per main Portuguese regions, sex and age groups. Minimum sample size was estimated to be 2077 elderly (979 in the community and 1098 in nursing homes). Data will be collected on food habits and eating patterns, nutritional status, food insecurity, lifestyle, self-rated general health status and self-reported diseases, functionality, loneliness, cognitive function, emotional status and demographic and socio-economic characterization. This is the first national survey to evaluate the prevalence of nutritional risk and malnutrition of the Portuguese population above 65 years old, including those living in nursing homes. It will allow the identification of population subgroups of elderly with increased odds of malnutrition and nutritional risk. In addition, this survey will contribute to the identification of psychosocial and clinical predictors of malnutrition among elderly, which is an important risk factor for other devastating medical conditions.

Psychosocial factors for influencing healthy aging in adults in Korea.

PubMed

Han, KyungHun; Lee, YunJung; Gu, JaSung; Oh, Hee; Han, JongHee; Kim, KwuyBun

2015-03-07

Healthy aging includes physical, psychological, social, and spiritual well-being in later years. The purpose of this study is to identify the psychosocial factors influencing healthy aging and examining their socio-demographic characteristics. Perceived health status, depression, self-esteem, self-achievement, ego-integrity, participation in leisure activities, and loneliness were identified as influential factors in healthy aging. 171 Korean adults aged between 45 and 77 years-old participated in the study. Self-reporting questionnaires were used, followed by descriptive statistics and multiple regressions as inferential statistical analyses. There were significant differences between participants' general characteristics: age, education, religion, housing, hobby, and economic status. The factors related to healthy aging had positive correlation with perceived health status, self-esteem, self-achievements, and leisure activities, and negative correlation with depression and loneliness. The factors influencing healthy aging were depression, leisure activities, perceived health status, ego integrity, and self-achievements. These factors were able to explain 51.9%. According to the results, depression is the factor with the greatest influence on healthy aging. Perceived health status, ego integrity, self-achievement, self-esteem, participation of leisure activities were also influential on healthy aging as beneficial factors.

Advanced visualization platform for surgical operating room coordination: distributed video board system.

PubMed

Hu, Peter F; Xiao, Yan; Ho, Danny; Mackenzie, Colin F; Hu, Hao; Voigt, Roger; Martz, Douglas

2006-06-01

One of the major challenges for day-of-surgery operating room coordination is accurate and timely situation awareness. Distributed and secure real-time status information is key to addressing these challenges. This article reports on the design and implementation of a passive status monitoring system in a 19-room surgical suite of a major academic medical center. Key design requirements considered included integrated real-time operating room status display, access control, security, and network impact. The system used live operating room video images and patient vital signs obtained through monitors to automatically update events and operating room status. Images were presented on a "need-to-know" basis, and access was controlled by identification badge authorization. The system delivered reliable real-time operating room images and status with acceptable network impact. Operating room status was visualized at 4 separate locations and was used continuously by clinicians and operating room service providers to coordinate operating room activities.

Life and living in advanced age: a cohort study in New Zealand--e Puāwaitanga o Nga Tapuwae Kia Ora Tonu, LiLACS NZ: study protocol.

PubMed

Hayman, Karen J; Kerse, Ngaire; Dyall, Lorna; Kepa, Mere; Teh, Ruth; Wham, Carol; Clair, Valerie Wright-St; Wiles, Janine; Keeling, Sally; Connolly, Martin J; Wilkinson, Tim J; Moyes, Simon; Broad, Joanna B; Jatrana, Santosh

2012-06-29

The number of people of advanced age (85 years and older) is increasing and health systems may be challenged by increasing health-related needs. Recent overseas evidence suggests relatively high levels of wellbeing in this group, however little is known about people of advanced age, particularly the indigenous Māori, in Aotearoa, New Zealand. This paper outlines the methods of the study Life and Living in Advanced Age: A Cohort Study in New Zealand. The study aimed to establish predictors of successful advanced ageing and understand the relative importance of health, frailty, cultural, social & economic factors to successful ageing for Māori and non-Māori in New Zealand. A total population cohort study of those of advanced age. Two cohorts of equal size, Māori aged 80-90 and non-Māori aged 85, oversampling to enable sufficient power, were enrolled. A defined geographic region, living in the Bay of Plenty and Lakes District Health Board areas of New Zealand, defined the sampling frame. Rūnanga (Māori tribal organisations) and Primary Health Organisations were subcontracted to recruit on behalf of the University. Measures--a comprehensive interview schedule was piloted and administered by a trained interviewer using standardised techniques. Socio-demographic and personal history included tribal affiliation for Māori and participation in cultural practices; physical and psychological health status used standardised validated research tools; health behaviours included smoking, alcohol use and nutrition risk; and environmental data included local amenities, type of housing and neighbourhood. Social network structures and social support exchanges are recorded. Measures of physical function; gait speed, leg strength and balance, were completed. Everyday interests and activities, views on ageing and financial interests complete the interview. A physical assessment by a trained nurse included electrocardiograph, blood pressure, hearing and vision, anthropometric measures, respiratory function testing and blood samples. A longitudinal study of people of advanced age is underway in New Zealand. The health status of a population based sample of older people will be established and predictors of successful ageing determined.

Life and Living in Advanced Age: A Cohort Study in New Zealand -Te Puāwaitanga o Nga Tapuwae Kia Ora Tonu, LiLACS NZ: Study protocol

PubMed Central

2012-01-01

Background The number of people of advanced age (85 years and older) is increasing and health systems may be challenged by increasing health-related needs. Recent overseas evidence suggests relatively high levels of wellbeing in this group, however little is known about people of advanced age, particularly the indigenous Māori, in Aotearoa, New Zealand. This paper outlines the methods of the study Life and Living in Advanced Age: A Cohort Study in New Zealand. The study aimed to establish predictors of successful advanced ageing and understand the relative importance of health, frailty, cultural, social & economic factors to successful ageing for Māori and non-Māori in New Zealand. Methods/design A total population cohort study of those of advanced age. Two cohorts of equal size, Māori aged 80–90 and non-Māori aged 85, oversampling to enable sufficient power, were enrolled. A defined geographic region, living in the Bay of Plenty and Lakes District Health Board areas of New Zealand, defined the sampling frame. Rūnanga (Māori tribal organisations) and Primary Health Organisations were subcontracted to recruit on behalf of the University. Measures - a comprehensive interview schedule was piloted and administered by a trained interviewer using standardised techniques. Socio-demographic and personal history included tribal affiliation for Māori and participation in cultural practices; physical and psychological health status used standardised validated research tools; health behaviours included smoking, alcohol use and nutrition risk; and environmental data included local amenities, type of housing and neighbourhood. Social network structures and social support exchanges are recorded. Measures of physical function; gait speed, leg strength and balance, were completed. Everyday interests and activities, views on ageing and financial interests complete the interview. A physical assessment by a trained nurse included electrocardiograph, blood pressure, hearing and vision, anthropometric measures, respiratory function testing and blood samples. Discussion A longitudinal study of people of advanced age is underway in New Zealand. The health status of a population based sample of older people will be established and predictors of successful ageing determined. PMID:22747503

Do women in major cities experience better health? A comparison of chronic conditions and their risk factors between women living in major cities and other cities in Indonesia.

PubMed

Christiani, Yodi; Byles, Julie E; Tavener, Meredith; Dugdale, Paul

2015-01-01

Inhabitants of rural areas can be tempted to migrate to urban areas for the type and range of facilities available. Although urban inhabitants may benefit from greater access to human and social services, living in a big city can also bring disadvantages to some residents due to changes in social and physical environments. We analysed data from 4,208 women aged >15 years old participating in the fourth wave of the Indonesia Family Life Survey. Chronic condition risk factors - systolic and diastolic blood pressure (SBP and DBP), body mass index (BMI), and tobacco use - among women in four major cities in Indonesia (Jakarta, Surabaya, Medan, and Bandung) were compared against other cities. Fractional polynomial regression models were applied to examine the association between living in the major cities and SBP, DBP, BMI, and tobacco use. The models were also adjusted for age, education, employment status, migration status, ethnic groups, and religion. The patterns of SBP, DBP, and BMI were plotted and contrasted between groups of cities. Chronic condition prevalence was higher for women in major cities than in contrasting cities (p<0.005). Living in major cities increased the risk of having higher SBP, DBP, BMI and being a current smoker. Chronic disease risk factors in major cities were evident from younger ages. Women residing in Indonesia's major cities have a higher risk of developing chronic conditions, starting at younger ages. The findings highlight the challenges inherent in providing long-term healthcare with its associated cost within major Indonesian cities and the importance of chronic disease prevention programmes targeting women at an early age.

Do women in major cities experience better health? A comparison of chronic conditions and their risk factors between women living in major cities and other cities in Indonesia

PubMed Central

Christiani, Yodi; Byles, Julie E.; Tavener, Meredith; Dugdale, Paul

2015-01-01

Background Inhabitants of rural areas can be tempted to migrate to urban areas for the type and range of facilities available. Although urban inhabitants may benefit from greater access to human and social services, living in a big city can also bring disadvantages to some residents due to changes in social and physical environments. Design We analysed data from 4,208 women aged >15 years old participating in the fourth wave of the Indonesia Family Life Survey. Chronic condition risk factors – systolic and diastolic blood pressure (SBP and DBP), body mass index (BMI), and tobacco use – among women in four major cities in Indonesia (Jakarta, Surabaya, Medan, and Bandung) were compared against other cities. Fractional polynomial regression models were applied to examine the association between living in the major cities and SBP, DBP, BMI, and tobacco use. The models were also adjusted for age, education, employment status, migration status, ethnic groups, and religion. The patterns of SBP, DBP, and BMI were plotted and contrasted between groups of cities. Results Chronic condition prevalence was higher for women in major cities than in contrasting cities (p<0.005). Living in major cities increased the risk of having higher SBP, DBP, BMI and being a current smoker. Chronic disease risk factors in major cities were evident from younger ages. Conclusions Women residing in Indonesia's major cities have a higher risk of developing chronic conditions, starting at younger ages. The findings highlight the challenges inherent in providing long-term healthcare with its associated cost within major Indonesian cities and the importance of chronic disease prevention programmes targeting women at an early age. PMID:26689455

E-Learning in Supplemental Educational Systems in Taiwan: Present Status and Future Challenges

ERIC Educational Resources Information Center

Zhang, Ke; Hung, Jui-Long

2009-01-01

As Taiwan's full-scale e-learning initiatives moved to the seventh year in 2009, the current status and challenges of e-learning development there are yet to be fully understood. Further extending Zhang and Hung's (2006) investigation on e-learning in all universities and colleges in Taiwan, this study investigated the after-school programs (ASPs)…

Improving the Status of Women in the Third World: A Challenge to Adult Educators.

ERIC Educational Resources Information Center

Clark, Elmer J.

Adult educators face a challenge if they are to aid in the improvement of the status of women in the Third World. Women in developing countries, especially those in rural and poverty areas, are often restricted to second class educational and work opportunities. Adult educators could contribute to the reduction of such discrimination in the…

Reducing health inequalities among girls and adolescent women living in poverty: the success of Bangladesh.

PubMed

Rousham, Emily K; Khandakar, Ikhtiar Uddin

2016-01-01

Bangladesh has made dramatic improvements in the health of girls and women in the last 20 years. This paper examines whether gender inequalities in health are evident among older children and adolescents among extremely poor households and identifies future health challenges for improving the health of girls and women. Gender inequalities in health were examined using data from a school health survey of school children and adolescents (n = 900, 6.5-13.5 years). Anthropometric status, household possessions and number of siblings were measured. Under-nutrition was assessed as stunting (height-for-age z-score) and thinness (BMI-for-age z-score). The prevalence of under-nutrition was high (35.3% stunting; 42.4% thinness), but there were no significant differences according to gender or socio-economic indicators (via possession score). Girls had more younger siblings (p < 0.05), while boys had more older siblings (p < 0.05). These findings accord with the national picture of successful reductions in gender inequalities in health through low cost, community-based health programmes and education policies targeting the poorest sectors. The prevalence of under-nutrition, however, remains high. Reproductive behaviours may still be influenced by poverty and the gender of existing offspring. Future challenges lie in reducing the adverse health consequences to women and their infants associated with early age at marriage and childbirth.

Syndrome of Electrical Status Epilepticus During Sleep: Epileptic Encephalopathy Related to Brain Development.

PubMed

Chen, Xiao-Qiao; Zhang, Wei-Na; Hu, Lin-Yan; Liu, Meng-Jia; Zou, Li-Ping

2016-03-01

Epileptic encephalopathy with electrical status epilepticus during sleep is an age-related and self-limited disorder. The present study analyzed the etiology, demographics, and pathogenesis of patients with electrical status epilepticus during sleep to provide information on the diagnosis and therapy of this syndrome. The etiologies of epileptic encephalopathy with electrical status epilepticus during sleep in patients admitted in Chinese People's Liberation Army General Hospital from 2009 to 2014 were retrospectively analyzed. Patients were classified into the genetic, structural-metabolic, and unknown groups according to the etiology. Demographics and clinical characteristics of all the patients were then analyzed and compared among groups. The etiologies of epileptic encephalopathy with electrical status epilepticus during sleep in 75 patients mainly included benign childhood epilepsy with centrotemporal spikes, Landau-Kleffner syndrome, polymicrogyria, and migration disorders. Age at onset of epilepsy did not show a specific pattern, but age at onset of epileptic encephalopathy with electrical status epilepticus during sleep was concentrated at age 6-9 years. The mean age at onset of epilepsy in the genetic group was significantly older than that in the structural-metabolic group (P < 0.05). Age at onset of epileptic encephalopathy with electrical status epilepticus during sleep did not significantly differ between the two groups. Electrical status epilepticus during sleep is an epileptic encephalopathy related to brain development and presents an age-dependent occurrence. Copyright © 2016 Elsevier Inc. All rights reserved.

Nutritional status in the healthy longeval population from Sardinia (Italy).

PubMed

Buffa, R; Floris, G; Lodde, M; Cotza, M; Marini, E

2010-02-01

The aim of this study was to evaluate sex- and age-related variations of the nutritional status in the aged population of central Sardinia, a geographical area with a high frequency of long-lived people, particularly men. The sample consisted of 200 subjects over 70 years of age (men: N= 100, age= 81.0 +/- 7.0 years; women: N= 100, age= 81.5 +/- 7.3 years). Orroli (central Sardinia, Italy). Mini nutritional assessment (MNA) and bioelectrical impedance vector analysis (BIVA) were used to evaluate nutritional status and body composition. The indicators revealed a generally good nutritional status. The MNA results (men: 24.6 +/- 2.2; women: 23.4 +/- 2.5) showed that 64.1% of the subjects had a normal nutritional status and only a small proportion (1.2%) could be classified as malnourished. BIVA showed that most subjects (74.2%) were normal, while the prevalence of low body cell mass was 10.7% and that of dehydration 11.2%. According to the MNA, the nutritional status was significantly better in the men. Almost three-quarters of the men (73.1%) were well nourished vs. half of the women (50.6%). A worsening of the nutritional status with age was observed. The proportion of malnourished individuals, as assessed by MNA, increased from 0% to 9.1% from 70-79 to > 90 years. With respect to their contemporaries from other regions, the elderly of Orroli presented a better nutritional status, a similar worsening with age and generally higher sexual dimorphism.

Ageism, Aging and HIV: Community Responses to Prevention, Treatment, Care and Support.

PubMed

DeMarco, Rosanna F; Brennan-Ing, Mark; Sprague, Courtenay; Brown, Shelley M

Ageism, in the form of prejudice, stereotyping, and discrimination targeting older adults, represents a barrier to addressing the graying of the HIV epidemic. There is widespread misperception on the part of older adults themselves, as well as service providers and society in general that HIV risk is low as one ages. In addition, internalized ageism may play a role in poorer physical and mental health outcomes, as the negative stereotypes associated with aging become a self-fulfilling prophecy. A number of steps can be taken to address HIV and aging in the context of ageism with regard to: prevention, education, and outreach; treatment guidelines for older adults with HIV; funding to address the aging of the epidemic; engagement of communities, health and social service organizations, and other providers around mental health and social support, and addressing the needs of special populations. Caring for an aging population with HIV represents a challenge, which is exacerbated in low and/or middle-income countries that typically lack the infrastructure of high resource settings. How we address the aging-related issues of the HIV epidemic across regions and settings could serve as a model in dealing with aging in our society in general regardless of HIV status. © 2017 S. Karger AG, Basel.

Harmonizing professional, personal, and social responsibilities: Indian women dentists' perspectives.

PubMed

Nagda, Suhasini Jayantilal

2015-05-01

Women in Indian culture have a paradoxical status: on the one hand, goddesses are worshipped for power and prosperity; on the other hand, working women face challenges due to age-old beliefs and sociocultural norms. With 60% of the students enrolled in undergraduate dental education currently being women, there is a need to study the challenges these women are facing and how they tackle them. The aim of this survey study was to assess the barriers women dentists face in career advancement and how successfully they balance the personal, professional, and social aspects of their lives. Questionnaires, consisting of four qualitative and 24 quantitative items, were distributed to 500 women dentists: postgraduate residents and faculty members in dental colleges of Mumbai and Navi Mumbai, as well as private dental practitioners. Of the 500 women, 210 returned the survey, for an overall response rate of 42%. The results showed that 95% of the respondents believed they successfully balance the various spheres of their lives, but the most common challenges they faced continued to be traditional gender bias, dual professional and home responsibilities, and preconceived ideas about women.

Dress codes and appearance policies: challenges under federal legislation, part 2: title VII of the civil rights act and gender.

PubMed

Mitchell, Michael S; Koen, Clifford M; Darden, Stephen M

2014-01-01

As more and more individuals express themselves with tattoos and body piercings and push the envelope on what is deemed appropriate in the workplace, employers have an increased need for creation and enforcement of reasonable dress codes and appearance policies. As with any employment policy or practice, an appearance policy must be implemented and enforced without regard to an individual's race, color, gender, national origin, religion, disability, age, or other protected status. A policy governing dress and appearance based on the business needs of an employer that is applied fairly and consistently and does not have a disproportionate effect on any protected class will generally be upheld if challenged in court. By examining some of the more common legal challenges to dress codes and how courts have resolved the disputes, health care managers can avoid many potential problems. This article, the second part of a 3-part examination of dress codes and appearance policies, focuses on the issue of gender under the Civil Rights Act of 1964. Pertinent court cases that provide guidance for employers are addressed.

Dress codes and appearance policies: challenges under federal legislation, part 1: title VII of the civil rights act and religion.

PubMed

Mitchell, Michael S; Koen, Clifford M; Moore, Thomas W

2013-01-01

As more and more individuals choose to express themselves and their religious beliefs with headwear, jewelry, dress, tattoos, and body piercings and push the envelope on what is deemed appropriate in the workplace, employers have an increased need for creation and enforcement of reasonable dress codes and appearance policies. As with any employment policy or practice, an appearance policy must be implemented and enforced without regard to an individual's race, color, sex, national origin, religion, disability, age, or any other protected status. A policy governing dress and appearance based on the business needs of an employer that is applied fairly and consistently and does not have a disproportionate effect on any protected class will generally be upheld if challenged in court. By examining some of the more common legal challenges to dress codes and how courts have resolved the disputes, health care managers can avoid many potential problems. This article addresses the issue of religious discrimination focusing on dress and appearance and some of the court cases that provide guidance for employers.

The evaluation of MCI, MI, PMI and GT on both genders with different age and dental status.

PubMed

Bozdag, G; Sener, S

2015-01-01

The aim of this study was to measure the mandibular cortical index (MCI), mental index (MI), panoramic mandibular index (PMI) and cortical bone thickness in the zone of the gonial angle (GT) in panoramic radiographies from a large sample of males and females and to determine how they relate to patients' age, gender and dental status. 910 panoramic radiographs were obtained and grouped into age, dental status and gender. The MCI, MI, PMI and GT were analysed. Remarkable differences were observed for MCI and GT regarding gender, age groups and dental status on both sides (p < 0.05). While age and dental status had an effect on the MI and PMI in females, dental status had an effect on the MI and PMI in males (p < 0.05). Also, gender had an effect on the MI and PMI (p < 0.05). The effects of age and tooth loss are different in females and males. In females, the harmful effects of tooth loss and age are more prominent according to the PMI and MI measurements. The effects of age and tooth loss in the GT and MCI measurements are similar, and these indices can be accepted as more reliable in studies including both genders.

The evaluation of MCI, MI, PMI and GT on both genders with different age and dental status

PubMed Central

Sener, S

2015-01-01

Objectives: The aim of this study was to measure the mandibular cortical index (MCI), mental index (MI), panoramic mandibular index (PMI) and cortical bone thickness in the zone of the gonial angle (GT) in panoramic radiographies from a large sample of males and females and to determine how they relate to patients' age, gender and dental status. Methods: 910 panoramic radiographs were obtained and grouped into age, dental status and gender. The MCI, MI, PMI and GT were analysed. Results: Remarkable differences were observed for MCI and GT regarding gender, age groups and dental status on both sides (p < 0.05). While age and dental status had an effect on the MI and PMI in females, dental status had an effect on the MI and PMI in males (p < 0.05). Also, gender had an effect on the MI and PMI (p < 0.05). Conclusions: The effects of age and tooth loss are different in females and males. In females, the harmful effects of tooth loss and age are more prominent according to the PMI and MI measurements. The effects of age and tooth loss in the GT and MCI measurements are similar, and these indices can be accepted as more reliable in studies including both genders. PMID:26133366

Assessment of risk factors for earlier onset of sporadic Alzheimer's disease dementia.

PubMed

de Oliveira, Fabricio Ferreira; Bertolucci, Paulo Henrique Ferreira; Chen, Elizabeth Suchi; Smith, Marilia Cardoso

2014-01-01

Pharmacological treatment has mild effects for patients with Alzheimer's disease dementia (AD); therefore, the search for modifiable risk factors is an important challenge. Though risk factors for AD are widely recognized, elements that influence the time of dementia onset have not been comprehensively reported. We aimed to investigate which risk factors might be related to the age of onset of AD in a sample of patients with highly variable educational levels, taking into account the Framingham risk scoring as the sole measure of vascular risk. We included 209 consecutive late-onset AD patients to find out which factors among educational levels, coronary heart disease risk estimated by way of Framingham risk scores, history of head trauma or depression, surgical procedures under general anesthesia, family history of neurodegenerative diseases, gender, marital status and APOE haplotypes might be related to the age of dementia onset in this sample of patients with low mean schooling. Mean age of AD onset was 73.38±6.5 years old, unaffected by schooling or family history of neurodegenerative diseases. Patients who were APOE-ε4 carriers, married, or with history of depression, had earlier onset of AD, particularly when they were women. Coronary heart disease risk was marginally significant for later onset of AD. APOE haplotypes, marital status and history of depression were the most important factors to influence the age of AD onset in this sample. While midlife cerebrovascular risk factors may increase incidence of AD, they may lead to later dementia onset when present in late life.

Nutritional status and HIV in rural South African children.

PubMed

Kimani-Murage, Elizabeth W; Norris, Shane A; Pettifor, John M; Tollman, Stephen M; Klipstein-Grobusch, Kerstin; Gómez-Olivé, Xavier F; Dunger, David B; Kahn, Kathleen

2011-03-25

Achieving the Millennium Development Goals that aim to reduce malnutrition and child mortality depends in part on the ability of governments/policymakers to address nutritional status of children in general and those infected or affected by HIV/AIDS in particular. This study describes HIV prevalence in children, patterns of malnutrition by HIV status and determinants of nutritional status. The study involved 671 children aged 12-59 months living in the Agincourt sub-district, rural South Africa in 2007. Anthropometric measurements were taken and HIV testing with disclosure was done using two rapid tests. Z-scores were generated using WHO 2006 standards as indicators of nutritional status. Linear and logistic regression analyses were conducted to establish the determinants of child nutritional status. Prevalence of malnutrition, particularly stunting (18%), was high in the overall sample of children. HIV prevalence in this age group was 4.4% (95% CI: 2.79 to 5.97). HIV positive children had significantly poorer nutritional outcomes than their HIV negative counterparts. Besides HIV status, other significant determinants of nutritional outcomes included age of the child, birth weight, maternal age, age of household head, and area of residence. This study documents poor nutritional status among children aged 12-59 months in rural South Africa. HIV is an independent modifiable risk factor for poor nutritional outcomes and makes a significant contribution to nutritional outcomes at the individual level. Early paediatric HIV testing of exposed or at risk children, followed by appropriate health care for infected children, may improve their nutritional status and survival.

Diet and socio-economic factors and their association with the nutritional status of pre-school children in a low income suburb of Kampala City, Uganda.

PubMed

Kikafunda, J K; Tumwine, J K

2006-10-01

To establish dietary and socio-economic factors and their association with the nutritional status of pre-school children in a poor suburb of Kampala city, Uganda. A cross-sectional study. Three nursery schools in a low income suburb of Kampala city, Uganda. A sub-sample of forty one randomly selected pre-school children (three to six years of age) from a larger intervention study, participated in the present investigation. The results reveal high levels of chronic malnutrition (stunting and underweight) among the children. Almost half (46.3%) and one third (29.3%) of the children had height-for-age and weight-for-age centiles, respectively, below the 20th centile. The father's educational status was significantly (p = 0.017) associated with the children's nutritional status with all the children whose fathers had tertiary education and above having better weight-for-age centiles (above the 50th). Economic status too was significantly (p = 0.026) associated with the nutritional status of the children with children from the upper and mid-upper socio-economic classes having better weight-for-age centiles than children from the lower socio-economic status. Analysis of the diet showed a significant association between the nutrition status of the children and some of the foods consumed. Children who were above the 50th weight-for-age centiles consumed significantly more bread (p = 0.008) and light-green-leafy vegetables (p = 0.020) than those who had lower weight-for-age centiles. Children who were above their 50th height-for-age centiles consumed significantly (p = 0.049) more soybeans than children who had lower height-for-age centiles. Socio-economic as well as dietary factors were found to be inextricably linked and have been shown to be significantly associated with the nutritional status in this group of suburban pre-school children in Kampala city, Uganda.

Vitamin D insufficiency in the first 6 months of infancy and challenge-proven IgE-mediated food allergy at 1 year of age: a case-cohort study.

PubMed

Molloy, J; Koplin, J J; Allen, K J; Tang, M L K; Collier, F; Carlin, J B; Saffery, R; Burgner, D; Ranganathan, S; Dwyer, T; Ward, A C; Moreno-Betancur, M; Clarke, M; Ponsonby, A L; Vuillermin, P

2017-08-01

Ecological evidence suggests vitamin D insufficiency (VDI) due to lower ambient ultraviolet radiation (UVR) exposure may be a risk factor for IgE-mediated food allergy. However, there are no studies relating directly measured VDI during early infancy to subsequent challenge-proven food allergy. To prospectively investigate the association between VDI during infancy and challenge-proven food allergy at 1 year. In a birth cohort (n = 1074), we used a case-cohort design to compare 25-hydroxyvitamin D 3 (25(OH)D 3 ) levels among infants with food allergy vs a random subcohort (n = 274). The primary exposures were VDI (25(OH)D 3 <50 nM) at birth and 6 months of age. Ambient UVR and time in the sun were combined to estimate UVR exposure dose. IgE-mediated food allergy status at 1 year was determined by formal challenge. Binomial regression was used to examine associations between VDI, UVR exposure dose and food allergy and investigate potential confounding. Within the random subcohort, VDI was present in 45% (105/233) of newborns and 24% (55/227) of infants at 6 months. Food allergy prevalence at 1 year was 7.7% (61/786), and 6.5% (53/808) were egg-allergic. There was no evidence of an association between VDI at either birth (aRR 1.25, 95% CI 0.70-2.22) or 6 months (aRR 0.93, 95% CI 0.41-2.14) and food allergy at 1 year. There was no evidence that VDI during the first 6 months of infancy is a risk factor for food allergy at 1 year of age. These findings primarily relate to egg allergy, and larger studies are required. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Occupational Status and Suicide.

ERIC Educational Resources Information Center

Lampert, Dominique I.; And Others

1984-01-01

Examined relationship between occupational status and suicide in California males since 1925. Findings show an inverse relationship between occupational status and suicide for all age groups. Over time, male suicide rates have increased, particularly for employed males over 65, employed males aged 14 to 24, and males in low-status occupations.…

Resilience to adversity and the early origins of disease.

PubMed

Brody, Gene H; Yu, Tianyi; Beach, Steven R H

2016-11-01

For the past quarter century, scientists at the Center for Family Research at the University of Georgia have conducted research designed to promote understanding of normative developmental trajectories among low socioeconomic status African American children, youths, and young adults. In this paper, we describe a recent expansion of this research program using longitudinal, epidemiological studies and randomized prevention trials to test hypotheses about the origins of disease among rural African American youths. The contributions of economic hardship, downward mobility, neighborhood poverty, and racial discrimination to allostatic load and epigenetic aging are illustrated. The health benefits of supportive family relationships in protecting youths from these challenges are also illustrated. A cautionary set of studies is presented showing that some psychosocially resilient youths demonstrate high allostatic loads and accelerated epigenetic aging, suggesting that, for some, "resilience is just skin deep." Finally, we end on an optimistic note by demonstrating that family-centered prevention programs can have health benefits by reducing inflammation, helping to preserve telomere length, and inhibiting epigenetic aging.

Physician retirement: a case for concern in Canadian hospitals.

PubMed Central

Gillies, J H; Ross, L C

1984-01-01

Mandatory retirement is being challenged on the basis of age discrimination, and physicians are not divorced from this social trend. In January 1982 legal precedent was set by the Manitoba Court of Appeal concerning the retirement policy for physicians in Canada. Currently, Canadian hospital bylaws include clauses that require a change in membership status once a physician reaches 65 years of age. The main arguments in favour of this change include easier physician manpower management, ensured public safety and, in some instances, greater productivity. The main arguments against this change include loss of income to physicians, loss of skilled manpower to the profession and adverse effects on the mental and physical health of retiring physicians. In an effort to resolve this conflict some Canadian hospitals are developing strategies for reviewing the specific privileges and responsibilities physicians will retain once they reach age 65. The medical staff of the Victoria General Hospital in Halifax, NS have addressed this issue through their annual reappointment process. PMID:6744174

Biological Ageing, Inflammation and Nutrition: How Might They Impact on Systemic Sclerosis?

PubMed

Shiels, Paul G; Ritzau-Reid, Kaja

2015-01-01

The number of aged individuals within the global population is increasing, which foreshadows a major societal and global health challenge. By 2050 those over 65 years old will outnumber children under 15 years of age. This situation will bring with it multifarious variations in health and functional status, occurring with increasing age and which remain incompletely understood. Ageing, however, is not solely a passive degenerative process but one that is actively regulated by distinct molecular pathways. Understanding this molecular basis of ageing is an essential step for therapeutic manipulation to combat age-related disease. Diseases such as SSc, RA and SLE may share common age related pathways of early dysregulation with other diseases of ageing, such that the biomarkers and interventions applied to prevent late stage disease will also tackle common fundamental pathways of ageing processes. This chapter will seek to explore and discuss the possible influence of these factors and their impact on disease processes, with specific reference to SSc in the context of it being a disease of ageing. It will address the contribution of socioeconomic, psychosocial and nutritional confounders of health span through the life course. In particular, it will seek to contextualize the development of inflammatory burden and allostatic overload and their contribution to morbidity and mortality. Importantly, this chapter will provide a context for transgenerational and other epigenetic effects, which are emerging as contributory components in disease susceptibility and progression.

Geographical and socioeconomic inequalities in women and children's nutritional status in Pakistan in 2011: an analysis of data from a nationally representative survey

PubMed Central

Cesare, Mariachiara Di; Bhatti, Zaid; Soofi, Sajid B; Fortunato, Lea; Ezzati, Majid; Bhutta, Zulfiqar A

2015-01-01

Summary Background Pakistan has one of the highest levels of child and maternal undernutrition worldwide, but little information about geographical and socioeconomic inequalities is available. We aimed to analyse anthropometric indicators for childhood and maternal nutrition at a district level in Pakistan and assess the association of nutritional status with food security and maternal and household socioeconomic factors. Methods We used data from the 2011 Pakistan National Nutrition Survey, which included anthropometric measurements for 33 638 children younger than 5 years and 24 826 women of childbearing age. We estimated the prevalences of stunting, wasting, and underweight among children and of underweight, overweight, and obesity in women for all 143 districts of Pakistan using a Bayesian spatial technique. We used a mixed-effect linear model to analyse the association of nutritional status with individual and household sociodemographic factors and food security. Findings Stunting prevalence in Pakistan's districts ranged between 22% (95% credible interval 19–26) and 76% (69–83); the lowest figures for wasting and underweight were both less than 2·5% and the highest were 42% (34–50) for wasting and 54% (49–59) for underweight. In 106 districts, more women were overweight than were underweight; in 49 of these districts more women were obese than were underweight. Children were better nourished if their mothers were taller or had higher weight, if they lived in wealthier households, and if their mothers had 10 or more years of education. Severe food insecurity was associated with worse nutritional outcomes for both children and women. Interpretation We noted large social and geographical inequalities in child and maternal nutrition in Pakistan, masked by national and provincial averages. Pakistan is also beginning to face the concurrent challenge of high burden of childhood undernutrition and overweight and obesity among women of reproductive age. Planning, implementation, and evaluation of programmes for food and nutrition should be based on district-level needs and outcomes. Funding Bill & Melinda Gates Foundation, Grand Challenges Canada, UK Medical Research Council. PMID:25794676

Geographical and socioeconomic inequalities in women and children's nutritional status in Pakistan in 2011: an analysis of data from a nationally representative survey.

PubMed

Di Cesare, Mariachiara; Bhatti, Zaid; Soofi, Sajid B; Fortunato, Lea; Ezzati, Majid; Bhutta, Zulfiqar A

2015-04-01

Pakistan has one of the highest levels of child and maternal undernutrition worldwide, but little information about geographical and socioeconomic inequalities is available. We aimed to analyse anthropometric indicators for childhood and maternal nutrition at a district level in Pakistan and assess the association of nutritional status with food security and maternal and household socioeconomic factors. We used data from the 2011 Pakistan National Nutrition Survey, which included anthropometric measurements for 33 638 children younger than 5 years and 24 826 women of childbearing age. We estimated the prevalences of stunting, wasting, and underweight among children and of underweight, overweight, and obesity in women for all 143 districts of Pakistan using a Bayesian spatial technique. We used a mixed-effect linear model to analyse the association of nutritional status with individual and household sociodemographic factors and food security. Stunting prevalence in Pakistan's districts ranged between 22% (95% credible interval 19-26) and 76% (69-83); the lowest figures for wasting and underweight were both less than 2·5% and the highest were 42% (34-50) for wasting and 54% (49-59) for underweight. In 106 districts, more women were overweight than were underweight; in 49 of these districts more women were obese than were underweight. Children were better nourished if their mothers were taller or had higher weight, if they lived in wealthier households, and if their mothers had 10 or more years of education. Severe food insecurity was associated with worse nutritional outcomes for both children and women. We noted large social and geographical inequalities in child and maternal nutrition in Pakistan, masked by national and provincial averages. Pakistan is also beginning to face the concurrent challenge of high burden of childhood undernutrition and overweight and obesity among women of reproductive age. Planning, implementation, and evaluation of programmes for food and nutrition should be based on district-level needs and outcomes. Bill & Melinda Gates Foundation, Grand Challenges Canada, UK Medical Research Council. Copyright © 2015 Di Cesare et al. Open Access article distributed under the terms of CC BY-NC-ND. Published by .. All rights reserved.

Agreement between self-reported and physically verified male circumcision status in Nyanza region, Kenya: Evidence from the TASCO study.

PubMed

Odoyo-June, Elijah; Agot, Kawango; Mboya, Edward; Grund, Jonathan; Musingila, Paul; Emusu, Donath; Soo, Leonard; Otieno-Nyunya, Boaz

2018-01-01

Self-reported male circumcision (MC) status is widely used to estimate community prevalence of circumcision, although its accuracy varies in different settings depending on the extent of misreporting. Despite this challenge, self-reported MC status remains essential because it is the most feasible method of collecting MC status data in community surveys. Therefore, its accuracy is an important determinant of the reliability of MC prevalence estimates based on such surveys. We measured the concurrence between self-reported and physically verified MC status among men aged 25-39 years during a baseline household survey for a study to test strategies for enhancing MC uptake by older men in Nyanza region of Kenya. The objective was to determine the accuracy of self-reported MC status in communities where MC for HIV prevention is being rolled out. Agreement between self-reported and physically verified MC status was measured among 4,232 men. A structured questionnaire was used to collect data on MC status followed by physical examination to verify the actual MC status whose outcome was recorded as fully circumcised (no foreskin), partially circumcised (foreskin is past corona sulcus but covers less than half of the glans) or uncircumcised (foreskin covers half or more of the glans). The sensitivity and specificity of self-reported MC status were calculated using physically verified MC status as the gold standard. Out of 4,232 men, 2,197 (51.9%) reported being circumcised, of whom 99.0% were confirmed to be fully circumcised on physical examination. Among 2,035 men who reported being uncircumcised, 93.7% (1,907/2,035) were confirmed uncircumcised on physical examination. Agreement between self-reported and physically verified MC status was almost perfect, kappa (k) = 98.6% (95% CI, 98.1%-99.1%. The sensitivity of self-reporting being circumcised was 99.6% (95% CI, 99.2-99.8) while specificity of self-reporting uncircumcised was 99.0% (95% CI, 98.4-99.4) and did not differ significantly by age group based on chi-square test. Rate of consenting to physical verification of MC status differed by client characteristics; unemployed men were more likely to consent to physical verification (odds ratio [OR] = 1.48, (95% CI, 1.30-1.69) compared to employed men and those with post-secondary education were less likely to consent to physical verification than those with primary education or less (odds ratio [OR] = 0.61, (95% CI, 0.51-0.74). In this Kenyan context, both sensitivity and specificity of self-reported MC status was high; therefore, MC prevalence estimates based on self-reported MC status should be deemed accurate and applicable for planning. However MC programs should assess accuracy of self-reported MC status periodically for any secular changes that may undermine its usefulness for estimating community MC prevalence in their unique settings.

Risk factors for suicidal ideation in Korean middle-aged adults: the role of socio-demographic status.

PubMed

Moon, Sang-Sik; Park, Sang-Mi

2012-11-01

The investigations of the risk factors for suicidal ideation among middle-aged adults may be especially important for predicting suicidal actions, given the steep increase in suicide among Koreans aged 45-54. Few studies have sought to investigate the effect of socio-demographic status on suicidal ideation among middle-aged adults. This study investigated the influence of socio-demographic status on suicidal ideation among middle-aged adults in South Korea. The sample consisted of middle-aged men (n = 3,214) and middle-aged women (n = 4,087) aged 40-64 years who had participated in the 2005 cross-sectional Seoul Citizens Health and Social Indicators Survey. Using multiple logistic regression analysis, we examined the effect of socio-demographic status, health behaviours and health status on suicidal ideation in middle-aged adults. The outstanding finding was that suicidal ideation was most prevalent among middle-aged women who engaged in manual labour (i.e. blue-collar workers) (OR = 2.77, 95% CI = 1.20-6.42). The absence of a spouse was significantly associated with suicidal ideation among middle-aged men (OR = 2.10, 95% CI = 1.30-3.40). The effect of enhanced security related to stable employment was strongest among middle-aged women in blue-collar jobs, and the effect of intensive counselling services was strongest among divorced or widowed middle-aged men.

Adolescent Health in the United States, 2007

ERIC Educational Resources Information Center

MacKay, Andrea P.; Duran, Catherine

2008-01-01

This report presents data on the current status of adolescent health. Many of the measures of health status are shown by single year of age or by 2- or 3-year age intervals to highlight the changes that occur in health status as adolescents move through this important developmental period. Summary measures combining 5- or 10-year age groups (the…

Health Related Concerns and Psychological Well-Being of Middle-Aged Women.

ERIC Educational Resources Information Center

Baruch, Grace K.

A two-stage study of women aged 35-55 focused on issues, concerns, and gratification and their relationship to family status, work status, age, and sense of psychological well-being. The sample was composed of women who occupied jointly one of three family statuses (never married, married without children, married with children) and one of six…

[Evaluation of nutritional status of school-age children after implementation of "Nutrition Improvement Program" in rural area in Hunan, China].

PubMed

Deng, Zhu-Juan; Mao, Guang-Xu; Wang, Yu-Jun; Liu, Li; Chen, Yan

2016-09-01

To investigate the nutritional status of school-age children in rural area in Hunan, China from 2012 to 2015 and to evaluate the effectiveness of the "Nutrition Improvement Program for Compulsory Education Students in Rural Area" (hereinafter referred to as "Nutrition Improvement Program"). The nutritional status of school-age children aged 6-14 years was evaluated after the implementation of the "Nutrition Improvement Program" and the changing trend of the children's nutritional status was analyzed. The statistical analysis was performed on the monitoring data of the school-age children aged 6-14 years in rural area in Hunan, China from 2012 to 2015, which came from "The Nutrition and Health Status Monitoring and Evaluation System of Nutrition Improvement Program for Compulsory Education Students in Rural Area". In 2015, female students aged 6-7 years in rural area in Hunan, China had a significantly greater body length than the rural average in China (P<0.05). However, the other age groups had significantly smaller body length and weight than the rural averages in China (P<0.05). After the implementation of "Nutrition Improvement Program", the prevalence rate of growth retardation decreased (P<0.05), but the prevalence rate of emaciation increased (P<0.05). At the same time, the prevalence rate of overweight/obesity increased (P<0.05) and the prevalence rate of anemia decreased (P<0.05). The implementation of "Nutrition Improvement Program" has achieved some success, but the nutritional status of school-age children has not improved significantly. Overweight/obesity and malnutrition are still present. Therefore, to promote the nutritional status of school-age children it is recommended to improve the measures for the "Nutrition Improvement Program".

Assessment of health status by molecular measures in adults ranging from middle-aged to old: Ready for clinical use?

PubMed

Waaijer, M E C; Westendorp, R G J; Goldeck, D; Gunn, D A; Pawelec, G; Stijntjes, M; Slagboom, P E; Maier, A B

2017-01-01

In addition to measures already used in clinical practice, molecular measures have been proposed to assess health status, but these have not yet been introduced into clinical practice. We aimed to test the association of functional capacity measures used in current practice and molecular measures with age and health status. The cohort consisted of 178 middle-aged to old participants of the Leiden Longevity Study (range 42-82years). We tested associations between functional capacity measures (physical tests: grip strength, 4-meter walk, chair stand test; cognitive tests: Stroop test, digit symbol substitution test and 15-picture learning test) with age and with cardiovascular or metabolic disease as a measure of the health status. These associations with age and health status were also tested for molecular measures (C reactive protein (CRP), numbers of senescent p16INK4a positive cells in the epidermis and dermis and putative immunosenescence (presence of CD57+ T cells)). All functional capacity measures were associated with age. CRP and epidermal p16INK4a positivity were also associated with age, but with smaller estimates. Grip strength and the Stroop test were associated with cardiovascular or metabolic disease, as was epidermal p16INK4a positivity. All associations with cardiovascular or metabolic disease attenuated when adjusting for age. In conclusion, in middle-aged to old persons, the molecular measures tested here were more weakly associated with age and health status than functional capacity measures. Whether these molecular measures associate more closely with health status in the elderly or in specific groups of patients needs to be explored further. Crown Copyright © 2016. Published by Elsevier Inc. All rights reserved.

Education, employment, and sustainable development in the European union

NASA Astrophysics Data System (ADS)

Gaballah, I.; Dufourg, A.; Tondeur, D.

2002-11-01

This paper examines the current and prospective status of education, employment, and sustainable development in the European Union (EU). Due to the decrease of the birth rate and the increase of life expectation, the size of the labor force is decreasing and its average age is increasing. Moreover, rapid technological evolution will necessitate “long-life learning” for the old workers and young people. It will be a challenge to supply the EU’s labor market with an adequate number of workers with the appropriate skill ad tempus. This will change profoundly the classical education system that will become the largest economic sector in the next decade.

Head and Neck Cancer and the Elderly Patient.

PubMed

Cervenka, Brian P; Rao, Shyam; Bewley, Arnaud F

2018-05-22

Management of head and neck cancer in the elderly patient is particularly challenging given the high morbidity associated with treatment. Surgery, radiotherapy, and chemotherapy have all been demonstrated as effective in older patients; however, older patients are more susceptible to treatment-induced toxicity, which can limit the survival benefits of certain interventions. This susceptibility is better associated with the presence of multiple comorbidities and decreasing functional status than with age alone. Screening tools allow for risk stratification, treatment deintensification, and even treatment avoidance in patients who are deemed at high-risk of being harmed by standard therapy. Copyright © 2018 Elsevier Inc. All rights reserved.

Life-course origins of the ages at menarche and menopause

PubMed Central

Forman, Michele R; Mangini, Lauren D; Thelus-Jean, Rosenie; Hayward, Mark D

2013-01-01

A woman’s age at menarche (first menstrual period) and her age at menopause are the alpha and omega of her reproductive years. The timing of these milestones is critical for a woman’s health trajectory over her lifespan, as they are indicators of ovarian function and aging. Both early and late timing of either event are associated with risk for adverse health and psychosocial outcomes. Thus, the search for a relationship between age at menarche and menopause has consequences for chronic disease prevention and implications for public health. This article is a review of evidence from the fields of developmental biology, epidemiology, nutrition, demography, sociology, and psychology that examine the menarche–menopause connection. Trends in ages at menarche and menopause worldwide and in subpopulations are presented; however, challenges exist in constructing trends. Among 36 studies that examine the association between the two sentinel events, ten reported a significant direct association, two an inverse association, and the remainder had null findings. Multiple factors, including hormonal and environmental exposures, socioeconomic status, and stress throughout the life course are hypothesized to influence the tempo of growth, including body size and height, development, menarche, menopause, and the aging process in women. The complexity of these factors and the pathways related to their effects on each sentinel event complicate evaluation of the relationship between menarche and menopause. Limitations of past investigations are discussed, including lack of comparability of socioeconomic status indicators and biomarker use across studies, while minority group differences have received scant attention. Suggestions for future directions are proposed. As research across endocrinology, epidemiology, and the social sciences becomes more integrated, the confluence of perspectives will yield a richer understanding of the influences on the tempo of a woman’s reproductive life cycle as well as accelerate progress toward more sophisticated preventive strategies for chronic disease. PMID:24600293

Radiomic analysis in prediction of Human Papilloma Virus status.

PubMed

Yu, Kaixian; Zhang, Youyi; Yu, Yang; Huang, Chao; Liu, Rongjie; Li, Tengfei; Yang, Liuqing; Morris, Jeffrey S; Baladandayuthapani, Veerabhadran; Zhu, Hongtu

2017-12-01

Human Papilloma Virus (HPV) has been associated with oropharyngeal cancer prognosis. Traditionally the HPV status is tested through invasive lab test. Recently, the rapid development of statistical image analysis techniques has enabled precise quantitative analysis of medical images. The quantitative analysis of Computed Tomography (CT) provides a non-invasive way to assess HPV status for oropharynx cancer patients. We designed a statistical radiomics approach analyzing CT images to predict HPV status. Various radiomics features were extracted from CT scans, and analyzed using statistical feature selection and prediction methods. Our approach ranked the highest in the 2016 Medical Image Computing and Computer Assisted Intervention (MICCAI) grand challenge: Oropharynx Cancer (OPC) Radiomics Challenge, Human Papilloma Virus (HPV) Status Prediction. Further analysis on the most relevant radiomic features distinguishing HPV positive and negative subjects suggested that HPV positive patients usually have smaller and simpler tumors.

Diagnostic Performance of Afternoon Urine Osmolality to Assess Optimal Hydration Status in an Adult Healthy Population.

PubMed

Hustrini, Ni Made; Siregar, Parlindungan; Nainggolan, Ginova; Harimurti, Kuntjoro

2017-04-01

optimal hydration represents adequate total daily fluid intake to compensate for daily water losses, ensure adequate urine output to reduce the risk of urolithiasis and renal function decline, and also avoid the production of arginine vasopressin (AVP). Twenty-four-hour urine osmolality has been used to assess hydration status, but it is challenging because of the possibility of spilling urine and limitation of daily activities. This study is aimed to determine the performance of the afternoon urine osmolality to assess the optimal hydration status compared with 24-hour urine osmolality. a cross sectional study was conducted on healthy employees aged 18-59 years at Universitas Indonesia Medical Faculty/Cipto Mangunkusumo Hospital, with consecutive sampling method. The ROC curve was analyzed to obtain the optimal cut off point and the accuracy of the afternoon urine osmolality in assessing the optimal hydration status. between August-September 2016 there were 120 subjects (73.8% female, median age 32 years) who met the study criteria with a median 24-hour urine osmolality 463.5 (95% CI, 136-1427) mOsm/kg H2O and median afternoon urine osmolality 513 (95% CI, 73-1267). We found moderate correlation (r=0.59; p<0.001) between afternoon urine osmolality and a 24-hour urine osmolality. Using ROC curve, the AUC value was 0.792 (95% CI, 0.708-0.875) with the cut off 528 mOsm/kg H2O. To assess the optimal hydration status, the afternoon urine osmolality had the sensitivity of 0.7 (95% CI, 0.585-0.795) and the specificity of 0.76 (95% CI, 0.626-0.857), Likelihood Ratio (LR) (+) 2.917 (95% CI, 1.74-4.889) and LR (-) 0.395 (95% CI, 0.267-0.583). afternoon urine osmolality can be used as a diagnostic tool to assess the optimal hydration status in healthy population with cut off 528 mOsm/kg H2O, sensitivity of 0.7, and specificity of 0.76.

13 CFR 127.601 - May a protest challenging the size and status of a concern as an EDWOSB or WOSB be filed together?

Code of Federal Regulations, 2010 CFR

2010-01-01

... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false May a protest challenging the size and status of a concern as an EDWOSB or WOSB be filed together? 127.601 Section 127.601 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION WOMEN-OWNED SMALL BUSINESS FEDERAL CONTRACT...

6 CFR 7.30 - Classification challenges.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 6 Domestic Security 1 2012-01-01 2012-01-01 false Classification challenges. 7.30 Section 7.30... INFORMATION Classified Information § 7.30 Classification challenges. (a) Authorized holders of information... classified are encouraged and expected to challenge the classification status of that information pursuant to...

6 CFR 7.30 - Classification challenges.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 6 Domestic Security 1 2013-01-01 2013-01-01 false Classification challenges. 7.30 Section 7.30... INFORMATION Classified Information § 7.30 Classification challenges. (a) Authorized holders of information... classified are encouraged and expected to challenge the classification status of that information pursuant to...

6 CFR 7.30 - Classification challenges.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 6 Domestic Security 1 2014-01-01 2014-01-01 false Classification challenges. 7.30 Section 7.30... INFORMATION Classified Information § 7.30 Classification challenges. (a) Authorized holders of information... classified are encouraged and expected to challenge the classification status of that information pursuant to...

6 CFR 7.30 - Classification challenges.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 6 Domestic Security 1 2010-01-01 2010-01-01 false Classification challenges. 7.30 Section 7.30... INFORMATION Classified Information § 7.30 Classification challenges. (a) Authorized holders of information... classified are encouraged and expected to challenge the classification status of that information pursuant to...

6 CFR 7.30 - Classification challenges.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 6 Domestic Security 1 2011-01-01 2011-01-01 false Classification challenges. 7.30 Section 7.30... INFORMATION Classified Information § 7.30 Classification challenges. (a) Authorized holders of information... classified are encouraged and expected to challenge the classification status of that information pursuant to...

The influence of Driving Status on Transportation Challenges Experienced by Older Adults.

PubMed

Weeks, Lori E; Stadnyk, Robin; Begley, Lorraine; MacDonald, Dany J

2015-06-01

We explored the severity, number, and reasons for transportation challenges experienced by older adult drivers, nondrivers who live with a driver, and nondrivers who do not live with a driver. A random sample of 1,670 Atlantic Canadian community-dwelling older adults completed a mailed survey. Drivers comprised 80% of the participants. Just more than one fifth of participants experienced at least occasional transportation challenges. Two thirds of nondrivers who lived with a driver reported having no transportation challenges. Almost half of the nondrivers who did not live with a driver indicated never experiencing transportation challenges, and 84% of drivers had no transportation challenges. Nondrivers who did not live with a driver experienced greater frequency and severity of transportation challenges. This research contributes to our understanding of the characteristics of older adults with different driving statuses and their transportation challenges, which can contribute to providing appropriate transportation supports for older adults in the future. © The Author(s) 2013.

Does low birthweight influence the nutritional status of children at school age? A cohort study in northeast Brazil.

PubMed

de Jesus Machado Amorim, Rosemary; de Carvalho Lima, Marilia; Cabral de Lira, Pedro Israel; Emond, Alan Martin

2011-07-01

Birthweight is recognized to be a determinant of a full term infant's early growth pattern; however, few studies have explored whether this effect is sustained into school age, especially in developing countries. We have used a cohort study from North East Brazil to investigate factors determining the anthropometric status of eight-year-old children born at full-term with low or appropriate weight. A cohort of 375 full-term infants was recruited at birth in six maternity hospitals between 1993 and 1994, in a poor region of the interior of the State of Pernambuco. At the age of 8 years, 86 born with low birthweight and 127 with appropriate birthweight were traced. Multivariable linear regression analyses were used to identify the net effect of socioeconomic conditions, maternal nutritional status and child factors on weight-for-age and height-for-age. An enter approach was used to estimate the contribution of different factors on child anthropometry. Birthweight had little influence on child nutritional status at school age. Maternal BMI and height together were the biggest contributors to variation in child weight-for-age (12.3%) and height-for-age (13.2%), followed by family socioeconomic conditions. Maternal height as a proxy of maternal constraint was the single factor that best explained the variation in both indices (6.2% for weight-for-age and 11.1% for height-for-age). Haemoglobin level measured at eight years made a small but significant contribution to variation in height-for-age (5.6%) and weight for age (1.4%). Maternal nutritional status, reflecting genetic inheritance and the poor socioeconomic conditions of this population, was the most important determinant of the nutritional status of children at school age, rather than birthweight. © 2010 Blackwell Publishing Ltd.

Decomposing socioeconomic inequality in self-rated health in Tehran.

PubMed

Nedjat, Saharnaz; Hosseinpoor, Ahmad Reza; Forouzanfar, Mohammad Hossein; Golestan, Banafsheh; Majdzadeh, Reza

2012-06-01

Measuring the distribution of health is a part of assessing health system performance. This study aims to estimate health inequality between different socioeconomic groups and its determinants in Tehran, the capital of Iran. Self-rated health (SRH) and demographic characteristics, including gender, age, marital status, educational years, and assets, were measured by structured interviews of 2464 residents of Tehran in 2008. A concentration index was calculated to measure health inequality by economic status. The association of potential determinants and SRH was assessed through multivariate logistic regression. The contribution to concentration index of level of education, marital status and other determining factors was assessed by decomposition. The mean age of respondents was 41.4 years (SD 17.7) and 49% of them were men. The mean score of SRH status was 3.72 (range: 1-5; SD 0.93). 282 respondents (11.5%) rated their health status as poor or very poor. The concentration index was -0.29 (SE 0.03; p<0.001). Age, marital status, level of education and household economic status were significantly associated with SRH in both the crude and adjusted analyses. The main contributors to inequality in SRH were economic status (47.8%), level of education (29.2%) and age (23.0%). Sub-optimal SRH was more in lower than in higher economic status. After controlling for age, the levels of education and household wealth have the greatest contributions to SRH inequality.

Equol-producing status, isoflavone intake, and breast density in a sample of U.S. Chinese women.

PubMed

Tseng, Marilyn; Byrne, Celia; Kurzer, Mindy S; Fang, Carolyn Y

2013-11-01

Differences in ability to metabolize daidzein to equol might help explain inconsistent findings about isoflavones and breast cancer. We examined equol-producing status in relation to breast density, a marker of breast cancer risk, and evaluated whether an association of isoflavone intake with breast density differs by equol-producing status in a sample of Chinese immigrant women. Participants were 224 women, ages 36 to 58 years, enrolled in a study on diet and breast density. All women completed dietary recall interviews, underwent a soy challenge to assess equol-producing status, and received a mammogram assessed for breast density using a computer-assisted method. In our sample, 30% were classified as equol producers. In adjusted linear regression models, equol producers had significantly lower mean dense tissue area (32.8 vs. 37.7 cm(2), P = 0.03) and lower mean percent breast density (32% vs. 35%, P = 0.03) than nonproducers. Significant inverse associations of isoflavone intake with dense area and percent density were apparent, but only in equol producers (interaction P = 0.05 for both). These results support the possibility that equol-producing status affects breast density and that effects of isoflavones on breast density depend on ability to metabolize daidzein to equol. Although these findings warrant confirmation in a larger sample, they offer a possible explanation for the inconsistent findings about soy intake and breast density and possibly breast cancer risk as well. The findings further suggest the importance of identifying factors that influence equol-producing status and exploring appropriate targeting of interventions. ©2013 AACR.

Rethinking the relationship between socioeconomic status and health: Challenging how socioeconomic status is currently used in health inequality research.

PubMed

Gagné, Thierry; Ghenadenik, Adrian E

2018-02-01

The Scandinavian Journal of Public Health recently reiterated the importance of addressing social justice and health inequalities in its new editorial policy announcement. One of the related challenges highlighted in that issue was the limited use of sociological theories able to inform the complexity linking the resources and mechanisms captured by the concept of socioeconomic status. This debate article argues that part of the problem lies in the often unchallenged reliance on a generic conceptualization and operationalization of socioeconomic status. These practices hinder researchers' capacity to examine in finer detail how resources and circumstances promote the unequal distribution of health through distinct yet intertwined pathways. As a potential way forward, this commentary explores how research practices can be challenged through concrete publication policies and guidelines. To this end, we propose a set of recommendations as a tool to strengthen the study of socioeconomic status and, ultimately, the quality of health inequality research. Authors, reviewers, and editors can become champions of change toward the implementation of sociological theory by holding higher standards regarding the conceptualization, operationalization, analysis, and interpretation of results in health inequality research.

Meal patterns among children and adolescents and their associations with weight status and parental characteristics.

PubMed

Würbach, Ariane; Zellner, Konrad; Kromeyer-Hauschild, Katrin

2009-08-01

To describe the meal patterns of Jena schoolchildren and their associations with children's weight status and parental characteristics. Cross-sectional study. Twenty schools in Jena (100,000 inhabitants), south-east Germany. A total of 2054 schoolchildren aged 7-14 years with information on BMI standard deviation score (BMI-SDS) and weight status (based on German reference values), of whom 1571 had additional information about their parents (parental education and employment status, weight status according to WHO guidelines) and meal patterns (school lunch participation rate, meal frequencies, breakfast consumption and frequency of family meals). Weight status of the children was associated with weight status, education and employment status of the parents. Meal patterns were strongly dependent on children's age and parental employment. As age increased, the frequency of meal consumption, participation rate in school lunches and the number of family meals decreased. Using linear regression analysis, a high inverse association between BMI-SDS and meal frequency was observed, in addition to relationships with parental weight status and paternal education. Age-specific prevention programmes should encourage greater meal frequency. The close involvement of parents is essential in any strategy for improving children's (families') diets.

Patterns of disclosure and antiretroviral treatment adherence in a South African mining workplace programme and implications for HIV prevention.

PubMed

Bhagwanjee, Anil; Govender, Kaymarlin; Akintola, Olagoke; Petersen, Inge; George, Gavin; Johnstone, Leigh; Naidoo, Kerisha

2011-01-01

Social and psychological barriers to the disclosure of one's seropositive HIV status to significant others and poor adherence to taking medications pose significant challenges to the scaling-up of access to antiretroviral treatment (ART) in the workplace. Such barriers are predictive of sub-optimal treatment outcomes and bedevil HIV-prevention interventions at a societal level. Against this background, this article explores the lived experiences of 19 HIV-positive male participants, between the ages of 33 and 57 years, who were enrolled in an ART programme managed at an occupational health clinic at a mining company in South Africa. The majority of these mineworkers had been aware of their HIV status for between 5 and 7 years. The study explored psychological and relational factors, as aspects of these participants lived experiences, which had a bearing on their adherence to their ART regimen and the disclosure choices that they made regarding their HIV status. In our sample, those participants who were adherent demonstrated higher levels of control and acceptance of their HIV infection and were more confident in their ability to manage their treatment, while the group who were non-adherent presented with lower levels of adherence motivation and self-efficacy, difficulties in maintaining a healthy lifestyle and significant challenges in maintaining control over their lives. While most of the men favoured disclosing their HIV status to their partners for the sake of treatment support, they were less sure about disclosing to family members and non-family members, respectively, because of their need to protect these persons and due to their fear of being stigmatised. It was evident that treatment adherence choices and behaviours were impacted by psychological and relational factors, including disclosure decisions. We conclude with a bivariate model for understanding the adherence behaviours that influenced different patterns of ART adherence among the sample, and offer recommendations for HIV-prevention and treatment interventions in a mining workplace.

NASA GRC MBSE Implementation Status

NASA Technical Reports Server (NTRS)

Parrott, Edith; Trase, Katie; Green, Randi; Varga, Denise; Powell, Joe

2016-01-01

This presentation gives a brief overview on GRCs Model Based System Engineering (MBSE) implementation status. This overview covers: history, project usage and implementation, challenges and future work.

Caries experience and oral hygiene status of a group of visually impaired children in Istanbul, Turkey.

PubMed

Bekiroglu, Nural; Acar, Nihan; Kargul, Betul

2012-01-01

To evaluate the caries experience, oral hygiene status and oral health knowledge of a group of visually impaired students. The study was conducted at one of the largest visually impaired children's schools among students aged between 7 and 16 years (n = 178) in Istanbul, Turkey. A 16-item questionnaire was asked in addition to a clinical tooth examination. The 16-item verbal questionnaire was developed to record the students' general health, impairment, the socioeconomic profile and education level of their parents, oral health knowledge, sources of information about oral health and oral hygiene habits. Oral hygiene was assessed according to Greene and Vermillion's Simplified Oral Hygiene Index (OHI-S). To measure the oral hygiene status, OHI-S index scores were recorded. Additionally, DMFT and dft indices were documented. Only 26.40% of children were caries free, and only 2.2% of students had good oral hygiene. A total of 3.3% of these students were mildly retarded and 2.8% of them had a developmental disability. Visually impaired children exhibited a fair-to-poor level of oral hygiene. Maintenance of oral hygiene remains the greatest challenge in the care of visually impaired children.

Education in a homeless shelter to improve the nutrition of young children.

PubMed

Yousey, Yvonne; Leake, Jacquelyn; Wdowik, Melissa; Janken, Janice K

2007-01-01

To improve the nutritional status of homeless children by implementing an educational program for their mothers and the cafeteria staff at a homeless shelter. Program evaluation including before and after measures of mothers' nutritional knowledge and nutritional quality of foods served in the cafeteria. Fifty-six mothers with children aged 18 months to 6 years and 3 cafeteria staff. Four nutrition classes developed by a registered nutritionist were taught to mothers by clinic nurses; 3 nutrition classes were taught to the cafeteria staff by the nutritionist. Mothers scored higher on posttests than on pretests, indicating improved nutritional knowledge. Minimal differences in the nutritional quality of foods served to residents were observed after staff education. This project demonstrates the challenges of altering the nutritional status of children in a homeless shelter. Despite mothers showing better knowledge of nutritional requirements for children, the types of food served in the cafeteria were an obstacle to them in practicing what they had learned. The cafeteria staff's ability to demonstrate their learning was impeded by the constraints of food donations. Educational strategies may need to be augmented by policies to improve the nutritional status of children in homeless shelters.

Current status, crisis and trends in Chinese dental technicians.

PubMed

Chaoyi, Ma; Liwei, Zheng; Li, Yue; Min, Zhou; Haiyang, Yu

2012-04-01

Chinese dental technicians play a significant role in the globalised market of dental prosthesis fabrication, but this subject has not been investigated in detail. The demand for dental prostheses increases as individuals pay increasing attention to their oral health. Therefore, it is important to investigate the status of Chinese dental technicians. To evaluate the current status of Chinese dental technicians. Dental technicians' resumés, which reveal information regarding dental technician manpower, degrees, working age and salary, etc., were analysed and compared with those abroad. We also estimated the future demands of dental technician manpower, and discussed some potential solutions. There are fewer dental technicians in China than in other developed countries; they are also of a lower standard. Male technicians outnumber females. The education level of technicians is insufficient, and the education programme is still in its exploratory stage. The development of dental technician teams in China represents both an opportunity and a challenge. It is important to move forward from the current situation to yield long-term development. This article provides information on the Chinese dental technology industry, identifies the problems and offers solutions for its development. © 2012 FDI World Dental Federation.

Menopausal status and physical performance in middle aged women: a cross-sectional community-based study in Northeast Brazil.

PubMed

da Câmara, Saionara M A; Zunzunegui, Maria Victoria; Pirkle, Catherine; Moreira, Mayle A; Maciel, Álvaro C C

2015-01-01

To examine associations between menopausal status and physical performance in middle-aged women from the Northeast region of Brazil. Cross-sectional study of women between 40 to 65 years old living in Parnamirim. Women were recruited by advertisements in primary care neighborhood centers across the city. Physical performance was assessed by grip strength, gait speed and chair stands. Menopausal status was determined using the Stages of Reproductive Aging Workshop classification and women were classified in: premenopausal, perimenopausal or postmenopausal. Multiple linear regression analyses were performed to model the effect of menopausal status on each physical performance measure, adjusting for covariates (age, family income, education, body mass index, parity and age at first birth). The premenopausal women were significantly stronger and performed better in chair stands than perimenopausal and postmenopausal women. Gait speed did not vary significantly by menopausal status. In multivariate analyses, menopausal status remained statistically significant only for grip strength. In fully adjusted analyses, premenopausal women had grip strength mean of 2.226 Kgf (95% CI: 0.361 - 4.091) higher than the postmenopausal group. This study provides further evidence for the associations between menopause and physical performance in middle-aged women, since grip strength is weaker in peri and postmenopausal women compared to premenopausal, even adjusted for age and other covariates.

Nutritional status and HIV in rural South African children

PubMed Central

2011-01-01

Background Achieving the Millennium Development Goals that aim to reduce malnutrition and child mortality depends in part on the ability of governments/policymakers to address nutritional status of children in general and those infected or affected by HIV/AIDS in particular. This study describes HIV prevalence in children, patterns of malnutrition by HIV status and determinants of nutritional status. Methods The study involved 671 children aged 12-59 months living in the Agincourt sub-district, rural South Africa in 2007. Anthropometric measurements were taken and HIV testing with disclosure was done using two rapid tests. Z-scores were generated using WHO 2006 standards as indicators of nutritional status. Linear and logistic regression analyses were conducted to establish the determinants of child nutritonal status. Results Prevalence of malnutrition, particularly stunting (18%), was high in the overall sample of children. HIV prevalence in this age group was 4.4% (95% CI: 2.79 to 5.97). HIV positive children had significantly poorer nutritional outcomes than their HIV negative counterparts. Besides HIV status, other significant determinants of nutritional outcomes included age of the child, birth weight, maternal age, age of household head, and area of residence. Conclusions This study documents poor nutritional status among children aged 12-59 months in rural South Africa. HIV is an independent modifiable risk factor for poor nutritional outcomes and makes a significant contribution to nutritional outcomes at the individual level. Early paediatric HIV testing of exposed or at risk children, followed by appropriate health care for infected children, may improve their nutritional status and survival. PMID:21439041

Chronic Wound Repair and Healing in Older Adults: Current Status and Future Research

PubMed Central

Gould, Lisa; Abadir, Peter; Brem, Harold; Carter, Marissa; Conner-Kerr, Teresa; Davidson, Jeff; DiPietro, Luisa; Falanga, Vincent; Fife, Caroline; Gardner, Sue; Grice, Elizabeth; Harmon, John; Hazzard, William R.; High, Kevin P.; Houghton, Pamela; Jacobson, Nasreen; Kirsner, Robert S.; Kovacs, Elizabeth J.; Margolish, David; McFarland Horne, Frances; Reed, May J.; Sullivan, Dennis H.; Thom, Stephen; Tomic-Canic, Marjana; Walston, Jeremy; Whitney, JoAnne; Williams, John; Zieman, Susan; Schmader, Kenneth

2014-01-01

The incidence of chronic wounds is increased among older adults, and the impact of chronic wounds on quality of life is particularly profound in this population. It is well established that wound healing slows with age. However, the basic biology underlying chronic wounds and the influence of age-associated changes on wound healing are poorly understood. Most studies have used in vitro approaches and various animal models, but observed changes translate poorly to human healing conditions. The impact of age and accompanying multi-morbidity on the effectiveness of existing and emerging treatment approaches for chronic wounds is also unknown, and older adults tend to be excluded from randomized clinical trials. Poorly defined outcomes and variables, lack of standardization in data collection, and variations in the definition, measurement, and treatment of wounds also hamper clinical studies. The Association of Specialty Professors, in conjunction with the National Institute on Aging and the Wound Healing Society, held a workshop, summarized in this paper, to explore the current state of knowledge and research challenges, engage investigators across disciplines, and identify key research questions to guide future study of age-associated changes in chronic wound healing. PMID:25486905

Chronic Wound Repair and Healing in Older Adults: Current Status and Future Research

PubMed Central

Gould, Lisa; Abadir, Peter; Brem, Harold; Carter, Marissa; Conner-Kerr, Teresa; Davidson, Jeff; DiPietro, Luisa; Falanga, Vincent; Fife, Caroline; Gardner, Sue; Grice, Elizabeth; Harmon, John; Hazzard, William R.; High, Kevin P.; Houghton, Pamela; Jacobson, Nasreen; Kirsner, Robert S.; Kovacs, Elizabeth J.; Margolis, David; Horne, Frances McFarland; Reed, May J.; Sullivan, Dennis H.; Thom, Stephen; Tomic-Canic, Marjana; Walston, Jeremy; Whitney, Jo Anne; Williams, John; Zieman, Susan; Schmader, Kenneth

2015-01-01

Older adults are more likely to have chronic wounds than younger people, and the effect of chronic wounds on quality of life is particularly profound in this population. Wound healing slows with age, but the basic biology underlying chronic wounds and the influence of age-associated changes on wound healing are poorly understood. Most studies have used in vitro approaches and various animal models, but observed changes translate poorly to human healing conditions. The effect of age and accompanying multimorbidity on the effectiveness of existing and emerging treatment approaches for chronic wounds is also unknown, and older adults tend to be excluded from randomized clinical trials. Poorly defined outcomes and variables; lack of standardization in data collection; and variations in the definition, measurement, and treatment of wounds also hamper clinical studies. The Association of Specialty Professors, in conjunction with the National Institute on Aging and the Wound Healing Society, held a workshop, summarized in this article, to explore the current state of knowledge and research challenges, engage investigators across disciplines, and identify research questions to guide future study of age-associated changes in chronic wound healing. PMID:25753048

Do changes in spousal employment status lead to domestic violence? Insights from a prospective study in Bangalore, India.

PubMed

Krishnan, Suneeta; Rocca, Corinne H; Hubbard, Alan E; Subbiah, Kalyani; Edmeades, Jeffrey; Padian, Nancy S

2010-01-01

The prevalence of physical domestic violence--violence against women perpetrated by husbands--is staggeringly high across the Indian subcontinent. Although gender-based power dynamics are thought to underlie women's vulnerability, relatively little is known about risk and protective factors. This prospective study in southern India examined the association between key economic aspects of gender-based power, namely spousal employment status, and physical domestic violence. In 2005-2006, 744 married women, aged 16-25, residing in low-income communities in Bangalore, India were enrolled in the study. Data were collected at enrollment, 12 and 24 months. Multivariable logistic regression models were used to examine the prospective association between women's employment status, their perceptions of their husband's employment stability, and domestic violence. Women who were unemployed at one visit and began employment by the next visit had an 80% higher odds of violence, as compared to women who maintained their unemployed status. Similarly, women whose husbands had stable employment at one visit and newly had difficulty with employment had 1.7 times the odds of violence, as compared to women whose husbands maintained their stable employment. To our knowledge, this study is the first from a developing country to confirm that changes in spousal employment status are associated with subsequent changes in violence risk. It points to the complex challenges of violence prevention, including the need for interventions among men and gender-transformative approaches to promote gender-equitable attitudes, practices and norms among men and women.

[Correlational study among anger, perceived stress and mental health status in middle aged women].

PubMed

Lee, Pyoung-Sook

2003-10-01

This study was to identify the relationships of trait anger, mode of anger expression, and perceived stress to mental health status in middle aged women. The subjects were 157 middle aged women from 40s to 60s who lived in Seoul. Data was collected by questionnaire surveys using the convenience sampling. The instruments used for this study were Spielberger's trait anger scale and anger expression scale, Cohen, Kamarck, and Mermelstein's perceived stress and Derogatis's SCL-90-R. The collected data was analyzed using descriptive statistics, Pearson correlation coefficient, and Stepwise multiple regression with SAS/PC. The trait anger of middle aged women indicated a significantly positive correlation to perceived stress(r=.180, p=.023) and mental health status(r.=021, p=.014). Anger-in(r=.237, p<.05), and perceived stress(p=.461, p<.01) showed significantly positive correlation to mental health status. The most significant predictor influencing health status of middle aged women was perceived stress, and anger-in and the variance explained was 27%. These results suggested that middle aged women with high degree of trait anger is likely to be high in stress perception. Perceived stress and anger-in are major factors influencing mental health status.

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

PubMed

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

2014-02-28

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

Blood pressure reactivity to psychological stress predicts hypertension in the CARDIA study.

PubMed

Matthews, Karen A; Katholi, Charles R; McCreath, Heather; Whooley, Mary A; Williams, David R; Zhu, Sha; Markovitz, Jerry H

2004-07-06

A longstanding but controversial hypothesis is that individuals who exhibit frequent, large increases in blood pressure (BP) during psychological stress are at risk for developing essential hypertension. We tested whether BP changes during psychological stress predict incident hypertension in young adults. We used survival analysis to predict hypertensive status during 13 years of follow-up in a sample of >4100 normotensive black and white men and women (age at entry, 18 to 30 years) enrolled in the CARDIA study. BP responses to 3 psychological challenges--cold pressor, star tracing, and video game tasks--were measured. Hypertensive status was defined as use of antihypertensive medication or measured BP > or =140/90 mm Hg. After adjustment for race, gender, covariates (education, body mass index, age, and resting pressure), and their significant interactions, the larger the BP responses were to each of the 3 tasks, the earlier hypertension occurred (P<0.0001 to <0.01). The systolic BP effect for the cold pressor task was apparent for women and for whites in race- and gender-specific models, whereas the diastolic BP effect for the video game was apparent for men. Young adults who show a large BP response to psychological stress may be at risk for hypertension as they approach midlife.

Issues in assessing multi-institutional performance of BI-RADS-based CAD systems

NASA Astrophysics Data System (ADS)

Markey, Mia K.; Lo, Joseph Y.

2005-04-01

The purpose of this study was to investigate factors that impact the generalization of breast cancer computer-aided diagnosis (CAD) systems that utilize the Breast Imaging Reporting and Data System (BI-RADS). Data sets from four institutions were analyzed: Duke University Medical Center, University of Pennsylvania Medical Center, Massachusetts General Hospital, and Wake Forest University. The latter two data sets are subsets of the Digital Database for Screening Mammography. Each data set consisted of descriptions of mammographic lesions according to the BI-RADS lexicon, patient age, and pathology status (benign/malignant). Models were developed to predict pathology status from the BI-RADS descriptors and the patient age. Comparisons between the models built on data from the different institutions were made in terms of empirical (non-parametric) receiver operating characteristic (ROC) curves. Results suggest that BI-RADS-based CAD systems focused on specific classes of lesions may be more generally applicable than models that cover several lesion types. However, better generalization was seen in terms of the area under the ROC curve than in the partial area index (>90% sensitivity). Previous studies have illustrated the challenges in translating a BI-RADS-based CAD system from one institution to another. This study provides new insights into possible approaches to improve the generalization of BI-RADS-based CAD systems.

Impact of sociodemographic factors on cognitive function in school-aged HIV-infected Nigerian children.

PubMed

Boyede, Gbemisola O; Lesi, Foluso Ea; Ezeaka, Veronica C; Umeh, Charles S

2013-01-01

In this study, we sought to evaluate the influence of sociodemographic factors, ie, age, sex, socioeconomic status, maternal education, and human immunodeficiency virus (HIV) status, on cognitive performance in school-aged HIV-infected Nigerian children. Sixty-nine HIV-positive children aged 6-15 years were matched with 69 HIV-negative control children for age and sex. The children were subdivided for the purpose of analysis into two cognitive developmental stages using Piaget's staging, ie, the concrete operational stage (6-11 years) and the formal operational stage (12-15 years). All participants underwent cognitive assessment using Raven's Standard Progressive Matrices (RPM). Sociodemographic data for the study participants, ie, age, sex, socioeconomic status, and level of maternal education, were obtained using a study proforma. Logistic regression analyses were used to determine associations of HIV status and sociodemographic characteristics with RPM cognitive scores. The overall mean RPM score for the HIV-positive children was 18.2 ± 9.8 (range 8.0-47.0) which was significantly lower than the score of 27.2 ± 13.8 (range 8.0-52.0) for the HIV-negative children (P < 0.001). On RPM grading, 56.5% of the HIV-positive children had cognitive performance at below average to intellectually defective range. Below average RPM scores were found to be significantly associated with younger age (6-11 years), positive HIV status, lower socioeconomic status, and low level of maternal education. Younger age, poor socioeconomic status, and low level of maternal education were factors apart from HIV infection that were significantly associated with low cognitive function in school-aged HIV-infected Nigerian children.

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

PubMed

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

2010-09-01

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

Liver transplantation in infants younger than 1 year of age.

PubMed Central

Colombani, P M; Cigarroa, F G; Schwarz, K; Wise, B; Maley, W E; Klein, A S

1996-01-01

OBJECTIVE: The authors report on experience with liver transplantation for infants younger than 1 year of age. SUMMARY BACKGROUND DATA: Over the last 15 years, orthotopic liver transplant has become the only lifesaving procedure available for infants with end-stage liver disease. Many transplant centers initially required infants to reach a specific weight or age to minimize morbidity and mortality. Size-appropriate infant donors also were uncommon. As a result, many children, in the first few years of life, died of their disease. The availability of reduced-size cadaveric and living-related liver transplants has offered the ability to transplant the young infant with liver failure. METHODS: The authors instituted a program to aggressively transplant infants with liver failure in the first year of life using both cadaveric and living-related liver donors. RESULTS: Between June 1991 and January 1995, 13 infants were transplanted for rapidly progressive liver failure. Infant age ranged from 4 to 11 months (mean, 7.5 months). The cause of liver failure included biliary atresia (11), alpha 1-antitrypsin deficiency (1), and liver failure secondary to echovirus 7 (1). The United Network for Organ Sharing status at the time of transplant ranged from status 4, intensive care unit bound (4 patients); status 3, hospitalized (4 patients); or status 2, failing at home (5 patients). Six patients (46%) received cadaveric whole organ (2) or segmental transplants (4). Seven patients (54%) received left lateral segment living-related transplants from parental donors. After operation, patients received cyclosporine or FK506-based immunosuppression. Three patients (23%) required four retransplants (two cadaveric for primary nonfunction; one living-related for graft thrombosis in the face of fungal infection and bile leak). Postoperative complications included primary nonfunction (15%), rejection (85%), graft vascular thrombosis (15%, two of three revascularized successfully), bacterial and fungal infections (77%), and viral infections (46%). Epstein-Barr virus-associated lymphoproliferative developed in two patients (15%). Intestinal perforation requiring reoperation developed in two patients (15%). Bile leaks requiring reoperation or transhepatic stinting or both developed in three patients (23%). Two patients died in the perioperative period (< 1 month) from a combination of primary nonfunction or graft thrombosis and sepsis. Overall survival was 85%, ranging from 11.0 months to 4.5 years. CONCLUSIONS: Orthotopic liver transplantation in infants younger than 1 year of age poses significant challenges from technical and infectious complications. Despite these barriers, overall patient survival is comparable to that of older children and adults. PMID:8645039

Role of Sex, Socioeconomic Status, and Emotional Support in Predicting Aging Perception Among Older Adults.

PubMed

Yaghoobzadeh, Ameneh; Sharif Nia, Hamid; Pahlevan Sharif, Saeed; Hosseinigolafshani, Seyedeh Zahra; Mohammadi, Fatemeh; Oveisi, Sonia; Allen, Kelly A

2017-01-01

Self-perception is found to be a central predictive factor in experiencing successful aging. The aim of this study was to explore the role of sex, socioeconomic status, and emotional support in elders' aging perception. A cross-sectional design was used with 300 older aged participants recruited from 23 clinics and health centers in Qazvin, Iran. Data were collected included questions to elicit demographic information and Barker's aging perception questionnaire. Exploratory multiple linear regression showed that the level of emotional support (β: -12.10; 95% CI: [-20.72, -3.48]), socioeconomic status (β: 2.84; 95% CI: [0.25, 5.43]), and women (β: -4.34; 95% CI: [-6.91, -1.77]) were associated with aging perception among elders. Educational level and marital status did not significantly contribute to the variance of AP. Findings revealed that aging perception was related to individual differences as well as social and emotional factors. Researchers, health-care professionals, and elders may benefit from thinking about old age as an inevitable life stage.

Rural Residents’ Perspectives on Multiple Morbidity Management and Disease Prevention

PubMed Central

Bardach, Shoshana H.; Schoenberg, Nancy E.; Tarasenko, Yelena N.; Fleming, Steven T.

2013-01-01

Middle-aged and older adults often experience several simultaneously occurring chronic conditions or “multiple morbidity” (MM). The task of both managing MM and preventing chronic conditions can be overwhelming, particularly in populations with high disease burdens, low socioeconomic status, and health care provider shortages. This article sought to understand Appalachian residents’ perspectives on MM management and prevention. Forty-one rural Appalachian residents aged 50 and above with MM were interviewed about disease management and colorectal cancer (CRC) prevention. Transcripts were examined for overall analytic categories and coded using techniques to enhance transferability and rigor. Participants indicate facing various challenges to prevention due, in part, to conditions within their rural environment. Patients and providers spend significant time and energy on MM management, often precluding prevention activities. This article discusses implications of MM management for CRC prevention and strategies to increase disease prevention among this rural, vulnerable population burdened by MM. PMID:23833393

Independence at risk: older Californians with disabilities struggle to remain at home as public supports shrink.

PubMed

Kietzman, Kathryn G; Durazo, Eva M; Torres, Jacqueline M; Choi, Anne Soon; Wallace, Steven P

2011-12-01

This policy brief presents findings from a yearlong study that closely followed a small but typical set of older Californians with disabilities who depend on fragile arrangements of paid public programs and unpaid help to live safely and independently at home. Many of these older adults have physical and mental health needs that can rise or fall with little warning; most are struggling with increasing disability as they age. In spite of these challenges, most display resilience and fortitude, and all share a common determination to maintain their independence at almost any cost. Declines in health status and other personal circumstances among aging Californians have been exacerbated by recent reductions in public support, and will be made even worse by significant additional cuts that are pending. Policy recommendations include consolidating long-term care programs and enhancing support for caregivers.

[Early Intervention and Cognitive Development: A Longitudinal Study with Psychologically Stressed Mother-Child-Dyad during Early Childhood].

PubMed

Zwönitzer, Annabel; Ziegenhain, Ute; Bovenschen, Ina; Pillhofer, Melanie; Spangler, Gottfried; Gerlach, Jennifer; Gabler, Sandra; Kindler, Heinz; Fegert, Jörg M; Künster, Anne Katrin

2016-01-01

Early intervention programs aiming at developing parents’ relationship and parenting skills and supporting young families have become increasingly established in Germany throughout the last decade. The present longitudinal study analyzed 53 children and their mothers receiving early intervention due to their psychosocially highly challenging life situations and personal circumstances. The children were examined at birth and at an age of twelve months as well as between ages two and four. The results revealed that the child’s cognitive development could be predicted by both maternal sensitivity and mother’s psychosocial stress. However, the amount, type, and intensity of early intervention did not have any effect on the child’s development. In terms of the effectiveness of early interventions the results implicate that interventions seems to be offered in an unspecific manner and does not contribute to an improvement of the child’s developmental status.

Research Priorities in Geriatric Palliative Care: Multimorbidity

PubMed Central

Zulman, Donna M.

2013-01-01

Abstract With global aging and scientific advances extending survival, the number of adults experiencing multiple chronic conditions has grown substantially and is projected to increase by another third between 2000 and 2030. Among the many challenges posed by multimorbidity, some of the most pressing include how to characterize and measure comorbid conditions, understand symptoms and illness burden, and provide person-centered care in the context of competing health care priorities and increasing complexity. In this white paper emanating from a National Institute on Aging supported conference to discuss research gaps at the geriatrics–palliative care interface, the authors review common definitions of multimorbidity; describe the association between multimorbidity and quality of life, functional status, quality of care, and health care utilization; note content and methodological gaps in multimorbidity evidence; and make recommendations regarding research priorities in this area of expanding public health impact. PMID:23777331

Management of the failing Fontan.

PubMed

De Rita, Fabrizio; Crossland, David; Griselli, Massimo; Hasan, Asif

2015-01-01

With and increasing number of early survivors after the palliation of the single ventricle physiology there is a burgeoning Fontan population worldwide that will pose unique challenges because of the inevitable sequelae related to the absence of the alleged "needless" sub-pulmonic ventricle. The increasing number and older-age single-ventricle patients highlights the results of successful contemporary surgical palliation in children, leading to the development of an adult single-ventricle population with unpredictable socio-economic and health service impacts. The wide variability in clinical status of patients with Fontan circulation reflects not only the broadened spectrum of morphological substrates involved, but also the evolving surgical techniques during the last four decades. This has come in the wake of a gradual understanding of an incredibly tricky physiology. The magnitude of the disease, the physio-pathological mechanisms, and the therapeutic options to optimize the "failing Fontan" status and to delay the irreversible deterioration of "Fontan failure" condition are discussed in this review. Copyright © 2015 Elsevier Inc. All rights reserved.

12 CFR 128.3 - Nondiscrimination in applications.

Code of Federal Regulations, 2013 CFR

2013-01-01

... basis of the age or location of the dwelling, or on the basis of the race, color, religion, sex, handicap, familial status (having one or more children under the age of 18), marital status, age (provided...

12 CFR 528.3 - Nondiscrimination in applications.

Code of Federal Regulations, 2013 CFR

2013-01-01

... basis of the age or location of the dwelling, or on the basis of the race, color, religion, sex, handicap, familial status (having one or more children under the age of 18), marital status, age (provided...

12 CFR 528.3 - Nondiscrimination in applications.

Code of Federal Regulations, 2011 CFR

2011-01-01

... basis of the age or location of the dwelling, or on the basis of the race, color, religion, sex, handicap, familial status (having one or more children under the age of 18), marital status, age (provided...

12 CFR 528.3 - Nondiscrimination in applications.

Code of Federal Regulations, 2012 CFR

2012-01-01

... basis of the age or location of the dwelling, or on the basis of the race, color, religion, sex, handicap, familial status (having one or more children under the age of 18), marital status, age (provided...

12 CFR 128.3 - Nondiscrimination in applications.

Code of Federal Regulations, 2014 CFR

2014-01-01

... basis of the age or location of the dwelling, or on the basis of the race, color, religion, sex, handicap, familial status (having one or more children under the age of 18), marital status, age (provided...

12 CFR 128.3 - Nondiscrimination in applications.

Code of Federal Regulations, 2012 CFR

2012-01-01

... basis of the age or location of the dwelling, or on the basis of the race, color, religion, sex, handicap, familial status (having one or more children under the age of 18), marital status, age (provided...

12 CFR 528.3 - Nondiscrimination in applications.

Code of Federal Regulations, 2010 CFR

2010-01-01

... basis of the age or location of the dwelling, or on the basis of the race, color, religion, sex, handicap, familial status (having one or more children under the age of 18), marital status, age (provided...

12 CFR 528.3 - Nondiscrimination in applications.

Code of Federal Regulations, 2014 CFR

2014-01-01

... basis of the age or location of the dwelling, or on the basis of the race, color, religion, sex, handicap, familial status (having one or more children under the age of 18), marital status, age (provided...

Trends in Loss to Follow-Up among Migrant Workers on Antiretroviral Therapy in a Community Cohort in Lesotho

PubMed Central

Bygrave, Helen; Kranzer, Katharina; Hilderbrand, Katherine; Whittall, Jonathan; Jouquet, Guillaume; Goemaere, Eric; Vlahakis, Nathalie; Triviño, Laura; Makakole, Lipontso; Ford, Nathan

2010-01-01

Background The provision of antiretroviral therapy (ART) to migrant populations raises particular challenges with respect to ensuring adequate treatment support, adherence, and retention in care. We assessed rates of loss to follow-up for migrant workers compared with non-migrant workers in a routine treatment programme in Morjia, Lesotho. Design All adult patients (≥18 years) initiating ART between January 1, 2008, and December 31, 2008, and followed up until the end of 2009, were included in the study. We described rates of loss to follow-up according to migrant status by Kaplan-Meier estimates, and used Poisson regression to model associations between migrant status and loss to follow-up controlling for potential confounders identified a priori. Results Our cohort comprised 1185 people, among whom 12% (148) were migrant workers. Among the migrant workers, median age was 36.1 (29.6–45.9) and the majority (55%) were male. We found no statistically significant differences between baseline characteristics and migrant status. Rates of lost to follow up were similar between migrants and non-migrants in the first 3 months but differences increased thereafter. Between 3 and 6 months after initiating antiretroviral therapy, migrants had a 2.78-fold increased rate of defaulting (95%CI 1.15–6.73); between 6 and 12 months the rate was 2.36 times greater (95%CI 1.18–4.73), whereas after 1 year the rate was 6.69 times greater (95%CI 3.18–14.09). Conclusions Our study highlights the need for programme implementers to take into account the specific challenges that may influence continuity of antiretroviral treatment and care for migrant populations. PMID:20976289

Women in Arab countries: challenging the patriarchal system?

PubMed

Fargues, Philippe

2005-05-01

Progress in the empowerment of Arab women was found to be low in a 2002 report. Yet Arab women's status is not reflected in continuing high fertility, which in 2000 had dropped sharply in one generation to 3.4. This paper discusses why fertility decline could nevertheless have taken place in the Arab countries. Islam has not stood in the way of fertility decline, as Iran and Algeria show. From the mid- 1970s to 1980s, subsidised consumption through oil wealth redistribution reduced the cost of children, and social conservatism kept married women out of the labour force, both of which promoted higher fertility. The early stages of fertility decline were mainly due to longer length of education of girls, rising female age at first marriage, e.g. 28 in urban Morocco and 29 in Libya, and entry into the labour force of young, single women. There is also a growing population sub-group of never-married young women. Collapsing oil prices and structural adjustment reduced household resources and became an effective fertility regulation factor. Girls born since the 1950s have not only been educated longer than their mothers, but also their fathers, which increases their authority. These factors, and women's activism and civil and political lobbying for the reform of personal status now underway in a number of Arab countries, could all challenge the patriarchal system.

Multigenerational links between mothers' experiences of autonomy in childhood and preschoolers' respiratory sinus arrhythmia: Variations by maltreatment status.

PubMed

Noll, Laura K; Clark, Caron A C; Skowron, Elizabeth A

2015-11-01

Despite burgeoning evidence linking early exposure to child maltreatment (CM) to deficits in self-regulation, the pathways to strong regulatory development in these children are not well understood, and significant heterogeneity is observed in their outcomes. Experiences of autonomy may play a key role in transmitting self-regulatory capacity across generations and help explain individual differences in maltreatment outcomes. In this study, we investigated multigenerational associations between Generation 1 (G1)-Generation 2 (G2) mothers' early experience of warmth and autonomy in relation to their own mothers and their Generation 3 (G3) children's autonomic physiological regulation in CM (n = 85) and non-CM (n = 128) families. We found that G2 mothers who recalled greater autonomy in their childhood relationship with their G1 mothers had preschool-age G3 children with higher respiratory sinus arrhythmia at baseline when alone while engaged in individual challenge tasks, during social exchanges with their mother in joint challenge tasks, and during the portions of the strange situation procedure when the mother was present. Although no clear mediators of this association emerged, multigenerational links among G1-G2 relations, maternal representations of her child, child behavior, and child respiratory sinus arrhythmia differed by maltreatment status, thus possibly representing important targets for future research and intervention.

Multigenerational links between mothers’ experiences of autonomy in childhood and preschoolers’ respiratory sinus arrhythmia: Variations by maltreatment status

PubMed Central

NOLL, LAURA K.; CLARK, CARON A. C.; SKOWRON, ELIZABETH A.

2017-01-01

Despite burgeoning evidence linking early exposure to child maltreatment (CM) to deficits in self-regulation, the pathways to strong regulatory development in these children are not well understood, and significant heterogeneity is observed in their outcomes. Experiences of autonomy may play a key role in transmitting self-regulatory capacity across generations and help explain individual differences in maltreatment outcomes. In this study, we investigated multigenerational associations between Generation 1 (G1)–Generation 2 (G2) mothers’ early experience of warmth and autonomy in relation to their own mothers and their Generation 3 (G3) children’s autonomic physiological regulation in CM (n = 85) and non-CM (n = 128) families. We found that G2 mothers who recalled greater autonomy in their childhood relationship with their G1 mothers had preschool-age G3 children with higher respiratory sinus arrhythmia at baseline when alone while engaged in individual challenge tasks, during social exchanges with their mother in joint challenge tasks, and during the portions of the strange situation procedure when the mother was present. Although no clear mediators of this association emerged, multigenerational links among G1–G2 relations, maternal representations of her child, child behavior, and child respiratory sinus arrhythmia differed by maltreatment status, thus possibly representing important targets for future research and intervention. PMID:26535936

A Model of Aging Perception in Iranian Elders With Effects of Hope, Life Satisfaction, and Socioeconomic Status: A Path Analysis.

PubMed

Yaghoobzadeh, Ameneh; Gorgulu, Ozkan; Yee, Bit-Lian; Wibisono, Ahmad Hasyim; Pahlevan Sharif, Saeed; Sharif Nia, Hamid; Allen, Kelly A

2018-01-01

Aging perception plays a central role in the experience of healthy aging by older people. Research identified that factors such as hope, life satisfaction, and socioeconomic status influence the perception of aging in older populations. This study sought to test a hypothetical model to quantitatively evaluate the relationship between hope, life satisfaction, and socioeconomic status with aging perception. A cross-sectional design was used with 504 older aged participants who live in Qazvin, Iran. Data were collected using the Barker's Aging Perception Questionnaire, Life Satisfaction Index-Z, and Herth Hope Index. The results of path analysis showed that hope was the most important factor affecting aging perception. Results drawn from correlation analysis indicated that there was a positive significant correlation ( r = .383, p < .001) between hope and aging perception. Further analysis found that hope had the strongest impact on aging perception compared with the other variables analyzed (e.g., life satisfaction and socioeconomic status). A model of aging perception in Iranian elders is presented. The findings suggested that hope had a significant and positive impact on aging perception. Implications for clinical practice and research are discussed.

A Review of the Oncology Patient's Challenges for Utilizing Fertility Preservation Services

PubMed Central

Flink, Dina M.; Sheeder, Jeanelle

2017-01-01

Purpose: The American Society of Clinical Oncology issued practice guidelines in 2006 to provide critical information about fertility impact to adolescents and young adults (AYA) at the time of cancer diagnosis. Survivors continue to express concerns about their long-term reproductive health after cancer therapy even as treatment options for fertility preservation evolve. An underutilization of fertility preservation methods by cancer patients continues to persist. A review of the literature cites barriers and challenges that limit fertility information and preservation options for AYA cancer patients. Methods: A review of medical literature was conducted to examine current practice for patients receiving fertility information and the barriers to patients receiving fertility preservation services. Results: A total of 69 publications were included in this review. The review summarizes (1) patient experiences with receiving fertility information and (2) patient desires, barriers, and challenges to utilizing fertility preservation services. Conclusions: Despite advances in fertility preservation, there are challenges for patients to utilizing fertility preservation services. Barriers include the following: urgency to initiate treatment, inadequate information, clinic time constraints, and perceptions around patients' gender, age, cost, parity, race, relationship, and sociodemographic status influence whether patients receive fertility preservation consultation. Patients report a lack of adequate information to make informed fertility decisions. PMID:27529573

APPETITE PREDICTS INTAKE AND NUTRITIONAL STATUS IN PATIENTS RECEIVING PERITONEAL DIALYSIS.

PubMed

Young, Valerie; Balaam, Sarah; Orazio, Linda; Bates, Annerley; Badve, Sunil V; Johnson, David W; Campbell, Katrina L

2016-06-01

Sub-optimal nutrition status is common amongst patients receiving peritoneal dialysis (PD) and leads to poor clinical outcome. This population experiences multi-factorial challenges to achieving optimal nutritional status, particularly driven by inadequate intake. The aim of this investigation was to identify factors associated with inadequate protein intake and sub-optimal nutritional status in patients undergoing PD. This was a cross-sectional study of 67 adult patients receiving PD (mean age 59 ± 14 years; 57% male) within a single centre. Participants were consecutively recruited and interviewed by renal dietitians, collecting: Subjective Global Assessment (SGA); quality of life (using EQ-5D); dietary intake (via dietary interview); and appetite (using Appetite and Diet Assessment Tool). Participant demographics were obtained via survey or medical charts. Main outcome measures were inadequate dietary protein intake (<1.1 g/kg adjusted body weight/day) and malnutrition (as defined by SGA rating B or C). Overall, 15 (22%) patients were malnourished and 29 (43%) had inadequate protein intake. Poor appetite (anorexia) was reported in 62% (18/29) of participants with inadequate protein malnourished patients reported anorexia versus 12 (23%) of the well-nourished patients (p = 0.0001). Anorexia was a key risk factor for inadequate protein intake and malnutrition in patients undergoing PD. These findings highlight a need to closely monitor patients with appetite disturbances. © 2016 European Dialysis and Transplant Nurses Association/European Renal Care Association.

Self- Perception of Body Weight Status in Older Dutch Adults.

PubMed

Monteagudo, C; Dijkstra, S C; Visser, M

2015-06-01

The prevalence of obesity is highest in older persons and a correct self-perception of body weight status is necessary for optimal weight control. The aim of this study was to determine self-perception of, and satisfaction with, body weight status, and to compare current versus ideal body image in a large, nationally representative sample of older people. Furthermore, determinants of misperception were explored. A cross-sectional study. The Longitudinal Aging Study Amsterdam (LASA), conducted in a population-based sample in the Netherlands. 1295 men and women aged 60-96 years. Body weight status was assessed using measured weight and height. Self-perceived body weight status, satisfaction with body weight and current and ideal body image were also assessed. Multiple logistic regression analysis was used to investigate the association of age, educational level and objectively measured BMI with underestimation of body weight status. The prevalence of obesity was 19.9% in men and 29.3% in women. The agreement between objective and self-perceived body weight status was low (Kappa < 0.2). Among overweight and obese persons, 42.1% of men and 44.1% of women were (very) dissatisfied with their body weight status and >99% of obese participants desired to be thinner (ideal body image < current image). Only 4.4% of obese men and 12.3% of obese women perceived their body weight status correctly. Higher age (women), lower educational level (men) and higher BMI (all) were associated with greater underestimation of body weight status. Many older persons misperceive their body weight status. Future actions to improve body weight perception in older persons are necessary to increase the impact of public health campaigns focussing on a healthy body weight in old age.

Neighborhood socioeconomic status at the age of 40 years and ischemic stroke before the age of 50 years: A nationwide cohort study from Sweden.

PubMed

Carlsson, Axel C; Li, Xinjun; Holzmann, Martin J; Ärnlöv, Johan; Wändell, Per; Gasevic, Danijela; Sundquist, Jan; Sundquist, Kristina

2017-10-01

Objective We aimed to study the association between neighborhood socioeconomic status at the age of 40 years and risk of ischemic stroke before the age of 50 years. Methods All individuals in Sweden were included if their 40th birthday occurred between 1998 and 2010. National registers were used to categorize neighborhood socioeconomic status into high, middle, and low and to retrieve information on incident ischemic strokes. Hazard ratios and their 95% confidence intervals were estimated. Results A total of 1,153,451 adults (women 48.9%) were followed for a mean of 5.5 years (SD 3.5 years), during which 1777 (0.30%) strokes among men and 1374 (0.24%) strokes among women were recorded. After adjustment for sex, marital status, education level, immigrant status, region of residence, and neighborhood services, there was a lower risk of stroke in residents from high-socioeconomic status neighborhoods (hazard ratio 0.87, 95% confidence interval 0.78-0.96), and an increased risk of stroke in adults from low-socioeconomic status neighborhoods (hazard ratio 1.16, 95% confidence interval 1.06-1.27), compared to their counterparts living in middle-socioeconomic status neighborhoods. After further adjustment for hospital diagnoses of hypertension, diabetes, heart failure, and atrial fibrillation prior to the age of 40, the higher risk in neighborhoods with low socioeconomic status was attenuated, but remained significant (hazard ratio 1.12, 95% confidence interval 1.02-1.23). Conclusions In a nationwide study of individuals between 40 and 50 years, we found that the risk of ischemic stroke differed depending on neighborhood socioeconomic status, which calls for increased efforts to prevent cardiovascular diseases in low socioeconomic status neighborhoods.

Body Mass Transitions Through Childhood and Early Adolescence: A Multistate Life Table Approach

PubMed Central

Tran, Melanie K.; Krueger, Patrick M.; McCormick, Emily; Davidson, Arthur; Main, Deborah S.

2016-01-01

The growing prevalence of overweight and obesity among children is well documented, but prevalence estimates offer little insight into rates of transition to higher or lower body mass index (BMI; weight (kg)/height (m)2) categories. We estimated the expected numbers of years children would live as normal weight, overweight, and obese by race/ethnicity and sex, given rates of transition across BMI status levels. We used multistate life table methods and transition rates estimated from prospective cohort data (2007–2013) for Denver, Colorado, public schoolchildren aged 3–15 years. At age 3 years, normal-weight children could expect to live 11.1 of the following 13 years with normal weight status, and obese children could expect to live 9.8 years with obese status. At age 3 years, overweight children could expect to live 4.5 of the following 13 years with normal weight status, 5.1 years with overweight status, and 3.4 years with obese status. Whites and Asians lived more years at lower BMI status levels than did blacks or Hispanics; sex differences varied by race/ethnicity. Children who were normal weight or obese at age 3 years were relatively unlikely to move into a different BMI category by age 15 years. Overweight children are relatively likely to transition to normal weight or obese status. PMID:26984962

The evolution of human phenotypic plasticity: age and nutritional status at maturity.

PubMed

Gage, Timothy B

2003-08-01

Several evolutionary optimal models of human plasticity in age and nutritional status at reproductive maturation are proposed and their dynamics examined. These models differ from previously published models because fertility is not assumed to be a function of body size or nutritional status. Further, the models are based on explicitly human demographic patterns, that is, model human life-tables, model human fertility tables, and, a nutrient flow-based model of maternal nutritional status. Infant survival (instead of fertility as in previous models) is assumed to be a function of maternal nutritional status. Two basic models are examined. In the first the cost of reproduction is assumed to be a constant proportion of total nutrient flow. In the second the cost of reproduction is constant for each birth. The constant proportion model predicts a negative slope of age and nutritional status at maturation. The constant cost per birth model predicts a positive slope of age and nutritional status at maturation. Either model can account for the secular decline in menarche observed over the last several centuries in Europe. A search of the growth literature failed to find definitive empirical documentation of human phenotypic plasticity in age and nutritional status at maturation. Most research strategies confound genetics with phenotypic plasticity. The one study that reports secular trends suggests a marginally insignificant, but positive slope. This view tends to support the constant cost per birth model.

Effects of attractiveness and status in dating desire in homosexual and heterosexual men and women.

PubMed

Ha, Thao; van den Berg, Judith E M; Engels, Rutger C M E; Lichtwarck-Aschoff, Anna

2012-06-01

The present study examined partner preferences of homosexual and heterosexual men and woman, focusing on attractiveness and status. Homosexual (N=591 men; M age=28.87 years, SD=10.21; N=249 women; M age=33.36 years, SD=13.12) and heterosexual participants (N=346 men; M age=39.74 years, SD=14.26; N=400 women; M age=35.93 years, SD=13.72) rated the importance of attractiveness and social status of potential partners and then, in a vignette test, expressed their desire to date hypothetical potential partners based on photographs that varied in attractiveness and status-related profiles. With ratings, heterosexual men valued attractiveness the most, followed by homosexual men, heterosexual women, and homosexual women. Heterosexual women rated social status as most important. When status profiles were manipulated and accompanied with photographs of faces, the pattern of differences between homosexuals and heterosexuals supported the self-reported results. Overall, homosexual men and women have similar mate preferences to heterosexual men and women by showing more dating desire for attractive and high social status persons. Compared to attractiveness, status played a smaller role in dating desire.

Identity statuses and psychosocial functioning in Turkish youth: a person-centered approach.

PubMed

Morsunbul, Umit; Crocetti, Elisabetta; Cok, Figen; Meeus, Wim

2016-02-01

In the present study, we tested whether the five identity statuses of the original Meeus-Crocetti model could be extracted in a Turkish sample. Their three-factor model of identity was used to examine identity formation. Participants were 1201 (59.6% females) youth aged between 12 and 24 years (Mage = 17.53 years, SDage = 3.25). Findings revealed that the five identity statuses extracted in previous studies (Crocetti, Rubini, Luyckx, & Meeus, 2008; Crocetti, Schwartz, Fermani, Klimstra, & Meeus, 2012) also emerged in a sample of Turkish adolescents and emerging adults. Findings indicated that gender and age affected the distribution of the individuals among the five identity statuses. Furthermore, individuals in the five identity statuses represented distinct profiles according to personality and self characteristics, problem behaviors and well-being, and interpersonal and group relationships. Finally, the status × age interactions indicated that the searching moratorium status became more problematic with age. Implications and suggestions for future research are also discussed. Copyright © 2015 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

In the eye of the beholder: Can counter-stereotypes change perceptions of older adults' social status?

PubMed

Robertson, Deirdre A; Weiss, David

2017-09-01

Negative age-related stereotypes often entail the perception that older adults have a lower social status than middle-aged adults. We hypothesized that older adults are perceived to have lower social status because they are less likely to be seen in prestigious occupational positions. People tend to infer general assumptions about group characteristics from exemplars. According to this, presenting a stereotype-inconsistent exemplar (i.e., older person in a high-status position) should change perceptions of older adults' social status. Study 1 (60 countries, N = 86,026, 18-99 years) showed that people in countries with an older relative to a younger political leader do not perceive as great a decline in social status from middle-aged to older adults. Study 2 (N = 131; 19-74 years) tested the causal link demonstrating that participants exposed to older exemplars holding a prestigious occupational position were significantly more likely to rate older adults as having a relative higher social status. We discuss implications for future interventions to change negative age-related stereotypes. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Increasing Immunization Compliance by Reducing Provisional Admittance

ERIC Educational Resources Information Center

Davis, Wendy S.; Varni, Susan E.; Barry, Sara E.; Frankowski, Barbara L.; Harder, Valerie S.

2016-01-01

Students in Vermont with incomplete or undocumented immunization status are provisionally admitted to schools and historically had a calendar year to resolve their immunization status. The process of resolving these students' immunization status was challenging for school nurses. We conducted a school-based quality improvement effort to increase…

USING HISTORICAL BIOLOGICAL DATA TO EVALUATE STATUS AND TRENDS IN THE BIG DARBY CREEK WATERSHED (OHIO, USA)

EPA Science Inventory

Assessment of watershed ecological status and trends is challenging for managers who lack randomly or consistently sampled data, or monitoring programs developed from a watershed perspective. This study investigated analytical approaches for assessment of status and trends using ...

Accelerated ageing and renal dysfunction links lower socioeconomic status and dietary phosphate intake.

PubMed

McClelland, Ruth; Christensen, Kelly; Mohammed, Suhaib; McGuinness, Dagmara; Cooney, Josephine; Bakshi, Andisheh; Demou, Evangelia; MacDonald, Ewan; Caslake, Muriel; Stenvinkel, Peter; Shiels, Paul G

2016-05-01

We have sought to explore the impact of dietary Pi intake on human age related health in the pSoBid cohort (n=666) to explain the disparity between health and deprivation status in this cohort. As hyperphosphataemia is a driver of accelerated ageing in rodent models of progeria we tested whether variation in Pi levels in man associate with measures of biological ageing and health. We observed significant relationships between serum Pi levels and markers of biological age (telomere length (p=0.040) and DNA methylation content (p=0.028), gender and chronological age (p=0.032). When analyses were adjusted for socio-economic status and nutritional factors, associations were observed between accelerated biological ageing (telomere length, genomic methylation content) and dietary derived Pi levels among the most deprived males, directly related to the frequency of red meat consumption. Accelerated ageing is associated with high serum Pi levels and frequency of red meat consumption. Our data provide evidence for a mechanistic link between high intake of Pi and age-related morbidities tied to socio-economic status.

Suicide mortality and marital status for specific ages, genders, and education levels in South Korea: Using a virtually individualized dataset from national aggregate data.

PubMed

Park, Soo Kyung; Lee, Chung Kwon; Kim, Haeryun

2018-09-01

Previous studies in Eastern as well as Western countries have shown a relationship between marital status and suicide mortality. However, to date, no Korean study has calculated national suicide rates by marital status for specific genders, ages, and education levels. This study investigated whether the relationship between marital status and suicide differs by age, gender, and educational attainment, and analyzed the effect of marital status on suicide risk after controlling for these socio-demographic variables. Using national mortality data from 2015, and aggregated census data from 2010 in South Korea, we created a virtually individualized dataset with multiple weighting algorithms, including individual socio-demographic characteristics and suicide rates across the entire population. The findings show that the following groups faced the highest relative suicide risks: 1) divorced men of all ages and men aged more than 75 years, particularly divorced men aged more than 75; and 2) never-married men aged 55-64 years, and never-married women of lower education status. We did not account for important variables such as mental health, substance abuse, employment insecurity, social integration, perceived loneness, and family income which we were unable to access. This current research extends prior theoretical and methodological work on suicide, aiding efforts to reduce suicide mortality in South Korea. Copyright © 2018 Elsevier B.V. All rights reserved.

Development of the use of conversational cues to assess reality status

PubMed Central

Woolley, Jacqueline D.; Ma, Lili; Lopez-Mobilia, Gabriel

2011-01-01

In this study we assessed children’s ability to use information overheard in other people’s conversations to judge the reality status of a novel entity. Three- to 9-year-old children (N = 101) watched video clips in which two adults conversed casually about a novel being. Videos contained statements that either explicitly denied, explicitly affirmed, or implicitly acknowledged the entity’s existence. Results indicated that children of all ages used statements of denial to discount the reality status of the novel entity, but that this ability improved with age. By age 5, children used implicit existence cues to judge a novel entity as being real. Not until age 9, however, did children begin to doubt the existence of entities whose reality status was explicitly affirmed in conversation. Overall, results indicate that the ability to use conversational cues to determine reality status is present in some children as early as age 3, but recognition of the nuanced language of belief continues to develop during the elementary-school years. PMID:22241965

Correlation of educational status and clinicopathological characteristics of breast cancer: a single center experience.

PubMed

Sarici, Furkan; Babacan, Taner; Buyukhatipoglu, Hakan; Balakan, Ozan; Sever, Ali R; Kertmen, Neyran; Unlu, Ozan; Ates, Ozturk; Diker, Omer; Akin, Serkan; Sunar, Veli; Karakas, Yusuf; Lacin, Sahin; Altundag, Kadri

2016-01-01

Educational status may be an important parameter in assessing breast cancer risk and prognosis. The purpose of this study was to investigate the correlation between the level of education and clinicopathological characteristics of breast cancer, including tumor grade, HER-2 and estrogen receptor (ER) status, tumor size, axillary lymph node involvement and metastasis. The study included 1800 women who were diagnosed with invasive breast cancer during 2005-2013 at Hacettepe University Cancer Institute. Patients were divided into three groups according to their educational status at the time of diagnosis as follows: low (illiterate and elementary school, 5 years or less of education), medium (secondary school and upper secondary school, 6-12 years of education) and high (university level, more than 12 years of education). The associations between educational status and clinicopathologic features of breast cancer at the time of diagnosis were evaluated. In all patient, a significant relationship was found between educational status and T stages (p<0.0001). Patients with higher educational levels were reported to have smaller tumor size regardless to their age and were less likely to have axillary lymph node involvement (p=0.001) or metastasis (p=0.001). A significant correlation was found between educational status and ER positivity in patients over 50 years of age (p=0.03). When the patients of all ages were evaluated, no statistically significant correlation was shown (p=0.27) between educational status and ER positivity. A significant relationship was found between educational status and HER-2 status (p=0.003), regardless of the patients' age. HER-2 positivity increased in patients with low educational status, however this significance was lost in patients over the age of 50 (p=0.1). The relationship between educational status and biological factors in breast cancer are not conclusive as yet, but this particular study revealed that educational status played a major influence in each of the five breast cancer prognostic factors: ER status, HER-2 status, tumor size, lymph node status and metastasis.

PREVALENCE OF EATING DISTURBANCE AND BODY IMAGE DISSATISFACTION IN YOUNG GIRLS: AN EXAMINATION OF THE VARIANCE ACROSS RACIAL AND SOCIOECONOMIC GROUPS.

PubMed

Deleel, Marissa L; Hughes, Tammy L; Miller, Jeffrey A; Hipwell, Alison; Theodore, Lea A

2009-09-01

Eating disorder research has predominantly focused on White adolescent females. More recent research suggests that eating disorders occur in various racial and age groups. The current study examines prevalence and stability of body image dissatisfaction and eating disturbance in 9- and 10-year-old girls and whether there is variability by racial group or socioeconomic status (SES). Five hundred eighty-one girls completed the Children's Eating Attitude Test (ChEAT) and the Body Image Measure (BIM). Results showed that 11% of the sample scored in the Anorexic range at age 9 and about 7% at age 10. When examining body image, 35% of the sample at age 9 and 38% at age 10 selected Ideal Figures that were smaller than their Real Figures on the BIM. There was a significant difference between the racial groups in their reports of eating disturbance, but not body image dissatisfaction. Specifically, the Minority group had higher eating disturbance scores on average at ages 9 and 10 when compared to the White group. SES did not account for eating disturbance or body image dissatisfaction. These results challenge the maxim that eating disturbance and body image dissatisfaction occur primarily in White females from middle and upper SES populations.

Digit Sucking, Age, Sex, and Socioeconomic Status as Determinants of Oral Hygiene Status and Gingival Health of Children in Suburban Nigeria.

PubMed

Agbaje, Hakeem O; Kolawole, Kikelomo A; Folayan, Morenike O; Onyejaka, Nneka K; Oziegbe, Elizabeth O; Oyedele, Titus A; Chukwumah, Nneka M; Oshomoji, Olusegun V

2016-09-01

This study determines prevalence of digit sucking and gingivitis, and association among age, sex, socioeconomic status, presence of digit-sucking habits, oral hygiene status (OHS), and gingivitis among a group of Nigerian children. Data of 992 children aged 1 to 12 years recruited through a household survey conducted in Osun State, Nigeria were analyzed. Information on age, sex, socioeconomic status, and history of digit-sucking habits were collected. Children were assessed for OHS and severity of gingivitis using the simplified oral hygiene index and the gingival index, respectively. Predictors of presence of gingivitis and poor oral hygiene were determined using multivariate logistic regression. One (0.2%) and 454 (93.0%) children aged 1 to 5 years had poor oral hygiene and mild gingivitis, respectively. Twenty-two (4.4%) and 361 (72.9%) children aged 6 to 12 years had poor oral hygiene and mild gingivitis, respectively. The odds of having poor oral hygiene (adjusted odds ratio [AOR]: 0.26; 95% confidence interval [CI]: 0.20 to 0.35; P <0.001) and gingivitis (AOR: 0.21; 95% CI: 0.14 to 0.31; P <0.001) was significantly reduced for children aged 1 to 5 years. The odds of having gingivitis was increased in children with low socioeconomic status (AOR: 2.09; 95% CI: 1.32 to 3.31; P = 0.002). There was no significant relationship among sex, digit sucking, OHS, and presence of gingivitis. A digit-sucking habit did not increase chances of having poor oral hygiene and gingivitis. Increasing age and low socioeconomic status were factors that significantly increased chances of having poor oral hygiene and gingivitis.

Weight Status and Behavioral Problems among Very Young Children in Chile.

PubMed

Kagawa, Rose M C; Fernald, Lia C H; Behrman, Jere R

2016-01-01

Our objective was to explore the association between weight status and behavioral problems in children before school age. We examined whether the association between weight status and behavioral problems varied by age and sex. This study used cross-sectional data from a nationally-representative sample of children and their families in Chile (N = 11,207). These children were selected using a cluster-stratified random sampling strategy. Data collection for this study took place in 2012 when the children were 1.5-6 years of age. We used multivariable analyses to examine the association between weight status and behavioral problems (assessed using the Child Behavior Checklist), while controlling for child's sex, indigenous status, birth weight, and months breastfed; primary caregiver's BMI and education level; and household wealth. Approximately 24% of our sample was overweight or obese. Overweight or obese girls showed more behavioral problems than normal weight girls at age 6 (β = 0.270 SD, 95% CI = 0.047, 0.493, P = 0.018). Among boys age 1 to 5 years, overweight/obesity was associated with a small reduction in internalizing behaviors (β = -0.09 SD, 95% CI = -0.163, -0.006, P = 0.034). Our data suggest that the associations between weight status and behavioral problems vary across age and sex.

Dissociation between history and challenge in patients with physical urticaria.

PubMed

Komarow, Hirsh D; Arceo, Sarah; Young, Michael; Nelson, Celeste; Metcalfe, Dean D

2014-01-01

Physical urticaria is a subtype of chronic urticaria induced by a physical stimulus. To evaluate the consistency between a history of physical urticaria and results of challenge testing. Seventy-six subjects, ages 3 to 77 years old, were referred with the diagnosis of a physical urticaria and were evaluated by using challenge testing directed toward the presenting diagnosis, yet included other stimuli based on history. The majority of subjects were tested to 3 or more stimuli, thus 294 provocation tests were performed. Fifty-seven subjects were surveyed for the status of their physical urticaria at least 1 year after initial evaluation. Of the 76 subjects with a positive history of a physical urticaria, 38% (n = 29) were challenge negative to the presenting diagnosis. Eight subjects within the challenge negative group reacted positively to additional testing, thus 28% (n = 21) remained negative to all challenge testing, which allowed discontinuation of medications and avoidance behavior. A negative challenge result was less likely with subjects who presented with cold-induced urticaria (25%), delayed pressure urticaria (25%), and dermatographism (29%), yet more common with cholinergic (65%) and solar urticaria (67%). A 1-year follow-up survey of 57 subjects was consistent with initial results. Nineteen of this subgroup were rechallenged for the presenting diagnosis, and the outcome was unchanged in 17 subjects and, in 2 subjects the urticaria had resolved. The diagnosis by history of a physical urticaria should be verified by testing whenever possible and particularly if the condition is judged as severe and thus requires both significant life-style changes and pharmacologic intervention. Published by Elsevier Inc.

Wind Power on Native American Lands: Opportunities, Challenges, and Status (Poster)

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

Jimenez, A.; Johnson, P. B.; Gough, R.

2007-06-01

The United States is home to more than 700 American Indian tribes and Native Alaska villages and corporations located on 96 million acres. Many of these tribes and villages have excellent wind resources that could be commercially developed to meet their electricity needs or for electricity export. This conference poster for Windpower 2007 describes the opportunities, challenges, and status of wind energy projects on Native American lands in the United States.

[Association between obstetric factors, hormone levels and nutritional status with the development of breast cancer].

PubMed

González-Jiménez, Emilio; Montero-Alonso, Miguel Ángel; Schmidt Riovalle, Jacqueline

2013-12-01

Recent studies suggest that the age at first pregnancy, number of children and the lapse between births may protect against breast cancer. Furthermore, serum levels of estrogen, prolactin and progesterone appear to contribute to the development of this tumors in obese women. To verify whether the variables age at first pregnancy, number of children, birth interval, hormone levels and nutritional status are associated with the age at diagnosis of breast cancer. Retrospective analysis of medical records of 550 female patients, diagnosed and treated for breast cancer at a hospital in Spain between 2009 and 2012. We found a significant and positive association between age at diagnosis of cancer and the variables age at first pregnancy, parity and interval between pregnancies. There was also a significant correlation (p < 0.000) between serum levels of estrogen, prolactin and progesterone and nutritional status of patients. In this sample, age at first pregnancy or number of children, hormone levels and nutritional status are related to the age of onset of cancer.

Who purchases cigarettes from cheaper sources in China? Findings from the ITC China Survey

PubMed Central

Yao, Tingting; Huang, Jidong; Sung, Hai-Yen; Ong, Michael K.; Mao, Zhengzhong; Jiang, Yuan; Fong, Geoffrey T.; Max, Wendy

2014-01-01

Objective The availability of cigarettes from cheaper sources constitutes a major challenge to public health throughout the world, including China, because it may counteract price-based tobacco control policies. The goal of this study was to identify factors associated with purchasing cigarettes from cheaper sources among adult smokers in China. Methods Data were analyzed from Waves 1–3 of the International Tobacco Control China Survey, conducted in 2006–2009 among adult smokers in six cities in China (N=7,980). One survey question asked, “In the last six months, have you purchased cheaper cigarettes than you can get from local stores for economic reasons?” We examined whether sociodemographic factors and smoking intensity were associated with purchasing cigarettes from cheaper sources using the general estimating equations (GEE) model. Sociodemographic factors considered were gender, age, marital status, monthly household income, education, employment status, and city of residence. Results 15.6% of smokers reported purchasing cigarettes from cheaper sources. After controlling for other covariates, the associations of the behavior of purchasing cigarettes from cheaper sources with age (AOR=1.49, 95% CI=1.17–3.92 for age 18–24 compared to age 55+) and with income (AOR=2.93, 95%CI=2.27–3.79 for low income compared to high income) were statistically significant, but there was no statistically significant relationship with smoking intensity. Conclusions Our findings indicate that young and low income smokers are more likely than older and high income smokers to purchase cigarettes from cheaper sources in China. Tobacco control policies that reduce the availability of cigarettes from cheaper sources could have an impact on reducing cigarette consumption among young and low income smokers in China. PMID:24078076

Who purchases cigarettes from cheaper sources in China? Findings from the ITC China Survey.

PubMed

Yao, Tingting; Huang, Jidong; Sung, Hai-Yen; Ong, Michael K; Mao, Zhengzhong; Jiang, Yuan; Fong, Geoffrey T; Max, Wendy

2014-03-01

The availability of cigarettes from cheaper sources constitutes a major challenge to public health throughout the world, including China, because it may counteract price-based tobacco control policies. The goal of this study was to identify factors associated with purchasing cigarettes from cheaper sources among adult smokers in China. Data were analysed from Waves 1 to 3 of the International Tobacco Control China Survey conducted in 2006-2009 among adult smokers in six cities in China (N=7980). One survey question asked, "In the last 6 months, have you purchased cheaper cigarettes than you can get from local stores for economic reasons?" We examined whether sociodemographic factors and smoking intensity were associated with purchasing cigarettes from cheaper sources using the general estimating equations model. Sociodemographic factors considered were gender, age, marital status, monthly household income, education, employment status and city of residence. 15.6% of smokers reported purchasing cigarettes from cheaper sources. After controlling for other covariates, the associations of the behaviour of purchasing cigarettes from cheaper sources with age (adjusted OR (AOR)=1.49, 95% CI 1.17 to 3.92 for age 18-24 compared with age 55+) and with income (AOR=2.93, 95% CI 2.27 to 3.79 for low income compared with high income) were statistically significant, but there was no statistically significant relationship with smoking intensity. Our findings indicate that young and low-income smokers are more likely than older and high-income smokers to purchase cigarettes from cheaper sources in China. Tobacco control policies that reduce the availability of cigarettes from cheaper sources could have an impact on reducing cigarette consumption among young and low-income smokers in China.

Virtual reality applications for addressing the needs of those aging with disability.

PubMed

Rizzo, Albert; Requejo, Phil; Winstein, Carolee J; Lange, Belinda; Ragusa, Gisele; Merians, Alma; Patton, James; Banerjee, Pat; Aisen, Mindy

2011-01-01

As persons with disabilities age, progressive declines in health and medical status can challenge the adaptive resources required to maintain functional independence and quality of life [1]. These challenges are further compounded by economic factors, medication side effects, loss of a spouse or caregiver, and psychosocial disorders [1-2]. With the gradual loss of functional independence and increased reliance on others for transportation, access to general medical and rehabilitation care can be jeopardized [2]. The combination of these factors when seen in the context of the average increase in lifespan in industrialized societies has lead to a growing crisis that is truly global in proportion. While research indicates that functional motor capacity can be improved, maintained, or recovered via consistent participation in a motor exercise and rehabilitation regimen [3], independent adherence to such preventative and/or rehabilitative programming outside the clinic setting is notoriously low [1]. This state of affairs has produced a compelling and ethical motivation to address the needs of individuals who are aging with disabilities by promoting home-based access to low-cost, interactive virtual reality (VR) systems designed to engage and motivate individuals to participate with "game"-driven physical activities and rehabilitation programming. The creation of such systems could serve to enhance, maintain and rehabilitate the sensorimotor processes that are needed to maximize independence and quality of life. This is the theme of the research to be presented at this MMVR workshop.

12 CFR 701.31 - Nondiscrimination requirements.

Code of Federal Regulations, 2013 CFR

2013-01-01

... basis of race, color, national origin, religion, sex, handicap, or familial status (having children..., religion, sex, handicap, or familial status (having children under the age of 18) of: (i) Any applicant or..., color, national origin, religion, sex, handicap, or familial status (having children under the age of 18...

12 CFR 701.31 - Nondiscrimination requirements.

Code of Federal Regulations, 2011 CFR

2011-01-01

... basis of race, color, national origin, religion, sex, handicap, or familial status (having children..., religion, sex, handicap, or familial status (having children under the age of 18) of: (i) Any applicant or..., color, national origin, religion, sex, handicap, or familial status (having children under the age of 18...

Nutritional status of children in two districts of the mountain region of Nepal.

PubMed

Thapa, M; Neopane, A K; Singh, U K; Aryal, N; Agrawal, K; Shrestha, B

2013-09-01

Nutritional status is a prime indicator of health. Generally, three anthropometric indicators are often used to assess nutritional status during childhood and adolescence: underweight (weight-for-age), stunting (height- for-age) and thinness (BMI-for-age). Malnutrition in children is a major public health problem in many developing countries. This study was conducted to assess nutritional status among children attending health camps in two mountainous districts in Nepal. Five hundred and seventy five children below 15 years of age attending the medical camp in Humla and Mugu districts in October 2011 were assessed for nutritional status. For children less than five years, weight for age, weight for height and height for age as per WHO classification, and for children between five to 15 years age specific values of height, weight and Body Mass Index (BMI) were calculated. In Humla district, 28.2% children were undernourished, 8.8% wasted and 22.4% stunted in less than five years. In the same age group, 31.7% children were undernourished, 9.4% wasted and 29.4% stunted in Mugu district. In the age group five to 15 years, thinness was seen in 22.4% and 29.4% children in Humla and Mugu respectively. Malnutrition (underweight, stunting, wasting and thinness) still constitutes a major health problem among Nepalese children, particularly in mountainous regions.

Soil-Transmitted Helminths in Southwestern China: A Cross-Sectional Study of Links to Cognitive Ability, Nutrition, and School Performance among Children

PubMed Central

Liu, Chengfang; Luo, Renfu; Yi, Hongmei; Zhang, Linxiu; Li, Shaoping; Bai, Yunli; Medina, Alexis; Rozelle, Scott; Smith, Scott; Wang, Guofei; Wang, Jujun

2015-01-01

Background Empirical evidence suggests that the prevalence of soil-transmitted helminth (STH) infections in remote and poor rural areas is still high among children, the most vulnerable to infection. There is concern that STH infections may detrimentally affect children’s healthy development, including their cognitive ability, nutritional status, and school performance. Medical studies have not yet identified the exact nature of the impact STH infections have on children. The objective of this study is to examine the relationship between STH infections and developmental outcomes among a primary school-aged population in rural China. Methodology/Principal Findings We conducted a large-scale survey in Guizhou province in southwest China in May 2013. A total of 2,179 children aged 9-11 years living in seven nationally-designated poverty counties in rural China served as our study sample. Overall, 42 percent of the sample’s elementary school-aged children were infected with one or more of the three types of STH—Ascaris lumbricoides (ascaris), Trichuris trichuria (whipworm) and the hookworms Ancylostoma duodenale or Necator americanus. After controlling for socioeconomic status, we observed that infection with one or more STHs is associated with worse cognitive ability, worse nutritional status, and worse school performance than no infection. This study also presents evidence that children with Trichuris infection, either infection with Trichuris only or co-infected with Trichuris and Ascaris, experience worse cognitive, nutritional and schooling outcomes than their uninfected peers or children infected with only Ascaris. Conclusions/Significance We find that STH infection still poses a significant health challenge among children living in poor, rural, ethnic areas of southwest China. Given the important linkages we find between STH infection and a number of important child health and educational outcomes, we believe that our results will contribute positively to the debate surrounding the recent Cochrane report. PMID:26110518

Implicit rationing criteria in non-small-cell lung cancer treatment.

PubMed Central

Arndt, K.; Coy, P.; Schaafsma, J.

1996-01-01

Data collected from lung cancer patients attending the Victoria Clinic of the British Columbia Cancer Agency are used to investigate how resources are rationed in the treatment of non-small-cell lung cancer (NSCLC). An ordered logit model is estimated to analyse empirically the relationship between treatment selection and: tumour stage, size and differentiation; the Feinstein index; Karnofsky performance status (KPS); and the patient's age, gender and marital and smoking status. Implicit rationing is found to occur with respect to all of these factors except the Feinstein index, gender and marital status. With respect to age, KPS and smoker status the main empirical results are: (a) an increase in age from 50 to 85 reduces the expected treatment expenditure by 50-70%, depending on the patient's KPS and smoker status; (b) patients with a KPS less than 80 and of 80, receive 30-46% and 75-85%, respectively, of the expected treatment expenditure for patients with a KPS of 90 or 100, depending on age and smoker status; (c) the expected treatment expenditure for active smokers is about 71-86% of the expenditure for non- or former smokers depending on age and KPS. PMID:8611380

To evaluate the comparative status of oral health practices, oral hygiene and periodontal status amongst visually impaired and sighted students.

PubMed

Jain, Ashish; Gupta, Jyoti; Aggarwal, Vyom; Goyal, Chinu

2013-01-01

The aim of this study was to evaluate the comparative status of oral health practices, oral hygiene, and periodontal status amongst visually impaired and sighted students. In this study, 142 visually impaired children from a blind school in the age group of 6-18 years were enrolled with a similar number of age and sex matched sighted students studying in different schools of Chandigarh. The outcome variables were oral hygiene practices, oral hygiene status, and periodontal status. The visually impaired had been found to have better oral hygiene practices, a nonsignificant difference of oral hygiene scores but a significantly high value for bleeding scores as compared to sighted students. Age wise comparisons showed that bleeding scores were highly significant in 9-11 years and 12-14 years age group as compared to 6-8 years and 15-18 years age group. It could be related that the increased prevalence of bleeding sites despite of better oral hygiene practices in visually impaired group might be the result of their handicap to visualize plaque. ©2012 Special Care Dentistry Association and Wiley Periodicals, Inc.

Exploring Career Development in Emerging Adult Collegians

ERIC Educational Resources Information Center

Rosemond, Marie Michelle; Owens, Delila

2018-01-01

Emerging adulthood is defined as age-based (18-29 years of age). This age range is central to traditional age collegians who are a very diverse group (i.e., relative to race/ethnicity, gender, socioeconomic status, relationship status, and educational attainment). In an effort to explore the career development process of college students this…

Good, now keep going: challenging the status quo in STEM pipeline and access programs

NASA Astrophysics Data System (ADS)

Wiseman, Dawn; Herrmann, Randy

2018-03-01

This contribution engages in conversation with McMahon, Griese, and Kenyon (this issue) to consider how the SURE program they describe represents a pragmatic approach to addressing the issue of underrepresentation of Indigenous people in STEM post-secondary programs. We explore how such programs are generally positioned and how they might be positioned differently to challenge the status quo within Western post-secondary institutions. The challenge arises from moving beyond the immediate pragmatics of addressing an identifiable issue framed as a problem to considering how post-secondary institutions and people developing access recruitment programs might begin unlearning colonialism.

Race, Age, and Neighborhood Socioeconomic Status in Low Birth Weight Disparities Among Adolescent Mothers: An Intersectional Inquiry.

PubMed

Coley, Sheryl L; Nichols, Tracy R

2016-01-01

Few studies examined socioeconomic contributors to racial disparities in low birth weight outcomes between African-American and Caucasian adolescent mothers. This cross-sectional study examined the intersections of maternal racial status, age, and neighborhood socioeconomic status in explaining these disparities in low birth weight outcomes across a statewide sample of adolescent mothers. Using data from the North Carolina State Center of Health Statistics for 2010-2011, birth cases for 16,472 adolescents were geocoded by street address and linked to census-tract information from the 2010 United States Census. Multilevel models with interaction terms were used to identify significant associations between maternal racial status, age, and neighborhood socioeconomic status (as defined by census-tract median household income) and low birth weight outcomes across census tracts. Significant racial differences were identified in which African-American adolescents had greater odds of low birth weight outcomes than Caucasian adolescents (OR=1.88, 95% CI 1.64, 2.15). Although racial disparities in low birth weight outcomes remained significant in context of maternal age and neighborhood socioeconomic status, the greatest disparities were found between African-American and Caucasian adolescents that lived in areas of higher socioeconomic status (p<.001). Maternal age was not significantly associated with racial differences in low birth weight outcomes. These findings indicate that racial disparities in low birth weight outcomes among adolescent mothers can vary by neighborhood socioeconomic status. Further investigations using intersectional frameworks are needed for examining the relationships between neighborhood socioeconomic status and birth outcome disparities among infants born to adolescent mothers.

12 CFR 626.6005 - Nondiscrimination in lending and other services.

Code of Federal Regulations, 2010 CFR

2010-01-01

..., religion, sex, handicap, familial status, or national origin. (b) No Farm Credit institution may... because of: (1) Race, color, religion, national origin, sex, marital status, or age (provided that the... race, color, religion, sex, handicap, familial status (having one or more children under the age of 18...

12 CFR 626.6005 - Nondiscrimination in lending and other services.

Code of Federal Regulations, 2013 CFR

2013-01-01

... race, color, religion, sex, handicap, familial status (having one or more children under the age of 18..., religion, sex, handicap, familial status, or national origin. (b) No Farm Credit institution may... because of: (1) Race, color, religion, national origin, sex, marital status, or age (provided that the...

12 CFR 626.6005 - Nondiscrimination in lending and other services.

Code of Federal Regulations, 2012 CFR

2012-01-01

... race, color, religion, sex, handicap, familial status (having one or more children under the age of 18..., religion, sex, handicap, familial status, or national origin. (b) No Farm Credit institution may... because of: (1) Race, color, religion, national origin, sex, marital status, or age (provided that the...

12 CFR 626.6005 - Nondiscrimination in lending and other services.

Code of Federal Regulations, 2014 CFR

2014-01-01

... race, color, religion, sex, handicap, familial status (having one or more children under the age of 18..., religion, sex, handicap, familial status, or national origin. (b) No Farm Credit institution may... because of: (1) Race, color, religion, national origin, sex, marital status, or age (provided that the...

12 CFR 626.6005 - Nondiscrimination in lending and other services.

Code of Federal Regulations, 2011 CFR

2011-01-01

... race, color, religion, sex, handicap, familial status (having one or more children under the age of 18..., religion, sex, handicap, familial status, or national origin. (b) No Farm Credit institution may... because of: (1) Race, color, religion, national origin, sex, marital status, or age (provided that the...

Regenerating Eye Tissues to Preserve and Restore Vision.

PubMed

Stern, Jeffrey H; Tian, Yangzi; Funderburgh, James; Pellegrini, Graziella; Zhang, Kang; Goldberg, Jeffrey L; Ali, Robin R; Young, Michael; Xie, Yubing; Temple, Sally

2018-06-01

Ocular regenerative therapies are on track to revolutionize treatment of numerous blinding disorders, including corneal disease, cataract, glaucoma, retinitis pigmentosa, and age-related macular degeneration. A variety of transplantable products, delivered as cell suspensions or as preformed 3D structures combining cells and natural or artificial substrates, are in the pipeline. Here we review the status of clinical and preclinical studies for stem cell-based repair, covering key eye tissues from front to back, from cornea to retina, and including bioengineering approaches that advance cell product manufacturing. While recognizing the challenges, we look forward to a deep portfolio of sight-restoring, stem cell-based medicine. VIDEO ABSTRACT. Copyright © 2018 Elsevier Inc. All rights reserved.

HIV-Positive Mothers With Late Adolescent/Early Adult Children: “Empty Nest” Concerns

PubMed Central

Murphy, Debra A.; Roberts, Kathleen Johnston; Herbeck, Diane M.

2012-01-01

In-depth interviews about the “empty nest” were conducted with 57 HIV-positive mothers of late adolescent/early adult children. Empty nest worries included: (1) identity loss, (2) loss of social support, (3) financial insecurity, (4) worsening of physical health, and (5) death/dying. Hopes included: (1) self-improvement, (2) change of life focus, (3) travel, (4) romantic partners, and (5) familial ties. Respondents’ HIV/AIDS status colored their thoughts/feelings about the empty nest; some worries were specific to being HIV-positive, and would not occur for non-ill mothers. Midlife HIV positive women need healthcare/social service resources as they navigate health and social-psychological challenges to successful aging. PMID:22420679

HIV-positive mothers with late adolescent/early adult children: "empty nest" concerns.

PubMed

Murphy, Debra A; Roberts, Kathleen Johnston; Herbeck, Diane M

2012-01-01

In-depth interviews about the "empty nest" were conducted with 57 HIV-positive mothers of late adolescent/early adult children. Empty nest worries included the following: (a) identity loss, (b) loss of social support, (c) financial insecurity, (d) worsening of physical health, and (e) death/dying. Hopes included the following: (a) self-improvement, (a) change of life focus, (c) travel, (d) romantic partners, and (e) familial ties. Respondents' HIV/AIDS status colored their thoughts/feelings about the empty nest; some worries were specific to being HIV positive and would not occur for nonill mothers. Midlife HIV-positive women need health care/social service resources as they navigate health and social-psychological challenges to successful aging.

Artificial Blood Substitutes: First Steps on the Long Route to Clinical Utility

PubMed Central

Moradi, Samira; Jahanian-Najafabadi, Ali; Roudkenar, Mehryar Habibi

2016-01-01

The 21st century is challenging for human beings. Increased population growth, population aging, generation of new infectious agents, and natural disasters are some threatening factors for the current state of blood transfusion. However, it seems that science and technology not only could overcome these challenges but also would turn many human dreams to reality in this regard. Scientists believe that one of the future evolutionary innovations could be artificial blood substitutes that might pave the way to a new era in transfusion medicine. In this review, recent status and progresses in artificial blood substitutes, focusing on red blood cells substitutes, are summarized. In addition, steps taken toward the development of artificial blood technology and some of their promises and hurdles will be highlighted. However, it must be noted that artificial blood is still at the preliminary stages of development, and to fulfill this dream, ie, to routinely transfuse artificial blood into human vessels, we still have to strengthen our knowledge and be patient. PMID:27812292

Emergency Surgery for Refractory Status Epilepticus.

PubMed

Botre, Abhijeet; Udani, Vrajesh; Desai, Neelu; Jagadish, Spoorthy; Sankhe, Milind

2017-08-15

Management of refractory status epilepticus in children is extremely challenging. Two children with medically refractory status epilepticus, both of whom had lesional pathology on MRI and concordant data on EEG and PET scan. Emergency hemispherotomy performed in both patients. A complete, sustained seizure freedom obtained postoperatively. Emergency surgery is a treatment option in selected cases of drug refractory status epilepticus with lesional pathology and concordant data.

Effects of age and weaning conditions on blood indicators of oxidative status in pigs

PubMed Central

Belloc, Catherine; Leblanc-Maridor, Mily; Merlot, Elodie

2017-01-01

Weaning is a source of social, nutritional and environmental disorders that challenge piglet health. This study assesses the relevance of using plasma indicators of oxidative status as biomarkers of health around weaning in pigs. Blood antioxidant potential (BAP), hydroperoxides (HPO), oxidative stress index (OSI, e.g. HPO/BAP), vitamin A and E concentrations were investigated in two different trials. Trial A was carried out in an experimental unit to investigate the effects of age (from 12 to 147 days of age), weaning (at 21 or 28 days of age) and management at weaning (in optimal (OC) or deteriorated (DC) conditions) on those parameters. Trial B was performed in 16 commercial pig farms to describe the variability of these indicators on field between 26 and 75 days of age. In trial A, between 12 and 147 days of age, HPO globally increased (P < 0.001), vitamin E concentration decreased (P < 0.001) whereas BAP and vitamin A concentration remained relatively stable (P > 0.1). Vitamins E and A concentrations dropped 5 days after weaning independently of weaning age, weaning conditions and expression of diarrhea (P < 0.001). Twelve days after weaning, whatever the weaning age, HPO and OSI increased in DC compared to OC piglets (P = 0.05 and P < 0.01) and in piglets exhibiting diarrhea compared to those without diarrhea (P < 0.01 and P < 0.001). In DC pigs, BAP was also decreased (P < 0.05) 12 days after weaning. On trial B, plasma concentrations of vitamins A and E decreased and HPO increased 5 and 19 days respectively after weaning (P < 0,001). Contrarily to trial A, BAP values did not drop after weaning. Piglets which had the lowest ADG (Average Daily Gain) after weaning had greater HPO and OSI and lower vitamin A and E concentrations after weaning but also lower vitamin E concentration before weaning (P < 0.05). In conclusion, HPO or OSI seem to be good indicators of health disorders around weaning and plasma concentration of vitamin E before weaning is associated to growth after weaning. PMID:28542567

The Computational Fluid Dynamics Rupture Challenge 2013—Phase I: prediction of rupture status in intracranial aneurysms.

PubMed

Janiga, G; Berg, P; Sugiyama, S; Kono, K; Steinman, D A

2015-03-01

Rupture risk assessment for intracranial aneurysms remains challenging, and risk factors, including wall shear stress, are discussed controversially. The primary purpose of the presented challenge was to determine how consistently aneurysm rupture status and rupture site could be identified on the basis of computational fluid dynamics. Two geometrically similar MCA aneurysms were selected, 1 ruptured, 1 unruptured. Participating computational fluid dynamics groups were blinded as to which case was ruptured. Participants were provided with digitally segmented lumen geometries and, for this phase of the challenge, were free to choose their own flow rates, blood rheologies, and so forth. Participants were asked to report which case had ruptured and the likely site of rupture. In parallel, lumen geometries were provided to a group of neurosurgeons for their predictions of rupture status and site. Of 26 participating computational fluid dynamics groups, 21 (81%) correctly identified the ruptured case. Although the known rupture site was associated with low and oscillatory wall shear stress, most groups identified other sites, some of which also experienced low and oscillatory shear. Of the 43 participating neurosurgeons, 39 (91%) identified the ruptured case. None correctly identified the rupture site. Geometric or hemodynamic considerations favor identification of rupture status; however, retrospective identification of the rupture site remains a challenge for both engineers and clinicians. A more precise understanding of the hemodynamic factors involved in aneurysm wall pathology is likely required for computational fluid dynamics to add value to current clinical decision-making regarding rupture risk. © 2015 by American Journal of Neuroradiology.

Ten commandments for the future of ageing research in the UK: a vision for action

PubMed Central

Franco, Oscar H; Kirkwood, Thomas BL; Powell, Jonathan R; Catt, Michael; Goodwin, James; Ordovas, Jose M; van der Ouderaa, Frans

2007-01-01

Increases in longevity resulting from improvements in health care and living conditions together with a decrease in fertility rates have contributed to a shift towards an aged population profile. For the first time the UK has more people over age 60 than below 16 years of age. The increase in longevity has not been accompanied by an increase in disease-free life expectancy and research into ageing is required to improve the health and quality of life of older people. However, as the House of Lords reported, ageing research in the UK is not adequately structured and a clear vision and plan are urgently required. Hence, with the aim of setting a common vision for action in ageing research in the UK, a 'Spark Workshop' was organised. International experts from different disciplines related to ageing research gathered to share their perspectives and to evaluate the present status of ageing research in the UK. A detailed assessment of potential improvements was conducted and the prospective secondary gains were considered, which were subsequently distilled into a list of 'ten commandments'. We believe that these commandments, if followed, will help to bring about the necessary implementation of an action plan for ageing research in the UK, commensurate with the scale of the challenge, which is to transform the manifold opportunities of increased longevity into actual delivery of a society living not only for longer, but also healthier, wealthier and happier. PMID:17477869

Maternal well-being and child behavior in families with fragile X syndrome.

PubMed

Hauser, Claire T; Kover, Sara T; Abbeduto, Leonard

2014-10-01

The purpose of this study was to examine the bidirectional relationships relationship between maternal mental health status, maternal stress, family environment and behavioral functioning of children with fragile X syndrome (FXS), the leading cause of inherited intellectual disability. Children with FXS commonly demonstrate challenging behavior related to anxiety, attention, and aggression, whereas mothers of children with FXS have been identified as susceptible to mental health challenges due to their status as genetic carriers of the FXS premutation, as well as the environmental stressors of raising children with special needs. The longitudinal design of this study builds upon prior work that established a concurrent relationship among these factors in families of children with other intellectual disorders. Findings indicated that maternal mental health status was not significantly related to changes in levels of child challenging behavior, heightened child challenging behavior was related to improvements in maternal depression over time, and heightened levels of child challenging behavior was related to increased feelings of maternal closeness toward the child over time. The unexpected nature of the results regarding maternal depression and closeness provides new and more complex hypotheses about how mothers of special needs children demonstrate adaptation and resilience. The findings have implications for maternal and familial mental health treatment as well as future research. Copyright © 2014 Elsevier Ltd. All rights reserved.

[ASSOCIATION BETWEEN HEALTH RELATED QUALITY OF LIFE, BODYWEIGHT STATUS (BMI) AND PHYSICAL ACTIVITY AND FITNESS LEVELS IN CHILEAN ADOLESCENTS].

PubMed

García-Rubio, Javier; Olivares, Pedro R; Lopez-Legarrea, Patricia; Gómez-Campos, Rossana; Cossio-Bolaños, Marco A; Merellano-Navarro, Eugenio

2015-10-01

the objective of this study was to analyze the potential relationships between Health Related Quality of Life (HRQoL) with weight status, physical activity (PA) and fitness in Chilean adolescents in both, independent and combined analysis. a sample of 767 participants (47.5% females) and aged between 12 and 18 (mean age 15.5) was employed. All measurements were carried out using selfreported instruments and Kidscreen-10, iPAQ and IFIS were used to assess HRQoL, PA and Fitness respectively. One factor ANOVA and linear regression models were applied to analyze associations between HRQoL, weight status, PA and fitness using age and sex as confounders. body mass index, level of PA and fitness were independently associated with HRQoL in Chilean adolescents. However, the combined and adjusted by sex and age analysis of these associations showed that only the fitness was significantly related with HRQoL. general fitness is associated with HRQoL independently of sex, age, bodyweight status and level of PA. The relationship between nutritional status and weekly PA with HRQoL are mediated by sex, age and general fitness. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

Age and Functional Health Status

DTIC Science & Technology

1989-06-01

age groups. However, decrements in functional health status occurred selectively among older individuals with many of the elderly scoring as well as...Illinois adults (18 and above) were asked to assess their health compared to others their age , only those 61 and older rated their health as better than...and more variable physical functioning, role functioning,, and perceived health in older age groups, particularly those groups aged 50 and

“Do Changes in Spousal Employment Status Lead to Domestic Violence? Insights from a Prospective Study in Bangalore, India”

PubMed Central

Rocca, Corinne H; Hubbard, Alan E; Subbiah, Kalyani; Edmeades, Jeffrey; Padian, Nancy S

2009-01-01

The prevalence of physical domestic violence – violence against women perpetrated by husbands – is staggeringly high across the Indian subcontinent. Although gender-based power dynamics are thought to underlie women's vulnerability, relatively little is known about risk and protective factors. This prospective study in southern India examined the association between key economic aspects of gender-based power, namely spousal employment status, and physical domestic violence. In 2005-2006, 744 married women, aged 16-25, residing in low-income communities in Bangalore, India were enrolled in the study. Data were collected at enrolment, 12 and 24 months. Multivariable logistic regression models were used to examine the prospective association between women's employment status, their perceptions of their husband's employment stability, and domestic violence. Women who were unemployed at one visit and began employment by the next visit had an 80% higher odds of violence, as compared to women who maintained their unemployed status. Similarly, women whose husbands had stable employment at one visit and newly had difficulty with employment had 1.7 times the odds of violence, as compared to women whose husbands maintained their stable employment. To our knowledge, this study is the first from a developing country to confirm that changes in spousal employment status are associated with subsequent changes in violence risk. It points to the complex challenges of violence prevention, including the need for interventions among men and gender transformative approaches to promote gender-equitable attitudes, practices and norms among men and women. PMID:19828220

The status of Iranian hospital pharmacies according to age-friendly pharmacies criteria

PubMed Central

Bastani, Peivand; Marzaleh, Milad Ahmadi; Dehghani, Mina; Falahatzadeh, Maryam; Rahmati, Elahe; Tahernezhad, Ali

2017-01-01

Due to the increasing elderly population and the subsequent increase in their need for medication and more referrals to the pharmacy, this study was conducted to investigate the Iranian hospital pharmacies in terms of age-friendliness criteria. This was a cross-sectional study conducted in 2017. The study population included 3 metropolitan hospital pharmacies selected through clustered sampling, and all their 67 pharmacies were included by census. Data collection tool was a reliable researcher-made checklist (t = 0.85, α = 0.9) Data analysis was performed using Kruskal–Wallis test and Mann–Whitney test through SPSS version 24. The results in these three cities showed that only two pharmacies were in a high level of age-friendly. The relationship between type of pharmacy and the final score of age-friendly situation in these cities showed no significant relationship. There was no significant relationship among the average of the final score of the age-friendly situation in three studied cities. Due to the increasing elderly population and the aging society, readiness of Iranian hospital pharmacies to provide services to the elderly will be one of the most challenging issues in the long term. With proper legislation and policies on health-care systems, especially pharmacies, physical and psychological problems in elderly can be reduced in the future. Furthermore, with advancing toward age-friendly pharmacies, the community can be empower and become ready encountering elderly problems. PMID:29184842

Age-specific oxidative status and the expression of pre- and postcopulatory sexually selected traits in male red junglefowl, Gallus gallus

PubMed Central

Noguera, Jose C; Dean, Rebecca; Isaksson, Caroline; Velando, Alberto; Pizzari, Tommaso

2012-01-01

Oxidative stress is emerging as a key factor underpinning life history and the expression of sexually selected traits. Resolving the role of oxidative stress in life history and sexual selection requires a pluralistic approach, which investigates how age affects the relationship between oxidative status (i.e., antioxidants and oxidative damage) and the multiple traits contributing to variation in reproductive success. Here, we investigate the relationship between oxidative status and the expression of multiple sexually selected traits in two-age classes of male red junglefowl, Gallus gallus, a species which displays marked male reproductive senescence. We found that, irrespective of male age, both male social status and comb size were strongly associated with plasma oxidative status, and there was a nonsignificant tendency for sperm motility to be associated with seminal oxidative status. Importantly, however, patterns of plasma and seminal antioxidant levels differed markedly in young and old males. While seminal antioxidants increased with plasma antioxidants in young males, the level of seminal antioxidants remained low and was independent of plasma levels in old males. In addition, old males also accumulated more oxidative damage in their sperm DNA. These results suggest that antioxidant allocation across different reproductive traits and somatic maintenance might change drastically as males age, leading to age-specific patterns of antioxidant investment. PMID:23139875

Seizure drawings: insight into the self-image of children with epilepsy.

PubMed

Stafstrom, Carl E; Havlena, Janice

2003-02-01

Epilepsy is a chronic disorder that is associated with numerous psychological challenges, especially in children. Drawings have been underutilized as a method to obtain insight into psychological issues in children with epilepsy. We asked 105 children with epilepsy, ages 5 to 18 years, to draw a picture of what it is like to have a seizure. Across ages and epilepsy syndromes, the drawings showed evidence of impaired self-concept, low self-esteem, and a sense of helplessness and vulnerability. Overall, the drawings of human figures were less developed than expected for chronological age. In some drawings, indicators of underlying depression were found. When considered by epilepsy syndrome or seizure type, some specific artistic features were noted. Children with simple partial (motor) seizures drew distorted body parts, especially limbs. Those with complex partial seizures depicted sensory symptoms and mental status changes such as confusion. Children with generalized tonic-clonic seizures showed shaking extremities. Drawings by children with absence seizures illustrated mainly staring. In conclusion, drawings are a powerful method to examine the self-concept of children with epilepsy and gain insight into their feelings about themselves and their world.

Sociometric Stability and the Behavioral Correlates of Peer Acceptance in Early Childhood

ERIC Educational Resources Information Center

Walker, Sue

2009-01-01

The author presents findings from an Australian study examining the behavioral correlates and stability of social status among preschool-aged children. Using sociometric assessment, the author determined the social status of an initial sample of 187 preschool-aged children (94 boys, 93 girls; M age = 62.4 months, SD age = 4.22 months). The author…

Impact of litter Salmonella status during feed withdrawal on Salmonella recovery from the broiler crop and ceca.

PubMed

Buhr, R J; Bourassa, D V; Hinton, A; Fairchild, B D; Ritz, C W

2017-12-01

Research was conducted to evaluate the impact of litter Salmonella status during feed withdrawal on Salmonella recovery from the crop and ceca following feed withdrawal. In 4 experiments, pens of broilers in separate rooms were challenged with marker strains of either Salmonella Montevideo or Salmonella Heidelberg. Three d post challenge, a 12-hour feed withdrawal was initiated, and one pen of broilers was switched between rooms for each Salmonella serotype. In experiments 3 and 4, non-challenged broilers also were added to the Salmonella challenge pens. The litter of each pen was sampled before and after the feed withdrawal period, the broilers euthanized, and the crop and ceca aseptically removed for Salmonella isolation. Results showed that only the challenge Salmonella serotype was recovered from the litter in challenge pens where broilers were not moved, while both Salmonella serotypes were recovered from the litter of the switched pens. Salmonella was recovered from 56/80 crops and from 66/80 ceca of challenged broilers that remained in the challenge pens. The challenge Salmonella serotype was recovered from 50/80 crops and from 60/80 ceca, and the switched pens' litter Salmonella serotype was recovered from 19/80 crops but not from the ceca in broilers challenged with Salmonella and then switched between pens. For experiments 3 and 4, Salmonella was recovered from 19/40 crops and from only 2/40 ceca from the non-challenged broilers placed into the Salmonella challenge pens. The results from broilers that were switched between Salmonella challenge pens indicate that the recovery of Salmonella from the crop of broilers following feed withdrawal (on Salmonella-contaminated litter) appears to depend mainly on the initial challenge Salmonella (62%) and less on the litter Salmonella (24%) status during the feed withdrawal period. In contrast, only the initial challenge Salmonella was recovered from the ceca (79%) from broilers that remained in challenge pens or were switched between Salmonella challenge pens. However, when non-challenged broilers were placed into the Salmonella challenge pens and commingled during the 12-hour feed and water withdrawal period, it was possible to recover the pen litter Salmonella from the ceca at a low level of 5% (2/40). Published by Oxford University Press on behalf of Poultry Science Association 2017.

Nutritional risk and anthropometric evaluation in pediatric liver transplantation.

PubMed

Zamberlan, Patrícia; Leone, Cláudio; Tannuri, Uenis; Carvalho, Werther Brunow de; Delgado, Artur Figueiredo

2012-12-01

To analyze the nutritional status of pediatric patients after orthotopic liver transplantation and the relationship with short-term clinical outcome. Anthropometric evaluations of 60 children and adolescents after orthotopic liver transplantation, during the first 24 hours in a tertiary pediatric intensive care unit. Nutritional status was determined from the Z score for the following indices: weight/age height/age or length/age, weight/height or weight/length, body mass index/age, arm circumference/age and triceps skinfold/age. The severity of liver disease was evaluated using one of the two models which was adequated to the patients' age: 1. Pediatric End-stage Liver Disease, 2. Model for End-Stage Liver Disease. We found 50.0% undernutrition by height/age; 27.3% by weight/age; 11.1% by weight/height or weight/ length; 10.0% by body mass index/age; 61.6% by arm circumference/age and 51.0% by triceps skinfold/age. There was no correlation between nutritional status and Pediatric End-stage Liver Disease or mortality. We found a negative correlation between arm circumference/age and length of hospitalization. Children with chronic liver diseases experience a significant degree of undernutrition, which makes nutritional support an important aspect of therapy. Despite the difficulties in assessment, anthropometric evaluation of the upper limbs is useful to evaluate nutritional status of children before or after liver transplantation.

Speed of Heart Rate Recovery in Response to Orthostatic Challenge.

PubMed

McCrory, Cathal; Berkman, Lisa F; Nolan, Hugh; O'Leary, Neil; Foley, Margaret; Kenny, Rose Anne

2016-08-19

Speed of heart rate recovery (HRR) may serve as an important biomarker of aging and mortality. To examine whether the speed of HRR after an orthostatic maneuver (ie, active stand from supine position) predicts mortality. A longitudinal cohort study involving a nationally representative sample of community-dwelling older individuals aged ≥50 years. A total of 4475 participants completed an active stand at baseline as part of a detailed clinic-based cardiovascular assessment. Beat-to-beat heart rate and blood pressure responses to standing were measured during a 2-minute window using a finometer and binned in 10-s intervals. We modeled HRR to the stand by age group, cardiovascular disease burden, and mortality status using a random effects model. Mortality status during a mean follow-up duration of 4.3 years served as the primary end point (n=138). Speed of HRR in the immediate 20 s after standing was a strong predictor of mortality. A 1-bpm slower HRR between 10 and 20 s after standing increased the hazard of mortality by 6% controlling for established risk factors. A clear dose-response relationship was evident. Sixty-nine participants in the slowest HRR quartile died during the observation period compared with 14 participants in the fastest HRR quartile. Participants in the slowest recovery quartile were 2.3× more likely to die compared with those in the fastest recovery quartile. Speed of orthostatic HRR predicts mortality and may aid clinical decision making. Attenuated orthostatic HRR may reflect dysregulation of the parasympathetic branch of the autonomic nervous system. © 2016 American Heart Association, Inc.

Hematology of southern Beaufort Sea polar bears (2005-2007): biomarker for an Arctic ecosystem health sentinel.

PubMed

Kirk, Cassandra M; Amstrup, Steven; Swor, Rhonda; Holcomb, Darce; O'Hara, Todd M

2010-09-01

Declines in sea-ice habitats have resulted in declining stature, productivity, and survival of polar bears in some regions. With continuing sea-ice declines, negative population effects are projected to expand throughout the polar bear's range. Precise causes of diminished polar bear life history performance are unknown, however, climate and sea-ice condition change are expected to adversely impact polar bear (Ursus maritimus) health and population dynamics. As apex predators in the Arctic, polar bears integrate the status of lower trophic levels and are therefore sentinels of ecosystem health. Arctic residents feed at the apex of the ecosystem, thus polar bears can serve as indicators of human health in the Arctic. Despite their value as indicators of ecosystem welfare, population-level health data for U.S. polar bears are lacking. We present hematological reference ranges for southern Beaufort Sea polar bears. Hematological parameters in southern Beaufort Sea polar bears varied by age, geographic location, and reproductive status. Total leukocytes, lymphocytes, monocytes, eosinophils, and serum immunoglobulin G were significantly greater in males than females. These measures were greater in nonlactating females ages ≥5, than lactating adult females ages ≥5, suggesting that females encumbered by young may be less resilient to new immune system challenges that may accompany ongoing climate change. Hematological values established here provide a necessary baseline for anticipated changes in health as arctic temperatures warm and sea-ice declines accelerate. Data suggest that females with dependent young may be most vulnerable to these changes and should therefore be a targeted cohort for monitoring in this sentinel.

State and trait anxiety levels of adolescents in a changing society, Kirikkale city, Turkey.

PubMed

Oğuztürk, Ömer; Bülbül, Selda Hızel; Özen, Nurper Erberk; Ekici, Mehmet; Örnek, Kemal; Ünlü, Erdal; Yüksel, Serhat

2012-06-01

Adolescents face rapidly changing challenges. Psychosocial health problems during adolescence are relatively common in all cultures. This study was designed to evaluate the state and trait anxiety status and influencing sociodemographic and other factors, thought to pertain to youth, on anxiety among school children in Kirikkale. It was carried out at three public primary and two high schools representative of two different socioeconomic statuses. 430 Turkish school children (246 girls, 184 boys) were asked voluntarily to answer a set of questionnaires in their classrooms at the beginning of a training programme. Then the State and Trait Anxiety Inventory for Children was administered. Mean age of the students was 14.16 ± 1.87 years. The mean total STAI-CS and STAI-CT scores were 40.24 ± 11.64, and 44.71 ± 9.64, respectively. There were no differences in STAI-CS and STAI-CT scores between boys and girls in both schools and in all age groups. Among girls, a positive body image had a significant effect on state anxiety scores. There was a positive correlation between age and anxiety scores (r = .17, F:12.176, p < .001). Students identifying their families SES as bad and/or moderate scored significantly higher in comparison to the other groups (p < .05). STAI-CS scores were higher for lower educational grade, higher body weight and sleep problems. In Kirikkale, a city faced with substantial changes in cultural and traditional norms, adolescents could be expected to be under stress and appear to be responding to stress with anxiety.

Change in Coping and Defense Mechanisms across Adulthood: Longitudinal Findings in a European-American Sample

PubMed Central

Diehl, Manfred; Chui, Helena; Hay, Elizabeth L.; Lumley, Mark A.; Grühn, Daniel; Labouvie-Vief, Gisela

2014-01-01

This study examined longitudinal changes in coping and defense mechanisms in an age- and gender-stratified sample of 392 European-American adults. Nonlinear age-related changes were found for the coping mechanisms of sublimation and suppression and the defense mechanisms of intellectualization, doubt, displacement, and regression. The change trajectories for sublimation and suppression showed that their use increased from adolescence to late middle age and early old age, and remained mostly stable into late old age. The change trajectory for intellectualization showed that the use of this defense mechanism increased from adolescence to middle age, remained stable until late midlife, and started to decline thereafter. The defense mechanisms of doubt, displacement, and regression showed decreases from adolescence until early old age, with increases occurring again after the age of 65. Linear age-related decreases were found for the coping mechanism of ego regression and the defense mechanisms of isolation and rationalization. Gender and socioeconomic status were associated with the mean levels of several coping and defense mechanisms, but did not moderate age-related changes. Increases in ego level were associated with increased use of the defense mechanism intellectualization and decreased use of the defense mechanisms of doubt and displacement. Overall, these findings in a European-American sample suggest that most individuals showed development in the direction of more adaptive and less maladaptive coping and defense strategies from adolescence until late middle age or early old age. However, in late old age this development was reversed, presenting potential challenges to the adaptive capacity of older adults. PMID:23834293

Self-Control Protects Against Overweight Status in the Transition from Childhood to Adolescence

PubMed Central

Tsukayama, Eli; Toomey, Sara L.; Faith, Myles; Duckworth, Angela Lee

2010-01-01

Objective To determine whether more self-controlled children are protected from weight gain as they enter adolescence. Design Prospective, longitudinal study. Setting Ten sites across the United States from 1991-2007. Participants The 844 children in the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development birth cohort who had height and weight information at age 15 (in 2006). Main Exposure A composite measure of self-control was created from mother, father, and teacher-report ratings using items from the Social Skills Rating System. Main Outcome Measure Overweight status at age 15 years. Results Approximately one-third of the sample (n = 262) was overweight at age 15. Compared to their non-overweight peers, overweight adolescents at age 15 were about a half-standard deviation lower in self-control at age 9 (unstandardized difference = 0.15, pooled SD = 0.29, P < .001). Children rated higher by their parents and teachers in self-control at age 9 were less likely to be overweight at age 15 (RR, 0.74; 95% CI, 0.56-0.98), controlling for overweight status at age 10, pubertal development, age, IQ, gender, ethnicity, socioeconomic status, and maternal overweight status. Conclusion More self-controlled boys and girls are less likely to become overweight as they enter adolescence. The ability to control impulses and delay gratification enables children to maintain a healthy weight even in today's obesogenic environment. PMID:20603463

International Student Mental Health

ERIC Educational Resources Information Center

Prieto-Welch, Susan L.

2016-01-01

This chapter describes the mental health status of international students in institutions of higher education, unique challenges these students face and their impact on mental health, and suggestions for ways to address these challenges.

The impact of individual characteristics in self-esteem and locus of control of young adults with visual impairments.

PubMed

Papadopoulos, Konstantinos

2014-03-01

In this study the impact of personal/individual characteristics (gender, vision status, age, age at loss of sight, recency of vision loss, education level, employment status, and ability of independent movement) in locus of control (LOC) and self-esteem were examined. Eighty-four young adults with visual impairments (42 with blindness and 42 with low vision) took part in this study. The significant predictors of self-esteem were vision status, age at loss of sight, recency of vision loss and educational level. Moreover, significant predictors of LOC were vision status and independent movement. Copyright © 2014 Elsevier Ltd. All rights reserved.

Investigating the Visual-Motor Integration Skills of 60-72-Month-Old Children at High and Low Socio-Economic Status as Regard the Age Factor

ERIC Educational Resources Information Center

Ercan, Zülfiye Gül; Ahmetoglu, Emine; Aral, Neriman

2011-01-01

This study aims to define whether age creates any differences in the visual-motor integration skills of 60-72 months old children at low and high socio-economic status. The study was conducted on a total of 148 children consisting of 78 children representing low socio-economic status and 70 children representing high socio-economic status in the…

Infant temperament: stability by age, gender, birth order, term status, and socioeconomic status.

PubMed

Bornstein, Marc H; Putnick, Diane L; Gartstein, Maria A; Hahn, Chun-Shin; Auestad, Nancy; O'Connor, Deborah L

2015-01-01

Two complementary studies focused on stability of infant temperament across the 1st year and considered infant age, gender, birth order, term status, and socioeconomic status (SES) as moderators. Study 1 consisted of 73 mothers of firstborn term girls and boys queried at 2, 5, and 13 months of age. Study 2 consisted of 335 mothers of infants of different gender, birth order, term status, and SES queried at 6 and 12 months. Consistent positive and negative affectivity factors emerged at all time points across both studies. Infant temperament proved stable and robust across gender, birth order, term status, and SES. Stability coefficients for temperament factors and scales were medium to large for shorter (< 9 months) interassessment intervals and small to medium for longer (> 10 months) intervals. Published 2015. This article is a U.S. Government work and is in the public domain in the USA.

Prevalence of overweight/obesity and economical status of schoolchildren.

PubMed

Azambuja, Ana Paula de O; Netto-Oliveira, Edna Regina; de Oliveira, Amauri Aparecido B; Azambuja, Maximiliano dos Anjos; Rinaldi, Wilson

2013-06-01

To associate the nutritional status of elementary schoolchildren with their gender, age group, and economic status based on a cross-sectional study carried out at public schools in the municipality of Cruzeiro do Oeste, Southern Brazil. The study was performed in 2010 including 939 schoolchildren aged six to ten years-old. The economical status of the families was classified based on a socioeconomic ranking questionnaire (Brazilian Association of Survey Companies), and the body mass index was calculated. Data were analyzed by descriptive statistics, and differences between independent groups were verified by Mann-Whitney and Kruskal-Wallis tests, while possible associations were verified by the chi-square test, being significant p<0.05. The prevalence of obesity in the sample was 8.0%, and overweight, 16.4%. No association was found between the socioeconomic and nutritional status or between the nutritional status and gender. A high prevalence of overweight and obesity was found in this study, indicating that children of both genders are affected regardless of their economical status and age.

Socioeconomic status, anthropometric status, and psychomotor development of Kenyan children from resource-limited settings: A path-analytic study

PubMed Central

Abubakar, Amina; de Vijver, Fons Van; Baar, Anneloes Van; Mbonani, Leonard; Kalu, Raphael; Newton, Charles; Holding, Penny

2014-01-01

Background Sub-optimal physical growth has been suggested as a key pathway between the effect of environmental risk and developmental outcome. Aim To determine if anthropometric status mediates the relation between socioeconomic status and psychomotor development of young children in resource-limited settings. Study design A cross-sectional study design was used. Subjects A total of 204 (105 girls) children from two resource-limited communities in the Coast Province, Kenya. The mean age of these children was 29 months (SD=3.43; range: 24–35 months). Outcome measure Psychomotor functioning was assessed using a locally developed and validated measure, the Kilifi Developmental Inventory. Results A significant association was found between anthropometric status (as measured by weight-for-age, height-for-age, mid-upper arm circumference, and head circumference) and psychomotor functioning and also between socioeconomic status and anthropometric status; no direct effects were found between socioeconomic status and developmental outcome. The models showed that weight, height and to a lesser extent mid-upper arm circumference mediate the relation between socioeconomic status and developmental outcome, while head circumference did not show the same effect. Conclusion Among children under 3 years living in poverty, anthropometric status shows a clear association with psychomotor development while socioeconomic status may only have an indirect association. PMID:18499363

Total antioxidant/oxidant status in meningism and meningitis.

PubMed

Aycicek, Ali; Iscan, Akin; Erel, Ozcan; Akcali, Mustafa; Selek, Sahbettin

2006-12-01

The objective of this study was to investigate the antioxidant/oxidant status of serum and cerebrospinal fluid in children with meningismus and acute bacterial meningitis. Twenty-three children (age range, 0.75 to 9 years) with fever and meningeal signs that required analysis of the cerebrospinal fluid, but no cytologic or biochemical evidence of meningitis in their serum and cerebrospinal fluid, constituted the meningismus group. Thirty-one children (age range, 0.5 to 10 years) with acute bacterial meningitis constituted the meningitis group. Twenty-nine healthy children (age range, 0.5 to 11 years) were recruited as control subjects. Antioxidant status (ascorbic acid, albumin, thiol, uric acid, total bilirubin, total antioxidant capacity, catalase and ceruloplasmin concentrations) and oxidant status (lipid hydroperoxide and total oxidant status) were measured. The serum antioxidant status was lower, and oxidant status levels higher in both meningitis and meningismus subjects than in the control children (P < 0.001). Cerebrospinal fluid oxidant status was lower in the meningitis group than in the meningismus group (P < 0.05). These results indicate that serum antioxidant status was lower, and serum oxidant status was higher in children in the meningismus and meningitis groups, whereas cerebrospinal fluid oxidant status was higher in the meningismus group than in the meningitis group.

Inflammation, aging, and cancer: tumoricidal versus tumorigenesis of immunity: a common denominator mapping chronic diseases.

PubMed

Khatami, Mahin

2009-01-01

Acute inflammation is a highly regulated defense mechanism of immune system possessing two well-balanced and biologically opposing arms termed apoptosis ('Yin') and wound healing ('Yang') processes. Unresolved or chronic inflammation (oxidative stress) is perhaps the loss of balance between 'Yin' and 'Yang' that would induce co-expression of exaggerated or 'mismatched' apoptotic and wound healing factors in the microenvironment of tissues ('immune meltdown'). Unresolved inflammation could initiate the genesis of many age-associated chronic illnesses such as autoimmune and neurodegenerative diseases or tumors/cancers. In this perspective 'birds' eye' view of major interrelated co-morbidity risk factors that participate in biological shifts of growth-arresting ('tumoricidal') or growth-promoting ('tumorigenic') properties of immune cells and the genesis of chronic inflammatory diseases and cancer will be discussed. Persistent inflammation is perhaps a common denominator in the genesis of nearly all age-associated health problems or cancer. Future challenging opportunities for diagnosis, prevention, and/or therapy of chronic illnesses will require an integrated understanding and identification of developmental phases of inflammation-induced immune dysfunction and age-associated hormonal and physiological readjustments of organ systems. Designing suitable cohort studies to establish the oxido-redox status of adults may prove to be an effective strategy in assessing individual's health toward developing personal medicine for healthy aging.

Happy Aged People Are All Alike, While Every Unhappy Aged Person Is Unhappy in Its Own Way

PubMed Central

Tumminello, Michele; Miccichè, Salvatore; Dominguez, Ligia J.; Lamura, Giovanni; Melchiorre, Maria Gabriella; Barbagallo, Mario; Mantegna, Rosario N.

2011-01-01

Aging of the world's population represents one of the most remarkable success stories of medicine and of humankind, but it is also a source of various challenges. The aim of the collaborative cross-cultural European study of adult well being (ESAW) is to frame the concept of aging successfully within a causal model that embraces physical health and functional status, cognitive efficacy, material security, social support resources, and life activity. Within the framework of this project, we show here that the degree of heterogeneity among people who view aging in a positive light is significantly lower than the degree of heterogeneity of those who hold a negative perception of aging. We base this conclusion on our analysis of a survey involving 12,478 people aged 50 to 90 from six West European countries. We treat the survey database as a bipartite network in which individual respondents are linked to the actual answers they provide. Taking this perspective allows us to construct a projected network of respondents in which each link indicates a statistically validated similarity of answers profile between the connected respondents, and to identify clusters of individuals independently of demographics. We show that mental and physical well-being are key factors determining a positive perception of aging. We further observe that psychological aspects, like self-esteem and resilience, and the nationality of respondents are relevant aspects to discriminate among participants who indicate positive perception of aging. PMID:21931596

Modernization in Bali, Indonesia and the influence of socio-economic factors on the nutritional status of preschool children in 1989/1990: an anthropometric study.

PubMed

Huntsman, A C; White, N G

2007-01-01

Bali has undergone rapid economic modernization over the past 30 years, however, very few anthropometric studies have examined the impact of modernization variables on the nutritional status of Balinese children. The study examined the relationships between variables associated with the modernization process on the nutritional status of Balinese children in 1989/1990, as assessed by anthropometrics. The mean height-for-age, weight-for-height and weight-for-age of 691 preschool children from nine localities across Bali were reported by age group and gender and related to the degree of modernization (using such parameters as household wealth and education level of the mother) and other variables such as the age, weight and height of the mother. Using the CDC/WHO 1978 growth references (Dibley et al. 1978), overall 35% of children were stunted (height-for-age <-2 SD), 22% were underweight (weight-for-age <-2 SD), 5% were wasted (weight-for-height <-2 SD) and 6% were overweight (weight-for-height >2 SD). The nutritional status of infants was significantly better than that of older children with growth faltering most evident during the second year of life. Maternal height and weight, the age of the child and wealth index were significantly associated with height-for-age of children, while the age of the child, maternal weight and family size were significantly associated with weight-for-height and weight-for-age of children. Maternal height and weight, wealth index and the age of the child were key factors influencing the body size for age of Balinese children. The strong association between maternal and child nutritional status was most likely due to environmental rather than genetic factors.

A system for classifying disease comorbidity status from medical discharge summaries using automated hotspot and negated concept detection.

PubMed

Ambert, Kyle H; Cohen, Aaron M

2009-01-01

OBJECTIVE Free-text clinical reports serve as an important part of patient care management and clinical documentation of patient disease and treatment status. Free-text notes are commonplace in medical practice, but remain an under-used source of information for clinical and epidemiological research, as well as personalized medicine. The authors explore the challenges associated with automatically extracting information from clinical reports using their submission to the Integrating Informatics with Biology and the Bedside (i2b2) 2008 Natural Language Processing Obesity Challenge Task. DESIGN A text mining system for classifying patient comorbidity status, based on the information contained in clinical reports. The approach of the authors incorporates a variety of automated techniques, including hot-spot filtering, negated concept identification, zero-vector filtering, weighting by inverse class-frequency, and error-correcting of output codes with linear support vector machines. MEASUREMENTS Performance was evaluated in terms of the macroaveraged F1 measure. RESULTS The automated system performed well against manual expert rule-based systems, finishing fifth in the Challenge's intuitive task, and 13(th) in the textual task. CONCLUSIONS The system demonstrates that effective comorbidity status classification by an automated system is possible.

Homebound older persons: Prevalence, characteristics, and longitudinal predictors

PubMed Central

Cohen-Mansfield, Jiska; Shmotkin, Dov; Hazan, Haim

2011-01-01

The current study examines the prevalence and correlates of homebound status aiming to elucidate the predictors and implications of being homebound. Analyzed sample was drawn from two representative cohorts of older persons in Israel, including 1191 participants (mean age = 83.10 ± 5.3 years) of the first wave of the Cross-Sectional and Longitudinal Aging Study (CALAS) and 418 participants (mean age = 83.13 ± 5.2) of the Israeli Multidisciplinary Aging Study (IMAS). Cross-sectional and longitudinal analyses were conducted. Homebound prevalence rates of 17.7% -19.5% were found. Homebound participants tended to be older, female, have obese or underweight body mass index (BMI), poorer health, lower functional status, less income, higher depressed affect, were significantly lonelier (in CALAS), and more likely to have stairs and no elevators, than their counterparts. Predictors of becoming homebound include low functional IADL status, having stairs and no elevator (in both cohorts), old age, female gender, and being obese or underweight (in CALAS). The study shows homebound status is a prevalent problem in old-old Israelis. Economic and socio-demographic resources, environment, and function play a role in determining the older person's homebound status. Implications for preventing homebound status and mitigating its impact with regards to the Israeli context are discussed. PMID:21420181

Prevalence of Smoking and Obesity Among U.S. Cancer Survivors: Estimates From the National Health Interview Survey, 2008-2012.

PubMed

Shoemaker, Meredith L; White, Mary C; Hawkins, Nikki A; Hayes, Nikki S

2016-07-01

To describe smoking and obesity prevalence among male and female cancer survivors in the United States.
. Cross-sectional survey.
. Household interviews.
. 9,753 survey respondents who reported ever having a malignancy, excluding nonmelanoma skin cancers. 
. Data from the National Health Interview Survey (2008-2012) were used to calculate weighted smoking status prevalence estimates. Cross-tabulations of smoking and weight status were produced, along with Wald chi-square tests and linear contrasts.
. Cancer history, smoking status, obesity status, gender, age, and age at diagnosis.
. Seventeen percent of cancer survivors reported current smoking. Female survivors had higher rates of current smoking than males, particularly in the youngest age category. Male survivors who currently smoked had lower obesity prevalence rates than males who previously smoked or never smoked. Among female survivors, 31% were obese and no significant differences were seen in obesity prevalence by smoking status for all ages combined. 
. The findings highlight the variation in smoking status and weight by age and gender. Smoking interventions may need to be targeted to address barriers specific to subgroups of cancer survivors.
. Nurses can be instrumental in ensuring that survivors receive comprehensive approaches to address both weight and tobacco use to avoid trading one risk for another.

Perfluoroalkyl substances and glycemic status in pregnant Danish women: The Odense Child Cohort.

PubMed

Jensen, Richard Christian; Glintborg, Dorte; Timmermann, Clara Amalie Gade; Nielsen, Flemming; Kyhl, Henriette Boye; Andersen, Helle Raun; Grandjean, Philippe; Jensen, Tina Kold; Andersen, Marianne

2018-07-01

Perfluoroalkyl substances (PFASs) are persistent chemicals with suspected endocrine disrupting abilities applied in consumer products. PFASs have potentially modulating effects on glucose homeostasis. Insulin resistance prevails during third trimester of pregnancy, and this challenge of glucose homeostasis may reveal putative effects of PFAS concentrations on glycemic status. To investigate associations between five serum PFASs and glucose-related outcomes in pregnant Danish women based on their risk of gestational diabetes mellitus (GDM). In the prospective Odense Child Cohort serum concentrations of five PFASs - perfluorohexane sulfonic acid (PFHxS), perfluorooctane sulfonic acid (PFOS), perfluorooctanoic acid (PFOA), perfluorononanoic acid (PFNA) and perfluorodecanoic acid (PFDA) - were measured at median gestational week (GW) 11 in pregnant women. An oral glucose tolerance test (OGTT) was performed at GW 28. The statistical analysis was conducted among 158 women with high GDM risk and 160 women with low GDM risk matched by gestational age. Multiple linear regression models were performed to estimate associations between PFAS concentrations and glucose, insulin, C-peptide, homeostatic model of assessment of insulin resistance (HOMA-IR) and beta cell function (HOMA-%β), and insulin sensitivity (Matsuda index) during the 2-h OGTT. In women with high risk for GDM, a two-fold increase in PFHxS concentration was significantly associated with increased fasting glucose, fasting insulin and HOMA-IR after adjusting for age, parity, educational level and pre-pregnancy BMI. Adjusting for the same confounders, a doubling in PFNA concentration was associated with higher fasting insulin and HOMA-%β. In women with low GDM risk, no associations were found between PFAS concentrations and glucose-related outcomes. PFHxS and PFNA concentrations were associated with impaired glycemic status in metabolically vulnerable pregnant women and might further enhance the risk of developing GDM. Copyright © 2018 Elsevier Ltd. All rights reserved.

Early Childhood Dental Caries, Mouth Pain, and Malnutrition in the Ecuadorian Amazon Region

PubMed Central

So, Marvin; Ellenikiotis, Yianni A.; Husby, Hannah M.; Paz, Cecilia Leonor; Seymour, Brittany; Sokal-Gutierrez, Karen

2017-01-01

Malnutrition and dental caries in early childhood remain persistent and intertwined global health challenges, particularly for indigenous and geographically-remote populations. To examine the prevalence and associations between early childhood dental caries, parent-reported mouth pain and malnutrition in the Amazonian region of Ecuador, we conducted a cross-sectional study of the oral health and nutrition status of 1407 children from birth through age 6 in the “Alli Kiru” program (2011–2013). We used multivariate regression analysis to examine relationships between severe caries, parent-reported mouth pain measures, and nutritional status. The prevalence of dental caries was 65.4%, with 44.7% of children having deep or severe caries, and 33.8% reporting mouth pain. The number of decayed, missing and filled teeth (dmft) increased dramatically with age. Malnutrition was prevalent, with 35.9% of children stunted, 1.1% wasted, 7.4% underweight, and 6.8% overweight. As mouth pain increased in frequency, odds for severe caries increased. For each unit increase in mouth pain frequency interfering with sleeping, children had increased odds for being underweight (Adjusted Odds Ratio (AOR): 1.27; 95% CI: 1.02–1.54) and decreased odds for being overweight (AOR: 0.76; 95% CI: 0.58–0.97). This relationship was most pronounced among 3–6 year-olds. Early childhood caries, mouth pain and malnutrition were prevalent in this sample of young children. Parent-reported mouth pain was associated with severe caries, and mouth pain interfering with sleeping was predictive of poor nutritional status. We demonstrate the utility of a parsimonious parent-reported measure of mouth pain to predict young children’s risk for severe early childhood caries and malnutrition, which has implications for community health interventions. PMID:28531148

Early Childhood Dental Caries, Mouth Pain, and Malnutrition in the Ecuadorian Amazon Region.

PubMed

So, Marvin; Ellenikiotis, Yianni A; Husby, Hannah M; Paz, Cecilia Leonor; Seymour, Brittany; Sokal-Gutierrez, Karen

2017-05-22

Malnutrition and dental caries in early childhood remain persistent and intertwined global health challenges, particularly for indigenous and geographically-remote populations. To examine the prevalence and associations between early childhood dental caries, parent-reported mouth pain and malnutrition in the Amazonian region of Ecuador, we conducted a cross-sectional study of the oral health and nutrition status of 1407 children from birth through age 6 in the "Alli Kiru" program (2011-2013). We used multivariate regression analysis to examine relationships between severe caries, parent-reported mouth pain measures, and nutritional status. The prevalence of dental caries was 65.4%, with 44.7% of children having deep or severe caries, and 33.8% reporting mouth pain. The number of decayed, missing and filled teeth (dmft) increased dramatically with age. Malnutrition was prevalent, with 35.9% of children stunted, 1.1% wasted, 7.4% underweight, and 6.8% overweight. As mouth pain increased in frequency, odds for severe caries increased. For each unit increase in mouth pain frequency interfering with sleeping, children had increased odds for being underweight (Adjusted Odds Ratio (AOR): 1.27; 95% CI: 1.02-1.54) and decreased odds for being overweight (AOR: 0.76; 95% CI: 0.58-0.97). This relationship was most pronounced among 3-6 year-olds. Early childhood caries, mouth pain and malnutrition were prevalent in this sample of young children. Parent-reported mouth pain was associated with severe caries, and mouth pain interfering with sleeping was predictive of poor nutritional status. We demonstrate the utility of a parsimonious parent-reported measure of mouth pain to predict young children's risk for severe early childhood caries and malnutrition, which has implications for community health interventions.

Prevalence of overweight and obesity in Canadian children, 2004 to 2013: Impact of socioeconomic determinants.

PubMed

Rodd, Celia; Sharma, Atul K

2017-06-01

We recently reported an encouraging decline in the prevalence of overweight (OW) or obesity (OB) in Canadian children from 31% to 27% with stabilization in OB rates at ~13% using national survey data between 2004 and 2013. Although rates were lower for toddlers, girls and those of European (White) race-ethnicity, secular trends persisted after adjustment. In this follow-up study, we explored the ability of socioeconomic status to explain or modify these relationships using the same data set. We analyzed a decade of anthropometric data from 14,014 children aged 3 to 19 years. We explored the influence of income adequacy, education, immigration status, family type (e.g., single-parent) and geographic region by multivariable logistic regression. Data sets included Canadian Community Health Survey cycle 2.2 and Canadian Health Measures Surveys cycles 2 and 3. Children from higher-income families fared better than their lower-income counterparts in each survey era and demonstrated a significant decline in OW/OB from 29.1% (95% confidence interval [CI]: 27.3 to 30.8) in 2004 to 2005 to 22.2% (95% CI: 19.8 to 24.6) in 2012 to 2013, P<0.001. Regression models confirmed the effects of time, age, sex, race, income, education, immigration and region. Although single-parent families did less well in univariate analyses, this effect vanished after adjustment for other socioeconomic status variables, such as income and education. Regional variations persisted, with lower rates of OB and OW/OB in British Columbia and higher rates in Atlantic Canada. These results confirm that progress is possible against this important public health challenge, underline the need to better understand sociodemographic risk factors and identify groups at higher risk for possible interventions.

The impact of internal displacement on child mortality in post-earthquake Haiti: a difference-in-differences analysis.

PubMed

Chen, Bradley; Halliday, Timothy J; Fan, Victoria Y

2016-07-19

The Haiti earthquake in 2010 resulted in 1.5 million internally displaced people (IDP), yet little is known about the impact of displacement on health. In this study, we estimate the impact of displacement on infant and child mortality and key health-behavior mechanisms. We employ a difference-in-differences (DID) design with coarsened exact matching (CEM) to ensure comparability among groups with different displacement status using the 2012 Haiti Demographic and Health Survey (DHS). The participants are 21,417 births reported by a nationally representative sample of 14,287 women aged 15-49. The main independent variables are household displacement status which includes households living in camps, IDP households (not in camps), and households not displaced. The main outcomes are infant and child mortality; health status (height-for-age, anemia); uptake of public health interventions (bed net use, spraying against mosquitoes, and vaccinations); and other conditions (hunger; cholera). Births from the camp households have higher infant mortality (OR = 2.34, 95 % CI 1.15 to 4.75) and child mortality (OR = 2.34, 95 % CI 1.10 to 5.00) than those in non-camp IDP households following the earthquake. These odds are higher despite better access to food, water, bed net use, mosquito spraying, and vaccines among camp households. IDP populations are heterogeneous and households that are displaced outside of camps may be self-selected or self-insured. Meanwhile, even households not displaced by a disaster may face challenges in access to basic necessities and health services. Efforts are needed to identify vulnerable populations to provide targeted assistance in post-disaster relief.

Impact of oral health education by audio aids, braille and tactile models on the oral health status of visually impaired children of Bhopal City.

PubMed

Gautam, Anjali; Bhambal, Ajay; Moghe, Swapnil

2018-01-01

Children with special needs face unique challenges in day-to-day practice. They are dependent on their close ones for everything. To improve oral hygiene in such visually impaired children, undue training and education are required. Braille is an important language for reading and writing for the visually impaired. It helps them understand and visualize the world via touch. Audio aids are being used to impart health education to the visually impaired. Tactile models help them perceive things which they cannot visualize and hence are an important learning tool. This study aimed to assess the improvement in oral hygiene by audio aids and Braille and tactile models in visually impaired children aged 6-16 years of Bhopal city. This was a prospective study. Sixty visually impaired children aged 6-16 years were selected and randomly divided into three groups (20 children each). Group A: audio aids + Braille, Group B: audio aids + tactile models, and Group C: audio aids + Braille + tactile models. Instructions were given for maintaining good oral hygiene and brushing techniques were explained to all children. After 3 months' time, the oral hygiene status was recorded and compared using plaque and gingival index. ANNOVA test was used. The present study showed a decrease in the mean plaque and gingival scores at all time intervals in individual group as compared to that of the baseline that was statistically significant. The study depicts that the combination of audio aids, Braille and tactile models is an effective way to provide oral health education and improve oral health status of visually impaired children.

Health at the borders: Bayesian multilevel analysis of women's malnutrition determinants in Ethiopia.

PubMed

Delbiso, Tefera Darge; Rodriguez-Llanes, Jose Manuel; Altare, Chiara; Masquelier, Bruno; Guha-Sapir, Debarati

2016-01-01

Women's malnutrition, particularly undernutrition, remains an important public health challenge in Ethiopia. Although various studies examined the levels and determinants of women's nutritional status, the influence of living close to an international border on women's nutrition has not been investigated. Yet, Ethiopian borders are regularly affected by conflict and refugee flows, which might ultimately impact health. To investigate the impact of living close to borders in the nutritional status of women in Ethiopia, while considering other important covariates. Our analysis was based on the body mass index (BMI) of 6,334 adult women aged 20-49 years, obtained from the 2011 Ethiopian Demographic and Health Survey (EDHS). A Bayesian multilevel multinomial logistic regression analysis was used to capture the clustered structure of the data and the possible correlation that may exist within and between clusters. After controlling for potential confounders, women living close to borders (i.e. ≤100 km) in Ethiopia were 59% more likely to be underweight (posterior odds ratio [OR]=1.59; 95% credible interval [CrI]: 1.32-1.90) than their counterparts living far from the borders. This result was robust to different choices of border delineation (i.e. ≤50, ≤75, ≤125, and ≤150 km). Women from poor families, those who have no access to improved toilets, reside in lowland areas, and are Muslim, were independently associated with underweight. In contrast, more wealth, higher education, older age, access to improved toilets, being married, and living in urban or lowlands were independently associated with overweight. The problem of undernutrition among women in Ethiopia is most worrisome in the border areas. Targeted interventions to improve nutritional status in these areas, such as improved access to sanitation, economic and livelihood support, are recommended.

Infant Temperament: Stability by Age, Gender, Birth Order, Term Status, and SES

PubMed Central

Bornstein, Marc H.; Putnick, Diane L.; Gartstein, Maria A.; Hahn, Chun-Shin; Auestad, Nancy; O’Connor, Deborah L.

2015-01-01

Two complementary studies focused on stability of infant temperament across the first year and considered infant age, gender, birth order, term status, and socioeconomic status (SES) as moderators. Study 1 consisted of 73 mothers of firstborn term girls and boys queried at 2, 5, and 13 months of age. Study 2 consisted of 335 mothers of infants of different gender, birth order, term status, and SES queried at 6 and 12 months. Consistent positive and negative affectivity factors emerged at all time-points across both studies. Infant temperament proved stable and robust across gender, birth order, term status, and SES. Stability coefficients for temperament factors and scales were medium to large for shorter (<9 months) inter-assessment intervals and small to medium for longer (>10 months) intervals. PMID:25865034

[[Method of forming a multiple attrition life table and its application to the study of nuptiality among women in China

PubMed

Zeng, Y

1987-01-01

Trends in marital status among women in China for the period 1950-1970 and for 1981 are analyzed using the multiple decrement life table method. The results confirm those obtained with traditional methods of data analysis. It is found that over the past 30 years, Chinese women have experienced a high rate of marriage and a low divorce rate. The significant increase in age at marriage and the lowering of the death rate have affected marital status at all ages. The development of a marital status life table permits the author to estimate current numbers of women in the four marital statuses of unmarried, currently married, widowed, and divorced by age and their future likelihood of changing marital status.

Corticosterone administration and high-energy feed results in enhanced fat accumulation and insulin resistance in broiler chickens.

PubMed

Yuan, L; Lin, H; Jiang, K J; Jiao, H C; Song, Z G

2008-07-01

1. Two experiments were conducted to investigate the effects of exogenous corticosterone administration (30 mg/kg diet) and dietary energy level on feed or energy intake and fat deposition in broiler chickens of 1 and 4 weeks of age. 2. Corticosterone treatment significantly suppressed body weight (BW) gain and reduced feed and caloric efficiencies. The retarded growth may conceal the stimulatory effect of corticosterone on feed consumption or metabolisable energy (ME) intake. A high-energy diet may increase energy intake and partially alleviate the suppressing effect of corticosterone on growth of broilers. 3. Corticosterone administration promoted the conservation of energy stores as fat at both abdominal and subcutaneous sites and this process occurred regardless of dietary energy level in ad libitum feeding status. A high-energy diet increased fat accumulation and showed no significant interaction with corticosterone treatment. 4. The suppressed development of breast and thigh muscles by corticosterone treatment was observed only in 1-week-old chickens fed on the low-energy diet. In contrast, the yield of breast muscle but not thigh muscle was significantly decreased by corticosterone in 4-week-old chickens, suggesting that the tissue specificity to corticosterone challenge is age dependent. 5. Plasma concentrations of glucose, insulin, triglyceride, non-esterified fatty acids (NEFA) and very low density lipoprotein were increased by corticosterone treatment regardless of diet treatment. A high-energy diet increased plasma levels of NEFA and resulted in hyperinsulinism in 4-week-old chickens but not in 1-week-old chickens. 6. Lipoprotein lipase (LPL) activities in adipose tissues may have been up-regulated by corticosterone treatment and showed tissue specificity. The increased LPL activities at ad libitum feeding status were not necessarily linked with the increased fat accumulation in corticosterone challenged chickens. 7. Corticosterone resulted in augmented energy consumption and altered energy redistribution toward lipid deposition. The induced insulin resistance and enhanced hepatic de novo lipogenesis by corticosterone are likely to be responsible for the increased fat deposition.

Socioeconomic inequalities in health in older women.

PubMed

Rostad, Berit; Deeg, Dorly J H; Schei, Berit

2009-03-01

Socioeconomic status differentials in health are well documented. Less is known about the socioeconomic variation in health in older people, and in older women in particular. The aim of the study was to examine the association between socioeconomic status and health in older women in relation to two indicators of socioeconomic status and three measures of health, and further, to investigate whether socioeconomic differences in health increase or decrease with advancing age. Data from a cross-sectional population based health survey inviting all women ≥70 years were analysed; 6,380 women aged 70-103 years participated. Logistic regression was applied to analyse variation in health by socioeconomic status. Disadvantaged socioeconomic status (i.e. lower educational levels and previous manual or never been in paid work) was significantly associated with poorer health outcomes, whether measured as self-assessed health or depression. Limiting long-standing illness was significantly associated with never been in paid work. The associations were not attenuated by simultaneous adjustments for health behavioural factors, social support, and marital status. Additional adjustments for medical conditions did only alter the significant association between employment status and limiting long-standing illness. The analyses revealed that educational inequalities did not decrease with advancing age, whereas the results for employment varied across age groups. Our findings suggest an enduring relation between socioeconomic status and health in later life. The study adds to the understanding of the consistent associations between poorer health and social disadvantages at older age. We are not aware of any previous study showing the persistence of social inequalities in health upon adjustments for medical conditions.

Sociodemographic and behavioral characteristics associated with self-reported diagnosed diabetes mellitus in adults aged 50+ years in Ghana and South Africa: results from the WHO-SAGE wave 1

PubMed Central

Padyab, Mojgan; Schröders, Julia; Stewart Williams, Jennifer

2018-01-01

Objective The objective is to identify and describe the sociodemographic and behavioral characteristics of adults, aged 50 years and over, who self-reported having been diagnosed and treated for diabetes mellitus (DM) in Ghana and South Africa. Research design and methods This is a cross-sectional study based on the WHO Study on global AGEing and adult health (SAGE) wave 1. Information on sociodemographic factors, health states, risk factors and chronic conditions is captured from questionnaires administered in face-to-face interviews. Self-reported diagnosed and treated DM is confirmed through a ‘yes’ response to questions regarding 1 having previously been diagnosed with DM, and 2 having taken insulin or other blood sugar lowering medicines. Crude and adjusted logistic regressions test associations between candidate variables and DM status. Analyses include survey sampling weights. The variance inflation factor statistic tested for multicollinearity. Results In this nationally representative sample of adults aged 50 years and over in Ghana, after adjusting for the effects of sex, residence, work status, body mass index, waist-hip and waist-height ratios, smoking, alcohol, fruit and vegetable intake and household wealth, WHO-SAGE survey respondents who were older, married, had higher education, very high-risk waist circumference measurements and did not undertake high physical activity, were significantly more likely to report diagnosed and treated DM. In South Africa, respondents who were older, lived in urban areas and had high-risk waist circumference measurements were significantly more likely to report diagnosed and treated DM. Conclusions Countries in sub-Saharan Africa are challenged by unprecedented ageing populations and transition from communicable to non-communicable diseases such as DM. Information on those who are already diagnosed and treated needs to be combined with estimates of those who are prediabetic or, as yet, undiagnosed. Multisectoral approaches that include socioculturally appropriate strategies are needed to address diverse populations in SSA countries. PMID:29503732

Cancer-Related Distress in Young Adults Compared to Middle-Aged and Senior Adults.

PubMed

Burgoyne, Mary Jo; Bingen, Kristin; Leuck, Julianne; Dasgupta, Mahua; Ryan, Polly; Hoffmann, Raymond G

2015-06-01

Little is known about cancer-related distress during young adulthood. Results from the few studies that have directly assessed this age group have indicated that young adults (YAs) may be at greater risk of developing psychosocial difficulties due to their unique challenges of coping with cancer. This study's objective was to investigate cancer-related distress in YAs compared to older adults. This retrospective cross-sectional study compared the distress level of YAs (18-39 years old) with that of middle-aged (40-64 years old) and senior adults (65-90 years old) using the Distress Thermometer (DT) and associated Problem List (PL). Factors that may be associated with distress by age group were examined, including demographics, cancer type, and PL items endorsed. YAs had higher cancer-related distress than senior adults but similar distress levels to middle-aged adults. Findings from distress comparisons across demographics, cancer types, and PL items endorsed suggest that YAs and middle-aged adults had similar distress patterns when compared to senior adults, who had the lowest DT scores. Multivariable analyses indicated age-related risk factors for high distress, including gynecologic cancers for YAs; divorced, single, or unemployed statuses for middle-aged adults; and being of Hispanic ethnicity for senior adults. Female gender and practical, emotional, and physical problems were associated with distress for all age groups. There is a differential impact of cancer by age. It is important to screen for cancer-related distress, paying attention to risk factors by age to determine age-appropriate supportive care needs.

'And when a certain health issue happen, they try to cover it': Stakeholder perspectives on the health of temporary foreign workers and their families.

PubMed

Salami, Bukola; Hegadoren, Kathleen; Kirova, Anna; Meherali, Salima; Nsaliwa, Christina; Chiu, Yvonne

2018-01-01

This study examines stakeholders' perspectives on the health and well-being of temporary foreign workers (TFWs) and their families in Alberta, Canada. We used a critically informed qualitative methodology. We interviewed 13 stakeholders, including service providers and policy makers. Stakeholders involved in providing services to TFWs perceived that the workers experience (1) barriers in accessing mental health services, (2) mental health challenges, (3) family health challenges, (4) occupational health challenges, and (5) income and social status as a social determinant of health. Immigration and class status intersect to influence the health of this vulnerable population in Canada.

Determinants of nutritional status of pre-school children in India.

PubMed

Bharati, Susmita; Pal, Manoranjan; Bharati, Premananda

2008-11-01

The aim of this paper is to assess the spatial distribution of nutritional status of children of less than three years through Z-scores of weight-for-age, height-for-age and weight-for-height using data collected by the National Family Health Survey (NFHS-2, 1998-99), India. The nutritional status of pre-school children was regressed on different socio-demographic factors after eliminating the effect of age. The data show that there are gender differences and spatial variations in the nutritional status of children in India. Gender difference is not very pronounced and almost disappears when the effects of age and socio-demographic variables are removed. The spatial difference, especially the rural-urban difference, was found to be very large and decreased substantially when the effects of age and socioeconomic variables were removed. However, the differences were not close to zero. All the variables were found to affect significantly the nutritional status of children. However, the literacy of mothers did not affect height-for-age significantly. The weight-for-age and height-for-age scores showed a dismal picture of the health condition of children in almost all states in India. The worst affected states are Bihar, Madhya Pradesh, Orissa and Uttar Pradesh. Assam and Rajasthans are also lagging behind. Weight-for-height scores do not give a clear picture of state-wise variation. Goa, Kerala and Punjab are the three most developed states in India and also have the lowest percentages of underweight children according to the Z-scores. Along with these three states come the north-eastern states where women are well educated. Thus overall development, enhancement of level of education and low gender inequality are the key factors for improvement in the health status of Indian children.

Self-esteem and peer-perceived social status in early adolescence and prediction of eating pathology in young adulthood.

PubMed

Smink, Frédérique R E; van Hoeken, Daphne; Dijkstra, Jan Kornelis; Deen, Mathijs; Oldehinkel, Albertine J; Hoek, Hans W

2018-04-27

Self-esteem is implied as a factor in the development of eating disorders. In adolescence peers have an increasing influence. Support for the role of self-esteem in eating disorders is ambiguous and little is known about the influence of social status as judged by others. The present study investigates whether self-esteem and peer status in early adolescence are associated with eating pathology in young adulthood. This study is part of TRAILS, a longitudinal cohort study on mental health and social development from preadolescence into adulthood. At age 11, participants completed the Self-Perception Profile for Children, assessing global self-esteem and self-perceptions regarding social acceptance, physical appearance, and academic competence. At age 13, peer status among classmates was assessed regarding likeability, physical attractiveness, academic performance, and popularity in a subsample of 1,007 participants. The Eating Disorder Diagnostic Scale was administered at age 22. The present study included peer-nominated participants with completed measures of self-perception at age 11 and eating pathology at age 22 (N = 732; 57.8% female). In a combined model, self-perceived physical attractiveness at age 11 and peer popularity at age 13 were inversely correlated with eating pathology at 22 years, while likeability by peers at age 13 was positively related to eating pathology. Both self-perceptions and peer status in early adolescence are significant predictors of eating pathology in young adults. Specific measures of self-esteem and peer-perceived status may be more relevant to the prediction of eating pathology than a global measure of self-esteem. © 2018 The Authors International Journal of Eating Disorders Published by Wiley Periodicals, Inc.

Trajectory of Life Satisfaction and Its Relationship with Subjective Economic Status and Successful Aging

ERIC Educational Resources Information Center

Hsu, Hui-Chuan

2010-01-01

The aim of the study was to explore the relationship between subjective economic status and indicators of successful aging to life satisfaction trajectories among the elderly in Taiwan. Data were from the four waves of "Survey of Health and Living Status of the Elderly in Taiwan". Hierarchical linear modeling was conducted. Subjective…

The Relationship between Intellectual Disability, Indigenous Status and Risk of Reoffending in Juvenile Offenders on Community Orders

ERIC Educational Resources Information Center

Frize, M.; Kenny, D.; Lennings, C.

2008-01-01

Background: Intellectual disability (ID), age and aboriginal status have been independently implicated as risk factors for offending to varying degrees. This study examined the relationship between age, ID and the Indigenous status of juvenile offenders. It also examined the outcomes of the sample's offending in terms of court appearances and…

[Nutritional status of urban and rural Chilean school children of the metropolitan area].

PubMed

Ivanović, R; Olivares, M; Ivanović, D

1990-01-01

The objective of this study was to assess the nutritional status of chilean students by geographic area. In this respect, a representative sample of 4,509 students from elementary and high school was chosen from the Metropolitan Region of Chile (representative of 38.0% of chilean school population). Nutritional status was assessed through anthropometric measurements. Percent weight for age (% W/A), height for age (% H/A) and weight for height (% W/H) were compared with WHO standard; head circumference for age (% HC/A) with Tanner standard; arm circumference for age (% AC/A), triceps skinfold for age (% TS/A), arm muscle area for age (% AMA/A) and arm fat area/age (% AFA/A) with Frisancho norms. Socioeconomic status (SES) was measured through Graffar modified scale. Percent W/H is a better indicator of nutritional status due to growth failure which was thus detected in 27.6% of the whole sample (24.2% and 46.8%, respectively, in urban and rural area, p less than 0.001). According to % W/H, the frequencies of obesity were 13.4% and 10.5%, and those for undernutrition 5.7% and 8.2%, in urban and rural area, respectively, (p less than 0.05). Students from rural area showed significantly lower values for % HC/A, % AC/A, % TS/A and % AFA/A (p less than 0.001). There were no differences for % AMA/A. The fact that 90.5% of rural students belong to low SES must be taken into account to explain differences in the nutritional status of students of different geographic areas.

Marital history from age 15 to 40 years and subsequent 10-year mortality: a longitudinal study of Danish males born in 1953.

PubMed

Lund, Rikke; Holstein, Bjørn Evald; Osler, Merete

2004-04-01

The aims of the present study are to analyse the association between marital status at age 24, 29, 34, and 39 years and subsequent mortality in a cohort of men born in 1953 (sensitive period); to study the impact of number of years married, number of years divorced/widowed, and number of marital break-ups on mortality (cumulative effect), and to examine whether these effects were independent of marital status at age 39 (proximity effect). Prospective birth cohort study with follow-up of mortality from 1992 to 2002. Participants were 10891 men born within the metropolitan area of Copenhagen, Denmark. Marital status in 1992 as well as start and termination of all previous marital status events from 1968 to 1992 were retrieved from the Danish Civil Registration System. Were hazard ratios (HR) for all-cause mortality from age 40 to 49 years. We found a strong protective effect of being married compared with never being married or divorced/widowed at every age. The association increased in strength with increasing age. Number of years divorced was associated with increased mortality risk in a dose-dependent manner at age 34 and 39 years. One or more marital break-ups was associated with higher mortality, whereas increasing number of years married was associated with lower mortality. Inclusion of current marital status attenuated the strength of the associations but most of them remained statistically significant. Marital status and cumulated marital periods, especially cumulated periods divorced/widowed are strong independent predictors of mortality among younger males.

Status Problem and Expectations of Competence: A Challenging Path for Teachers

ERIC Educational Resources Information Center

Pescarmona, Isabella

2015-01-01

Complex Instruction (CI) is a cooperative learning approach, which aims at improving the equal status interaction among students working in groups who may be at different academic and social levels. Based on an ethnographic research, the article examines how a group of Italian primary school teachers understand the status problem and how the…

Prognostics and Health Management of Wind Turbines: Current Status and Future Opportunities

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

Sheng, Shuangwen

This presentation was given at the 2016 Annual Conference of the Prognostics and Health Management Society. It covers the current status and challenges and opportunities of prognostics and health management of wind turbines.

Ageing, health status and coverage rate effects on community prescription costs in Ireland.

PubMed

Kenneally, Martin; Lynch, Brenda

2018-06-01

This paper aims to explore how GMS drug costs depend on age, gender, income, health status, community drug scheme coverage rates and whether they display significant differences across regions of Ireland. We also aim to find out whether the GMS drug costs of high and low income cohorts respond similarly to changes in their health status. The paper projects GMS drug costs in 2026 and examines the separate cost of population ageing and population growth over the period. We also aim to simulate the estimated model to show how much giving free prescription drugs to all persons aged 'under 5' would add to 2026 GMS drug costs, and also how much giving universal GMS coverage to all persons in 2026 would add to 2026 GMS drug costs. We construct a multivariate logistic regression model of GMS community drug costs in Ireland. We progress the methodology used in earlier studies by explicitly modelling how regional incomes and regional health status interact in determining GMS drug costs in Ireland. An age cohort and region breakdown of the simulated GMS drug costs, of both projected demographic trends and public policy measures that have been adopted or are under consideration, are also investigated. We find that GMS drug costs depend on age-but not gender-on income, health status, community drug scheme coverage rates, and they are significantly lower for all age cohorts in Donegal and the North West region. The GMS drug costs of high income cohorts tend to increase as their health status improves, whereas they tend to decrease as the health status of low income cohorts improves. A uniform 1% gain in health status has little impact on total GMS prescribing costs. Similarly, if the health status of all Irish regions improved to match that of the East region in 2010 it would only have reduced public prescription costs by around 32 € million of the 1.8 € billion GMS drugs bill. We find that giving free prescription drugs to all persons aged 'under 5' in 2010 would have only a minor impact on 2010 GMS drug costs, whereas giving universal GMS coverage to all persons would have doubled public prescription costs from 1.8 € billion to circa 3.6 € billion.

Power and action in critical theory across disciplines: implications for critical community psychology.

PubMed

Davidson, Heather; Evans, Scot; Ganote, Cynthia; Henrickson, Jorie; Jacobs-Priebe, Lynette; Jones, Diana L; Prilleltensky, Isaac; Riemer, Manuel

2006-09-01

Although critical scholarship and community psychology share similar aspirations, the links between them remain unexplored and under-theorized. In this article we explore the implications of critical scholarship in various specialties for the field of community psychology. To understand the contributions of critical scholarship to a theory of power and action for social change, we conducted a systematic analysis of a ten-year period of publications in seven journals associated with the critical scholarship tradition. We created precise criteria for the concepts of power and action and applied them to the publications. Results indicate an interesting paradox at play. Whereas community psychology is more action oriented than critical scholarship, its actions fall short of challenging institutionalized power structures and the status quo; and whereas critical scholarship is more challenging of the status quo than community psychology in theory, it has failed to produce viable actions that challenge the status quo. We discuss the implications of this state of affairs for the development of a more critical community psychology.

The clinical presentation and biochemical diagnosis of acromegaly and gigantism.

PubMed

Jialal, I; Nathoo, B C; Joubert, S; Asmal, A C; Pillay, N L

1982-04-24

Over a 5-year period 14 patients with acromegaly and gigantism were seen at the endocrine clinic of King Edward VIII Hospital: 9 were Blacks and 5 Indians; 8 of the patients were women. The mean age of the patients was 46 years. Surprisingly, only 2 patients complained of acral overgrowth. Symptomatology was varied and not characteristic of the condition. On examination all patients had unequivocal signs of soft-tissue and bony overgrowth, 64% had visual abnormalities and 50% hypertension. Radiologically, 88% showed an enlarged pituitary fossa. On biochemical investigation, the fasting levels of growth hormone (GH) were increased in 12 patients and during oral glucose tolerance tests, the GH levels in these 12 patients were not suppressed. One patient in whom the fasting GH level was not increased had progressed to the stage of panhypopituitarism, in the remaining patient challenge with thyrotrophin-releasing hormone (TRH) led to increased GH levels and L-dopa challenge resulted in a paradoxical decrease in GH levels. Seven patients with increased GH levels who were challenged with L-dopa showed the typical decrease in GH levels found in this condition; in 5 of these patients, challenged with TRH, GH levels increased. The findings emphasize that despite the ease of clinical diagnosis, appropriate biochemical investigations are necessary to confirm the exact status of the disease, which is rare in the population studied.

Ageing and COPD affect different domains of nutritional status: the ECCE study.

PubMed

Battaglia, S; Spatafora, M; Paglino, G; Pedone, C; Corsonello, A; Scichilone, N; Antonelli-Incalzi, R; Bellia, V

2011-06-01

Chronic obstructive pulmonary disease (COPD) and ageing may contribute to malnutrition. We aimed to explore whether COPD and ageing determine malnutrition in different manners. 460 stable COPD outpatients (376 males and 84 females) from the Extrapulmonary Consequences of COPD in the Elderly (ECCE) study database were investigated (age 75.0±5.9 yrs; forced expiratory volume in 1 s 54.7±18.3% predicted). Nutritional status was evaluated using the Mini Nutritional Assessment® (MNA) questionnaire. From the MNA, three scores exploring the domains of the nutritional status were calculated: body composition, energy intake and body functionality scores. Global Initiative for Chronic Obstructive Lung Disease (GOLD) stages were negatively correlated with five MNA items exploring mobility, patient's perception of own nutrition and health status, and arm and calf circumferences (lowest Spearman's rho (rs)=-0.011; highest p=0.039). GOLD stages were independently correlated with body composition and body functionality scores (model r2=0.073). Age was negatively correlated with four MNA items exploring loss of appetite, fluid intake, mobility and autonomy in daily life (lowest rs=-0.013; highest p=0.030). Age was independently correlated with body functionality score (model r2=0.037). Severe COPD and ageing are independent and probably concurrent conditions leading to malnutrition. The MNA questionnaire allows a valuable insight into the complexity of components of nutritional status and may provide useful clues for treatment strategies.

Transitions in pregnancy planning in women recruited for a large prospective cohort study.

PubMed

Luderer, U; Li, T; Fine, J P; Hamman, R F; Stanford, J B; Baker, D

2017-06-01

Do the rates at which women transition among different intensities of pregnancy planning vary with age, marital status and race/ethnicity? Rates of transition from low or moderate pregnancy probability groups (PPGs) to higher PPGs vary by age, marital status and race/ethnicity. The design of prospective studies of the effects of pre- and peri-conception exposures on fecundity, pregnancy and children's health is challenging because at any specific time only a small percentage of reproductive age women is attempting to conceive. To our knowledge, there has been no population-based, prospective study that repeatedly assessed pregnancy planning, which included women who were not already planning pregnancy at enrollment and whose ages spanned the female reproductive age range. A longitudinal study was carried out that repeatedly assessed pregnancy probability in 12 916 women for up to 21 months from January 2009 to September 2010. We analyzed data from the National Children's Study Vanguard Study, a pilot study for a large-scale epidemiological birth cohort study of children and their parents. During the Vanguard Study, investigators followed population-based samples of reproductive age women in each of seven geographically dispersed and diverse study locations over time to identify when they sought to become pregnant, providing a unique opportunity to prospectively assess changes in pregnancy planning in a large sample of US women. At study entry and each follow-up contact, which occurred at 1, 3 or 6 month intervals depending on PPG, a questionnaire was used to assess behavior dimensions of pregnancy planning to assign women to low, moderate, high non-tryer and high tryer PPGs. Crude rates of pregnancy increased with higher assigned PPG, validating the utility of the instrument. The initial PPG and probabilities of transitioning from low or moderate PPG to higher PPG or pregnancy varied with age, marital status and race/ethnicity. Women aged 25 to <35 years had shorter times to transition to higher PPGs or to pregnant compared with women <25 years. Women who were not currently married had longer times to transition from any initial PPG to pregnant, high tryer or high non-tryer status than currently married women. Non-Hispanic Black (NHB) and Hispanic women had shorter time to transition from low or moderate to high non-tryer than non-Hispanic White (NHW) women. NHB women also had shorter time to transition from low to high tryer than NHW women. High tryers are more likely to be aged 25 to <30 years, to be married, and to be Hispanic, NHB or other race/ethnicity than women in the low PPG. Loss to follow-up varied by age, marital status and race/ethnicity. Although weights were not developed for the Vanguard study, the self-weighting design minimizes the bias of unweighted analysis. Nonetheless, the SEs for some estimates may be under-estimated. Our results show that demographic characteristics are strong predictors of women's behaviors toward pregnancy. The results further show that frequent follow-up assessments of pregnancy planning behavior in large numbers of women are required to recruit an unbiased sample of preconception women. These findings will be useful to investigators designing prospective studies of fecundability, pregnancy outcomes and children's health. National Institutes of Health (contracts N01-HD53414, N01-HD63416, N01-HD53410, N01-HD53415, N01-HD53396, N01-HD53413 and N01-HD-53411; grant R21 ES016846) and by the University of California Irvine Center for Occupational and Environmental Health. No competing interests. None. © The Author 2017. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com

The relationship between socio-economic status and cancer detection at screening

NASA Astrophysics Data System (ADS)

Taylor-Phillips, Sian; Ogboye, Toyin; Hamborg, Tom; Kearins, Olive; O'Sullivan, Emma; Clarke, Aileen

2015-03-01

It is well known that socio-economic status is a strong predictor of screening attendance, with women of higher socioeconomic status more likely to attend breast cancer screening. We investigated whether socio-economic status was related to the detection of cancer at breast screening centres. In two separate projects we combined UK data from the population census, the screening information systems, and the cancer registry. Five years of data from all 81 screening centres in the UK was collected. Only women who had previously attended screening were included. The study was given ethical approval by the University of Warwick Biomedical Research Ethics committee reference SDR-232-07- 2012. Generalised linear models with a log-normal link function were fitted to investigate the relationship between predictors and the age corrected cancer detection rate at each centre. We found that screening centres serving areas with lower average socio-economic status had lower cancer detection rates, even after correcting for the age distribution of the population. This may be because there may be a correlation between higher socio-economic status and some risk factors for breast cancer such as nullparity (never bearing children). When applying adjustment for age, ethnicity and socioeconomic status of the population screened (rather than simply age) we found that SDR can change by up to 0.11.

Sources of Variation on the Mini-Mental State Examination in a Population-Based Sample of Centenarians

PubMed Central

Dai, Ting; Davey, Adam; Woodard, John L.; Miller, L. Stephen; Gondo, Yasuyuki; Kim, Seock-Ho; Poon, Leonard W.

2013-01-01

Centenarians represent a rare but rapidly growing segment of the oldest-old. This study presents item-level data from the Mini-Mental State Examination (MMSE, M=16.2, SD=8.8, Range 0–30) in a cross-sectional, population-based sample of 244 centenarians and near-centenarians (aged 98–108, 16% men, 21% African-American, 38% community-dwelling) from the Georgia Centenarian Study (2001–2008) by age, education, sex, race, and residential status. Multiple-Indicator Multiple-Causes (MIMIC) models were used to identify systematic domain-level differences on MMSE scores by key demographic characteristics in this age group. Indirect effects of age, educational attainment, race, and residential status were found on MMSE scores. Direct effects were limited to concentration for education and race, and orientation for residential status. Mean levels of cognitive functioning in centenarians were low, with mean values below most commonly-used cut-offs. Overall scores on the MMSE differed as a function of age, education, race, and residential status, with differences in scale performance limited primarily to concentration and orientation, with no evidence for interactions among centenarian characteristics. Adjusting for education was not sufficient to account for differences by race; adjusting for residential status was not sufficient to account for differences by age. PMID:23889552

Influence of weight gain rate on early life nutritional status and body composition of children.

PubMed

Vieira, Sarah Aparecida; Magalhães, Taís Cristina Araújo; Ribeiro, Andréia Queiroz; Priore, Silvia Eloiza; Franceschini, Sylvia do Carmo Castro; Sant'Ana, Luciana Ferreira da Rocha

2014-01-01

To evaluate the influence of the weight gain rate at 4-6 months on nutritional status and body composition in children between 4 and 7 years of age. Retrospective cohort study, sample of 257 children. Data collection was performed in two stages, with the first relating to retrospective data of weight gain from birth to the first 4-6 months of life in the patient records. Measurements of weight, height, waist circumference, and body composition in children between ages 4 and 7 years were obtained. Nutritional status was assessed by the BMI/age. Control variables, such as pregnancy, breastfeeding, lifestyle, and sociodemographics, were studied. Descriptive analysis and multiple linear regression were performed. In the nutritional status assessment, the prevalence of overweight observed was 24.9%. After adjusting for control variables, it was found that the increase of the WGR at 4-6 months of age explained the occurrence of higher BMI/age, percentage of total body fat, body fat percentage in the android region, and waist circumference in children between 4 and 7 years of age. The increase of the WGR in the first months of life can lead to the occurrence of higher values of parameters of nutritional status and body composition in later life.

Identity Formation in Adulthood: A Longitudinal Study from Age 27 to 50

PubMed Central

Fadjukoff, Päivi; Pulkkinen, Lea; Kokko, Katja

2016-01-01

ABSTRACT Longitudinal patterns of identity formation were analyzed in a representative cohort group of Finnish men and women born in 1959 across ages 27, 36, 42, and 50. The data were drawn from the Jyväskylä Longitudinal Study of Personality. Identity status (diffused, moratorium, foreclosed, achieved) from all four ages was available for 172 participants (54% females). Marcia’s Identity Status Interview used in this research included five domains: religious beliefs, political identity, occupational career, intimate relationships, and lifestyle. The findings indicated great variability in identity status across domains at each age level, and the identity trajectories fluctuated from age 27 to 50. The developmental trend from age 27 to 50 was moderately progressive (toward achievement) for the five domains and for overall identity, with the exception of a slightly regressive trend in male religious identity. Remaining stable in the same status category across the four measurements was rare and emerged only for diffusion in the ideological domains. Women generally outnumbered men in identity achievement at earlier ages, but the gender differences diminished in most domains at age 50, except in religious identity. In women overall diffusion decreased over time, but in men it remained at about 20% at ages 42 and 50. PMID:27019650

Unmasking the 'elderly mystique': Why it is time to make the personal political in ageing research.

PubMed

Carney, Gemma M; Gray, Mia

2015-12-01

This article uses feminist scholarship to investigate 'the elderly mystique'-which contends that the potential of old age is masked by a set of false beliefs about ageing (i.e. ageism) which permeate social, economic, and political life (Cohen, 1988). The article presents a theoretical model which explores the extent to which institutionalised ageism shapes the trajectory of life after 60.(1) The hypothesis underpinning the model is simple: The challenge for ageing societies is not the average age of a given population, but rather, how age is used to structure economic, social and political life. An inter-disciplinary framework is used to examine how biological facts about ageing are used to segregate older from younger people, giving older people the status of 'other'; economically through retirement, politically through assumptions about 'the grey vote,' and socially through ageist stereotyping in the media and through denial and ridicule of the sexuality of older people. Each domain is informed by the achievements of feminist theory and research on sexism and how its successes and failures can inform critical investigations of ageism. The paper recognises the role of ageism in de-politicising the lived experience of ageing. The paper concludes that feminist scholarship, particularly work by feminists in their seventies, eighties, and nineties, has much to offer in terms of re-framing gerontology as an emancipatory project for current and future cohorts of older people. Copyright © 2015 Elsevier Inc. All rights reserved.

Language growth in children with heterogeneous language disorders: a population study.

PubMed

Norbury, Courtenay Frazier; Vamvakas, George; Gooch, Debbie; Baird, Gillian; Charman, Tony; Simonoff, Emily; Pickles, Andrew

2017-10-01

Language development has been characterised by significant individual stability from school entry. However, the extent to which trajectories of language growth vary in children with language disorder as a function of co-occurring developmental challenges is a question of theoretical import, with implications for service provision. SCALES employed a population-based survey design with sample weighting procedures to estimate growth in core language skills over the first three years of school. A stratified sample (n = 529) received comprehensive assessment of language, nonverbal IQ, and social, emotional and behavioural difficulties at 5-6 years of age and 95% of the sample (n = 499) were assessed again at ages 7-8. Language growth was measured using both raw and standard scores in children with typical development, children with language disorder of unknown origin, and children with language disorders associated with a known clinical condition and/or intellectual disability. Overall, language was stable at the individual level (estimated ICC = 0.95) over the first three years of school. Linear mixed effects models highlighted steady growth in language raw scores across all three groups, including those with multiple developmental challenges. There was little evidence, however, that children with language disorders were narrowing the gap with peers (z-scores). Adjusted models indicated that while nonverbal ability, socioeconomic status and social, emotional and behavioural deficits predicted initial language score (intercept), none predicted language growth (slope). These findings corroborate previous studies suggesting stable language trajectories after ages 5-6 years, but add considerably to previous work by demonstrating similar developmental patterns in children with additional nonverbal cognitive deficits, social, emotional, and behavioural challenges, social disadvantage or clinical diagnoses. © 2017 The Authors. Journal of Child Psychology and Psychiatry published by John Wiley & Sons Ltd on behalf of Association for Child and Adolescent Mental Health.

25 CFR 115.430 - Will your account lose its supervised status when you reach the age of 18?

Code of Federal Regulations, 2011 CFR

2011-04-01

... reach the age of 18? 115.430 Section 115.430 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE... Will your account lose its supervised status when you reach the age of 18? Your account will no longer be supervised when you reach the age of 18 unless statutory language or a tribal resolution specifies...

25 CFR 115.430 - Will your account lose its supervised status when you reach the age of 18?

Code of Federal Regulations, 2010 CFR

2010-04-01

... reach the age of 18? 115.430 Section 115.430 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE... Will your account lose its supervised status when you reach the age of 18? Your account will no longer be supervised when you reach the age of 18 unless statutory language or a tribal resolution specifies...

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

PubMed

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

2017-02-01

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

Assessment of iron status in settings of inflammation: challenges and potential approaches.

PubMed

Suchdev, Parminder S; Williams, Anne M; Mei, Zuguo; Flores-Ayala, Rafael; Pasricha, Sant-Rayn; Rogers, Lisa M; Namaste, Sorrel Ml

2017-12-01

The determination of iron status is challenging when concomitant infection and inflammation are present because of confounding effects of the acute-phase response on the interpretation of most iron indicators. This review summarizes the effects of inflammation on indicators of iron status and assesses the impact of a regression analysis to adjust for inflammation on estimates of iron deficiency (ID) in low- and high-infection-burden settings. We overviewed cross-sectional data from 16 surveys for preschool children (PSC) ( n = 29,765) and from 10 surveys for nonpregnant women of reproductive age (WRA) ( n = 25,731) from the Biomarkers Reflecting the Inflammation and Nutritional Determinants of Anemia (BRINDA) project. Effects of C-reactive protein (CRP) and α1-acid glycoprotein (AGP) concentrations on estimates of ID according to serum ferritin (SF) (used generically to include plasma ferritin), soluble transferrin receptor (sTfR), and total body iron (TBI) were summarized in relation to infection burden (in the United States compared with other countries) and population group (PSC compared with WRA). Effects of the concentrations of CRP and AGP on SF, sTfR, and TBI were generally linear, especially in PSC. Overall, regression correction changed the estimated prevalence of ID in PSC by a median of +25 percentage points (pps) when SF concentrations were used, by -15 pps when sTfR concentrations were used, and by +14 pps when TBI was used; the estimated prevalence of ID in WRA changed by a median of +8 pps when SF concentrations were used, by -10 pps when sTfR concentrations were used, and by +3 pps when TBI was used. In the United States, inflammation correction was done only for CRP concentrations because AGP concentrations were not measured; regression correction for CRP concentrations increased the estimated prevalence of ID when SF concentrations were used by 3 pps in PSC and by 7 pps in WRA. The correction of iron-status indicators for inflammation with the use of regression correction appears to substantially change estimates of ID prevalence in low- and high-infection-burden countries. More research is needed to determine the validity of inflammation-corrected estimates, their dependence on the etiology of inflammation, and their applicability to individual iron-status assessment in clinical settings.

ADDRESSING ENVIRONMENTAL ENGINEERING CHALLENGES WITH COMPUTATIONAL FLUID DYNAMICS

EPA Science Inventory

This paper discusses the status and application of Computational Fluid Dynamics )CFD) models to address environmental engineering challenges for more detailed understanding of air pollutant source emissions, atmospheric dispersion and resulting human exposure. CFD simulations ...

Native American Challenge Demonstration Project Act of 2009

THOMAS, 111th Congress

Sen. Murkowski, Lisa [R-AK

2009-05-05

Senate - 11/18/2010 Committee on Indian Affairs. Ordered to be reported with an amendment in the nature of a substitute favorably. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

Characteristics of Middle-Aged Daughters and Help to Their Elderly Mothers.

ERIC Educational Resources Information Center

Lang, Abigail M.; Brody, Elaine M.

1983-01-01

Examined relationships between characteristics of middle-aged daughters (N=161) and the nature and amount of help that they provide to their elderly mothers. Data analyses indicated that the daughters' characteristics--their age, marital status, work/nonwork status, and living arrangements--were related significantly to the amount of help they…

Older Adults With Intellectual Disability in Residential Care Centers in Israel: Health Status and Service Utilization

ERIC Educational Resources Information Center

Merrick, Joav; Davidson, Philip W.; Morad, Mohammed; Janicki, Matthew P.; Wexler, Orren; Henderson, C. Michael

2004-01-01

To determine their health status, we studied 2,282 Israeli adults with intellectual disability who were at least 40 years of age and lived in residential care. Results showed that age is a significant factor in health status. The frequency of different disease categories (e.g., cardiovascular disease, cancer, and sensory impairments) increased…

Boys' and Girls' Weight Status and Math Performance from Kindergarten Entry through Fifth Grade: A Mediated Analysis

ERIC Educational Resources Information Center

Gable, Sara; Krull, Jennifer L.; Chang, Yiting

2012-01-01

This study tests a mediated model of boys' and girls' weight status and math performance with 6,250 children from the Early Childhood Longitudinal Study. Five data points spanning kindergarten entry (mean age = 68.46 months) through fifth grade (mean age = 134.60 months) were analyzed. Three weight status groups were identified: persistent…

Cortical signal-in-noise coding varies by noise type, signal-to-noise ratio, age, and hearing status

PubMed Central

Maamor, Nashrah; Billings, Curtis J.

2017-01-01

The purpose of this study was to determine the effects of noise type, signal-to-noise ratio (SNR), age, and hearing status on cortical auditory evoked potentials (CAEPs) to speech sounds. This helps to explain the hearing-in-noise difficulties often seen in the aging and hearing impaired population. Continuous, modulated, and babble noise types were presented at varying SNRs to 30 individuals divided into three groups according to age and hearing status. Significant main effects of noise type, SNR, and group were found. Interaction effects revealed that the SNR effect varies as a function of noise type and is most systematic for continuous noise. Effects of age and hearing loss were limited to CAEP latency and were differentially modulated by energetic and informational-like masking. It is clear that the spectrotemporal characteristics of signals and noises play an important role in determining the morphology of neural responses. Participant factors such as age and hearing status, also play an important role in determining the brain’s response to complex auditory stimuli and contribute to the ability to listen in noise. PMID:27838448

Women's preferences for vaginal antimicrobial contraceptives. II. Preferred characteristics according to women's age and socioeconomic status.

PubMed

Hardy, E; de Pádua, K S; Jiménez, A L; Zaneveld, L J

1998-10-01

A study was carried out to identify characteristics that women would want for an idealized vaginal contraceptive, and the possible association of these characteristics with age and socioeconomic status. The study was done in Campinas, São Paulo State, Brazil. A total of 635 women were selected by age and socioeconomic status, using the "social network" technique. Almost half were adolescents (15-19 years old) and the rest were adults (20-45 years old). Half were of low socioeconomic status and the rest of medium-high status. The data were analyzed with SPSS-PC and EPI-INFO 6.0. Logistic regression and chi 2 were used for the analysis. Despite some differences found between age and socioeconomic status in regard to the characteristics desired for the idealized method, most of the participants expressed the same preferences. The results indicate that women would like the idealized method to be a cream, rather than a suppository, with no odor or flavor, to be colorless, to be placed in the vagina with an applicator well before coitus, and to offer protection against sexually transmitted diseases including AIDS.

Age, sex, marital status and suicide: an empirical study of east and west.

PubMed

Yip, P S

1998-02-01

The relationships among age, sex, marital status and suicidal behaviour in Australia and Hong Kong showed disparity in age-specific suicide rates among the four marital status groups, never married, married, widowed and divorced, for both sexes in the two locations. Examining the coefficients of preservation suggested the coefficient for never married to married in all cases was larger than 1, except for the groups of teenagers aged 15-19 years for both sexes and of elderly women aged 60 years or over in Hong Kong. The widowed or divorced groups have lower suicide rates than the married women among the elderly in Hong Kong. Hong Kong women seem not to have been benefited in marriage as much as men. Responsibility and workload in married life rather than low social status are the likely reasons for the relative high female suicide rate in Hong Kong. Possible cultural and environmental factors which are somewhat speculative (yet to be confirmed) are discussed.

Life expectancy inequalities in the elderly by socioeconomic status: evidence from Italy.

PubMed

Lallo, Carlo; Raitano, Michele

2018-04-12

Life expectancy considerably increased in most developed countries during the twentieth century. However, the increase in longevity is neither uniform nor random across individuals belonging to various socioeconomic groups. From an economic policy perspective, the difference in mortality by socioeconomic conditions challenges the fairness of the social security systems. We focus on the case of Italy and aim at measuring differences in longevity at older ages by individuals belonging to different socioeconomic groups, also in order to assess the effective fairness of the Italian public pension system, which is based on a notional defined contribution (NDC) benefit computation formula, whose rules do not take into account individual heterogeneity in expected longevity. We use a longitudinal dataset that matches survey data on individual features recorded in the Italian module of the EU-SILC, with information on the whole working life and until death collected in the administrative archives managed by the Italian National Social Security Institute. In more detail, we follow until 2009 a sample of 11,281 individuals aged at least 60 in 2005. We use survival analysis and measure the influence of a number of events experienced in the labor market and individual characteristics on mortality. Furthermore, through Kaplan-Meier simulations of hypothetical social groups, adjusted by a Brass relational model, we estimate and compare differences in life expectancy of individuals belonging to different socioeconomic groups. Our findings confirm that socioeconomic status strongly predicts life expectancy even in old age. All estimated models show that the prevalent type of working activity before retirement is significantly associated with the risk of death, even when controlling for dozens of variables as proxies of individual demographic and socioeconomic characteristics. The risk of death for self-employed individuals is 26% lower than that of employees, and life expectancy at 60 differs by five years between individuals with opposite socioeconomic statuses. Our study is the first that links results based on a micro survival analysis on subgroups of the elderly population with results related to the entire Italian population. The extreme differences in mortality risks by socioeconomic status found in our study confirm the existence of large health inequalities and strongly question the fairness of the Italian public pension system.

[The health situation and health care needs of unaccompanied minor refugees - an approximation based on qualitative and quantitative studies from Bielefeld, Germany].

PubMed

Spallek, Jacob; Tempes, Jana; Ricksgers, Hannah; Marquardt, Louisa; Prüfer-Krämer, Luise; Krämer, Alexander

2016-05-01

Unaccompanied minor refugees are children or adolescents below the age of 18 years who are not accompanied by their parents. International studies show that unaccompanied minor refugees represent a special risk group. Currently, empirical study results about the health status of unaccompanied minor refugees barely exist for Germany. Therefore, the goal of this article is an assessment of the health status and health care of unaccompanied minor refugees in Bielefeld, Germany. For this purpose, two qualitative studies and one quantitative study from Bielefeld are used.Results demonstrate that the health care of unaccompanied minor refugees underlies certain peculiarities that indicate major medical needs: Firstly, the need for psychological/psychiatric care and secondly the need for health care regarding infectious diseases. Further challenges in the health care needs of this population group result from its specific situation, and comprise legal conditions, as well as language and cultural competencies on behalf of the health care providers and the unaccompanied minor refugees themselves.

Educational Challenges of Internal Migrant Girls: A Case Study among Primary School Children in Turkey

ERIC Educational Resources Information Center

Altinyelken, Hulya Kosar

2009-01-01

This article seeks to investigate education-related challenges encountered by internal migrant girls studying at primary schools in Turkey. From the perspectives of participants, the emerging themes included adaptation, language, low socio-economic status, peer relations, discrimination and bullying. These challenges seem to have direct or…

Vocational and Technical Education in Lebanon: Strategic Issues and Challenges

ERIC Educational Resources Information Center

Karam, Gebran

2006-01-01

The current status of the Lebanese vocational and technical education (VTE) system is assessed and the strategic issues and challenges facing it are identified. In addition to the economic and social challenges that are common to many developing countries, the Lebanese system suffers from idiosyncratic problems, which may require innovative and…

Fetal environment and early age at natural menopause in a British birth cohort study

PubMed Central

Tom, Sarah E.; Cooper, Rachel; Kuh, Diana; Guralnik, Jack M.; Hardy, Rebecca; Power, Chris

2010-01-01

BACKGROUND Early life development may influence the timing of natural menopause through association with size of the initial follicle pool or early follicular loss. This study examines the relationships of birthweight, gestational age and birthweight standardized by gestational age with early menopause in the 1958 British birth cohort study. METHODS Study participants were over 2900 women with data on birthweight, gestational age (obtained at birth), menopausal status at age 44–45 years and potential confounding factors. Logistic regression was used to study relationships of birthweight, gestational age and birthweight standardized by gestational age with post-menopausal status by 44–45 years, with and without adjustments for confounding factors. RESULTS There was a U-shaped association between birthweight and menopausal status at 44–45 years: women at either extremes of birthweight (<2.5 and ≥4.0 kg) had increased odds of post-menopausal status compared with those weighing 3.0–3.49 kg [odds ratio (OR) = 1.91, 95% confidence interval (CI) 1.08, 3.38; 1.81, 95% CI 1.11, 2.97, respectively]. Women with higher birthweight standardized by gestational age (which indicates faster fetal growth rate) also had increased odds of being post-menopausal by 44–45 years (OR for fastest quarter versus second fastest quarter = 1.80; 95% CI 1.16, 2.81). These associations persisted after adjustment for socioeconomic position at birth, adult smoking status and use of oral contraceptives. CONCLUSIONS These findings suggest that variations in fetal environment may be associated with the timing of menopause. Given that extremes of birthweight and higher birthweight standardized by gestational age were associated with earlier age at menopause, mechanisms related to these characteristics that also regulate ovarian function should be investigated further. PMID:20047935

Laboratory methodologies for indicators of iron status: strengths, limitations, and analytical challenges.

PubMed

Pfeiffer, Christine M; Looker, Anne C

2017-12-01

Biochemical assessment of iron status relies on serum-based indicators, such as serum ferritin (SF), transferrin saturation, and soluble transferrin receptor (sTfR), as well as erythrocyte protoporphyrin. These indicators present challenges for clinical practice and national nutrition surveys, and often iron status interpretation is based on the combination of several indicators. The diagnosis of iron deficiency (ID) through SF concentration, the most commonly used indicator, is complicated by concomitant inflammation. sTfR concentration is an indicator of functional ID that is not an acute-phase reactant, but challenges in its interpretation arise because of the lack of assay standardization, common reference ranges, and common cutoffs. It is unclear which indicators are best suited to assess excess iron status. The value of hepcidin, non-transferrin-bound iron, and reticulocyte indexes is being explored in research settings. Serum-based indicators are generally measured on fully automated clinical analyzers available in most hospitals. Although international reference materials have been available for years, the standardization of immunoassays is complicated by the heterogeneity of antibodies used and the absence of physicochemical reference methods to establish "true" concentrations. From 1988 to 2006, the assessment of iron status in NHANES was based on the multi-indicator ferritin model. However, the model did not indicate the severity of ID and produced categorical estimates. More recently, iron status assessment in NHANES has used the total body iron stores (TBI) model, in which the log ratio of sTfR to SF is assessed. Together, sTfR and SF concentrations cover the full range of iron status. The TBI model better predicts the absence of bone marrow iron than SF concentration alone, and TBI can be analyzed as a continuous variable. Additional consideration of methodologies, interpretation of indicators, and analytic standardization is important for further improvements in iron status assessment. © 2017 American Society for Nutrition.

Effects of age, socioeconomic status, and menstrual cycle on pulmonary response to ozone

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

Seal, E. Jr.; McDonnell, W.F.; House, D.E.

The purpose of this study was to investigate the effects of age, socioeconomic status, and menstrual cycle phase on the pulmonary response to ozone exposure. Three hundred seventy-two healthy white and black young adults, between the ages of 18 and 35 y, were exposed only once to 0.0, 0.12, 0.18, 0.24, 0.30, or 0.40 ppm ozone for 2.3 h. Prior to and after exposure, pulmonary function tests were obtained. Prior to exposure, each subject completed a personal and family-history questionnaire. The response to this questionnaire were used to investigate age, socioeconomic status, and menstrual cycle phase effects on pulmonary responsivenessmore » to ozone. We concluded that the ages of subjects, within the age range studied, had an effect on responsiveness (i.e., decrements in forced expiratory volume in 1 s decreased as the subjects` ages decreased). Socioeconomic status, as reflected by education of fathers, also appeared to affect forced expiratory volume in 1-s responsiveness to ozone, with the middle socioeconomic group being the most responsive. The phase of menstrual cycle did not have an impact on individual responsiveness to ozone. 14 refs., 4 figs.« less

How Possibly Do Leisure and Social Activities Impact Mental Health of Middle-Aged Adults in Japan?: An Evidence from a National Longitudinal Survey.

PubMed

Takeda, Fumi; Noguchi, Haruko; Monma, Takafumi; Tamiya, Nanako

2015-01-01

This study aimed to investigate longitudinal relations between leisure and social activities and mental health status, considering the presence or absence of other persons in the activity as an additional variable, among middle-aged adults in Japan. This study used nationally representative data in Japan with a five-year follow-up period. This study focused on 16,642 middle-aged adults, age 50-59 at baseline, from a population-based, six-year panel survey conducted by the Japanese Ministry of Health, Labour and Welfare. To investigate the relations between two leisure activities ('hobbies or cultural activities' and 'exercise or sports') and four social activities ('community events', 'support for children', 'support for elderly individuals' and 'other social activities') at baseline and mental health status at follow-up, multiple logistic regression analysis was used. We also used multiple logistic regression analysis to investigate the association between ways of participating in these activities ('by oneself', 'with others', or 'both' (both 'by oneself' and 'with others')) at baseline and mental health status at follow-up. Involvement in both leisure activity categories, but not in social activities, was significantly and positively related to mental health status in both men and women. Furthermore, in men, both 'hobbies or cultural activities' and 'exercise or sports' were significantly related to mental health status only when conducted 'with others'. In women, the effects of 'hobbies or cultural activities' on mental health status were no differences regardless of the ways of participating, while the result of 'exercise or sports' was same as that in men. Leisure activities appear to benefit mental health status among this age group, whereas specific social activities do not. Moreover, participation in leisure activities would be effective especially if others are present. These findings should be useful for preventing the deterioration of mental health status in middle-aged adults in Japan.

Urinary iodine concentration identifies pregnant women as iodine deficient yet school-aged children as iodine sufficient in rural Niger.

PubMed

Hess, Sonja Y; Ouédraogo, Césaire T; Young, Rebecca R; Bamba, Ibrahim F; Stinca, Sara; Zimmermann, Michael B; Wessells, K Ryan

2017-05-01

To assess iodine status among pregnant women in rural Zinder, Niger and to compare their status with the iodine status of school-aged children from the same households. Seventy-three villages in the catchment area of sixteen health centres were randomly selected to participate in the cross-sectional survey. Salt iodization is mandatory in Niger, requiring 20-60 ppm iodine at the retail level. A spot urine sample was collected from randomly selected pregnant women (n 662) and one school-aged child from the same household (n 373). Urinary iodine concentration (UIC) was assessed as an indicator of iodine status in both groups. Dried blood spots (DBS) were collected from venous blood samples of pregnant women and thyroglobulin (Tg), thyroid-stimulating hormone and total thyroxine were measured. Iodine content of household salt samples (n 108) was assessed by titration. Median iodine content of salt samples was 5·5 ppm (range 0-41 ppm), 98 % had an iodine content 40 µg/l. In this region of Niger, most salt is inadequately iodized. UIC in pregnant women indicated iodine deficiency, whereas UIC of school-aged children indicated marginally adequate iodine status. Thus, estimating population iodine status based solely on monitoring of UIC among school-aged children may underestimate the risk of iodine deficiency in pregnant women.

Prevalence of Smoking and Obesity Among U.S. Cancer Survivors: Estimates From the National Health Interview Survey, 2008–2012

PubMed Central

Shoemaker, Meredith L.; White, Mary C.; Hawkins, Nikki A.; Hayes, Nikki S.

2017-01-01

Purpose/Objectives To describe smoking and obesity prevalence among male and female cancer survivors in the United States. Design Cross-sectional survey. Setting Household interviews. Sample 9,753 survey respondents who reported ever having a malignancy, excluding nonmelanoma skin cancers. Methods Data from the National Health Interview Survey (2008–2012) were used to calculate weighted smoking status prevalence estimates. Cross-tabulations of smoking and weight status were produced, along with Wald chi-square tests and linear contrasts. Main Research Variables Cancer history, smoking status, obesity status, gender, age, and age at diagnosis. Findings Seventeen percent of cancer survivors reported current smoking. Female survivors had higher rates of current smoking than males, particularly in the youngest age category. Male survivors who currently smoked had lower obesity prevalence rates than males who previously smoked or never smoked. Among female survivors, 31% were obese and no significant differences were seen in obesity prevalence by smoking status for all ages combined. Conclusions The findings highlight the variation in smoking status and weight by age and gender. Smoking interventions may need to be targeted to address barriers specific to subgroups of cancer survivors. Implications for Nursing Nurses can be instrumental in ensuring that survivors receive comprehensive approaches to address both weight and tobacco use to avoid trading one risk for another. PMID:27314186

The relationship between demographic characteristics and motivational factors in the employees of social security hospitals in Mazandaran.

PubMed

Heidarian, Ali Reza; Jafari Kelarijani, Seyed Ebrahim; Jamshidi, Reza; Khorshidi, Mohamad

2015-01-01

Health worker motivation has the potential to have a large impact on health system performance, and this depends on some factors. The purpose of this study was to determine the factors affecting this motivation. From Winter 2013 to Spring 2014, 1046 employees and physicians (439 males and 607 females) with a mean age of 36 and 37.2 years in men and women, respectively were chosen in selected hospitals of Social Security Organization (SSO). They were randomly categorized into six different classes of service record, age education class of hiring (permanent and contractual), marital status, and gender. The variables assessed via the classification groups were as follows: interpersonal relations, working conditions, equity, pay, job security, supervision, advancement, recognition, responsibility, and attractiveness of job, educational and organizational policies. Bachelor's degree (65%) or higher were the education degrees of most participants. Significant relations were observed regarding age, marital status, hiring, gender and years of service with promotion, recognition, responsibility, attractiveness of job, education, relations, working condition, equity, salary, job security, supervision and organizational policies. There were significant relations with hire status and degree with advancement and other variables. There were significant relations between marital status, gender, years of service and age with the above variables. The results show that the important variables that influence motivational factors are academic degree, hire status, marital status, gender, age and years of service.

Causes, Consequences and Public Health Implications of Low B-Vitamin Status in Ageing

PubMed Central

Porter, Kirsty; Hoey, Leane; Hughes, Catherine F.; Ward, Mary; McNulty, Helene

2016-01-01

The potential protective roles of folate and the metabolically related B-vitamins (vitamins B12, B6 and riboflavin) in diseases of ageing are of increasing research interest. The most common cause of folate and riboflavin deficiencies in older people is low dietary intake, whereas low B12 status is primarily associated with food-bound malabsorption, while sub-optimal vitamin B6 status is attributed to increased requirements in ageing. Observational evidence links low status of folate and the related B-vitamins (and/or elevated concentrations of homocysteine) with a higher risk of degenerative diseases including cardiovascular disease (CVD), cognitive dysfunction and osteoporosis. Deficient or low status of these B-vitamins alone or in combination with genetic polymorphisms, including the common MTHFR 677 C → T polymorphism, could contribute to greater disease risk in ageing by causing perturbations in one carbon metabolism. Moreover, interventions with the relevant B-vitamins to optimise status may have beneficial effects in preventing degenerative diseases. The precise mechanisms are unknown but many have been proposed involving the role of folate and the related B-vitamins as co-factors for one-carbon transfer reactions, which are fundamental for DNA and RNA biosynthesis and the maintenance of methylation reactions. This review will examine the evidence linking folate and related B-vitamins with health and disease in ageing, associated mechanisms and public health implications. PMID:27854316

Influences of age and maxillary anterior teeth status on patient's satisfaction with dental appearance and tooth colour.

PubMed

Lajnert, Vlatka; Pavičić, Daniela K; Gržić, Renata; Kovač, Zoran; Pahor, Dana; Kuis, Davor; Simonić-Kocijan, Sunčana; Antonić, Robert; Bakarčić, Danko

2012-06-01

To study the impact of age, gender, tooth colour and maxillary anterior teeth status on patient's satisfaction with their dental appearance. A total of 259 Caucasian subjects participated in the study (119 men, mean age 56 years; 140 women, mean age 61 years) divided into three age groups (young <35 age; middle aged 35-54 age; old ≥55 age). Their maxillary anterior teeth status was classified into three groups: (1) natural teeth (NTG) group; (2) composite filling group (CFG) and (3) porcelain-fused-to-metal fixed prosthodontic restoration group (FPDG). The participants judged appearance and tooth colour using a scale with three categories: completely dissatisfied, moderately dissatisfied and completely satisfied. Almost half of the participants were completely satisfied with their dental appearance and tooth colour. Half of the 'young' and 'middle-aged' participants with natural maxillary anterior teeth were completely satisfied and half of the 'old' participants were moderately satisfied with their dental appearance and tooth colour. The majority of participants with composite restorations (45-51%) were moderately satisfied with their dental appearance, one-third of 'young' and 'middle-aged' participants were moderately satisfied or dissatisfied with their tooth colour and more than 70% of older participants were dissatisfied with their tooth colour (p > 0.05). Satisfaction with the appearance of the maxillary anterior teeth differed both between individuals of different age and different dental status. © 2011 The Gerodontology Society and John Wiley & Sons A/S.

Risk factors for visible lesions or positive laboratory tests in bovine tuberculosis reactor cattle in Northern Ireland.

PubMed

O'Hagan, M J H; Courcier, E A; Drewe, J A; Gordon, A W; McNair, J; Abernethy, D A

2015-07-01

An observational case-control study was conducted to investigate risk factors for confirmed bovine tuberculosis (bTB) infection in cattle reacting positively to the single intradermal comparative cervical test (SICCT) in Northern Ireland in the years 1998, 2002 and 2006. Macroscopic lesions were detected at slaughter (positive visible lesion (VL) status) in 43.0% of reactor cattle, whilst 45.3% of those sampled were confirmed as bTB positive due to the presence of lesions or positive histopathology/mycobacterial culture (positive bTB status). In 97.5% of the reactors, the VL status and bTB status were either both negative or both positive. Generalized linear mixed model analyses were conducted on data of 24,923 reactor cattle with the variables herd identifier, local veterinary office (DVO) and abattoir being used as random effects within all the models generated at univariable and multivariable level. The other variables within the dataset were used as fixed effects. Significant risk factors associated with VL status and bTB status at multivariable level (p<0.05) included age at death, breed, sex, test year, net increase in skin thickness at bovine tuberculin injection site, epidemiological status of skin test, total number of reactors at the disclosure test, mean herd size and prior response to the skin test. These risk factors are likely related to the time since infection, the strength of the challenge of infection and the susceptibility of the animal. These findings are important as the detection of visible lesions and the confirmation of bTB are an integral part of the overall bTB control programme in Northern Ireland and the veterinary meat inspection and hygiene programme. The visible lesion status and bTB status of an animal can affect the way in which bTB breakdowns are managed, since failure to detect visible lesions and recovery of Mycobacterium bovis can lead to a less stringent follow-up after other risk factors have been taken into account. Copyright © 2015 Elsevier B.V. All rights reserved.

Sex-specific interaction effects of age, occupational status, and workplace stress on psychiatric symptoms and allostatic load among healthy Montreal workers.

PubMed

Juster, Robert-Paul; Moskowitz, D S; Lavoie, Joel; D'Antono, Bianca

2013-11-01

Socio-demographics and workplace stress may affect men and women differently. The aim of this cross-sectional study was to assess sex-specific interactions among age, occupational status, and workplace Demand-Control-Support (D-C-S) factors in relation to psychiatric symptoms and allostatic load levels representing multi-systemic "wear and tear". It was hypothesized that beyond main effects, D-C-S factors would be moderated by occupational status and age in sex-specific directions predictive of subjective psychiatric symptoms and objective physiological dysregulations. Participants included healthy male (n = 81) and female (n = 118) Montreal workers aged 20 to 64 years (Men: M = 39.4 years, SD = 11.3; Women: M = 42.8 years, SD = 11.38). The Job Content Questionnaire was administered to assess workplace D-C-S factors that included psychological demands, decisional latitude, and social support. Occupational status was coded using the Nam--Powers--Boyd system derived from the Canadian census. Psychiatric symptoms were assessed using the Beck Anxiety Scale and the Beck Depression Inventory II. Sex-specific allostatic load indices were calculated based on fifteen biomarkers. Regression analyses revealed that higher social support was associated with less depressive symptoms in middle aged (p = 0.033) and older men (p = 0.027). Higher occupational status was associated with higher allostatic load levels for men (p = 0.035), while the reverse occurred for women (p = 0.048). Women with lower occupational status but with higher decision latitude had lower allostatic load levels, as did middle-aged (p = 0.031) and older women (p = 0.003) with higher psychological demands. In summary, age and occupational status moderated workplace stress in sex-specific ways that have occupational health implications.

Impact of severe haemophilia A on patients' health status: results from the guardian(™) 1 clinical trial of turoctocog alfa (NovoEight(®) ).

PubMed

Ozelo, M; Chowdary, P; Regnault, A; Busk, A K

2015-07-01

Haemophilia and its treatment interfere with patients' life and may affect adherence to treatment. This study explored the impact of severe haemophilia A on patients' health status, especially in young adults (YA), using data from guardian(™) 1, a multinational, open-label, non-controlled phase 3 trial investigating safety and efficacy of turoctocog alfa (NovoEight(®) ) in previously treated patients aged 12 years and older with severe haemophilia A (FVIII ≤ 1%). Health status was assessed using the EuroQoL-5 dimensions (EQ-5D-3L), covering 5 dimensions of health (mobility, self-care, usual activities, pain/discomfort and anxiety/depression), and a visual analogue scale (VAS) measuring self-rated overall health status. EQ-5D was administered pretreatment (screening/baseline) and posttreatment (end-of-trial). Baseline responses to the EQ-5D dimensions and VAS were described overall and by age and compared to reference values from UK general population. Guardian(™) 1 included 150 patients (16 adolescents, 83 YA aged 16-29 and 51 adults aged 30+). All five dimensions of patients' health status were impacted at baseline. The percentage of haemophilia patients reporting problems was consistently significantly greater than age-matched general population reference values. Likewise, for all age groups mean baseline EQ-5D VAS score was significantly lower for haemophilia patients (YA: 78.0) than for the general population (YA aged 18-29: 87.3). The health status of patients with severe haemophilia A entering guardian(™) 1 was markedly poorer than that of the general population, particularly regarding mobility and pain. YA patients reported better health status than older patients, but considerably lower than that of the general YA population. © 2015 The Authors. Haemophilia Published by John Wiley & Sons Ltd.

Aging with a traumatic brain injury: Could behavioral morbidities and endocrine symptoms be influenced by microglial priming?

PubMed

Ziebell, Jenna M; Rowe, Rachel K; Muccigrosso, Megan M; Reddaway, Jack T; Adelson, P David; Godbout, Jonathan P; Lifshitz, Jonathan

2017-01-01

A myriad of factors influence the developmental and aging process and impact health and life span. Mounting evidence indicates that brain injury, even moderate injury, can lead to lifetime of physical and mental health symptoms. Therefore, the purpose of this mini-review is to discuss how recovery from traumatic brain injury (TBI) depends on age-at-injury and how aging with a TBI affects long-term recovery. TBI initiates pathophysiological processes that dismantle circuits in the brain. In response, reparative and restorative processes reorganize circuits to overcome the injury-induced damage. The extent of circuit dismantling and subsequent reorganization depends as much on the initial injury parameters as other contributing factors, such as genetics and age. Age-at-injury influences the way the brain is able to repair itself, as a result of developmental status, extent of cellular senescence, and injury-induced inflammation. Moreover, endocrine dysfunction can occur with TBI. Depending on the age of the individual at the time of injury, endocrine dysfunction may disrupt growth, puberty, influence social behaviors, and possibly alter the inflammatory response. In turn, activation of microglia, the brain's immune cells, after injury may continue to fuel endocrine dysfunction. With age, the immune system develops and microglia become primed to subsequent challenges. Sustained inflammation and microglial activation can continue for weeks to months post-injury. This prolonged inflammation can influence developmental processes, behavioral performance and age-related decline. Overall, brain injury may influence the aging process and expedite glial and neuronal alterations that impact mental health. Copyright © 2016 Elsevier Inc. All rights reserved.

Assessment of iodine status and associated factors in vulnerable populations in Henan Province, China, in 2012.

PubMed

Yang, Jin; Zheng, Heming; Li, Xiaofeng; Zhu, Lin; Hao, Zongyu; Chen, Gan; Liu, Yang; Wang, Yanli

2014-01-01

Iodine content in table salt was adjusted from 30-50 mg/kg to 21-39 mg/kg from March of 2012 in Henan Province, China. The vulnerable population may be at risk of iodine deficiency. To determine whether the iodine intake was sufficient in vulnerable populations and to investigate what factors may be associated with iodine status in these vulnerable populations in Henan Province, China. A cross-sectional survey was conducted in 17 cities in Henan Province, China, from April 2012 to December 2012 to assess the iodine status in vulnerable populations, including women of reproductive-age (n=2648), pregnant women (n=39684), lactating women (n=6859), infants <2 years of age (n=16481), and children aged 8-10 years (n=3198). Questionnaires (n=4865) related to demographic and dietary factors were collected from the investigated women to identify factors that were related to iodine intake and iodine status. The median urinary iodine concentrations (mUICs) were 205 μg/L, 198 μg/L, 167 μg/L, 205 μg/L and 200 μg/L, respectively, in reproductiveage, pregnant and lactating women, infants <2 years of age and children aged 8-10 years. Higher income, and consuming more poultry and fish in the diet had positive impact on UIC levels. Low salt intake, consuming more rice and vegetables in the diet were negative factors for UIC. Iodine status of the vulnerable populations was generally adequate in Henan Province, China, according to WHO criteria. But the mUICs were slightly above the adequate level in reproductive-age women and children aged 8-10 years. It's important to monitor the iodine status in vulnerable populations after the adjustment on iodine content in table salt.

Food restriction enhances oxidative status in aging rats with neuroprotective effects on myenteric neuron populations in the proximal colon.

PubMed

Schoffen, João Paulo Ferreira; Santi Rampazzo, Ana Paula; Cirilo, Carla Possani; Zapater, Mariana Cristina Umada; Vicentini, Fernando Augusto; Comar, Jurandir Fernando; Bracht, Adelar; Natali, Maria Raquel Marçal

2014-03-01

Food restriction may slow the aging process by increasing the levels of antioxidant defenses and reducing cell death. We evaluated the effects of food restriction on oxidative and nutritional status, myenteric cell populations, and the colonic muscle layer in aging rats. Wistar rats were distributed into control groups (7, 12, and 23months of age) and subjected to food restriction (50% of normal diet) beginning at 7months of age. The animals were sacrificed, and blood was collected to evaluate its components and markers of oxidative status, including thiobarbituric acid-reactive substances, reduced glutathione, catalase, glutathione peroxidase, and total antioxidant capacity. The proximal colon was collected to evaluate HuC/D and neuronal nitric oxide synthase (nNOS)-positive and -negative myenteric neurons, S-100 glial cells, and the muscle layer. Age negatively affected oxidative status in the animals, which also increased the levels of total cholesterol, protein, and globulins and increased the thickness of the muscle layer. Aging also reduced the number and hypertrophied glial cell bodies, HuC/D neurons, and nNOS-negative and -positive neurons. An improvement was observed in oxidative status and the levels of total cholesterol and triglycerides with food restriction, which also provided neuroprotection of the intrinsic innervation. However, food restriction accentuated the loss of enteric glia and caused hypertrophy in the muscle layer at 23months. Food restriction improved oxidative and nutritional status in rats and protected HuC/D neurons and nNOS-negative and -positive neurons against neuronal loss. Nevertheless, food restriction caused morphoquantitative changes in glial cell populations, with possible interference with colonic neuromuscular control. Copyright © 2014 Elsevier Inc. All rights reserved.

The effect of maternal near miss on adverse infant nutritional outcomes.

PubMed

Zanardi, Dulce M; Moura, Erly C; Santos, Leonor P; Leal, Maria C; Cecatti, Jose G

2016-10-01

To evaluate the association between self-reported maternal near miss and adverse nutritional status in children under one year of age. This study is a secondary analysis of a study in which women who took their children under one year of age to the national vaccine campaign were interviewed. The self-reported condition of maternal near miss used the criteria of Intensive Care Unit admission; eclampsia; blood transfusion and hysterectomy; and their potential associations with any type of nutritional disorder in children, including deficits in weight-for-age, deficits in height-for-age, obesity and breastfeeding. The rates of near miss for the country, regions and states were initially estimated. The relative risks of infant adverse nutritional status according to near miss and maternal/childbirth characteristics were estimated with their 95% CIs using bivariate and multiple analyses. The overall prevalence of near miss was 2.9% and was slightly higher for the Legal Amazon than for other regions. No significant associations were found with nutritional disorders in children. Only a 12% decrease in overall maternal breastfeeding was associated with near miss. Living in the countryside and child over 6 months of age increased the risk of altered nutritional status by approximately 15%, while female child gender decreased this risk by 30%. Maternal near miss was not associated with an increased risk of any alteration in infant nutritional status. There was no association between maternal near miss and altered nutritional status in children up to one year of age. The risk of infant adverse nutritional status was greater in women living in the countryside, for children over 6 months of age and for male gender.

The status of US allergy/immunology physicians in the 21st century: a report from the American Academy of Allergy, Asthma & Immunology Workforce Committee.

PubMed

Marshall, Gailen D

2007-04-01

The American Academy of Allergy, Asthma & Immunology has tracked the US allergy/immunology physician workforce (AIPW) over the past 3 decades by funding 2 workforce surveys (1999, 2004). Results have demonstrated both accomplishments of and challenges for the US AIPW. Accomplishments include increases in diversity (25% women in 2004, 20% in 1999, 10% in 1989; 6% underrepresented minorities in 2004, 5% in 1999), 95% of AIPW has completed an allergy/immunology (A/I) training program, and 91% are American Board of Allergy and Immunology (a conjoint board of the American Board of Internal Medicine and the American Board of Pediatrics)-certified (90% in 1999). Training positions and program numbers are slowly increasing, and numbers of new graduates from accredited A/I programs have also increased. We are seeing patients with more complex allergic and immune diseases and giving less allergen immunotherapy. Personal, professional, and economic satisfaction is increasing. Challenges relate primarily to diminishing practitioner supply (4245 in 2004 vs 4356 in 1999) amid growing US population demand. The AIPW is gradually aging (the average age is 53 years in 2004, compared with 51 years in 1999) and working longer before retiring. The combination of job satisfaction, the high demand for A/I services, and the large number of fellowship applicants all support expanding the supply of trained allergists/immunologists.

How residential mobility and school choice challenge assumptions of neighborhood place-based interventions.

PubMed

Silver, Diana; Weitzman, Beth C; Mijanovich, Tod; Holleman, Martha

2012-01-01

Explore the importance of residential mobility and use of services outside neighborhoods when interventions targeting low-income families are planned and implemented. Analysis of cross-sectional telephone household survey data on childhood mobility and school enrollment in four large distressed cities. Baltimore, Maryland; Detroit, Michigan; Philadelphia, Pennsylvania; and Richmond, Virginia. Total of 1723 teens aged 10 to 18 years and their parents. Continuous self-report of the number of years parents lived in the neighborhood of residence and city; self-report of whether the child attends school in their neighborhood; and categorical self report of parents' marital status, mother's education, parent race, family income, child's age, and child's sex. Chi-square and multivariate logistic regression. In this sample, 85.2% of teens reported living in the city where they were born. However, only 44.4% of black teens lived in neighborhoods where they were born, compared with 59.2% of white teens. Although 50.3% of black teens attended schools outside of their current neighborhoods, only 31.4% of whites did. Residential mobility was more common among black than white children (odds ratio = 1.82; p < .001), and black teens had 43% lesser odds of attending school in their home communities. Mobility among low-income and minority families challenges some assumptions of neighborhood interventions premised on years of exposure to enriched services and changes in the built environment.

12 CFR 528.2 - Nondiscrimination in lending and other services.

Code of Federal Regulations, 2014 CFR

2014-01-01

... the dwelling, or on the basis of the race, color, religion, sex, handicap, familial status (having one or more children under the age of 18), marital status, age (provided the person has the capacity to...

12 CFR 128.2 - Nondiscrimination in lending and other services.

Code of Federal Regulations, 2013 CFR

2013-01-01

... the dwelling, or on the basis of the race, color, religion, sex, handicap, familial status (having one or more children under the age of 18), marital status, age (provided the person has the capacity to...

12 CFR 128.2 - Nondiscrimination in lending and other services.

Code of Federal Regulations, 2014 CFR

2014-01-01

... the dwelling, or on the basis of the race, color, religion, sex, handicap, familial status (having one or more children under the age of 18), marital status, age (provided the person has the capacity to...

12 CFR 528.2 - Nondiscrimination in lending and other services.

Code of Federal Regulations, 2010 CFR

2010-01-01

... the dwelling, or on the basis of the race, color, religion, sex, handicap, familial status (having one or more children under the age of 18), marital status, age (provided the person has the capacity to...

12 CFR 528.2 - Nondiscrimination in lending and other services.

Code of Federal Regulations, 2013 CFR

2013-01-01

... the dwelling, or on the basis of the race, color, religion, sex, handicap, familial status (having one or more children under the age of 18), marital status, age (provided the person has the capacity to...

12 CFR 128.2 - Nondiscrimination in lending and other services.

Code of Federal Regulations, 2012 CFR

2012-01-01

... the dwelling, or on the basis of the race, color, religion, sex, handicap, familial status (having one or more children under the age of 18), marital status, age (provided the person has the capacity to...

12 CFR 528.2 - Nondiscrimination in lending and other services.

Code of Federal Regulations, 2012 CFR

2012-01-01

... the dwelling, or on the basis of the race, color, religion, sex, handicap, familial status (having one or more children under the age of 18), marital status, age (provided the person has the capacity to...

12 CFR 528.2 - Nondiscrimination in lending and other services.

Code of Federal Regulations, 2011 CFR

2011-01-01

... the dwelling, or on the basis of the race, color, religion, sex, handicap, familial status (having one or more children under the age of 18), marital status, age (provided the person has the capacity to...

Relationships between nutritional status, depression and pleasure of eating in aging men and women.

PubMed

Bailly, Nathalie; Maître, Isabelle; Van Wymelbeke, Virginie

2015-01-01

Nutritional health is an essential component of quality of life among older adults. The aim of this study was to identify the predictors of nutritional status in order to identify both common and sex specific predictive pathways in an aging population. A questionnaire was administered to 464 people living at home aged 65 years and above. Part of the questionnaire contained questions about nutritional status (MNA), depression (GDS), pleasure of eating and demographic characteristics. Structural equation modeling was used to examine relationships between the variables. For both sexes, results indicate that depression and pleasure of eating are related to nutritional status. In addition, different pathways were found between men and women. In particular, while pleasure of eating is affected by depression among aging women this is not the case for men. The implications of the findings for nutrition communication are discussed. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Challenges with Final Status Surveys at a Large Decommissioning Site - 13417

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

Downey, Heath; Collopy, Peter; Shephard, Eugene

2013-07-01

As part of decommissioning a former nuclear fuel manufacturing site, one of the crucial final steps is to conduct Final Status Surveys (FSS) in order to demonstrate compliance with the release criteria. At this decommissioning site, the area for FSS was about 100 hectares (248 acres) and included varying terrain, wooded areas, ponds, excavations, buildings and a brook. The challenges in performing the FSS included determining location, identifying FSS units, logging gamma walkover survey data, determining sample locations, managing water in excavations, and diverting water in the brook. The approaches taken to overcome these challenges will be presented in themore » paper. The paper will present and discuss lessons learned that will aid others in the FSS process. (authors)« less

Growth outcome: nutritionist perspective.

PubMed

Agostoni, Carlo; Fattore, Giovanni

2013-01-01

Increasing evidence points to a fundamental role of early nutrition on rates of growth and development, and later health. We may identify three major fields of scientific interest and clinical application. (1) In developing countries poor growth is associated with greater risk of morbidity and mortality from infectious diseases, mainly lower respiratory infections and diarrhea. In these settings, failure to promote compensatory growth may have negative short-term consequences, and the nutritionist's task is the primary prevention of nutrient deficiencies to promote the full expression of the individual genetic potential, while allowing for recovery of early secondary functional deficiencies. (2) A second challenge for nutritionists is represented by the approach to growth impairments in rare disorders, ranging from congenital disorders to chronic infections. Most disorders are favorably influenced by improved nutritional status and better growth, and patients may satisfactorily reach adolescence, pubertal and reproductive age, up to ageing. Even for the less positive conditions, an improvement in the quality of life for families is in any case a rewarding aim. (3) A third challenge is represented by the definition of the role of nutrition on growth in physiological conditions for all individuals. Concern has been raised about the potential adverse long-term consequences of accelerated child growth rates, possibly resulting in a predisposition to develop non-communicable chronic diseases in the adult age. Accordingly, this hypothesis might explain the benefits of breastfeeding in terms of slower early growth, and the fetal origins hypothesis in terms of adverse postnatal catch-up growth in infants born small. Therefore, growth as viewed by a pediatric nutritionist perspective is a complex matter, ranging from the early stages of intrauterine development up to adult ages and ageing processes. Cost/benefit analyses of interventions on growth such as cost per DALYs (disability-adjusted life years) or QALYs (quality-adjusted life years) should be expanded on population basis and extended also to congenital and invalidating disorders to identify the most effective and economic sustainable strategies of action. Copyright © 2013 S. Karger AG, Basel.

Smoking-attributable medical expenditures by age, sex, and smoking status estimated using a relative risk approach☆

PubMed Central

Maciosek, Michael V.; Xu, Xin; Butani, Amy L.; Pechacek, Terry F.

2015-01-01

Objective To accurately assess the benefits of tobacco control interventions and to better inform decision makers, knowledge of medical expenditures by age, gender, and smoking status is essential. Method We propose an approach to distribute smoking-attributable expenditures by age, gender, and cigarette smoking status to reflect the known risks of smoking. We distribute hospitalization days for smoking-attributable diseases according to relative risks of smoking-attributable mortality, and use the method to determine national estimates of smoking-attributable expenditures by age, sex, and cigarette smoking status. Sensitivity analyses explored assumptions of the method. Results Both current and former smokers ages 75 and over have about 12 times the smoking-attributable expenditures of their current and former smoker counterparts 35–54 years of age. Within each age group, the expenditures of formers smokers are about 70% lower than current smokers. In sensitivity analysis, these results were not robust to large changes to the relative risks of smoking-attributable mortality which were used in the calculations. Conclusion Sex- and age-group-specific smoking expenditures reflect observed disease risk differences between current and former cigarette smokers and indicate that about 70% of current smokers’ excess medical care costs is preventable by quitting. PMID:26051203

Low Prevalence of Vitamin D Insufficiency among Nepalese Infants Despite High Prevalence of Vitamin D Insufficiency among Their Mothers

PubMed Central

Haugen, Johanne; Ulak, Manjeswori; Chandyo, Ram K.; Henjum, Sigrun; Thorne-Lyman, Andrew L.; Ueland, Per Magne; Midtun, Øivind; Shrestha, Prakash S.; Strand, Tor A.

2016-01-01

Background: Describing vitamin D status and its predictors in various populations is important in order to target public health measures. Objectives: To describe the status and predictors of vitamin D status in healthy Nepalese mothers and infants. Methods: 500 randomly selected Nepalese mother and infant pairs were included in a cross-sectional study. Plasma 25(OH)D concentrations were measured by LC-MS/MS and multiple linear regression analyses were used to identify predictors of vitamin D status. Results: Among the infants, the prevalence of vitamin D insufficiency (25(OH)D <50 nmol/L) and deficiency (<30 nmol/L) were 3.6% and 0.6%, respectively, in contrast to 59.8% and 14.0% among their mothers. Infant 25(OH)D concentrations were negatively associated with infant age and positively associated with maternal vitamin D status and body mass index (BMI), explaining 22% of the variability in 25(OH)D concentration. Global solar radiation, maternal age and BMI predicted maternal 25(OH)D concentration, explaining 9.7% of its variability. Conclusion: Age and maternal vitamin D status are the main predictors of vitamin D status in infants in Bhaktapur, Nepal, who have adequate vitamin D status despite poor vitamin D status in their mothers. PMID:28009810

Associations of marital status with mortality from all causes and mortality from cardiovascular disease in Japanese haemodialysis patients.

PubMed

Tanno, Kozo; Ohsawa, Masaki; Itai, Kazuyoshi; Kato, Karen; Turin, Tanvir Chowdhury; Onoda, Toshiyuki; Sakata, Kiyomi; Okayama, Akira; Fujioka, Tomoaki

2013-04-01

Marital status is an important social factor associated with increased mortality from cardiovascular disease (CVD) and all causes. However, there has been no study on the association of marital status with mortality in haemodialysis patients. We analysed data from a 5-year prospective cohort study of 1064 Japanese haemodialysis patients aged 30 years or older. Marital status was classified into three groups: married, single and divorced/widowed. Cox's regression was used to estimate multivariate hazard ratios (HRs) [95% confidence intervals (CIs)] for all-cause mortality and CVD mortality according to marital status after adjusting for age, sex, duration of haemodialysis, cause of renal failure, body mass index, systolic blood pressure, total cholesterol, high density lipoprotein-cholesterol, albumin, high-sensitivity C-reactive protein, co-morbid conditions, smoking, alcohol consumption, education levels and job status. Single patients had higher risks than married patients for mortality from all causes (HR = 1.51, 95% CI: 1.06-2.16) and mortality from CVD (HR = 1.68, 95% CI: 1.03-2.76), and divorced/widowed patients had a higher risk than married patients for mortality from CVD (HR = 1.73, 95% CI: 1.15-2.60). After stratification by age, single patients aged 30-59 years had significantly higher risks for all-cause mortality and CVD mortality. The findings suggest that single status is a significant predictor for all-cause mortality and CVD mortality and that divorced/widowed status is a significant predictor for CVD mortality in haemodialysis patients.

Children with cerebral palsy in Ghana: malnutrition, feeding challenges, and caregiver quality of life.

PubMed

Polack, Sarah; Adams, Mel; O'banion, David; Baltussen, Marjolein; Asante, Sandra; Kerac, Marko; Gladstone, Melissa; Zuurmond, Maria

2018-05-07

To assess feeding difficulties and nutritional status among children with cerebral palsy (CP) in Ghana, and whether severity of feeding difficulties and malnutrition are independently associated with caregiver quality of life (QoL). This cross-sectional survey included 76 children with CP (18mo-12y) from four regions of Ghana. Severity of CP was classified using the Gross Motor Function Classification System and anthropometric measures were taken. Caregivers rated their QoL (using the Pediatric Quality of Life Inventory Family Impact Module) and difficulties with eight aspects of child feeding. Logistic regression analysis explored factors (socio-economic characteristics, severity of CP, and feeding difficulties) associated with being underweight. Linear regression was undertaken to assess the relationship between caregiver QoL and child malnutrition and feeding difficulties. Poor nutritional status was common: 65% of children aged under 5 years were categorized as underweight, 54% as stunted, and 58% as wasted. Reported difficulties with child's feeding were common and were associated with the child being underweight (odds ratio 10.7, 95% confidence interval 2.3-49.6) and poorer caregiver QoL (p<0.001). No association between caregiver QoL and nutritional status was evident. Among rural, low resource populations in Ghana, there is a need for appropriate, accessible caregiver training and support around feeding practices of children with CP, to improve child nutritional status and caregiver well-being. What this paper adds Malnutrition is very common among children with cerebral palsy in this rural population in Ghana. Feeding difficulties in this population were strongly associated with being underweight. Feeding difficulties were associated with poorer caregiver quality of life (QoL). Child nutritional status was not associated with caregiver QoL. © 2018 Mac Keith Press.

Nutritional requirements during lactation. Towards European alignment of reference values: the EURRECA network.

PubMed

Hall Moran, Victoria; Lowe, Nicola; Crossland, Nicola; Berti, Cristiana; Cetin, Irene; Hermoso, Maria; Koletzko, Berthold; Dykes, Fiona

2010-10-01

There is considerable variation in reference values for micronutrient intake during lactation across Europe. The European Micronutrients Recommendations Aligned project aims to harmonize dietary recommendations throughout Europe. Recommended nutrient intakes during lactation are based on limited data and are often extrapolated from known secretion of the nutrient in milk with adjustments for bioavailability, so that differences between values can be partly ascribed to differences in methodological approaches and how these approaches were applied. Few studies have considered the impact of lactation on the mother's nutritional status. Rather, focus has been placed on the influence of maternal nutritional status on the composition of her breast milk. Most common nutritional deficits in breast milk are the result of maternal deficiencies of the water-soluble vitamins, thiamine, riboflavin and vitamins B6 and B12. Other than maternal vitamin A status, which to some extent is reflected in breast milk, concentrations of fat-soluble vitamins and most minerals in breast milk are less affected by maternal status. Factors relating to suboptimal maternal nutritional status during lactation include maternal age, diet and lifestyle factors and spacing of consecutive births. Recent research is providing new knowledge on the micronutrient requirements of lactating women. Identifying needs for research and improving understanding of the differences in values that have been derived by various committees and groups across Europe will enhance transparency and facilitate the application of dietary recommendations in policy-making decision and their translation into recommendations for lactating women. Given the wide variation in breastfeeding practices across Europe, making nutritional recommendations for lactating women is complex and challenging. Thus, it is crucial to first examine the cultural practices within and across European populations and to assess its relevance before making recommendations. © 2010 Blackwell Publishing Ltd.

Marital Status and Reproduction: Associations with Childhood Intelligence and Adult Social Class in the Aberdeen Children of the 1950s Study

ERIC Educational Resources Information Center

von Stumm, Sophie; Batty, G. David; Deary, Ian J.

2011-01-01

Childhood intelligence (age 11) and occupational social status at midlife (age 46 to 51) was associated with marital status and reproduction in a sample from the Aberdeen Children of the 1950s cohort study (N = 9614). Male and female divorcees had lower childhood intelligence test scores than their married counterparts, but no meaningful…

The Effects of Employment Status and Daily Stressors on Time Spent on Daily Household Chores in Middle-Aged and Older Adults

ERIC Educational Resources Information Center

Wong, Jen D.; Almeida, David M.

2013-01-01

Purpose of the study: This study examines how employment status (worker vs. retiree) and life course influences (age, gender, and marital status) are associated with time spent on daily household chores. Second, this study assesses whether the associations between daily stressors and time spent on daily household chores differ as a function of…

Vitamin D Intake and Status in 6-Year-Old Icelandic Children Followed up from Infancy.

PubMed

Thorisdottir, Birna; Gunnarsdottir, Ingibjorg; Steingrimsdottir, Laufey; Palsson, Gestur I; Birgisdottir, Bryndis E; Thorsdottir, Inga

2016-02-04

High serum 25-hydroxyvitamin D (25(OH)D) levels have been observed in infants in Nordic countries, likely due to vitamin D supplement use. Internationally, little is known about tracking vitamin D status from infancy to childhood. Following up 1-year-old infants in our national longitudinal cohort, our aims were to study vitamin D intake and status in healthy 6-year-old Icelandic children (n = 139) and to track vitamin D status from one year of age. At six years, the mean 25(OH)D level was 56.5 nmol/L (SD 17.9) and 64% of children were vitamin D sufficient (25(OH)D ≥ 50 nmol/L). A logistic regression model adjusted for gender and breastfeeding showed that higher total vitamin D intake (Odds ratio (OR) = 1.27, 95% confidence interval (CI) = 1.08-1.49), blood samples collected in summer (OR = 8.88, 95% CI = 1.83-43.23) or autumn (OR = 5.64, 95% CI = 1.16-27.32) compared to winter/spring, and 25(OH)D at age one (OR = 1.02, 95% CI = 1.002-1.04) were independently associated with vitamin D sufficiency at age six. The correlation between 25(OH)D at age one and six was 0.34 (p = 0.003). Our findings suggest that vitamin D status in infancy, current vitamin D intake and season are predictors of vitamin D status in early school age children. Our finding of vitamin D status tracking from infancy to childhood provides motivation for further studies on tracking and its clinical significance.

Where to next with animal health in Latin America? The transition from endemic to disease-free status.

PubMed

Rojas, H; Romero, J R

2017-04-01

The Latin American and Caribbean region (LAC) is a leading global producer and exporter of animal products. Its livestock production systems are diverse, ranging from large-scale commercial enterprises to family farms. Countries in this region have sought to improve their animal health status through both public and private efforts. Despite significant advances in eradicating such diseases as foot and mouth disease and classical swine fever, other animal health challenges remain; constraining exports, causing negative economic impacts and threatening food security. Obtaining certification of disease-free status is only the first step towards gaining benefits from improvements in animal health. Increasing international trade means that countries must manage the sustainability of their disease-free status in conjunction with trade partners and must comply with additional food safety and animal welfare standards. This paper comments on the challenges created by this new scenario in relation to the epidemiology and economics of animal health, when seeking to improve decisionmaking for animal health management. The authors characterise the current LAC livestock landscape and animal health situation, describing transitions in disease control and the use of economics in improving animal health. They conclude with remarks on the challenges presented by decision-making, economic rationality, sources of benefits, distribution and incentives.

Beverage intake of girls at age 5 y predicts adiposity and weight status in childhood and adolescence.

PubMed

Fiorito, Laura M; Marini, Michele; Francis, Lori A; Smiciklas-Wright, Helen; Birch, Leann L

2009-10-01

Increased consumption of sweetened beverage has been linked to higher energy intake and adiposity in childhood. The objective was to assess whether beverage intake at age 5 y predicted energy intake, adiposity, and weight status across childhood and adolescence. Participants were part of a longitudinal study of non-Hispanic white girls and their parents (n = 170) who were assessed biennially from age 5 to 15 y. At each assessment, beverage intake (milk, fruit juice, and sweetened beverages) and energy intake were assessed by using three 24-h recalls. Percentage body fat and waist circumference were measured. Height and weight were measured and used to calculate body mass index. Multiple regression analyses were used to predict the girls' adiposity. In addition, at age 5 y, girls were categorized as consuming <1, > or =1 and <2, or > or =2 servings of sweetened beverages. A mixed modeling approach was used to assess longitudinal differences and patterns of change in sweetened beverage and energy intake, adiposity, and weight status by frequency of sweetened beverage intake. Sweetened beverage intake at age 5 y, but not milk or fruit juice intake, was positively associated with adiposity from age 5 to 15 y. Greater consumption of sweetened beverages at age 5 y (> or =2 servings/d) was associated with a higher percentage body fat, waist circumference, and weight status from age 5 to 15 y. These findings provide new longitudinal evidence that early intake of sweetened beverages predicts adiposity and weight status across childhood and adolescence.

Estimated maturity status and perceptions of adult autonomy support in youth soccer players.

PubMed

Cumming, Sean P; Battista, Rebecca A; Martyn, Standage; Ewing, Martha E; Malina, Robert M

2006-10-01

In this study, we examined the relations between biological maturity status, body mass index, age, and perceptions of adult autonomy support in the context of youth soccer. A total of 70 female and 43 male soccer players, aged 9 - 15 years, completed three adult-specific versions (i.e. mother, father, coach) of the perceived autonomy support subscale from the Interpersonal Style Scale. The participants' percent predicted adult stature was used as an estimate of biological maturity status. Multiple linear regression analyses revealed that advanced maturity status in male players predicted lower perceptions of autonomy support from the coach. Maturity status was unrelated to perceptions of autonomy support from the coach in female soccer players, and paternal and maternal autonomy support in male and female players. Age and body mass index were unrelated to perceptions of adult (i.e. coach, mother, father) autonomy support in male and female players.

Status epilepticus in the elderly: epidemiology, clinical aspects and treatment

PubMed Central

de Assis, Telma M.R.; Costa, Gersonita; Bacellar, Aroldo; Orsini, Marco; Nascimento, Osvaldo J.M.

2012-01-01

The aim of the study was to review the epidemiology, clinical profile and discuss the etiology, prognosis and treatment options in patients aged 60 years or older presenting with status epilepticus. We performed a systematic review involving studies published from 1996 to 2010, in Medline/PubMed, Scientific Electronic Library on line (Scielo), Latin-American and Caribbean Center of Health Sciences Information (Lilacs) databases and textbooks. Related articles published before 1996, when relevant for discussing epilepsy in older people, were also included. Several population studies had shown an increased incidence of status epilepticus after the age of 60 years. Status epilepticus is a medical and neurological emergency that is associated with high morbidity and mortality, and is a major concern in the elderly compared to the general population. Prompt diagnosis and effective treatment of convulsive status epilepticus are crucial to avoid brain injury and reduce the fatality rate in this age group. PMID:23355930

Understanding sickle cell carrier status identified through newborn screening: a qualitative study

PubMed Central

Miller, Fiona A; Paynter, Martha; Hayeems, Robin Z; Little, Julian; Carroll, June C; Wilson, Brenda J; Allanson, Judith; Bytautas, Jessica P; Chakraborty, Pranesh

2010-01-01

The expansion of newborn screening (NBS) is increasing the generation of incidental results, notably carrier results. Although carrier status is generally understood to be clinically benign, concerns persist that parents may misunderstand its meaning, with deleterious effects on children and their families. Expansion of the NBS panel in Ontario, Canada in 2006 to include sickle cell disorders drew attention to the policy challenge of incidental carrier results. We conducted a study of consumer and provider attitudes to inform policy on disclosure. In this paper, we report the results of (i) qualitative interviews with health-care providers, advocates and parents of carrier infants and (ii) focus groups with new parents and individuals active with the sickle cell community. Lay and provider participants generally believed that carrier results were clinically insignificant. However, some uncertainty persisted among lay consumers in the form of conjecture or doubt. In addition, consumers and advocates who were most informed about the disease articulated insistent yet dissonant claims of clinical significance. Meanwhile, providers referenced research knowledge to offer an equivocal assessment of the possibility and significance of clinically symptomatic carrier status. We conclude that many interpretations of carrier status are in circulation, failing to fit neatly into the categories of ‘clinically significant' or ‘benign.' This creates challenges for communicating clearly with parents – challenges exacerbated by inconsistent messages from screening programs regarding the significance of sickle cell carrier status. Disclosure policy related to incidentally generated infant carrier results needs to account for these complex realities. PMID:19809482

Influences of gender and socioeconomic status on the motor proficiency of children in the UK.

PubMed

Morley, David; Till, Kevin; Ogilvie, Paul; Turner, Graham

2015-12-01

As the development of movement skills are so crucial to a child's involvement in lifelong physical activity and sport, the purpose of this study was to assess the motor proficiency of children aged 4-7 years (range=4.3-7.2 years), whilst considering gender and socioeconomic status. 369 children (176 females, 193 males, aged=5.96 ± 0.57 years) were assessed for fine motor precision, fine motor integration, manual dexterity, bilateral co-ordination, balance, speed and agility, upper-limb co-ordination and strength. The average standard score for all participants was 44.4 ± 8.9, classifying the participants towards the lower end of the average score. Multivariate analysis of covariance identified significant effects for gender (p<0.001) and socioeconomic status (p<0.001). Females outperformed males for fine motor skills and boys outperformed girls for catch and dribble gross motor skills. High socioeconomic status significantly outperformed middle and/or low socioeconomic status for total, fine and gross motor proficiency. Current motor proficiency of primary children aged 4-7 years in the UK is just below average with differences evident between gender and socioeconomic status. Teachers and sport coaches working with primary aged children should concentrate on the development of movement skills, whilst considering differences between genders and socioeconomic status. Crown Copyright © 2015. Published by Elsevier B.V. All rights reserved.

Impact of age-related macular degeneration in patients with glaucoma: understanding the patients' perspective.

PubMed

Skalicky, Simon E; Fenwick, Eva; Martin, Keith R; Crowston, Jonathan; Goldberg, Ivan; McCluskey, Peter

2016-07-01

The aim of the study is to measure the impact of age-related macular degeneration on vision-related activity limitation and preference-based status for glaucoma patients. This was a cross-sectional study. Two-hundred glaucoma patients of whom 73 had age-related macular degeneration were included in the research. Sociodemographic information, visual field parameters and visual acuity were collected. Age-related macular degeneration was scored using the Age-Related Eye Disease Study system. The Rasch-analysed Glaucoma Activity Limitation-9 and the Visual Function Questionnaire Utility Index measured vision-related activity limitation and preference-based status, respectively. Regression models determined factors predictive of vision-related activity limitation and preference-based status. Differential item functioning compared Glaucoma Activity Limitation-9 item difficulty for those with and without age-related macular degeneration. Mean age was 73.7 (±10.1) years. Lower better eye mean deviation (β: 1.42, 95% confidence interval: 1.24-1.63, P < 0.001) and age-related macular degeneration (β: 1.26 95% confidence interval: 1.10-1.44, P = 0.001) were independently associated with worse vision-related activity limitation. Worse eye visual acuity (β: 0.978, 95% confidence interval: 0.961-0.996, P = 0.018), high risk age-related macular degeneration (β: 0.981, 95% confidence interval: 0.965-0.998, P = 0.028) and severe glaucoma (β: 0.982, 95% confidence interval: 0.966-0.998, P = 0.032) were independently associated with worse preference-based status. Glaucoma patients with age-related macular degeneration found using stairs, walking on uneven ground and judging distances of foot to step/curb significantly more difficult than those without age-related macular degeneration. Vision-related activity limitation and preference-based status are negatively impacted by severe glaucoma and age-related macular degeneration. Patients with both conditions perceive increased difficulty walking safely compared with patients with glaucoma alone. © 2015 Royal Australian and New Zealand College of Ophthalmologists.

12 CFR 390.142 - Nondiscrimination in lending and other services.

Code of Federal Regulations, 2013 CFR

2013-01-01

... dwelling, or on the basis of the race, color, religion, sex, handicap, familial status (having one or more children under the age of 18), marital status, age (provided the person has the capacity to contract) or...

12 CFR 390.142 - Nondiscrimination in lending and other services.

Code of Federal Regulations, 2014 CFR

2014-01-01

... dwelling, or on the basis of the race, color, religion, sex, handicap, familial status (having one or more children under the age of 18), marital status, age (provided the person has the capacity to contract) or...

12 CFR 390.142 - Nondiscrimination in lending and other services.

Code of Federal Regulations, 2012 CFR

2012-01-01

... dwelling, or on the basis of the race, color, religion, sex, handicap, familial status (having one or more children under the age of 18), marital status, age (provided the person has the capacity to contract) or...

A Population Profile of Measles Susceptibility in Tianjin, China

PubMed Central

Boulton, Matthew L.; Wang, Xiexiu; Zhang, Ying; Montgomery, JoLynn P.; Wagner, Abram L.; Carlson, Bradley F.; Ding, Yaxing; Li, Xiaoyan; Gillespie, Brenda; Su, Xu

2016-01-01

Background Measles is a highly infectious illness requiring herd immunity of 95% to interrupt transmission. Measles is targeted for elimination in China, which has not reached elimination goals despite high vaccination coverage. We developed a population profile of measles immunity among residents aged 0 through 49 years in Tianjin, China. Methods Participants were either from community population registers or community immunization records. Measles IgG antibody status was assessed using dried blood spots. We examined the association between measles IgG antibody status and independent variables including urbanicity, sex, vaccination, measles history, and age. Results 2,818 people were enrolled. The proportion measles IgG negative increased from 50.7% for infants aged 1 month to 98.3% for those aged 7 months. After 8 months, the age of vaccination eligibility, the proportion of infants and children measles IgG negative decreased. Overall, 7.8% of participants 9 months of age or older lacked measles immunity including over 10% of those 20–39 years. Age and vaccination status were significantly associated with measles IgG status in the multivariable model. The odds of positive IgG status were 0.337 times as high for unvaccinated compared to vaccinated (95% CI: 0.217, 0.524). Conclusions The proportion of persons in Tianjin, China immune to measles was lower than herd immunity threshold with less than 90% of people aged 20–39 years demonstrating protection. Immunization programs in Tianjin have been successful in vaccinating younger age groups although high immunization coverage in infants and children alone won’t provide protective herd immunity, given the large proportion of non-immune adults. PMID:27151881

Midlife contributors to socioeconomic differences in frailty during later life: a prospective cohort study.

PubMed

Brunner, Eric J; Shipley, Martin J; Ahmadi-Abhari, Sara; Valencia Hernandez, Carlos; Abell, Jessica G; Singh-Manoux, Archana; Kawachi, Ichiro; Kivimaki, Mika

2018-06-13

Health inequalities persist into old age. We aimed to investigate risk factors for socioeconomic differences in frailty that could potentially be modified through policy measures. In this multi-wave longitudinal cohort study (Whitehall II study), we assessed participants' socioeconomic status, behavioural and biomedical risk factors, and disease status at age 45-55 years, and frailty (defined according to the Fried phenotype) at baseline and at one or more of three clinic visits about 18 years later (mean age 69 years [SD 5·9]). We used logistic mixed models to examine the associations between socioeconomic status and risk factors at age 50 years and subsequent prevalence of frailty (adjusted for sex, ethnic origin, and age), with sensitivity analyses and multiple imputation for missing data. Between Sept 9, 2007, and Dec 8, 2016, 6233 middle-aged adults were measured for frailty. Frailty was present in 562 (3%) of 16 164 person-observations, and varied by socioeconomic status: 145 (2%) person-observations had high socioeconomic status, 241 (4%) had intermediate status, and 176 (7%) had low socioeconomic status, adjusting for sex and age. Risk factors for frailty included cardiovascular disease, depression, smoking, high or abstinent alcohol consumption, low fruit and vegetable consumption, physical inactivity, poor lung function, hypertension, and overweight or obesity. Cardiometabolic markers for future frailty were high ratio of total to high-density lipoprotein cholesterol, and raised interleukin-6 and C-reactive protein concentrations. The five most important factors contributing to the frailty gradient, assessed by percent attenuation of the association between socioeconomic status and frailty, were physical activity (13%), interleukin-6 (13%), body-mass index category (11%), C-reactive protein (11%), and poor lung function (10%). Overall, socioeconomic differences in frailty were reduced by 40% in the maximally-adjusted model compared with the minimally-adjusted model. Behavioural and cardiometabolic risk factors in midlife account for more than a third of socioeconomic differences in frailty. Our findings suggest that interventions targeting physical activity, obesity, smoking, and low-grade inflammation in middle age might reduce socioeconomic differences in later-life frailty. British Heart Foundation and British Medical Research Council. Copyright © 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.

Guantanamo Detainees: Habeas Corpus Challenges in Federal Court

DTIC Science & Technology

2005-12-07

Separation of Powers Issues . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23 Eliminating Federal Court Jurisdiction Where There is No State Court Review . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24 Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25 1 The amendment refers to both the Combatant Status Review Tribunals (“ CSRTs” ), the initial administrative procedure to confirm the detainees’ status as enemy

Attractants for ACP trapping technology: Challenges, status, and opportunities

USDA-ARS?s Scientific Manuscript database

Psyllid host searching behavior is complex and sophisticated. It can be influenced by host species, growth stage, and physiological condition, psyllid gender and mating status, behavioral plasticity, usurpation by phytopathogens of host aromas, and psyllid-induced emission of foliar volatiles. Asian...

Mastering Reading and Mathematics in the Early Grades. Challenge to Lead Series

ERIC Educational Resources Information Center

Lord, Joan; Wade, Robin; Creech, Joseph

2004-01-01

The "Challenge to Lead" goal for early grades students is first about student achievement in reading and mathematics. The goal is that students in the early grades, regardless of their economic status, school location, ethnicity or gender will be as proficient in reading and mathematics as youngsters anywhere in the nation. "Challenge to Lead"…

State of Mississippi Campuses Step Up to the Challenge

ERIC Educational Resources Information Center

Hug, Jack

2010-01-01

Making the right decisions at the right time is critical. Following through on those decisions is challenging and can take courage. One example of a group of institutions and facility management professionals stepping up to the task and having the courage to challenge the status quo is the State of Mississippi Institutions of Higher Learning…

Leapfrogging Over the Status Quo: E-Learning and the Challenge of Adult Literacy.

ERIC Educational Resources Information Center

McCain, Mary

E-learning's potential for responding to the challenges of adult literacy was explored through a review of research and input from program managers, developers, and funders. The study identified adult literacy e-learning products, programs, and resources that are available or in development. Challenges to greater use of technology in adult…

Household food group expenditure patterns are associated with child anthropometry at ages 5, 8 and 12 years in Ethiopia, India, Peru and Vietnam.

PubMed

Humphries, Debbie L; Dearden, Kirk A; Crookston, Benjamin T; Woldehanna, Tassew; Penny, Mary E; Behrman, Jere R

2017-08-01

Population-level analysis of dietary influences on nutritional status is challenging in part due to limitations in dietary intake data. Household expenditure surveys, covering recent household expenditures and including key food groups, are routinely conducted in low- and middle-income countries. These data may help identify patterns of food expenditure that relate to child growth. We investigated the relationship between household food expenditures and child growth using factor analysis. We used data on 6993 children from Ethiopia, India, Peru and Vietnam at ages 5, 8 and 12y from the Young Lives cohort. We compared associations between household food expenditures and child growth (height-for-age z scores, HAZ; body mass index-for-age z scores, BMI-Z) using total household food expenditures and the "household food group expenditure index" (HFGEI) extracted from household expenditures with factor analysis on the seven food groups in the child dietary diversity scale, controlling for total food expenditures, child dietary diversity, data collection round, rural/urban residence and child sex. We used the HFGEI to capture households' allocations of their finances across food groups in the context of local food pricing, availability and pReferences RESULTS: The HFGEI was associated with significant increases in child HAZ in Ethiopia (0.07), India (0.14), and Vietnam (0.07) after adjusting for all control variables. Total food expenditures remained significantly associated with increases in BMI-Z for India (0.15), Peru (0.11) and Vietnam (0.06) after adjusting for study round, HFGEI, dietary diversity, rural residence, and whether the child was female. Dietary diversity was inversely associated with BMI-Z in India and Peru. Mean dietary diversity increased from age 5y to 8y and decreased from age 8y to 12y in all countries. Household food expenditure data provide insights into household food purchasing patterns that significantly predict HAZ and BMI-Z. Including food expenditure patterns data in analyses may yield important information about child nutritional status and linear growth. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.