Sample records for decline rate study

  1. The effects of site factors on the rate of hemlock decline: a case study in New Jersey

    Treesearch

    Denise Royle; Richard Lathrop

    2000-01-01

    The rate of decline of hemlock (Tsuga canadensis) trees infested with hemlock woolly adelgid (Adelges tsugae) appears to be highly variable and site dependent. Rates of hemlock forest decline have not been quantified at the landscape scale and reasons for observed variations in the rate of decline remain unknown. Others have...

  2. Hierarchy and Speed of Loss in Physical Functioning: A Comparison Across Older U.S. and English Men and Women.

    PubMed

    Bendayan, Rebecca; Cooper, Rachel; Wloch, Elizabeth G; Hofer, Scott M; Piccinin, Andrea M; Muniz-Terrera, Graciela

    2017-08-01

    We aimed to identify the hierarchy of rates of decline in 16 physical functioning measures in U.S. and English samples, using a systematic and integrative coordinated data analysis approach. The U.S. sample consisted of 13,612 Health and Retirement Study participants, and the English sample consisted of 5,301 English Longitudinal Study of Ageing participants. Functional loss was ascertained using self-reported difficulties performing 6 activities of daily living and 10 mobility tasks. The variables were standardized, rates of decline were computed, and mean rates of decline were ranked. Mann-Whitney U tests were performed to compare rates of decline between studies. In both studies, the rates of decline followed a similar pattern; difficulty with eating was the activity that showed the slowest decline and climbing several flights of stairs and stooping, kneeling, or crouching the fastest declines. There were statistical differences in the speed of decline in all 16 measures between countries. American women had steeper declines in 10 of the measures than English women. Similar differences were found between American and English men. Reporting difficulties climbing several flights of stairs without resting, and stooping, kneeling, or crouching are the first indicators of functional loss reported in both populations. © The Author 2016. Published by Oxford University Press on behalf of The Gerontological Society of America.

  3. The impact of retirement on age related cognitive decline - a systematic review.

    PubMed

    Meng, Annette; Nexø, Mette Andersen; Borg, Vilhelm

    2017-07-21

    Knowledge on factors affecting the rate of cognitive decline and how to maintain cognitive functioning in old age becomes increasingly relevant. The purpose of the current study was to systematically review the evidence for the impact of retirement on cognitive functioning and on age related cognitive decline. We conducted a systematic literature review, following the principles of the PRISMA statement, of longitudinal studies on the association between retirement and cognition. Only seven studies fulfilled the inclusion criteria. We found weak evidence that retirement accelerates the rate of cognitive decline in crystallised abilities, but only for individuals retiring from jobs high in complexity with people. The evidence of the impact of retirement on the rate of decline in fluid cognitive abilities is conflicting. The review revealed a major knowledge gap in regards to the impact of retirement on cognitive decline. More knowledge on the association between retirement and age related cognitive decline as well as knowledge on the mechanisms behind these associations is needed.

  4. Downward Spirals, Boiled Frogs, and Catastrophes: Examining the Rate of School Decline

    ERIC Educational Resources Information Center

    Hochbein, Craig

    2012-01-01

    The purpose of this study is to determine the validity of common assumptions about the rate at which school decline manifests. From a population of 981 elementary schools in the state of Virginia, the author uses three operational definitions of school decline to identify samples of declining schools: Absolute (n = 217), Relational (n = 510), and…

  5. Differential rate in decline in ovarian reserve markers in women with polycystic ovary syndrome compared with control subjects: results of a longitudinal study.

    PubMed

    Ahmad, Asima K; Kao, Chia-Ning; Quinn, Molly; Lenhart, Nikolaus; Rosen, Mitchell; Cedars, Marcelle I; Huddleston, Heather

    2018-03-01

    To estimate rates of ovarian aging in polycystic ovary syndrome (PCOS) subjects versus a community control population. Longitudinal. Tertiary academic center. PCOS subjects diagnosed according to the 2004 Rotterdam criteria were systematically enrolled in a PCOS cohort study. The comparison control subjects were from the Ovarian Aging study, a prospective longitudinal study of ovarian aging in healthy women with regular menstrual cycles. Clinical data collection over two study visits. Antral follicle count (AFC), ovarian volume (OV), and antimüllerian hormone level (AMH). PCOS subjects were found to have higher baseline values for all ovarian reserve markers compared with control subjects. Univariate models indicated that, compared with control subjects, PCOS patients experienced significantly faster rates of decline for both AFC and AMH. Change in OV did not differ significantly. To account for potential confounder effects, multiple analysis of covariance models were evaluated for the best fit, considering age, body mass index, and baseline ovarian reserve markers. Adjusted models demonstrated that PCOS patients do not experience a significant difference in AFC decline compared with control subjects, but they do experience a faster rate of decline in AMH (P<.01) and slower rate of decline in OV (P<.01). Ovarian aging in PCOS is characterized by a more rapid decline in AMH and a slower decline in OV compared with control subjects. Copyright © 2017 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  6. Clinical Use of Dornase Alfa Is Associated with a Slower Rate of FEV1 Decline in Cystic Fibrosis

    PubMed Central

    Konstan, Michael W.; Wagener, Jeffrey S.; Pasta, David J.; Millar, Stefanie J.; Jacobs, Joan R.; Yegin, Ashley; Morgan, Wayne J.

    2014-01-01

    SUMMARY Objectives Randomized controlled trials of dornase alfa have shown forced expiratory volume in 1 second (FEV1) to improve in patients with cystic fibrosis (CF) but have not assessed change in the rate of lung function decline. We assessed the relationship of dornase alfa use and FEV1 decline using the Epidemiologic Study of CF (ESCF). Methodology Patients aged 8–38 years who had been enrolled in ESCF for 2 years when initially treated with dornase alfa were selected if they remained on treatment during the following 2 years. A comparator group included patients aged 8–38 who were not yet reported to have received dornase alfa. For each patient we estimated the annual rate of decline in FEV1 % predicted before and after the index using a mixed-effects model adjusted for age, gender, pulmonary exacerbations, respiratory therapies, and nutritional supplements. Results The dornase alfa group (n = 2,230) had a lower FEV1 % predicted at index and a more rapid decline during the pre-index period. The mean rate of FEV1 decline improved for the dornase alfa group; the improvement was similar in adults and children 8–17 years old but was not statistically significant in adults. The comparator group (n = 5,970) showed no change among adults and an increased rate of decline among children 8–17 years old. Conclusions The use of dornase alfa for a 2-year period is associated with a reduction in the rate of FEV1 decline. These results also demonstrate the value of using an observational study to assess the association of instituting new therapies in the clinical setting with changes in the rate of FEV1 decline in patients with CF. PMID:21438174

  7. Effect of fishing effort on catch rate and catchability of largemouth bass in small impoundments

    USGS Publications Warehouse

    Wegener, M. G.; Schramm, Harold; Neal, J. W.; Gerard, P.D.

    2018-01-01

    Largemouth bass Micropterus salmoides (Lacepède) catch rates decline with sustained fishing effort, even without harvest. It is unclear why declines in catch rate occur, and little research has been directed at how to improve catch rate. Learning has been proposed as a reason for declining catch rate, but has never been tested on largemouth bass. If catch rate declines because fish learn to avoid lures, periods of no fishing could be a management tool for increasing catch rate. In this study, six small impoundments with established fish populations were fished for two May to October fishing seasons to evaluate the effect of fishing effort on catch rate. Closed seasons were implemented to test whether a 2‐month period of no fishing improved catch rates and to determine whether conditioning from factors other than being captured reduced catch rate. Mixed‐model analysis indicated catch rate and catchability declined throughout the fishing season. Catch rate and catchability increased after a 2‐month closure but soon declined to the lowest levels of the fishing season. These changes in catch rate and catchability support the conclusion of learned angler avoidance, but sustained catchability of fish not previously caught does not support that associative or social learning affected catchability.

  8. Hemoglobin Decline in Children with Chronic Kidney Disease: Baseline Results from the Chronic Kidney Disease in Children Prospective Cohort Study

    PubMed Central

    Fadrowski, Jeffrey J.; Pierce, Christopher B.; Cole, Stephen R.; Moxey-Mims, Marva; Warady, Bradley A.; Furth, Susan L.

    2008-01-01

    Background and objectives: The level of glomerular filtration rate at which hemoglobin declines in chronic kidney disease is poorly described in the pediatric population. Design, setting, participants, & measurements: This cross-sectional study of North American children with chronic kidney disease examined the association of glomerular filtration rate, determined by the plasma disappearance of iohexol, and hemoglobin concentration. Results: Of the 340 patients studied, the mean age was 11 ± 4 yr, the mean glomerular filtration rate was 42 ± 14 ml/min per 1.73 m2, and the mean hemoglobin was 12.5 ± 1.5. Below a glomerular filtration rate of 43, the hemoglobin declined by 0.3 g/dl (95% confidence interval −0.2 to −0.5) for every 5-ml/min per 1.73 m2 decrease in glomerular filtration rate. Above a glomerular filtration rate of 43 ml/min per 1.73 m2, the hemoglobin showed a nonsignificant decline of 0.1 g/dl for every 5-ml/min per 1.73 m2 decrease in glomerular filtration rate. Conclusions: In pediatric patients with chronic kidney disease, hemoglobin declines as an iohexol-determined glomerular filtration rate decreases below 43 ml/min per 1.73 m2. Because serum creatinine–based estimated glomerular filtration rates may overestimate measured glomerular filtration rate in this population, clinicians need to be mindful of the potential for hemoglobin decline and anemia even at early stages of chronic kidney disease, as determined by current Schwartz formula estimates. Future longitudinal analyses will further characterize the relationship between glomerular filtration rate and hemoglobin, including elucidation of reasons for the heterogeneity of this association among individuals. PMID:18235140

  9. Trends in fatal occupational injuries and industrial restructuring in North Carolina in the 1980s.

    PubMed Central

    Richardson, D; Loomis, D

    1997-01-01

    OBJECTIVES: This study examined the relationship between changes in employment in North Carolina in the 1980s and fatal occupational injury rates. METHODS: Unintentional fatal occupational injuries (n = 1989) in North Carolina between 1978 and 1991 were identified via the medical examiner's system. RESULTS: Overall fatal injury rates declined during the 1980s, but rates increased 9.6% per year among manufacturing industries that declined in employment size; rates fell among service sector and manufacturing industries that grew. CONCLUSIONS: Increasing occupational fatal injury rates accompanied the decline in workforce in North Carolina's traditional, labor-intensive manufacturing industries during the 1980s, while service sector and expanding manufacturing industries have experienced declining fatal injury rates. PMID:9224194

  10. The relationship of self-rated function and self-rated health to concurrent functional ability, functional decline, and mortality: findings from the Nun Study.

    PubMed

    Greiner, P A; Snowdon, D A; Greiner, L H

    1996-09-01

    We investigated the relationship of self-rated function (i.e., the ability to take care of oneself) and self-rated health to concurrent functional ability, functional decline, and mortality in participants in the Nun Study, a longitudinal study of aging and Alzheimer's disease. A total of 629 of the 678 study participants self-rated their function and health and completed an initial functional assessment in 1991-93. Survivors completed a second assessment in 1993-94. Overall, self-rated function had a stronger relationship to functional ability at the first assessment and to functional decline between the first and second assessments than did self-rated health. Self-rated function also had a stronger relationship to mortality than did self-rated health. Self-rated function may be a better marker of global function than is self-rated health and may be a useful addition to clinical assessment and scientific investigation of the relationships among function, health, and disease.

  11. Ohia forest decline: its spread and severity in Hawaii

    Treesearch

    Edwin Q. P. Petteys; Robert E. Burgan; Robert E. Nelson

    1975-01-01

    Ohia forest decline–its severity and rate of spread–was studied by aerial photographic techniques on a 197,000-acre (80,000-ha) portion of the island of Hawaii. In 1954, only 300 acres (121 ha) showed signs of severe decline; by 1972, the acreage of severely affected forest had increased to 85,200 acres (34,480 ha). Rate of decline and current severity were related to...

  12. Sequential Gaussian co-simulation of rate decline parameters of longwall gob gas ventholes.

    PubMed

    Karacan, C Özgen; Olea, Ricardo A

    2013-04-01

    Gob gas ventholes (GGVs) are used to control methane inflows into a longwall mining operation by capturing the gas within the overlying fractured strata before it enters the work environment. Using geostatistical co-simulation techniques, this paper maps the parameters of their rate decline behaviors across the study area, a longwall mine in the Northern Appalachian basin. Geostatistical gas-in-place (GIP) simulations were performed, using data from 64 exploration boreholes, and GIP data were mapped within the fractured zone of the study area. In addition, methane flowrates monitored from 10 GGVs were analyzed using decline curve analyses (DCA) techniques to determine parameters of decline rates. Surface elevation showed the most influence on methane production from GGVs and thus was used to investigate its relation with DCA parameters using correlation techniques on normal-scored data. Geostatistical analysis was pursued using sequential Gaussian co-simulation with surface elevation as the secondary variable and with DCA parameters as the primary variables. The primary DCA variables were effective percentage decline rate, rate at production start, rate at the beginning of forecast period, and production end duration. Co-simulation results were presented to visualize decline parameters at an area-wide scale. Wells located at lower elevations, i.e., at the bottom of valleys, tend to perform better in terms of their rate declines compared to those at higher elevations. These results were used to calculate drainage radii of GGVs using GIP realizations. The calculated drainage radii are close to ones predicted by pressure transient tests.

  13. Sequential Gaussian co-simulation of rate decline parameters of longwall gob gas ventholes

    USGS Publications Warehouse

    Karacan, C. Özgen; Olea, Ricardo A.

    2013-01-01

    Gob gas ventholes (GGVs) are used to control methane inflows into a longwall mining operation by capturing the gas within the overlying fractured strata before it enters the work environment. Using geostatistical co-simulation techniques, this paper maps the parameters of their rate decline behaviors across the study area, a longwall mine in the Northern Appalachian basin. Geostatistical gas-in-place (GIP) simulations were performed, using data from 64 exploration boreholes, and GIP data were mapped within the fractured zone of the study area. In addition, methane flowrates monitored from 10 GGVs were analyzed using decline curve analyses (DCA) techniques to determine parameters of decline rates. Surface elevation showed the most influence on methane production from GGVs and thus was used to investigate its relation with DCA parameters using correlation techniques on normal-scored data. Geostatistical analysis was pursued using sequential Gaussian co-simulation with surface elevation as the secondary variable and with DCA parameters as the primary variables. The primary DCA variables were effective percentage decline rate, rate at production start, rate at the beginning of forecast period, and production end duration. Co-simulation results were presented to visualize decline parameters at an area-wide scale. Wells located at lower elevations, i.e., at the bottom of valleys, tend to perform better in terms of their rate declines compared to those at higher elevations. These results were used to calculate drainage radii of GGVs using GIP realizations. The calculated drainage radii are close to ones predicted by pressure transient tests.

  14. Sequential Gaussian co-simulation of rate decline parameters of longwall gob gas ventholes

    PubMed Central

    Karacan, C.Özgen; Olea, Ricardo A.

    2015-01-01

    Gob gas ventholes (GGVs) are used to control methane inflows into a longwall mining operation by capturing the gas within the overlying fractured strata before it enters the work environment. Using geostatistical co-simulation techniques, this paper maps the parameters of their rate decline behaviors across the study area, a longwall mine in the Northern Appalachian basin. Geostatistical gas-in-place (GIP) simulations were performed, using data from 64 exploration boreholes, and GIP data were mapped within the fractured zone of the study area. In addition, methane flowrates monitored from 10 GGVs were analyzed using decline curve analyses (DCA) techniques to determine parameters of decline rates. Surface elevation showed the most influence on methane production from GGVs and thus was used to investigate its relation with DCA parameters using correlation techniques on normal-scored data. Geostatistical analysis was pursued using sequential Gaussian co-simulation with surface elevation as the secondary variable and with DCA parameters as the primary variables. The primary DCA variables were effective percentage decline rate, rate at production start, rate at the beginning of forecast period, and production end duration. Co-simulation results were presented to visualize decline parameters at an area-wide scale. Wells located at lower elevations, i.e., at the bottom of valleys, tend to perform better in terms of their rate declines compared to those at higher elevations. These results were used to calculate drainage radii of GGVs using GIP realizations. The calculated drainage radii are close to ones predicted by pressure transient tests. PMID:26190930

  15. A remote sensing-assisted risk rating study to predict oak decline and recovery in the Missouri Ozark Highlands, USA

    Treesearch

    Cuizhen Wang; Hong S. He; John M. Kabrick

    2008-01-01

    Forests in the Ozark Highlands underwent widespread oak decline affected by severe droughts in 1999-2000. In this study, the differential normalized difference water index was calculated to detect crown dieback. A multi-factor risk rating system was built to map risk levels of stands. As a quick response to drought, decline in 2000 mostly occurred in stands at low to...

  16. Effects of Sex and Education on Cognitive Change Over a 27-Year Period in Older Adults: The Rancho Bernardo Study.

    PubMed

    Reas, Emilie T; Laughlin, Gail A; Bergstrom, Jaclyn; Kritz-Silverstein, Donna; Barrett-Connor, Elizabeth; McEvoy, Linda K

    2017-08-01

    This study investigated how cognitive function changes with age and whether rates of decline vary by sex or education in a large, homogenous longitudinal cohort characterized by high participation rates, long duration of follow-up, and minimal loss to follow-up. Between 1988 and 2016, 2,225 community-dwelling participants of the Rancho Bernardo Study, aged 31 to 99 years at their initial cognitive assessment, completed neuropsychological testing approximately every 4 years, over a maximum 27-year follow-up. Linear mixed effects regression models defined sex-specific cognitive trajectories, adjusting for education and retest effects. Significant decline across all cognitive domains began around age 65 years and accelerated after age 80 years. Patterns of decline were generally similar between sexes, although men declined more rapidly than women on the global function test. Higher education was associated with slower decline on the tests of executive and global functions. After excluding 517 participants with evidence of cognitive impairment, accelerating decline with age remained for all tests, and women declined more rapidly than men on the executive function test. Accelerating decline with advancing age occurs across multiple cognitive domains in community-dwelling older adults, with few differences in rates of decline between men and women. Higher education may provide some protection against executive and global function decline with age. These findings better characterize normal cognitive aging, a critical prerequisite for identifying individuals at risk for cognitive impairment, and lay the groundwork for future studies of health and behavioral factors that affect age-related decline in this cohort. Copyright © 2017 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

  17. A systematic review of cognitive decline in dementia with Lewy bodies versus Alzheimer’s disease

    PubMed Central

    2014-01-01

    Introduction The aim of this review was to investigate whether there is a faster cognitive decline in dementia with Lewy bodies (DLB) than in Alzheimer’s disease (AD) over time. Methods PsycINFO and Medline were searched from 1946 to February 2013. A quality rating from 1 to 15 (best) was applied to the included studies. A quantitative meta-analysis was done on studies with mini mental state examination (MMSE) as the outcome measure. Results A total of 18 studies were included. Of these, six (36%) reported significant differences in the rate of cognitive decline. Three studies reported a faster cognitive decline on MMSE in patients with mixed DLB and AD compared to pure forms, whereas two studies reported a faster decline on delayed recall and recognition in AD and one in DLB on verbal fluency. Mean quality scores for studies that did or did not differ were not significantly different. Six studies reported MMSE scores and were included in the meta-analysis, which showed no significant difference in annual decline on MMSE between DLB (mean 3.4) and AD (mean 3.3). Conclusions Our findings do not support the hypothesis of a faster rate of cognitive decline in DLB compared to AD. Future studies should apply recent diagnostic criteria, as well as extensive diagnostic evaluation and ideally autopsy diagnosis. Studies with large enough samples, detailed cognitive tests, at least two years follow up and multivariate statistical analysis are also needed. PMID:25478024

  18. Heterogeneity in Rate of Decline in Grip, Hip, and Knee Strength and the Risk of All-Cause Mortality: The Women’s Health and Aging Study II

    PubMed Central

    Xue, Qian-Li; Beamer, Brock A.; Chaves, Paulo H.M.; Guralnik, Jack M.; Fried, Linda P.

    2010-01-01

    OBJECTIVES To assess the relationship between rate of change in muscle strength and all-cause mortality. DESIGN A prospective observational study of the causes and course of physical disability. SETTING Twelve contiguous ZIP code areas in Baltimore, Maryland. PARTICIPANTS Three hundred and seven community-dwelling women aged 70–79 years at study baseline. MEASUREMENTS The outcome is all-cause mortality (1994–2009); predictors include up to seven repeated measurements of handgrip, knee extension, and hip flexion strength, with a median follow-up time of 9 years. Demographic factors, body mass index, smoking status, number of chronic diseases, depressive symptoms, physical activity, Interlukin-6, and albumin were assessed at baseline and included as confounders. The associations between declining muscle strength and mortality were assessed using a joint longitudinal and survival model.. RESULTS Grip and hip strength declined an average of 1.10 and 1.31 kg per year between age 70 and 75and 0.50 and 0.39 kg/year thereafter, respectively; knee strength declined at a constant rate of 0.57 kg/year. Faster rates of decline in grip and hip strength, but not knee strength, independently predicted of mortality after accounting for their baseline levels and potential confounders (Hazard Ratio (HR)=1.33 (95% confidence interval (CI)=1.06–1.67), 1.14 (CI=0.91–1.41), and 2.62 (CI=1.43–4.78) for every 0.5 standard deviation increase in rate of decline in grip, knee, and hip strength, respectively. CONCLUSION Monitoring the rate of decline in grip and hip flexion strength in addition to the absolute levels may greatly improve the identification of women most at risk of dying. PMID:21054287

  19. Meta-regression analysis of commensal and pathogenic Escherichia coli survival in soil and water.

    PubMed

    Franz, Eelco; Schijven, Jack; de Roda Husman, Ana Maria; Blaak, Hetty

    2014-06-17

    The extent to which pathogenic and commensal E. coli (respectively PEC and CEC) can survive, and which factors predominantly determine the rate of decline, are crucial issues from a public health point of view. The goal of this study was to provide a quantitative summary of the variability in E. coli survival in soil and water over a broad range of individual studies and to identify the most important sources of variability. To that end, a meta-regression analysis on available literature data was conducted. The considerable variation in reported decline rates indicated that the persistence of E. coli is not easily predictable. The meta-analysis demonstrated that for soil and water, the type of experiment (laboratory or field), the matrix subtype (type of water and soil), and temperature were the main factors included in the regression analysis. A higher average decline rate in soil of PEC compared with CEC was observed. The regression models explained at best 57% of the variation in decline rate in soil and 41% of the variation in decline rate in water. This indicates that additional factors, not included in the current meta-regression analysis, are of importance but rarely reported. More complete reporting of experimental conditions may allow future inference on the global effects of these variables on the decline rate of E. coli.

  20. Forecasting the burden of future postmenopausal hip fractures.

    PubMed

    Omsland, T K; Magnus, J H

    2014-10-01

    A growing elderly population is expected worldwide, and the rate of hip fractures is decisive for the future fracture burden. Significant declines in hip fracture rates in Norway, the USA, France, Germany, and the UK are required to counteract the impact of the ageing effects. This study aims to evaluate the consequences of the expected growth of the elderly population worldwide on the hip fracture burden using Norway as an example. Furthermore, we wanted to estimate the decline in hip fracture rates required to counteract the anticipated increase in the burden of hip fracture for Norway, the USA, France, Germany, and the UK. The burden of future postmenopausal hip fractures in Norway were estimated given (1) constant age-specific rates, (2) continued decline, and (3) different cohort scenarios. Based on population projection estimates and population age-specific hip fracture rates in women 65 years and older, we calculated the required declines in hip fracture rates needed to counteract the growing elderly populations in Norway, the USA, France, Germany, and the UK. The level of age-specific hip fracture rates had a huge impact on the future hip fracture burden in Norway. Even if the hip fracture rates decline at the same speed, a 22 % increase in the burden of hip fractures can be expected by 2040. An annual decline in hip fracture rates of 1.1-2.2 % until 2040 is required to counteract the effects of the growing elderly population on the future burden of hip fractures in Norway, the USA, France, Germany, and the UK. Hip fracture rates have a great impact on the burden of hip fractures. The rates will have to decline significantly to counteract the impact of a growing elderly population. A change in preventive strategies and further studies are warranted to identify the complex causes associated to hip fractures.

  1. Patients with ALS show highly correlated progression rates in left and right limb muscles.

    PubMed

    Rushton, David J; Andres, Patricia L; Allred, Peggy; Baloh, Robert H; Svendsen, Clive N

    2017-07-11

    Amyotrophic lateral sclerosis (ALS) progresses at different rates between patients, making clinical trial design difficult and dependent on large cohorts of patients. Currently, there are few data showing whether the left and right limbs progress at the same or different rates. This study addresses rates of decline in specific muscle groups of patients with ALS and assesses whether there is a relationship between left and right muscles in the same patient, regardless of overall progression. A large cohort of patients was used to assess decline in muscle strength in right and left limbs over time using 2 different methods: The Tufts Quantitative Neuromuscular Exam and Accurate Test of Limb Isometric Strength protocol. Then advanced linear regression statistical methods were applied to assess progression rates in each limb. This report shows that linearized progression models can predict general slopes of decline with good accuracy. Critically, the data demonstrate that while overall decline is variable, there is a high degree of correlation between left and right muscle decline in ALS. This implies that irrespective of which muscle starts declining soonest or latest, their rates of decline following onset are more consistent. First, this study demonstrates a high degree of power when using unilateral treatment approaches to detect a slowing in disease progression in smaller groups of patients, thus allowing for paired statistical tests. These findings will be useful in transplantation trials that use muscle decline to track disease progression in ALS. Second, these findings discuss methods, such as tactical selection of muscle groups, which can improve the power efficiency of all ALS clinical trials. Copyright © 2017 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology.

  2. FEV1 decline in patients with chronic obstructive pulmonary disease associated with biomass exposure.

    PubMed

    Ramírez-Venegas, Alejandra; Sansores, Raul H; Quintana-Carrillo, Roger H; Velázquez-Uncal, Monica; Hernandez-Zenteno, Rafael J; Sánchez-Romero, Candelaria; Velazquez-Montero, Alejandra; Flores-Trujillo, Fernando

    2014-11-01

    Biomass exposure is an important risk factor for chronic obstructive pulmonary disease (COPD). However, the time-course behavior of FEV1 in subjects exposed to biomass is unknown. We undertook this study to determine the FEV1 rate decline in subjects exposed to biomass. Pulmonary function was assessed every year in a Mexican cohort of patients with COPD associated with biomass or tobacco during a 15-year follow-up period. The mean rate of decline was significantly lower for the biomass exposure COPD group (BE-COPD) than for the tobacco smoke COPD group (TS-COPD) (23 vs. 42 ml, respectively; P < 0.01). Of the TS-COPD group, 11% were rapid decliners, whereas only one rapid decliner was found in the BE-COPD group; 69 and 21% of smokers versus 17 and 83% of the BE-COPD group were slow decliners and sustainers, respectively. A higher FEV1 both as % predicted and milliliters was a predictive factor for decline for BE-COPD and TS-COPD, whereas reversibility to bronchodilator was a predictive factor for both groups when adjusted by FEV1% predicted and only for the TS-COPD group when adjusted by milliliters. In the biomass exposure COPD group the rate of FEV1 decline is slower and shows a more homogeneous rate of decline over time in comparison with smokers. The rapid rate of FEV1 decline is a rare feature of biomass-induced airflow limitation.

  3. Recent trends in elderly suicide rates in England and Wales.

    PubMed

    Hoxey, K; Shah, A

    2000-03-01

    The proportion of elderly in the population is increasing due to increased life expectancy and falling birth rate, and suicide rates increase with age. This study examined the following in England and Wales: (i) recent trends in the elderly suicide rate; (ii) recent trends in method-specific elderly suicide rate; (iii) the relationship between elderly population size and elderly suicide rate in recent years; and (iv) the sex difference in overall and method-specific elderly suicide rate. Data on the various suicide variables were ascertained from the annually published mortality data for years 1985 to 1996. The main findings of this study were: (i) there is a trend towards decline in the overall pure and combined suicide rates for elderly men and women over the 12 year study period; (ii) the main contributors to this decline are suicides due to poisoning by solid and liquid substances (E950), hanging, strangulation and suffocation (E953), drowning (E954), firearms and explosives (E955), and jumping from high places (E957); (iii) the overall pure and combined suicide rates and that for most categories of suicide was higher in men compared to women; and (iv) suicide rates decreased with an increase in the elderly population size. Suicide rates can decline due to a number of reasons. The challenge now is to ensure further decline in suicide rates to meet the Our Healthier Nations target.

  4. Effects of education and race on cognitive decline: An integrative study of generalizability versus study-specific results.

    PubMed

    Gross, Alden L; Mungas, Dan M; Crane, Paul K; Gibbons, Laura E; MacKay-Brandt, Anna; Manly, Jennifer J; Mukherjee, Shubhabrata; Romero, Heather; Sachs, Bonnie; Thomas, Michael; Potter, Guy G; Jones, Richard N

    2015-12-01

    The objective of the study was to examine variability across multiple prospective cohort studies in level and rate of cognitive decline by race/ethnicity and years of education. We compare data across studies, we harmonized estimates of common latent factors representing overall or general cognitive performance, memory, and executive function derived from the: (a) Washington Heights, Hamilton Heights, Inwood Columbia Aging Project (N = 4,115), (b) Spanish and English Neuropsychological Assessment Scales (N = 525), (c) Duke Memory, Health, and Aging study (N = 578), and (d) Neurocognitive Outcomes of Depression in the Elderly (N = 585). We modeled cognitive change over age for cognitive outcomes by race, education, and study. We adjusted models for sex, dementia status, and study-specific characteristics. The results found that for baseline levels of overall cognitive performance, memory, and executive function, differences in race and education tended to be larger than between-study differences and consistent across studies. This pattern did not hold for rate of cognitive decline: effects of education and race/ethnicity on cognitive change were not consistently observed across studies, and when present were small, with racial/ethnic minorities and those with lower education declining at faster rates. In this diverse set of datasets, non-Hispanic Whites and those with higher education had substantially higher baseline cognitive test scores. However, differences in the rate of cognitive decline by race/ethnicity and education did not follow this pattern. This study suggests that baseline test scores and longitudinal change have different determinants, and future studies to examine similarities and differences of causes of cognitive decline in racially/ethnically and educationally diverse older groups is needed. (c) 2015 APA, all rights reserved).

  5. Understanding the Declining Canadian Homicide Rate: A Test of Holinger's Relative Cohort Size Hypothesis

    ERIC Educational Resources Information Center

    Leenaars, Antoon A.; Lester, David

    2004-01-01

    Homicide rates in Canada have shown a decline since 1975, but there has been little empirical study of this trend. P. Holinger (1987) predicted and confirmed that the size of the cohort aged 15-24 in the United States population was associated with the rise and fall of the homicide rate in that country. This study was designed to test this…

  6. Antihypertensive treatment and US trends in stroke mortality, 1962 to 1980.

    PubMed Central

    Casper, M; Wing, S; Strogatz, D; Davis, C E; Tyroler, H A

    1992-01-01

    OBJECTIVES. This study examines the association between increases in antihypertensive pharmacotherapy and declines in stroke mortality among 96 US groups stratified by race, sex, age, metropolitan status, and region from 1962 to 1980. METHODS. Data on the prevalence of controlled hypertension and socioeconomic profiles were obtained from three successive national health surveys. Stroke mortality rates were calculated using data from the National Center for Health Statistics and the Bureau of the Census. The association between controlled hypertension trends and stroke mortality declines was assessed with weighted regression. RESULTS. Prior to 1972, there was no association between trends in controlled hypertension and stroke mortality declines (beta = 0.04, P = .69). After 1972, groups with larger increases in controlled hypertension experienced slower rates of decline in stroke mortality (beta = 0.16, P = .003). Faster rates of decline were modestly but consistently related to improvements in socioeconomic indicators only for the post-1972 period. CONCLUSIONS. These results do not support the hypothesis that increased antihypertensive pharmacotherapy has been the primary determinant of recent declines in stroke mortality. Additional studies should address the association between declining stroke mortality and trends in socioeconomic resources, dietary patterns, and cigarette smoking. PMID:1456333

  7. Effects of education and race on cognitive decline: An integrative analysis of generalizability versus study-specific results

    PubMed Central

    Gross, Alden L.; Mungas, Dan M.; Crane, Paul K.; Gibbons, Laura E.; MacKay-Brandt, Anna; Manly, Jennifer J.; Mukherjee, Shubhabrata; Romero, Heather; Sachs, Bonnie; Thomas, Michael; Potter, Guy G.; Jones, Richard N.

    2015-01-01

    Objective To examine variability across multiple prospective cohort studies in level and rate of cognitive decline by race/ethnicity and years of education. Method To compare data across studies, we harmonized estimates of common latent factors representing overall or general cognitive performance, memory, and executive function derived from the: 1) Washington Heights, Hamilton Heights, Inwood Columbia Aging Project (N=4,115), 2) Spanish and English Neuropsychological Assessment Scales (N=525), 3) Duke Memory, Health, and Aging study (N=578), and 4) Neurocognitive Outcomes of Depression in the Elderly (N=585). We modeled cognitive change over age for cognitive outcomes by race, education, and study. We adjusted models for sex, dementia status, and study-specific characteristics. Results For baseline levels of overall cognitive performance, memory, and executive function, differences in race and education tended to be larger than between-study differences and consistent across studies. This pattern did not hold for rate of cognitive decline: effects of education and race/ethnicity on cognitive change were not consistently observed across studies, and when present were small, with racial/ethnic minorities and those with lower education declining at faster rates. Discussion In this diverse set of datasets, non-Hispanic whites and those with higher education had substantially higher baseline cognitive test scores. However, differences in the rate of cognitive decline by race/ethnicity and education did not follow this pattern. This study suggests that baseline test scores and longitudinal change have different determinants, and future studies to examine similarities and differences of causes of cognitive decline in racially/ethnically and educationally diverse older groups is needed. PMID:26523693

  8. Modelling lamb carcase pH and temperature decline parameters: relationship to shear force and abattoir variation.

    PubMed

    Hopkins, David L; Holman, Benjamin W B; van de Ven, Remy J

    2015-02-01

    Carcase pH and temperature decline rates influence lamb tenderness; therefore pH decline parameters are beneficial when modelling tenderness. These include pH at temperature 18 °C (pH@Temp18), temperature when pH is 6 (Temp@pH6), and pH at 24 h post-mortem (pH24). This study aimed to establish a relationship between shear force (SF) as a proxy for tenderness and carcase pH decline parameters estimated using both linear and spline estimation models for the m. longissimus lumborum (LL). The study also compared abattoirs regarding their achievement of ideal pH decline, indicative of optimal tenderness. Based on SF measurements of LL and m. semimembranosus collected as part of the Information Nucleus slaughter programme (CRC for Sheep Industry Innovation) this study found significant relationships between tenderness and pH24LL, consistent across the meat cuts and ageing periods examined. Achievement of ideal pH decline was shown not to have significantly differed across abattoirs, although rates of pH decline varied significantly across years within abattoirs.

  9. Increased planned delivery contributes to declining rates of pregnancy hypertension in Australia: a population-based record linkage study.

    PubMed

    Roberts, Christine L; Algert, Charles S; Morris, Jonathan M; Ford, Jane B

    2015-10-05

    Since the 1990s, pregnancy hypertension rates have declined in some countries, but not all. Increasing rates of early planned delivery (before the due date) have been hypothesised as the reason for the decline. The aim of this study was to explore whether early planned delivery can partly explain the declining pregnancy hypertension rates in Australia. Population-based record linkage study utilising linked birth and hospital records. A cohort of 1,076,122 deliveries in New South Wales, Australia, 2001-2012. Pregnancy hypertension (including gestational hypertension, pre-eclampsia and eclampsia) was the main outcome; pre-eclampsia was a secondary outcome. From 2001 to 2012, pregnancy hypertension rates declined by 22%, from 9.9% to 7.7%, and pre-eclampsia by 27%, from 3.3% to 2.4% (trend p<0.0001). At the same time, planned deliveries increased: prelabour caesarean section by 43% (12.9-18.4%) and labour inductions by 10% (24.8-27.2%). Many maternal risk factors for pregnancy hypertension significantly increased (p<0.01) over the study period including nulliparity, age ≥35 years, diabetes, overweight and obesity, and use of assisted reproductive technologies; some risk factors decreased including multifetal pregnancies, age <20 years, autoimmune diseases and previous pregnancy hypertension. Given these changes in risk factors, the pregnancy hypertension rate was predicted to increase to 10.5%. Examination of annual gestational age distributions showed that pregnancy hypertension rates actually declined from 38 weeks gestation and were steepest from 41 weeks; at least 36% of the decrease could be attributed to planned deliveries. The risk factors for pregnancy hypertension were also risk factors for planned delivery. It appears that an unanticipated consequence of increasing early planned deliveries is a decline in the incidence of pregnancy hypertension. Women with risk factors for hypertension were relatively more likely to be selected for early delivery. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  10. Theoretical Analysis of Maximum Flow Declination Rate versus Maximum Area Declination Rate in Phonation

    ERIC Educational Resources Information Center

    Titze, Ingo R.

    2006-01-01

    Purpose: Maximum flow declination rate (MFDR) in the glottis is known to correlate strongly with vocal intensity in voicing. This declination, or negative slope on the glottal airflow waveform, is in part attributable to the maximum area declination rate (MADR) and in part to the overall inertia of the air column of the vocal tract (lungs to…

  11. A decomposition analysis of recent fertility decline in Fiji.

    PubMed

    Gubhaju, B; Shahidullah, M

    1990-12-01

    Over the period 1966-86, both the Fijian and Indian populations of Fiji demonstrated declines in fertility. Differentials in the decline were, however, noted with the total fertility rate (TFR) of the Fijian population declining by 26% over the period compared to a 50% decline in the Indian TFR. Moreover, rate declines were not smooth and consistent over the period. Faster fertility decline was experienced in the 1st decade for both groups, slowing in the 2nd decade for Indian women, and stabilizing among the Fijians. This paper decomposes these differential changes in fertility rate into marital structure and marital fertility. The study was conducted using data from the censuses of 1966, 1976, and 1986. For the period 1966-76, declines in marital fertility contributed most to overall TFR decline for both ethnic groups. Marital structure had a reducing effect upon TFR among Indian women in the 1st decaed, but not during the 2nd. Fijian women experienced an overall negative impact from marital structure. Contraception plays an important role in limiting fertility in these 2 populations. Accordingly, differentials in acceptance were noticed, the family planning acceptance rate for Indians being almost twice that of Fijians; 35.6% and 18.7%, respectively in 1986. Compared to Indian women, Fijian women were more literate, more economically active, had higher life expectancies, and experience lower infant mortality rates. Nonetheless, they are not motivated to use family planning. Motivational, cultural, religious, and behavioral factors are suggested as causal factors determining acceptance and use of modern contraceptive methods.

  12. Nutritional Status is Associated with Faster Cognitive Decline and Worse Functional Impairment in the Progression of Dementia: The Cache County Dementia Progression Study1

    PubMed Central

    Sanders, Chelsea; Behrens, Stephanie; Schwartz, Sarah; Wengreen, Heidi; Corcoran, Chris D.; Lyketsos, Constantine G.; Tschanz, JoAnn T.

    2017-01-01

    Nutritional status may be a modifiable factor in the progression of dementia. We examined the association of nutritional status and rate of cognitive and functional decline in a U.S. population-based sample. Study design was an observational longitudinal study with annual follow-ups up to 6 years of 292 persons with dementia (72% Alzheimer’s disease, 56% female) in Cache County, UT using the Mini-Mental State Exam (MMSE), Clinical Dementia Rating Sum of Boxes (CDR-sb), and modified Mini Nutritional Assessment (mMNA). mMNA scores declined by approximately 0.50 points/year, suggesting increasing risk for malnutrition. Lower mMNA score predicted faster rate of decline on the MMSE at earlier follow-up times, but slower decline at later follow-up times, whereas higher mMNA scores had the opposite pattern (mMNA by time β = 0.22, p = 0.017; mMNA by time2 β = −0.04, p = 0.04). Lower mMNA score was associated with greater impairment on the CDR-sb over the course of dementia (β = 0.35, p < 0.001). Assessment of malnutrition may be useful in predicting rates of progression in dementia and may provide a target for clinical intervention. PMID:26967207

  13. Nutritional Status is Associated with Faster Cognitive Decline and Worse Functional Impairment in the Progression of Dementia: The Cache County Dementia Progression Study1.

    PubMed

    Sanders, Chelsea; Behrens, Stephanie; Schwartz, Sarah; Wengreen, Heidi; Corcoran, Chris D; Lyketsos, Constantine G; Tschanz, JoAnn T

    2016-02-27

    Nutritional status may be a modifiable factor in the progression of dementia. We examined the association of nutritional status and rate of cognitive and functional decline in a U.S. population-based sample. Study design was an observational longitudinal study with annual follow-ups up to 6 years of 292 persons with dementia (72% Alzheimer's disease, 56% female) in Cache County, UT using the Mini-Mental State Exam (MMSE), Clinical Dementia Rating Sum of Boxes (CDR-sb), and modified Mini Nutritional Assessment (mMNA). mMNA scores declined by approximately 0.50 points/year, suggesting increasing risk for malnutrition. Lower mMNA score predicted faster rate of decline on the MMSE at earlier follow-up times, but slower decline at later follow-up times, whereas higher mMNA scores had the opposite pattern (mMNA by time β= 0.22, p = 0.017; mMNA by time2 β= -0.04, p = 0.04). Lower mMNA score was associated with greater impairment on the CDR-sb over the course of dementia (β= 0.35, p <  0.001). Assessment of malnutrition may be useful in predicting rates of progression in dementia and may provide a target for clinical intervention.

  14. Trajectories of impairment in amyotrophic lateral sclerosis: Insights from the Pooled Resource Open-Access ALS Clinical Trials cohort.

    PubMed

    Thakore, Nimish J; Lapin, Brittany R; Pioro, Erik P

    2018-06-01

    Rate of decline of the Amyotrophic Lateral Sclerosis Functional Rating Scale-Revised (ALSFRS-R) score is a common outcome measure and a powerful predictor of mortality in ALS. Observed rate of decline (postslope) of ALSFRS-R, its linearity, and its relationship to decline at first visit (preslope) were examined in the Pooled Resource Open-Access ALS Clinical Trials cohort by using longitudinal mixed effects models. Mean ALSFRS-R postslope in 3,367 patients was -0.99 points/month. Preslope and postslope were correlated and had powerful effects on survival. ALSFRS-R trajectories were slightly accelerated overall, but slope and direction/degree of curvature varied. Subscore decline was sequential by site of onset. Respiratory subscore decline was the least steep. Variable curvilinearity of ALSFRS-R trajectories confounds interpretation in clinical studies that assume linear decline. Subscore trajectories recapitulate phenotypic diversity and topographical progression of ALS. ALSFRS-R is better used as a multidimensional measure. Muscle Nerve 57: 937-945, 2018. © 2017 Wiley Periodicals, Inc.

  15. Aquifer geometry, lithology, and water levels in the Anza–Terwilliger area—2013, Riverside and San Diego Counties, California

    USGS Publications Warehouse

    Landon, Matthew K.; Morita, Andrew Y.; Nawikas, Joseph M.; Christensen, Allen H.; Faunt, Claudia C.; Langenheim, Victoria E.

    2015-11-24

    On the basis of data from 33 wells, water levels mostly declined between the fall of 2006 and the fall of 2013; the median decline was 5.1 feet during this period, for a median rate of decline of about 0.7 feet/year. Based on data from 40 wells, water-level changes between fall 2004 and fall 2013 were variable in magnitude and trend, but had a median decline of 2.4 feet and a median rate of decline of about 0.3 feet/ year. These differences in apparent rates of groundwater-level change highlight the value of ongoing water-level measurements to distinguish decadal, or longer term, trends in groundwater storage often associated with climatic variability and trends. Fifty-four long-term hydrographs indicated the sensitivity of groundwater levels to climatic conditions; they also showed a general decline in water levels across the study area since 1986 and, in some cases, dating back to the 1950s.

  16. Industry contributions to aggregate workplace injury and illness rate trends: 1992-2008.

    PubMed

    Ruser, John W

    2014-10-01

    Aggregate workplace injury and illness rates have generally declined over the past quarter century. Assessing which industries contributed to these declines is hampered by industry coding changes that broke time series data. Ratios were estimated to convert older incidence rate data to current industry codes and to create long industry time series from data of the BLS Survey of Occupational Injuries and Illnesses. These data were used to assess contributions to aggregate trends from within-industry incidence rate trends and across-industry hours shifts. Hours shifts toward safer industries do not explain aggregate incidence rate declines. Rather declines resulted from within-industry declines. The top 20 contributors out of 307 industries account for 40 percent of the decline and include both goods-producing and service-providing industries. These data help focus future research on industries responsible for rate declines and factors hypothesized as contributing to declines. © Published 2014 by Wiley Periodicals, Inc.

  17. 26 CFR 1.167(b)-2 - Declining balance method.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 26 Internal Revenue 2 2010-04-01 2010-04-01 false Declining balance method. 1.167(b)-2 Section 1... Declining balance method. (a) Application of method. Under the declining balance method a uniform rate is... declining balance rate may be determined without resort to formula. Such rate determined under section 167(b...

  18. 26 CFR 1.167(b)-2 - Declining balance method.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 26 Internal Revenue 2 2011-04-01 2011-04-01 false Declining balance method. 1.167(b)-2 Section 1... Declining balance method. (a) Application of method. Under the declining balance method a uniform rate is... declining balance rate may be determined without resort to formula. Such rate determined under section 167(b...

  19. Aβ-related memory decline in APOE ε4 noncarriers: Implications for Alzheimer disease.

    PubMed

    Lim, Yen Ying; Laws, Simon M; Villemagne, Victor L; Pietrzak, Robert H; Porter, Tenielle; Ames, David; Fowler, Christopher; Rainey-Smith, Stephanie; Snyder, Peter J; Martins, Ralph N; Salvado, Olivier; Bourgeat, Pierrick; Rowe, Christopher C; Masters, Colin L; Maruff, Paul

    2016-04-26

    As the absence of Aβ-related memory decline in APOE ε4 noncarriers may be due to the relative brevity of previous studies, we aimed to characterize Aβ-related cognitive decline over 72 months in APOE ε4 carriers and noncarriers who were cognitively normal (CN). CN older adults (n = 423) underwent Aβ imaging and APOE genotyping. Participants completed comprehensive neuropsychological testing at baseline 18-, 36-, 54-, and 72-month assessments. Relative to Aβ- CN ε4 noncarriers, both Aβ+ CN ε4 carriers and noncarriers showed significantly increased decline in measures of memory, language, and executive function as well as higher rates of progression to a clinical classification of mild cognitive impairment. Memory decline was greater in Aβ+ CN ε4 carriers than in Aβ+ CN ε4 noncarriers. No cognitive decline was evident in Aβ- CN ε4 carriers. In CN older adults, Aβ+ is associated with memory decline in ε4 noncarriers; however, the rate of this decline is much slower than that observed in ε4 carriers. These data indicate that the processes by which ε4 carriage increases the rate of Aβ-related cognitive decline occur in the preclinical stage of Alzheimer disease. © 2016 American Academy of Neurology.

  20. Aging, Brain Size, and IQ.

    ERIC Educational Resources Information Center

    Bigler, Erin D.; And Others

    1995-01-01

    Whether cross-sectional rates of decline for brain volume and the Performance Intellectual Quotient of the Wechsler Adult Intelligence Scale-Revised were equivalent over the years 16 to 65 was studied with 196 volunteers. Results indicate remarkably similar rates of decline in perceptual-motor functions and aging brain volume loss. (SLD)

  1. Scarcity of ecosystem services: an experimental manipulation of declining pollination rates and its economic consequences for agriculture.

    PubMed

    Sandhu, Harpinder; Waterhouse, Benjamin; Boyer, Stephane; Wratten, Steve

    2016-01-01

    Ecosystem services (ES) such as pollination are vital for the continuous supply of food to a growing human population, but the decline in populations of insect pollinators worldwide poses a threat to food and nutritional security. Using a pollinator (honeybee) exclusion approach, we evaluated the impact of pollinator scarcity on production in four brassica fields, two producing hybrid seeds and two producing open-pollinated ones. There was a clear reduction in seed yield as pollination rates declined. Open-pollinated crops produced significantly higher yields than did the hybrid ones at all pollination rates. The hybrid crops required at least 0.50 of background pollination rates to achieve maximum yield, whereas in open-pollinated crops, 0.25 pollination rates were necessary for maximum yield. The total estimated economic value of pollination services provided by honeybees to the agricultural industry in New Zealand is NZD $1.96 billion annually. This study indicates that loss of pollination services can result in significant declines in production and have serious implications for the market economy in New Zealand. Depending on the extent of honeybee population decline, and assuming that results in declining pollination services, the estimated economic loss to New Zealand agriculture could be in the range of NZD $295-728 million annually.

  2. Scarcity of ecosystem services: an experimental manipulation of declining pollination rates and its economic consequences for agriculture

    PubMed Central

    Waterhouse, Benjamin; Wratten, Steve

    2016-01-01

    Ecosystem services (ES) such as pollination are vital for the continuous supply of food to a growing human population, but the decline in populations of insect pollinators worldwide poses a threat to food and nutritional security. Using a pollinator (honeybee) exclusion approach, we evaluated the impact of pollinator scarcity on production in four brassica fields, two producing hybrid seeds and two producing open-pollinated ones. There was a clear reduction in seed yield as pollination rates declined. Open-pollinated crops produced significantly higher yields than did the hybrid ones at all pollination rates. The hybrid crops required at least 0.50 of background pollination rates to achieve maximum yield, whereas in open-pollinated crops, 0.25 pollination rates were necessary for maximum yield. The total estimated economic value of pollination services provided by honeybees to the agricultural industry in New Zealand is NZD $1.96 billion annually. This study indicates that loss of pollination services can result in significant declines in production and have serious implications for the market economy in New Zealand. Depending on the extent of honeybee population decline, and assuming that results in declining pollination services, the estimated economic loss to New Zealand agriculture could be in the range of NZD $295–728 million annually. PMID:27441108

  3. Lessons learned from a randomized trial of airway secretion clearance techniques in cystic fibrosis

    PubMed Central

    Sontag, Marci K.; Quittner, Alexandra L.; Modi, Avani C.; Koenig, Joni M.; Giles, Don; Oermann, Christopher M.; Konstan, Michael W.; Castile, Robert; Accurso, Frank J.

    2014-01-01

    Rationale Airway secretion clearance therapies are a cornerstone of cystic fibrosis care, however longitudinal comparative studies are rare. Our objectives were to compare three therapies [postural drainage and percussion: (postural drainage), flutter device, and high frequency chest wall oscillation: (vest)], by studying 1) change in pulmonary function; 2) time to need for IV antibiotics, 3) use of pulmonary therapies, 4) adherence to treatment, 5) treatment satisfaction, and 6) quality of life. Methods Participants were randomly assigned to one of three therapies twice daily. Clinical outcomes were assessed quarterly over 3 years. Results Enrollment goals were not met, and withdrawal rates were high, especially in postural drainage (51%) and flutter device (26%), compared to vest (9%), resulting in early termination. FEV1 decline, time to need IV antibiotics, and other pulmonary therapies were not different. The annual FEF25–75% predicted rate of decline was greater in those using vest (p=0.02). Adherence was not significantly different (p=0.09). Overall treatment satisfaction was higher in vest and flutter device than in postural drainage (p<0.05). Health-related quality of life was not different. The rate of FEV1 decline was 1.23% predicted/year. Conclusions The study was ended early due to dropout and smaller than expected decline in FEV1. Patients were more satisfied with vest and flutter device. The longitudinal decline in FEF25–75% was faster in vest; we found no other difference in lung function decline, taken together this warrants further study. The slow decline in FEV1 illustrates the difficulty with FEV1 decline as a clinical trial outcome. PMID:20146387

  4. Estimates of performance in the rate of decline of under-five mortality for 113 low- and middle-income countries, 1970-2010.

    PubMed

    Verguet, Stéphane; Jamison, Dean T

    2014-03-01

    BACKGROUND; Measuring country performance in health has focused on assessing predicted vs observed levels of outcomes, an indicator that varies slowly over time. An alternative is to measure performance in terms of the rate of change in how a selected outcome compares to what would be expected given contextual determinants. Rates of change in health indicators can prove more sensitive than levels to changes in social, intersectoral or health policy context. It is thus similar to the growth rate of gross domestic product in the economic context. We assess performance in the rate of change (decline) of under-five mortality for 113 low- and middle-income countries. For 1970-2010, we study the evolution in rates of decline of under-five mortality. For each decade, we define performance as the average of the difference between the observed rate of decline and a rate of decline predicted by a model controlling for the contextual factors of income, female education levels, decade and geographical location. In the 1970s, the top performer in the rate of decline of under-five mortality was Costa Rica. In the 2000s, the top performer was Turkey. Overall, performance in rates of decline correlated little with performance in levels of under-five mortality. A major transition in performance between decades suggests a change in underlying determinants and we report the magnitude of these transitions. For example, heavily AIDS impacted countries, such as Botswana, experienced major drops in performance between the 1980s and the 1990s and some, including Botswana, experienced major compensatory improvements between the 1990s and the 2000s. Rate-based measures of country performance in health provide a starting point for assessments of the importance of health system, social and intersectoral determinants of performance.

  5. Effects of harvest and climate on population dynamics of northern bobwhites in south Florida

    USGS Publications Warehouse

    Rolland, V.; Hostetler, J.A.; Hines, T.C.; Johnson, F.A.; Percival, H.F.; Oli, M.K.

    2011-01-01

    Context Hunting-related (hereafter harvest) mortality is assumed to be compensatory in many exploited species. However, when harvest mortality is additive, hunting can lead to population declines, especially on public land where hunting pressure can be intense. Recent studies indicate that excessive hunting may have contributed to the decline of a northern bobwhite (Colinus virginianus) population in south Florida. Aims This study aimed to estimate population growth rates to determine potential and actual contribution of vital rates to annual changes in population growth rates, and to evaluate the role of harvest and climatic variables on bobwhite population decline. Methods We used demographic parameters estimated from a six-year study to parameterise population matrix models and conduct prospective and retrospective perturbation analyses. Key results The stochastic population growth rate (?? S=0.144) was proportionally more sensitive to adult winter survival and survival of fledglings, nests and broods from first nesting attempts; the same variables were primarily responsible for annual changes in population growth rate. Demographic parameters associated with second nesting attempts made virtually no contribution to population growth rate. All harvest scenarios consistently revealed a substantial impact of harvest on bobwhite population dynamics. If the lowest harvest level recorded in the study period (i.e. 0.08 birds harvested per day per km2 in 2008) was applied, S would increase by 32.1%. Winter temperatures and precipitation negatively affected winter survival, and precipitation acted synergistically with harvest in affecting winter survival. Conclusions Our results suggest that reduction in winter survival due to overharvest has been an important cause of the decline in our study population, but that climatic factors might have also played a role. Thus, for management actions to be effective, assessing the contribution of primary (e.g. harvesting) but also secondary factors (e.g. climate) to population decline may be necessary. Implications Reducing hunting pressure would be necessary for the recovery of the bobwhite population at our study site. In addition, an adaptive harvest management strategy that considers weather conditions in setting harvest quota would help reverse the population decline further. ?? 2011 CSIRO.

  6. Predicting the Rate of Cognitive Decline in Alzheimer Disease: Data From the ICTUS Study.

    PubMed

    Canevelli, Marco; Kelaiditi, Eirini; Del Campo, Natalia; Bruno, Giuseppe; Vellas, Bruno; Cesari, Matteo

    2016-01-01

    Different rates of cognitive progression have been observed among Alzheimer disease (AD) patients. The present study aimed at evaluating whether the rate of cognitive worsening in AD may be predicted by widely available and easy-to-assess factors. Mild to moderate AD patients were recruited in the ICTUS study. Multinomial logistic regression analysis was performed to measure the association between several sociodemographic and clinical variables and 3 different rates of cognitive decline defined by modifications (after 1 year of follow-up) of the Mini Mental State Examination (MMSE) score: (1) "slow" progression, as indicated by a decrease in the MMSE score ≤1 point; (2) "intermediate" progression, decrease in the MMSE score between 2 and 5 points; and (3) "rapid" progression, decrease in the MMSE score ≥6 points. A total of 1005 patients were considered for the present analyses. Overall, most of the study participants (52%) exhibited a slow cognitive course. Higher ADAS-Cog scores at baseline were significantly associated with both "intermediate" and "rapid" decline. Conversely, increasing age was negatively associated with "rapid" cognitive worsening. A slow progression of cognitive decline is common among AD patients. The influence of age and baseline cognitive impairment should always be carefully considered when designing AD trials and defining study populations.

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

    PubMed

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

    2009-05-01

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

  8. Microbleeds do not affect rate of cognitive decline in Alzheimer disease.

    PubMed

    van der Vlies, Annelies E; Goos, Jeroen D C; Barkhof, Frederik; Scheltens, Philip; van der Flier, Wiesje M

    2012-08-21

    To investigate the relationship between brain microbleeds (MBs) and the rate of cognitive decline in Alzheimer disease (AD). In this cohort study, we studied 221 patients with AD with available baseline MRI scans (1.0 or 1.5 T) and at least 2 Mini-Mental State Examinations (MMSE) scores obtained more than 1 year apart from our memory clinic. Mean ± SD follow-up time was 3 ± 1 years, and patients had a median of 4 MMSE scores (range 2-17). We used linear mixed models with sex and age as covariates to investigate whether MBs influenced the rate of cognitive decline. Mean age was 68 ± 9 years, 109 (49%) patients were female, and the baseline MMSE score was 22 ± 4. There were 39 patients (18%) with MBs (median 2, range 1-27) and 182 without. Linear mixed models showed that overall patients declined 2 MMSE points per year. We found no association of the presence of MBs with baseline MMSE or change in MMSE. Adjustment for atrophy, white matter hyperintensities, lacunes, and vascular risk factors did not change the results nor did stratification for MB location, APOE ε4 carriership, or age at onset (≤65 years vs >65 years). Repeating the analyses with number of MBs as predictor rendered similar results. MBs did not influence the rate of cognitive decline in patients with AD. The formerly reported increased risk of mortality in patients with MBs seems not to be attributable to a steeper rate of decline per se but might be due to vascular events, including (hemorrhagic) stroke.

  9. Age-related cognitive decline and associations with sex, education and apolipoprotein E genotype across ethnocultural groups and geographic regions: a collaborative cohort study.

    PubMed

    Lipnicki, Darren M; Crawford, John D; Dutta, Rajib; Thalamuthu, Anbupalam; Kochan, Nicole A; Andrews, Gavin; Lima-Costa, M Fernanda; Castro-Costa, Erico; Brayne, Carol; Matthews, Fiona E; Stephan, Blossom C M; Lipton, Richard B; Katz, Mindy J; Ritchie, Karen; Scali, Jacqueline; Ancelin, Marie-Laure; Scarmeas, Nikolaos; Yannakoulia, Mary; Dardiotis, Efthimios; Lam, Linda C W; Wong, Candy H Y; Fung, Ada W T; Guaita, Antonio; Vaccaro, Roberta; Davin, Annalisa; Kim, Ki Woong; Han, Ji Won; Kim, Tae Hui; Anstey, Kaarin J; Cherbuin, Nicolas; Butterworth, Peter; Scazufca, Marcia; Kumagai, Shuzo; Chen, Sanmei; Narazaki, Kenji; Ng, Tze Pin; Gao, Qi; Reppermund, Simone; Brodaty, Henry; Lobo, Antonio; Lopez-Anton, Raúl; Santabárbara, Javier; Sachdev, Perminder S

    2017-03-01

    The prevalence of dementia varies around the world, potentially contributed to by international differences in rates of age-related cognitive decline. Our primary goal was to investigate how rates of age-related decline in cognitive test performance varied among international cohort studies of cognitive aging. We also determined the extent to which sex, educational attainment, and apolipoprotein E ε4 allele (APOE*4) carrier status were associated with decline. We harmonized longitudinal data for 14 cohorts from 12 countries (Australia, Brazil, France, Greece, Hong Kong, Italy, Japan, Singapore, Spain, South Korea, United Kingdom, United States), for a total of 42,170 individuals aged 54-105 y (42% male), including 3.3% with dementia at baseline. The studies began between 1989 and 2011, with all but three ongoing, and each had 2-16 assessment waves (median = 3) and a follow-up duration of 2-15 y. We analyzed standardized Mini-Mental State Examination (MMSE) and memory, processing speed, language, and executive functioning test scores using linear mixed models, adjusted for sex and education, and meta-analytic techniques. Performance on all cognitive measures declined with age, with the most rapid rate of change pooled across cohorts a moderate -0.26 standard deviations per decade (SD/decade) (95% confidence interval [CI] [-0.35, -0.16], p < 0.001) for processing speed. Rates of decline accelerated slightly with age, with executive functioning showing the largest additional rate of decline with every further decade of age (-0.07 SD/decade, 95% CI [-0.10, -0.03], p = 0.002). There was a considerable degree of heterogeneity in the associations across cohorts, including a slightly faster decline (p = 0.021) on the MMSE for Asians (-0.20 SD/decade, 95% CI [-0.28, -0.12], p < 0.001) than for whites (-0.09 SD/decade, 95% CI [-0.16, -0.02], p = 0.009). Males declined on the MMSE at a slightly slower rate than females (difference = 0.023 SD/decade, 95% CI [0.011, 0.035], p < 0.001), and every additional year of education was associated with a rate of decline slightly slower for the MMSE (0.004 SD/decade less, 95% CI [0.002, 0.006], p = 0.001), but slightly faster for language (-0.007 SD/decade more, 95% CI [-0.011, -0.003], p = 0.001). APOE*4 carriers declined slightly more rapidly than non-carriers on most cognitive measures, with processing speed showing the greatest difference (-0.08 SD/decade, 95% CI [-0.15, -0.01], p = 0.019). The same overall pattern of results was found when analyses were repeated with baseline dementia cases excluded. We used only one test to represent cognitive domains, and though a prototypical one, we nevertheless urge caution in generalizing the results to domains rather than viewing them as test-specific associations. This study lacked cohorts from Africa, India, and mainland China. Cognitive performance declined with age, and more rapidly with increasing age, across samples from diverse ethnocultural groups and geographical regions. Associations varied across cohorts, suggesting that different rates of cognitive decline might contribute to the global variation in dementia prevalence. However, the many similarities and consistent associations with education and APOE genotype indicate a need to explore how international differences in associations with other risk factors such as genetics, cardiovascular health, and lifestyle are involved. Future studies should attempt to use multiple tests for each cognitive domain and feature populations from ethnocultural groups and geographical regions for which we lacked data.

  10. Age-related cognitive decline and associations with sex, education and apolipoprotein E genotype across ethnocultural groups and geographic regions: a collaborative cohort study

    PubMed Central

    Lipnicki, Darren M.; Crawford, John D.; Thalamuthu, Anbupalam; Castro-Costa, Erico; Stephan, Blossom C. M.; Lipton, Richard B.; Katz, Mindy J.; Ritchie, Karen; Scali, Jacqueline; Ancelin, Marie-Laure; Scarmeas, Nikolaos; Yannakoulia, Mary; Dardiotis, Efthimios; Lam, Linda C. W.; Fung, Ada W. T.; Vaccaro, Roberta; Davin, Annalisa; Kim, Ki Woong; Han, Ji Won; Kim, Tae Hui; Cherbuin, Nicolas; Butterworth, Peter; Scazufca, Marcia; Kumagai, Shuzo; Chen, Sanmei; Narazaki, Kenji; Lobo, Antonio; Lopez-Anton, Raúl; Santabárbara, Javier; Sachdev, Perminder S.

    2017-01-01

    Background The prevalence of dementia varies around the world, potentially contributed to by international differences in rates of age-related cognitive decline. Our primary goal was to investigate how rates of age-related decline in cognitive test performance varied among international cohort studies of cognitive aging. We also determined the extent to which sex, educational attainment, and apolipoprotein E ε4 allele (APOE*4) carrier status were associated with decline. Methods and findings We harmonized longitudinal data for 14 cohorts from 12 countries (Australia, Brazil, France, Greece, Hong Kong, Italy, Japan, Singapore, Spain, South Korea, United Kingdom, United States), for a total of 42,170 individuals aged 54–105 y (42% male), including 3.3% with dementia at baseline. The studies began between 1989 and 2011, with all but three ongoing, and each had 2–16 assessment waves (median = 3) and a follow-up duration of 2–15 y. We analyzed standardized Mini-Mental State Examination (MMSE) and memory, processing speed, language, and executive functioning test scores using linear mixed models, adjusted for sex and education, and meta-analytic techniques. Performance on all cognitive measures declined with age, with the most rapid rate of change pooled across cohorts a moderate -0.26 standard deviations per decade (SD/decade) (95% confidence interval [CI] [-0.35, -0.16], p < 0.001) for processing speed. Rates of decline accelerated slightly with age, with executive functioning showing the largest additional rate of decline with every further decade of age (-0.07 SD/decade, 95% CI [-0.10, -0.03], p = 0.002). There was a considerable degree of heterogeneity in the associations across cohorts, including a slightly faster decline (p = 0.021) on the MMSE for Asians (-0.20 SD/decade, 95% CI [-0.28, -0.12], p < 0.001) than for whites (-0.09 SD/decade, 95% CI [-0.16, -0.02], p = 0.009). Males declined on the MMSE at a slightly slower rate than females (difference = 0.023 SD/decade, 95% CI [0.011, 0.035], p < 0.001), and every additional year of education was associated with a rate of decline slightly slower for the MMSE (0.004 SD/decade less, 95% CI [0.002, 0.006], p = 0.001), but slightly faster for language (-0.007 SD/decade more, 95% CI [-0.011, -0.003], p = 0.001). APOE*4 carriers declined slightly more rapidly than non-carriers on most cognitive measures, with processing speed showing the greatest difference (-0.08 SD/decade, 95% CI [-0.15, -0.01], p = 0.019). The same overall pattern of results was found when analyses were repeated with baseline dementia cases excluded. We used only one test to represent cognitive domains, and though a prototypical one, we nevertheless urge caution in generalizing the results to domains rather than viewing them as test-specific associations. This study lacked cohorts from Africa, India, and mainland China. Conclusions Cognitive performance declined with age, and more rapidly with increasing age, across samples from diverse ethnocultural groups and geographical regions. Associations varied across cohorts, suggesting that different rates of cognitive decline might contribute to the global variation in dementia prevalence. However, the many similarities and consistent associations with education and APOE genotype indicate a need to explore how international differences in associations with other risk factors such as genetics, cardiovascular health, and lifestyle are involved. Future studies should attempt to use multiple tests for each cognitive domain and feature populations from ethnocultural groups and geographical regions for which we lacked data. PMID:28323832

  11. Lung function decline over 25 years of follow-up among black and white adults in the ARIC study cohort.

    PubMed

    Mirabelli, Maria C; Preisser, John S; Loehr, Laura R; Agarwal, Sunil K; Barr, R Graham; Couper, David J; Hankinson, John L; Hyun, Noorie; Folsom, Aaron R; London, Stephanie J

    2016-04-01

    Interpretation of longitudinal information about lung function decline from middle to older age has been limited by loss to follow-up that may be correlated with baseline lung function or the rate of decline. We conducted these analyses to estimate age-related decline in lung function across groups of race, sex, and smoking status while accounting for dropout from the Atherosclerosis Risk in Communities Study. We analyzed data from 13,896 black and white participants, aged 45-64 years at the 1987-1989 baseline clinical examination. Using spirometry data collected at baseline and two follow-up visits, we estimated annual population-averaged mean changes in forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) by race, sex, and smoking status using inverse-probability-weighted independence estimating equations conditioning-on-being-alive. Estimated rates of FEV1 decline estimated using inverse-probability-weighted independence estimating equations conditioning on being alive were higher among white than black participants at age 45 years (e.g., male never smokers: black: -29.5 ml/year; white: -51.9 ml/year), but higher among black than white participants by age 75 (black: -51.2 ml/year; white: -26). Observed differences by race were more pronounced among men than among women. By smoking status, FEV1 declines were larger among current than former or never smokers at age 45 across all categories of race and sex. By age 60, FEV1 decline was larger among former and never than current smokers. Estimated annual declines generated using unweighted generalized estimating equations were smaller for current smokers at younger ages in all four groups of race and sex compared with results from weighted analyses that accounted for attrition. Using methods accounting for dropout from an approximately 25-year health study, estimated rates of lung function decline varied by age, race, sex, and smoking status, with largest declines observed among current smokers at younger ages. Published by Elsevier Ltd.

  12. Predicting Metapopulation Responses to Conservation in Human-Dominated Landscapes

    Treesearch

    Zachary S. Ladin; Vincent D' Amico; Jan M. Baetens; Roland R. Roth; W. Gregory Shriver

    2016-01-01

    Loss of habitat to urbanization is a primary cause of population declines as human-dominated landscapes expand at increasing rates. Understanding how the relative effects of different conservation strategies is important to slow population declines for species in urban landscapes. We studied the wood thrush Hylocichla mustelina, a declining forest-...

  13. Progression from Mild Cognitive Impairment to Alzheimer's disease: effects of gender, butyrylcholinesterase genotype and rivastigmine treatment

    PubMed Central

    Ferris, Steven; Nordberg, Agneta; Soininen, Hilkka; Darreh-Shori, Taher; Lane, Roger

    2014-01-01

    Objective Evaluate the influence of gender and butyrylcholinesterase (BuChE) genotype on incidence of progression to AD, rate of cognitive and functional decline, and response to rivastigmine treatment in mild cognitive impairment (MCI) subjects. Methods This retrospective exploratory analysis from a 3–4 year, randomized, placebo-controlled study of rivastigmine in MCI subjects included participants who consented to pharmacogenetic testing. Results Of 1018 total patients, 490 (253 [52%] female) were successfully genotyped for BuChE. In subjects receiving placebo, the BuChE wt/wt genotype was associated with a statistically significantly higher rate of progression to AD and functional decline in women, compared with men with the BuChE wt/wt genotype. In subjects with a BuChE-K allele receiving placebo, incidence of progression to AD and rate of functional decline were not significantly different by gender, however cognitive decline was significantly faster in men. Statistically significant benefits of rivastigmine treatment on progression to AD, functional decline, ventricular volume expansion, whole brain atrophy and white matter loss were evident in female BuChE wt/wt. Conclusion Gender appears to differentially influence the type of decline in MCI subjects according to BuChE genotype, with more rapid progression of cognitive decline in male BuChE-K, and more rapid progression to AD and functional decline in female BuChE wt/wt. Cognitive decline in male BuChE-K and functional decline and progression to AD in female BuChE wt/wt were significantly attenuated by rivastigmine. Rivastigmine treatment also significantly reduced ventricular expansion, whole brain atrophy rate and white matter loss in female BuChE wt/wt, suggesting a possible disease-modifying effect. PMID:19617863

  14. Hearing conservation in the primary aluminium industry

    PubMed Central

    Frisch, N.; Dixon-Ernst, C.; Chesson, B. J.; Cullen, M. R.

    2016-01-01

    Background Noise-induced hearing loss has been an intractable problem for heavy industry. Aims To report our experience in reducing the incidence of age-corrected confirmed 10 dB hearing shifts (averaged over 2, 3 and 4kHz) in employees in the primary aluminium industry in Australia over the period 2006–13. Methods We analysed annual audiometric data to determine the number of permanent hearing shifts that occurred in employees in two bauxite mines, three alumina refineries and two aluminium smelters. Annual hearing shift rates were calculated based on the number of employees tested per year. Hearing conservation initiatives undertaken during the study period are described. An assessment of similar exposure group noise exposures was also undertaken to determine the magnitude of noise exposure reduction during the study period. Results Across all operations, hearing shift rates declined from 5.5% per year in 2006 to 1.3% per year in 2013 (P < 0.001). The decline in shift rates was greater in mines and refineries, where baseline shift rates were higher, than in smelter workers. Modest reductions in noise exposure occurred during the study period. Conclusions We observed a substantial decline in hearing shift rates during the study period. We describe the hearing conservation initiatives that were collectively associated with this decline. We suspect these initiatives could be deployed relatively easily and at modest cost in other industries with noise-exposed employees. PMID:26470945

  15. Neighborhood socioeconomic context and cognitive decline among older Mexican Americans: results from the Sacramento Area Latino Study on Aging.

    PubMed

    Zeki Al Hazzouri, Adina; Haan, Mary N; Osypuk, Theresa; Abdou, Cleopatra; Hinton, Ladson; Aiello, Allison E

    2011-08-15

    In 1 previous study, it was shown that neighborhood socioeconomic disadvantage is associated with cognitive decline among Latinos. No studies have explored whether and to what extent individual-level socioeconomic factors account for the relation between neighborhood disadvantage and cognitive decline. The purpose of the present study was to assess the influence of neighborhood socioeconomic position (SEP) on cognitive decline and examine how individual-level SEP factors (educational level, annual income, and occupation) influenced neighborhood associations over the course of 10 years. Participants (n = 1,789) were community-dwelling older Mexican Americans from the Sacramento Area Latino Study on Aging. Neighborhood SEP was derived by linking the participant's individual data to the 2000 decennial census. The authors assessed cognitive function with the Modified Mini-Mental State Examination. Analyses used 3-level hierarchical linear mixed models of time within individuals within neighborhoods. After adjustment for individual-level sociodemographic characteristics, higher neighborhood SEP was significantly associated with cognitive function (β = -0.033; P < 0.05) and rates of decline (β = -0.0009; P < 0.10). After adjustment for individual educational level, neighborhood SEP remained associated with baseline cognition but not with rates of decline. Differences in individual educational levels explained most of the intra- and interneighborhood variance. These results suggest that the effect of neighborhood SEP on cognitive decline among Latinos is primarily accounted for by education.

  16. Effects of Hurricane Katrina on nursing facility resident mortality, hospitalization, and functional decline.

    PubMed

    Dosa, David; Feng, Zhanlian; Hyer, Kathy; Brown, Lisa M; Thomas, Kali; Mor, Vincent

    2010-09-01

    The study was designed to examine the 30- and 90-day mortality and hospitalization rates among nursing facility (NF) residents in the affected areas of Louisiana and Mississippi following Hurricane Katrina and to assess the rate of significant posthurricane functional decline. A secondary data analysis was conducted using Medicare claims merged with NF resident data from the Minimum Data Set. Thirty- and 90-day mortality and hospitalization rates for long-stay (>90 days) residents residing in 141 at-risk NFs during Hurricane Katrina were compared to rates for residents residing at the same facilities during the same time period in prior nonhurricane years (2003 and 2004). Functional decline was assessed as a 4+ drop in function using a 28-point Minimum Data Set Activities of Daily Living Scale. There were statistically significant differences (all P < .0001) in mortality, hospitalization, and functional decline among residents exposed to Hurricane Katrina. At 30 days, the mortality rate was 3.88% among the exposed cohort compared with 2.10% and 2.28% for residents in 2003 and 2004, respectively. The 90-day mortality rate was 9.27% compared with 6.71% and 6.31%, respectively. These mortality differences translated into an additional 148 deaths at 30 days and 230 deaths at 90 days. The 30-day hospitalization rate was 9.87% compared with 7.21% and 7.53%, respectively. The 90-day hospitalization rate was 20.39% compared with 18.61% and 17.82%, respectively. Finally, the rate of significant functional decline among survivors was 6.77% compared with 5.81% in 2003 and 5.10% in 2004. NF residents experienced a significant increase in mortality, hospitalization, and functional decline during Hurricane Katrina.

  17. Declines in Employer-Sponsored Insurance between 2000 and 2008: Examining the Components of Coverage by Firm Size

    PubMed Central

    Vistnes, Jessica; Zawacki, Alice; Simon, Kosali; Taylor, Amy

    2012-01-01

    Objective To examine trends in employer-sponsored health insurance coverage rates and its associated components between 2000 and 2008, to provide a baseline for later evaluations of the Affordable Care Act, and to provide information to policy makers as they design the implementation details of the law. Data Sources Private sector employer data from the 2000, 2001, and 2008 Medical Expenditure Panel Survey-Insurance Component (MEPS-IC). Study Design We examine time trends in employer offer, eligibility, and take-up rates. We add a new dimension to the literature by examining dependent coverage and decomposing its trends. We investigate heterogeneity in trends by firm size. Data Collection The MEPS-IC is an annual survey, sponsored by the Agency for Healthcare Research and Quality and conducted by the U.S. Census Bureau. The MEPS-IC obtains information on establishment characteristics, whether an establishment offers health insurance, and details on up to four plans. Principal Findings We find that coverage rates for workers declined in both small and large firms. In small firms, coverage declined due to a drop in both offer and take-up rates. In the largest firms, offer rates were stable and the decline was due to falling take-up rates. In addition, enrollment shifted toward single coverage and away from dependent coverage in both small and large firms. For small firms, this shift was due to declining offer and take-up rates for dependent coverage. In large firms, offers of dependent coverage were stable but take-up rates dropped. Within the category of dependent coverage, the availability of employee-plus-one plans increased in all firm size categories, but take-up rates for these plans declined in small firms. PMID:22250730

  18. Predictive abilities of cardiovascular biomarkers to rapid decline of renal function in Chinese community-dwelling population: a 5-year prospective analysis.

    PubMed

    Fu, Shihui; Liu, Chunling; Luo, Leiming; Ye, Ping

    2017-11-09

    Predictive abilities of cardiovascular biomarkers to renal function decline are more significant in Chinese community-dwelling population without glomerular filtration rate (GFR) below 60 ml/min/1.73m 2 , and long-term prospective study is an optimal choice to explore this problem. Aim of this analysis was to observe this problem during the follow-up of 5 years. In a large medical check-up program in Beijing, there were 948 participants with renal function evaluated at baseline and follow-up of 5 years. Physical examinations were performed by well-trained physicians. Blood samples were analyzed by qualified technicians in central laboratory. Median rate of renal function decline was 1.46 (0.42-2.91) mL/min/1.73m 2 /year. Rapid decline of renal function had a prevalence of 23.5% (223 participants). Multivariate linear and Logistic regression analyses confirmed that age, sex, baseline GFR, homocysteine and N-terminal pro B-type natriuretic peptide (NT-proBNP) had independently predictive abilities to renal function decline rate and rapid decline of renal function (p < 0.05 for all). High-sensitivity cardiac troponin T (hs-cTnT), carotid femoral pulse wave velocity and central augmentation index had no statistically independent association with renal function decline rate and rapid decline of renal function (p > 0.05 for all). Homocysteine and NT-proBNP rather than hs-cTnT had independently predictive abilities to rapid decline of renal function in Chinese community-dwelling population without GFR below 60 ml/min/1.73m 2 . Baseline GFR was an independent factor predicting the rapid decline of renal function. Arterial stiffness and compliance had no independent effect on rapid decline of renal function. This analysis has a significant implication for public health, and changing the homocysteine and NT-proBNP levels might slow the rapid decline of renal function.

  19. The role of cognitive reserve on terminal decline: a cross-cohort analysis from two European studies: OCTO-Twin, Sweden, and Newcastle 85+, UK.

    PubMed

    Cadar, Dorina; Stephan, Blossom C M; Jagger, Carol; Johansson, Boo; Hofer, Scott M; Piccinin, Andrea M; Muniz-Terrera, Graciela

    2016-06-01

    Cognitive performance shows a marked deterioration in close proximity to death, as postulated by the terminal decline hypothesis. The effect of education on the rate of terminal decline in the oldest people (i.e. persons 85+ years) has been controversial and not entirely understood. In the current study, we investigated the rate of decline prior to death with a special focus on the role of education and socioeconomic position, in two European longitudinal studies of ageing: the Origins of Variance in the Old-Old: Octogenarian Twins (OCTO-Twin) and the Newcastle 85+ study. A process-based approach was used in which individuals' cognitive scores were aligned according to distance to death. In a coordinated analysis, multilevel models were employed to examine associations between different markers of cognitive reserve (education and socioeconomic position) and terminal decline using the mini-mental state examination (MMSE), controlling for age at baseline, sex, dementia incidence and time to death from the study entry to the time of death within each cohort. The current findings suggest that education was positively associated with higher MMSE scores prior to death in the OCTO-Twin, but not in the Newcastle 85+ study, independent of socioeconomic position and other factors such as baseline age, sex and time to death from the study entry. However, education was not associated with the rate of terminal decline in both of these studies. Our results offer only partial support to the cognitive reserve hypothesis and cognitive performance prior to death. © 2015 The Authors International Journal of Geriatric Psychiatry Published by John Wiley & Sons Ltd.

  20. Elderly suicide rates in the United Kingdom: trends from 1979 to 2002.

    PubMed

    Shah, Ajit

    2007-01-01

    The proportion of elderly in the population is increasing due to a falling birth rate and increased life expectancy, and suicide rates increase with age. Trends in elderly suicide rates over a 24-year period, 1979 to 2002, were examined. Differences in suicide rates between elderly men and women and between the age-bands 65 to 74 years and 75+ years were examined. Data was ascertained from the WHO website. Suicide rates for men and women for the age-bands 65 to 74 years and 75+ years declined over the 24-year study period. Suicide rates were higher in men than women for both the age bands. In men, suicide rates were higher in the 75+ age-band than in the 65 to 74 years age-band. Various national initiatives may have contributed to the decline in suicide rates. The challenge will be to sustain the decline, given that the population is ageing and suicide rates generally increase with age.

  1. Stroke trends in an aging population. The Technology Assessment Methods Project Team.

    PubMed

    Niessen, L W; Barendregt, J J; Bonneux, L; Koudstaal, P J

    1993-07-01

    Trends in stroke incidence and survival determine changes in stroke morbidity and mortality. This study examines the extent of the incidence decline and survival improvement in the Netherlands from 1979 to 1989. In addition, it projects future changes in stroke morbidity during the period 1985 to 2005, when the country's population will be aging. A state-event transition model is used, which combines Dutch population projections and existing data on stroke epidemiology. Based on the clinical course of stroke, the model describes historical national age- and sex-specific hospital admission and mortality rates for stroke. It extrapolates observed trends and projects future changes in stroke morbidity rates. There is evidence of a continuing incidence decline. The most plausible rate of change is an annual decline of -1.9% (range, -1.7% to -2.1%) for men and -2.4% (range, -2.3% to -2.8%) for women. Projecting a constant mortality decline, the model shows a 35% decrease of the stroke incidence rate for a period of 20 years. Prevalence rates for major stroke will decline among the younger age groups but increase among the oldest because of increased survival in the latter. In absolute numbers this results in an 18% decrease of acute stroke episodes and an 11% increase of major stroke cases. The increase in survival cannot fully explain the observed mortality decline and, therefore, a concomitant incidence decline has to be assumed. Aging of the population partially outweighs the effect of an incidence decline on the total burden of stroke. Increase in cardiovascular survival leads to a further increase in major stroke prevalence among the oldest age groups.

  2. Patterns of Senescence in Human Cardiovascular Fitness: VO2max in Subsistence and Industrialized Populations

    PubMed Central

    Pisor, Anne C.; Gurven, Michael; Blackwell, Aaron D.; Kaplan, Hillard; Yetish, Gandhi

    2014-01-01

    Objectives This study explores whether cardiovascular fitness levels and senescent decline are similar in the Tsimane of Bolivia and Canadians, as well as other subsistence and industrialized populations. Among Tsimane, we examine whether morbidity predicts lower levels and faster decline of cardiovascular fitness, or whether their lifestyle (e.g., high physical activity) promotes high levels and slow decline. Alternatively, high activity levels and morbidity might counterbalance such that Tsimane fitness levels and decline are similar to those in industrialized populations. Methods Maximal oxygen uptake (VO2max) was estimated using a step test heart rate method for 701 participants. We compared these estimates to the Canadian Health Measures Survey and previous studies in industrialized and subsistence populations. We evaluated whether health indicators and proxies for market integration were associated with VO2max levels and rate of decline for the Tsimane. Results The Tsimane have significantly higher levels of VO2max and slower rates of decline than Canadians; initial evidence suggests differences in VO2max levels between other subsistence and industrialized populations. Low hemoglobin predicts low VO2max for Tsimane women while helminth infection predicts high VO2max for Tsimane men, though results might be specific to the VO2max scaling parameter used. No variables tested interact with age to moderate decline. Conclusions The Tsimane demonstrate higher levels of cardiovascular fitness than industrialized populations, but levels similar to other subsistence populations. The high VO2max of Tsimane is consistent with their high physical activity and few indicators of cardiovascular disease, measured in previous studies. PMID:24022886

  3. Change in employment status of 5-year cancer survivors.

    PubMed

    Torp, Steffen; Nielsen, Roy A; Fosså, Sophie D; Gudbergsson, Saevar B; Dahl, Alv A

    2013-02-01

    To follow the employment status of 5-year cancer survivors for 5 years after diagnosis with their first lifetime invasive cancer and to identify socio-demographic, work-related and cancer-related predictors of employment status after 5 years. This prospective registry study concerned all 3278 people in Norway (18-61 years old) diagnosed with their first lifetime invasive cancer in 1999 and alive in 2004 and a cancer-free control group (n = 6368) matched by sex, age, educational level and employment status in 1998. The employment rate among male cancer survivors declined steadily every year, from 94% the year before diagnosis (1998) to 77% 5 years after diagnosis (2004). This change did not differ significantly from that of male controls. The employment rate of female survivors also declined steadily, from 87% (1998) to 69% (2004). This decline was greater than that among female controls, and in 2004 survivors had a significantly lower employment rate. For both men and women, the significant pre-diagnosis predictors of being employed in 2004 concerned higher socio-economic position. For both sexes, lung cancer survivors had the highest decline in employment rate, and male skin cancer survivors had a lower decline in employment rate than controls. Socio-demographic and work-related factors explained more of the variance in employment status than did cancer diagnosis. The employment rate among 5-year cancer survivors did not change significantly except for female survivors. Low socio-economic position is a risk factor for decline in employment rate and should be focused on to prevent cancer-related inequity.

  4. Explaining the Decline in Mexico-U.S. Migration: The Effect of the Great Recession

    PubMed Central

    Villarreal, Andrés

    2014-01-01

    The rate of Mexico-U.S. migration has declined precipitously in recent years. From 25 migrants per thousand in 2005, the annual international migration rate for Mexican men dropped to 7 per thousand by 2012. If sustained, this low migration rate is likely to have a profound effect on the ethnic and national-origin composition of the U.S. population. This study examines the origins of the migration decline using a nationally representative panel survey of Mexican households. The results support an explanation that attributes a large part of the decline to lower labor demand for Mexican immigrants in the United States. Decreases in labor demand in industrial sectors that employ a large percentage of Mexican-born workers, such as construction, are found to be strongly associated with lower rates of migration for Mexican men. Second, changes in migrant selectivity are also consistent with an economic explanation for the decline in international migration. The largest declines in migration occurred precisely among the demographic groups most affected by the Great Recession: namely, economically active young men with low education. Results from the statistical analysis also show that the reduction in labor demand in key sectors of the U.S. economy resulted in a more positive educational selectivity of young migrants. PMID:25407844

  5. Explaining the decline in Mexico-U.S. Migration: the effect of the Great Recession.

    PubMed

    Villarreal, Andrés

    2014-12-01

    The rate of Mexico-U.S. migration has declined precipitously in recent years. From 25 migrants per thousand in 2005, the annual international migration rate for Mexican men dropped to 7 per thousand by 2012. If sustained, this low migration rate is likely to have a profound effect on the ethnic and national-origin composition of the U.S. population. This study examines the origins of the migration decline using a nationally representative panel survey of Mexican households. The results support an explanation that attributes a large part of the decline to lower labor demand for Mexican immigrants in the United States. Decreases in labor demand in industrial sectors that employ a large percentage of Mexican-born workers, such as construction, are found to be strongly associated with lower rates of migration for Mexican men. Second, changes in migrant selectivity are also consistent with an economic explanation for the decline in international migration. The largest declines in migration occurred precisely among the demographic groups most affected by the Great Recession: namely, economically active young men with low education. Results from the statistical analysis also show that the reduction in labor demand in key sectors of the U.S. economy resulted in a more positive educational selectivity of young migrants.

  6. Seagrass on the brink: Decline of threatened seagrass Posidonia australis continues following protection

    PubMed Central

    Evans, Suzanna M.; Blick, Ray A. J.; Poore, Alistair G. B.; Vergés, Adriana

    2018-01-01

    Seagrasses are in decline globally due to sustained pressure from coastal development, water quality declines and the ongoing threat from climate change. The result of this decline has been a change in coastal productivity, a reduction in critical fisheries habitat and increased erosion. Attempts to slow this decline have included legislative protection of habitat and direct restoration efforts. Monitoring the success of these approaches requires tracking changes in the abundance of seagrasses, but such monitoring is frequently conducted at either too coarse a spatial scale, or too infrequently to adequately detect changes within individual meadows. Here, we used high resolution aerial imagery to quantify the change in meadows dominated by Posidonia australis over five years at 14 sites in five estuaries in south-eastern Australia. Australia has some of the world's most diverse and extensive seagrass meadows, but the widely distributed P. australis has a slow growth rate, recovers poorly after disturbance, and suffers runaway attrition if the conditions for recovery are not met. In 2010, after declines of 12–57% between the 1940s and 1980s, P. australis was listed as a threatened ecological community in New South Wales. We quantified changes in area at fine spatial scales and, where loss was observed, describe the general patterns of temporal decline within each meadow. Our results demonstrate that seagrass meadows dominated by P. australis underwent declines of ~ 2–40% total area at 11 out of 14 study sites between 2009 and 2014. In the iconic Sydney Harbour, our analyses suggest that P. australis meadows are declining at an average rate greater than 10% yr-1, exceeding the global rate of seagrass decline. Highlighting these alarming declines across the study region should serve as means to prioritise management action and review the effectiveness of legislative listing as a method to limit impacts at an ecosystem level. PMID:29624579

  7. A Metropolitan Desegregation Plan--Where the White Students Went.

    ERIC Educational Resources Information Center

    Cunningham, George K.; Husk, William L.

    Much evidence exists to show that white enrollment declines with the advent of desegregation. This study conducted in Jefferson County, Kentucky (Louisville) explains the causes of this decline in terms of birth rate decline, nonpublic school enrollment, and movement out of the county. A determination of the degree that each of these take place…

  8. Accelerating rates of cognitive decline and imaging markers associated with β-amyloid pathology.

    PubMed

    Insel, Philip S; Mattsson, Niklas; Mackin, R Scott; Schöll, Michael; Nosheny, Rachel L; Tosun, Duygu; Donohue, Michael C; Aisen, Paul S; Jagust, William J; Weiner, Michael W

    2016-05-17

    To estimate points along the spectrum of β-amyloid pathology at which rates of change of several measures of neuronal injury and cognitive decline begin to accelerate. In 460 patients with mild cognitive impairment (MCI), we estimated the points at which rates of florbetapir PET, fluorodeoxyglucose (FDG) PET, MRI, and cognitive and functional decline begin to accelerate with respect to baseline CSF Aβ42. Points of initial acceleration in rates of decline were estimated using mixed-effects regression. Rates of neuronal injury and cognitive and even functional decline accelerate substantially before the conventional threshold for amyloid positivity, with rates of florbetapir PET and FDG PET accelerating early. Temporal lobe atrophy rates also accelerate prior to the threshold, but not before the acceleration of cognitive and functional decline. A considerable proportion of patients with MCI would not meet inclusion criteria for a trial using the current threshold for amyloid positivity, even though on average, they are experiencing cognitive/functional decline associated with prethreshold levels of CSF Aβ42. Future trials in early Alzheimer disease might consider revising the criteria regarding β-amyloid thresholds to include the range of amyloid associated with the first signs of accelerating rates of decline. © 2016 American Academy of Neurology.

  9. Accelerating rates of cognitive decline and imaging markers associated with β-amyloid pathology

    PubMed Central

    Mattsson, Niklas; Mackin, R. Scott; Schöll, Michael; Nosheny, Rachel L.; Tosun, Duygu; Donohue, Michael C.; Aisen, Paul S.; Jagust, William J.; Weiner, Michael W.

    2016-01-01

    Objective: To estimate points along the spectrum of β-amyloid pathology at which rates of change of several measures of neuronal injury and cognitive decline begin to accelerate. Methods: In 460 patients with mild cognitive impairment (MCI), we estimated the points at which rates of florbetapir PET, fluorodeoxyglucose (FDG) PET, MRI, and cognitive and functional decline begin to accelerate with respect to baseline CSF Aβ42. Points of initial acceleration in rates of decline were estimated using mixed-effects regression. Results: Rates of neuronal injury and cognitive and even functional decline accelerate substantially before the conventional threshold for amyloid positivity, with rates of florbetapir PET and FDG PET accelerating early. Temporal lobe atrophy rates also accelerate prior to the threshold, but not before the acceleration of cognitive and functional decline. Conclusions: A considerable proportion of patients with MCI would not meet inclusion criteria for a trial using the current threshold for amyloid positivity, even though on average, they are experiencing cognitive/functional decline associated with prethreshold levels of CSF Aβ42. Future trials in early Alzheimer disease might consider revising the criteria regarding β-amyloid thresholds to include the range of amyloid associated with the first signs of accelerating rates of decline. PMID:27164667

  10. Accelerating rates of cognitive decline and imaging markers associated with β-amyloid pathology

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

    Insel, Philip S.; Mattsson, Niklas; Mackin, R. Scott

    Objective: Our objective is to estimate points along the spectrum of β-amyloid pathology at which rates of change of several measures of neuronal injury and cognitive decline begin to accelerate. Methods: In 460 patients with mild cognitive impairment (MCI), we estimated the points at which rates of florbetapir PET, fluorodeoxyglucose (FDG) PET, MRI, and cognitive and functional decline begin to accelerate with respect to baseline CSF Aβ 42. Points of initial acceleration in rates of decline were estimated using mixed-effects regression. Results: Rates of neuronal injury and cognitive and even functional decline accelerate substantially before the conventional threshold for amyloidmore » positivity, with rates of florbetapir PET and FDG PET accelerating early. Temporal lobe atrophy rates also accelerate prior to the threshold, but not before the acceleration of cognitive and functional decline. Conclusions: A considerable proportion of patients with MCI would not meet inclusion criteria for a trial using the current threshold for amyloid positivity, even though on average, they are experiencing cognitive/functional decline associated with prethreshold levels of CSF Aβ 42. Lastly, future trials in early Alzheimer disease might consider revising the criteria regarding β-amyloid thresholds to include the range of amyloid associated with the first signs of accelerating rates of decline.« less

  11. Accelerating rates of cognitive decline and imaging markers associated with β-amyloid pathology

    DOE PAGES

    Insel, Philip S.; Mattsson, Niklas; Mackin, R. Scott; ...

    2016-04-15

    Objective: Our objective is to estimate points along the spectrum of β-amyloid pathology at which rates of change of several measures of neuronal injury and cognitive decline begin to accelerate. Methods: In 460 patients with mild cognitive impairment (MCI), we estimated the points at which rates of florbetapir PET, fluorodeoxyglucose (FDG) PET, MRI, and cognitive and functional decline begin to accelerate with respect to baseline CSF Aβ 42. Points of initial acceleration in rates of decline were estimated using mixed-effects regression. Results: Rates of neuronal injury and cognitive and even functional decline accelerate substantially before the conventional threshold for amyloidmore » positivity, with rates of florbetapir PET and FDG PET accelerating early. Temporal lobe atrophy rates also accelerate prior to the threshold, but not before the acceleration of cognitive and functional decline. Conclusions: A considerable proportion of patients with MCI would not meet inclusion criteria for a trial using the current threshold for amyloid positivity, even though on average, they are experiencing cognitive/functional decline associated with prethreshold levels of CSF Aβ 42. Lastly, future trials in early Alzheimer disease might consider revising the criteria regarding β-amyloid thresholds to include the range of amyloid associated with the first signs of accelerating rates of decline.« less

  12. HbA1c, diabetes and cognitive decline: the English Longitudinal Study of Ageing.

    PubMed

    Zheng, Fanfan; Yan, Li; Yang, Zhenchun; Zhong, Baoliang; Xie, Wuxiang

    2018-04-01

    The aim of the study was to evaluate longitudinal associations between HbA 1c levels, diabetes status and subsequent cognitive decline over a 10 year follow-up period. Data from wave 2 (2004-2005) to wave 7 (2014-2015) of the English Longitudinal Study of Ageing (ELSA) were analysed. Cognitive function was assessed at baseline (wave 2) and reassessed every 2 years at waves 3-7. Linear mixed models were used to evaluate longitudinal associations. The study comprised 5189 participants (55.1% women, mean age 65.6 ± 9.4 years) with baseline HbA 1c levels ranging from 15.9 to 126.3 mmol/mol (3.6-13.7%). The mean follow-up duration was 8.1 ± 2.8 years and the mean number of cognitive assessments was 4.9 ± 1.5. A 1 mmol/mol increment in HbA 1c was significantly associated with an increased rate of decline in global cognitive z scores (-0.0009 SD/year, 95% CI -0.0014, -0.0003), memory z scores (-0.0005 SD/year, 95% CI -0.0009, -0.0001) and executive function z scores (-0.0008 SD/year, 95% CI -0.0013, -0.0004) after adjustment for baseline age, sex, total cholesterol, HDL-cholesterol, triacylglycerol, high-sensitivity C-reactive protein, BMI, education, marital status, depressive symptoms, current smoking, alcohol consumption, hypertension, CHD, stroke, chronic lung disease and cancer. Compared with participants with normoglycaemia, the multivariable-adjusted rate of global cognitive decline associated with prediabetes and diabetes was increased by -0.012 SD/year (95% CI -0.022, -0.002) and -0.031 SD/year (95% CI -0.046, -0.015), respectively (p for trend <0.001). Similarly, memory, executive function and orientation z scores showed an increased rate of cognitive decline with diabetes. Significant longitudinal associations between HbA 1c levels, diabetes status and long-term cognitive decline were observed in this study. Future studies are required to determine the effects of maintaining optimal glucose control on the rate of cognitive decline in people with diabetes.

  13. Is gastroenterology research in decline? A comparison of abstract publication rates from The British Society of Gastroenterology meetings between 1995 and 2005.

    PubMed

    Prendergast, Sarah; Mattishent, Katharina; Broughton, Tom; Beales, Ian

    2013-02-22

    Reports have suggested that academic medicine may be in decline within the UK. Further evidence suggests that rates of subsequent full publication of abstracts presented at major scientific meetings are low and may be declining. We have compared the publication rates of abstracts presented at meetings of the British Society of Gastroenterology (BSG) between 1995 and 2005 and examined factors associated with full paper publication.  Abstracts presented at BSG meetings in 1995 and 2005 were assessed by cross-referencing with multiple databases. Abstract characteristics associated with publication were analysed. There were no differences in overall publication rates, impact factors or time to publication between 1995 and 2005. Overall, basic-science abstracts were twice as likely to achieve full publication than non-basic science. There was a significant fall in the publication rates for case series and audits, and significantly increased rates for fundamental/basic-science abstracts over the study period. There were non-significant increases in publication rates for controlled trials and systematic reviews. In general, publication rates for all predominantly clinically orientated abstracts reduced between the two periods with the most notable fall occurring in nutrition.  There was no evidence of a decline in overall abstract publication rates between 1995 and 2005. There seemed to be trend for increased publication rates of abstracts using perceived high-quality study methodologies with a corresponding decrease in those with lower quality methods. The proportion of basic-science abstracts is likely to be a determinant of overall full publication rates following scientific meetings.

  14. Is gastroenterology research in decline? A comparison of abstract publication rates from The British Society of Gastroenterology meetings between 1995 and 2005.

    PubMed

    Prendergast, Sarah; Mattishent, Katharina; Broughton, Tom; Beales, Ian

    2013-01-01

    Background: Reports have suggested that academic medicine may be in decline within the UK. Further evidence suggests that rates of subsequent full publication of abstracts presented at major scientific meetings are low and may be declining. We have compared the publication rates of abstracts presented at meetings of the British Society of Gastroenterology (BSG) between 1995 and 2005 and examined factors associated with full paper publication.  Methods: Abstracts presented at BSG meetings in 1995 and 2005 were assessed by cross-referencing with multiple databases. Abstract characteristics associated with publication were analysed. Results: There were no differences in overall publication rates, impact factors or time to publication between 1995 and 2005. Overall, basic-science abstracts were twice as likely to achieve full publication than non-basic science. There was a significant fall in the publication rates for case series and audits, and significantly increased rates for fundamental/basic-science abstracts over the study period. There were non-significant increases in publication rates for controlled trials and systematic reviews. In general, publication rates for all predominantly clinically orientated abstracts reduced between the two periods with the most notable fall occurring in nutrition.  Conclusions: There was no evidence of a decline in overall abstract publication rates between 1995 and 2005. There seemed to be trend for increased publication rates of abstracts using perceived high-quality study methodologies with a corresponding decrease in those with lower quality methods. The proportion of basic-science abstracts is likely to be a determinant of overall full publication rates following scientific meetings.

  15. US lung cancer trends by histologic type.

    PubMed

    Lewis, Denise Riedel; Check, David P; Caporaso, Neil E; Travis, William D; Devesa, Susan S

    2014-09-15

    Lung cancer incidence rates overall are declining in the United States. This study investigated the trends by histologic type and demographic characteristics. Surveillance, Epidemiology, and End Results (SEER) program rates of microscopically confirmed lung cancer overall and squamous cell, small cell, adenocarcinoma, large cell, other, and unspecified carcinomas among US whites and blacks diagnosed from 1977 to 2010 and white non-Hispanics, Asian/Pacific Islanders, and white Hispanics diagnosed from 1992 to 2010 were analyzed by sex and age. Squamous and small cell carcinoma rates declined since the 1990s, although less rapidly among females than males. Adenocarcinoma rates decreased among males and only through 2005, after which they then rose during 2006 to 2010 among every racial/ethnic/sex group; rates for unspecified type declined. Male/female rate ratios declined among whites and blacks more than among other groups. Recent rates among young females were higher than among males for adenocarcinoma among all racial/ethnic groups and for other specified carcinomas among whites. US lung cancer trends vary by sex, histologic type, racial/ethnic group, and age, reflecting historical cigarette smoking rates, duration, cessation, cigarette composition, and exposure to other carcinogens. Substantial excesses among males have diminished and higher rates of adenocarcinoma among young females have emerged as rates among males declined more rapidly. The recognition of EGFR mutation and ALK rearrangements that occur primarily in adenocarcinomas are the primary basis for the molecular revolution that has transformed lung cancer diagnosis and treatment over the past decade, and these changes have affected recent type-specific trends. © 2014 American Cancer Society.

  16. Consumption of alcoholic beverages and cognitive decline at middle age: the Doetinchem Cohort Study.

    PubMed

    Nooyens, Astrid C J; Bueno-de-Mesquita, H Bas; van Gelder, Boukje M; van Boxtel, Martin P J; Verschuren, W M Monique

    2014-02-01

    Accelerated cognitive decline increases the risk of dementia. Slowing down the rate of cognitive decline leads to the preservation of cognitive functioning in the elderly, who can live independently for a longer time. Alcohol consumption may influence the rate of cognitive decline. The aim of the present study was to evaluate the associations between the total consumption of alcoholic beverages and different types of alcoholic beverages and cognitive decline at middle age. In 2613 men and women of the Doetinchem Cohort Study, aged 43-70 years at baseline (1995-2002), cognitive function (global cognitive function and the domains memory, speed and flexibility) was assessed twice, with a 5-year time interval. In linear regression analyses, the consumption of different types of alcoholic beverages was analysed in relation to cognitive decline, adjusting for confounders. We observed that, in women, the total consumption of alcoholic beverages was inversely associated with the decline in global cognitive function over a 5-year period (P for trend = 0·02), while no association was observed in men. Regarding the consumption of different types of alcoholic beverages in men and women together, red wine consumption was inversely associated with the decline in global cognitive function (P for trend < 0·01) as well as memory (P for trend < 0·01) and flexibility (P for trend = 0·03). Smallest declines were observed at a consumption of about 1·5 glasses of red wine per d. No other types of alcoholic beverages were associated with cognitive decline. In conclusion, only (moderate) red wine consumption was consistently associated with less strong cognitive decline. Therefore, it is most likely that non-alcoholic substances in red wine are responsible for any cognition-preserving effects.

  17. Atrial fibrillation and cognitive decline-the role of subclinical cerebral infarcts: the atherosclerosis risk in communities study.

    PubMed

    Chen, Lin Y; Lopez, Faye L; Gottesman, Rebecca F; Huxley, Rachel R; Agarwal, Sunil K; Loehr, Laura; Mosley, Thomas; Alonso, Alvaro

    2014-09-01

    The mechanism underlying the association of atrial fibrillation (AF) with cognitive decline in stroke-free individuals is unclear. We examined the association of incident AF with cognitive decline in stroke-free individuals, stratified by subclinical cerebral infarcts (SCIs) on brain MRI scans. We analyzed data from 935 stroke-free participants (mean age±SD, 61.5±4.3 years; 62% women; and 51% black) from 1993 to 1995 through 2004 to 2006 in the Atherosclerosis Risk in Communities Study, a biracial community-based prospective cohort study. Cognitive testing (including the digit symbol substitution and the word fluency tests) was performed in 1993 to 1995, 1996 to 1998, and 2004 to 2006 and brain MRI scans in 1993 to 1995 and 2004 to 2006. During follow-up, there were 48 incident AF events. Incident AF was associated with greater annual average rate of decline in digit symbol substitution (-0.77; 95% confidence interval, -1.55 to 0.01; P=0.054) and word fluency (-0.80; 95% confidence interval, -1.60 to -0.01; P=0.048). Among participants without SCIs on brain MRI scans, incident AF was not associated with cognitive decline. In contrast, incident AF was associated with greater annual average rate of decline in word fluency (-2.65; 95% confidence interval, -4.26 to -1.03; P=0.002) among participants with prevalent SCIs in 1993 to 1995. Among participants who developed SCIs during follow-up, incident AF was associated with a greater annual average rate of decline in digit symbol substitution (-1.51; 95% confidence interval, -3.02 to -0.01; P=0.049). The association of incident AF with cognitive decline in stroke-free individuals can be explained by the presence or development of SCIs, raising the possibility of anticoagulation as a strategy to prevent cognitive decline in AF. © 2014 American Heart Association, Inc.

  18. Early predicted time to normalization of tumor markers predicts outcome in poor-prognosis nonseminomatous germ cell tumors.

    PubMed

    Fizazi, Karim; Culine, Stéphane; Kramar, Andrew; Amato, Robert J; Bouzy, Jeannine; Chen, Isan; Droz, Jean-Pierre; Logothetis, Christopher J

    2004-10-01

    The prognostic relevance of the rate of decline of serum alpha-fetoprotein (AFP) and human chorionic gonadotropin (HCG) during the first 3 weeks of chemotherapy for nonseminomatous germ cell tumors (NSGCT) was studied in the context of the International Germ Cell Cancer Collaborative Group (IGCCCG) classification. Data from 653 patients prospectively recruited in clinical trials were studied. Tumor markers were obtained before chemotherapy and 3 weeks later. Decline rates were calculated using a logarithmic formula and expressed as a predicted time to normalization (TTN). A favorable TTN was defined when both AFP and HCG had a favorable decline rate, including cases with normal values. The median follow-up was 50 months (range, 2 to 151 months). Tumor decline rate expressed as a predicted TTN was associated with both progression-free survival (PFS; P <.0001) and overall survival (OS; P <.0001). The 4-year PFS rates were 64% and 38% in patients from the poor-prognosis group who had a favorable and an unfavorable TTN, respectively. The 4-year OS rates were 83% and 58%, respectively. This effect was independent from the initial tumor marker values, the primary tumor site, and the presence of nonpulmonary visceral metastases: tumor marker decline rate remained a strong predictor for both PFS (hazard ratio = 2.5; P =.01) and OS (hazard ratio = 4.6; P =.002) in patients from the IGCCCG poor-prognosis group in multivariate analysis. Early predicted time to tumor marker normalization is an independent prognostic factor in patients with poor-prognosis NSGCT and may be a useful tool in the therapeutic management of these patients.

  19. Does increasing daylength control seasonal changes in clutch sizes of Northern Pintails (Anas acuta)?

    USGS Publications Warehouse

    Krapu, G.L.; Sargeant, G.A.; Perkins, A.E.H.

    2002-01-01

    We evaluated spatiotemporal variation in clutch sizes of Northern Pintails (pintails; Anas acuta) nesting in California (1985 to 1996), North Dakota (1982 to 1985), Saskatchewan (1982 to 1985) and Alaska (1991 to 1993) to determine whether seasonal declines in clutch size varied in ways that were consistent with a controlling influence of increasing day length. Pintails began nesting in mid-March in California, mid-April in North Dakota and Saskatchewan, and mid-May in Alaska. Observed durations of nesting were 70 ± 2.6 days (SE) in California, 60 ± 6.3 days in North Dakota, 66 ± 1.3 days in Saskatchewan, and 42 ± 0.7 days in Alaska. Annual differences were the principal source of variation in mean clutch sizes (σ̂Y2 = 0.15, SE = 0.049), which varied little among study locations (σ̂A2 = 0.002, SE = 0.013). Predicted rates of seasonal decline in clutch sizes increased with latitude early in the nesting season, but declined as the nesting season progressed, except in California. Rates of decline in clutch sizes thus were not directly related to rates of increase in day length. Predicted declines in numbers of eggs per clutch over the nesting season were similar for all four locations (range, 3.05–3.12) despite wide variation in durations of nesting. Evidence suggests that reduced nutrient availability during nesting contributes to a higher rate of decline in clutch sizes in Alaska than in temperate regions. Pintails that nest early lay large initial clutches, but thereafter clutch sizes decline rapidly and breeding terminates early. This reproductive strategy is adaptive because young that hatch earliest exhibit the highest survival rates; however, the conversion of grassland to cropland on the primary prairie breeding grounds has reduced hatching rates of clutches laid early in the nesting season. Under these conditions, the limited capacity to renest in late spring on their prairie breeding grounds probably has contributed to Pintail population declines.

  20. Patients with type 2 diabetes having higher glomerular filtration rate showed rapid renal function decline followed by impaired glomerular filtration rate: Japan Diabetes Complications Study.

    PubMed

    Moriya, Tatsumi; Tanaka, Shiro; Sone, Hirohito; Ishibashi, Shun; Matsunaga, Satoshi; Ohashi, Yasuo; Akanuma, Yasuo; Haneda, Masakazu; Katayama, Shigehiro

    2017-02-01

    The Japan Diabetes Complications Study (JDCS), a nation-wide, multicenter, prospective study of patients with type 2 diabetes, reported that hemoglobin A 1c (HbA 1c ), systolic blood pressure, and smoking were risk factors for the onset of macroalbuminuria. This study explored the risk factors for glomerular filtration rate (GFR) decline in the JDCS patients. We examined the 1407 JDCS patients (667 women, mean age 59years, 974 normoalbuminuria, 433 microalbuminuria) whose urinary albumin-to-creatinine ratio (UACR) and estimated GFR (eGFR) were determined at baseline with an 8-year follow-up. We divided all the patients into four groups according to baseline eGFR: G1 (120≤eGFR), G2 (90≤eGFR<120), G3 (60≤eGFR<90), G4 (eGFR<60). The eGFRs in groups G1 and G2 decreased at follow-up compared to those at the baseline. The risk of annual eGFR decline rate≥3ml/min/1.73m 2 (rapid decliners) increased as the baseline eGFR increased. Advanced age, high HbA 1c , and UACR, or diabetic retinopathy at baseline were risk factors for the rapid decliners. Especially the G1 group had a significant risk for the rapid decliners. The frequency of the patients with GFR<60ml/min/1.73m 2 at the follow-up amounted to 31.1% in the rapid decliners, which was higher than 12% in the non-rapid decliners. In normo- and microalbuminuric patients with type 2 diabetes, extra careful attention should be paid to patients with eGFR ≥120ml/min/1.73m 2 to detect cases with rapidly decreased GFR under the normal range. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. Blood Leukocyte Concentrations, FEV1 Decline, and Airflow Limitation. A 15-Year Longitudinal Study of World Trade Center-exposed Firefighters.

    PubMed

    Zeig-Owens, Rachel; Singh, Ankura; Aldrich, Thomas K; Hall, Charles B; Schwartz, Theresa; Webber, Mayris P; Cohen, Hillel W; Kelly, Kerry J; Nolan, Anna; Prezant, David J; Weiden, Michael D

    2018-02-01

    Rescue/recovery work at the World Trade Center disaster site (WTC) caused a proximate decline in lung function in Fire Department of the City of New York firefighters. A subset of this cohort experienced an accelerated rate of lung function decline over 15 years of post-September 11, 2001 (9/11) follow-up. To determine if early postexposure blood leukocyte concentrations are biomarkers for subsequent FEV 1 decline and incident airflow limitation. Individual rates of forced expiratory volume in 1 second (FEV 1 ) change were calculated for 9,434 firefighters using 88,709 spirometric measurements taken between September 11, 2001, and September 10, 2016. We categorized FEV 1 change rates into three trajectories: accelerated FEV 1 decline (FEV 1 loss >64 ml/yr), expected FEV 1 decline (FEV 1 loss between 0 and 64 ml/yr), and improved FEV 1 (positive rate of change >0 ml/yr). Occurrence of FEV 1 /FVC less than 0.70 after 9/11 defined incident airflow limitation. Using regression models, we assessed associations of post-9/11 blood eosinophil and neutrophil concentrations with subsequent FEV 1 decline and airflow limitation, adjusted for age, race, smoking, height, WTC exposure level, weight change, and baseline lung function. Accelerated FEV 1 decline occurred in 12.7% of participants (1,199 of 9,434), whereas post-9/11 FEV 1 improvement occurred in 8.3% (780 of 9,434). Higher blood eosinophil and neutrophil concentrations were each associated with accelerated FEV 1 decline after adjustment for covariates (odds ratio [OR], 1.10 per 100 eosinophils/μl; 95% confidence interval [CI], 1.05-1.15; and OR, 1.10 per 1,000 neutrophils/μl; 95% CI, 1.05-1.15, respectively). Multivariable-adjusted linear regression models showed that a higher blood neutrophil concentration was associated with a faster rate of FEV 1 decline (1.14 ml/yr decline per 1,000 neutrophils/μl; 95% CI, 0.69-1.60 ml/yr; P < 0.001). Higher blood eosinophil concentrations were associated with a faster rate of FEV 1 decline in ever-smokers (1.46 ml/yr decline per 100 eosinophils/μl; 95% CI, 0.65-2.26 ml/yr; P < 0.001) but not in never-smokers (P for interaction = 0.004). Higher eosinophil concentrations were also associated with incident airflow limitation (adjusted hazard ratio, 1.10 per 100 eosinophils/μl; 95% CI, 1.04-1.15). Compared with the expected FEV 1 decline group, individuals experiencing accelerated FEV 1 decline were more likely to have incident airflow limitation (adjusted OR, 4.12; 95% CI, 3.30-5.14). Higher post-9/11 blood neutrophil and eosinophil concentrations were associated with subsequent accelerated FEV 1 decline in WTC-exposed firefighters. Both higher blood eosinophil concentrations and accelerated FEV 1 decline were associated with incident airflow limitation in WTC-exposed firefighters.

  2. Basal area growth of sugar maple in relation to acid deposition, stand health, and soil nutrients.

    PubMed

    Duchesne, Louis; Ouimet, Rock; Houle, Daniel

    2002-01-01

    Previous studies have shown in noncalcareous soils that acid deposition may have increased soil leaching of basic cations above the input rate from soil weathering and atmospheric depositions. This phenomenon may have increased soil acidity levels, and, as a consequence, may have reduced the availability of these essential nutrients for forest growth. Fourteen plots of the Forest Ecosystem Research and Monitoring Network in Québec were used to examine the relation between post-industrial growth trends of sugar maple (Acer saccharum Marsh.) and acid deposition (N and S), stand decline rate, and soil exchangeable nutrient concentrations. Atmospheric N and S deposition and soil exchangeable acidity were positively associated with stand decline rate, and negatively with the average tree basal area increment trend. The growth rate reduction reached on average 17% in declining stands compared with healthy ones. The results showed a significant sugar maple growth rate reduction since 1960 on acid soils. The appearance of the forest decline phenomenon in Québec can be attributed, at least partially, to soil acidification and acid deposition levels.

  3. Predicting clinical decline in progressive agrammatic aphasia and apraxia of speech.

    PubMed

    Whitwell, Jennifer L; Weigand, Stephen D; Duffy, Joseph R; Clark, Heather M; Strand, Edythe A; Machulda, Mary M; Spychalla, Anthony J; Senjem, Matthew L; Jack, Clifford R; Josephs, Keith A

    2017-11-28

    To determine whether baseline clinical and MRI features predict rate of clinical decline in patients with progressive apraxia of speech (AOS). Thirty-four patients with progressive AOS, with AOS either in isolation or in the presence of agrammatic aphasia, were followed up longitudinally for up to 4 visits, with clinical testing and MRI at each visit. Linear mixed-effects regression models including all visits (n = 94) were used to assess baseline clinical and MRI variables that predict rate of worsening of aphasia, motor speech, parkinsonism, and behavior. Clinical predictors included baseline severity and AOS type. MRI predictors included baseline frontal, premotor, motor, and striatal gray matter volumes. More severe parkinsonism at baseline was associated with faster rate of decline in parkinsonism. Patients with predominant sound distortions (AOS type 1) showed faster rates of decline in aphasia and motor speech, while patients with segmented speech (AOS type 2) showed faster rates of decline in parkinsonism. On MRI, we observed trends for fastest rates of decline in aphasia in patients with relatively small left, but preserved right, Broca area and precentral cortex. Bilateral reductions in lateral premotor cortex were associated with faster rates of decline of behavior. No associations were observed between volumes and decline in motor speech or parkinsonism. Rate of decline of each of the 4 clinical features assessed was associated with different baseline clinical and regional MRI predictors. Our findings could help improve prognostic estimates for these patients. © 2017 American Academy of Neurology.

  4. Association between late-onset depression and incident dementia in Chinese older persons.

    PubMed

    Tam, C W C; Lam, L C W

    2013-12-01

    OBJECTIVE. Previous studies have shown that depression is a precursor / prodrome or susceptible state for the development of dementia. This study aimed to examine the relationship between late-onset depression and subsequent cognitive and functional decline in a cohort of non-demented older Chinese persons at their 2-year follow-up and investigate for possible predictors of cognitive decline. METHODS. A total of 81 depressed subjects and 468 non-depressed community controls were recruited. RESULTS. Subjects with late-onset depression showed significantly more incident Clinical Dementia Rating (CDR) scale decline (odds ratio = 3.87, 95% confidence interval = 2.23-6.70) and dementia (odds ratio = 3.44, 95% confidence interval = 1.75-6.77) than those without depression. A higher proportion of depressed CDR 0 subjects had CDR and functional decline than their non-depressed counterparts. Depressed CDR 0.5 subjects had significantly higher rates of functional decline and lower rates of improvement in CDR than their non-depressed counterparts. CONCLUSION. Diagnosis of depression was a robust predictor of incident very mild dementia (i.e. CDR of 0.5) and depression severity was a predictor of progression to dementia from CDR of 0.5. The association between depression and the risk of CDR decline and dementia was observed in non-demented Chinese subjects. Depression was also associated with persistent mild cognitive deficits in CDR 0.5 subjects.

  5. Child mortality after Hurricane Katrina.

    PubMed

    Kanter, Robert K

    2010-03-01

    Age-specific pediatric health consequences of community disruption after Hurricane Katrina have not been analyzed. Post-Katrina vital statistics are unavailable. The objectives of this study were to validate an alternative method to estimate child mortality rates in the greater New Orleans area and compare pre-Katrina and post-Katrina mortality rates. Pre-Katrina 2004 child mortality was estimated from death reports in the local daily newspaper and validated by comparison with pre-Katrina data from the Louisiana Department of Health. Post-Katrina child mortality rates were analyzed as a measure of health consequences. Newspaper-derived estimates of mortality rates appear to be valid except for possible underreporting of neonatal rates. Pre-Katrina and post-Katrina mortality rates were similar for all age groups except infants. Post-Katrina, a 92% decline in mortality rate occurred for neonates (<28 days), and a 57% decline in mortality rate occurred for postneonatal infants (28 days-1 year). The post-Katrina decline in infant mortality rate exceeds the pre-Katrina discrepancy between newspaper-derived and Department of Health-reported rates. A declining infant mortality rate raises questions about persistent displacement of high-risk infants out of the region. Otherwise, there is no evidence of long-lasting post-Katrina excess child mortality. Further investigation of demographic changes would be of interest to local decision makers and planners for recovery after public health emergencies in other regions.

  6. Paradoxical physiological transitions from aging to late life in Drosophila.

    PubMed

    Shahrestani, Parvin; Quach, Julie; Mueller, Laurence D; Rose, Michael R

    2012-02-01

    In a variety of organisms, adulthood is divided into aging and late life, where aging is a period of exponentially increasing mortality rates and late life is a period of roughly plateaued mortality rates. In this study we used ∼57,600 Drosophila melanogaster from six replicate populations to examine the physiological transitions from aging to late life in four functional characters that decline during aging: desiccation resistance, starvation resistance, time spent in motion, and negative geotaxis. Time spent in motion and desiccation resistance declined less quickly in late life compared to their patterns of decline during aging. Negative geotaxis declined at a faster rate in late life compared to its rate of decline during aging. These results yield two key findings: (1) Late-life physiology is distinct from the physiology of aging, in that there is not simply a continuation of the physiological trends which characterize aging; and (2) late life physiology is complex, in that physiological characters vary with respect to their stabilization, deceleration, or acceleration in the transition from aging to late life. These findings imply that a correct understanding of adulthood requires identifying and appropriately characterizing physiology during properly delimited late-life periods as well as aging periods.

  7. Paradoxical Physiological Transitions from Aging to Late Life in Drosophila

    PubMed Central

    Quach, Julie; Mueller, Laurence D.; Rose, Michael R.

    2012-01-01

    Abstract In a variety of organisms, adulthood is divided into aging and late life, where aging is a period of exponentially increasing mortality rates and late life is a period of roughly plateaued mortality rates. In this study we used ∼57,600 Drosophila melanogaster from six replicate populations to examine the physiological transitions from aging to late life in four functional characters that decline during aging: desiccation resistance, starvation resistance, time spent in motion, and negative geotaxis. Time spent in motion and desiccation resistance declined less quickly in late life compared to their patterns of decline during aging. Negative geotaxis declined at a faster rate in late life compared to its rate of decline during aging. These results yield two key findings: (1) Late-life physiology is distinct from the physiology of aging, in that there is not simply a continuation of the physiological trends which characterize aging; and (2) late life physiology is complex, in that physiological characters vary with respect to their stabilization, deceleration, or acceleration in the transition from aging to late life. These findings imply that a correct understanding of adulthood requires identifying and appropriately characterizing physiology during properly delimited late-life periods as well as aging periods. PMID:22233126

  8. Hearing conservation in the primary aluminium industry.

    PubMed

    Donoghue, A M; Frisch, N; Dixon-Ernst, C; Chesson, B J; Cullen, M R

    2016-04-01

    Noise-induced hearing loss has been an intractable problem for heavy industry. To report our experience in reducing the incidence of age-corrected confirmed 10 dB hearing shifts (averaged over 2, 3 and 4 kHz) in employees in the primary aluminium industry in Australia over the period 2006-13. We analysed annual audiometric data to determine the number of permanent hearing shifts that occurred in employees in two bauxite mines, three alumina refineries and two aluminium smelters. Annual hearing shift rates were calculated based on the number of employees tested per year. Hearing conservation initiatives undertaken during the study period are described. An assessment of similar exposure group noise exposures was also undertaken to determine the magnitude of noise exposure reduction during the study period. Across all operations, hearing shift rates declined from 5.5% per year in 2006 to 1.3% per year in 2013 (P < 0.001). The decline in shift rates was greater in mines and refineries, where baseline shift rates were higher, than in smelter workers. Modest reductions in noise exposure occurred during the study period. We observed a substantial decline in hearing shift rates during the study period. We describe the hearing conservation initiatives that were collectively associated with this decline. We suspect these initiatives could be deployed relatively easily and at modest cost in other industries with noise-exposed employees. © The Author 2015. Published by Oxford University Press on behalf of the Society of Occupational Medicine.

  9. Persistent high rates of smoking among Israeli Arab males with concomitant decrease among Jews.

    PubMed

    Baron-Epel, Orna; Keinan-Boker, Lital; Weinstein, Ruth; Shohat, Tamy

    2010-12-01

    During the last few decades much effort has been invested into lowering smoking rates due to its heavy burden on the population's health and on costs for the health care services. To compare trends in smoking rates between adult Arab men and Jewish men and women during 2000-2008. Six random telephone surveys were conducted by the Israel Center for Disease Control in 2000-2008 to investigate smoking rates. The number of respondents was 24,976 Jewish men and women and 2564 Arab men. The percent of respondents reporting being current smokers was calculated for each population group (Jews and Arabs) by age, gender and education, and were studied in relation to time. Among Jewish men aged 21-64 smoking declined during 2000-2008 by about 3.5%. In the 21-44 age group this decline occurred only among respondents with an academic education. Among Jewish women this decline also occurred at ages 21-64, and in the 45-64 age group this decline was due only to a decline in smoking among those with an academic education. Among Arab men aged 21-64 an increase in smoking rates of about 6.5% was observed among both educated and less educated respondents. Smoking prevalence is declining in Israel among Jews, but not among Arab men. The larger decrease in smoking rates among academics will, in the future, add to the inequalities in health between the lower and higher socioeconomic status groups and between Arabs and Jews. This calls for tailored interventions among the less educated Jews and all Arab men.

  10. Demographics and diaspora, gender and genealogy: anthropological notes on Greek population policy.

    PubMed

    Paxson, H

    1997-01-01

    Since World War II, Greece's birth rate has fallen into a worsening decline. With the steady emigration of Greeks throughout the century to North America, Australia, and Germany, Greece has experienced one of the most rapid population declines in Europe. In 1991, the PASOK government convened a special Parliamentary Commission to study the demographic problem and develop recommendations for its resolution. Released in 1993, and comparing Greece's depressed population growth rates with the markedly higher ones of Albania and Turkey, the report argues that the demographic problem is one of national survival because a decline in the population undermines the territorial integrity and national independence of the country. At least half of all pregnancies in Greece end in abortion, and the report attributes 40% of the declining population growth rate to women who have repeat abortions. To confront the population dilemma, Greek officials are downplaying the diaspora and encouraging women at home to produce more babies. Maternal pensions forwarded by the state as family and population policies are being criticized by Athenian women as a means of professionalizing motherhood and perpetuating a limited vision of female adulthood. The author explores why the declining birth rate is considered to be such a problem in Greece, even though the other countries of Europe are also experiencing birth rate declines; why and how women are blamed for the demographic situation; and why the state, despite its vehement rhetoric, has failed to implement a family policy capable of boosting fertility.

  11. Declining mortality from smoking in the United States.

    PubMed

    Rodu, Brad; Cole, Philip

    2007-07-01

    The proportion of Americans who smoke cigarettes has declined 50% since 1965. The effect on mortality of this considerable reduction has received little attention and is described in this study. U.S. national data were used to enumerate current, former, and never-smokers aged 35 years or older in 1987 and 2002. Mortality rate ratios were used to estimate smoking-attributable deaths among these groups, and corresponding age-adjusted smoking-attributable mortality rates (SAMRs) were calculated. There were 402,000 deaths attributable to smoking in 1987 and 322,000 in 2002. The SAMR for men aged 35 years or more was 556 deaths per 100,000 person-years in 1987, accounting for 24% of all male deaths. By 2002 the SAMR declined 41% to 329 and accounted for only 17% of deaths. The SAMR for women in 1987 was 175, accounting for 12% of deaths. By 2002 the SAMR among women had declined 30% to 122, representing 9% of deaths. The U.S. mortality rate attributable to smoking declined about 35% between 1987 and 2002. The impact of smoking on American society will diminish even further in the foreseeable future as smoking prevalence continues its decline among men and women.

  12. Perioperative Care and the Importance of Continuous Quality Improvement—A Controlled Intervention Study in Three Tanzanian Hospitals

    PubMed Central

    Mtatifikolo, Ferdinand; Ngoli, Baltazar; Neuner, Bruno; Wernecke, Klaus–Dieter; Spies, Claudia

    2015-01-01

    Introduction Surgical services are increasingly seen to reduce death and disability in Sub-Saharan Africa, where hospital-based mortality remains alarmingly high. This study explores two implementation approaches to improve the quality of perioperative care in a Tanzanian hospital. Effects were compared to a control group of two other hospitals in the region without intervention. Methods All hospitals conducted quality assessments with a Hospital Performance Assessment Tool. Changes in immediate outcome indicators after one and two years were compared to final outcome indicators such as Anaesthetic Complication Rate and Surgical Case Fatality Rate. Results Immediate outcome indicators for Preoperative Care in the intervention hospital improved (52.5% in 2009; 84.2% in 2011, p<0.001). Postoperative Inpatient Care initially improved to then decline again (63.3% in 2009; 70% in 2010; 58.6% in 2011). In the control group, preoperative care declined from 50.8% (2009) to 32.8% (2011, p <0.001), while postoperative care did not significantly change. Anaesthetic Complication Rate in the intervention hospital declined (1.89% before intervention; 0.96% after intervention, p = 0.006). Surgical Case Fatality Rate in the intervention hospital declined from 5.67% before intervention to 2.93% after intervention (p<0.0010). Surgical Case Fatality Rate in the control group was 4% before intervention and 3.8% after intervention (p = 0.411). Anaesthetic Complication Rate in the control group was not available. Discussion Immediate outcome indicators initially improved, while at the same time final outcome declined (Surgical Case Fatality, Anaesthetic Complication Rate). Compared to the control group, final outcome improved more in the intervention hospital, although the effect was not significant over the whole study period. Documentation of final outcome indicators seemed inconsistent. Immediate outcome indicators seem more helpful to steer the Continuous Quality Improvement program. Conclusion Specific interventions as part of Continuous Quality Improvement might lead to sustainable improvement of the quality of care, if embedded in a multi-faceted approach. PMID:26327392

  13. Perioperative Care and the Importance of Continuous Quality Improvement--A Controlled Intervention Study in Three Tanzanian Hospitals.

    PubMed

    Bosse, Goetz; Abels, Wiltrud; Mtatifikolo, Ferdinand; Ngoli, Baltazar; Neuner, Bruno; Wernecke, Klaus-Dieter; Spies, Claudia

    2015-01-01

    Surgical services are increasingly seen to reduce death and disability in Sub-Saharan Africa, where hospital-based mortality remains alarmingly high. This study explores two implementation approaches to improve the quality of perioperative care in a Tanzanian hospital. Effects were compared to a control group of two other hospitals in the region without intervention. All hospitals conducted quality assessments with a Hospital Performance Assessment Tool. Changes in immediate outcome indicators after one and two years were compared to final outcome indicators such as Anaesthetic Complication Rate and Surgical Case Fatality Rate. Immediate outcome indicators for Preoperative Care in the intervention hospital improved (52.5% in 2009; 84.2% in 2011, p<0.001). Postoperative Inpatient Care initially improved to then decline again (63.3% in 2009; 70% in 2010; 58.6% in 2011). In the control group, preoperative care declined from 50.8% (2009) to 32.8% (2011, p <0.001), while postoperative care did not significantly change. Anaesthetic Complication Rate in the intervention hospital declined (1.89% before intervention; 0.96% after intervention, p = 0.006). Surgical Case Fatality Rate in the intervention hospital declined from 5.67% before intervention to 2.93% after intervention (p<0.0010). Surgical Case Fatality Rate in the control group was 4% before intervention and 3.8% after intervention (p = 0.411). Anaesthetic Complication Rate in the control group was not available. Immediate outcome indicators initially improved, while at the same time final outcome declined (Surgical Case Fatality, Anaesthetic Complication Rate). Compared to the control group, final outcome improved more in the intervention hospital, although the effect was not significant over the whole study period. Documentation of final outcome indicators seemed inconsistent. Immediate outcome indicators seem more helpful to steer the Continuous Quality Improvement program. Specific interventions as part of Continuous Quality Improvement might lead to sustainable improvement of the quality of care, if embedded in a multi-faceted approach.

  14. Low Serum Bicarbonate and Kidney Function Decline: The Multi-Ethnic Study of Atherosclerosis (MESA)

    PubMed Central

    Driver, Todd H.; Shlipak, Michael G.; Katz, Ronit; Goldenstein, Leonard; Sarnak, Mark J.; Hoofnagle, Andrew N.; Siscovick, David S.; Kestenbaum, Bryan; de Boer, Ian H.; Ix, Joachim H.

    2014-01-01

    Background Among populations with established chronic kidney disease (CKD), metabolic acidosis is associated with more rapid progression of kidney disease. The association of serum bicarbonate concentrations with early declines in kidney function is less clear. Study Design Retrospective cohort study. Setting & Participants 6380 participants in the Multi-Ethnic Study of Atherosclerosis (MESA) with a baseline estimated glomerular filtration rate (eGFR) >60 mL/min/1.73m2 using the CKD-EPI (CKD Epidemiology Collaboration) creatinine–cystatin C equation. Predictors Serum bicarbonate concentrations. Outcomes Rapid kidney function decline (eGFR decline >5% per year) and incident reduced eGFR (eGFR<60 mL/min/1.73 m2 with minimum rate of eGFR loss of 1 mL/min/1.73 m2 per year). Results The average bicarbonate concentration was 23.2 ± 1.8 mEq/L. 1730 (33%) participants had rapid kidney function decline, and 487 had incident reduced eGFR during follow-up. Each 1-SD lower baseline bicarbonate concentration was associated with 12% higher adjusted odds of rapid kidney function decline (95% CI, 6%–20%) and higher risk of incident reduced eGFR (adjusted incidence rate ratio, 1.11; 95% CI, 1.03–1.20) in models adjusting for demographics, baseline eGFR, albuminuria, and CKD risk factors. The OR for the associations of bicarbonate <21mEq/L relative to 23–24 mEq/L was 1.35 (95% CI, 1.05–1.73) for rapid kidney function decline, and the incidence rate ratio was 1.16 (95% CI, 0.83–1.62) for incident reduced eGFR. Limitations Etiology of metabolic acidosis cannot be determined in this study. Conclusions Lower serum bicarbonate concentrations are independently associated with rapid kidney function decline independent of eGFR or albuminuria in community-living persons with a baseline eGFR >60 mL/min/1.73 m2. If confirmed, our findings suggest that metabolic acidosis may indicate either early kidney disease that is not captured by eGFR or albuminuria, or may have a causal role in the development of an eGFR <60 mL/min/1.73 m2. PMID:24953891

  15. CFSC (Community and Family Study Center) study finds birth rates falling everywhere - family planning (family planning) is a factor.

    PubMed

    1978-08-01

    The findings of the Community and Family Study Center study, based on estimated crude birthrates and total fertility rates for 1968 and 1975, indicate that there has been a significant reduction in fertility levels of both developed and developing countries. Despite regional variations, the estimates show an average proportional decline of 8.5% in total fertility rates between 1968 and 1975. Of the 148 nations studied, 113 were in developing regions and 35 in the developed regions. Information on important social and economic development factors, such as life expectancy, literacy, percent of labor force in agriculture, per capita income, and family planning program strength were gathered for each country. Analyses of these data are reported in "The Public Interest" (to be published) "Population Reference Bulletin," October 1978, and a paper presented at the 1978 Population Association of America Meetings in Atlanta, Georgia. The recent change in fertility affected 81% of the world's population, primarily the peoples of Asia, Latin America, and North America. The total fertility rate in the world in 1968 was 4635 and declined to 4068 in 1975. More substantial declines occurred in Asia and Latin America, where the number of fewer births 1000 women would bear under a given fertility schedule declined by 845 births and 617 births, respectively. As more research is conducted to investigate the underlying causes of this decline, it is likely to confirm the important role that family planning programs have had in developing nations. Although major improvements in the socioeconomic well-being of the developing areas continue as an essential goal, the need to maintain the organized provision of family planning services should not be understated.

  16. Diversification rates have declined in the Malagasy herpetofauna.

    PubMed

    Scantlebury, Daniel P

    2013-09-07

    The evolutionary origins of Madagascar's biodiversity remain mysterious despite the fact that relative to land area, there is no other place with consistently high levels of species richness and endemism across a range of taxonomic levels. Most efforts to explain diversification on the island have focused on geographical models of speciation, but recent studies have begun to address the island's accumulation of species through time, although with conflicting results. Prevailing hypotheses for diversification on the island involve either constant diversification rates or scenarios where rates decline through time. Using relative-time-calibrated phylogenies for seven endemic vertebrate clades and a model-fitting framework, I find evidence that diversification rates have declined through time on Madagascar. I show that diversification rates have clearly declined throughout the history of each clade, and models invoking diversity-dependent reductions to diversification rates best explain the diversification histories for each clade. These results are consistent with the ecological theory of adaptive radiation, and, coupled with ancillary observations about ecomorphological and life-history evolution, strongly suggest that adaptive radiation was an important formative process for one of the most species-rich regions on the Earth. These results cast the Malagasy biota in a new light and provide macroevolutionary justification for conservation initiatives.

  17. Mortality with musculoskeletal disorders as underlying cause in Sweden 1997-2013: a time trend aggregate level study.

    PubMed

    Kiadaliri, Aliasghar A; Englund, Martin

    2016-04-14

    The aim was to assess time trend of mortality with musculoskeletal disorders (MSD) as underlying cause of death in Sweden from 1997 to 2013. We obtained data on MSD as underlying cause of death across age and sex groups from the National Board of Health and Welfare's Cause of Death Register. Age-standardized mortality rates per million population for all MSD, its six major subgroups, and all other ICD-10 (International Classification of Disease) chapters were calculated. We computed the average annual percent change (AAPC) in the mortality rates across age/sex groups using joinpoint regression analysis by fitting a regression line to the natural logarithm of the age-standardized mortality rates and calendar year as a predictor. There were a total of 7 976 deaths (0.5% of all causes deaths) with MSD as the underlying cause of death (32.5% of these deaths caused by rheumatoid arthritis [RA]). The overall age-standardized mortality rates (95% CI) were 16.0 (15.4 to 16.7) and 24.9 (24.1 to 25.7) per million among men and women, respectively (women/men rate ratio 1.55; 95%CI 1.47 to 1.63). On average, mortality rate declined by 2.3% per year and only circulatory system mortality had a more favourable decline than mortality with MSD as underlying cause. Among MSD the highest decline was observed in RA (3.7% per year) during study period. Across age groups, while there were generally stable or declining trends, spondylopathies and osteoporosis mortality among people ≥ 75 years increased by 2 and 1.5% per year, respectively. In overall, mortality with MSD as underlying cause has declined in Sweden over last two decades, with the highest decline for RA. However, there are variations across MSD subgroups which warrants further investigations.

  18. Bighorn sheep (Ovis canadensis) survivorship and habitat studies in Bighorn Canyon National Recreation Area and surrounding lands, Wyoming and Montana, 2000–2003

    USGS Publications Warehouse

    Schoenecker, Kathryn A.; Singer, Francis J.; Grams, Kayla A.; Roelle, James E.

    2004-01-01

    In the 1850s, bighorn sheep (Ovis canadensis) were numerous and distributed throughout the Bighorn and Pryor Mountains of Montana and Wyoming. After European settlement, bighorn sheep populations declined, and local extinctions occurred in much of their historic range in the western United States. The current bighorn sheep population of Bighorn Canyon National Recreation Area (BICA) is the product of several reintroductions into BICA and surrounding lands. Following a release in 1973 and growth rates near maximum potential of 19.8% per year, the population grew to an estimated peak population of about 211 animals in 1993 and 1994 (Kissell and others, 1996). Recent counts indicate the bighorn sheep population has declined. Kissell and others (1996) reported that the population began to decline rapidly in 1995 and 1996. He noted low ewe:lamb ratios during the decline phase. Bighorn sheep numbers declined to the lowest minimum viable population size of 100 animals recommended by several bighorn sheep experts (Bailey, 1990; Berger, 1990; Smith and others, 1991). National Park Service (NPS) and Bureau of Land Management (BLM) managers were concerned about the decline and requested a study of its causes. In 2000, the U.S. Geological Survey- Biological Resources Division (USGS-BRD) received funding to start a 3-year study of survivorship, condition, and population growth rate of the BICA bighorn sheep population.Several possibilities exist for the bighorn sheep decline. The herd may have experienced a rapid population expansion, followed by a decline to stability at a lower long-term carrying capacity. This pattern of apparently overshooting carrying capacity following an initial release has been reported for a number of ungulates (Caughley, 1976). Disease may have caused the decline; predation and/or competition with wild horses (Equus caballus) may also have been factors. A spatial model of wild horse carrying capacity (Coughenour, 1999) was developed to assist managers in evaluating wild horse population numbers. Studies of summer consumption rates by wild horses and other ungulates were conducted by James Detling and students from Colorado State University (Peterson and others, 1997; Gerhardt and Detling, 1998; Fahnestock, 1998). Diets and habitat use of wild horses, bighorn sheep and mule deer were studied by Coates and Schemnitz (1989) and Kissell and others (1996). Both Coates and Schemnitz (1989) and Kissell and others (1996) reported a high degree of dietary overlap between wild horses and bighorn sheep. However, Kissell and others (1996) concluded that a high degree of spatial separation between wild horses and bighorn sheep, at least under the study conditions, precluded any significant negative competitive influences. The most important overlap of bighorn sheep and wild horses seems to be on winter range. Competition can be difficult to determine, since current conditions may not reveal competition that has already occurred. Managers remained concerned about the declining bighorn population for the following reasons: Our objectives for the study were to: Evaluate current disease problems and mortality rates, including predation rates, in bighorn sheep through captures and monitoring of bighorn sheep.Determine winter spatial relations of wild horses and bighorn sheep through aerial surveys of winter range.Conduct habitat measurements to determine why bighorn sheep were not using what had been mapped with a GIS-based habitat model as suitable bighorn sheep habitat, and sample winter and summer consumption rates of key forage species to see if there were other factors precluding use of these areas by bighorn sheep.Compare winter lamb recruitment rates and total vegetation consumption rates on bighorn sheep winter use areas, with and without wild horses present.Complete year-round GIS-based distribution maps for wild horses and bighorn sheep in order to identify key areas of species overlap and key areas of species separation for potential habitat improvements.NPS park staff asked USGS to answer the following questions: (a) how large is the population?; (b) how many rams are in the population?; (c) in addition to low lamb recruitment, is mortality or dispersal of adults likely contributing to the decline?; and (d) is trophy hunting of rams contributing to the decline?

  19. Labor force participation among persons with musculoskeletal conditions, 1970-1987. National estimates derived from a series of cross-sections.

    PubMed

    Yelin, E H; Katz, P P

    1991-11-01

    In the present study, we estimated the labor force participation rate among persons with musculoskeletal conditions in 1987, compared this rate with that experienced by persons with other chronic conditions or with none, and estimated the change in labor force participation rates among persons with musculoskeletal conditions for the period 1970-1987. Rates were estimated from 18 years of National Health Interview Survey data, and the sampling weights from this survey were used to obtain population estimates. To ensure statistically stable estimates, we averaged the rates over 6 years of data. In 1987, 42.9% of all working-age persons with musculoskeletal conditions were out of the labor force, this study's definition of work disability. Overall labor force participation rates among persons with musculoskeletal conditions declined from 71% to 56% between 1976-1981 and 1982-1987, 22% in relative terms. Much of this decline was concentrated among men, especially men 55-64 years of age. However, women 55-64 years of age with musculoskeletal conditions also experienced declining labor force participation rates. Labor force participation patterns among persons with musculoskeletal conditions fit more general labor market trends, with gains among younger women more than offset by declines among older men and women. However, these trends appear to be more accentuated among persons with musculoskeletal conditions, suggesting that enforcement of the employment provisions of the Americans with Disabilities Act of 1990 place special emphasis on labor force participation among such persons.

  20. Trajectories of physical function prior to death and brain neuropathology in a community-based cohort: the act study.

    PubMed

    LaCroix, Andrea Z; Hubbard, Rebecca A; Gray, Shelly L; Anderson, Melissa L; Crane, Paul K; Sonnen, Joshua A; Zaslavsky, Oleg; Larson, Eric B

    2017-11-02

    Mechanisms linking cognitive and physical functioning in older adults are unclear. We sought to determine whether brain pathological changes relate to the level or rate of physical performance decline. This study analyzed data from 305 participants in the autopsy subcohort of the prospective Adult Changes in Thought (ACT) study. Participants were aged 65+ and free of dementia at enrollment. Physical performance was measured at baseline and every two years using the Short Physical Performance Battery (SPPB). Data from 3174 ACT participants with ≥2 SPPB measurements were used to estimate two physical function measures: 1) rate of SPPB decline defined by intercept and slope; and 2) estimated SPPB 5 years prior to death. Neuropathology findings at autopsy included neurofibrillary tangles (Braak stage), neuritic plaques (CERAD level), presence of amyloid angiopathy, microinfarcts, cystic infarcts, and Lewy bodies. Associations (adjusted for sex, age, body mass index and education) between dichotomized neuropathologic outcomes and SPPB measures were estimated using modified Poisson regression with inverse probability weights (IPW) estimated via Generalized Estimating Equations (GEE). Relative risks for the 20 th , 40 th , and 60 th percentiles (lowest levels and highest rates of decline) relative to the 80th percentile (highest level and lowest rate of decline) were calculated. Decedents with the least vs. most SPPB decline (slope > 75 th vs. < 25 th percentiles) had higher SPPB scores, and were more likely to be male, older, have higher education, and exercise regularly at baseline. No significant associations were observed between neuropathology findings and rate of SPPB decline. Lower predicted SPPB scores 5 years prior to death were associated with higher risk of microinfarcts (RR = 3.08, 95% confidence interval (CI) 0.93-1.07 for the 20 th vs. 80 th percentiles of SPPB) and significantly higher risk of cystic infarcts (RR = 2.72, 95% CI 1.45-5.57 for 20 th vs. 80 th percentiles of SPPB). Cystic infarcts and microinfarcts, but not neuropathology findings of Alzheimer's disease, were related to physical performance levels five years before death. No pathology findings were associated with rates of physical performance decline. Physical function levels in the years prior to death may be affected by vascular brain pathologies.

  1. HIV/HCV Co-infection, Liver Disease Progression, and Age-Related IGF-1 Decline.

    PubMed

    Quinn, Jeffrey; Astemborski, Jacquie; Mehta, Shruti H; Kirk, Gregory D; Thomas, David L; Balagopal, Ashwin

    2017-01-01

    We have previously reported that persons co-infected with HIV and hepatitis C virus (HCV) had liver disease stages similar to HIV-uninfected individuals who were approximately 10 years older. Insulin-like growth factor 1(IGF-1) levels have long been known to decline with advancing age in humans and non-humans alike. We examined whether HIV infection affects the expected decline in IGF-1 in persons with chronic hepatitis C virus (HCV) infection and if that alteration in IGF-1 decline contributes to the link between HIV, aging, and liver disease progression. A total of 553 individuals with HCV infection were studied from the AIDS Linked to the Intravenous Experience (ALIVE) cohort for whom more than 10 years of follow-up was available. Serum IGF-1 levels were determined by ELISA and evaluated according to baseline characteristics and over time by HIV status and liver disease progression. Linear regression with generalized estimating equations was used to determine whether IGF-1 decline over time was independently associated with liver disease progression. Baseline IGF-1 levels were strongly associated with age ( P < 0.0001) but not with gender or HIV infection. Levels of IGF-1 declined at a rate of -1.75 ng/mL each year in HCV mono-infected individuals and at a rate of -1.23 ng/mL each year in HIV/HCV co-infected individuals ( P < 0.05). In a multivariable linear regression model, progression of liver fibrosis was associated with HIV infection and age, as well as with a slower rate of IGF-1 decline ( P = 0.001); however, the rate of IGF-1 decline did not alter the strength of the associations between HIV, liver disease, and age. The normal decline in IGF-1 levels with age was attenuated in HIV/HCV co-infected individuals compared to those with HCV mono-infection, and slower IGF-1 decline was independently associated with liver disease progression.

  2. Achieving the Goals of the National HIV/AIDS Strategy: Declining HIV Diagnoses, Improving Clinical Outcomes, and Diminishing Racial/Ethnic Disparities in King County, WA (2004-2013).

    PubMed

    Golden, Matthew R; Bennett, Amy B; Dombrowski, Julia C; Buskin, Susan E

    2016-05-01

    The US National HIV/AIDS Strategy defines national objectives related to HIV prevention and care. The extent to which US cities are meeting those objectives is uncertain. We analyzed King County, WA, HIV surveillance data collected between 2004 and 2013. The study population included 9539 persons diagnosed as having and living with HIV infection and 3779 persons with newly diagnosed HIV infection. Between 2004 and 2013, the rate of new HIV diagnosis decreased from 18.4 to 13.2 per 100,000 residents (decline of 28%); AIDS diagnosis rates declined 42% from 12 to 7 per 100,000; and age-adjusted death rates decreased from 27 to 15 per 1000 persons living with HIV/AIDS (decline of 42%; P<0.0001 for all 3 trends). The rate of new HIV diagnosis declined 26% among men who have sex with men (MSM; P=0.0002), with the largest decline occurring in black MSM (44%). Among 8679 individuals with laboratory results reported to National HIV Surveillance System from 2006 through 2013, viral suppression (viral load<200 copies/mL) increased from 45% to 86% (P<0.0001), with all racial/ethnic groups achieving greater than 80% viral suppression in 2013. The rates of new HIV diagnosis, AIDS diagnoses, and mortality in persons living with HIV in King County, WA, have significantly declined over the last decade. These changes have occurred concurrent with a dramatic increase in HIV viral suppression and have affected diverse populations, including MSM and African American MSM. These findings demonstrate substantial local success in achieving the goals of the National HIV/AIDS Strategy.

  3. Metabolic Syndrome and 16-year Cognitive Decline in Community-Dwelling Older Adults

    PubMed Central

    McEvoy, Linda K.; Laughlin, Gail A.; Barrett-Connor, Elizabeth; Bergstrom, Jaclyn; Kritz-Silverstein, Donna; Der-Martirosian, Claudia; von Mühlen, Denise

    2012-01-01

    PURPOSE To determine whether metabolic syndrome is associated with accelerated cognitive decline in community-dwelling older adults. METHODS Longitudinal study of 993 adults (mean 66.8 ± 8.7 years) from the Rancho Bernardo Study. Metabolic syndrome components, defined by 2001 NCEP-ATP III criteria, were measured in 1984–87. Cognitive function was first assessed in 1988–92. Cognitive assessments were repeated approximately every four years, for a maximum 16-year follow-up. Mixed-effects models examined longitudinal rate of cognitive decline by metabolic syndrome status, controlling for factors plausibly associated with cognitive function (diabetes, inflammation). RESULTS Metabolic syndrome was more common in men than women (14% vs. 9%, p=0.01). In women, metabolic syndrome was associated with greater executive function and long term memory decline. These associations did not differ by inflammatory biomarker levels. Diabetes did not alter the association of metabolic syndrome with long-term recall but modified the association with executive function: metabolic syndrome was associated with accelerated executive function decline in diabetic women only. Metabolic syndrome was not related to rate of decline on any cognitive measure in men. CONCLUSIONS Metabolic syndrome was a risk factor for accelerated cognitive decline, but only in women. Prevention of metabolic syndrome may aid in maintenance of cognitive function with age. PMID:22285865

  4. Teen Birth Rates for Urban and Rural Areas in the United States, 2007-2015.

    PubMed

    Hamilton, Brady E; Rossen, Lauren M; Branum, Amy M

    2016-11-01

    Data from the National Vital Statistics System •Birth rates for teenagers aged 15-19 declined in urban and rural counties from 2007 through 2015, with the largest declines in large urban counties and the smallest declines in rural counties. •From 2007 through 2015, the teen birth rate was lowest in large urban counties and highest in rural counties. •Declines in teen birth rates in all urban counties between 2007 and 2015 were largest in Arizona, Massachusetts, Connecticut, Minnesota, and Colorado, with 17 states experiencing a decline of 50% or more. •Declines in teen birth rates in all rural counties between 2007 and 2015 were largest (50% or more) in Colorado and Connecticut. •In 2015, teen birth rates were highest in rural counties and lowest in large urban counties for non-Hispanic white, non-Hispanic black, and Hispanic females. Teen birth rates have demonstrated an unprecedented decline in the United States since 2007 (1). Declines occurred in all states and among all major racial and Hispanic-origin groups, yet disparities by both geography and demographic characteristics persist (2,3). Although teen birth rates and related declines have been described by state, patterns by urban-rural location have not yet been examined. This report describes trends in teen birth rates in urban (metropolitan) and rural (nonmetropolitan) areas in the United States overall and by state from 2007 through 2015 and by race and Hispanic origin for 2015. All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.

  5. Associations of interleukin-1 gene cluster polymorphisms with C-reactive protein concentration and lung function decline in smoking-induced chronic obstructive pulmonary disease

    PubMed Central

    Wang, Yu; Shumansky, Karey; Sin, Don D; Man, SF Paul; Akhabir, Loubna; Connett, John E; Anthonisen, Nicholas R; Paré, Peter D; Sandford, Andrew J; He, Jian-Qing

    2015-01-01

    Objective: We reported association of haplotypes formed by IL-1b (IL1B)-511C/T (rs16944) and a variable number of tandem repeats (rs2234663) in intron 3 of IL-1 receptor antagonist (IL1RN) with rate of lung function decline in smoking-induced COPD. The aim of current study was to further investigate this association. Methods: We genotyped an additional 19 polymorphisms in IL1 cluster (including IL1A, IL1B and IL1RN) in non-Hispanic whites who had the fastest (n = 268) and the slowest (n = 292) decline of FEV1% predicted in the same study. We also analyzed the association of all 21 polymorphisms with serum CRP levels. Results: None of 21 polymorphisms showed significant association with rate of decline of lung function or CRP levels after adjusting for multiple comparisons. Before adjusting for multiple comparisons, only IL1RN_19327 (rs315949) showed significant association with lung function decline (P = 0.03, additive model). The frequencies of genotypes containing the IL1RN_19327A allele were 71.9% and 62.2%, respectively in the fast and slow decline groups (P = 0.02, odds ratio = 1.6, 95% confidence interval = 1.1-2.3); the IL1B_5200 (rs1143633) and rs2234663 in IL1RN were associated with serum CRP levels (P=0.04 and 0.03, respectively). Conclusions: No single marker was significantly associated with either rate of lung function decline or serum CRP levels. PMID:26722511

  6. Effects of perceived job insecurity on depression, suicide ideation, and decline in self-rated health in Korea: a population-based panel study.

    PubMed

    Kim, Min-Seok; Hong, Yun-Chul; Yook, Ji-Hoo; Kang, Mo-Yeol

    2017-10-01

    To investigate the effects of job security on new development of depressive episode, suicide ideation, and decline in self-rated health. Data from the Korea Welfare Panel Study from 2012 to 2015 were analysed. A total of 2912 waged workers self-assessed their depressive episode, suicide ideation, and health annually by answering the questionnaire. Participants were divided into three groups according to the level of job security: high, intermediate and low. To evaluate the influence of job security, we performed survival analysis after stratification by gender with adjustment for covariates. The result was further stratified by whether the respondent was the head of household. After adjusting for covariates, men in low job security group showed significantly higher hazard ratios (HRs) for depression (HR 1.27, 95% CI 1.01-1.60), suicide ideation (HR 3.25, 95% CI 1.72-6.16), and decline in self-rated health (HR 1.73, 95% CI 1.16-2.59). Women showed significantly higher HR of depression in the intermediate (HR 1.37, 95% CI 1.01-1.87) and low (HR 1.50, 95% CI 1.12-1.99) job security group. Male head of household with low job security showed significantly higher HR of depression, suicide ideation, and decline in self-rated health. Non-head-of-household women with intermediate and low job security showed higher risk of depression than those with high job security. We found that perceived job insecurity is associated with the new development of depressive episode, suicide ideation, and decline in self-rated health.

  7. Hypertension is associated with cognitive decline in elderly people at high risk for dementia.

    PubMed

    Wysocki, Michael; Luo, Xiaodong; Schmeidler, James; Dahlman, Karen; Lesser, Gerson T; Grossman, Hillel; Haroutunian, Vahram; Beeri, Michal Schnaider

    2012-02-01

    Cardiovascular risk factors including hypertension (HTN) have been shown to increase the risk of Alzheimer disease. The current study investigated whether individuals with HTN are more susceptible to increased cognitive decline and whether the influence of HTN on cognitive decline varied as a function of dementia severity. A total of 224 nursing home and assisted living residents, with a mean age of 84.9 (±7.6) years, were assessed longitudinally with Mini Mental State Exams (MMSEs) and Clinical Dementia Ratings (CDR). Baseline dementia status was defined by the CDR score. As described in , MMSE scores in persons with HTN and questionable dementia (CDR = 0.5) declined significantly faster than nonhypertensive questionably demented persons. Hypertensive participants did not decline significantly faster than nonhypertensive participants in persons with intact cognition (CDR = 0) or frank dementia (CDR ≥ 1). These results suggest an increased risk of subsequent cognitive decline in hypertensive individuals who are especially vulnerable to developing dementia and raises the possibility that avoiding or controlling HTN might reduce the rate of cognitive decline in cognitively vulnerable individuals, potentially delaying their conversion to full-fledged dementia.

  8. Seven-Year Evaluation of Insecticide Tools for Emerald Ash Borer in Fraxinus pennsylvanica (Lamiales: Oleaceae) Trees.

    PubMed

    Bick, Emily N; Forbes, Nora J; Haugen, Christopher; Jones, Grant; Bernick, Shawn; Miller, Fredric

    2018-04-02

    Emerald ash borer (EAB), Agrilus planipennis (Fairmaire; Coleoptera: Buprestidae), is decimating ash trees (Fraxinus spp.) in North America. Combatting EAB includes the use of insecticides; however, reported insecticide efficacy varies among published studies. This study assessed the effects of season of application, insecticide active ingredient, and insecticide application rate on green ash (Fraxinus pennsylvanica Marsh.) (Lamiales: Oleaceae) canopy decline caused by EAB over a 5- to 7-yr interval. Data suggested that spring treatments were generally more effective in reducing canopy decline than fall treatments, but this difference was not statistically significant. Lowest rates of decline (<5% over 5 yr) were observed in trees treated with imidacloprid injected annually in the soil during spring (at the higher of two tested application rates; 1.12 g/cm diameter at 1.3 m height) and emamectin benzoate injected biennially into the stem. All tested insecticides (dinotefuran, emamectin benzoate, and imidacloprid) under all tested conditions significantly reduced the rate of increase of dieback.

  9. Dementia and Depression in Elders with Mental Retardation: A Pilot Study.

    ERIC Educational Resources Information Center

    Harper, Dennis C.; Wadsworth, John S.

    1990-01-01

    This article investigates cognitive decline and depressive symptomatology among older adults with mental retardation. A pilot study of assessment instruments is reported. Findings reveal that decreasing cognitive ability is associated with higher rates of observed depression and reported behavioral problems. Cognitive decline was associated with…

  10. 40 CFR 73.19 - Certain units with declining SO2 rates.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 16 2010-07-01 2010-07-01 false Certain units with declining SO2 rates... declining SO2 rates. (a) Eligibility. A unit is eligible for allowance allocations under this section if it... generator with nameplate capacity equal to or greater than 75 MWe; (3) Its 1985 actual SO2 emissions rate...

  11. Slowdown in the decline of stroke mortality in the United States, 1978-1986.

    PubMed

    Cooper, R; Sempos, C; Hsieh, S C; Kovar, M G

    1990-09-01

    The gradual decline in stroke mortality rates observed in the United States since 1900 accelerated markedly around 1973 for whites and around 1968 for blacks. During the next decade stroke mortality rates decreased by almost 50% so that the United States now experiences one of the lowest stroke mortality rates in the world. Beginning in 1979, however the annual rate of decline in stroke mortality began to slow considerably. Comparing the period 1979-1986 with the previous decade, a 57% slowing in the absolute rate of decline (as estimated by the slope of the linear portion of the mortality curve) was observed for white men; the corresponding slowdowns in the rate of decline were 58% for white women, 44% for black men, and 62% for black women. If the decline during the 1980s had continued at the rate observed for the period 1968/73-1978, there would have been 131,000 fewer stroke deaths during the period 1979-1986, 28,000 fewer in 1986 alone. This slowdown in the rate of decline in stroke mortality is occurring while mortality rates for both coronary heart disease and all causes are leveling off. The reasons for this change in the mortality trend remain unknown, and corresponding trends in the treatment and control of hypertension do not provide an entirely satisfactory explanation.

  12. CD4 decline is associated with increased risk of cardiovascular disease, cancer, and death in virally suppressed patients with HIV.

    PubMed

    Helleberg, Marie; Kronborg, Gitte; Larsen, Carsten S; Pedersen, Gitte; Pedersen, Court; Obel, Niels; Gerstoft, Jan

    2013-07-01

    The clinical implications of a considerable CD4 decline despite antiretroviral treatment and viral suppression are unknown. We aimed to test the hypothesis that a major CD4 decline could be a marker of cardiovascular disease or undiagnosed cancer. Patients with human immunodeficiency virus (HIV) were followed in the Danish nationwide, population-based cohort study in the period 1995-2010 with quarterly CD4 measurements. Associations between a CD4 decline of ≥30% and cardiovascular disease, cancer, and death were analyzed using Poisson regression with date of CD4 decline as a time-updated variable. We followed 2584 virally suppressed HIV patients for 13 369 person-years (PY; median observation time, 4.7 years). Fifty-six patients developed CD4 decline (incidence rate, 4.2/1000 PY [95% confidence interval {CI}, 3.2-5.4]). CD4 counts dropped from a median of 492 cells/µL to 240 cells/µL. CD8, CD3, and total lymphocyte counts dropped concomitantly. No HIV-related factors, apart from treatment with didanosine, were associated with CD4 decline. The risk of cardiovascular disease, cancer, and death increased markedly ≤6 months after CD4 decline (incidence rate ratio, 11.7 [95% CI, 3.6-37.4] and 13.7 [95% CI, 4.3-43.6], respectively, and mortality rate ratio 4.3 [95% CI, 1.1-17.6]). A major decline in CD4 count is associated with a marked increased risk of cardiovascular disease, cancer, and death among virally suppressed HIV patients.

  13. Low serum bicarbonate and kidney function decline: the Multi-Ethnic Study of Atherosclerosis (MESA).

    PubMed

    Driver, Todd H; Shlipak, Michael G; Katz, Ronit; Goldenstein, Leonard; Sarnak, Mark J; Hoofnagle, Andrew N; Siscovick, David S; Kestenbaum, Bryan; de Boer, Ian H; Ix, Joachim H

    2014-10-01

    Among populations with established chronic kidney disease (CKD), metabolic acidosis is associated with more rapid progression of kidney disease. The association of serum bicarbonate concentrations with early declines in kidney function is less clear. Retrospective cohort study. 5,810 participants in the Multi-Ethnic Study of Atherosclerosis (MESA) with a baseline estimated glomerular filtration rate (eGFR) > 60mL/min/1.73 m(2) using the CKD-EPI (CKD Epidemiology Collaboration) creatinine-cystatin C equation. Serum bicarbonate concentrations. Rapid kidney function decline (eGFR decline > 5% per year) and incident reduced eGFR (eGFR < 60mL/min/1.73 m(2) with minimum rate of eGFR loss of 1 mL/min/1.73 m(2) per year). Average bicarbonate concentration was 23.2 ± 1.8mEq/L. 1,730 (33%) participants had rapid kidney function decline, and 487 had incident reduced eGFR during follow-up. Each 1-SD lower baseline bicarbonate concentration was associated with 12% higher adjusted odds of rapid kidney function decline (95% CI, 6%-20%) and higher risk of incident reduced eGFR (adjusted incidence rate ratio, 1.11; 95% CI, 1.03-1.20) in models adjusting for demographics, baseline eGFR, albuminuria, and CKD risk factors. The OR for the associations of bicarbonate level < 21 mEq/L relative to 23-24 mEq/L was 1.35 (95% CI, 1.05-1.73) for rapid kidney function decline, and the incidence rate ratio was 1.16 (95% CI, 0.83-1.62) for incident reduced eGFR. Cause of metabolic acidosis cannot be determined in this study. Lower serum bicarbonate concentrations are associated independently with rapid kidney function decline independent of eGFR or albuminuria in community-living persons with baseline eGFR > 60 mL/min/1.73 m(2). If confirmed, our findings suggest that metabolic acidosis may indicate either early kidney disease that is not captured by eGFR or albuminuria or may have a causal role in the development of eGFR < 60 mL/min/1.73 m(2). Copyright © 2014 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

  14. Forest Disturbance Across the Conterminous United States from 1985-2012: The Emerging Dominance of Forest Decline

    NASA Technical Reports Server (NTRS)

    Cohen, Warren B.; Yang, Zhiqiang; Stehman, Stephen; Schroeder, Todd; Bell, David M.; Masek, Jeffrey; Huang, Chengquan; Meigs, Garrett W.

    2015-01-01

    Evidence of shifting dominance among major forest disturbance agent classes regionally to globally has been emerging in the literature. For example, climate-related stress and secondary stressors on forests (e.g., insect and disease, fire) have dramatically increased since the turn of the century globally, while harvest rates in the western US and elsewhere have declined. For shifts to be quantified, accurate historical forest disturbance estimates are required as a baseline for examining current trends. We report annual disturbance rates (with uncertainties) in the aggregate and by major change causal agent class for the conterminous US and five geographic subregions between 1985 and 2012. Results are based on human interpretations of Landsat time series from a probability sample of 7200 plots (30 m) distributed throughout the study area. Forest disturbance information was recorded with a Landsat time series visualization and data collection tool that incorporates ancillary high-resolution data. National rates of disturbance varied between 1.5% and 4.5% of forest area per year, with trends being strongly affected by shifting dominance among specific disturbance agent influences at the regional scale. Throughout the time series, national harvest disturbance rates varied between one and two percent, and were largely a function of harvest in the more heavily forested regions of the US (Mountain West, Northeast, and Southeast). During the first part of the time series, national disturbance rates largely reflected trends in harvest disturbance. Beginning in the mid-90s, forest decline-related disturbances associated with diminishing forest health (e.g., physiological stress leading to tree canopy cover loss, increases in tree mortality above background levels), especially in the Mountain West and Lowland West regions of the US, increased dramatically. Consequently, national disturbance rates greatly increased by 2000, and remained high for much of the decade. Decline-related disturbance rates reached as high as 8% per year in the western regions during the early-2000s. Although low compared to harvest and decline, fire disturbance rates also increased in the early- to mid-2000s. We segmented annual decline-related disturbance rates to distinguish between newly impacted areas and areas undergoing gradual but consistent decline over multiple years. We also translated Landsat reflectance change into tree canopy cover change information for greater relevance to ecosystem modelers and forest managers, who can derive better understanding of forest-climate interactions and better adapt management strategies to changing climate regimes. Similar studies could be carried out for other countries where there are sufficient Landsat data and historic temporal snapshots of high-resolution imagery.

  15. Incorporating benthic community changes into hydrochemical-based projections of coral reef calcium carbonate production under ocean acidification

    NASA Astrophysics Data System (ADS)

    Shaw, Emily C.; Hamylton, Sarah M.; Phinn, Stuart R.

    2016-06-01

    The existence of coral reefs is dependent on the production and maintenance of calcium carbonate (CaCO3) framework that is produced through calcification. The net production of CaCO3 will likely decline in the future, from both declining net calcification rates (decreasing calcification and increasing dissolution) and shifts in benthic community composition from calcifying organisms to non-calcifying organisms. Here, we present a framework for hydrochemical studies that allows both declining net calcification rates and changes in benthic community composition to be incorporated into projections of coral reef CaCO3 production. The framework involves upscaling net calcification rates for each benthic community type using mapped proportional cover of the benthic communities. This upscaling process was applied to the reef flats at One Tree and Lady Elliot reefs (Great Barrier Reef) and Shiraho Reef (Okinawa), and compared to existing data. Future CaCO3 budgets were projected for Lady Elliot Reef, predicting a decline of 53 % from the present value by end-century (800 ppm CO2) without any changes to benthic community composition. A further 5.7 % decline in net CaCO3 production is expected for each 10 % decline in calcifier cover, and net dissolution is predicted by end-century if calcifier cover drops below 18 % of the present extent. These results show the combined negative effect of both declining net calcification rates and changing benthic community composition on reefs and the importance of considering both processes for determining future reef CaCO3 production.

  16. Cognitive Decline in a Colombian Kindred With Autosomal Dominant Alzheimer Disease: A Retrospective Cohort Study.

    PubMed

    Aguirre-Acevedo, Daniel C; Lopera, Francisco; Henao, Eliana; Tirado, Victoria; Muñoz, Claudia; Giraldo, Margarita; Bangdiwala, Shrikant I; Reiman, Eric M; Tariot, Pierre N; Langbaum, Jessica B; Quiroz, Yakeel T; Jaimes, Fabian

    2016-04-01

    Data from an autosomal dominant Alzheimer disease (ADAD) kindred were used to track the longitudinal trajectory of cognitive decline associated with preclinical ADAD and explore factors that may modify the rate of cognitive decline. To evaluate the onset and rate of cognitive decline during preclinical ADAD and the effect of socioeconomic, vascular, and genetic factors on the cognitive decline. We performed a retrospective cohort study from January 1, 1995, through June 31, 2012, of individuals from Antioquia, Colombia, who tested positive for the ADAD-associated PSEN1 E280A mutation. Data analysis was performed from August 20, 2014, through November 30, 2015. A mixed-effects model was used to estimate annual rates of change in cognitive test scores and to mark the onset of cognitive decline. Memory, language, praxis, and total scores from the Consortium to Establish a Registry for Alzheimer Disease test battery. Chronologic age was used as a time scale in the models. We explore the effects of sex; educational level; socioeconomic status; residence area; occupation type; marital status; history of hypertension, diabetes mellitus, and dyslipidemia; tobacco and alcohol use; and APOE ε4 on the rates of cognitive decline. A total of 493 carriers met the inclusion criteria and were analyzed. A total of 256 carriers had 2 or more assessments. At the time of the initial assessment, participants had a mean (SD) age of 33.4 (11.7) years and a mean (SD) educational level of 7.2 (4.2) years. They were predominantly female (270 [54.8%]), married (293 [59.4%]), and of low socioeconomic status (322 [65.3%]). Word list recall scores provided the earliest indicator of preclinical cognitive decline at 32 years of age, 12 and 17 years before the kindred's respective median ages at mild cognitive impairment and dementia onset. After the change point, carriers had a statistically significant cognitive decline with a loss of 0.24 (95% CI, -0.26 to -0.22) points per year for the word list recall test and 2.13 (95% CI, -2.29 to -1.96) points per year for total scores. Carriers with high educational levels had an increase of approximately 36% in the rate of cognitive decline after the change point when compared with those with low educational levels (-2.89 vs -2.13 points per year, respectively). Onset of cognitive decline was delayed by 3 years in individuals with higher educational levels compared with those with lower educational levels. Those with higher educational level, middle/high socioeconomic status, history of diabetes and hypertension, and tobacco and alcohol use had a steeper cognitive decline after onset. Preclinical cognitive decline was evident in PSEN1 E280A mutation carriers 12 years before the onset of clinical impairment. Educational level may be a protective factor against the onset of cognitive impairment.

  17. Longitudinal associations between physical and cognitive performance among community-dwelling older adults.

    PubMed

    Tolea, Magdalena I; Morris, John C; Galvin, James E

    2015-01-01

    To assess the directionality of the association between physical and cognitive decline in later life, we compared patterns of decline in performance across groups defined by baseline presence of cognitive and/or physical impairment [none (n = 217); physical only (n = 169); cognitive only (n = 158), or both (n = 220)] in a large sample of participants in a cognitive aging study at the Knight Alzheimer's Disease Research Center at Washington University in St. Louis who were followed for up to 8 years (3,079 observations). Rates of decline reached 20% for physical performance and varied across cognitive tests (global, memory, speed, executive function, and visuospatial skills). We found that physical decline was better predicted by baseline cognitive impairment (slope = -1.22, p<0.001), with baseline physical impairment not contributing to further decline in physical performance (slope = -0.25, p = 0.294). In turn, baseline physical impairment was only marginally associated with rate of cognitive decline across various cognitive domains. The cognitive-functional association is likely to operate in the direction of cognitive impairment to physical decline although physical impairment may also play a role in cognitive decline/dementia. Interventions to prevent further functional decline and development of disability and complete dependence may benefit if targeted to individuals with cognitive impairment who are at increased risk.

  18. Predictors of Residual Renal Function Decline in Patients Undergoing Continuous Ambulatory Peritoneal Dialysis

    PubMed Central

    Szeto, Cheuk-Chun; Kwan, Bonnie Ching-Ha; Chow, Kai-Ming; Chung, Sebastian; Yu, Vincent; Cheng, Phyllis Mei-Shan; Leung, Chi-Bon; Law, Man-Ching; Li, Philip Kam-Tao

    2015-01-01

    ♦ Background: Residual renal function (RRF) is an important prognostic indicator in continuous ambulatory peritoneal dialysis (CAPD) patients. We determined the predictors of RRF loss in a cohort of incident CAPD patients. ♦ Methods: We reviewed the record of 645 incident CAPD patients. RRF loss is represented by the slope of decline of residual glomerular filtration rate (GFR) as well as the time to anuria. ♦ Results: The average rate of residual GFR decline was -0.083 ± 0.094 mL/min/month. The rate of residual GFR decline was faster with a higher proteinuria (r = -0.506, p < 0.0001) and baseline residual GFR (r = -0.560, p < 0.0001). Multivariate analysis showed that proteinuria, baseline residual GFR, and the use of diuretics were independent predictors of residual GFR decline. Cox proportional hazard model showed that proteinuria, glucose exposure, and the number of peritonitis episodes were independent predictors of progression to anuria, while a higher baseline GFR was protective. Each 1 g/day of proteinuria is associated with a 13.2% increase in the risk of progressing to anuria, each 10 g/day higher glucose exposure is associated with a 2.5% increase in risk, while each peritonitis episode confers a 3.8% increase in risk. ♦ Conclusions: Our study shows that factors predicting the loss of residual solute clearance and urine output are different. Proteinuria, baseline residual GFR, and the use of diuretics are independently related to the rate of RRF decline in CAPD patients, while proteinuria, glucose exposure, and the number of peritonitis episodes are independent predictors for the development of anuria. The role of anti-proteinuric therapy and measures to prevent peritonitis episodes in the preservation of RRF should be tested in future studies. PMID:24497594

  19. Decline in admissions for childhood asthma, a 26-year period population-based study.

    PubMed

    Mikalsen, Ingvild Bruun; Skeiseid, Liliane; Tveit, Line Merete; Engelsvold, David Hugo; Øymar, Knut

    2015-12-01

    The prevalence of childhood asthma has increased, although the rate of hospitalization for asthma seems to decrease. In Norway, the rate of hospital admission for childhood asthma from 1984 to 2000 increased. The aim of this study was to assess further trends in hospital admissions for childhood asthma up to 2010. A population-based study including children 1-13 yrs of age hospitalized for asthma during six periods from 1984/1985 to 2009/2010 in Rogaland, Norway, was performed. Medical records from 1536 admissions (1050 children) were studied; and gender, age, number of admissions, length of hospital stay, medications and symptoms were recorded. For all age groups, the rate of admissions per 10.000 increased from 20.1 in 1984/85 to 33.7 in 1989/90, but declined to 14.4 in 2009/2010. Rates were highest in boys (OR 1.87; 95% CI: 1.69, 2.09), younger age groups (OR 2.51; 2.38, 2.64) and decreased from 1984 to 2010 (OR 0.92; 0.88, 0.94). The rates of readmissions were higher than for primary admissions (OR 1.33; 1.19, 1.47). From 1984 to 2010, there was an increased use of inhaled corticosteroids prior to admission (6 to 51%) and started at discharge (7 to 37%), and systemic steroids given during admission (19 to 83%). There has been a substantial decline in the rate of hospital admissions for childhood asthma after 1989/1990, with major differences between age groups and genders. The decline could be due to improved care of children with asthma or a real reduction in asthma exacerbations. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  20. Job insecurity, chances on the labour market and decline in self-rated health in a representative sample of the Danish workforce.

    PubMed

    Rugulies, R; Aust, B; Burr, H; Bültmann, U

    2008-03-01

    To investigate if job insecurity and poor labour market chances predict a decline in self-rated health in the Danish workforce. Job insecurity, labour market chances, self-rated health and numerous covariates were measured in 1809 women and 1918 men who responded to a questionnaire in 1995 and again in 2000. Multivariate logistic regression analyses were used to analyse the impact of job insecurity and labour market chances measured in 1995 on decline in health in 2000. Prospective cohort study with a representative sample of the Danish workforce using the Danish Work Environment Cohort Study (DWECS). All participants were employed at baseline. Women with job insecurity had an increased risk of a decline in health at follow-up, after adjustment for all covariates (OR = 1.78, 95% CI: 1.24 to 2.54). Effect estimates were strongest among women 50 years of age or younger with poor labour market chances (OR = 2.13, 95% CI: 1.32 to 3.45). Among men, there was no main effect for job insecurity. However, men aged 50 years or younger with poor labour market chances showed an OR of 1.64 (95% CI: 0.95 to 2.84) for a decline in health. Job insecurity is a predictor for a decline in health in employed women in Denmark. Among men, a suggestive effect of job insecurity was found in employees aged 50 years or younger with poor labour market chances.

  1. Genetic variation in glia-neuron signalling modulates ageing rate.

    PubMed

    Yin, Jiang-An; Gao, Ge; Liu, Xi-Juan; Hao, Zi-Qian; Li, Kai; Kang, Xin-Lei; Li, Hong; Shan, Yuan-Hong; Hu, Wen-Li; Li, Hai-Peng; Cai, Shi-Qing

    2017-11-08

    The rate of behavioural decline in the ageing population is remarkably variable among individuals. Despite the considerable interest in studying natural variation in ageing rate to identify factors that control healthy ageing, no such factor has yet been found. Here we report a genetic basis for variation in ageing rates in Caenorhabditis elegans. We find that C. elegans isolates show diverse lifespan and age-related declines in virility, pharyngeal pumping, and locomotion. DNA polymorphisms in a novel peptide-coding gene, named regulatory-gene-for-behavioural-ageing-1 (rgba-1), and the neuropeptide receptor gene npr-28 influence the rate of age-related decline of worm mating behaviour; these two genes might have been subjected to recent selective sweeps. Glia-derived RGBA-1 activates NPR-28 signalling, which acts in serotonergic and dopaminergic neurons to accelerate behavioural deterioration. This signalling involves the SIR-2.1-dependent activation of the mitochondrial unfolded protein response, a pathway that modulates ageing. Thus, natural variation in neuropeptide-mediated glia-neuron signalling modulates the rate of ageing in C. elegans.

  2. A model for sex ratio decline in India.

    PubMed

    Thukral, A K

    1996-01-01

    "The sex ratio in India has declined from 972 females per 1,000 males in 1901 to 929 females per 1,000 males in 1991. A model [is] proposed for the quantitative analysis of the problem.... The study reveals that there has been a sex discriminated population growth in India in the twentieth century, although the rate of decline of the female has decreased. If the current trend of population growth continues, there will be a further decline in the [sex ratio]." excerpt

  3. Respiratory Muscle Strength Predicts Decline in Mobility in Older Persons

    PubMed Central

    Buchman, A.S.; Boyle, P.A.; Wilson, R.S.; Leurgans, S.; Shah, R.C.; Bennett, D.A.

    2008-01-01

    Objectives To test the hypothesis that respiratory muscle strength is associated with the rate of change in mobility even after controlling for leg strength and physical activity. Methods Prospective study of 890 ambulatory older persons without dementia who underwent annual clinical evaluations to examine change in the rate of mobility over time. Results In a linear mixed-effect model adjusted for age, sex, and education, mobility declined about 0.12 unit/year, and higher levels of respiratory muscle strength were associated with a slower rate of mobility decline (estimate 0.043, SE 0.012, p < 0.001). Respiratory muscle strength remained associated with the rate of change in mobility even after controlling for lower extremity strength (estimate 0.036, SE 0.012, p = 0.004). In a model that included terms for respiratory muscle strength, lower extremity strength and physical activity together, all three were independent predictors of mobility decline in older persons. These associations remained significant even after controlling for body composition, global cognition, the development of dementia, parkinsonian signs, possible pulmonary disease, smoking, joint pain and chronic diseases. Conclusion Respiratory muscle strength is associated with mobility decline in older persons independent of lower extremity strength and physical activity. Clinical interventions to improve respiratory muscle strength may decrease the burden of mobility impairment in the elderly. PMID:18784416

  4. Species-specific declines in the linear extension of branching corals at a subtropical reef, Lord Howe Island

    NASA Astrophysics Data System (ADS)

    Anderson, Kristen D.; Heron, Scott F.; Pratchett, Morgan S.

    2015-06-01

    Reef-building corals are extremely sensitive to changing temperature regimes, such that sustained increases in ocean temperatures are generally expected to have negative effects on coral growth and survivorship. At high-latitude reefs, however, projected increases in ocean temperature may actually increase coral growth (relaxing constraints imposed by cool winter temperatures), though this will depend upon on the rate and extent of declines in aragonite saturation, which is already much lower at high latitudes. This study quantified linear extension rates of six scleractinian corals, Acropora yongei, Isopora cuneata, Pocillopora damicornis, Porites heronensis, Seriatopora hystrix, and Stylophora pistillata, at Lord Howe Island in 2010/11. Contemporary growth rates were compared to equivalent data collected in 1994/95. There was marked interspecific variation in growth rates, with A. yongei growing almost twice the rate of all other species. Temporal changes in annual growth also varied among species. Growth rates of both A. yongei and Pocillopora damicornis were 30 % of that recorded in 1994/95. However, growth rates of Porites heronensis had not changed. Declines in the growth rates of these branching species may be attributable to declines in aragonite saturation or increases in summertime temperatures above limits for optimal growth, but either way it appears that climate change is having negative effects on corals, even at subtropical locations.

  5. Comparative trends in incident fracture rates for all long-term care and community-dwelling seniors in Ontario, Canada, 2002-2012.

    PubMed

    Papaioannou, A; Kennedy, C C; Ioannidis, G; Cameron, C; Croxford, R; Adachi, J D; Mursleen, S; Jaglal, S

    2016-03-01

    In this population-based study, we compared incident fracture rates in long-term care (LTC) versus community seniors between 2002 and 2012. Hip fracture rates declined more rapidly in LTC than in the community. An excess burden of fractures occurred in LTC for hip, pelvis, and humerus fractures in men and hip fractures only in women. This study compares trends in incident fracture rates between long-term care (LTC) and community-dwelling seniors ≥65 years, 2002-2012. This is a population-based cohort study using administrative data. Measurements were age/sex-adjusted incident fracture rates and rate ratios (RR) and annual percent change (APC). Over 11 years, hip fracture rates had a marked decline occurring more rapidly in LTC (APC, -3.49 (95% confidence interval (CI), -3.97, -3.01)) compared with the community (APC, -2.93 (95% CI, -3.28, -2.57); p < 0.05 for difference in slopes). Humerus and wrist fracture rates decreased; however, an opposite trend occurred for pelvis and spine fractures with rates increasing over time in both cohorts (all APCs, p < 0.05). In 2012, incident hip fracture rates were higher in LTC than the community (RRs: women, 1.55 (95% CI, 1.45, 1.67); men, 2.18 (95% CI, 1.93, 2.47)). Higher rates of pelvis (RR, 1.48 (95% CI, 1.22, 1.80)) and humerus (RR, 1.40 (95% CI, 1.07, 1.84)) fractures were observed in LTC men, not women. In women, wrist (RR, 0.76 (95% CI, 0.71, 0.81)) and spine (RR, 0.52 (95% CI, 0.45, 0.61)) fracture rates were lower in LTC than the community; in men, spine (RR, 0.75 (95% CI, 0.57, 0.98) but not wrist fracture (RR, 0.91 (95% CI, 0.67, 1.23)) rates were significantly lower in LTC than the community. Previous studies in the community have shown declining hip fracture rates over time, also demonstrated in our study but at a more rapid rate in LTC. Rates of humerus and wrist fractures also declined. An excess burden of fractures in LTC occurred for hip fractures in women and for hip, pelvis, and humerus fractures in men.

  6. Evaluation of Borama tuberculosis control program in Somaliland, Somalia.

    PubMed

    Qayad, Mohamed Gedi; Tarsitani, Gianfranco

    2017-02-28

    The Borama TB program in Somalia lost resources for TB operations in 2003. We evaluated the impact of the loss on the program. Pre-event (2002-2003) and post-event (2007) design were used. All TB patients registered in Borama and a sample of four months from Hargeisa (comparison) TB patients in both periods were abstracted. The following TB treatment outcomes were estimated: treatment success, treatment failure, case fatality, treatment interruption and transfer rates, along with percentage of patients with sputum specimen prior to treatment, percentage of patients from neighboring countries, and monthly average patients enrolled in treatment. The pre-event to post-event outcomes and measures were compared using descriptive and multivariate analyses. In total, 3,367 TB cases were abstracted. In Borama, the TB treatment success rate increased 6% in the post-event. The treatment failure and interruption rates both declined 75%. Monthly average TB patients declined 55%. Percentage of patients smear tested prior to the initiation of the treatment declined 9%. Percentage of TB patients from neighboring countries and other parts of Somalia declined 51%. Treatment interruption/transfer rates declined significantly in the post-event, compared to the pre-event period. Treatment failure/death rate did not change in the post-event period. In Hargeisa, the treatment success, failure/death, and interruption/transfer rates were similar in both periods. The RR did not change in these measures after adjusting for age and gender. This study indicates a significant setback to the Borama TB control program in the majority of measures evaluated, except the TB success rate.

  7. Elective oocyte cryopreservation for deferred childbearing.

    PubMed

    Goldman, Kara N; Grifo, Jamie A

    2016-12-01

    Elective oocyte cryopreservation for deferred childbearing has gained popularity worldwide, commensurate with increased knowledge regarding age-related fertility decline. The purpose of this review is to summarize recent data regarding trends in delayed childbearing, review recent findings surrounding age-related fertility decline, acknowledge significant gaps in knowledge among patients and providers regarding fertility decline and review outcomes following elective oocyte cryopreservation. Despite an inevitable decline in fertility and increase in miscarriage with increasing female age, there is a growing worldwide trend to delay childbearing. Patients and providers alike demonstrate large gaps in knowledge surrounding age-related fertility decline. Oocyte cryopreservation is clinically approved for medically indicated fertility preservation, but a growing number of women are using oocyte cryopreservation to defer childbearing and maintain reproductive autonomy. Mounting data support the efficacy and safety of oocyte cryopreservation when used to electively defer childbearing, with recent studies demonstrating rates of euploidy, implantation and live birth rates equivalent to in-vitro fertilization (IVF) with fresh oocytes. Oocyte cryopreservation provides women with an option to defer childbearing and maintain reproductive autonomy, with IVF success rates on par with fresh IVF. However, it is critical that patients understand the limitations of oocyte cryopreservation. Greater education regarding age-related fertility decline should be geared toward patients and providers to prevent unintended childlessness.

  8. Longitudinal changes in speech recognition in older persons.

    PubMed

    Dubno, Judy R; Lee, Fu-Shing; Matthews, Lois J; Ahlstrom, Jayne B; Horwitz, Amy R; Mills, John H

    2008-01-01

    Recognition of isolated monosyllabic words in quiet and recognition of key words in low- and high-context sentences in babble were measured in a large sample of older persons enrolled in a longitudinal study of age-related hearing loss. Repeated measures were obtained yearly or every 2 to 3 years. To control for concurrent changes in pure-tone thresholds and speech levels, speech-recognition scores were adjusted using an importance-weighted speech-audibility metric (AI). Linear-regression slope estimated the rate of change in adjusted speech-recognition scores. Recognition of words in quiet declined significantly faster with age than predicted by declines in speech audibility. As subjects aged, observed scores deviated increasingly from AI-predicted scores, but this effect did not accelerate with age. Rate of decline in word recognition was significantly faster for females than males and for females with high serum progesterone levels, whereas noise history had no effect. Rate of decline did not accelerate with age but increased with degree of hearing loss, suggesting that with more severe injury to the auditory system, impairments to auditory function other than reduced audibility resulted in faster declines in word recognition as subjects aged. Recognition of key words in low- and high-context sentences in babble did not decline significantly with age.

  9. Effectiveness of the HomeSafe Pilot Program in reducing injury rates among residential construction workers, 1994-1998.

    PubMed

    Darragh, Amy Rowntree; Stallones, Lorann; Bigelow, Phillip L; Keefe, Thomas J

    2004-02-01

    The construction industry typically has one of the highest fatal and non-fatal injury rates compared with other industries. Residential construction workers are at particular risk of injury (work is in remote sites with small crews, there are often many subcontractors, and they have limited access to safety programs). Difficulty accessing information specific to this group has made research more challenging, therefore, there are few studies. This study evaluated the effectiveness of the HomeSafe Pilot Program, a safety education and training program designed to reduce injuries among residential construction workers. Researchers evaluated whether overall and severe injury incidence rates declined during the intervention period. Data were analyzed using incidence rates and Poisson regression to control for the effect of antecedent secular trend. Injury incidence rates declined significantly following HomeSafe; however, this effect was not statistically significant once temporal variation was controlled. The decline in injury rates following HomeSafe cannot be attributed solely to HomeSafe, however, programmatic and methodologic limitations contributed to the inconclusive results. Further research into the hazards faced by residential construction workers is needed. Am. J. Ind. Med. 45:210-217, 2004. Copyright 2004 Wiley-Liss, Inc.

  10. Cardiovascular disease mortality in the Americas: current trends and disparities.

    PubMed

    de Fatima Marinho de Souza, Maria; Gawryszewski, Vilma Pinheiro; Orduñez, Pedro; Sanhueza, Antonio; Espinal, Marcos A

    2012-08-01

    To describe the current situation and trends in mortality due to cardiovascular disease (CVD) in the Americas and explore their association with economic indicators. This time series study analysed mortality data from 21 countries in the region of the Americas from 2000 to the latest available year. Age-adjusted death rates, annual variation in death rates. Regression analysis was used to estimate the annual variation and the association between age-adjusted rates and country income. Currently, CVD comprised 33.7% of all deaths in the Americas. Rates were higher in Guyana (292/100 000), Trinidad and Tobago (289/100 000) and Venezuela (246/100 000), and lower in Canada (108/100 000), Puerto Rico (121/100 000) and Chile (125/100 000). Male rates were higher than female rates in all countries. The trend analysis showed that CVD death rates in the Americas declined -19% overall (-20% among women and -18% among men). Most countries had a significant annual decline, except Guatemala, Guyana, Suriname, Paraguay and Panama. The largest annual declines were observed in Canada (-4.8%), the USA (-3.9%) and Puerto Rico (-3.6%). Minor declines were in Mexico (-0.8%) and Cuba (-1.1%). Compared with high-income countries the difference between the median of death rates in lower middle-income countries was 56.7% higher and between upper middle-income countries was 20.6% higher. CVD death rates have been decreasing in most countries in the Americas. Considerable disparities still remain in the current rates and trends.

  11. Investigating recent trends in the U.S. teen birth rate.

    PubMed

    Kearney, Melissa S; Levine, Phillip B

    2015-05-01

    We investigate trends in the U.S. rate of teen childbearing between 1981 and 2010, focusing specifically on the sizable decline since 1991. We focus on establishing the role of state-level demographic changes, economic conditions, and targeted policies in driving recent aggregate trends. We offer three main observations. First, the recent decline cannot be explained by the changing racial and ethnic composition of teens. Second, the only targeted policies that have had a statistically discernible impact on aggregate teen birth rates are declining welfare benefits and expanded access to family planning services through Medicaid, but these policies can account for only 12.6 percent of the observed decline since 1991. Third, higher unemployment rates lead to lower teen birth rates and can account for 16 percent of the decline in teen birth rates since the Great Recession began. Copyright © 2015 Elsevier B.V. All rights reserved.

  12. Diversification rates have declined in the Malagasy herpetofauna

    PubMed Central

    Scantlebury, Daniel P.

    2013-01-01

    The evolutionary origins of Madagascar's biodiversity remain mysterious despite the fact that relative to land area, there is no other place with consistently high levels of species richness and endemism across a range of taxonomic levels. Most efforts to explain diversification on the island have focused on geographical models of speciation, but recent studies have begun to address the island's accumulation of species through time, although with conflicting results. Prevailing hypotheses for diversification on the island involve either constant diversification rates or scenarios where rates decline through time. Using relative-time-calibrated phylogenies for seven endemic vertebrate clades and a model-fitting framework, I find evidence that diversification rates have declined through time on Madagascar. I show that diversification rates have clearly declined throughout the history of each clade, and models invoking diversity-dependent reductions to diversification rates best explain the diversification histories for each clade. These results are consistent with the ecological theory of adaptive radiation, and, coupled with ancillary observations about ecomorphological and life-history evolution, strongly suggest that adaptive radiation was an important formative process for one of the most species-rich regions on the Earth. These results cast the Malagasy biota in a new light and provide macroevolutionary justification for conservation initiatives. PMID:23843388

  13. BDNF polymorphism predicts the rate of decline in skilled task performance and hippocampal volume in healthy individuals

    PubMed Central

    Sanchez, M Millan; Das, D; Taylor, J L; Noda, A; Yesavage, J A; Salehi, A

    2011-01-01

    Numerous studies have indicated a link between the presence of polymorphism in brain-derived neurotrophic factor (BDNF) and cognitive and affective disorders. However, only a few have studied these effects longitudinally along with structural changes in the brain. This study was carried out to investigate whether valine-to-methionine substitution at position 66 (val66met) of pro-BDNF could be linked to alterations in the rate of decline in skilled task performance and structural changes in hippocampal volume. Participants consisted of 144 healthy Caucasian pilots (aged 40–69 years) who completed a minimum of 3 consecutive annual visits. Standardized flight simulator score (SFSS) was measured as a reliable and quantifiable indicator for skilled task performance. In addition, a subset of these individuals was assessed for hippocampal volume alterations using magnetic resonance imaging. We found that val66met substitution in BDNF correlated longitudinally with the rate of decline in SFSS. Structurally, age-dependent hippocampal volume changes were also significantly altered by this substitution. Our study suggests that val66met polymorphism in BDNF can be linked to the rate of decline in skilled task performance. Furthermore, this polymorphism could be used as a predictor of the effects of age on the structure of the hippocampus in healthy individuals. Such results have implications for understanding possible disabilities in older adults performing skilled tasks who are at a higher risk for cognitive and affective disorders. PMID:22833197

  14. Why Don't Our Students Respond? Understanding Declining Participation in Survey Research among College Students

    ERIC Educational Resources Information Center

    Tschepikow, William K.

    2012-01-01

    Declining response rates among college students threaten the effectiveness of survey research at institutions of higher education. The purpose of this qualitative study was to understand the conditions that promote participation in survey research among this population. The researcher identified three themes through this study. First, participants…

  15. Cognitive and behavioral assessment in dogs and pet food market applications.

    PubMed

    Zicker, Steven C

    2005-03-01

    A multi-disciplinary program was developed to assess the efficacy of antioxidant inclusion in a canine pet food on cognitive decline in aged beagles. A systematic approach to development of the food was used prior to beginning the cognitive studies. Comprehensive evaluation of antioxidant ingredients included assessments of commodities with naturally occurring antioxidants and synthetic antioxidants not commonly utilized, or at different concentrations than what was commonly utilized, in commercial pet foods. Studies were conducted to insure stability through processing, absorption from the gastrointestinal tract, safety, and tests for potential antioxidant biological benefit by ex vivo tests. Testing of the antioxidant-fortified food in aged beagles slowed the rate of cognitive decline in aged dogs. In addition, environmental enrichment also slowed the rate of cognitive decline. Importantly, the combination of dietary antioxidants and environmental enrichment was synergistic and resulted in the least amount of cognitive decline over the 30-month study period. Finally, a clinical study showed that antioxidant fortified food improved age-related behavioral changes in older pet dogs at in-home situations.

  16. Temporal Trends in the Utilization of Noninvasive Diagnostic Tests for Coronary Artery Disease in Ontario Between 2008 and 2014: A Population-Based Study.

    PubMed

    Roifman, Idan; Wijeysundera, Harindra C; Austin, Peter C; Maclagan, Laura C; Rezai, Mohammad R; Wright, Graham A; Tu, Jack V

    2017-02-01

    The proliferation of cardiac diagnostic tests over the past few decades has received substantial attention from policymakers. However, contemporary population-based temporal trends of the utilization of noninvasive cardiac diagnostic tests for coronary artery disease are not known. Our objective was to examine the temporal trends in the utilization of coronary computed tomography angiography (CCTA), myocardial perfusion imaging (MPI), exercise stress testing (GXT), and stress echocardiography between 2008 and 2014. We performed a population-based repeated cross-sectional study of the adult population of Ontario between January 1, 2008 and December 31, 2014. Annual utilization rates of noninvasive cardiac diagnostic tests were computed. For each cardiac testing modality, a negative binomial regression model was used to assess temporal changes in test utilization. GXT and MPI collectively accounted for 88% of all cardiac noninvasive diagnostic tests throughout our study period. Age- and sex-standardized rates of GXT declined from 26.7/1000 adult population to 21.6/1000 adult population (mean annual reduction of 3.4%; P < 0.001). MPI rates declined from 21.1/1000 adult population to 19.5/1000 adult population (mean annual reduction of 1.3%; P < 0.001). Although utilization rates for both CCTA and stress echocardiography increased over time, the combined rate of all available tests decreased from 50.8/1000 adult population to 49.1/1000 adult population (mean annual reduction of 1.1%; P < 0.001). In conclusion, utilization rates for the most prevalent noninvasive cardiac diagnostic tests-GXT and MPI-declined over our study period. Furthermore, the overall test utilization rate also declined over time. We believe our findings are encouraging from a health policy perspective. Nonetheless, rising utilization rates for CCTA and stress echocardiography will need to be monitored in the future. Copyright © 2016 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

  17. Fine-particulate Air Pollution from Diesel Emission Control and Mortality Rates in Tokyo: A Quasi-experimental Study.

    PubMed

    Yorifuji, Takashi; Kashima, Saori; Doi, Hiroyuki

    2016-11-01

    Evidence linking air pollution with adverse health outcomes is accumulating. However, few studies have adopted a quasi-experimental design to evaluate whether decline in air pollution from regulatory action improves public health. We evaluated the effect of a diesel emission control ordinance introduced in 2003 on mortality rates in 23 wards of the Tokyo metropolitan area, Japan, from October 2000 to September 2012, taking into account change in mortality rates in a reference population (Osaka) with a introduction of such a regulation in 2009. We obtained daily counts of all-cause and cause-specific mortality and concentrations of nitrogen dioxide (NO2) and particulate matter less than 2.5 μm in diameter (PM2.5) during the study period. We employed interrupted time-series analysis to analyze the data. Decline in NO2 during the study period was similar in the two areas, while decline in PM2.5 and the improvement in age-standardized mortality rates were greater in Tokyo's 23 wards compared with Osaka. Even after adjusting for age-standardized mortality rates in Osaka, percent changes in mortality between the first 3-year interval (October 2000 to September 2003) and the last 3-year interval (October 2009 to September 2012) were -6.0% for all causes, -11% for cardiovascular disease, -10% for ischemic heart disease, -6.2% for cerebrovascular disease, -22% for pulmonary disease, and -4.9% for lung cancer. We did not observe a decline in mortality from other causes. This quasi-experimental study in Tokyo suggests that emission control was associated with improvements in both air quality and health outcomes.

  18. Impact of vaccination uptake on hospitalizations due to rotavirus acute gastroenteritis in 2 different socioeconomic areas of Spain

    PubMed Central

    Giménez Sánchez, Francisco; Nogueira, Esperanza Jiménez; Sánchez Forte, Miguel; Ibáñez Alcalde, Mercedes; Cobo, Elvira; Angulo, Raquel; Garrido Fernández, Pablo

    2016-01-01

    ABSTRACT Rotavirus is the leading cause of hospitalization due to acute gastroenteritis (AGE) in infants and toddlers. However, rotavirus vaccination has been associated with a decline in hospitalization rates due to rotavirus AGE. A descriptive retrospective study was conducted to analyze the impact of rotavirus vaccination on the rate of hospitalizations due to AGE among children ≤2 years old in 2 areas of the province of Almería, Spain. After eight years of rotavirus vaccination, rates of hospitalizations due to rotavirus AGE are diminished. This decline is closely related to vaccine coverage in the studied areas. PMID:26810147

  19. Age-related annual decline of lung function in patients with COPD.

    PubMed

    Kim, Soo Jung; Lee, Jinwoo; Park, Young Sik; Lee, Chang-Hoon; Yoon, Ho Il; Lee, Sang-Min; Yim, Jae-Joon; Kim, Young Whan; Han, Sung Koo; Yoo, Chul-Gyu

    2016-01-01

    According to the Fletcher-Peto curve, rate of decline in forced expiratory volume in 1-second (FEV1) accelerates as age increases. However, recent studies have not demonstrated that the rate of FEV1 decline accelerates with age among COPD patients. The objective of the study is to evaluate annual rate of FEV1 decline as age increases among COPD patients. In this retrospective cohort study, we enrolled COPD patients who were followed up at two tertiary care university hospitals from January 2000 to August 2013. COPD was defined as post-bronchodilator (BD) FEV1/forced vital capacity (FVC) of <0.7. All participants had more than two spirometries, including BD response. Age groups were categorized as follows: below versus above median age or four quartiles. A total of 518 participants (94.2% male; median age, 67 years; range, 42-90 years) were included. Mean absolute and predictive values of post-BD FEV1 were 1.57±0.62 L and 52.53%±18.29%, respectively. Distribution of Global initiative for Chronic Obstructive Lung Disease groups did not show statistical differences between age groups categorized by two different criteria. After grouping the population by age quartiles, the rate of FEV1 decline was faster among older patients than younger ones whether expressed as absolute value (-10.60±5.57 mL/year, -15.84±6.01 mL/year, -18.63±5.53 mL/year, 32.94±6.01 mL/year, respectively; P=0.048) or predicted value (-0.34%±0.19%/year, -0.53%±0.21%/year, -0.62%±0.19%/year, -1.26%±0.21%/year, respectively, P=0.010). As suggested conceptually by the Fletcher-Peto curve, annual FEV1 decline among COPD patients is accelerated among older patients than younger ones.

  20. Ecological regime shift drives declining growth rates of sea turtles throughout the West Atlantic

    USGS Publications Warehouse

    Bjorndal, Karen A.; Bolten, Alan B.; Chaloupka, Milani; Saba, Vincent S.; Bellini, Cláudio; Marcovaldi, Maria A.G.; Santos, Armando J.B.; Bortolon, Luis Felipe Wurdig; Meylan, Anne B.; Meylan, Peter A.; Gray, Jennifer; Hardy, Robert; Brost, Beth; Bresette, Michael; Gorham, Jonathan C.; Connett, Stephen; Crouchley, Barbara Van Sciver; Dawson, Mike; Hayes, Deborah; Diez, Carlos E.; van Dam, Robert P.; Willis, Sue; Nava, Mabel; Hart, Kristen M.; Cherkiss, Michael S.; Crowder, Andrew; Pollock, Clayton; Hillis-Starr, Zandy; Muñoz Tenería, Fernando A.; Herrera-Pavón, Roberto; Labrada-Martagón, Vanessa; Lorences, Armando; Negrete-Philippe, Ana; Lamont, Margaret M.; Foley, Allen M.; Bailey, Rhonda; Carthy, Raymond R.; Scarpino, Russell; McMichael, Erin; Provancha, Jane A.; Brooks, Annabelle; Jardim, Adriana; López-Mendilaharsu, Milagros; González-Paredes, Daniel; Estrades, Andrés; Fallabrino, Alejandro; Martínez-Souza, Gustavo; Vélez-Rubio, Gabriela M.; Boulon, Ralf H.; Collazo, Jaime; Wershoven, Robert; Hernández, Vicente Guzmán; Stringell, Thomas B.; Sanghera, Amdeep; Richardson, Peter B.; Broderick, Annette C.; Phillips, Quinton; Calosso, Marta C.; Claydon, John A.B.; Metz, Tasha L.; Gordon, Amanda L.; Landry, Andre M.; Shaver, Donna J.; Blumenthal, Janice; Collyer, Lucy; Godley, Brendan J.; McGowan, Andrew; Witt, Matthew J.; Campbell, Cathi L.; Lagueux, Cynthia J.; Bethel, Thomas L.; Kenyon, Lory

    2017-01-01

    Somatic growth is an integrated, individual-based response to environmental conditions, especially in ectotherms. Growth dynamics of large, mobile animals are particularly useful as bio-indicators of environmental change at regional scales. We assembled growth rate data from throughout the West Atlantic for green turtles, Chelonia mydas, which are long-lived, highly migratory, primarily herbivorous mega-consumers that may migrate over hundreds to thousands of kilometers. Our dataset, the largest ever compiled for sea turtles, has 9690 growth increments from 30 sites from Bermuda to Uruguay from 1973 to 2015. Using generalized additive mixed models, we evaluated covariates that could affect growth rates; body size, diet, and year have significant effects on growth. Growth increases in early years until 1999, then declines by 26% to 2015. The temporal (year) effect is of particular interest because two carnivorous species of sea turtles – hawksbills, Eretmochelys imbricata, and loggerheads, Caretta caretta – exhibited similar significant declines in growth rates starting in 1997 in the West Atlantic, based on previous studies. These synchronous declines in productivity among three sea turtle species across a trophic spectrum provide strong evidence that an ecological regime shift (ERS) in the Atlantic is driving growth dynamics. The ERS resulted from a synergy of the 1997/1998 El Niño Southern Oscillation (ENSO) – the strongest on record – combined with an unprecedented warming rate over the last two to three decades. Further support is provided by the strong correlations between annualized mean growth rates of green turtles and both sea surface temperatures (SST) in the West Atlantic for years of declining growth rates (r = -0.94) and the Multivariate ENSO Index (MEI) for all years (r = 0.74). Granger-causality analysis also supports the latter finding. We discuss multiple stressors that could reinforce and prolong the effect of the ERS. This study demonstrates the importance of region-wide collaborations.

  1. Ecological regime shift drives declining growth rates of sea turtles throughout the West Atlantic.

    PubMed

    Bjorndal, Karen A; Bolten, Alan B; Chaloupka, Milani; Saba, Vincent S; Bellini, Cláudio; Marcovaldi, Maria A G; Santos, Armando J B; Bortolon, Luis Felipe Wurdig; Meylan, Anne B; Meylan, Peter A; Gray, Jennifer; Hardy, Robert; Brost, Beth; Bresette, Michael; Gorham, Jonathan C; Connett, Stephen; Crouchley, Barbara Van Sciver; Dawson, Mike; Hayes, Deborah; Diez, Carlos E; van Dam, Robert P; Willis, Sue; Nava, Mabel; Hart, Kristen M; Cherkiss, Michael S; Crowder, Andrew G; Pollock, Clayton; Hillis-Starr, Zandy; Muñoz Tenería, Fernando A; Herrera-Pavón, Roberto; Labrada-Martagón, Vanessa; Lorences, Armando; Negrete-Philippe, Ana; Lamont, Margaret M; Foley, Allen M; Bailey, Rhonda; Carthy, Raymond R; Scarpino, Russell; McMichael, Erin; Provancha, Jane A; Brooks, Annabelle; Jardim, Adriana; López-Mendilaharsu, Milagros; González-Paredes, Daniel; Estrades, Andrés; Fallabrino, Alejandro; Martínez-Souza, Gustavo; Vélez-Rubio, Gabriela M; Boulon, Ralf H; Collazo, Jaime A; Wershoven, Robert; Guzmán Hernández, Vicente; Stringell, Thomas B; Sanghera, Amdeep; Richardson, Peter B; Broderick, Annette C; Phillips, Quinton; Calosso, Marta; Claydon, John A B; Metz, Tasha L; Gordon, Amanda L; Landry, Andre M; Shaver, Donna J; Blumenthal, Janice; Collyer, Lucy; Godley, Brendan J; McGowan, Andrew; Witt, Matthew J; Campbell, Cathi L; Lagueux, Cynthia J; Bethel, Thomas L; Kenyon, Lory

    2017-11-01

    Somatic growth is an integrated, individual-based response to environmental conditions, especially in ectotherms. Growth dynamics of large, mobile animals are particularly useful as bio-indicators of environmental change at regional scales. We assembled growth rate data from throughout the West Atlantic for green turtles, Chelonia mydas, which are long-lived, highly migratory, primarily herbivorous mega-consumers that may migrate over hundreds to thousands of kilometers. Our dataset, the largest ever compiled for sea turtles, has 9690 growth increments from 30 sites from Bermuda to Uruguay from 1973 to 2015. Using generalized additive mixed models, we evaluated covariates that could affect growth rates; body size, diet, and year have significant effects on growth. Growth increases in early years until 1999, then declines by 26% to 2015. The temporal (year) effect is of particular interest because two carnivorous species of sea turtles-hawksbills, Eretmochelys imbricata, and loggerheads, Caretta caretta-exhibited similar significant declines in growth rates starting in 1997 in the West Atlantic, based on previous studies. These synchronous declines in productivity among three sea turtle species across a trophic spectrum provide strong evidence that an ecological regime shift (ERS) in the Atlantic is driving growth dynamics. The ERS resulted from a synergy of the 1997/1998 El Niño Southern Oscillation (ENSO)-the strongest on record-combined with an unprecedented warming rate over the last two to three decades. Further support is provided by the strong correlations between annualized mean growth rates of green turtles and both sea surface temperatures (SST) in the West Atlantic for years of declining growth rates (r = -.94) and the Multivariate ENSO Index (MEI) for all years (r = .74). Granger-causality analysis also supports the latter finding. We discuss multiple stressors that could reinforce and prolong the effect of the ERS. This study demonstrates the importance of region-wide collaborations. © 2017 John Wiley & Sons Ltd.

  2. Annual Report to the Nation: Overall cancer mortality declines

    Cancer.gov

    The 2018 Annual Report to the Nation on the Status of Cancer finds overall cancer death rates continue to decline and cancer incidence dropped in men and remained stable in women. A companion study reports on recent changes in prostate cancer trends.

  3. Demographics of the Disappearing Bottlenose Dolphin in Argentina: A Common Species on Its Way Out?

    PubMed Central

    Vermeulen, Els; Bräger, Stefan

    2015-01-01

    Populations of the once common bottlenose dolphin (Tursiops truncatus) in Argentina have precipitously declined throughout the country in the past decades. Unfortunately, local declines of common species are easily overlooked when establishing priorities for conservation. In this study, demographics of what may well be the last remaining resident population in the country were assessed using mark—recapture analysis (Pollock’s Robust Design) of a photo-identification dataset collected during 2006–2011 in Bahía San Antonio (Patagonia, Argentina). Total abundance, corrected for unmarked individuals, ranged from 40 (95%CI: 16.1–98.8) to 83 (95%CI = 45.8–151.8) individuals and showed a decrease over the years. Adult survival rates varied between 0.97 (± 0.037 SE) and 0.99 (± 0.010 SE). Average calving interval equalled 3.5 ± 1.03 years, with 3.5 births/year in the entire population and a minimum annual birth rate of 4.2%. However, data suggest that calves may have been born and lost before being documented, underestimating birth rate, calf mortality, and possibly the number of reproductive females. Either way, the recruitment rate of calves appears to be insufficient to support the size of the population. This population is relatively small and declining. Considering the disappearance of populations north and south of the study area, an incessant decline will have severe consequences for the continuous existence of this species in Argentina, indicating an urgent need for serious conservation efforts. This study provides insight into how the failure to recognize local population declines can threaten the national (and eventually the international) status of a common species like the bottlenose dolphin. PMID:25786234

  4. Validation analysis of informant's ratings of cognitive function in African Americans and Nigerians

    PubMed Central

    Shen, Jianzhao; Gao, Sujuan; Unverzagt, Frederick W.; Ogunniyi, Adesola; Baiyewu, Olusegun; Gureje, Oye; Hendrie, Hugh C.; Hall, Kathleen S.

    2011-01-01

    SUMMARY Objectives To examine informant validity using the Community Screening Interview for Dementia (CSI ‘D’) both cross-sectionally and longitudinally in two very different cultures and to explore the effects of informants and study participants’ characteristics on the validity of informants’ reports. Methods Elderly African Americans age 65 years and older residing in Indianapolis, USA and elderly Yoruba Nigerians age 65 years and older residing in Ibadan, Nigeria were assessed on cognitive functioning using the CSI ‘D’ at baseline (1992–1993) and five-year follow-up (1997–1998). At baseline, the informant validity in both samples was evaluated against participants’ cognitive tests using Pearson correlation and regular regression models. At follow-up, informants ratings on cognitive decline were assessed against participants’ cognitive decline scores from baseline to follow-up using biserial correlation and logistic regressions. Results At baseline, informants’ reports on cognitive functioning significantly correlated with cognitive scores in both samples (Indianapolis:r = –0.43, p < 0.001; Ibadan:r = –0.47, p < 0.001). The participant–informant relationships significantly affected the informants’ reports in the two samples with different patterns (p = 0.005 for Indianapolis and p < 0.001 for Ibadan) at a given level of cognitive functioning. African Americans spouses reported more cognitive problems, while siblings reported more problems for the Yoruba Nigerians. At follow-up, informants’ ratings on cognitive decline significantly correlated with the cognitive decline scores (Indianapolis r = 0.38, p < 0.001; Ibadan r = 0.32, p < 0.001). The characteristics of study participants and informants had little impact on the informants’ ratings on cognitive decline. Conclusions Informant reports are valid in assessing the cognitive functioning of study participants both cross-sectionally and longitudinally in two very different cultures, languages and environments. PMID:16802282

  5. The natural history of cardiac and pulmonary function decline in patients with duchenne muscular dystrophy.

    PubMed

    Roberto, Rolando; Fritz, Anto; Hagar, Yolanda; Boice, Braden; Skalsky, Andrew; Hwang, Hosun; Beckett, Laurel; McDonald, Craig; Gupta, Munish

    2011-07-01

    Retrospective review of scoliosis progression, pulmonary and cardiac function in a series of patients with Duchenne Muscular Dystrophy (DMD). To determine whether operative treatment of scoliosis decreases the rate of pulmonary function loss in patients with DMD. It is generally accepted that surgical intervention should be undertaken in DMD scoliosis once curve sizes reach 35° to allow intervention before critical respiratory decline has occurred. There are conflicting reports, however, regarding the effect of scoliosis stabilization on the rate of pulmonary function decline when compared to nonoperative cohorts. We reviewed spinal radiographs, echocardiograms, and spirometry, hospital, and operative records of all patients seen at our tertiary referral center from July 1, 1992 to June 1, 2007. Data were recorded to Microsoft Excel (Microsoft, Redmond, WA) and analyzed with SAS (SAS Institute, Cary, NC) and R statistical processing software (www.r-project.org). The percent predicted forced vital capacity (PPFVC) decreased 5% per year before operation. The mean PPFVC was 54% (SD = 21%) before operation with a mean postoperative PPFVC of 43% (SD = 14%). Surgical treatment was associated with a 12% decline in PPFVC independent of other treatment variables. PPFVC after operation declined at a rate of 1% per year and while this rate was lower, it was not significantly different than the rate of decline present before operation (P = 0.18). Cardiac function as measured by left ventricular fractional shortening declined at a rate of 1% per year with most individuals exhibiting a left ventricular fractional shortening rate of more than 30 before operation. Operative treatment of scoliosis in DMD using the Luque Galveston method was associated with a reduction of forced vital capacity related to operation. The rate of pulmonary function decline after operation was not significantly reduced when compared with the rate of preoperative forced vital capacity decline.

  6. Disease progression among 446 children with newly diagnosed type 1 diabetes located in Scandinavia, Europe, and North America during the last 27 yr.

    PubMed

    Max Andersen, Marie Louise; Nielsen, Lotte B; Svensson, Jannet; Pörksen, Sven; Hougaard, Philip; Beam, Craig; Greenbaum, Carla; Becker, Dorothy; Petersen, Jacob S; Hansen, Lars; Mortensen, Henrik B

    2014-08-01

    To clarify whether the rate of decline in stimulated C-peptide (SCP) from 2 to 15 months after diagnosis has changed over an interval of 27 yr. The rate of decline in SCP levels at 1, 2, 3, 6, 9, 12, and 15 months after diagnosis was compared in four paediatric cohorts from Scandinavian and European countries including 446 children with new onset type 1 diabetes (T1D, 1982-2004). Findings were evaluated against 78 children (2004-2009) from the TrialNet studies. The mean rate of decline [%/month (±SEM)] in SCP for a 10-yr-old child was 7.7%/month (±1.5) in the 1982-1985 Cohort, 6.3%/month (±1.7) in the 1995-1998 Cohort, 7.8%/month (±0.7) in the 1999-2000 Cohort, and 10.7%/month (±0.9) in the latest 2004-2005 Cohort (p = 0.05). Including the TrialNet Cohort with a rate of decline in SCP of 10.0%/month (±0.9) the differences between the cohorts are still significant (p = 0.039). The rate of decline in SCP was negatively associated with age (p < 0.0001), insulin antibodies (IA) (p = 0.003), and glutamic acid decarboxylase-65 (GAD65A) (p = 0.03) initially with no statistically significant effect of body mass index (BMI) Z-score at 3 months. Also, at 3 months the time around partial remission, the effect of age on SCP was significantly greater in children ≤5 yr compared with older children (p ≤ 0.0001). During the past 27 yr, initial C-peptide as well as the rate of C-peptide decline seem to have increased. The rate of decline was affected significantly by age, GAD65A, and IA, but not BMI Z-score or initial C-peptide. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  7. Functional decline in Huntington's disease.

    PubMed

    Feigin, A; Kieburtz, K; Bordwell, K; Como, P; Steinberg, K; Sotack, J; Zimmerman, C; Hickey, C; Orme, C; Shoulson, I

    1995-03-01

    We prospectively evaluated 129 patients with manifest Huntington's disease (HD) to determine the rate of illness progression and the clinical features that correlate with functional decline. A single examiner evaluated each patient using the HD Functional Capacity Scale. Standardized motor performance was also assessed in 94 of the patients (73%) using the HD Rating Scale. Total Functional Capacity declined at a rate of 0.63 +/- 0.75 U per year. As functional capacity worsened, chorea lessened, and dystonia intensified. There was no correlation between rate of functional decline and age at onset of HD, body weight, gender of affected parent, or history of neuroleptic use.

  8. Association of High-Dose Ibuprofen Use, Lung Function Decline, and Long-Term Survival in Children with Cystic Fibrosis.

    PubMed

    Konstan, Michael W; VanDevanter, Donald R; Sawicki, Gregory S; Pasta, David J; Foreman, Aimee J; Neiman, Evgueni A; Morgan, Wayne J

    2018-04-01

    Cystic fibrosis deaths result primarily from lung function loss, so chronic respiratory therapies, intended to preserve lung function, are cornerstones of cystic fibrosis care. Although treatment-associated reduction in rate of lung function loss should ultimately improve cystic fibrosis survival, no such relationship has been described for any chronic cystic fibrosis therapy. In part, this is because the ages of most rapid lung function decline-early adolescence-precede the median age of cystic fibrosis deaths by more than a decade. To study associations of high-dose ibuprofen treatment with the rate of forced expiratory volume in 1 second decline and mortality among children followed in the Epidemiologic Study of Cystic Fibrosis and subsequently in the U.S. Cystic Fibrosis Foundation Patient Registry. We performed a matched cohort study using data from Epidemiologic Study of Cystic Fibrosis. Exposure was defined as high-dose ibuprofen use reported at ≥80% of encounters over 2 years. Unexposed children were matched to exposed children 5:1 using propensity scores on the basis of demographic, clinical, and treatment covariates. The rate of decline of percent predicted forced expiratory volume in 1 second during the 2-year follow-up period was estimated by mixed-effects modeling with random slopes and intercepts. Survival over 16 follow-up years in the U.S. Cystic Fibrosis Foundation Patient Registry was compared between treatment groups by using proportional hazards modeling controlling for matching and covariates. We included 775 high-dose ibuprofen users and 3,665 nonusers who were well matched on demographic, clinical, and treatment variables. High-dose ibuprofen users declined on average 1.10 percent predicted forced expiratory volume in 1 second/yr (95% confidence interval; 0.51, 1.69) during the 2-year treatment period, whereas nonusers declined at a rate of 1.76% percent predicted forced expiratory volume in 1 second/yr (95% confidence interval; 1.48, 2.04) during the corresponding 2-year period, a 37.5% slower decline among users compared with nonusers (95% confidence interval; 0.4%, 71.3%; P = 0.046). The users had better subsequent survival (P < 0.001): the unadjusted and adjusted hazard ratios for mortality (high-dose ibuprofen/non-high-dose ibuprofen) (95% confidence interval) were 0.75 (0.64, 0.87) and 0.82 (0.69, 0.96). In a propensity-score matched cohort study of children with cystic fibrosis, we observed an association between high-dose ibuprofen use and both slower lung function decline and improved long-term survival. These results are consistent with the hypothesis that treatment-associated reduction of lung function decline in children with cystic fibrosis leads to improved survival.

  9. Changes in Echocardiographic Parameters According to the Rate of Residual Renal Function Decline in Incident Peritoneal Dialysis Patients

    PubMed Central

    Koo, Hyang Mo; Doh, Fa Mee; Kim, Chan Ho; Lee, Mi Jung; Kim, Eun Jin; Han, Jae Hyun; Han, Ji Suk; Ryu, Dong-Ryeol; Oh, Hyung Jung; Park, Jung Tak; Han, Seung Hyeok; Yoo, Tae-Hyun; Kang, Shin-Wook

    2015-01-01

    Abstract Residual renal function (RRF) is associated with left ventricular (LV) hypertrophy as well as all-cause and cardiovascular (CV) mortality in patients with end-stage renal disease. However, no studies have yet examined the serial changes in echocardiographic findings according to the rate of RRF decline in incident dialysis patients. A total of 81 patients who started peritoneal dialysis (PD) between 2005 and 2012 at Yonsei University Health System, Seoul, South Korea, and who underwent baseline and follow-up echocardiography within the first year of PD were recruited. Patients were dichotomized into “faster” and “slower” RRF decline groups according to the median values of RRF decline slope (−1.60 mL/min/y/1.73 m2). Baseline RRF and echocardiographic parameters were comparable between the 2 groups. During the first year of PD, there were no significant changes in LV end-diastolic volume index (LVEDVI), left atrial volume index (LAVI), or LV mass index (LVMI) in the “faster” RRT decline group, while these indices decreased in the “slower” RRT decline group. The rate of RRF decline was a significant determinant of 1-year changes in LVEDVI, LAVI, and LVMI. The linear mixed model further confirmed that there were significant differences in the changes in LVEDVI, LAVI, and LVMI between the 2 groups (P = 0.047, 0.048, and 0.001, respectively). During a mean follow-up duration of 31.9 months, 4 (4.9%) patients died. Compared with the “slower” RRF decline group, CV composite (20.29/100 vs 7.18/100 patient-years [PY], P = 0.098), technique failure (18.80/100 vs 4.19/100 PY, P = 0.006), and PD peritonitis (15.73/100 vs 4.95/100 PY, P = 0.064) developed more frequently in patients with “faster” RRF decline rate. On multivariate Cox regression analysis, patients with “faster” RRF decline rate showed 4.82-, 4.44-, and 7.37-fold higher risks, respectively, for each clinical outcome. Preservation of RRF is important for conserving cardiac performance, resulting in an improvement in clinical outcomes of incident PD patients. PMID:25700308

  10. Oak decline risk rating for the southeastern United States

    Treesearch

    S. Oak; F. Tainter; J. Williams; D. Starkey

    1996-01-01

    Oak decline risk rating models were developed for upland hardwood forests in the southeastern United States using data gathered during regional oak decline surveys. Stepwise discriminant analyses were used to relate 12 stand and site variables with major oak decline incidence for each of three subregions plus one incorporating all subregions. The best model for the...

  11. Dealing with China's future population decline: a proposal for replacing low birth rates with sustainable rates.

    PubMed

    Cao, Shixiong; Wang, Xiuqing

    2009-09-01

    Decreasing population levels due to declining birth rates are becoming a potentially serious social problem in developed and rapidly developing countries. China urgently needed to reduce birth rates so that its population would decline to a sustainable level, and the family planning policy designed to achieve this goal has largely succeeded. However, continuing to pursue this policy is leading to serious, unanticipated problems such as a shift in the country's population distribution towards the elderly and increasing difficulty supporting that elderly population. Social and political changes that promoted low birth rates and the lack of effective policies to encourage higher birth rates suggest that mitigating the consequences of the predicted population decline will depend on a revised approach based on achieving sustainable birth rates.

  12. Projected response of an endangered marine turtle population to climate change

    NASA Astrophysics Data System (ADS)

    Saba, Vincent S.; Stock, Charles A.; Spotila, James R.; Paladino, Frank V.; Tomillo, Pilar Santidrián

    2012-11-01

    Assessing the potential impacts of climate change on individual species and populations is essential for the stewardship of ecosystems and biodiversity. Critically endangered leatherback turtles in the eastern Pacific Ocean are excellent candidates for such an assessment because their sensitivity to contemporary climate variability has been substantially studied. If incidental fisheries mortality is eliminated, this population still faces the challenge of recovery in a rapidly changing climate. Here we combined an Earth system model, climate model projections assessed by the Intergovernmental Panel on Climate Change and a population dynamics model to estimate a 7% per decade decline in the Costa Rica nesting population over the twenty-first century. Whereas changes in ocean conditions had a small effect on the population, the ~2.5°C warming of the nesting beach was the primary driver of the decline through reduced hatching success and hatchling emergence rate. Hatchling sex ratio did not substantially change. Adjusting nesting phenology or changing nesting sites may not entirely prevent the decline, but could offset the decline rate. However, if future observations show a long-term decline in hatching success and emergence rate, anthropogenic climate mitigation of nests (for example, shading, irrigation) may be able to preserve the nesting population.

  13. Hospital discharge rates before and after implementation of a city-wide smoking ban in a Texas city, 2004-2008.

    PubMed

    Head, Phil; Jackson, Bradford E; Bae, Sejong; Cherry, Debra

    2012-01-01

    The objective of this study was to examine hospital discharge data on 5 tobacco-related diagnoses before and after implementation of a smoking ban in a small Texas city. We compared hospital discharge rates for 2 years before and 2 years after implementation of the ban in the intervention city with discharge rates during the same time in a similar city with no ban. The discharge rates for blacks and whites combined declined significantly after the ban in the intervention city for acute myocardial infarction (MI) (rate ratio [RR], 0.74; 95% confidence interval [CI], 0.65-0.85) and for stroke or cerebrovascular accident (RR, 0.71; 95% CI, 0.62-0.82); discharge rates in the intervention city also declined significantly for chronic obstructive pulmonary disease (RR, 0.64; 95% CI, 0.54-0.75) and asthma (RR, 0.69; 95% CI, 0.52-0.91) for whites only. Discharge rates for 4 of 5 diagnoses in the control city did not change. Although postban reduction in acute MI is well documented, this is one of the first studies to show a racial disparity in health benefits and a decline in tobacco-related diagnoses other than acute MI after implementation of a city-wide smoking ban.

  14. QuickStats: Birth Rates Among Teens Aged 15-19 Years, by Race/Hispanic Ethnicity* - National Vital Statistics System, United States,(†) 2007 and 2015(§).

    PubMed

    2016-08-19

    From 2007 to 2015, the birth rate for female teens aged 15-19 years declined 46%, from 41.5 to 22.3 births per 1,000, the lowest rate ever recorded for this population in the United States. In 2015, rates declined to record lows for all racial/ethnic populations, with declines ranging from 41% for non-Hispanic white teens to 54% for Hispanic teens. Despite the declines, teen birth rates by race/Hispanic ethnicity continued to reflect wide disparities, with rates ranging from 6.9 per 1,000 for Asian or Pacific Islander teens to 34.9 for Hispanic teens in 2015.

  15. Response rates in case-control studies of cancer by era of fieldwork and by characteristics of study design.

    PubMed

    Xu, Mengting; Richardson, Lesley; Campbell, Sally; Pintos, Javier; Siemiatycki, Jack

    2018-04-09

    The purpose of this study was to describe time trends in response rates in case-control studies of cancer and identify study design factors that influence response rate. We reviewed 370 case-control studies of cancer published in 12 journals during indicator years in each of the last four decades. We estimated time trends of response rates and reasons for nonresponse in each of the following types of study subjects: cases, medical source controls, and population controls. We also estimated response rates according to characteristics of study context. Median response rates among cases and population controls were between 75% and 80% in the 1970s. Between 1971 and 2010, study response rates declined by 0.31% per year for cases and 0.78% for population controls. Only a minority of studies reported reasons for nonparticipation; subject refusal was the most common reported reason. Studies conducted in North America had lower median response rates than studies conducted in Europe. In-person and telephone interviews elicited higher response rates than mail questionnaires. Response rates from case-control studies of cancer have declined, and this could threaten the validity of results derived from these studies. Copyright © 2018 Elsevier Inc. All rights reserved.

  16. Early body composition, but not body mass, is associated with future accelerated decline in muscle quality

    PubMed Central

    Chiles Shaffer, Nancy; Gonzalez‐Freire, Marta; Shardell, Michelle D.; Zoli, Marco; Studenski, Stephanie A.; Ferrucci, Luigi

    2017-01-01

    Abstract Background Muscle quality (MQ) or strength‐to‐mass ratio declines with aging, but the rate of MQ change with aging is highly heterogeneous across individuals. The identification of risk factors for accelerated MQ decline may offer clues to identity the underpinning physiological mechanisms and indicate targets for prevention and treatment. Using data from the Baltimore Longitudinal Study of Aging, we tested whether measures of body mass and body composition are associated with differential rates of changes in MQ with aging. Methods Participants included 511 men and women, aged 50 years or older, followed for an average of 4 years (range: 1–8). MQ was operationalized as ratio between knee‐extension isokinetic strength and CT‐thigh muscle cross‐sectional area. Predictors included body mass and body composition measures: weight (kg), body mass index (BMI, kg/m2), dual‐energy x‐ray absorptiometry‐measured total body fat mass (TFM, kg) and lean mass (TLM, kg), and body fatness (TFM/weight). Covariates were baseline age, sex, race, and body height. Results Muscle quality showed a significant linear decline over the time of the follow up (average rate of decline 0.02 Nm/cm2 per year, P < .001). Independent of covariates, neither baseline body weight (P = .756) nor BMI (P = .777) was predictive of longitudinal rate of decline in MQ. Instead, higher TFM and lower TLM at baseline predicted steeper longitudinal decline in MQ (P = .036 and P < .001, respectively). In particular, participants with both high TFM and low TLM at baseline experienced the most dramatic decline compared with those with low TFM and high TLM (about 3% per year vs. 0.5% per year, respectively). Participants in the higher tertile of baseline body fatness presented a significantly faster decline of MQ than the rest of the population (P = .021). Similar results were observed when body mass, TFM, and TLM were modeled as time‐dependent predictors. Conclusions Body composition, but not weight nor BMI, is associated with future MQ decline, suggesting that preventive strategies aimed at maintaining good MQ with aging should specifically target body composition features. PMID:28198113

  17. Declining survival of black brant from subarctic and arctic breeding areas

    USGS Publications Warehouse

    Leach, Alan G.; Ward, David H.; Sedinger, James S.; Lindberg, Mark S.; Boyd, W. Sean; Hupp, Jerry W.; Ritchie, Robert J.

    2017-01-01

    Since the mid 1990s, the number of black brant (Branta bernicla nigricans; brant) nests on the Yukon‐Kuskokwim Delta (YKD), Alaska, USA, the historically predominant breeding area of brant, has declined steadily. This has caused researchers and managers to question if arctic breeding populations can compensate for the reduction in brant nests on the YKD. An important component of the assessment of brant population dynamics is having current estimates of first‐year and adult survival. We banded brant at 4 locations in Arctic Alaska and western Canada, and at 1 location in the subarctic, the Tutakoke River (TR) colony on the YKD, 1990–2015. We used joint live and dead mark‐recapture models to estimate first‐year and adult (≥1 yr old) survival of brant. We also used band recovery rates from a Brownie model to assess temporal trends in band recovery rates of adult brant. First‐year survival of brant hatched at TR declined from approximately 0.60 to <0.20 and, although first‐year survival generally was higher for goslings marked in the Arctic, their survival declined from approximately 0.70 in the early 1990s to ≤0.45 in the 2010s. Annual survival of adult females decreased from an average of 0.881 (95% CI = 0.877–0.885) to 0.822 (95% CI = 0.815–0.829) at TR and from 0.851 (95% CI = 0.843–0.860) to 0.821 (95% CI = 0.805–0.836) in the Arctic, from 1990 to 2014. Band recovery rates of adults generally were <1.25% until the last several years of study, when they reached ≤3.5%. Although the current harvest rates may be partially additive to natural mortality, we do not believe that harvest is the main influence on the declines in survival. The general decline in survival rates of brant breeding across a large geographic area may be influenced by a reduction in the quality of migration and wintering ground habitats. We suggest an analysis of seasonal survival of brant to test the hypothesis that declining habitat quality on wintering or spring migration areas is reducing survival. Our results suggest that the number of breeding pairs at TR will continue to decline and also brings into question the ability of arctic breeding populations to grow at a rate necessary to offset the declines on the YKD. Researchers should continue to closely monitor survival and harvest rates of brant, and assess methods currently used to monitor their abundance.

  18. Rates of decline in Alzheimer disease decrease with age.

    PubMed

    Holland, Dominic; Desikan, Rahul S; Dale, Anders M; McEvoy, Linda K

    2012-01-01

    Age is the strongest risk factor for sporadic Alzheimer disease (AD), yet the effects of age on rates of clinical decline and brain atrophy in AD have been largely unexplored. Here, we examined longitudinal rates of change as a function of baseline age for measures of clinical decline and structural MRI-based regional brain atrophy, in cohorts of AD, mild cognitive impairment (MCI), and cognitively healthy (HC) individuals aged 65 to 90 years (total n = 723). The effect of age was modeled using mixed effects linear regression. There was pronounced reduction in rates of clinical decline and atrophy with age for AD and MCI individuals, whereas HCs showed increased rates of clinical decline and atrophy with age. This resulted in convergence in rates of change for HCs and patients with advancing age for several measures. Baseline cerebrospinal fluid densities of AD-relevant proteins, Aβ(1-42), tau, and phospho-tau(181p) (ptau), showed a similar pattern of convergence with advanced age across cohorts, particularly for ptau. In contrast, baseline clinical measures did not differ by age, indicating uniformity of clinical severity at baseline. These results imply that the phenotypic expression of AD is relatively mild in individuals older than approximately 85 years, and this may affect the ability to distinguish AD from normal aging in the very old. Our findings show that inclusion of older individuals in clinical trials will substantially reduce the power to detect disease-modifying therapeutic effects, leading to dramatic increases in required clinical trial sample sizes with age of study sample.

  19. Progress has Stalled in U.S. Stroke Death Rates after Decades of Decline

    MedlinePlus

    ... Library (PHIL) Progress has stalled in US stroke death rates after decades of decline More timely stroke ... cdc.gov/vitalsigns/stroke/infographic.html#graphic) Stroke death declines have stalled in 3 out of every ...

  20. Frequent baked egg ingestion was not associated with change in rate of decline in egg skin prick test in children with challenge confirmed egg allergy.

    PubMed

    Tey, D; Dharmage, S C; Robinson, M N; Allen, K J; Gurrin, L C; Tang, M L K

    2012-12-01

    It is controversial whether egg-allergic children should strictly avoid all forms of egg, or if regular ingestion of baked egg will either delay or hasten the resolution of egg allergy. This is the first study to examine the relationship between frequency of baked egg ingestion and rate of decline in egg skin prick test size in egg-allergic children. This was a retrospective clinical cohort study. All children with challenge-proven egg allergy who attended the Royal Children's Hospital Allergy Department 1996-2005 and had at least two egg skin prick tests performed in this period were included (n = 125). Frequency of baked egg ingestion was assessed by telephone questionnaire as follows: (a) frequent (> once per week), (b) regular (> once every 3 months, up to ≤ once per week) or (c) strict avoidance (≤ once every 3 months). The relationship between frequency of baked egg ingestion and rate of decline in egg skin prick test size was examined by multiple linear regression, adjusting for potential confounders. Mean rate of decline in egg skin prick test size in all children was 0.7 mm/year (95% CI 0.5-1.0 mm/year). There was no evidence (P = 0.57) that the rate of decline in egg skin prick test size differed between children who undertook frequent ingestion (n = 21, mean 0.4 mm/year, 95% CI -0.3-1.2 mm/year), regular ingestion (n = 37, mean 0.9 mm/year, 95% CI 0.4-1.4 mm/year) or strict avoidance (n = 67, mean 0.7 mm/year, 95% CI 0.4-1.1 mm/year) of baked egg. Compared with strict dietary avoidance, frequent consumption of baked egg was not associated with a different rate of decline in egg skin prick test size in egg-allergic children. Given that dietary restrictions can adversely impact on the family, it is reasonable to consider liberalizing baked egg in the diet of egg-allergic children. © 2012 Blackwell Publishing Ltd.

  1. Fixed but not autoadjusting positive airway pressure attenuates the time-dependent decline in glomerular filtration rate in patients with obstructive sleep apnea.

    PubMed

    Marrone, Oreste; Cibella, Fabio; Pépin, Jean-Louis; Grote, Ludger; Verbraecken, Johan; Saaresranta, Tarja; Kvamme, John A; Basoglu, Ozen K; Lombardi, Carolina; McNicholas, Walter T; Hedner, Jan; Bonsignore, Maria R

    2018-04-23

    The impact of treating obstructive sleep apnea (OSA) on renal function decline is controversial. Previous studies usually included small samples and did not consider specific effects of different continuous positive airway pressure (CPAP) modalities. The aim of this study was to evaluate the respective influence of fixed and auto-adjusting CPAP modes on estimated glomerular filtration rate (eGFR) in a large sample of patients derived from the prospective European Sleep Apnea Database (ESADA) cohort. In patients of the ESADA, eGFR before and after follow-up was calculated using the CKD-EPI equation. Three study groups were investigated, namely untreated patients (n=144), patients receiving fixed continuous positive airway pressure (fCPAP) (n=1,178), and patients on auto-adjusting CPAP (APAP) (n=485). In the whole sample, eGFR decreased over time. The rate of eGFR decline was significantly higher in the subgroup with eGFR above median [91.42 ml/min/1.73m 2 ] at baseline (p<0.0001 for effect of baseline eGFR). This decline was attenuated or absent (p<0.0001 for effect of treatment) in the subgroup of OSA treated by fCPAP. A follow-up duration exceeding the median (541 days), was associated with eGFR decline in the untreated and APAP groups, but not in the fCPAP group (p <0.0001 by two-way ANOVA for interaction between treatment and follow-up length). In multiple regression analysis, eGFR decline was accentuated by advanced age, female gender, cardiac failure, higher baseline eGFR and longer follow-up duration, while there was a protective effect of fCPAP. Fixed CPAP but not APAP, may prevent eGFR decline in OSA. Copyright © 2018 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

  2. Use of multiple dispersal pathways facilitates amphibian persistence in stream networks.

    PubMed

    Campbell Grant, Evan H; Nichols, James D; Lowe, Winsor H; Fagan, William F

    2010-04-13

    Although populations of amphibians are declining worldwide, there is no evidence that salamanders occupying small streams are experiencing enigmatic declines, and populations of these species seem stable. Theory predicts that dispersal through multiple pathways can stabilize populations, preventing extinction in habitat networks. However, empirical data to support this prediction are absent for most species, especially those at risk of decline. Our mark-recapture study of stream salamanders reveals both a strong upstream bias in dispersal and a surprisingly high rate of overland dispersal to adjacent headwater streams. This evidence of route-dependent variation in dispersal rates suggests a spatial mechanism for population stability in headwater-stream salamanders. Our results link the movement behavior of stream salamanders to network topology, and they underscore the importance of identifying and protecting critical dispersal pathways when addressing region-wide population declines.

  3. Use of multiple dispersal pathways facilitates amphibian persistence in stream networks

    USGS Publications Warehouse

    Campbell, Grant E.H.; Nichols, J.D.; Lowe, W.H.; Fagan, W.F.

    2010-01-01

    Although populations of amphibians are declining worldwide, there is no evidence that salamanders occupying small streams are experiencing enigmatic declines, and populations of these species seem stable. Theory predicts that dispersal through multiple pathways can stabilize populations, preventing extinction in habitat networks. However, empirical data to support this prediction are absent for most species, especially those at risk of decline. Our mark-recapture study of stream salamanders reveals both a strong upstream bias in dispersal and a surprisingly high rate of overland dispersal to adjacent headwater streams. This evidence of route-dependent variation in dispersal rates suggests a spatial mechanism for population stability in headwater-stream salamanders. Our results link the movement behavior of stream salamanders to network topology, and they underscore the importance of identifying and protecting critical dispersal pathways when addressing region-wide population declines.

  4. Use of multiple dispersal pathways facilitates amphibian persistence in stream networks

    PubMed Central

    Campbell Grant, Evan H.; Nichols, James D.; Lowe, Winsor H.; Fagan, William F.

    2010-01-01

    Although populations of amphibians are declining worldwide, there is no evidence that salamanders occupying small streams are experiencing enigmatic declines, and populations of these species seem stable. Theory predicts that dispersal through multiple pathways can stabilize populations, preventing extinction in habitat networks. However, empirical data to support this prediction are absent for most species, especially those at risk of decline. Our mark-recapture study of stream salamanders reveals both a strong upstream bias in dispersal and a surprisingly high rate of overland dispersal to adjacent headwater streams. This evidence of route-dependent variation in dispersal rates suggests a spatial mechanism for population stability in headwater-stream salamanders. Our results link the movement behavior of stream salamanders to network topology, and they underscore the importance of identifying and protecting critical dispersal pathways when addressing region-wide population declines. PMID:20351269

  5. Risk Factors for Rapid Kidney Function Decline Among African Americans: The Jackson Heart Study (JHS)

    PubMed Central

    Young, Bessie A.; Katz, Ronit; Boulware, Ebony; Kestenbaum, Bryan; de Boer, Ian H.; Wang, Wei; Fülöp, Tibor; Bansal, Nisha; Robinson-Cohen, Cassianne; Griswold, Michael; Powe, Neil N.; Himmelfarb, Jonathan; Correa, Adolfo

    2016-01-01

    Background Racial differences in rapid kidney function decline exist, but less is known regarding factors associated with rapid decline among African Americans. A greater understanding of potentially modifiable risk factors for early kidney function loss may help reduce the burden of kidney failure in this high-risk population. Study Design Prospective cohort study. Setting & Participants 3653 African-American participants enrolled in the Jackson Heart Study (JHS) with kidney function data from two of three examinations (2000-2004 and 2009-2013). Estimated glomerular filtration rate (eGFR) was calculated from serum creatinine using the CKD-EPI creatinine equation. Predictors Demographics, socioeconomic status, lifestyle, clinical risk factors for kidney failure. Outcomes Rapid decline was defined as a ≥ 30% decline in eGFR during follow-up. We quantified the association of risk factors with rapid decline in multivariable models. Measurements Clinical (systolic blood pressure, albuminuria [albumin-creatinine ratio]) and modifiable risk factors. Results Mean age was 54 ± 12 (SD) years, 37% were male, average body mass index was 31.8 ± 7.1 kg/m2, 19% had diabetes mellitus (DM) and mean eGFR was 96.0 ±20 ml/min/1.73m2 with an annual rate of decline of 1.27 ml/min/1.73m2. Those with rapid decline (11.5%) were older, more likely to be of low/middle income, had higher systolic blood pressure, and greater DM than those with non-rapid decline. Factors associated with ≥30% decline were older age (adjusted OR per 10 years older, 1.51; 95% CI, 1.34-1.71); cardiovascular disease (adjusted OR, 1.53; 95% CI, 1.12-2.10), higher systolic blood pressure (adjusted OR per 17 mm Hg greater, 1.22; 95% CI, 1.06-1.41); DM (adjusted OR, 2.63; 95% CI, 2.02-3.41), smoking (adjusted OR, 1.60; 95% CI, 1.10-2.31), and albumin-creatinine ratio > 30 mg/g (adjusted OR, 1.55; 95% CI, 1.08-1.21). Conversely, results did not support associations of waist circumference, C-reactive protein, and physical activity with rapid decline. Limitations No mid study creatinine measurement at examination 2 (2005-2008). Conclusions Rapid decline heterogeneity existed among African Americans in JHS. Interventions targeting potentially modifiable factors may help reduce the incidence of kidney failure. PMID:27066930

  6. Long-term population dynamics of a managed burrowing owl colony

    USGS Publications Warehouse

    Barclay, John H.; Korfanta, Nicole M.; Kauffman, Matthew J.

    2011-01-01

    We analyzed the population dynamics of a burrowing owl (Athene cunicularia) colony at Mineta San Jose International Airport in San Jose, California, USA from 1990-2007. This colony was managed by using artificial burrows to reduce the occurrence of nesting owls along runways and within major airport improvement projects during the study period. We estimated annual reproduction in natural and artificial burrows and age-specific survival rates with mark-recapture techniques, and we estimated the relative contribution of these vital rates to population dynamics using a life table response experiment. The breeding colony showed 2 distinct periods of change: high population growth from 7 nesting pairs in 1991 to 40 pairs in 2002 and population decline to 17 pairs in 2007. Reproduction was highly variable: annual nesting success (pairs that raised =1 young) averaged 79% and ranged from 36% to 100%, whereas fecundity averaged 3.36 juveniles/pair and ranged from 1.43 juveniles/pair to 4.54 juveniles/pair. We estimated annual adult survival at 0.710 during the period of colony increase from 1996 to 2001 and 0.465 during decline from 2002 to 2007, but there was no change in annual survival of juveniles between the 2 time periods. Long-term population growth rate (lambda) estimated from average vital rates was lambdaa=1.072 with lambdai=1.288 during colony increase and lambdad=0.921 (DELTA lambda=0.368) during decline. A life table response experiment showed that change in adult survival rate during increasing and declining phases explained more than twice the variation in growth rate than other vital rates. Our findings suggest that management and conservation of declining burrowing owl populations should address factors that influence adult survival.

  7. Age, gender, and voided volume dependency of peak urinary flow rate and uroflowmetry nomogram in the Indian population

    PubMed Central

    Kumar, Vikash; Dhabalia, Jayesh V.; Nelivigi, Girish G.; Punia, Mahendra S.; Suryavanshi, Manav

    2009-01-01

    Objectives: The objective of this study was measurement of urine flow parameters by a non invasive urodynamic test. Variation of flow rates based on voided volume, age, and gender are described. Different nomograms are available for different populations and racial differences of urethral physiology are described. Currently, there has been no study from the Indian population on uroflow parameters. So the purpose of this study was to establish normal reference ranges of maximum and average flow rates, to see the influence of age, gender, and voided volume on flow rates, and to chart these values in the form of a nomogram. Methods: We evaluated 1,011 uroflowmetry tests in different age groups in a healthy population (healthy relatives of our patients) 16-50 year old males, >50 year old males, 5-15 year old children, and >15 year pre-menopausal and post-menopausal females. The uroflowmetry was done using the gravitimetric method. Flow chart parameters were analyzed and statistical calculations were used for drawing uroflow nomograms. Results: Qmax values in adult males were significantly higher than in the elderly and Qmax values in young females were significantly higher than in young males. Qmax values in males increased with age until 15 years old; followed by a slow decline until reaching 50 years old followed by a rapid decline after 50 years old even after correcting voided volume. Qmax values in females increased with age until they reached age 15 followed by decline in flow rate until a pre-menopausal age followed by no significant decline in post-menopausal females. Qmax values increased with voided volume until 700 cc followed by a plateau and decline. Conclusions: Qmax values more significantly correlated with age and voided volume than Qavg. Nomograms were drawn in centile form to provide normal reference ranges. Qmax values in our population were lower than described in literature. Patients with voided volume up to 50 ml could be evaluated with a nomogram. PMID:19955668

  8. Child Deaths Due to Injury in the Four UK Countries: A Time Trends Study from 1980 to 2010

    PubMed Central

    Hardelid, Pia; Davey, Jonathan; Dattani, Nirupa; Gilbert, Ruth

    2013-01-01

    Background Injuries are an increasingly important cause of death in children worldwide, yet injury mortality is highly preventable. Determining patterns and trends in child injury mortality can identify groups at particularly high risk. We compare trends in child deaths due to injury in four UK countries, between 1980 and 2010. Methods We obtained information from death certificates on all deaths occurring between 1980 and 2010 in children aged 28 days to 18 years and resident in England, Scotland, Wales or Northern Ireland. Injury deaths were defined by an external cause code recorded as the underlying cause of death. Injury mortality rates were analysed by type of injury, country of residence, age group, sex and time period. Results Child mortality due to injury has declined in all countries of the UK. England consistently experienced the lowest mortality rate throughout the study period. For children aged 10 to 18 years, differences between countries in mortality rates increased during the study period. Inter-country differences were largest for boys aged 10 to 18 years with mortality rate ratios of 1.38 (95% confidence interval 1.16, 1.64) for Wales, 1.68 (1.48, 1.91) for Scotland and 1.81 (1.50, 2.18) for Northern Ireland compared with England (the baseline) in 2006–10. The decline in mortality due to injury was accounted for by a decline in unintentional injuries. For older children, no declines were observed for deaths caused by self-harm, by assault or from undetermined intent in any UK country. Conclusion Whilst child deaths from injury have declined in all four UK countries, substantial differences in mortality rates remain between countries, particularly for older boys. This group stands to gain most from policy interventions to reduce deaths from injury in children. PMID:23874585

  9. Education and Cognitive Decline in Older Americans: Results From the AHEAD Sample

    PubMed Central

    Alley, Dawn; Suthers, Kristen; Crimmins, Eileen

    2009-01-01

    Although education is consistently related to better cognitive performance, findings on the relationship between education and age-associated cognitive change have been conflicting. Using measures of multiple cognitive domains from four waves of the Asset and Health Dynamics of the Oldest Old study, a representative sample of Americans aged 70 years and older, the authors performed growth curve modeling to examine the relationships between education, initial cognitive score, and the rate of decline in cognitive function. More years of education were linked to better initial performance on each of the cognitive tests, and higher levels of education were linked to slower decline in mental status. However, more education was unrelated to the rate of decline in working memory, and education was associated with somewhat faster cognitive decline on measures of verbal memory. These findings highlight the role of early-life experiences not only in long-term cognitive performance but also in old-age cognitive trajectories. PMID:19830260

  10. Trends in Respiratory Syncytial Virus and Bronchiolitis Hospitalization Rates in High-Risk Infants in a United States Nationally Representative Database, 1997–2012

    PubMed Central

    Doucette, Abigail; Jiang, Xiaohui; Fryzek, Jon; Coalson, Jenna; McLaurin, Kimmie; Ambrose, Christopher S.

    2016-01-01

    Background Respiratory syncytial virus (RSV) causes significant pediatric morbidity and is the most common cause of bronchiolitis. Bronchiolitis hospitalizations declined among US infants from 2000‒2009; however, rates in infants at high risk for RSV have not been described. This study examined RSV and unspecified bronchiolitis (UB) hospitalization rates from 1997‒2012 among US high-risk infants. Methods The Kids’ Inpatient Database (KID) infant annual RSV (ICD-9 079.6, 466.11, 480.1) and UB (ICD-9 466.19, 466.1) hospitalization rates were estimated using weighted counts. Denominators were based on birth hospitalizations with conditions associated with high-risk for RSV: chronic perinatal respiratory disease (chronic lung disease [CLD]); congenital airway anomalies (CAA); congenital heart disease (CHD); Down syndrome (DS); and other genetic, metabolic, musculoskeletal, and immunodeficiency conditions. Preterm infants could not be identified. Hospitalizations were characterized by mechanical ventilation, inpatient mortality, length of stay, and total cost (2015$). Poisson and linear regression were used to test statistical significance of trends. Results RSV and UB hospitalization rates were substantially elevated for infants with higher-risk CHD, CLD, CAA and DS without CHD compared with all infants. RSV rates declined by 47.0% in CLD and 49.7% in higher-risk CHD infants; no other declines in high-risk groups were observed. UB rates increased in all high-risk groups except for a 22.5% decrease among higher-risk CHD. Among high-risk infants, mechanical ventilation increased through 2012 to 20.4% and 13.5% of RSV and UB hospitalizations; geometric mean cost increased to $31,742 and $25,962, respectively, and RSV mortality declined to 0.9%. Conclusions Among high-risk infants between 1997 and 2012, RSV hospitalization rates declined among CLD and higher-risk CHD infants, coincident with widespread RSV immunoprophylaxis use in these populations. UB hospitalization rates increased in all high-risk groups except higher-risk CHD, suggesting improvement in the health status of higher-risk CHD infants, potentially due to enhanced surgical interventions. Mechanical ventilation use and RSV and UB hospitalization costs increased while RSV mortality declined. PMID:27050095

  11. Does climate change explain the decline of a trans-Saharan Afro-Palaearctic migrant?

    PubMed

    Pearce-Higgins, J W; Yalden, D W; Dougall, T W; Beale, C M

    2009-03-01

    There is an urgent need to understand how climate change will impact on demographic parameters of vulnerable species. Migrants are regarded as particularly vulnerable to climate change; phenological mismatch has resulted in the local decline of one passerine, whilst variations in the survival of others have been related to African weather conditions. However, there have been few demographic studies on trans-Saharan non-passerine migrants, despite these showing stronger declines across Europe than passerines. We therefore analyse the effects of climate on the survival and productivity of common sandpipers Actitis hypoleucos, a declining non-passerine long-distant migrant using 28 years' data from the Peak District, England. Adult survival rates were significantly negatively correlated with winter North Atlantic Oscillation (NAO), being lower when winters were warm and wet in western Europe and cool and dry in northwest Africa. Annual variation in the productivity of the population was positively correlated with June temperature, but not with an index of phenological mismatch. The 59% population decline appears largely to have been driven by reductions in adult survival, with local productivity poorly correlated with subsequent population change, suggesting a low degree of natal philopatry. Winter NAO was not significantly correlated with adult survival rates in a second, Scottish Borders population, studied for 12 years. Variation in climatic conditions alone does not therefore appear to be responsible for common sandpiper declines. Unlike some passerine migrants, there was no evidence for climate-driven reductions in productivity, although the apparent importance of immigration in determining local recruitment complicates the assessment of productivity effects. We suggest that further studies to diagnose common sandpiper declines should focus on changes in the condition of migratory stop-over or wintering locations. Where possible, these analyses should be repeated for other declining migrants.

  12. Age-associated power decline from running, jumping, and throwing male masters world records.

    PubMed

    Gava, Paolo; Kern, Helmut; Carraro, Ugo

    2015-01-01

    BACKGROUND/STUDY CONTEXT: The capacity to perform everyday tasks is directly related to the muscular power the body can develop (see Appendix). The age-related loss of power is a fact, but the characterization or the rate of muscle power loss remains an open issue. Data useful to study the decline of the skeletal muscles power are largely available from sources other than medical tests, e.g., from track and field competitions of Masters athletes. The aim of our study is to identify the age-related decline trend of the power developed by the athletes in carrying out the track and field events. Absolute male world records of 16 events were collected along with world records of male Masters categories. Performance was normalized with respect to the absolute record; the performance of various age groups is consequently represented by a number ranging from 1 (world absolute records) to 0 (null performance). The performance of a jumping event is transformed into a parameter proportional to the power developed by the athletes: the displacement of the center of gravity of the athlete. Throwing events are further normalized for the decreasing weight of the implements with the increasing age of the Masters athletes. Most track and field events show a linear decline to 70 years. The annual rate of power decline for all the events (running, throwing, and jumping), using a simplified synthesis, is 1.25% per year. The events that involve mostly upper limbs (shot put, javelin throw) show a higher rate of decline (1.4% per year) compared to those where the lower limbs are mostly involved (long jump 1.1%, track events 0.6-0.7% per year). This analysis of muscle power decline is only partially in line with the results of works based on clinical tests. A clarification of the reasons for such discrepancy may provide clinically significant information. Human power decline in Masters athletes was analyzed, adopting a coherent approach based on an extended database. Skeletal muscle power starts declining after the age of 30, with slight variations depending on the events. This conclusion is in line with only some of the previous studies. The various trend lines point to 0 at the age of 110 years, which is in line with the present human survival age. The study can be further developed with a suitable database for male and female Masters performances to facilitate longitudinal studies, which are currently lacking.

  13. Type II Supernova Spectral Diversity. II. Spectroscopic and Photometric Correlations

    NASA Astrophysics Data System (ADS)

    Gutiérrez, Claudia P.; Anderson, Joseph P.; Hamuy, Mario; González-Gaitan, Santiago; Galbany, Lluis; Dessart, Luc; Stritzinger, Maximilian D.; Phillips, Mark M.; Morrell, Nidia; Folatelli, Gastón

    2017-11-01

    We present an analysis of observed trends and correlations between a large range of spectral and photometric parameters of more than 100 type II supernovae (SNe II), during the photospheric phase. We define a common epoch for all SNe of 50 days post-explosion, where the majority of the sample is likely to be under similar physical conditions. Several correlation matrices are produced to search for interesting trends between more than 30 distinct light-curve and spectral properties that characterize the diversity of SNe II. Overall, SNe with higher expansion velocities are brighter, have more rapidly declining light curves, shorter plateau durations, and higher 56Ni masses. Using a larger sample than previous studies, we argue that “Pd”—the plateau duration from the transition of the initial to “plateau” decline rates to the end of the “plateau”—is a better indicator of the hydrogen envelope mass than the traditionally used optically thick phase duration (OPTd: explosion epoch to end of plateau). This argument is supported by the fact that Pd also correlates with s 3, the light-curve decline rate at late times: lower Pd values correlate with larger s 3 decline rates. Large s 3 decline rates are likely related to lower envelope masses, which enables gamma-ray escape. We also find a significant anticorrelation between Pd and s 2 (the plateau decline rate), confirming the long standing hypothesis that faster declining SNe II (SNe IIL) are the result of explosions with lower hydrogen envelope masses and therefore have shorter Pd values. This paper includes data gathered with the 6.5 m Magellan Telescopes located at Las Campanas Observatory, Chile; and the Gemini Observatory, Cerro Pachon, Chile (Gemini Program GS- 2008B-Q-56). Based on observations collected at the European Organisation for Astronomical Research in the Southern Hemisphere, Chile (ESO Programs 076.A-0156, 078.D-0048, 080.A-0516, and 082.A-0526).

  14. Kidney function changes with aging in adults: comparison between cross-sectional and longitudinal data analyses in renal function assessment.

    PubMed

    Chung, Sang M; Lee, David J; Hand, Austin; Young, Philip; Vaidyanathan, Jayabharathi; Sahajwalla, Chandrahas

    2015-12-01

    The study evaluated whether the renal function decline rate per year with age in adults varies based on two primary statistical analyses: cross-section (CS), using one observation per subject, and longitudinal (LT), using multiple observations per subject over time. A total of 16628 records (3946 subjects; age range 30-92 years) of creatinine clearance and relevant demographic data were used. On average, four samples per subject were collected for up to 2364 days (mean: 793 days). A simple linear regression and random coefficient models were selected for CS and LT analyses, respectively. The renal function decline rates per year were 1.33 and 0.95 ml/min/year for CS and LT analyses, respectively, and were slower when the repeated individual measurements were considered. The study confirms that rates are different based on statistical analyses, and that a statistically robust longitudinal model with a proper sampling design provides reliable individual as well as population estimates of the renal function decline rates per year with age in adults. In conclusion, our findings indicated that one should be cautious in interpreting the renal function decline rate with aging information because its estimation was highly dependent on the statistical analyses. From our analyses, a population longitudinal analysis (e.g. random coefficient model) is recommended if individualization is critical, such as a dose adjustment based on renal function during a chronic therapy. Copyright © 2015 John Wiley & Sons, Ltd.

  15. The extension of smoke-free areas and acute myocardial infarction mortality: before and after study.

    PubMed

    Villalbí, Joan R; Sánchez, Emília; Benet, Josep; Cabezas, Carmen; Castillo, Antonia; Guarga, Alex; Saltó, Esteve; Tresserras, Ricard

    2011-05-18

    Recent studies suggest that comprehensive smoking regulations to decrease exposure to second-hand smoke reduce the rates of acute myocardial infarction (AMI). The objective of this paper is to analyse if deaths due to AMI in Spain declined after smoking prevention legislation came into force in January 2006. Information was collected on deaths registered by the Instituto Nacional de Estadística for 2004-2007. Age- and sex-specific annual AMI mortality rates with 95% CIs were estimated, as well as age-adjusted annual AMI mortality rates by sex. Annual relative risks of death from AMI were estimated with an age-standardised Poisson regression model. Adjusted AMI mortality rates in 2004 and 2005 are similar, but in 2006 they show a 9% decline for men and a 8.7% decline for women, especially among those over 64 years of age. In 2007 there is a slower rate of decline, which reaches statistical significance for men (-4.8%) but not for women (-4%). The annual relative risk of AMI death decreased in both sexes (p < 0.001) from 1 to 0.90 in 2006, and to 0.86 in 2007. The extension of smoke-free regulations in Spain was associated with a reduction in AMI mortality, especially among the elderly. Although other factors may have played a role, this pattern suggests a likely influence of the reduction in population exposure to second-hand smoke on AMI deaths.

  16. Evolving epidemiology of HIV-associated malignancies.

    PubMed

    Shiels, Meredith S; Engels, Eric A

    2017-01-01

    The purpose of this review is to describe the epidemiology of cancers that occur at an elevated rate among people with HIV infection in the current treatment era, including discussion of the cause of these cancers, as well as changes in cancer incidence and burden over time. Rates of Kaposi sarcoma, non-Hodgkin lymphoma and cervical cancer have declined sharply in developed countries during the highly active antiretroviral therapy era, but remain elevated 800-fold, 10-fold and four-fold, respectively, compared with the general population. Most studies have reported significant increases in liver cancer rates and decreases in lung cancer over time. Although some studies have reported significant increases in anal cancer rates and declines in Hodgkin lymphoma rates, others have shown stable incidence. Declining mortality among HIV-infected individuals has resulted in the growth and aging of the HIV-infected population, causing an increase in the number of non-AIDS-defining cancers diagnosed each year in HIV-infected people. The epidemiology of cancer among HIV-infected people has evolved since the beginning of the HIV epidemic with particularly marked changes since the introduction of modern treatment. Public health interventions aimed at prevention and early detection of cancer among HIV-infected people are needed.

  17. Reducing child mortality in India in the new millennium.

    PubMed Central

    Claeson, M.; Bos, E. R.; Mawji, T.; Pathmanathan, I.

    2000-01-01

    Globally, child mortality rates have been halved over the last few decades, a developmental success story. Nevertheless, progress has been uneven and in recent years mortality rates have increased in some countries. The present study documents the slowing decline in infant mortality rates in india; a departure from the longer-term trends. The major causes of childhood mortality are also reviewed and strategic options for the different states of India are proposed that take into account current mortality rates and the level of progress in individual states. The slowing decline in childhood mortality rates in India calls for new approaches that go beyond disease-, programme- and sector-specific approaches. PMID:11100614

  18. Probability of treatment following acute decline in lung function in children with cystic fibrosis is related to baseline pulmonary function.

    PubMed

    Morgan, Wayne J; Wagener, Jeffrey S; Yegin, Ashley; Pasta, David J; Millar, Stefanie J; Konstan, Michael W

    2013-10-01

    To determine whether the association between high forced expiratory volume in 1 second (FEV1) and increased rate of decline in FEV1 in children with cystic fibrosis could be due to less frequent intervention after acute declines (sudden decline events) in FEV1. Patients with cystic fibrosis aged 6-17 years enrolled in the Epidemiologic Study of Cystic Fibrosis were assessed for a sudden decline event, defined as a 10% relative decline in FEV1% predicted from an average of 3 consecutive stable baseline spirometries. The likelihood of therapeutic intervention within 14 days before and 56 days after this event was then related to their baseline FEV1% predicted age-specific decile using a logistic regression adjusting for age group (6-12 years, 13-17 years) and presence of Pseudomonas aeruginosa on respiratory culture. A total of 10 888 patients had at least 1 sudden decline event in FEV1. Patients in the highest FEV1 decile were significantly less likely than those in the lowest decile to receive intravenous antibiotics (OR, 0.14; 95% CI, 0.11-0.18; P < .001) or be hospitalized (OR, 0.18; 95% CI, 0.14-0.23; P < .001) following decline. Children and adolescents with high baseline lung function are less likely to receive a therapeutic intervention following an acute decline in FEV1, which may explain their greater rate of FEV1 decline. Copyright © 2013 Mosby, Inc. All rights reserved.

  19. Physical activity and motor decline in older persons.

    PubMed

    Buchman, A S; Boyle, P A; Wilson, R S; Bienias, Julia L; Bennett, D A

    2007-03-01

    We tested the hypothesis that physical activity modifies the course of age-related motor decline. More than 850 older participants of the Rush Memory and Aging Project underwent baseline assessment of physical activity and annual motor testing for up to 8 years. Nine strength measures and nine motor performance measures were summarized into composite measures of motor function. In generalized estimating equation models, global motor function declined during follow-up (estimate, -0.072; SE, 0.008; P < 0.001). Each additional hour of physical activity at baseline was associated with about a 5% decrease in the rate of global motor function decline (estimate, 0.004; SE, 0.001; P = 0.007). Secondary analyses suggested that the association of physical activity with motor decline was mostly due to the effect of physical activity on the rate of motor performance decline. Thus, higher levels of physical activity are associated with a slower rate of motor decline in older persons.

  20. White Flight: A Closer Look at the Assumptions.

    ERIC Educational Resources Information Center

    Cunningham, George K.; Husk, William L.

    1980-01-01

    Criticizes current research for equating declining urban school enrollments with White flight. Describes a study conducted in Louisville (Jefferson County), Kentucky, in which birth rate decline and ongoing out-migration variables were considered. Shows that many White families, rather than leaving the community, actually transferred their…

  1. Those ubiquitous fertility trends: United States, 1945-1979.

    PubMed

    Sweet, J A; Rindfuss, R R

    1983-01-01

    1970-79 US fertility trends among differnet racial, regional, age, educational, parity, and socioeconomic subgroups in the population were examined, using own children data from the 1976 Survey of Income and Education (SIE) and the March Current Population Surveys (CPS) from 1968-80. In addition, cross-sectional differences in fertility for the subgroups were compared for 1970 and 1976, using multiple regression analysis. 1st, the appropriateness of using fertility rates obtained from own children data was assessed by comparing fertility rates obtained from the SIE data with those derived from vital statistic and census data. The comparative analysis confirmed that the SIE data yielded an accurate estimate of period fertility rates for currently married women, provided the subgroup samples were sufficiently large. CPS fertility estimates were also judged to be accurate if data from 3 adjacent survey years was pooled to increase sample size. Fertility trends for 5 educational groups were assessed separately for 1967-73. During this periold, there was a marked decline in fertility for all 5 groups; for the group with 5-8 years of education the decline was only 14%, but for the other 4 groups, which included women with 9-16 or more years of education, the decline in fertility ranged from 26-29%. In assessing the 1970-76 trends, the sample was restricted to own children, aged 3 years or less, of currently married women, under 40 years of age. Among whites, there was an overall 20% decline in fertility between 1970-76 and an overall fertility increase of about 2% between 1976-79. These trends were observed in all 28 white subgroups. A similar pattern was observed for blacks. There was an overall fertility decline of 24% between 1970-76, and this decline was apparent for all subgroups except women with college degrees. Betwen 1976-79, black fertility rates, unlike white rates, continued to decline, but the rate of decline was only 3%. Furthermore, the decline in almost all the black subgroups was markedly less than in the 1970-76 periold, and for many of the subgroups the trend was reversed and fertility increased. In summary, the fertility trends noted for 1970-79 were pervasive for almost all the subgroups for both blacks and whites; i.e., there was a marked decline in fertility between 1970-76 and than a reversal or slowing down of the decline during the 1976-79 for all black and white subgroups. Cross-sectional fertility differences in the subgroups in 1970 and in 1979 were quite similar, and fertility rates differed markedly for the separate subgroups. These differences do not, of course, explain the pervasive trends observed in the analysis of the fertility rates over time. A similar study assessing fertility trends among subgroups for the early 1940's through the late 1960s also revealed the pervasive nature of period fertility trends. Demographers have not as yet been able to explain these shifts in fertility that cut across all subgroups in the US and which also characterize the period fertility rates in other developed countries. Tables provided information on 1) total fertility rates by educational level and by geographical region for 1945-1975; 2) % change in number of own children less than 3 years of age among women under age 40 by maternal age, maternal education, initial parity, geographical region, and husband's income; and 3) mean number of own children less than 3 years of age among women under age 40 by maternal age, education, parity, region, and husband's income.

  2. California's Youth and Young Adult Arrest Rates Continue a Historic Decline. Fact Sheet

    ERIC Educational Resources Information Center

    Males, Mike

    2016-01-01

    This Center on Juvenile and Criminal Justice (CJCJ) fact sheet shows that, in 2015, arrests of young people under age 25 dropped below 2014 levels and continue a decades-long trend of decline. While the causes of these declines are unknown, falling youth arrests rates coupled with decreased youth incarceration suggest that high rates of…

  3. Self-rated health is associated with subsequent functional decline among older adults in Japan.

    PubMed

    Hirosaki, Mayumi; Okumiya, Kiyohito; Wada, Taizo; Ishine, Masayuki; Sakamoto, Ryota; Ishimoto, Yasuko; Kasahara, Yoriko; Kimura, Yumi; Fukutomi, Eriko; Chen, Wen Ling; Nakatsuka, Masahiro; Fujisawa, Michiko; Otsuka, Kuniaki; Matsubayashi, Kozo

    2017-09-01

    Previous studies have reported that self-rated health (SRH) predicts subsequent mortality. However, less is known about the association between SRH and functional ability. The aim of this study was to examine whether SRH predicts decline in basic activities of daily living (ADL), even after adjustment for depression, among community-dwelling older adults in Japan. A three-year prospective cohort study was conducted among 654 residents aged 65 years and older without disability in performing basic ADL at baseline. SRH was assessed using a visual analogue scale (range; 0-100), and dichotomized into low and high groups. Information on functional ability, sociodemographic factors, depressive symptoms, and medical conditions were obtained using a self-administered questionnaire. Logistic regression analysis was used to examine the association between baseline SRH and functional decline three years later. One hundred and eight (16.5%) participants reported a decline in basic ADL at the three-year follow-up. Multiple logistic regression analysis showed that the low SRH group had a higher risk for functional decline compared to the high SRH group, even after controlling for potential confounding factors (odds ratio (OR) = 2.4; 95% confidence interval (CI) = 1.3-4.4). Furthermore, a 10-point difference in SRH score was associated with subsequent functional decline (OR = 1.37; 95% CI = 1.16-1.61). SRH was an independent predictor of functional decline. SRH could be a simple assessment tool for predicting the loss or maintenance of functional ability in community-dwelling older adults. Positive self-evaluation might be useful to maintain an active lifestyle and stay healthy.

  4. Declining Orangutan Encounter Rates from Wallace to the Present Suggest the Species Was Once More Abundant

    PubMed Central

    Meijaard, Erik; Welsh, Alan; Ancrenaz, Marc; Wich, Serge; Nijman, Vincent; Marshall, Andrew J.

    2010-01-01

    Background Bornean orangutans (Pongo pygmaeus) currently occur at low densities and seeing a wild one is a rare event. Compared to present low encounter rates of orangutans, it is striking how many orangutan each day historic collectors like Alfred Russel Wallace were able to shoot continuously over weeks or even months. Does that indicate that some 150 years ago encounter rates with orangutans, or their densities, were higher than now? Methodology/Principal Findings We test this hypothesis by quantifying encounter rates obtained from hunting accounts, museum collections, and recent field studies, and analysing whether there is a declining trend over time. Logistic regression analyses of our data support such a decline on Borneo between the mid-19th century and the present. Even when controlled for variation in the size of survey and hunting teams and the durations of expeditions, mean daily encounter rates appear to have declined about 6-fold in areas with little or no forest disturbance. Conclusions/Significance This finding has potential consequences for our understanding of orangutans, because it suggests that Bornean orangutans once occurred at higher densities. We explore potential explanations—habitat loss and degradation, hunting, and disease—and conclude that hunting fits the observed patterns best. This suggests that hunting has been underestimated as a key causal factor of orangutan density and distribution, and that species population declines have been more severe than previously estimated based on habitat loss only. Our findings may require us to rethink the biology of orangutans, with much of our ecological understanding possibly being based on field studies of animals living at lower densities than they did historically. Our approach of quantifying species encounter rates from historic data demonstrates that this method can yield valuable information about the ecology and population density of species in the past, providing new insight into species' conservation needs. PMID:20711451

  5. Cognitive function trajectories and their determinants in older people: 8 years of follow-up in the English Longitudinal Study of Ageing.

    PubMed

    Zaninotto, Paola; Batty, G David; Allerhand, Michael; Deary, Ian J

    2018-04-24

    Maintaining cognitive function is an important aspect of healthy ageing. In this study, we examined age trajectories of cognitive decline in a large nationally representative sample of older people in England. We explored the factors that influence such decline and whether these differed by gender. Latent growth curve modelling was used to explore age-specific changes, and influences on them, in an 8-year period in memory, executive function, processing speed and global cognitive function among 10 626 participants in the English Longitudinal Study of Ageing. We run gender-specific models with the following exposures: age, education, wealth, childhood socioeconomic status, cardiovascular disease, diabetes, physical function, body mass index, physical activity, alcohol, smoking, depression and dementia. After adjustment, women had significantly less decline than men in memory (0.011, SE 0.006), executive function (0.012, SE 0.006) and global cognitive function (0.016, SE 0.004). Increasing age and dementia predicted faster rates of decline in all cognitive function domains. Depression and alcohol consumption predicted decline in some cognitive function domains in men only. Poor physical function, physical inactivity and smoking were associated with faster rates of decline in specific cognitive domains in both men and women. For example, relative to study members who were physically active, the sedentary experienced greater declines in memory (women -0.018, SE 0.009) and global cognitive function (men -0.015, SE 0.007 and women -0.016, SE 0.007). The potential determinants of cognitive decline identified in this study, in particular modifiable risk factors, should be tested in the context of randomised controlled trials. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  6. Geographic and racial variation in teen pregnancy rates in Wisconsin.

    PubMed

    Layde, Molly M; Remington, Patrick L

    2013-08-01

    Despite recent declines in teen birth rates, teenage pregnancy remains an important public health problem in Wisconsin with significant social, economic, and health-related effects. Compare and contrast teen birth rate trends by race, ethnicity, and county in Wisconsin. Teen (ages 15-19 years) birth rates (per 1000 teenage females) in Wisconsin from 2001-2010 were compared by racelethnicity and county of residence using data from the Wisconsin Interactive Statistics on Health. Teen birth rates in Wisconsin have declined by 20% over the past decade, from 35.5/1000 teens in 2001 to 28.3/1000 teens in 2010-a relative decline of 20.3%. However, trends vary by race, with declines among blacks (-33%) and whites (-26%) and increases among American Indians (+21%) and Hispanics (+30%). Minority teen birth rates continue to be 3 to 5 times greater than birth rates among whites. Rates varied even more by county, with an over 14-fold difference between Ozaukee County (7.8/1000) and Menominee County (114.2). Despite recent declines, teen pregnancy continues to be an important public health problem in Wisconsin. Pregnancy prevention programs should be targeted toward the populations and counties with the highest rates.

  7. State of newborn health in India.

    PubMed

    Sankar, M J; Neogi, S B; Sharma, J; Chauhan, M; Srivastava, R; Prabhakar, P K; Khera, A; Kumar, R; Zodpey, S; Paul, V K

    2016-12-01

    About 0.75 million neonates die every year in India, the highest for any country in the world. The neonatal mortality rate (NMR) declined from 52 per 1000 live births in 1990 to 28 per 1000 live births in 2013, but the rate of decline has been slow and lags behind that of infant and under-five child mortality rates. The slower decline has led to increasing contribution of neonatal mortality to infant and under-five mortality. Among neonatal deaths, the rate of decline in early neonatal mortality rate (ENMR) is much lower than that of late NMR. The high level and slow decline in early NMR are also reflected in a high and stagnant perinatal mortality rate. The rate of decline in NMR, and to an extent ENMR, has accelerated with the introduction of National Rural Health Mission in mid-2005. Almost all states have witnessed this phenomenon, but there is still a huge disparity in NMR between and even within the states. The disparity is further compounded by rural-urban, poor-rich and gender differentials. There is an interplay of different demographic, educational, socioeconomic, biological and care-seeking factors, which are responsible for the differentials and the high burden of neonatal mortality. Addressing inequity in India is an important cross-cutting action that will reduce newborn mortality.

  8. State of newborn health in India

    PubMed Central

    Sankar, M J; Neogi, S B; Sharma, J; Chauhan, M; Srivastava, R; Prabhakar, P K; Khera, A; Kumar, R; Zodpey, S; Paul, V K

    2016-01-01

    About 0.75 million neonates die every year in India, the highest for any country in the world. The neonatal mortality rate (NMR) declined from 52 per 1000 live births in 1990 to 28 per 1000 live births in 2013, but the rate of decline has been slow and lags behind that of infant and under-five child mortality rates. The slower decline has led to increasing contribution of neonatal mortality to infant and under-five mortality. Among neonatal deaths, the rate of decline in early neonatal mortality rate (ENMR) is much lower than that of late NMR. The high level and slow decline in early NMR are also reflected in a high and stagnant perinatal mortality rate. The rate of decline in NMR, and to an extent ENMR, has accelerated with the introduction of National Rural Health Mission in mid-2005. Almost all states have witnessed this phenomenon, but there is still a huge disparity in NMR between and even within the states. The disparity is further compounded by rural–urban, poor–rich and gender differentials. There is an interplay of different demographic, educational, socioeconomic, biological and care-seeking factors, which are responsible for the differentials and the high burden of neonatal mortality. Addressing inequity in India is an important cross-cutting action that will reduce newborn mortality. PMID:27924104

  9. Progress in reducing premature deaths in Wisconsin counties, 2000-2010.

    PubMed

    Nonnweiler, Thomas; Pollock, Elizabeth A; Rudolph, Barbara; Remington, Patrick L

    2013-10-01

    Measuring trends in a county's premature death rate is a straightforward method that can be used to assess a county's progress in improving the health of the population. Age-adjusted premature death rate data from Wisconsin Interactive Statistics on Health for persons less than 75 years of age were collected for the years 2000-2010. Overall 10-year percent change was calculated, compared, and ranked for all Wisconsin counties during this time period. Progress was assessed as excellent (25.0% or greater decline), very good (20.0%-24.9% decline), good (10.0%-19.9% decline), fair (0.0%-9.9% decline), or poor (any increase). Overall, premature death rates in counties declined by 16.8% over the 10-year period 2000-2010 in Wisconsin. Trends varied by county, with 8, 15, 37, 9, and 3 counties having excellent, very good, good, fair, and poor progress, respectively. The most improvement was seen in Kewaunee County (decreasing 38.3%) and the least progress in Lafayette County (increasing 4.8%). Trends in premature death rates were not related to the county's initial death rate, population, rurality, or income. Although premature death rates declined overall in Wisconsin during the 2000s, this progress varied across counties and was not related to baseline mortality rates or other county characteristics.

  10. Correlating Cognitive Decline with White Matter Lesion and Brain Atrophy MRI Measurements in Alzheimer’s Disease

    PubMed Central

    Bilello, Michel; Doshi, Jimit; Nabavizadeh, S. Ali; Toledo, Jon B.; Erus, Guray; Xie, Sharon X.; Trojanowski, John Q.; Han, Xiaoyan; Davatzikos, Christos

    2015-01-01

    Background Vascular risk factors are increasingly recognized as risks factors for Alzheimer’s disease (AD) and early conversion from mild cognitive impairment (MCI) to dementia. While neuroimaging research in AD has focused on brain atrophy, metabolic function or amyloid deposition, little attention has been paid to the effect of cerebrovascular disease to cognitive decline. Objective To investigate the correlation of brain atrophy and white matter lesions with cognitive decline in AD, MCI, and control subjects. Methods Patients with AD and MCI, and healthy subjects were included in this study. Subjects had a baseline MRI scan, and baseline and follow-up neuropsychological battery (CERAD). Regional volumes were measured, and white matter lesion segmentation was performed. Correlations between rate of CERAD score decline and white matter lesion load and brain structure volume were evaluated. In addition, voxel-based correlations between baseline CERAD scores and atrophy and white matter lesion measures were computed. Results CERAD rate of decline was most significantly associated with lesion loads located in the fornices. Several temporal lobe ROI volumes were significantly associated with CERAD decline. Voxel-based analysis demonstrated strong correlation between baseline CERAD scores and atrophy measures in the anterior temporal lobes. Correlation of baseline CERAD scores with white matter lesion volumes achieved significance in multilobar subcortical white matter. Conclusion Both baseline and declines in CERAD scores correlate with white matter lesion load and gray matter atrophy. Results of this study highlight the dominant effect of volume loss, and underscore the importance of small vessel disease as a contributor to cognitive decline in the elderly. PMID:26402108

  11. Correlating Cognitive Decline with White Matter Lesion and Brain Atrophy Magnetic Resonance Imaging Measurements in Alzheimer's Disease.

    PubMed

    Bilello, Michel; Doshi, Jimit; Nabavizadeh, S Ali; Toledo, Jon B; Erus, Guray; Xie, Sharon X; Trojanowski, John Q; Han, Xiaoyan; Davatzikos, Christos

    2015-01-01

    Vascular risk factors are increasingly recognized as risks factors for Alzheimer's disease (AD) and early conversion from mild cognitive impairment (MCI) to dementia. While neuroimaging research in AD has focused on brain atrophy, metabolic function, or amyloid deposition, little attention has been paid to the effect of cerebrovascular disease to cognitive decline. To investigate the correlation of brain atrophy and white matter lesions with cognitive decline in AD, MCI, and control subjects. Patients with AD and MCI, and healthy subjects were included in this study. Subjects had a baseline MRI scan, and baseline and follow-up neuropsychological battery (CERAD). Regional volumes were measured, and white matter lesion segmentation was performed. Correlations between rate of CERAD score decline and white matter lesion load and brain structure volume were evaluated. In addition, voxel-based correlations between baseline CERAD scores and atrophy and white matter lesion measures were computed. CERAD rate of decline was most significantly associated with lesion loads located in the fornices. Several temporal lobe ROI volumes were significantly associated with CERAD decline. Voxel-based analysis demonstrated strong correlation between baseline CERAD scores and atrophy measures in the anterior temporal lobes. Correlation of baseline CERAD scores with white matter lesion volumes achieved significance in multilobar subcortical white matter. Both baseline and declines in CERAD scores correlate with white matter lesion load and gray matter atrophy. Results of this study highlight the dominant effect of volume loss, and underscore the importance of small vessel disease as a contributor to cognitive decline in the elderly.

  12. Value of FDG-PET scans of non-demented patients in predicting rates of future cognitive and functional decline.

    PubMed

    Torosyan, Nare; Mason, Kelsey; Dahlbom, Magnus; Silverman, Daniel H S

    2017-08-01

    The aim of this study was to examine the value of fluorodeoxyglucose (FDG) positron emission tomography (PET) in predicting subsequent rates of functional and cognitive decline among subjects considered cognitively normal (CN) or clinically diagnosed with mild cognitive impairment (MCI). Analyses of 276 subjects, 92 CN subjects and 184 with MCI, who were enrolled in the Alzheimer's Disease Neuroimaging Initiative, were conducted. Functional decline was assessed using scores on the Functional Activities Questionnaire (FAQ) obtained over a period of 36 months, while cognitive decline was determined using the Alzheimer's disease Assessment Scale-Cognitive subscale (ADAS-Cog) and Mini-Mental State Examination (MMSE) scores. PET images were analyzed using clinically routine brain quantification software. A dementia prognosis index (DPI), derived from a ratio of uptake values in regions of interest known to be hypometabolic in Alzheimer's disease to regions known to be stable, was generated for each baseline FDG-PET scan. The DPI was correlated with change in scores on the neuropsychological examinations to examine the predictive value of baseline FDG-PET. DPI powerfully predicted rate of functional decline among MCI patients (t = 5.75, p < 1.0E-8) and pooled N + MCI patient groups (t = 7.02, p < 1.0E-11). Rate of cognitive decline on MMSE was also predicted by the DPI among MCI (t = 6.96, p < 1.0E-10) and pooled N + MCI (t = 8.78, p < 5.0E-16). Rate of cognitive decline on ADAS-cog was powerfully predicted by the DPI alone among N (p < 0.001), MCI (t = 6.46, p < 1.0E-9) and for pooled N + MCI (t = 8.85, p = 1.1E-16). These findings suggest that an index, derivable from automated regional analysis of brain PET scans, can be used to help predict rates of functional and cognitive deterioration in the years following baseline PET.

  13. Trends in death rates among U.S. adults with and without diabetes between 1997 and 2006: findings from the National Health Interview Survey.

    PubMed

    Gregg, Edward W; Cheng, Yiling J; Saydah, Sharon; Cowie, Catherine; Garfield, Sanford; Geiss, Linda; Barker, Lawrence

    2012-06-01

    To determine whether all-cause and cardiovascular disease (CVD) death rates declined between 1997 and 2006, a period of continued advances in treatment approaches and risk factor control, among U.S. adults with and without diabetes. We compared 3-year death rates of four consecutive nationally representative samples (1997-1998, 1999-2000, 2001-2002, and 2003-2004) of U.S. adults aged 18 years and older using data from the National Health Interview Surveys linked to National Death Index. Among diabetic adults, the CVD death rate declined by 40% (95% CI 23-54) and all-cause mortality declined by 23% (10-35) between the earliest and latest samples. There was no difference in the rates of decline in mortality between diabetic men and women. The excess CVD mortality rate associated with diabetes (i.e., compared with nondiabetic adults) decreased by 60% (from 5.8 to 2.3 CVD deaths per 1,000) while the excess all-cause mortality rate declined by 44% (from 10.8 to 6.1 deaths per 1,000). Death rates among both U.S. men and women with diabetes declined substantially between 1997 and 2006, reducing the absolute difference between adults with and without diabetes. These encouraging findings, however, suggest that diabetes prevalence is likely to rise in the future if diabetes incidence is not curtailed.

  14. Temporal trends in obesity, osteoporosis treatment, bone mineral density, and fracture rates: a population-based historical cohort study.

    PubMed

    Leslie, William D; Lix, Lisa M; Yogendran, Marina S; Morin, Suzanne N; Metge, Colleen J; Majumdar, Sumit R

    2014-04-01

    Diverging international trends in fracture rates have been observed, with most reports showing that fracture rates have stabilized or decreased in North American and many European populations. We studied two complementary population-based historical cohorts from the Province of Manitoba, Canada (1996-2006) to determine whether declining osteoporotic fracture rates in Canada are attributable to trends in obesity, osteoporosis treatment, or bone mineral density (BMD). The Population Fracture Registry included women aged 50 years and older with major osteoporotic fractures, and was used to assess impact of changes in osteoporosis treatment. The BMD Registry included all women aged 50 years and older undergoing BMD tests, and was used to assess impact of changes in obesity and BMD. Model-based estimates of temporal changes in fracture rates (Fracture Registry) were calculated. Temporal changes in obesity and BMD and their association with fracture rates (BMD Registry) were estimated. In the Fracture Registry (n=27,341), fracture rates declined 1.6% per year (95% confidence interval [CI], 1.3% to 2.0%). Although osteoporosis treatment increased from 5.6% to 17.4%, the decline in fractures was independent of osteoporosis treatment. In the BMD Registry (n=36,587), obesity increased from 12.7% to 27.4%. Femoral neck BMD increased 0.52% per year and lumbar spine BMD increased 0.32% per year after covariate adjustment (p<0.001). Major osteoporotic fracture rates decreased in models that did not include femoral neck BMD (fully adjusted annual change -1.8%; 95% CI, -2.9 to -0.5), but adjusting for femoral neck BMD accounted for the observed reduction (annual change -0.5%; 95% CI, -1.8 to +1.0). In summary, major osteoporotic fracture rates declined substantially and linearly from 1996 to 2006, and this was explained by improvements in BMD rather than greater rates of obesity or osteoporosis treatment. © 2014 American Society for Bone and Mineral Research.

  15. Lung function decline rates according to GOLD group in patients with chronic obstructive pulmonary disease

    PubMed Central

    Kim, Joohae; Yoon, Ho Il; Oh, Yeon-Mok; Lim, Seong Yong; Lee, Ji-Hyun; Kim, Tae-Hyung; Lee, Sang Yeub; Lee, Jin Hwa; Lee, Sang-Do; Lee, Chang-Hoon

    2015-01-01

    Background Since the Global Initiative for Chronic Obstructive Lung Disease (GOLD) groups A–D were introduced, the lung function changes according to group have been evaluated rarely. Objective We investigated the rate of decline in annual lung function in patients categorized according to the 2014 GOLD guidelines. Methods Patients with COPD included in the Korean Obstructive Lung Disease (KOLD) prospective study, who underwent yearly postbronchodilator spirometry at least three times, were included. The main outcome was the annual decline in postbronchodilator forced expiratory volume in 1 second (FEV1), which was analyzed by random-slope and random-intercept mixed linear regression. Results A total 175 participants were included. No significant postbronchodilator FEV1 decline was observed between the groups (−34.4±7.9 [group A]; −26.2±9.4 [group B]; −22.7±16.0 [group C]; and −24.0±8.7 mL/year [group D]) (P=0.79). The group with less symptoms (−32.3±7.2 vs −25.0±6.5 mL/year) (P=0.44) and the low risk group (−31.0±6.1 vs −23.6±7.7 mL/year) (P=0.44) at baseline showed a more rapid decline in the postbronchodilator FEV1, but the trends were not statistically significant. However, GOLD stages classified by FEV1 were significantly related to the annual lung function decline. Conclusion There was no significant difference in lung function decline rates according to the GOLD groups. Prior classification using postbronchodilator FEV1 predicts decline in lung function better than does the new classification. PMID:26379432

  16. Prospective Study on the Impact of Fear of Falling on Functional Decline among Community Dwelling Elderly Women.

    PubMed

    Choi, Kyungwon; Jeon, Gyeong-Suk; Cho, Sung-Il

    2017-04-27

    Fear of falling (FOF) is expected to have effects on functional decline in the elderly. In this study, we examined over 2 years the effect of change in FOF on functional decline in community dwelling elderly. We conducted a secondary analysis using data from elderly women, 70 years of age and older, who participated in the Korean Longitudinal Study of Aging (KLoSA). Participants were divided into four categories according to change in FOF between the 2010 and 2012 surveys. Multiple logistic regression analysis was conducted regarding the effects of changes in FOF on functional decline after controlling for variables as known risk factors for functional decline. Rates of functional decline were highest in the "consistently having FOF" group, whereas they were lowest in the "consistently no FOF" group in both 2010 and 2012. Characteristics independently associated with functional decline were change in FOF, depressive symptoms, low frequency of meeting friends, and fear-induced activity avoidance. Longer exposure to FOF was associated with an increased risk of functional decline. FOF is an important health problem that deserves attention in its own right. Public health approaches for elderly persons should address early detection, prevention, and intervention programs for FOF.

  17. Declining Admission Rates And Thirty-Day Readmission Rates Positively Associated Even Though Patients Grew Sicker Over Time.

    PubMed

    Dharmarajan, Kumar; Qin, Li; Lin, Zhenqiu; Horwitz, Leora I; Ross, Joseph S; Drye, Elizabeth E; Keshawarz, Amena; Altaf, Faseeha; Normand, Sharon-Lise T; Krumholz, Harlan M; Bernheim, Susannah M

    2016-07-01

    Programs from the Centers for Medicare and Medicaid Services simultaneously promote strategies to lower hospital admissions and readmissions. However, there is concern that hospitals in communities that successfully reduce admissions may be penalized, as patients that are ultimately hospitalized may be sicker and at higher risk of readmission. We therefore examined the relationship between changes from 2010 to 2013 in admission rates and thirty-day readmission rates for elderly Medicare beneficiaries. We found that communities with the greatest decline in admission rates also had the greatest decline in thirty-day readmission rates, even though hospitalized patients did grow sicker as admission rates declined. The relationship between changing admission and readmission rates persisted in models that measured observed readmission rates, risk-standardized readmission rates, and the combined rate of readmission and death. Our findings suggest that communities can reduce admission rates and readmission rates in parallel, and that federal policy incentivizing reductions in both outcomes does not create contradictory incentives. Project HOPE—The People-to-People Health Foundation, Inc.

  18. Systemic Regulation of the Age-Related Decline of Pancreatic β-Cell Replication

    PubMed Central

    Salpeter, Seth J.; Khalaileh, Abed; Weinberg-Corem, Noa; Ziv, Oren; Glaser, Benjamin; Dor, Yuval

    2013-01-01

    The frequency of pancreatic β-cell replication declines dramatically with age, potentially contributing to the increased risk of type 2 diabetes in old age. Previous studies have shown the involvement of cell-autonomous factors in this phenomenon, particularly the decline of polycomb genes and accumulation of p16/INK4A. Here, we demonstrate that a systemic factor found in the circulation of young mice is able to increase the proliferation rate of old pancreatic β-cells. Old mice parabiosed to young mice have increased β-cell replication compared with unjoined old mice or old mice parabiosed to old mice. In addition, we demonstrate that old β-cells transplanted into young recipients have increased replication rate compared with cells transplanted into old recipients; conversely, young β-cells transplanted into old mice decrease their replication rate compared with young cells transplanted into young recipients. The expression of p16/INK4A mRNA did not change in heterochronic parabiosis, suggesting the involvement of other pathways. We conclude that systemic factors contribute to the replicative decline of old pancreatic β-cells. PMID:23630298

  19. Insulin-like Growth Factor 1 (IGF-1) as a marker of cognitive decline in normal ageing: A review.

    PubMed

    Frater, Julanne; Lie, David; Bartlett, Perry; McGrath, John J

    2018-03-01

    Insulin-like Growth Factor 1 (IGF-1) and its signaling pathway play a primary role in normal growth and ageing, however serum IGF-1 is known to reduce with advancing age. Recent findings suggest IGF-1 is essential for neurogenesis in the adult brain, and this reduction of IGF-1 with ageing may contribute to age-related cognitive decline. Experimental studies have shown manipulation of the GH/GF-1 axis can slow rates of cognitive decline in animals, making IGF-1 a potential biomarker of cognition, and/or its signaling pathway a possible therapeutic target to prevent or slow age-related cognitive decline. A systematic literature review and qualitative narrative summary of current evidence for IGF-1 as a biomarker of cognitive decline in the ageing brain was undertaken. Results indicate IGF-1 concentrations do not confer additional diagnostic information for those with cognitive decline, and routine clinical measurement of IGF-1 is not currently justified. In cases of established cognitive impairment, it remains unclear whether increasing circulating or brain IGF-1 may reverse or slow down the rate of further decline. Advances in neuroimaging, genetics, neuroscience and the availability of large well characterized biobanks will facilitate research exploring the role of IGF-1 in both normal ageing and age-related cognitive decline. Copyright © 2017 Elsevier B.V. All rights reserved.

  20. Translations on Eastern Europe. Political, Sociological, and Military Affairs, No. 1406

    DTIC Science & Technology

    1977-06-27

    of our century, Bulgaria was a country with one of the highest birth rates in the world. It reached h2.k live-born children per 1,000 of the...fecundity (fertility) of the Bulgarian women. As a result of this, the birth rate in Bulgaria has declined from 30.1 live-born children per 1,000 persons...development of the Bulgarian population. The study has shown that the average number of live-born children during the 1965-1975 period declined from

  1. Recent trend in family households in Beijing.

    PubMed

    Guo, Z; Guo, L

    1997-01-01

    This study examined trends in household size and age structure in Beijing, China, in 1995. Data were reliably obtained from the 1% sample survey of China. Findings indicate that the average size of a family household was 3.15 persons, that is, 0.050 persons fewer than the 3.20 from the 1990 Census. Children aged 0-14 years in each household averaged 0.04 fewer children during 1990-95. 80% of the decline in household size was due to decreases in the number of children. The percentage of single-family and single-person households declined. Three-person households were the only size group that increased (23.2-40.7%). The household headship (HH) rate for males increased dramatically between the ages of 20 and 30 years and stabilized after 35 years. The HH rate for women grew slowly and continuously until age 50 years and then stabilized. The gender gap in HH appeared at an early age and remained thereafter. The HH rate declined at older ages. The HH rate in Beijing, compared to the national rate, suggests relative gender equity in Beijing. As a child ages, the percentage of three-generation households declines and the percentage of two-generation households rises. As a child becomes an adult, the percentages of single-person households and single-couple households increase. Single-couple households decreased among the middle-aged. 67.4% of the elderly lived in two- or three-generation households. 31.4% of elderly lived in single-person/couple households. The percentage of elderly living with their children declined by 2 points during 1990-95.

  2. Getting a piece of the pie? The economic boom of the 1990s and declining teen birth rates in the United States.

    PubMed

    Colen, Cynthia G; Geronimus, Arline T; Phipps, Maureen G

    2006-09-01

    In the United States, the 1990s was a decade of dramatic economic growth as well as a period characterized by substantial declines in teenage childbearing. This study examines whether falling teen fertility rates during the 1990s were responsive to expanding employment opportunities and whether the implementation of the Personal Responsibility and Work Opportunities Act (PRWORA), increasing rates of incarceration, or restrictive abortion policies may have affected this association. Fixed-effects Poisson regression models were estimated to assess the relationship between age-specific birth rates and state-specific unemployment rates from 1990 to 1999 for Black and White females aged 10-29. Falling unemployment rates in the 1990s were associated with decreased childbearing among African-American women aged 15-24, but were largely unrelated to declines in fertility for Whites. For 18-19 year-old African-Americans, the group for whom teen childbearing is most normative, our model accounted for 85% of the decrease in rates of first births. Young Black women, especially older teens, may have adjusted their reproductive behavior to take advantage of expanded labor market opportunities.

  3. Normal rates of cognitive change in successful aging: the freedom house study.

    PubMed

    Royall, Donald R; Palmer, Raymond; Chiodo, Laura K; Polk, Marsha J

    2005-11-01

    We determined the rates of cognitive change associated with twenty individual measures. Participants included 547 noninstitutionalized septuagenarians and octogenarian residents of a comprehensive care retirement community who were studied over three years. Latent growth curves (LGC) of multiple cognitive measures were compared to a LGC model of the rates of change in Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL). All curves were standardized relative to each variable's baseline distribution. Baseline scores were within their expected normal age-specific ranges. Most measures showed significant rates of change over time. There was also significant variability about those rates, suggesting clinical heterogeneity. Many deteriorated over time, as did ADLs and IADLs. However, performance on some measures improved, consistent with learning effects. The rates of change in two measures, the Executive Interview and the Trail Making Test, were closely related to decline in IADLs. These results suggest that age-related cognitive decline is a dynamic longitudinal process affecting multiple cognitive domains. Heterogeneity in the rates of cognitive change may reflect the summed effects of age and comorbid conditions affecting cognition. Some measures may be ill-suited for measuring age-related changes in cognition, either because they are insensitive to change, or hindered by learning effects. Nonverbal measures appear to be particularly well suited for the prediction of age-related functional decline. These observations are relevant to the definition and diagnosis of "dementing" conditions.

  4. Preservation of cognitive and functional ability as markers of longevity.

    PubMed

    Schupf, Nicole; Costa, Rosann; Tang, Ming-Xin; Andrews, Howard; Tycko, Benjamin; Lee, Joseph H; Mayeux, Richard

    2004-10-01

    Longevity is a complex biological process for which the phenotypes have not been established. Preservation of cognitive and physical function may be important and preservation of these functions is, in part, inherited. We investigated the relation between rate of change in cognitive and functional abilities in probands and risk of death in their siblings. Probands were classified as showing no decline, slow, medium, or rapid rate of decline, based on the slope of change in cognitive and physical/functional factors over three or more assessments. Siblings of probands who did not decline on measures of memory, visuospatial/cognitive function or ADL skills were approximately half as likely to die as siblings of probands who had the most rapid decline. The reduction in risk of death in siblings of probands who did not decline in was primarily observed among siblings of probands who were older than 75 years, suggesting that genetic influences on life span may be greater at older ages. There was no association between probands' rate of change in language, IADL skills, upper or lower extremity mobility and risk of death in siblings. The results of the present study identify phenotypes associated with preserved cognitive and functional abilities which may serve as markers for longevity.

  5. Age-related decline in verbal learning is moderated by demographic factors, working memory capacity, and presence of amnestic mild cognitive impairment.

    PubMed

    Constantinidou, Fofi; Zaganas, Ioannis; Papastefanakis, Emmanouil; Kasselimis, Dimitrios; Nidos, Andreas; Simos, Panagiotis G

    2014-09-01

    Age-related memory changes are highly varied and heterogeneous. The study examined the rate of decline in verbal episodic memory as a function of education level, auditory attention span and verbal working memory capacity, and diagnosis of amnestic mild cognitive impairment (a-MCI). Data were available on a community sample of 653 adults aged 17-86 years and 70 patients with a-MCI recruited from eight broad geographic areas in Greece and Cyprus. Measures of auditory attention span and working memory capacity (digits forward and backward) and verbal episodic memory (Auditory Verbal Learning Test [AVLT]) were used. Moderated mediation regressions on data from the community sample did not reveal significant effects of education level on the rate of age-related decline in AVLT indices. The presence of a-MCI was a significant moderator of the direct effect of Age on both immediate and delayed episodic memory indices. The rate of age-related decline in verbal episodic memory is normally mediated by working memory capacity. Moreover, in persons who display poor episodic memory capacity (a-MCI group), age-related memory decline is expected to advance more rapidly for those who also display relatively poor verbal working memory capacity.

  6. Muscle fatigue during intermittent exercise in individuals with mental retardation.

    PubMed

    Zafeiridis, Andreas; Giagazoglou, Paraskevi; Dipla, Konstantina; Salonikidis, Konstantinos; Karra, Chrisanthi; Kellis, Eleftherios

    2010-01-01

    This study examined fatigue profile during intermittent exercise in 10 men with mild to moderate mental retardation (MR) and 10 men without mental retardation (C). They performed 4 x 30s maximal knee extensions and flexions with 1-min rest on an isokinetic dynamometer. Peak torque of flexors (PTFL) and extensors (PTEX), total work (TW), and lactate were measured. Fatigue was calculated as the magnitude of decline (%) in PTFL, PTEX, and TW and as rate of decline (linear slope) in TW from 1st to 4th set. MR had lower PTFL, PTEX, TW, and lactate throughout the protocol than C, while pre-motor time was greater in MR vs. C (p<0.05). MR demonstrated a delayed pattern of reduction in muscular performance. Lower values were observed in MR vs. C in the magnitude of decline for PTEX and TW and the rate of decline for TW. In conclusion, MR exhibit a different fatigue profile during intermittent exercise than C. The lower magnitude and decline rate in neuromuscular performance in MR during intermittent exercise is associated with their lower peak strength, short-term anaerobic capacity, and lactate accumulation. Rehabilitation and sport professionals should consider the differences in fatigue profile when designing intermittent exercise programs for MR. Copyright 2009 Elsevier Ltd. All rights reserved.

  7. Change in motor function and adverse health outcomes in older African-Americans.

    PubMed

    Buchman, Aron S; Wilson, Robert S; Leurgans, Sue E; Bennett, David A; Barnes, Lisa L

    2015-10-01

    We tested whether declining motor function accelerates with age in older African-Americans. Eleven motor performances were assessed annually in 513 older African-Americans. During follow-up of 5 years, linear mixed-effect models showed that motor function declined by about 0.03 units/year (Estimate, -0.026, p<0.001); about 4% more rapidly for each additional year of age at baseline. A proportional hazard model showed that both baseline motor function level and its rate of change were independent predictors of death and incident disability (all p's<0.001). These models showed that the additional annual amount of motor decline in 85 year old persons at baseline versus 65 year old persons was associated with a 1.5-fold higher rate of death and a 3-fold higher rate of developing Katz disability. The rate of declining motor function accelerates with increasing age and its rate of decline predicts adverse health outcomes in older African-Americans. Copyright © 2015 Elsevier Inc. All rights reserved.

  8. Change in Motor Function and Adverse Health Outcomes in Older African Americas

    PubMed Central

    Buchman, Aron S.; Wilson, Robert S.; Leurgans, Sue E.; Bennett, David A.; Barnes, Lisa L.

    2015-01-01

    Objective We tested whether declining motor function accelerates with age in older African Americans. Methods Eleven motor performances were assessed annually in 513 older African Americans. Results During follow-up of 5 years, linear mixed-effect models showed that motor function declined by about 0.03 units/yr (Estimate, −0.026, p<0.001); about 4% more rapidly for each additional year of age at baseline. A proportional hazard model showed that both baseline motor function level and its rate of change were independent predictors of death and incident disability (all p’s <0.001). These models showed that the additional annual amount of motor decline in 85 year old persons at baseline versus 65 year old persons was associated with a 1.5-fold higher rate of death and a 3-fold higher rate of developing Katz disability. Conclusions The rate of declining motor function accelerates with increasing age and its rate of decline predicts adverse health outcomes in older African Americans. PMID:26209439

  9. Computerized measures of finger tapping: effects of hand dominance, age, and sex.

    PubMed

    Hubel, Kerry A; Reed, Bruce; Yund, E William; Herron, Timothy J; Woods, David L

    2013-06-01

    Computerized measures of digit tapping rate were obtained over 3 successive, 10-sec. periods in the right and left index fingers, from a community sample of 1,519 participants (ages 18 to 65 years; 607 men, 912 women). Differences between the dominant and non-dominant hands were found for tapping rate, movement initiation, and button down times, and the decline in tapping rate over the successive, 10-sec. periods. Declines were found in tapping rate in older participants in association with increased intertap variability. Men had higher tapping rates than women in all age ranges. The computerized finger tapping test is an efficient and precise measure of tapping speed and kinetics of potential utility in research and clinical studies of motor performance.

  10. Suicide trends in Singapore: 1955-2004.

    PubMed

    Chia, Boon-Hock; Chia, Audrey; Yee, Ng Wai; Choo, Tai Bee

    2010-01-01

    The objective of this study was to investigate suicide trends in Singapore between 1955 and 2004. Suicide cases were identified from the Registry of Birth and Death, Singapore, and analyzed using Poisson regression. Overall, suicide rates in Singapore remained stable between 9.8-13.0/100,000 over the last 5 decades. Rates remain highest in elderly males, despite declines among the elderly and middle-aged males in recent years. Rates in ethnic Chinese and Indians were consistently higher than in Malays. While the rates among female Indians and Chinese have declined significantly between 1995 and 2004, some increase was noted in female Malays. Although there was no increase in overall suicide rates, risk within certain population segments has changed over time.

  11. The equalisation hypothesis and changes in geographical inequalities of age based mortality in England, 2002-2004 to 2008-2010.

    PubMed

    Green, Mark A

    2013-06-01

    The equalisation hypothesis argues that during adolescence and early adulthood, inequality in mortality declines and begins to even out. However the evidence for this phenomenon is contested and mainly based on old data. This study proposes to examine how age-specific inequalities in mortality rates have changed over the past decade, during a time of widening health inequalities. To test this, mortality rates were calculated for deprivation quintiles in England, split by individual ages and sex for three time periods (2002-2004, 2005-2007 and 2008-2010). The results showed evidence for equalisation, with a clear decline in the ratio of mortality rates during late adolescence. However this decline was not accounted for by traditional explanations of the hypothesis. Overall, geographical inequalities were shown to be widening for the majority of ages, although there was some narrowing of patterns observed. Copyright © 2013 Elsevier Ltd. All rights reserved.

  12. Cognitive Decline in a Colombian Kindred With Autosomal Dominant Alzheimer Disease

    PubMed Central

    Aguirre-Acevedo, Daniel C.; Lopera, Francisco; Henao, Eliana; Tirado, Victoria; Muñoz, Claudia; Giraldo, Margarita; Bangdiwala, Shrikant I.; Reiman, Eric M.; Tariot, Pierre N.; Langbaum, Jessica B.; Quiroz, Yakeel T.; Jaimes, Fabian

    2017-01-01

    IMPORTANCE Data from an autosomal dominant Alzheimer disease (ADAD) kindred were used to track the longitudinal trajectory of cognitive decline associated with preclinical ADAD and explore factors that may modify the rate of cognitive decline. OBJECTIVES To evaluate the onset and rate of cognitive decline during preclinical ADAD and the effect of socioeconomic, vascular, and genetic factors on the cognitive decline. DESIGN, SETTING, AND PARTICIPANTS We performed a retrospective cohort study from January 1, 1995, through June 31, 2012, of individuals from Antioquia, Colombia, who tested positive for the ADAD-associated PSEN1 E280A mutation. Data analysis was performed from August 20, 2014, through November 30, 2015. A mixed-effects model was used to estimate annual rates of change in cognitive test scores and to mark the onset of cognitive decline. MAIN OUTCOMES AND MEASURES Memory, language, praxis, and total scores from the Consortium to Establish a Registry for Alzheimer Disease test battery. Chronologic age was used as a time scale in the models. We explore the effects of sex; educational level; socioeconomic status; residence area; occupation type; marital status; history of hypertension, diabetes mellitus, and dyslipidemia; tobacco and alcohol use; and APOE ε4 on the rates of cognitive decline. RESULTS A total of 493 carriers met the inclusion criteria and were analyzed. A total of 256 carriers had 2 or more assessments. At the time of the initial assessment, participants had a mean (SD) age of 33.4 (11.7) years and a mean (SD) educational level of 7.2 (4.2) years. They were predominantly female (270 [54.8%]), married (293 [59.4%]), and of low socioeconomic status (322 [65.3%]). Word list recall scores provided the earliest indicator of preclinical cognitive decline at 32 years of age, 12 and 17 years before the kindred’s respective median ages at mild cognitive impairment and dementia onset. After the change point, carriers had a statistically significant cognitive decline with a loss of 0.24 (95% CI, −0.26 to −0.22) points per year for the word list recall test and 2.13 (95% CI, −2.29 to −1.96) points per year for total scores. Carriers with high educational levels had an increase of approximately 36% in the rate of cognitive decline after the change point when compared with those with low educational levels (−2.89 vs −2.13 points per year, respectively). Onset of cognitive decline was delayed by 3 years in individuals with higher educational levels compared with those with lower educational levels. Those with higher educational level, middle/high socioeconomic status, history of diabetes and hypertension, and tobacco and alcohol use had a steeper cognitive decline after onset. CONCLUSIONS AND RELEVANCE Preclinical cognitive decline was evident in PSEN1 E280A mutation carriers 12 years before the onset of clinical impairment. Educational level may be a protective factor against the onset of cognitive impairment. PMID:26902171

  13. Presentations to Alberta emergency departments for asthma: a time series analysis.

    PubMed

    Rosychuk, Rhonda J; Youngson, Erik; Rowe, Brian H

    2015-08-01

    Asthma is a common chronic respiratory condition, and exacerbations may cause individuals to seek care in emergency departments (EDs). This study examines the monthly patterns of asthma presentations to EDs in Alberta, Canada. All presentations to the ED for asthma from April 1999 to March 2011 were extracted from provincial administrative health databases. Data included age, sex, and health zone of residence. Crude rates per 100,000 population were calculated. Seasonal autoregressive integrated moving average (SARIMA) time-series models were developed. There were a total of 362,430 ED presentations for asthma, and the monthly rate of presentation declined from 115.5 to 41.6 per 100,000 during the study period. Males made 50.1% of ED presentations, and adults made 52.8%. The absolute number of ED presentations for asthma declined in each of the five administrative health zones in the province, with smaller percentage decreases seen in the most urbanized zones (32.1%) than the other zones (46.9%). One SARIMA model closely predicted overall presentation rates as well as the rates of ED presentations for age and zone subgroups. These models showed strong seasonal components, with the strongest estimates occurring for the pediatric subgroup and the southernmost provincial zone. Rates of ED presentations for asthma have been declining in this province during the past decade. The reasons for this decline warrant further exploration. The SARIMA models quantified the temporal patterns and may be helpful for planning research and health care service needs. © 2015 by the Society for Academic Emergency Medicine.

  14. Association of serum albumin levels with kidney function decline and incident chronic kidney disease in elders.

    PubMed

    Lang, Joshua; Katz, Ronit; Ix, Joachim H; Gutierrez, Orlando M; Peralta, Carmen A; Parikh, Chirag R; Satterfield, Suzanne; Petrovic, Snezana; Devarajan, Prasad; Bennett, Michael; Fried, Linda F; Cummings, Steven R; Sarnak, Mark J; Shlipak, Michael G

    2018-06-01

    Previous studies in HIV-infected individuals have demonstrated serum albumin to be strongly associated with kidney function decline, independent of urine albumin and inflammatory markers. Lower serum albumin concentrations may be an under-appreciated risk factor for kidney function decline in elders. We performed a cohort analysis in the Health Aging and Body Composition Study, a cohort of well-functioning, bi-racial, community-dwelling elders between the age of 70 and 79 years. We examined the associations of serum albumin concentration with longitudinal kidney function decline by estimated glomerular filtration rate (eGFR). Outcomes included linear eGFR decline, rapid kidney function decline defined as >30% decrease in eGFR, defined as a final eGFR <60 mL/min/1.73 m2 in those with an eGFR >60 mL/min/1.73 m2 at baseline. Cystatin C-based eGFR was calculated at baseline, Year 3 and Year 10. Mean age was 74 years, and mean eGFR was 73 mL/min/1.73 m2 at baseline. The mean rate of eGFR change was 1.81 mL/min/1.73 m2 per year. After multivariate adjustment, lower serum albumin concentrations were strongly and independently associated with kidney function decline (-0.11 mL/min/1.73 m2 per year for each standard deviation decrease serum albumin; -0.01 to - 0.20) with no attenuation after adjustment for urine albumin and inflammatory markers (-0.12, -0.03 to - 0.22). When divided into quartiles, serum albumin levels ≤3.80 g/dL were associated with increased odds of rapid kidney function decline (odds ratio 1.59; 1.12-2.26) and increased risk of incident chronic kidney disease (incident rate ratio 1.29; 1.03-1.62) relative to levels >4.21g/dL. Urine albumin to creatinine ratio (ACR) was also significantly and independently associated with kidney function decline (-0.08 mL/min/1.73 m2 per year for urine ACR >30 mg/g; -0.82 to - 0.13). Lower serum albumin levels are strongly and independently associated with kidney function decline in elders, independent of clinical risk factors, urine albumin and measured inflammatory markers.

  15. Long-term growth decline in Toona ciliata in a moist tropical forest in Bangladesh: Impact of global warming

    NASA Astrophysics Data System (ADS)

    Rahman, Mizanur; Islam, Rofiqul; Islam, Mahmuda

    2017-04-01

    Tropical forests are carbon rich ecosystems and small changes in tropical forest tree growth substantially influence the global carbon cycle. Forest monitoring studies report inconsistent growth changes in tropical forest trees over the past decades. Most of the studies highlighted changes in the forest level carbon gain, neglecting the species-specific growth changes which ultimately determine community-level responses. Tree-ring analysis can provide historical data on species-specific tree growth with annual resolution. Such studies are inadequate in Bangladesh, which is one of the most climate sensitive regions in the tropics. In this study, we investigated long-term growth rates of Toona ciliata in a moist tropical forest of Bangladesh by using tree-ring analysis. We sampled 50 trees of varying size, obtained increment cores from these trees and measured tree-ring width. Analyses of growth patterns revealed size-dependent growth increments. After correcting for the effect of tree size on tree growth (ontogenetic changes) by two different methods we found declining growth rates in T. ciliata from 1960 to 2013. Standardized ring-width index (RWI) was strongly negatively correlated with annual mean and maximum temperatures suggesting that rising temperature might cause the observed growth decline in T. ciliata. Assuming that global temperatures will rise at the current rate, the observed growth decline is assumed to continue. The analysis of stable carbon and oxygen isotopes may reveal more insight on the physiological response of this species to future climatic changes.

  16. The Effect of Alcohol and Road Traffic Policies on Crash Rates in Botswana, 2004–2011: A Time-Series Analysis

    PubMed Central

    Sebego, Miriam; Naumann, Rebecca B.; Rudd, Rose A.; Voetsch, Karen; Dellinger, Ann M.; Ndlovu, Christopher

    2015-01-01

    In Botswana, increased development and motorization have brought increased road traffic-related death rates. Between 1981 and 2001, the road traffic-related death rate in Botswana more than tripled. The country has taken several steps over the last several years to address the growing burden of road traffic crashes and particularly to address the burden of alcohol-related crashes. This study examines the impact of the implementation of alcohol and road safety-related policies on crash rates, including overall crash rates, fatal crash rates, and single-vehicle nighttime fatal (SVNF) crash rates, in Botswana from 2004 to 2011. The overall crash rate declined significantly in June 2009 and June 2010, such that the overall crash rate from June 2010 to December 2011 was 22% lower than the overall crash rate from January 2004 to May 2009. Additionally, there were significant declines in average fatal crash and SVNF crash rates in early 2010. Botswana’s recent crash rate reductions occurred during a time when aggressive policies and other activities (e.g., education, enforcement) were implemented to reduce alcohol consumption and improve road safety. While it is unclear which of the policies or activities contributed to these declines and to what extent, these reductions are likely the result of several, combined efforts. PMID:24686164

  17. The impact of alcohol and road traffic policies on crash rates in Botswana, 2004-2011: a time-series analysis.

    PubMed

    Sebego, Miriam; Naumann, Rebecca B; Rudd, Rose A; Voetsch, Karen; Dellinger, Ann M; Ndlovu, Christopher

    2014-09-01

    In Botswana, increased development and motorization have brought increased road traffic-related death rates. Between 1981 and 2001, the road traffic-related death rate in Botswana more than tripled. The country has taken several steps over the last several years to address the growing burden of road traffic crashes and particularly to address the burden of alcohol-related crashes. This study examines the impact of the implementation of alcohol and road safety-related policies on crash rates, including overall crash rates, fatal crash rates, and single-vehicle nighttime fatal (SVNF) crash rates, in Botswana from 2004 to 2011. The overall crash rate declined significantly in June 2009 and June 2010, such that the overall crash rate from June 2010 to December 2011 was 22% lower than the overall crash rate from January 2004 to May 2009. Additionally, there were significant declines in average fatal crash and SVNF crash rates in early 2010. Botswana's recent crash rate reductions occurred during a time when aggressive policies and other activities (e.g., education, enforcement) were implemented to reduce alcohol consumption and improve road safety. While it is unclear which of the policies or activities contributed to these declines and to what extent, these reductions are likely the result of several, combined efforts. Copyright © 2014 Elsevier Ltd. All rights reserved.

  18. NEA Report: Reading at Risk

    ERIC Educational Resources Information Center

    Arts Education Policy Review, 2004

    2004-01-01

    Literary reading is in dramatic decline, with fewer than half of American adults now reading literature, according to a July 2004 report by the National Endowment for the Arts (NEA). The survey "Reading at Risk: A Survey of Literary Reading in America" reports drops in all groups studied, with the steepest rate of decline--28…

  19. Texas Public School Attrition Study, 2011-12. IDRA Report

    ERIC Educational Resources Information Center

    Johnson, Roy L.; Montes, Felix

    2012-01-01

    This document contains 3 statistical reports. The first report, "Attrition Rate Decline Seems Promising--Though High Schools are Still Losing One in Four Students" (by Roy L. Johnson), presents results of long-term trend assessments of attrition data in Texas public high schools. The second report, "Slow Declining Pace Keeps Zero…

  20. Longitudinal Pulmonary Function in Newly Hired, Non-World Trade Center-Exposed Fire Department City of New York Firefighters

    PubMed Central

    Ye, Fen; Hall, Charles B.; Webber, Mayris P.; Cohen, Hillel W.; Dinkels, Michael; Cosenza, Kaitlyn; Weiden, Michael D.; Nolan, Anna; Christodoulou, Vasilios; Kelly, Kerry J.; Prezant, David J.

    2013-01-01

    Background: Few longitudinal studies characterize firefighters’ pulmonary function. We sought to determine whether firefighters have excessive FEV1 decline rates compared with control subjects. Methods: We examined serial measurements of FEV1 from about 6 months prehire to about 5 years posthire in newly hired male, never smoking, non-Hispanic black and white firefighters, hired between 2003 and 2006, without prior respiratory disease or World Trade Center exposure. Similarly defined Emergency Medical Service (EMS) workers served as control subjects. Results: Through June 30, 2011, 940 firefighters (82%) and 97 EMS workers (72%) who met study criteria had four or more acceptable posthire spirometries. Prehire FEV1% averaged higher for firefighters than EMS workers (99% vs 95%), reflecting more stringent job entry criteria. FEV1 (adjusted for baseline age and height) declined by an average of 45 mL/y both for firefighters and EMS workers, with Fire − EMS decline rate differences averaging 0.2 mL/y (CI, −9.2 to 9.6). Four percent of each group had FEV1 less than the lower limit of normal before hire, increasing to 7% for firefighters and 17.5% for EMS workers, but similar percentages of both groups had adjusted FEV1 decline rates ≥ 10%. Mixed effects modeling showed a significant influence of weight gain but not baseline weight: FEV1 declined by about 8 mL/kg gained for both groups. Adjusting for weight change, FEV1 decline averaged 38 mL/y for firefighters and 34 mL/y for EMS workers. Conclusions: During the first 5 years of duty, firefighters do not show greater longitudinal FEV1 decline than EMS control subjects, and fewer of them develop abnormal lung function. Weight gain is associated with a small loss of lung function, of questionable clinical relevance in this fit and active population. PMID:23188136

  1. Marked Decline in Malaria Prevalence among Pregnant Women and Their Offspring from 1996 to 2010 on the South Kenyan Coast

    PubMed Central

    Kalayjian, Benjamin C.; Malhotra, Indu; Mungai, Peter; Holding, Penny; King, Christopher L.

    2013-01-01

    Expanded malaria control in Kenya since the early 2000s has resulted in marked reduction in hospital admissions for malaria; however, no studies have reported changes in malaria infection rates in the same population over this period. Randomly selected archived blood samples from four cohorts of pregnant women and their children from 1996 to 2010 in Kwale District, Coast Province, Kenya, were examined for Plasmodium falciparum (Pf), P. malariae, P. ovale, and Plasmodium vivax by quantitative polymerase chain reaction (PCR) and microscopy. Maternal delivery Pf prevalence by PCR declined from 40% in 2000–2005 to 1% in 2009–2010, concordant with increased bed net and malaria chemoprophylaxis use. Individual risk of Pf infection in children from birth to 3 years in serial longitudinal cohort studies declined from almost 100% in 1996–1999 to 15% in 2006–2010. Declines in P. malariae and P. ovale infections rates were also observed. These results show a profound reduction in malaria transmission in coastal Kenya. PMID:24080635

  2. NFE2L2 pathway polymorphisms and lung function decline in chronic obstructive pulmonary disease

    PubMed Central

    Malhotra, Deepti; Boezen, H. Marike; Siedlinski, Mateusz; Postma, Dirkje S.; Wong, Vivien; Akhabir, Loubna; He, Jian-Qing; Connett, John E.; Anthonisen, Nicholas R.; Paré, Peter D.; Biswal, Shyam

    2012-01-01

    An oxidant-antioxidant imbalance in the lung contributes to the development of chronic obstructive pulmonary disease (COPD) that is caused by a complex interaction of genetic and environmental risk factors. Nuclear erythroid 2-related factor 2 (NFE2L2 or NRF2) is a critical molecule in the lung's defense mechanism against oxidants. We investigated whether polymorphisms in the NFE2L2 pathway affected the rate of decline of lung function in smokers from the Lung Health Study (LHS)(n = 547) and in a replication set, the Vlagtwedde-Vlaardingen cohort (n = 533). We selected polymorphisms in NFE2L2 in genes that positively or negatively regulate NFE2L2 transcriptional activity and in genes that are regulated by NFE2L2. Polymorphisms in 11 genes were significantly associated with rate of lung function decline in the LHS. One of these polymorphisms, rs11085735 in the KEAP1 gene, was previously shown to be associated with the level of lung function in the Vlagtwedde-Vlaardingen cohort but not with decline of lung function. Of the 23 associated polymorphisms in the LHS, only rs634534 in the FOSL1 gene showed a significant association in the Vlagtwedde-Vlaardingen cohort with rate of lung function decline, but the direction of the association was not consistent with that in the LHS. In summary, despite finding several nominally significant polymorphisms in the LHS, none of these associations were replicated in the Vlagtwedde-Vlaardingen cohort, indicating lack of effect of polymorphisms in the NFE2L2 pathway on the rate of decline of lung function. PMID:22693272

  3. NFE2L2 pathway polymorphisms and lung function decline in chronic obstructive pulmonary disease.

    PubMed

    Sandford, Andrew J; Malhotra, Deepti; Boezen, H Marike; Siedlinski, Mateusz; Postma, Dirkje S; Wong, Vivien; Akhabir, Loubna; He, Jian-Qing; Connett, John E; Anthonisen, Nicholas R; Paré, Peter D; Biswal, Shyam

    2012-08-01

    An oxidant-antioxidant imbalance in the lung contributes to the development of chronic obstructive pulmonary disease (COPD) that is caused by a complex interaction of genetic and environmental risk factors. Nuclear erythroid 2-related factor 2 (NFE2L2 or NRF2) is a critical molecule in the lung's defense mechanism against oxidants. We investigated whether polymorphisms in the NFE2L2 pathway affected the rate of decline of lung function in smokers from the Lung Health Study (LHS)(n = 547) and in a replication set, the Vlagtwedde-Vlaardingen cohort (n = 533). We selected polymorphisms in NFE2L2 in genes that positively or negatively regulate NFE2L2 transcriptional activity and in genes that are regulated by NFE2L2. Polymorphisms in 11 genes were significantly associated with rate of lung function decline in the LHS. One of these polymorphisms, rs11085735 in the KEAP1 gene, was previously shown to be associated with the level of lung function in the Vlagtwedde-Vlaardingen cohort but not with decline of lung function. Of the 23 associated polymorphisms in the LHS, only rs634534 in the FOSL1 gene showed a significant association in the Vlagtwedde-Vlaardingen cohort with rate of lung function decline, but the direction of the association was not consistent with that in the LHS. In summary, despite finding several nominally significant polymorphisms in the LHS, none of these associations were replicated in the Vlagtwedde-Vlaardingen cohort, indicating lack of effect of polymorphisms in the NFE2L2 pathway on the rate of decline of lung function.

  4. Decline of kidney function during the pre-dialysis period in chronic kidney disease patients: a systematic review and meta-analysis.

    PubMed

    Janmaat, Cynthia J; van Diepen, Merel; van Hagen, Cheyenne Ce; Rotmans, Joris I; Dekker, Friedo W; Dekkers, Olaf M

    2018-01-01

    Substantial heterogeneity exists in reported kidney function decline in pre-dialysis chronic kidney disease (CKD). By design, kidney function decline can be studied in CKD 3-5 cohorts or dialysis-based studies. In the latter, patients are selected based on the fact that they initiated dialysis, possibly leading to an overestimation of the true underlying kidney function decline in the pre-dialysis period. We performed a systematic review and meta-analysis to compare the kidney function decline during pre-dialysis in CKD stage 3-5 patients, in these two different study types. We searched PubMed, EMBASE, Web of Science and Cochrane to identify eligible studies reporting an estimated glomerular filtration rate (eGFR) decline (mL/min/1.73 m 2 ) in adult pre-dialysis CKD patients. Random-effects meta-analysis was performed to obtain weighted mean annual eGFR decline. We included 60 studies (43 CKD 3-5 cohorts and 17 dialysis-based studies). The meta-analysis yielded a weighted annual mean (95% CI) eGFR decline during pre-dialysis of 2.4 (95% CI: 2.2, 2.6) mL/min/1.73 m 2 in CKD 3-5 cohorts compared to 8.5 (95% CI: 6.8, 10.1) in dialysis-based studies (difference 6.0 [95% CI: 4.8, 7.2]). To conclude, dialysis-based studies report faster mean annual eGFR decline during pre-dialysis than CKD 3-5 cohorts. Thus, eGFR decline data from CKD 3-5 cohorts should be used to guide clinical decision making in CKD patients and for power calculations in randomized controlled trials with CKD progression during pre-dialysis as the outcome.

  5. Fibroblast Growth Factor 23: A Biomarker of Kidney Function Decline.

    PubMed

    Drew, David A; Katz, Ronit; Kritchevsky, Stephen; Ix, Joachim H; Shlipak, Michael G; Newman, Anne B; Hoofnagle, Andy; Fried, Linda; Sarnak, Mark J; Gutierrez, Orlando M

    2018-01-01

    Fibroblast growth factor 23 (FGF-23) is a hormone that regulates phosphorus levels and vitamin D metabolism. Previous studies have shown FGF-23 to be a risk factor for incident end-stage renal disease; however, there are less data on the association of FGF-23 with earlier kidney-related outcomes. Serum FGF-23 was assayed using an intact ELISA assay in 2,496 participants of the Healthy Aging and Body Composition Study, a cohort of well-functioning older adults. Kidney function was estimated by assaying cystatin C at baseline and years 3 and 10. The associations between FGF-23 and decline in kidney function (defined by estimated glomerular filtration rate (eGFR) decline ≥30% or ≥3 mL/min/year) and incident chronic kidney disease (CKD; incident eGFR <60 mL/min/1.73 m2 and ≥1 mL/min/year decline) were evaluated. Models were adjusted for demographics, baseline eGFR, urine albumin/creatinine ratio, comorbidity, and serum calcium, phosphorus, 25(OH) vitamin D and parathyroid hormone. The mean (SD) age was 75 (3) years, with 52% female and 38% black. There were 405 persons with 30% decline, 702 with >3 mL/min/year decline, and 536 with incident CKD. In fully adjusted continuous models, doubling of FGF-23 concentrations was not associated with kidney function decline (OR [95% CI] = 0.98 [0.82-1.19] for ≥30% decline and OR 1.17 [95% CI 1.00-1.37] for ≥3 mL/min/year decline), or incident CKD (incident rate ratio [IRR] 1.05 [95% CI 0.91-1.22]). In adjusted quartile analysis, the highest quartile of FGF-23 was significantly associated with incident CKD (IRR 1.27 [95% CI 1.02-1.58] for highest vs. lowest quartile). Higher FGF-23 concentrations were not consistently associated with decline in kidney function or incident CKD in community-dwelling older adults. © 2018 S. Karger AG, Basel.

  6. Lipid Profiles and APOE4 Allele Impact Midlife Cognitive Decline in HIV-Infected Men on Antiretroviral Therapy.

    PubMed

    Mukerji, Shibani S; Locascio, Joseph J; Misra, Vikas; Lorenz, David R; Holman, Alex; Dutta, Anupriya; Penugonda, Sudhir; Wolinsky, Steven M; Gabuzda, Dana

    2016-10-15

    Dyslipidemia and apolipoprotein E4 (APOE ϵ4) allele are risk factors for age-related cognitive decline, but how these risks are modified by human immunodeficiency virus (HIV) infection is unclear. In a longitudinal nested study from the Multicenter AIDS Cohort Study, 273 HIV type 1-infected (HIV(+)) men aged 50-65 years with baseline HIV RNA <400 copies/mL and on continuous antiretroviral therapy (ART) in ≥95% of follow-up visits were matched by sociodemographic variables to 516 HIV-uninfected (HIV(-)) controls. The association between lipid markers (total cholesterol, low-density lipoprotein cholesterol [LDL-C], high-density lipoprotein cholesterol [HDL-C], and triglycerides), APOE genotype, and cognitive decline in HIV infection was examined using mixed-effects models. The median baseline age of participants was 51, 81% were white, and 89% had education >12 years. HIV(+) men had similar baseline total cholesterol and LDL-C, but lower HDL-C and higher triglycerides than controls (P < .001). Higher total cholesterol and LDL-C were associated with faster rates of cognitive decline (P < .01), whereas higher HDL-C attenuated decline (P = .02) in HIV(+) men. In HIV(+) men with elevated cholesterol, statin use was associated with a slower estimated rate of decline (P = .02). APOE ϵ4 genotype accelerated cognitive decline in HIV(+) but not HIV(-) men (P = .01), with trajectories diverging from HIV(-) ε4 carriers after age 50. Total cholesterol levels did not modify the association of ϵ4 genotype with decline (P = .9). Elevated cholesterol and APOE ϵ4 genotype are independent risk factors for cognitive decline in ART-adherent HIV(+) men aged >50 years. Treatment of dyslipidemia may be an effective strategy to reduce cognitive decline in older HIV(+) individuals. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America.

  7. Metabolic syndrome but not obesity measures are risk factors for accelerated age-related glomerular filtration rate decline in the general population.

    PubMed

    Stefansson, Vidar T N; Schei, Jørgen; Solbu, Marit D; Jenssen, Trond G; Melsom, Toralf; Eriksen, Bjørn O

    2018-05-01

    Rapid age-related glomerular filtration rate (GFR) decline increases the risk of end-stage renal disease, and a low GFR increases the risk of mortality and cardiovascular disease. High body mass index and the metabolic syndrome are well-known risk factors for patients with advanced chronic kidney disease, but their role in accelerating age-related GFR decline independent of cardiovascular disease, hypertension and diabetes is not adequately understood. We studied body mass index, waist circumference, waist-hip ratio and metabolic syndrome as risk factors for accelerated GFR decline in 1261 middle-aged people representative of the general population without diabetes, cardiovascular disease or kidney disease. GFR was measured as iohexol clearance at baseline and repeated after a median of 5.6 years. Metabolic syndrome was defined as fulfilling three out of five criteria, based on waist circumference, blood pressure, glucose, high-density lipoprotein cholesterol and triglycerides. The mean GFR decline rate was 0.95 ml/min/year. Neither the body mass index, waist circumference nor waist-hip ratio predicted statistically significant changes in age-related GFR decline, but individuals with baseline metabolic syndrome had a significant mean of 0.30 ml/min/year faster decline than individuals without metabolic syndrome in a multivariable adjusted linear regression model. This association was mainly driven by the triglyceride criterion of metabolic syndrome, which was associated with a significant 0.36 ml/min/year faster decline when analyzed separately. Results differed significantly when GFR was estimated using creatinine and/or cystatin C. Thus, metabolic syndrome, but not the body mass index, waist circumference or waist-hip ratio, is an independent risk factor for accelerated age-related GFR decline in the general population. Copyright © 2017 International Society of Nephrology. Published by Elsevier Inc. All rights reserved.

  8. Inequalities and impact of socioeconomic-cultural factors in suicide rates across Italy.

    PubMed

    Pompili, Maurizio; Innamorati, Marco; Vichi, Monica; Masocco, Maria; Vanacore, Nicola; Lester, David; Serafini, Gianluca; Tatarelli, Roberto; De Leo, Diego; Girardi, Paolo

    2011-01-01

    Suicide is a major cause of premature death in Italy and occurs at different rates in the various regions. The aim of the present study was to provide a comprehensive overview of suicide in the Italian population aged 15 years and older for the years 1980-2006. Mortality data were extracted from the Italian Mortality Database. Mortality rates for suicide in Italy reached a peak in 1985 and declined thereafter. The different patterns observed by age and sex indicated that the decrease in the suicide rate in Italy was initially the result of declining rates in those aged 45+ while, from 1997 on, the decrease was attributable principally to a reduction in suicide rates among the younger age groups. It was found that socioeconomic factors underlined major differences in the suicide rate across regions. The present study confirmed that suicide is a multifaceted phenomenon that may be determined by an array of factors. Suicide prevention should, therefore, be targeted to identifiable high-risk sociocultural groups in each country.

  9. Association Between Decline in Slow Vital Capacity and Respiratory Insufficiency, Use of Assisted Ventilation, Tracheostomy, or Death in Patients With Amyotrophic Lateral Sclerosis

    PubMed Central

    Meng, Lisa; Kulke, Sarah F.; Rudnicki, Stacy A.; Wolff, Andrew A.; Bozik, Michael E.; Malik, Fady I.; Shefner, Jeremy M.

    2017-01-01

    Importance The prognostic value of slow vital capacity (SVC) in relation to respiratory function decline and disease progression in patients with amyotrophic lateral sclerosis (ALS) is not well understood. Objective To investigate the rate of decline in percentage predicted SVC and its association with respiratory-related clinical events and mortality in patients with ALS. Design, Setting, and Participants This retrospective study included 893 placebo-treated patients from 2 large clinical trials (EMPOWER and BENEFIT-ALS, conducted from March 28, 2011, to November 1, 2012, and from October 23, 2012, to March 21, 2014, respectively) and an ALS trial database (PRO-ACT, containing studies completed between 1990 and 2010) to investigate the rate of decline in SVC. Data from the EMPOWER trial (which enrolled adults with possible, probable, or definite ALS; symptom onset within 24 months before screening; and upright SVC at least 65% of predicted value for age, height, and sex) were used to assess the relationship of SVC to respiratory-related clinical events; 456 patients randomized to placebo were used in this analysis. The 2 clinical trials included patients from North America, Australia, and Europe. Main Outcomes and Measures Clinical events included the earlier of time to death or time to decline in the Amyotrophic Lateral Sclerosis Functional Rating Scale–Revised (ALSFRS-R) respiratory subdomain, time to onset of respiratory insufficiency, time to tracheostomy, and all-cause mortality. Results Among 893 placebo-treated patients with ALS, the mean (SD) patient age was 56.7 (11.2) years, and the mean (SD) SVC was 90.5% (17.1%) at baseline; 65.5% (585 of 893) were male, and 20.5% (183 of 893) had bulbar-onset ALS. In EMPOWER, average decline of SVC from baseline through 1.5-year follow-up was −2.7 percentage points per month. Steeper declines were found in patients older than 65 years (−3.6 percentage points per month [P = .005 vs <50 years and P = .007 vs 50-65 years) and in patients with an ALSFRS-R total score of 39 or less at baseline (−3.1 percentage points per month [P < .001 vs >39]). When the rate of decline of SVC was slower by 1.5 percentage points per month in the first 6 months, risk reductions for events after 6 months were 19% for decline in the ALSFRS-R respiratory subdomain or death after 6 months, 22% for first onset of respiratory insufficiency or death after 6 months, 23% for first occurrence of tracheostomy or death after 6 months, and 23% for death at any time after 6 months (P < .001 for all). Conclusions and Relevance The rate of decline in SVC is associated with meaningful clinical events in ALS, including respiratory failure, tracheostomy, or death, suggesting that it is an important indicator of clinical progression. PMID:29181534

  10. Marine fisheries declines viewed upside down: human impacts on consumer-driven nutrient recycling.

    PubMed

    Layman, Craig A; Allgeier, Jacob E; Rosemond, Amy D; Dahlgren, Craig P; Yeager, Lauren A

    2011-03-01

    We quantified how two human impacts (overfishing and habitat fragmentation) in nearshore marine ecosystems may affect ecosystem function by altering the role of fish as nutrient vectors. We empirically quantified size-specific excretion rates of one of the most abundant fishes (gray snapper, Lutjanus griseus) in The Bahamas and combined these with surveys of fish abundance to estimate population-level excretion rates. The study was conducted across gradients of two human disturbances: overfishing and ecosystem fragmentation (estuaries bisected by roads), to evaluate how each could result in reduced population-level nutrient cycling by consumers. Mean estimated N and P excretion rates for gray snapper populations were on average 456% and 541% higher, respectively, in unfished sites. Ecosystem fragmentation resulted in significant reductions of recycling rates by snapper, with degree of creek fragmentation explaining 86% and 72% of the variance in estimated excretion for dissolved N and P, respectively. Additionally, we used nutrient limitation assays and primary producer nutrient content to provide a simple example of how marine fishery declines may affect primary production. This study provides an initial step toward integrating marine fishery declines and consumer-driven nutrient recycling to more fully understand the implications of human impacts in marine ecosystems.

  11. Novel Method of Production Decline Analysis

    NASA Astrophysics Data System (ADS)

    Xie, Shan; Lan, Yifei; He, Lei; Jiao, Yang; Wu, Yong

    2018-02-01

    ARPS decline curves is the most commonly used in oil and gas field due to its minimal data requirements and ease application. And prediction of production decline which is based on ARPS analysis rely on known decline type. However, when coefficient index are very approximate under different decline type, it is difficult to directly recognize decline trend of matched curves. Due to difficulties above, based on simulation results of multi-factor response experiments, a new dynamic decline prediction model is introduced with using multiple linear regression of influence factors. First of all, according to study of effect factors of production decline, interaction experimental schemes are designed. Based on simulated results, annual decline rate is predicted by decline model. Moreover, the new method is applied in A gas filed of Ordos Basin as example to illustrate reliability. The result commit that the new model can directly predict decline tendency without needing recognize decline style. From arithmetic aspect, it also take advantage of high veracity. Finally, the new method improves the evaluation method of gas well production decline in low permeability gas reservoir, which also provides technical support for further understanding of tight gas field development laws.

  12. Declines in marathon performance: Sex differences in elite and recreational athletes.

    PubMed

    Zavorsky, Gerald S; Tomko, Kelly A; Smoliga, James M

    2017-01-01

    The first aim of this study was to determine the age group at which marathon performance declines in top male and female runners and to compare that to the runners of average ability. Another aim of this of this study was to examine the age-related yearly decline in marathon performance between age group winners and the average marathon finisher. Data from the New York (NYC), Boston, and Chicago marathons from 2001-2016 were analyzed. Age, sex, and location were used in multiple linear regression models to determine the rate of decline in marathon times. Winners of each age group were assessed in 5-year increments from 16 through 74 years old (n = 47 per age group). The fastest times were between 25-34 years old, with overall champion males at 28.3 years old, and overall champion females at 30.8 years old (p = 0.004). At 35 years of age up to 74 years of age, female age group winners had a faster yearly decline in marathon finishing times compared to male age group winners, irrespective of marathon location [women = (min:sec) 2:33 per year, n = 336; men = 2:06 per year, n = 373, p < 0.01]. The median times between each age group only slowed beginning at 50 years old, thereafter the decline was similar between both men and women (women = 2:36, n = 140; men = 2:57, n = 150, p = 0.11). The median times were fastest at Boston and similar between Chicago and NYC. In conclusion, the rate of decline at 35 years old up to 74 years old is roughly linear (adjusted r2 = 0.88, p < 0.001) with female age group winners demonstrating 27 s per year greater decline per year compared to male age group winners.

  13. Declines in marathon performance: Sex differences in elite and recreational athletes

    PubMed Central

    Tomko, Kelly A.; Smoliga, James M.

    2017-01-01

    The first aim of this study was to determine the age group at which marathon performance declines in top male and female runners and to compare that to the runners of average ability. Another aim of this of this study was to examine the age-related yearly decline in marathon performance between age group winners and the average marathon finisher. Data from the New York (NYC), Boston, and Chicago marathons from 2001–2016 were analyzed. Age, sex, and location were used in multiple linear regression models to determine the rate of decline in marathon times. Winners of each age group were assessed in 5-year increments from 16 through 74 years old (n = 47 per age group). The fastest times were between 25–34 years old, with overall champion males at 28.3 years old, and overall champion females at 30.8 years old (p = 0.004). At 35 years of age up to 74 years of age, female age group winners had a faster yearly decline in marathon finishing times compared to male age group winners, irrespective of marathon location [women = (min:sec) 2:33 per year, n = 336; men = 2:06 per year, n = 373, p < 0.01]. The median times between each age group only slowed beginning at 50 years old, thereafter the decline was similar between both men and women (women = 2:36, n = 140; men = 2:57, n = 150, p = 0.11). The median times were fastest at Boston and similar between Chicago and NYC. In conclusion, the rate of decline at 35 years old up to 74 years old is roughly linear (adjusted r2 = 0.88, p < 0.001) with female age group winners demonstrating 27 s per year greater decline per year compared to male age group winners. PMID:28187185

  14. Rate of change in renal function and mortality in elderly treated hypertensive patients.

    PubMed

    Chowdhury, Enayet K; Langham, Robyn G; Ademi, Zanfina; Owen, Alice; Krum, Henry; Wing, Lindon M H; Nelson, Mark R; Reid, Christopher M

    2015-07-07

    Evidence relating the rate of change in renal function, measured as eGFR, after antihypertensive treatment in elderly patients to clinical outcome is sparse. This study characterized the rate of change in eGFR after commencement of antihypertensive treatment in an elderly population, the factors associated with eGFR rate change, and the rate's association with all-cause and cardiovascular mortality. Data from the Second Australian National Blood Pressure study were used, where 6083 hypertensive participants aged ≥65 years were enrolled during 1995-1997 and followed for a median of 4.1 years (in-trial). Following the Second Australian National Blood Pressure study, participants were followed-up for a further median 6.9 years (post-trial). The annual rate of change in the eGFR was calculated in 4940 participants using creatinine measurements during the in-trial period and classified into quintiles (Q) on the basis of the following eGFR changes: rapid decline (Q1), decline (Q2), stable (Q3), increase (Q4), and rapid increase (Q5). A rapid decline in eGFR in comparison with those with stable eGFRs during the in-trial period was associated with older age, living in a rural area, wider pulse pressure at baseline, receiving diuretic-based therapy, taking multiple antihypertensive drugs, and having blood pressure <140/90 mmHg during the study. However, a rapid increase in eGFR was observed in younger women and those with a higher cholesterol level. After adjustment for baseline and in-trial covariates, Cox-proportional hazard models showed a significantly greater risk for both all-cause (hazard ratio, 1.28; 95% confidence interval, 1.09 to 1.52; P=0.003) and cardiovascular (hazard ratio, 1.40; 95% confidence interval, 1.11 to 1.76; P=0.004) mortality in the rapid decline group compared with the stable group over a median of 7.2 years after the last eGFR measure. No significant association with mortality was observed for a rapid increase in eGFR. In elderly persons with treated hypertension, a rapid decline in eGFR is associated with a higher risk of mortality. Copyright © 2015 by the American Society of Nephrology.

  15. Race and incarceration in an aging cohort of Vietnam veterans in treatment for post-traumatic stress disorder (PTSD).

    PubMed

    Coker, Kendell L; Rosenheck, Robert

    2014-03-01

    Cross sectional studies have addressed the incarceration of Vietnam veterans with post-traumatic stress disorder (PTSD), but no studies have examined changes in incarceration as they age. This study examines patterns of incarceration among Vietnam veterans treated in specialized veterans affairs (VA) intensive PTSD programs over time. Data was drawn from admission data from the initial episode of treatment of Caucasian and African American Vietnam veterans entering VA specialized intensive PTSD programs between 1993 and 2011 (N = 31,707). Bivariate correlations and logistic regression were used to examine associations among race and incarceration over time and the potentially confounding influence of demographic and clinical covariates on this relationship. Rates of reported incarceration declined from 63 to 43%. Over time, African American veterans were 34% more likely than Caucasian veterans to have a lifetime history of incarceration while interaction analysis showed steeper declines for Caucasians than African Americans. Rates of incarceration among these Vietnam veterans declined as they aged. Furthermore, African American veterans were substantially more likely than Caucasian veterans to have been incarcerated and showed less decline as the cohort aged. While reduced, needs for clinical PTSD services remain among aging combat veterans.

  16. DXA utilization between 2006 and 2012 in commercially insured younger postmenopausal women

    PubMed Central

    Overman, Robert A.; Farley, Joel F.; Curtis, Jeffrey R.; Zhang, Jie; Gourlay, Margaret L.; Deal, Chad L.

    2015-01-01

    Introduction Reimbursement for dual energy x-ray absorptiometry (DXA) scans in the outpatient setting has declined significantly since 2006. Research through 2011 has suggested reimbursement reductions for DXA scans have corresponded with an overall decreased utilization of DXA. This study updates utilization estimates for DXAs through 2012 in patients with commercial insurance and compares DXA rates before and after reimbursement changes. Methods We evaluated DXA utilization for women age 50–64 from Marketscan Commercial Claims and Encounter database between January 2006 and December 2012 based on CPT codes. We estimated utilization rates per 1,000 person years. We also employed segmented regression analysis of monthly rates to evaluate the change in utilization rates after a proposed reimbursement reduction in July 2009. Results In women aged 50–64; 451,656 DXAs were performed in 2006, a rate of 144 DXAs per 1,000 person years. This rate increased to 149 DXAs per 1,000 person years in 2009 before decreasing to 110 DXAs per 1,000 person years or 667,982 scans in 2012. DXA utilization increased by 2.24 per 1,000 person years until July 2009 then declined by 12.98 DXAs per 1,000 persons, resulting in 37.5 DXAs per person year fewer performed in 2012 compared to 2006. Conclusion Since July 2009 a significant decline in DXA utilization occurred in a younger postmenopausal commercially insured population. This decline corresponds with a time period of reductions in Medicare DXA reimbursement. PMID:25700662

  17. Blood eosinophils as a marker of response to inhaled corticosteroids in COPD.

    PubMed

    Barnes, Neil C; Sharma, Raj; Lettis, Sally; Calverley, Peter M A

    2016-05-01

    Identification of a biomarker that predicts response to inhaled corticosteroids (ICS) would help evaluate the risk/benefit profile of ICS in chronic obstructive pulmonary disease (COPD) and guide treatment.The ISOLDE study randomised 751 patients (mean post-bronchodilator forced expiratory volume in 1 s (FEV1) 1.4 L: 50% predicted normal) to fluticasone propionate 500 μg twice daily or placebo for 3 years, finding no difference in FEV1 rate of decline between treatments (p=0.16) and a significant reduction in median exacerbation rate with fluticasone propionate versus placebo (p=0.026). We re-analysed ISOLDE results by baseline blood eosinophil count to investigate whether eosinophil level predicts ICS benefit.Patients with eosinophils <2% (n=456) had a similar rate of post-bronchodilator FEV1 decline with fluticasone propionate as placebo (-2.9 mL·year(-1); p=0.688). With eosinophils ≥2% (n=214), the rate of decline decreased by 33.9 mL·year(-1) with fluticasone propionate versus placebo (p=0.003). Exacerbation rate reduction on ICS for fluticasone propionate versus placebo was higher in the eosinophil <2% group compared with the ≥2% group; time-to-first moderate/severe exacerbation was not different between treatments in either group.A baseline blood eosinophil count of ≥2% identifies a group of COPD patients with slower rates of decline in FEV1 when treated with ICS: prospective testing of this hypothesis is now warranted. Copyright ©ERS 2016.

  18. Annual summary of vital statistics--1995.

    PubMed

    Guyer, B; Strobino, D M; Ventura, S J; MacDorman, M; Martin, J A

    1996-12-01

    Recent trends in the vital statistics of the United States continued in 1995, including decreases in the number of births, the birth rate, the age-adjusted death rate, and the infant mortality rate; life expectancy at birth increased to a level equal to the record high of 75.8 years in 1992. Marriages and divorces both decreased. An estimated 3,900,089 infants were born during 1995, a decline of 1% from 1994. The preliminary birth rate for 1995 was 14.8 live births per 1000 total population, a 3% decline, and the lowest recorded in nearly two decades. The fertility rate, which relates births to women in the childbearing ages, declined to 65.6 live births per 1000 women 15 to 44 years old, the lowest rate since 1986. According to preliminary data for 1995, fertility rates declined for all racial groups with the gap narrowing between black and white rates. The fertility rate for black women declined 7% to a historic low level (71.7); the preliminary rate for white women (64.5) dropped just 1%. Fertility rates continue to be highest for Hispanic, especially Mexican-American, women. Preliminary data for 1995 suggest a 2% decline in the rate for Hispanic women to 103.7. The birth rate for teenagers has now decreased for four consecutive years, from a high of 62.1 per 1000 women 15 to 19 years old in 1991 to 56.9 in 1995, an overall decline of 8%. The rate of childbearing by unmarried mothers dropped 4% from 1994 to 1995, from 46.9 births per 1000 unmarried women 15 to 44 years old to 44.9, the first decline in the rate in nearly two decades. The proportion of all births occurring to unmarried women dropped as well in 1995, to 32.0% from 32.6% in 1994. Smoking during pregnancy dropped steadily from 1989 (19.5%) to 1994 (14.6%), a decline of about 25%. Prenatal care utilization continued to improve in 1995 with 81.2% of all mothers receiving care in the first trimester compared with 78.9% in 1993. Preliminary data for 1995 suggests continued improvement to 81.2%. The percent of infants delivered by cesarean delivery declined slightly to 20.8% in 1995. The percent of low birth weight (LBW) infants continued to climb in 1994 rising to 7.3%, from 7.2% in 1993. The proportion of LBW improved slightly among black infants, declining from 13.3% to 13.2% between 1993 and 1994. Preliminary figures for 1995 suggest continued decline in LBW for black infants (13.0%). The multiple birth ratio rose to 25.7 per 1000 births for 1994, an increase of 2% over 1993 and 33% since 1980. Age-adjusted death rates in 1995 were lower for heart disease, malignant neoplasms, accidents, and homicide. Although the total number of human immunodeficiency virus (HIV) infection deaths increased slightly from 42,114 in 1994 to an estimated 42,506 in 1995, the age-adjusted death rate for HIV infection did not increase, which may indicate a leveling off of the steep upward trend in mortality from HIV infection since 1987. Nearly 15,000 children between the ages of 1-14 years died in the United States (US) in 1995. The death rate for children 1 to 4 years old in 1995 was 40.4 per 100,000 population aged 1 to 4 years, 6% lower than the rate of 42.9 in 1994. The 1995 death rate for 5- to 14-year-olds was 22.1, 2% lower than the rate of 22.5 in 1994. Since 1979, death rates have declined by 37% for children 1 to 4 years old, and by 30% for children 5 to 14 years old. For children 1 to 4 years old, the leading cause of death was injuries, which accounted for for an estimated 2277 deaths in 1995, 36% of all deaths in this age group. Injuries were the leading cause of death for 5- to 14-year-olds as well, accounting for an ever higher percentage (41%) of all deaths. In 1995, the preliminary infant mortality rate was 7.5 per 1000live births, 6% lower than 1994, and the lowest ever recorded in the US. The decline occurred for neonatal as well as postneonatal mortality rates, and among white and black infants alike.

  19. Ambulatory Surgery Centers and Their Intended Effects on Outpatient Surgery.

    PubMed

    Hollenbeck, Brent K; Dunn, Rodney L; Suskind, Anne M; Strope, Seth A; Zhang, Yun; Hollingsworth, John M

    2015-10-01

    To assess the impact of ambulatory surgery centers (ASCs) on rates of hospital-based outpatient procedures and adverse events. Twenty percent national sample of Medicare beneficiaries. A retrospective study of beneficiaries undergoing outpatient surgery between 2001 and 2010. Health care markets were sorted into three groups-those with ASCs, those without ASCs, and those where one opened for the first time. Generalized linear mixed models were used to assess the impact of ASC opening on rates of hospital-based outpatient surgery, perioperative mortality, and hospital admission. Adjusted hospital-based outpatient surgery rates declined by 7 percent, or from 2,333 to 2,163 procedures per 10,000 beneficiaries, in markets where an ASC opened for the first time (p < .001 for test between slopes). Within these markets, procedure use at ASCs outpaced the decline observed in the hospital setting. Perioperative mortality and admission rates remained flat after ASC opening (both p > .4 for test between slopes). The opening of an ASC in a Hospital Service Area resulted in a decline in hospital-based outpatient surgery without increasing mortality or admission. In markets where facilities opened, procedure growth at ASCs was greater than the decline in outpatient surgery use at their respective hospitals. © Health Research and Educational Trust.

  20. Reducing Stock-Outs of Life Saving Malaria Commodities Using Mobile Phone Text-Messaging: SMS for Life Study in Kenya

    PubMed Central

    Githinji, Sophie; Kigen, Samwel; Memusi, Dorothy; Nyandigisi, Andrew; Mbithi, Agneta M.; Wamari, Andrew; Muturi, Alex N.; Jagoe, George; Barrington, Jim; Snow, Robert W.; Zurovac, Dejan

    2013-01-01

    Background Health facility stock-outs of life saving malaria medicines are common across Africa. Innovative ways of addressing this problem are urgently required. We evaluated whether SMS based reporting of stocks of artemether-lumefantrine (AL) and rapid diagnostic tests (RDT) can result in reduction of stock-outs at peripheral facilities in Kenya. Methods/Findings All 87 public health facilities in five Kenyan districts were included in a 26 week project. Weekly facility stock counts of four AL packs and RDTs were sent via structured incentivized SMS communication process from health workers’ personal mobile phones to a web-based system accessed by district managers. The mean health facility response rate was 97% with a mean formatting error rate of 3%. Accuracy of stock count reports was 79% while accuracy of stock-out reports was 93%. District managers accessed the system 1,037 times at an average of eight times per week. The system was accessed in 82% of the study weeks. Comparing weeks 1 and 26, stock-out of one or more AL packs declined by 38 percentage-points. Total AL stock-out declined by 5 percentage-points and was eliminated by the end of the project. Stock-out declines of individual AL packs ranged from 14 to 32 percentage-points while decline in RDT stock-outs was 24 percentage-points. District managers responded to 44% of AL and 73% of RDT stock-out signals by redistributing commodities between facilities. In comparison with national trends, stock-out declines in study areas were greater, sharper and more sustained. Conclusions Use of simple SMS technology ensured high reporting rates of reasonably accurate, real-time facility stock data that were used by district managers to undertake corrective actions to reduce stock-outs. Future work on stock monitoring via SMS should focus on assessing response rates without use of incentives and demonstrating effectiveness of such interventions on a larger scale. PMID:23349786

  1. Sensitivity Monitoring of the SECCHI COR1 Telescopes on STEREO

    NASA Astrophysics Data System (ADS)

    Thompson, William T.

    2018-03-01

    Measurements of bright stars passing through the fields of view of the inner coronagraphs (COR1) on board the Solar Terrestrial Relations Observatory (STEREO) are used to monitor changes in the radiometric calibration over the course of the mission. Annual decline rates are found to be 0.648 ± 0.066%/year for COR1-A on STEREO Ahead and 0.258 ± 0.060%/year for COR1-B on STEREO Behind. These rates are consistent with decline rates found for other space-based coronagraphs in similar radiation environments. The theorized cause for the decline in sensitivity is darkening of the lenses and other optical elements due to exposure to high-energy solar particles and photons, although other causes are also possible. The total decline in the COR-B sensitivity when contact with Behind was lost on 1 October 2014 was 1.7%, while COR1-A was down by 4.4%. As of 1 November 2017, the COR1-A decline is estimated to be 6.4%. The SECCHI calibration routines will be updated to take these COR1 decline rates into account.

  2. Frequency-dependent selection predicts patterns of radiations and biodiversity.

    PubMed

    Melián, Carlos J; Alonso, David; Vázquez, Diego P; Regetz, James; Allesina, Stefano

    2010-08-26

    Most empirical studies support a decline in speciation rates through time, although evidence for constant speciation rates also exists. Declining rates have been explained by invoking pre-existing niches, whereas constant rates have been attributed to non-adaptive processes such as sexual selection and mutation. Trends in speciation rate and the processes underlying it remain unclear, representing a critical information gap in understanding patterns of global diversity. Here we show that the temporal trend in the speciation rate can also be explained by frequency-dependent selection. We construct a frequency-dependent and DNA sequence-based model of speciation. We compare our model to empirical diversity patterns observed for cichlid fish and Darwin's finches, two classic systems for which speciation rates and richness data exist. Negative frequency-dependent selection predicts well both the declining speciation rate found in cichlid fish and explains their species richness. For groups like the Darwin's finches, in which speciation rates are constant and diversity is lower, speciation rate is better explained by a model without frequency-dependent selection. Our analysis shows that differences in diversity may be driven by incipient species abundance with frequency-dependent selection. Our results demonstrate that genetic-distance-based speciation and frequency-dependent selection are sufficient to explain the high diversity observed in natural systems and, importantly, predict decay through time in speciation rate in the absence of pre-existing niches.

  3. Risk Factors for Rapid Kidney Function Decline Among African Americans: The Jackson Heart Study (JHS).

    PubMed

    Young, Bessie A; Katz, Ronit; Boulware, L Ebony; Kestenbaum, Bryan; de Boer, Ian H; Wang, Wei; Fülöp, Tibor; Bansal, Nisha; Robinson-Cohen, Cassianne; Griswold, Michael; Powe, Neil R; Himmelfarb, Jonathan; Correa, Adolfo

    2016-08-01

    Racial differences in rapid kidney function decline exist, but less is known regarding factors associated with rapid decline among African Americans. Greater understanding of potentially modifiable risk factors for early kidney function loss may help reduce the burden of kidney failure in this high-risk population. Prospective cohort study. 3,653 African American participants enrolled in the Jackson Heart Study (JHS) with kidney function data from 2 of 3 examinations (2000-2004 and 2009-2013). Estimated glomerular filtration rate (eGFR) was calculated from serum creatinine using the CKD-EPI creatinine equation. Demographics, socioeconomic status, lifestyle, and clinical risk factors for kidney failure. Rapid decline was defined as a ≥30% decline in eGFR during follow-up. We quantified the association of risk factors with rapid decline in multivariable models. Clinical (systolic blood pressure and albuminuria [albumin-creatinine ratio]) and modifiable risk factors. Mean age was 54±12 (SD) years, 37% were men, average body mass index was 31.8±7.1kg/m(2), 19% had diabetes mellitus (DM), and mean eGFR was 96.0±20mL/min/1.73m(2) with an annual rate of decline of 1.27mL/min/1.73m(2). Those with rapid decline (11.5%) were older, were more likely to be of low/middle income, and had higher systolic blood pressures and greater DM than those with nonrapid decline. Factors associated with ≥30% decline were older age (adjusted OR per 10 years older, 1.51; 95% CI, 1.34-1.71), cardiovascular disease (adjusted OR, 1.53; 95% CI, 1.12-2.10), higher systolic blood pressure (adjusted OR per 17mmHg greater, 1.22; 95% CI, 1.06-1.41), DM (adjusted OR, 2.63; 95% CI, 2.02-3.41), smoking (adjusted OR, 1.60; 95% CI, 1.10-2.31), and albumin-creatinine ratio > 30mg/g (adjusted OR, 1.55; 95% CI, 1.08-1.21). Conversely, results did not support associations of waist circumference, C-reactive protein level, and physical activity with rapid decline. No midstudy creatinine measurement at examination 2 (2005-2008). Rapid decline heterogeneity exists among African Americans in JHS. Interventions targeting potentially modifiable factors may help reduce the incidence of kidney failure. Published by Elsevier Inc.

  4. Individualized prediction of lung-function decline in chronic obstructive pulmonary disease

    PubMed Central

    Zafari, Zafar; Sin, Don D.; Postma, Dirkje S.; Löfdahl, Claes-Göran; Vonk, Judith; Bryan, Stirling; Lam, Stephen; Tammemagi, C. Martin; Khakban, Rahman; Man, S.F. Paul; Tashkin, Donald; Wise, Robert A.; Connett, John E.; McManus, Bruce; Ng, Raymond; Hollander, Zsuszanna; Sadatsafavi, Mohsen

    2016-01-01

    Background: The rate of lung-function decline in chronic obstructive pulmonary disease (COPD) varies substantially among individuals. We sought to develop and validate an individualized prediction model for forced expiratory volume at 1 second (FEV1) in current smokers with mild-to-moderate COPD. Methods: Using data from a large long-term clinical trial (the Lung Health Study), we derived mixed-effects regression models to predict future FEV1 values over 11 years according to clinical traits. We modelled heterogeneity by allowing regression coefficients to vary across individuals. Two independent cohorts with COPD were used for validating the equations. Results: We used data from 5594 patients (mean age 48.4 yr, 63% men, mean baseline FEV1 2.75 L) to create the individualized prediction equations. There was significant between-individual variability in the rate of FEV1 decline, with the interval for the annual rate of decline that contained 95% of individuals being −124 to −15 mL/yr for smokers and −83 to 15 mL/yr for sustained quitters. Clinical variables in the final model explained 88% of variation around follow-up FEV1. The C statistic for predicting severity grades was 0.90. Prediction equations performed robustly in the 2 external data sets. Interpretation: A substantial part of individual variation in FEV1 decline can be explained by easily measured clinical variables. The model developed in this work can be used for prediction of future lung health in patients with mild-to-moderate COPD. Trial registration: Lung Health Study — ClinicalTrials.gov, no. NCT00000568; Pan-Canadian Early Detection of Lung Cancer Study — ClinicalTrials.gov, no. NCT00751660 PMID:27486205

  5. Terminal decline in well-being: The role of social orientation.

    PubMed

    Gerstorf, Denis; Hoppmann, Christiane A; Löckenhoff, Corinna E; Infurna, Frank J; Schupp, Jürgen; Wagner, Gert G; Ram, Nilam

    2016-03-01

    Well-being development at the end of life is often characterized by steep deteriorations, but individual differences in these terminal declines are substantial and not yet well understood. This study moved beyond typical consideration of health predictors and explored the role of social orientation and engagement. To do so, we used social variables at the behavioral level (self-ratings of social participation) and the motivational level (valuing social and family goals), assessed 2 to 4 years before death. We applied single- and multiphase growth models to up to 27-year annual longitudinal data from 2,910 now deceased participants of the nation-wide German Socio-Economic Panel Study (Mage at death = 74 years; SD = 14; 48% women). Results revealed that leading a socially active life and prioritizing social goals in late life were independently associated with higher late-life well-being, less pronounced late-life decline, and a later onset of terminal decline. Significant interaction effects suggested that the combination of (reduced) social participation and (lowered) social goals magnifies the effects of each other. Findings also indicated that less decline in social participation was associated with less severe rates and a later onset of well-being decline. We found little evidence that valuing family goals is associated with late-life trajectories of well-being. Associations were independent of key correlates of well-being and mortality, including age at death, gender, education, disability, hospital stays, and goals in other life domains. We discuss possible pathways by which maintaining social orientation into late life may help mitigate terminal decline in well-being. (c) 2016 APA, all rights reserved).

  6. Terminal Decline in Well-Being: The Role of Social Orientation

    PubMed Central

    Gerstorf, Denis; Hoppmann, Christiane A.; Löckenhoff, Corinna E.; Infurna, Frank J.; Schupp, Jürgen; Wagner, Gert G.; Ram, Nilam

    2016-01-01

    Well-being development at the end of life is often characterized by steep deteriorations, but individual differences in these terminal declines are substantial and not yet well understood. This study moved beyond the typical consideration of health predictors and explored the role of social orientation and engagement. To do so, we made use of social variables at the behavioral level (self-ratings of social participation) and the motivational level (valuing social and family goals), assessed two to four years before death. We applied single- and multi-phase growth models to up to 27-year annual longitudinal data from 2,910 now deceased participants of the nation-wide German Socio-Economic Panel Study (SOEP; age at death: M = 74 years; SD = 14; 48% women). Results revealed that leading a socially active life and prioritizing social goals in late life were independently associated with higher late-life well-being, less pronounced late-life decline, and a later onset of terminal decline. Significant interaction effects suggested that the effects of (reduced) social participation and (lowered) social goals were compounding each other.compound. Findings also indicated that less decline in social participation was associated with shallower rates and a later onset of well-being decline. We found little evidence that valuing family goals is associated with late-life trajectories of well-being. Associations were independent of key correlates of well-being and mortality, including age at death, gender, education, disability, hospital stays, and goals in other life domains. We discuss possible pathways by which maintaining social orientation into late life may help mitigate terminal decline in well-being. PMID:26950226

  7. Decline in a population of spectacled eiders nesting on the Yukon-Kuskokwim Delta, Alaska

    USGS Publications Warehouse

    Ely, Craig R.; Dau, Christian; Babcock, Christopher

    1994-01-01

    The number of spectacled eiders nesting on two study areas near the Kashunuk River, on the central Yukon-Kuskokwim (Y-K) Delta, Alaska, declined by over 75% in the last 20 years. Nesting densities have remained low, but have not significantly declined since 1985. There has been no decrease in the reproductive effort of individual females as indicated by average clutch sizes. There has been a significant decline in the proportion of nests located on islands on one of the two study areas. Nesting success declined significantly during the 1970's. Success was not monitored in recent years, but has likely been low, based on the poor nesting success and declining numbers of cackling Canada geese and black brant nesting on the area. Nest predation by arctic foxes severely limited the productivity of cackling Canada geese, and foxes were likely the major predators of eider nests. Persistent high predation rates may lead to local extirpation in highly philopatric species such as eiders.

  8. The cause of global amphibian declines: a developmental endocrinologist's perspective.

    PubMed

    Hayes, T B; Falso, P; Gallipeau, S; Stice, M

    2010-03-15

    Greater than 70% of the world's amphibian species are in decline. We propose that there is probably not a single cause for global amphibian declines and present a three-tiered hierarchical approach that addresses interactions among and between ultimate and proximate factors that contribute to amphibian declines. There are two immediate (proximate) causes of amphibian declines: death and decreased recruitment (reproductive failure). Although much attention has focused on death, few studies have addressed factors that contribute to declines as a result of failed recruitment. Further, a great deal of attention has focused on the role of pathogens in inducing diseases that cause death, but we suggest that pathogen success is profoundly affected by four other ultimate factors: atmospheric change, environmental pollutants, habitat modification and invasive species. Environmental pollutants arise as likely important factors in amphibian declines because they have realized potential to affect recruitment. Further, many studies have documented immunosuppressive effects of pesticides, suggesting a role for environmental contaminants in increased pathogen virulence and disease rates. Increased attention to recruitment and ultimate factors that interact with pathogens is important in addressing this global crisis.

  9. The cause of global amphibian declines: a developmental endocrinologist's perspective

    PubMed Central

    Hayes, T. B.; Falso, P.; Gallipeau, S.; Stice, M.

    2010-01-01

    Greater than 70% of the world's amphibian species are in decline. We propose that there is probably not a single cause for global amphibian declines and present a three-tiered hierarchical approach that addresses interactions among and between ultimate and proximate factors that contribute to amphibian declines. There are two immediate (proximate) causes of amphibian declines: death and decreased recruitment (reproductive failure). Although much attention has focused on death, few studies have addressed factors that contribute to declines as a result of failed recruitment. Further, a great deal of attention has focused on the role of pathogens in inducing diseases that cause death, but we suggest that pathogen success is profoundly affected by four other ultimate factors: atmospheric change, environmental pollutants, habitat modification and invasive species. Environmental pollutants arise as likely important factors in amphibian declines because they have realized potential to affect recruitment. Further, many studies have documented immunosuppressive effects of pesticides, suggesting a role for environmental contaminants in increased pathogen virulence and disease rates. Increased attention to recruitment and ultimate factors that interact with pathogens is important in addressing this global crisis. PMID:20190117

  10. Inquiry into terminal decline: five objectives for future study.

    PubMed

    Gerstorf, Denis; Ram, Nilam

    2013-10-01

    Notions of terminal decline propose that late-life change is primarily driven by processes closely tied to pathology and mortality rather than chronological age. We use the rationales of longitudinal research as outlined by Baltes and Nesselroade (Baltes, P., & Nesselroade, J. [1979]. History and rationale of longitudinal research. In J. R. Nesselroade & P. Baltes (Eds.), Longitudinal research in the study of behavior and development [pp. 1-39]. San Diego, CA: Academic Press) as a framework for organizing research on terminal decline. In doing so, we note that there are relatively robust descriptions of terminal decline across a variety of different domains, as well as the extent of interindividual differences in the levels of function, rates of change, and timing of terminal decline (research rationales 1 and 2). However, there is much more to learn about the interrelations among change in different domains, the underlying mechanisms of change, and the factors that contribute to interindividual differences in change (research rationales 3-5). Needed are new study designs and analytical models that better address the structural, temporal, and causal interrelations that contribute to and protect against terminal decline.

  11. Prospective Study on the Impact of Fear of Falling on Functional Decline among Community Dwelling Elderly Women

    PubMed Central

    Choi, Kyungwon; Jeon, Gyeong-Suk; Cho, Sung-il

    2017-01-01

    Fear of falling (FOF) is expected to have effects on functional decline in the elderly. In this study, we examined over 2 years the effect of change in FOF on functional decline in community dwelling elderly. We conducted a secondary analysis using data from elderly women, 70 years of age and older, who participated in the Korean Longitudinal Study of Aging (KLoSA). Participants were divided into four categories according to change in FOF between the 2010 and 2012 surveys. Multiple logistic regression analysis was conducted regarding the effects of changes in FOF on functional decline after controlling for variables as known risk factors for functional decline. Rates of functional decline were highest in the “consistently having FOF” group, whereas they were lowest in the “consistently no FOF” group in both 2010 and 2012. Characteristics independently associated with functional decline were change in FOF, depressive symptoms, low frequency of meeting friends, and fear-induced activity avoidance. Longer exposure to FOF was associated with an increased risk of functional decline. FOF is an important health problem that deserves attention in its own right. Public health approaches for elderly persons should address early detection, prevention, and intervention programs for FOF. PMID:28448461

  12. Temporal, spatial, and body size effects on growth rates of loggerhead sea turtles (Caretta caretta) in the Northwest Atlantic

    USGS Publications Warehouse

    Bjorndal, Karen A.; Schroeder, Barbara A.; Foley, Allen M.; Witherington, Blair E.; Bresette, Michael; Clark, David; Herren, Richard M.; Arendt, Michael D.; Schmid, Jeffrey R.; Meylan, Anne B.; Meylan, Peter A.; Provancha, Jane A.; Hart, Kristen M.; Lamont, Margaret M.; Carthy, Raymond R.; Bolten, Alan B.

    2013-01-01

    In response to a call from the US National Research Council for research programs to combine their data to improve sea turtle population assessments, we analyzed somatic growth data for Northwest Atlantic (NWA) loggerhead sea turtles (Caretta caretta) from 10 research programs. We assessed growth dynamics over wide ranges of geography (9–33°N latitude), time (1978–2012), and body size (35.4–103.3 cm carapace length). Generalized additive models revealed significant spatial and temporal variation in growth rates and a significant decline in growth rates with increasing body size. Growth was more rapid in waters south of the USA (<24°N) than in USA waters. Growth dynamics in southern waters in the NWA need more study because sample size was small. Within USA waters, the significant spatial effect in growth rates of immature loggerheads did not exhibit a consistent latitudinal trend. Growth rates declined significantly from 1997 through 2007 and then leveled off or increased. During this same interval, annual nest counts in Florida declined by 43 % (Witherington et al. in Ecol Appl 19:30–54, 2009) before rebounding. Whether these simultaneous declines reflect responses in productivity to a common environmental change should be explored to determine whether somatic growth rates can help interpret population trends based on annual counts of nests or nesting females. Because of the significant spatial and temporal variation in growth rates, population models of NWA loggerheads should avoid employing growth data from restricted spatial or temporal coverage to calculate demographic metrics such as age at sexual maturity.

  13. Stressful life events and cognitive decline in late life: moderation by education and age. The Cache County Study.

    PubMed

    Tschanz, Joann T; Pfister, Roxane; Wanzek, Joseph; Corcoran, Chris; Smith, Ken; Tschanz, Brian T; Steffens, David C; Østbye, Truls; Welsh-Bohmer, Kathleen A; Norton, Maria C

    2013-08-01

    Stressful life events (SLE) have been associated with increased dementia risk, but their association with cognitive decline has been inconsistent. In a longitudinal population-based study of older individuals, we examined the association between SLE and cognitive decline, and the role of potential effect modifiers. A total of 2665 non-demented participants of the Cache County Memory Study completed an SLE questionnaire at Wave 2 and were revisited 4 and 7 years later. The events were represented via several scores: total number, subjective rating (negative, positive, and unexpected), and a weighted summary based on their impact. Cognition was assessed at each visit with the modified Mini-Mental State Exam. General linear models were used to examine the association between SLE scores and cognition. Effect modification by age, education, and APOE genotype was tested. Years of formal education (p = 0.006) modified the effect of number of SLE, and age (p = 0.009) modified the effect of negative SLE on the rate of cognitive decline. Faster decline was observed among those with fewer years of education experiencing more SLE and also among younger participants experiencing more negative SLE. There was no association between other indicators of SLE and cognitive decline. APOE genotype did not modify any of the aforementioned associations. The effects of SLE on cognition in late life are complex and vary by individual factors such as age and education. These results may explain some of the contradictory findings in the literature. Copyright © 2012 John Wiley & Sons, Ltd.

  14. Changes in Breast Cancer Risk Distribution Among Vermont Women Using Screening Mammography

    PubMed Central

    Bolton, Kenyon C.; Mace, John L.; Vacek, Pamela M.; Herschorn, Sally D.; James, Ted A.; Tice, Jeffrey A.; Kerlikowske, Karla; Geller, Berta M.; Weaver, Donald L.

    2014-01-01

    Background Screening mammography utilization in Vermont has declined since 2009 during a time of changing screening guidelines and increased interest in personalized screening regimens. This study evaluates whether the breast cancer risk distribution of the state’s screened population changed during the observed decline. Methods We examined the breast cancer risk distribution among screened women between 2001 and 2012 using data from the Vermont Breast Cancer Surveillance System. We estimated each screened woman’s 5-year risk of breast cancer using the Breast Cancer Surveillance Consortium risk calculator. Annual screening counts by risk group were normalized and age-adjusted to the Vermont female population by direct standardization. Results The normalized rate of low-risk (5-year breast cancer risk of <1%) women screened increased 8.3% per year (95% confidence interval [CI] = 4.8 to 11.9) between 2003 and 2008 and then declined by −5.4% per year (95% CI = −8.1 to −2.6) until 2012. When stratified by age group, the rate of low-risk women screened declined −4.4% per year (95% CI = −8.8 to 0.1; not statistically significant) for ages 40 to 49 years and declined a statistically significant −7.1% per year (95% CI = −12.1 to −2.0) for ages 50 to 74 years during 2008 to 2012. These declines represented the bulk of overall decreases in screening after 2008, with rates for women categorized in higher risk levels generally exhibiting small annual changes. Conclusions The observed decline in women screened in Vermont in recent years is largely attributable to reductions in screening visits by women who are at low risk of developing breast cancer. PMID:24957223

  15. Neuropathology of dementia in Parkinson's disease: a prospective, community-based study.

    PubMed

    Aarsland, Dag; Perry, Robert; Brown, Andrew; Larsen, Jan P; Ballard, Clive

    2005-11-01

    Twenty-two patients with Parkinson's disease drawn from a community-based study were followed prospectively until their deaths. Even though 18 patients had dementia, none fulfilled Braak and Braak or The National Institute on Aging and Ronald and Nancy Reagan Institute of the Alzheimer's Association, whereas all patients had limbic or neocortical Lewy body disease. The Lewy body score and Braak and Braak stage were significantly associated with the rate of cognitive decline, but only the Lewy body score was associated with the rate of cognitive decline in the univariate analyses. This study strongly suggests that Lewy body disease is the main substrate driving the progression of cognitive impairment in Parkinson's disease.

  16. Predicting Speech Intelligibility Decline in Amyotrophic Lateral Sclerosis Based on the Deterioration of Individual Speech Subsystems

    PubMed Central

    Yunusova, Yana; Wang, Jun; Zinman, Lorne; Pattee, Gary L.; Berry, James D.; Perry, Bridget; Green, Jordan R.

    2016-01-01

    Purpose To determine the mechanisms of speech intelligibility impairment due to neurologic impairments, intelligibility decline was modeled as a function of co-occurring changes in the articulatory, resonatory, phonatory, and respiratory subsystems. Method Sixty-six individuals diagnosed with amyotrophic lateral sclerosis (ALS) were studied longitudinally. The disease-related changes in articulatory, resonatory, phonatory, and respiratory subsystems were quantified using multiple instrumental measures, which were subjected to a principal component analysis and mixed effects models to derive a set of speech subsystem predictors. A stepwise approach was used to select the best set of subsystem predictors to model the overall decline in intelligibility. Results Intelligibility was modeled as a function of five predictors that corresponded to velocities of lip and jaw movements (articulatory), number of syllable repetitions in the alternating motion rate task (articulatory), nasal airflow (resonatory), maximum fundamental frequency (phonatory), and speech pauses (respiratory). The model accounted for 95.6% of the variance in intelligibility, among which the articulatory predictors showed the most substantial independent contribution (57.7%). Conclusion Articulatory impairments characterized by reduced velocities of lip and jaw movements and resonatory impairments characterized by increased nasal airflow served as the subsystem predictors of the longitudinal decline of speech intelligibility in ALS. Declines in maximum performance tasks such as the alternating motion rate preceded declines in intelligibility, thus serving as early predictors of bulbar dysfunction. Following the rapid decline in speech intelligibility, a precipitous decline in maximum performance tasks subsequently occurred. PMID:27148967

  17. Predicting Speech Intelligibility Decline in Amyotrophic Lateral Sclerosis Based on the Deterioration of Individual Speech Subsystems.

    PubMed

    Rong, Panying; Yunusova, Yana; Wang, Jun; Zinman, Lorne; Pattee, Gary L; Berry, James D; Perry, Bridget; Green, Jordan R

    2016-01-01

    To determine the mechanisms of speech intelligibility impairment due to neurologic impairments, intelligibility decline was modeled as a function of co-occurring changes in the articulatory, resonatory, phonatory, and respiratory subsystems. Sixty-six individuals diagnosed with amyotrophic lateral sclerosis (ALS) were studied longitudinally. The disease-related changes in articulatory, resonatory, phonatory, and respiratory subsystems were quantified using multiple instrumental measures, which were subjected to a principal component analysis and mixed effects models to derive a set of speech subsystem predictors. A stepwise approach was used to select the best set of subsystem predictors to model the overall decline in intelligibility. Intelligibility was modeled as a function of five predictors that corresponded to velocities of lip and jaw movements (articulatory), number of syllable repetitions in the alternating motion rate task (articulatory), nasal airflow (resonatory), maximum fundamental frequency (phonatory), and speech pauses (respiratory). The model accounted for 95.6% of the variance in intelligibility, among which the articulatory predictors showed the most substantial independent contribution (57.7%). Articulatory impairments characterized by reduced velocities of lip and jaw movements and resonatory impairments characterized by increased nasal airflow served as the subsystem predictors of the longitudinal decline of speech intelligibility in ALS. Declines in maximum performance tasks such as the alternating motion rate preceded declines in intelligibility, thus serving as early predictors of bulbar dysfunction. Following the rapid decline in speech intelligibility, a precipitous decline in maximum performance tasks subsequently occurred.

  18. The Return of Rate Dependence.

    PubMed

    Quisenberry, Amanda J; Snider, Sarah E; Bickel, Warren K

    2016-11-01

    Rate dependence, a well-known phenomenon in behavioral pharmacology, appears to have declined as a topic of interest, perhaps, as a result of being viewed pertinent to only the preclinical investigation of drugs on schedule-controlled performance. Obstacles to data interpretation due to conflation with regression to the mean also appear to have contributed to the topic's decline. Despite this reduction in exposure, rate dependence is a useful concept and tool that can be used to determine sources of variability, predict therapeutic outcomes, and identify individuals that are most likely to respond therapeutically. Armed with new statistical methods and an understanding of the broad range of conditions under which rate dependence can be observed, we urge researchers to revisit the concept, use the appropriate analysis methods, and to design empirical studies a priori to further explore rate dependence.

  19. Declining case fatality rates for acute myocardial infarction in South Asian and white patients in the past 15 years.

    PubMed

    Liew, R; Sulfi, S; Ranjadayalan, K; Cooper, J; Timmis, A D

    2006-08-01

    To determine whether case fatality rates in South Asian (Bangladeshi, Indian and Pakistani) patients with acute myocardial infarction have shown similar declines to those reported for white patients during the past 15 years. Cross-sectional, observational study. Coronary care unit in east London. 2640 patients-29% South Asian-admitted with acute myocardial infarction between January 1988 and December 2002. Differences over time in rates of in-hospital death, ventricular fibrillation and left ventricular failure. The proportion of South Asians increased from 22% in 1988-92 to 37% in 1998-2002. Indices of infarct severity were similar in South Asian and white patients, with declining frequencies of ST elevation infarction (88.2% to 77.5%, p < 0.0001), Q wave development (78.1% to 56.9%, p < 0.0001) and mean (interquartile range) peak serum creatine kinase concentrations (1250 (567-2078) to 1007 (538-1758) IU/l, p < 0.0001) between 1988-92 and 1998-2002. Rates of in-hospital death (13.0% to 9.4%, p < 0.01), ventricular fibrillation (9.2% to 6.0%, p < 0.001) and left ventricular failure (33.2% to 26.5%, p < 0.0001) all declined; these changes did not interact significantly with ethnicity. Odds ratios for the effect of time on risk of death increased from 0.81 (95% CI 0.70 to 0.93) to 1.02 (95% CI 0.87 to 1.21) after adjustment for ethnicity and indices of infarct severity (ST elevation, peak creatine kinase, Q wave development and treatment with a thrombolytic). In the past 15 years, death from acute myocardial infarction among South Asians has declined at a rate similar to that seen in white patients. This is largely caused by reductions in indices of infarct severity.

  20. Secondhand smoke exposure in cars and rooms: trend comparisons among subpopulations of nonsmoking U.S. middle and high school students.

    PubMed

    McIntire, Russell K; Macy, Jonathan T; Seo, Dong-Chul; Nelson, Ashlyn A; Kolbe, Lloyd J

    2014-06-01

    Young people in the United States are exposed to secondhand smoke (SHS) primarily in 2 settings: homes and cars. Recently, researchers reported that the prevalence of U.S students exposed to SHS in cars decreased from 2000 to 2009; however, comparisons of trends across school levels, gender, and racial/ethnic groups were not assessed. Moreover, no studies have examined trends of exposure to SHS in rooms. We used data from the 2000, 2002, 2004, 2006, and 2009 waves of the National Youth Tobacco Survey, a nationally representative cross-sectional survey of U.S. middle and high school students. For SHS in cars and rooms, we identified exposure trends among nonsmokers from 2000 to 2009 and compared trends across subpopulations with binary logistic regression. We identified significant downward linear trends in SHS in cars and rooms for nearly all measured subpopulations of nonsmoking students from 2000 to 2009. SHS exposure in cars and rooms declined at a significantly greater rate for males than for females. SHS exposure in cars declined at a significantly greater rate for non-Hispanic (NH) Blacks than for NH Whites. SHS exposure in rooms declined at a significantly greater rate for NH Whites than for Hispanics and Native Hawaiians/Pacific Islanders. Although prevalence of exposure to SHS in cars and rooms among nonsmoking U.S. middle and high school students has declined from 2000 to 2009, the rates of decline were not equal across genders and racial/ethnic groups. Identification of these differing rates of exposure can help the public health community advocate for interventions focused on reducing adolescent SHS exposure.

  1. Premature death rates diverge in the United States

    Cancer.gov

    An NCI press release on a study that shows premature death rates have declined in the United States among Hispanics, blacks, and Asian/Pacific Islanders but increased among whites and American Indian/Alaska Natives.

  2. Trends in Average Living Children at the Time of Terminal Contraception: A Time Series Analysis Over 27 Years Using ARIMA (p, d, q) Nonseasonal Model.

    PubMed

    Mumbare, Sachin S; Gosavi, Shriram; Almale, Balaji; Patil, Aruna; Dhakane, Supriya; Kadu, Aniruddha

    2014-10-01

    India's National Family Welfare Programme is dominated by sterilization, particularly tubectomy. Sterilization, being a terminal method of contraception, decides the final number of children for that couple. Many studies have shown the declining trend in the average number of living children at the time of sterilization over a short period of time. So this study was planned to do time series analysis of the average children at the time of terminal contraception, to do forecasting till 2020 for the same and to compare the rates of change in various subgroups of the population. Data was preprocessed in MS Access 2007 by creating and running SQL queries. After testing stationarity of every series with augmented Dickey-Fuller test, time series analysis and forecasting was done using best-fit Box-Jenkins ARIMA (p, d, q) nonseasonal model. To compare the rates of change of average children in various subgroups, at sterilization, analysis of covariance (ANCOVA) was applied. Forecasting showed that the replacement level of 2.1 total fertility rate (TFR) will be achieved in 2018 for couples opting for sterilization. The same will be achieved in 2020, 2016, 2018, and 2019 for rural area, urban area, Hindu couples, and Buddhist couples, respectively. It will not be achieved till 2020 in Muslim couples. Every stratum of population showed the declining trend. The decline for male children and in rural area was significantly faster than the decline for female children and in urban area, respectively. The decline was not significantly different in Hindu, Muslim, and Buddhist couples.

  3. Economic development and family size.

    PubMed

    Rios, R J

    1991-01-01

    The demographic transition in Latin America has resulted in increased family size rather than the Western European model of reduced family size. In 1905, both fertility and mortality were high in Latin America, but mortality declined more rapidly in Latin America than in Europe. In 1905, the crude birth rate for 15 selected countries averaged 44/1000 population. Western fertility at a comparable transition point was much lower at 30/1000. Between 1905 and 1960, fertility declines were evident in Uruguay, Argentina, Cuba, and Chile. Between 1960 and 1985, fertility declines appeared in Costa Rica, Panama, Brazil, and Colombia. Fertility declines were smaller in the other Latin American countries. Crude birth rates declined markedly by 1985 but may overestimate fertility decline, which is more accurately measured by standardized birth rates. Fertility decline was evident in Argentina, Chile, and Costa Rica for standardized birth rates, survivorship ratio, and births surviving past the age of 15 years. Theoretically, families are expected to reduce family size when survivorship is assured; when mortality is 25%, only four children need be planned instead of six when mortality is 50%. A result of falling mortality is a cheaper cost of producing children, which may stimulate parents to raise bigger families. Western fertility decline has been attributed to mortality decline, urbanization, increased female labor force participation, rising wages, and more efficient contraception. Comparable economic development in Latin America has not resulted in large enough changes to encourage family size limitation. A table of fertility and economic indicators for selected countries in Latin America and Europe reflects the inverse relationship between income growth, urban growth, and growth in female educational status and fertility. The regression equation explains 60% of the variation in fertility rates among Latin American countries. Explanatory power increases to 75% when female high school enrollment is added to per capita gross national product. Fertility declines in Latin America in the future will be dependent on economic development, educational advancement for women, and a reduction in rural population.

  4. Did the elimination of lead from petrol reduce crime in the USA in the 1990s?

    PubMed Central

    Hall, Wayne

    2013-01-01

    This article assesses the evidence for the hypothesis that a decline in all types of crime since the early 1990s in the USA was a consequence of removing lead from petrol between 1975 and 1985. It describes ecological and econometric studies that have generally but not always found correlations between lead exposures in childhood and some types of crime 20 years later; a small number of epidemiological studies that have found a dose-response relationship between lead exposure in childhood and self-reported and officially recorded criminal offences in young adulthood; and evidence for the biological plausibility of a causal relationship. Lead exposure in childhood may have played a small role in rising and falling crime rates in the USA but it is unlikely to account for the very high percentage of the decline suggested by the ecological studies. The major anomaly in the evidence is that the associations reported in ecological studies are much stronger (explaining 56-90% of the variation in crime rates) than the weaker relationships found in the cohort studies (that typically explain less than 1% of the variance in offending).  Suggestions are made for research that will better assess the contribution that reduced lead exposure has made to declining crime rates in the USA. PMID:24555074

  5. Cohort-specific trends in stroke mortality in seven European countries were related to infant mortality rates.

    PubMed

    Amiri, M; Kunst, A E; Janssen, F; Mackenbach, J P

    2006-12-01

    To assess, in a population-based study, whether secular trends in cardiovascular disease mortality in seven European countries were correlated with past trends in infant mortality rate (IMR) in these countries. Data on ischemic heart disease (IHD) and stroke mortality in 1950-1999 in the Netherlands, England & Wales, France, and four Nordic countries were analyzed. We used Poisson regression to describe trends in mortality according to birth cohort, for the cohorts born between 1860 and 1939. Pearson correlation coefficients were calculated to determine associations between IMR and IHD, or stroke mortality. IHD mortality increased for successive cohorts up to 1900, and then started to decline. Stroke mortality levels were virtually stable among birth cohorts up to 1880, but declined rapidly among later cohorts. A strong positive association was found between cohort-specific IMR levels and stroke mortality rates. There were no strong cohort-wise associations between IMR and IHD mortality. These results support other studies in suggesting that living conditions in early childhood may influence population levels of stroke mortality. Future studies should determine the contribution of specific early life factors to the mortality decline in IHD and especially stroke.

  6. Change in physical mobility over 10 years in post-polio syndrome.

    PubMed

    Bickerstaffe, A; Beelen, A; Nollet, F

    2015-03-01

    Post-polio syndrome is characterised by progressive muscle weakness and other symptoms which can limit physical mobility. We assessed the rate of decline in mobility over 10 years in relation to strength decline; and investigated potential predictors for the rate of decline of walking capacity, a measure of mobility, in 48 patients with post-polio syndrome and proven quadriceps dysfunction at baseline. Average walking capacity and self-reported physical mobility declined over 10 years, by 6 and 14%, respectively. Concomitantly people lost an average of 15% of isometric quadriceps strength. Significantly more people used walking aids offering greater support at follow-up. Notably, there was much individual variation, with 18% of participants losing a substantial amount of walking capacity (27% decline) and concomitant self-reported physical mobility (38% decline). Loss of quadriceps strength only explained a small proportion of the variance of the decline in walking capacity (R = 11%) and the rate of decline could not be predicted from baseline values for strength, walking capacity, self-reported physical mobility or basic demographics. The individual variability, yet lack of predictive factors, underscores the need for personally tailored care based on actual functional decline in patients with post-polio syndrome. Copyright © 2014. Published by Elsevier B.V.

  7. National trends in rates of death and hospital admissions related to acute myocardial infarction, heart failure and stroke, 1994–2004

    PubMed Central

    Tu, Jack V.; Nardi, Lorelei; Fang, Jiming; Liu, Juan; Khalid, Laila; Johansen, Helen

    2009-01-01

    Background Rates of death from cardiovascular and cerebrovascular diseases have been steadily declining over the past few decades. Whether such declines are occurring to a similar degree for common disorders such as acute myocardial infarction, heart failure and stroke is uncertain. We examined recent national trends in mortality and rates of hospital admission for these 3 conditions. Methods We analyzed mortality data from Statistic Canada’s Canadian Mortality Database and data on hospital admissions from the Canadian Institute for Health Information’s Hospital Morbidity Database for the period 1994–2004. We determined age- and sex-standardized rates of death and hospital admissions per 100 000 population aged 20 years and over as well as in-hospital case-fatality rates. Results The overall age- and sex-standardized rate of death from cardiovascular disease in Canada declined 30.0%, from 360.6 per 100 000 in 1994 to 252.5 per 100 000 in 2004. During the same period, the rate fell 38.1% for acute myocardial infarction, 23.5% for heart failure and 28.2% for stroke, with improvements observed across most age and sex groups. The age- and sex-standardized rate of hospital admissions decreased 27.6% for stroke and 27.2% for heart failure. The rate for acute myocardial infarction fell only 9.2%. In contrast, the relative decline in the inhospital case-fatality rate was greatest for acute myocardial infarction (33.1%; p < 0.001). Much smaller relative improvements in case-fatality rates were noted for heart failure (8.1%) and stroke (8.9%). Interpretation The rates of death and hospital admissions for acute myocardial infarction, heart failure and stroke in Canada changed at different rates over the 10-year study period. Awareness of these trends may guide future efforts for health promotion and health care planning and help to determine priorities for research and treatment. PMID:19546444

  8. Measles, mumps, and rubella antibody patterns of persistence and rate of decline following the second dose of the MMR vaccine.

    PubMed

    Seagle, Emma E; Bednarczyk, Robert A; Hill, Tenisha; Fiebelkorn, Amy Parker; Hickman, Carole J; Icenogle, Joseph P; Belongia, Edward A; McLean, Huong Q

    2018-02-01

    Antibodies to measles, mumps, and rubella decline 3% per year on average, and have a high degree of individual variation. Yet, individual variations and differences across antigens are not well understood. To better understand potential implications on individual and population susceptibility, we reanalyzed longitudinal data to identify patterns of seropositivity and persistence. Children vaccinated with the second dose of measles, mumps, rubella vaccine (MMR2) at 4-6 years of age were followed up to 12 years post-vaccination. The rates of antibody decline were assessed using regression models, accounting for differences between and within subjects. Most of the 302 participants were seropositive throughout follow-up (96% measles, 88% mumps, 79% rubella). The rate of antibody decline was associated with MMR2 response and baseline titer for measles and age at first dose of MMR (MMR1) for rubella. No demographic or clinical factors were associated with mumps rate of decline. One month post-MMR2, geometric mean titer (GMT) to measles was high (3892 mIU/mL), but declined on average 9.7% per year among those with the same baseline titer and <2-fold increase post-MMR2. Subjects with ≥2-fold experienced a slower decline (≤7.4%). GMT to rubella was 149 one month post-MMR2, declining 2.6% and 5.9% per year among those who received MMR1 at 12-15 months and >15 months, respectively. GMT to mumps one month post-MMR2 was 151, declining 9.2% per year. Only 14% of subjects had the same persistence trends for all antigens. The rate of antibody decay varied substantially among individuals and the 3 antigen groups. A fast rate of decline coupled with high variation was observed for mumps, yet no predictors were identified. Future research should focus on better understanding waning titers to mumps and its impacts on community protection and individual susceptibility, in light of recent outbreaks in vaccinated populations. Copyright © 2018 Elsevier Ltd. All rights reserved.

  9. Determining the predictors of change in quality of life self-ratings and carer-ratings for community-dwelling people with Alzheimer disease.

    PubMed

    Bosboom, Pascalle R; Alfonso, Helman; Almeida, Osvaldo P

    2013-01-01

    The aim of this study was to determine the factors that mediate changes in Health Related Quality of Life (HRQoL) ratings by community-dwelling people with Alzheimer disease (AD) and carers over a period of 18 months. We completed an 18-month longitudinal study of 80 community-dwelling older adults diagnosed with probable AD of mild or moderate severity (NINCDS-ADRD criteria) and their family carers. The primary outcome of interest was the 18-month change in HRQoL ratings as measured with the Quality of Life-AD (QoL-AD) (by carer and by self). Explanatory variables included demographics, lifestyle, cognition, awareness, psychopathology, burden-of-care, use of medication, and functionality in daily life. We found a significant decline (8.7%, P=0.003) in QoL-AD carer-ratings, but not in self-ratings. The final parsimonious model of predictors of changes in QoL-AD self-ratings explained 22.6% of the variance; only changes on Hospital Anxiety and Depression Scale Anxiety retained significance. The final model of predictors of changes in carer-ratings explained 55.0% of the variance: that is, changes on Informant Questionnaire on Cognitive Decline in the Elderly, changes on Hospital Anxiety and Depression Scale Depression, practicing hobbies at 18 months, and number of visit(s) or admission(s) to hospital. HRQoL self-ratings and carer-ratings of community-dwelling people with AD do not decline at same rate over 18 months and changes are associated with different factors. Interventions designed to optimize quality of life of people with AD should consider carefully whose HRQoL ratings they wish to change.

  10. The Rate of Source Memory Decline across the Adult Life Span

    ERIC Educational Resources Information Center

    Cansino, Selene; Estrada-Manilla, Cinthya; Hernandez-Ramos, Evelia; Martinez-Galindo, Joyce Graciela; Torres-Trejo, Frine; Gomez-Fernandez, Tania; Ayala-Hernandez, Mariana; Osorio, David; Cedillo-Tinoco, Melisa; Garces-Flores, Lissete; Gomez-Melgarejo, Sandra; Beltran-Palacios, Karla; Guadalupe Garcia-Lazaro, Haydee; Garcia-Gutierrez, Fabiola; Cadena-Arenas, Yadira; Fernandez-Apan, Luisa; Bartschi, Andrea; Resendiz-Vera, Julieta; Rodriguez-Ortiz, Maria Dolores

    2013-01-01

    Previous studies have suggested that the ability to remember contextual information related to specific episodic experiences declines with advancing age; however, the exact moment in the adult life span when this deficit begins is still controversial. Source memory for spatial information was tested in a life span sample of 1,500 adults between…

  11. Timberland area change in the Lake States: past trends, causes, and projections.

    Treesearch

    Andrew Plantinga; Joseph Buongiorno; Ralph J. Alig; John S. Jr. Spencer

    1989-01-01

    Between the early 1960's and the mid-1980's, the area of timberland in the Lake States declined by about 3 million acres. This study confirms the influences of population, economics, ownership, and trends in other land uses on timberland area. Future declines are expected, but probably at a slower rate.

  12. Root-infecting fungi associated with a decline of longleaf pine in the southeastern United States

    Treesearch

    William J. Otrosina; Diane Bannwart; Ronald W. Roncadori

    1999-01-01

    A 35-year-old longleaf pine stand exhibited trees in various stages of decline. A study was conducted to determine root-infecting fungi and other abnormalities associated with varying degrees of crown symptoms. A four-class crown symptom rating system was devised according to ascending symptom severity. Leptographium procerum and L....

  13. A New Look at Voter Turnout: Good News after All?

    ERIC Educational Resources Information Center

    Social Education, 2006

    2006-01-01

    Many studies of the United States voting have sought to explain why voter participation is declining. Recent research by Michael P. McDonald suggests that the much lamented "decline in voter participation" is an artifact of the way in which turnout rates have been measured. McDonald is an assistant professor of government and politics in…

  14. Understanding the temporal dimension of the red-edge spectral region for forest decline detection using high-resolution hyperspectral and Sentinel-2a imagery

    NASA Astrophysics Data System (ADS)

    Zarco-Tejada, P. J.; Hornero, A.; Hernández-Clemente, R.; Beck, P. S. A.

    2018-03-01

    The operational monitoring of forest decline requires the development of remote sensing methods that are sensitive to the spatiotemporal variations of pigment degradation and canopy defoliation. In this context, the red-edge spectral region (RESR) was proposed in the past due to its combined sensitivity to chlorophyll content and leaf area variation. In this study, the temporal dimension of the RESR was evaluated as a function of forest decline using a radiative transfer method with the PROSPECT and 3D FLIGHT models. These models were used to generate synthetic pine stands simulating decline and recovery processes over time and explore the temporal rate of change of the red-edge chlorophyll index (CI) as compared to the trajectories obtained for the structure-related Normalized Difference Vegetation Index (NDVI). The temporal trend method proposed here consisted of using synthetic spectra to calculate the theoretical boundaries of the subspace for healthy and declining pine trees in the temporal domain, defined by CItime=n/CItime=n+1 vs. NDVItime=n/NDVItime=n+1. Within these boundaries, trees undergoing decline and recovery processes showed different trajectories through this subspace. The method was then validated using three high-resolution airborne hyperspectral images acquired at 40 cm resolution and 260 spectral bands of 6.5 nm full-width half-maximum (FWHM) over a forest with widespread tree decline, along with field-based monitoring of chlorosis and defoliation (i.e., 'decline' status) in 663 trees between the years 2015 and 2016. The temporal rate of change of chlorophyll vs. structural indices, based on reflectance spectra extracted from the hyperspectral images, was different for trees undergoing decline, and aligned towards the decline baseline established using the radiative transfer models. By contrast, healthy trees over time aligned towards the theoretically obtained healthy baseline. The applicability of this temporal trend method to the red-edge bands of the MultiSpectral Imager (MSI) instrument on board Sentinel-2a for operational forest status monitoring was also explored by comparing the temporal rate of change of the Sentinel-2-derived CI over areas with declining and healthy trees. Results demonstrated that the Sentinel-2a red-edge region was sensitive to the temporal dimension of forest condition, as the relationships obtained for pixels in healthy condition deviated from those of pixels undergoing decline.

  15. Association between late-life social activity and motor decline in older adults.

    PubMed

    Buchman, Aron S; Boyle, Patricia A; Wilson, Robert S; Fleischman, Debra A; Leurgans, Sue; Bennett, David A

    2009-06-22

    Loss of motor function is a common consequence of aging, but little is known about the factors that predict idiopathic motor decline. Our objective was to test the hypothesis that late-life social activity is related to the rate of change in motor function in old age. Longitudinal cohort study with a mean follow-up of 4.9 years with 906 persons without stroke, Parkinson disease, or dementia participating in the Rush Memory and Aging Project. At baseline, participants rated the frequency of their current participation in common social activities from which a summary measure of social activity was derived. The main outcome measure was annual change in a composite measure of global motor function, based on 9 measures of muscle strength and 9 motor performances. Mean (SD) social activity score at baseline was 2.6 (0.58), with higher scores indicating more frequent participation in social activities. In a generalized estimating equation model, controlling for age, sex, and education, global motor function declined by approximately 0.05 U/y (estimate, 0.016; 95% confidence interval [CI], -0.057 to 0.041 [P = .02]). Each 1-point decrease in social activity was associated with approximately a 33% more rapid rate of decline in motor function (estimate, 0.016; 95% CI, 0.003 to 0.029 [P = .02]). The effect of each 1-point decrease in the social activity score at baseline on the rate of change in global motor function was the same as being approximately 5 years older at baseline (age estimate, -0.003; 95% CI, -0.004 to -0.002 [P<.001]). Furthermore, this amount of motor decline per year was associated with a more than 40% increased risk of death (hazard ratio, 1.44; 95% CI, 1.30 to 1.60) and a 65% increased risk of incident Katz disability (hazard ratio, 1.65; 95% CI, 1.48 to 1.83). The association of social activity with the rate of global motor decline did not vary along demographic lines and was unchanged (estimate, 0.025; 95% CI, 0.005 to 0.045 [P = .01]) after controlling for potential confounders including late-life physical and cognitive activity, disability, global cognition depressive symptoms, body composition, and chronic medical conditions. Less frequent participation in social activities is associated with a more rapid rate of motor function decline in old age.

  16. Genetic association between human chitinases and lung function in COPD.

    PubMed

    Aminuddin, F; Akhabir, L; Stefanowicz, D; Paré, P D; Connett, J E; Anthonisen, N R; Fahy, J V; Seibold, M A; Burchard, E G; Eng, C; Gulsvik, A; Bakke, P; Cho, M H; Litonjua, A; Lomas, D A; Anderson, W H; Beaty, T H; Crapo, J D; Silverman, E K; Sandford, A J

    2012-07-01

    Two primary chitinases have been identified in humans--acid mammalian chitinase (AMCase) and chitotriosidase (CHIT1). Mammalian chitinases have been observed to affect the host's immune response. The aim of this study was to test for association between genetic variation in the chitinases and phenotypes related to chronic obstructive pulmonary disease (COPD). Polymorphisms in the chitinase genes were selected based on previous associations with respiratory diseases. Polymorphisms that were associated with lung function level or rate of decline in the Lung Health Study (LHS) cohort were analyzed for association with COPD affection status in four other COPD case-control populations. Chitinase activity and protein levels were also related to genotypes. In the caucasian LHS population, the baseline forced expiratory volume in one second (FEV(1)) was significantly different between the AA and GG genotypic groups of the AMCase rs3818822 polymorphism. Subjects with the GG genotype had higher AMCase protein and chitinase activity compared with AA homozygotes. For CHIT1 rs2494303, a significant association was observed between rate of decline in FEV(1) and the different genotypes. In the African American LHS population, CHIT1 rs2494303 and AMCase G339T genotypes were associated with rate of decline in FEV(1). Although a significant effect of chitinase gene alleles was found on lung function level and decline in the LHS, we were unable to replicate the associations with COPD affection status in the other COPD study groups.

  17. Population Trend and Elasticities of Vital Rates for Steller Sea Lions (Eumetopias jubatus) in the Eastern Gulf of Alaska: A New Life-History Table Analysis

    PubMed Central

    Maniscalco, John M.; Springer, Alan M.; Adkison, Milo D.; Parker, Pamela

    2015-01-01

    Steller sea lion (Eumetopias jubatus) numbers are beginning to recover across most of the western distinct population segment following catastrophic declines that began in the 1970s and ended around the turn of the century. This study makes use of contemporary vital rate estimates from a trend-site rookery in the eastern Gulf of Alaska (a sub-region of the western population) in a matrix population model to estimate the trend and strength of the recovery across this region between 2003 and 2013. The modeled population trend was projected into the future based on observed variation in vital rates and a prospective elasticity analysis was conducted to determine future trends and which vital rates pose the greatest threats to recovery. The modeled population grew at a mean rate of 3.5% per yr between 2003 and 2013 and was correlated with census count data from the local rookery and throughout the eastern Gulf of Alaska. If recent vital rate estimates continue with little change, the eastern Gulf of Alaska population could be fully recovered to pre-decline levels within 23 years. With density dependent growth, the population would need another 45 years to fully recover. Elasticity analysis showed that, as expected, population growth rate (λ) was most sensitive to changes in adult survival, less sensitive to changes in juvenile survival, and least sensitive to changes in fecundity. A population decline could be expected with only a 6% decrease in adult survival, whereas a 32% decrease in fecundity would be necessary to bring about a population decline. These results have important implications for population management and suggest current research priorities should be shifted to a greater emphasis on survival rates and causes of mortality. PMID:26488901

  18. Ingestion of Brachionus plicatilis under different microalgae conditions

    NASA Astrophysics Data System (ADS)

    Zhou, Wenli; Tang, Xuexi; Qiao, Xiuting; Wang, You; Wang, Renjun; Feng, Lei

    2009-09-01

    The effects of four microalgae, Chlorella vulgaris, Platymonas helgolandicavar, Isochrysis galbana, and Nitzschia closterium on the grazing and filtering rates of the marine rotifer, Brachionus plicatilis, were evaluated under laboratory conditions. The grazing rates in separate cultures of the four microalga were as follows: C. vulgaris > P. helgolandicavar > I. galbana > N. closterium. However, the filtering rates occurred in the following order: P. helgolandicavar > N. closterium > C. vulgaris > I. galbana. A mixed diets experiment revealed that P. helgolandicavar was the preferred diet of B. plicatilis. In addition, the grazing rate of B. plicatilis increased gradually as the density of the microalgae increased, until concentrations of 2.5×106 cells mL-1 for C. vulgaris and 1.5×106 cells mL-1 for I. galbana were obtained. Furthermore, the filtering rate increased slightly when the density of the microalgae was low, after which it declined as the microalgal density increased. The grazing rates of B. plicatilis were as follows during the different growth phases: stationary phase > exponential phase > lag phase > decline phase. Additionally, the filtering rates during the growth phases were: exponential phase > lag phase > stationary phase > decline phase. The results of this study provide foundational information that can be used to explore the optimal culture conditions for rotifers and to promote the development of aquaculture.

  19. The changing pattern and determinants of declining consanguinity in Jordan during 1990-2012.

    PubMed

    Islam, M Mazharul

    2018-03-01

    Consanguinity is a deep rooted cultural trait in Jordan. To examine the patterns and determinants of declining rates of consanguineous marriage in Jordan during 1990-2012 in the context of the changing pattern of socio-economic and demographic conditions. The data come from the 1990 and 2012 Jordan Population and Family Health Surveys (JPFHSs). A total of 6461 women in 1990 and 11,352 women in 2012 were successfully interviewed. Descriptive and multivariate statistical techniques were used for data analysis. Consanguinity was found to be widely practiced (35% in 2012) until recent times in Jordan. However, there has been a secular declining trend over the last few decades as the practice of consanguinity has declined from 56% in 1990 to 35% in 2012. Increasing age at marriage and female education, higher level of education of husbands, declining family size, increasing rate of urbanisation and female employment, exposure to mass media and higher economic status appeared as significant predictors of declining consanguinity in Jordan. The findings of this study support Goode's hypothesis of a decrease of consanguinity with modernisation. Although consanguinity is a deeply rooted cultural trend in Jordan, it is gradually losing ground due to modernisation and socio-demographic transition of the country.

  20. Guaranteed Student Loans: Eliminating Interest Rate Floors Could Generate Substantial Savings. Report to the Honorable George D. Mitchell, U.S. Senate.

    ERIC Educational Resources Information Center

    General Accounting Office, Washington, DC. Div. of Human Resources.

    A study was done of how interest rate floors on certain guaranteed student loans affect the federal government's and students' costs when rates on short-term government securities decline. The study developed cost comparisons using fixed and variable loan interest rates. For comparison Department of Education projections of loan volumes for fiscal…

  1. The rise and decline of nonsteroidal antiinflammatory drug-associated gastropathy in rheumatoid arthritis.

    PubMed

    Fries, James F; Murtagh, Kirsten N; Bennett, Mihoko; Zatarain, Ernesto; Lingala, Bharathi; Bruce, Bonnie

    2004-08-01

    Nonsteroidal antiinflammatory drug (NSAID)-associated gastropathy is a major cause of hospitalization and death. This study was undertaken to examine whether recent preventive approaches have been associated with a declining incidence of NSAID gastropathy, and, if so, what measures may have caused the decline. We studied 5,598 patients with rheumatoid arthritis (RA) over 31,262 patient-years at 8 sites. We obtained standardized longitudinal information on the patients that had been previously used to establish the incidence of NSAID gastropathy, and also information on patient risk factors and differences in toxicity between NSAIDs. Consecutive patients were followed up with biannual Health Assessment Questionnaires and medical record audits between 1981 and 2000. The major outcome measure was the annual rate of hospitalization involving bleeding, obstruction, or perforation of the gastrointestinal (GI) tract and related conditions. Rates of GI-related hospitalizations rose from 0.6% in 1981 to 1.5% in 1992 (P < 0.001), and then declined to 0.5% in 2000 (P < 0.001). The fitted spline curve fit the data well (R2 = 0.70). The period of rise was mainly associated with increasing patient age and the GI risk propensity score. The period of decline was associated with lower doses of ibuprofen and aspirin, a decline in the use of "more toxic" NSAIDs from 52% to 42% of patients, a rise in the use of "safer" NSAIDs from 19% to 48% of patients, and increasing use of proton-pump inhibitors, but not with change in age, NSAID exposure, or GI risk propensity score. The risk of serious NSAID gastropathy has declined by 67% in these cohorts since 1992. We estimate that 24% of this decline was the result of lower doses of NSAIDs, while 18% was associated with the use of proton-pump inhibitors and 14% with the use of less toxic NSAIDs. These declines in the incidence of NSAID gastropathy are likely to continue.

  2. Metabolic rates of benthic deep-sea decapod crustaceans decline with increasing depth primarily due to the decline in temperature

    NASA Astrophysics Data System (ADS)

    Childress, J. J.; Cowles, D. L.; Favuzzi, J. A.; Mickel, T. J.

    1990-06-01

    The oxygen consumption rates of 11 species of benthic deep-sea decapod crustaceans were measured at a variety of temperatures to test the hypothesis that the metabolic rates of benthic crustaceans decline with increasing depth of occurrence only to the extent explained by the decline in temperature with depth. The species were captured at depths between 150 and 2000m off Southern California using an epibenthic beam trawl equipped with a thermally protecting cod-end to bring the animals to the surface uncontaminated by sediment and at the depth temperature. The data, combined with those for six species of shallower-living crustaceans from California waters, showed a significant decline in oxygen consumption rate with increased species' depths of occurrence, when the measurements were made at temperatures appropriate to each species' depth range. There was no significant relation between wet weight and depth of occurrence in these species. When the data were adjusted to 10°C using a moderate temperature effect factor (corresponding to Q10 values of 2-2.3 depending on the species and temperature range), the significant relationship between oxygen consumption rate and depth was lost, indicating that the observed decline with depth was due to the decline in temperature with depth. When the relationship between metabolic rate and depth of occurrence for the most active (carideans and penaeid) species were compared (ANCOVA) with that for the rest of the species, the active species had significantly higher rates. By combining this data set with data from the literature for a wide variety of shallow-living benthic decapod crustaceans, it was possible to create a data set of 35 species in which the effects of temperature, minimum depth of occurrence and body mass could be separated by multiple linear regression. This demonstrated highly significant effects of size and temperature, but no significant effect of depth for the entire data set and for the data set excluding penaeids and carideans. In contrast, the carideans showed a significant effect of depth on metabolic rate. This is discussed in terms of the adaptive and selective factors responsible for the well-known decline in metabolic rates of midwater crustaceans and fishes, an effect which does exceed the effect of temperature. It is suggested that the typical pattern for deeper living animals may be that metabolic rates on average vary as a function of depth due primarily to variation in temperature, except for the visually orienting pelagic groups (cephalopods, crustaceans and fishes). For those benthic forms which are particularly visually oriented and/or partially pelagic some significant depth-related decline in metabolism beyond that due to the decline in temperature is expected.

  3. Screening Mammography for Free: Impact of Eliminating Cost Sharing on Cancer Screening Rates.

    PubMed

    Jena, Anupam B; Huang, Jie; Fireman, Bruce; Fung, Vicki; Gazelle, Scott; Landrum, Mary Beth; Chernew, Michael; Newhouse, Joseph P; Hsu, John

    2017-02-01

    To study the impact of eliminating cost sharing for screening mammography on mammography rates in a large Medicare Advantage (MA) health plan which in 2010 eliminated cost sharing in anticipation of the Affordable Care Act mandate. Large MA health maintenance organization offering individual-subscriber MA insurance and employer-supplemented group MA insurance. We investigated the impact on breast cancer screening of a policy that eliminated a $20 copayment for screening mammography in 2010 among 53,188 women continuously enrolled from 2007 to 2012 in an individual-subscriber MA plan, compared with 42,473 women with employer-supplemented group MA insurance in the same health maintenance organization who had full screening coverage during this period. We used differences-in-differences analysis to study the impact of cost-sharing elimination on mammography rates. Annual screening rates declined over time for both groups, with similar trends pre-2010 and a slower decline after 2010 among women whose copayments were eliminated. Among women aged 65-74 years in the individual-subscriber MA plan, 44.9 percent received screening in 2009 compared with 40.9 percent in 2012, while 49.5 percent of women in the employer-supplemented MA plan received screening in 2009 compared with 44.1 percent in 2012, that is, a difference-in-difference effect of 1.4 percentage points less decline in screening among women experiencing the cost-sharing elimination. Effects were concentrated among women without recent screening. There were no differences by neighborhood socioeconomic status or race/ethnicity. Eliminating cost sharing for screening mammography was associated with modesty lower decline in screening rates among women with previously low screening adherence. © Health Research and Educational Trust.

  4. Population growth, agrarian peasant economy and environmental degradation in Tanzania.

    PubMed

    Madulu, N F

    1995-03-01

    Population strategies to relieve the density pressures on land and resources in Tanzania have not considered the basic causes of population growth. Resettlement results in the same environmental degradation as in the original settlement. There should be a reduction in the population growth and planning of proper land use and resource exploitation before resettlement. Rural development must include a decline in the dependency on subsistence agriculture. Population in Tanzania increased by 213% during 1948-88. An absolute increase in population size during 1978-88 is recorded despite a slight decline in the rate of growth. Death rates declined, but birth rates were relatively stable at around 50 per 1000 population. Regions with the highest growth rates were Dar es Salaam (4.8%), Rukwa (4.3%), Arusha (3.8%), Mbeya (3.1%), and Ruvuma (3.2%). The regions with the lowest rates were Tanga and Kilimanjaro (2.1%), Coast (2.1%), Lindi (2%), and Mtwara (1.4%). Low growth rates are attributed to low fertility and high infertility. Other factors affecting high growth rates are culture, rates of natural increase, intensity of internal and international migration, climatic conditions, and availability of resources. In 1988 46% of the population was under 15 years old. Per capita land availability declined from 11.8 hectares in 1948 to 3.8 hectares in 1988. The number of landless peasants increased. Productivity declined, and distances to farms increased. The total fertility rate was 6.5 children per woman in 1988 and 6.1 during 1991-92. Slight declines were apparent in the crude birth rate also. High fertility was a response to universal marriage, low contraceptive use (7% using modern methods during 1991-92), declining lactation periods, high mortality rates, and old traditions favoring large families. Children were used extensively in time-consuming and labor-intensive activities, such as fetching water. The mean number of children ever born was higher among women with 1-4 years of schooling compared to women with no formal education and women with 5 or more years of education. Population growth contributes to deforestation, soil erosion, desertification, famine, drought, flooding, and demand for firewood.

  5. Trends and differentials in higher-birthweight infants at 28-31 weeks of gestation, by race and Hispanic origin, United States, 1990-2002.

    PubMed

    Kirmeyer, Sharon E W; Martin, Joyce A

    2007-09-01

    Birth certificate gestational age data based on the date of the mother's last menstrual period (LMP) are considered problematic. Of particular concern are birthweight distributions for infants reported on the birth certificate as having been delivered at 28-31 weeks' gestation; these distributions have been shown to be distinctly bimodal. The 'second curve' of the birthweight distribution at 28-31 weeks includes implausible birthweight/gestational age combinations and, thus, has been hypothesised to represent erroneous gestational ages due to misidentification of the date of LMP. It has been suggested that such 'misclassification' has declined in recent years and that this change can affect trends in preterm birth rates (<37 weeks' gestation), particularly rates among non-Hispanic black infants. This present study used primarily simple and multivariable analyses to review trends and differentials in birthweight distributions at 28-31 weeks by race and Hispanic origin of the mother. It aggregated data for the years 1990-92 and 2000-02 from the US vital statistics Natality files. Over the decade, the percentage of births in the second curve declined for all births and for each racial and Hispanic origin group studied. The largest decline was observed for non-Hispanic blacks; the smallest for Hispanic births. Later initiation of prenatal care, younger maternal age, lower educational attainment, higher birth order and vaginal and singleton delivery were positively associated with a larger second curve, suggesting misclassification of gestational age. Declines in the second curve over the study period were suggested to contribute significantly to the observed decrease in overall preterm birth rates for non-Hispanic black births. Further analysis is needed to estimate the influence of reporting error on preterm birth rates by race and Hispanic origin.

  6. Trends in Acute Nonvariceal Upper Gastrointestinal Bleeding in Dialysis Patients

    PubMed Central

    Yang, Ju-Yeh; Lee, Tsung-Chun; Montez-Rath, Maria E.; Paik, Jane; Chertow, Glenn M.; Desai, Manisha

    2012-01-01

    Impaired kidney function is a risk factor for upper gastrointestinal (GI) bleeding, an event associated with poor outcomes. The burden of upper GI bleeding and its effect on patients with ESRD are not well described. Using data from the US Renal Data System, we quantified the rates of occurrence of and associated 30-day mortality from acute, nonvariceal upper GI bleeding in patients undergoing dialysis; we used medical claims and previously validated algorithms where available. Overall, 948,345 patients contributed 2,296,323 patient-years for study. The occurrence rates for upper GI bleeding were 57 and 328 episodes per 1000 person-years according to stringent and lenient definitions of acute, nonvariceal upper GI bleeding, respectively. Unadjusted occurrence rates remained flat (stringent) or increased (lenient) from 1997 to 2008; after adjustment for sociodemographic characteristics and comorbid conditions, however, we found a significant decline for both definitions (linear approximation, 2.7% and 1.5% per year, respectively; P<0.001). In more recent years, patients had higher hematocrit levels before upper GI bleeding episodes and were more likely to receive blood transfusions during an episode. Overall 30-day mortality was 11.8%, which declined significantly over time (relative declines of 2.3% or 2.8% per year for the stringent and lenient definitions, respectively). In summary, despite declining trends worldwide, crude rates of acute, nonvariceal upper GI bleeding among patients undergoing dialysis have not decreased in the past 10 years. Although 30-day mortality related to upper GI bleeding declined, perhaps reflecting improvements in medical care, the burden on the ESRD population remains substantial. PMID:22266666

  7. Did abortion legalization reduce the number of unwanted children? Evidence from adoptions.

    PubMed

    Bitler, Marianne; Madeline, Zavodny

    2002-01-01

    The legalization of abortion in the United States led to well-known changes in reproductive behavior, but its effect on adoptions has not been investigated. Variation across states in the timing and extent of abortion legalization is used to identify the effects of changes in the legal status of abortion on adoption rates from 1961 to 1975. These effects are estimated in regression analyses that control for states' economic, demographic and political characteristics, as well as for health care availability within states. The rate of adoptions of children born to white women declined by 34-37% in states that repealed restrictive abortion laws before Roe v. Wade. The effect was concentrated among adoptions by petitioners not related to the child. Legal reforms resulting in small increases in access, such as in cases of rape and incest, were associated with a 15-18% decline in adoptions of children born to nonwhite women; however, this decline may have been due to other changes in the policy environment for such adoptions. Rates of adoption of children born to white women appear to have declined after Roe v. Wade, but this association is not statistically significant. The estimated effect of abortion legalization on adoption rates is sizable and can account for much of the decline in adoptions, particularly of children born to white women, during the early 1970s. These findings support previous studies' conclusions that abortion legalization led to a reduction in the number of "unwanted" children; such a reduction may have improved average infant health and children's living conditions.

  8. Dietary salt restriction is beneficial to the management of autosomal dominant polycystic kidney disease.

    PubMed

    Torres, Vicente E; Abebe, Kaleab Z; Schrier, Robert W; Perrone, Ronald D; Chapman, Arlene B; Yu, Alan S; Braun, William E; Steinman, Theodore I; Brosnahan, Godela; Hogan, Marie C; Rahbari, Frederic F; Grantham, Jared J; Bae, Kyongtae T; Moore, Charity G; Flessner, Michael F

    2017-02-01

    The CRISP study of polycystic kidney disease (PKD) found that urinary sodium excretion associated with the rate of total kidney volume increase. Whether sodium restriction slows the progression of Autosomal Dominant PKD (ADPKD) is not known. To evaluate this we conducted a post hoc analysis of the HALT-PKD clinical trials of renin-angiotensin blockade in patients with ADPKD. Linear mixed models examined whether dietary sodium affected rates of total kidney volume or change in estimated glomerular filtration rate (eGFR) in patients with an eGFR over 60 ml/min/1.73 m 2 (Study A) or the risk for a composite endpoint of 50% reduction in eGFR, end-stage renal disease or death, or the rate of eGFR decline in patients with an eGFR 25-60 ml/min/1.73 m 2 (Study B) all in patients initiated on an under100 mEq sodium diet. During the trial urinary sodium excretion significantly declined by an average of 0.25 and 0.41 mEq/24 hour per month in studies A and B, respectively. In Study A, averaged and time varying urinary sodium excretions were significantly associated with kidney growth (0.43%/year and 0.09%/year, respectively, for each 18 mEq urinary sodium excretion). Averaged urinary sodium excretion was not significantly associated with faster eGFR decline (-0.07 ml/min/1.73m 2 /year for each 18 mEq urinary sodium excretion). In Study B, the averaged but not time-varying urinary sodium excretion significantly associated with increased risk for the composite endpoint (hazard ratio 1.08 for each 18 mEq urinary sodium excretion) and a significantly faster eGFR decline (-0.09 ml/min/1.73m 2 /year for each mEq 18 mEq urinary sodium excretion). Thus, sodium restriction is beneficial in the management of ADPKD. Copyright © 2016 International Society of Nephrology. All rights reserved.

  9. The epidemiologic relationship between tuberculosis and non-tuberculous mycobacterial disease: a systematic review.

    PubMed

    Brode, S K; Daley, C L; Marras, T K

    2014-11-01

    Tuberculosis (TB) rates are decreasing in many areas, while non-tuberculous mycobacteria (NTM) infection rates are increasing. The relationship between the epidemiology of TB and NTM infections is not well understood. To understand the epidemiologic relationship between TB and NTM disease worldwide. A systematic review of Medline (1946-2014) was conducted to identify studies that reported temporal trends in NTM disease incidence. TB rates for each geographic area included were then retrieved. Linear regression models were fitted to calculate slopes describing changes over time. There were 22 studies reporting trends in rates of NTM disease, representing 16 geographic areas over four continents: 75% of areas had climbing incidence rates, while 12.5% had stable rates and 12.5% had declining rates. Most studies (81%) showed declining TB incidence rates. The proportion of incident mycobacterial disease caused by NTM was shown to be rising in almost every geographic area (94%). We found an increase in the proportion of mycobacterial disease caused by NTM in many parts of the world due to a simultaneous reduction in TB and increase in NTM disease. Research into the interaction between mycobacterial infections may help explain this inverse relationship.

  10. Abortion Incidence and Service Availability In the United States, 2014

    PubMed Central

    Jones, Rachel K.; Jerman, Jenna

    2017-01-01

    CONTEXT National and state-level information about abortion incidence can help inform policies and programs intended to reduce levels of unintended pregnancy. METHODS In 2015–2016, all U.S. facilities known or expected to have provided abortion services in 2013 or 2014 were surveyed. Data on the number of abortions were combined with population data to estimate national and state-level abortion rates. The number of abortion-providing facilities and changes since a similar 2011 survey were also assessed. The number and type of new abortion restrictions were examined in the states that had experienced the largest proportionate changes in clinics providing abortion services. RESULTS In 2014, an estimated 926,200 abortions were performed in the United States, 12% fewer than in 2011; the 2014 abortion rate was 14.6 abortions per 1,000 women aged 15–44, representing a 14% decline over this period. The number of clinics providing abortions declined 6% between 2011 and 2014, and declines were steepest in the Midwest (22%) and the South (13%). Early medication abortions accounted for 31% of nonhospital abortions, up from 24% in 2011. Most states that experienced the largest proportionate declines in the number of clinics providing abortions had enacted one or more new restrictions during the study period, but reductions were not always associated with declines in abortion incidence. CONCLUSIONS The relationship between abortion access, as measured by the number of clinics, and abortion rates is not straightforward. Further research is needed to understand the decline in abortion incidence. PMID:28094905

  11. First integrative trend analysis for a great ape species in Borneo.

    PubMed

    Santika, Truly; Ancrenaz, Marc; Wilson, Kerrie A; Spehar, Stephanie; Abram, Nicola; Banes, Graham L; Campbell-Smith, Gail; Curran, Lisa; d'Arcy, Laura; Delgado, Roberto A; Erman, Andi; Goossens, Benoit; Hartanto, Herlina; Houghton, Max; Husson, Simon J; Kühl, Hjalmar S; Lackman, Isabelle; Leiman, Ashley; Llano Sanchez, Karmele; Makinuddin, Niel; Marshall, Andrew J; Meididit, Ari; Mengersen, Kerrie; Musnanda; Nardiyono; Nurcahyo, Anton; Odom, Kisar; Panda, Adventus; Prasetyo, Didik; Purnomo; Rafiastanto, Andjar; Raharjo, Slamet; Ratnasari, Dessy; Russon, Anne E; Santana, Adi H; Santoso, Eddy; Sapari, Iman; Sihite, Jamartin; Suyoko, Ahmat; Tjiu, Albertus; Utami-Atmoko, Sri Suci; van Schaik, Carel P; Voigt, Maria; Wells, Jessie; Wich, Serge A; Willems, Erik P; Meijaard, Erik

    2017-07-07

    For many threatened species the rate and drivers of population decline are difficult to assess accurately: species' surveys are typically restricted to small geographic areas, are conducted over short time periods, and employ a wide range of survey protocols. We addressed methodological challenges for assessing change in the abundance of an endangered species. We applied novel methods for integrating field and interview survey data for the critically endangered Bornean orangutan (Pongo pygmaeus), allowing a deeper understanding of the species' persistence through time. Our analysis revealed that Bornean orangutan populations have declined at a rate of 25% over the last 10 years. Survival rates of the species are lowest in areas with intermediate rainfall, where complex interrelations between soil fertility, agricultural productivity, and human settlement patterns influence persistence. These areas also have highest threats from human-wildlife conflict. Survival rates are further positively associated with forest extent, but are lower in areas where surrounding forest has been recently converted to industrial agriculture. Our study highlights the urgency of determining specific management interventions needed in different locations to counter the trend of decline and its associated drivers.

  12. Is there progress toward eliminating racial/ethnic disparities in the leading causes of death?

    PubMed

    Keppel, Kenneth G; Pearcy, Jeffrey N; Heron, Melonie P

    2010-01-01

    We examined changes in relative disparities between racial/ethnic populations for the five leading causes of death in the United States from 1990 to 2006. The study was based on age-adjusted death rates for four racial/ethnic populations from 1990-1998 and 1999-2006. We compared the percent change in death rates over time between racial/ethnic populations to assess changes in relative differences. We also computed an index of disparity to assess changes in disparities relative to the most favorable group rate. Except for stroke deaths from 1990 to 1998, relative disparities among racial/ethnic populations did not decline between 1990 and 2006. Disparities among racial/ethnic populations increased for heart disease deaths from 1999 to 2006, for chronic obstructive pulmonary disease deaths from 1990 to 1998, and for chronic lower respiratory disease deaths from 1999 to 2006. Deaths rates for the leading causes of death are generally declining; however, relative differences between racial/ethnic groups are not declining. The lack of reduction in relative differences indicates that little progress is being made toward the elimination of racial/ethnic disparities.

  13. Births to teenagers in the United States, 1940-2000.

    PubMed

    Ventura, S J; Mathews, T J; Hamilton, B E

    2001-09-25

    This report presents trends in national birth rates for teenagers, with particular focus on the decade of the 1990s. The percent change in rates for 1991-2000 is presented for the United States, and the change for 1991-99 is presented for States. Tabular and graphical descriptions of the trends in teenage birth rates for the Nation and each State, by age group, race, and Hispanic origin, are discussed. Birth rates for teenagers 15-19 years generally declined in the United States since the late 1950s, except for a brief, but steep, upward climb in the late 1980s until 1991. The 2000 rate (49 births per 1,000) is about half the peak rate recorded in 1957 (96 per 1,000). Still the U.S. rate is considerably higher than rates for other developed countries. During the 1990s rate declines were especially large for black teenagers. State-specific rates fell significantly in all States for ages 15-19 and 15-17 years, and in all but three States for ages 18-19 years. Overall the range of decline in State rates for ages 15-19 years was 11 to 36 percent. For teenagers 15-17 years, the range of decline by State was 13 to 43 percent. Reductions by State were largest for black teenagers 15-19 years, with rates falling 40 percent or more in seven States. The factors accounting for these declines include decreased sexual activity reflecting changing attitudes towards premarital sex, increases in condom use, and adoption of newly available hormonal contraception, implants, and injectables.

  14. Ecosystem Consequences of Prolonged Ozone Pollution in the Southern Sierra Nevada

    NASA Astrophysics Data System (ADS)

    Cousins, S.; Battles, J. J.; Cisneros, R.; Esperanza, A.; Swenson, D.

    2015-12-01

    While acute O3 exposure is widely known to damage plant tissues, the chronic effects on long lived organisms such as trees remain unclear. In the southern Sierra Nevada, O3 pollution has afflicted pine-dominated forests for over 40 years. Here we report the results of a long-term study of O3 impact on tree injury, growth, and mortality. Our study employed a network of forest plots along a gradient of O3 pollution with recurring measurements from 1991-2012. Over the same period and locations, summer O3 was monitored via partnership with USNPS and USFS, making this one of the longest known ecosystem studies of O3 pollution and its effects. We found that exposure at the most polluted sites declined 33%, from a W126 index of 20.12 ppm-hrs in 1992 to 13.5 ppm-hrs in 2012. The severity of foliar pollution damage at these sites also declined, from 43.9 on the 0-100 Ozone Injury Index (OII) scale to 34.2, a drop of 22%. At locations with lower O3 exposure, damage declined from OII of 16.9 to 9.2. Mean annual tree mortality rates over the 20 year period, calculated with a profile likelihood approach, were 0.5%/yr (95% CI 0.3 to 0.8 %/yr). This rate is similar to that of healthy canopy trees in similar unpolluted stands. However, low and declining tree growth rates reveal possible ecosystem impacts of prolonged exposure to pollution. Across affected sites, mean relative growth rates were 1.1%/yr in 1991-2000, and just 0.9%/yr in 2000-2011, a decline of 15.6% in the second decade. Initial analyses suggest that tree damage is positively correlated with June-October O3, as indicated by previous studies. Further analysis will explore the drivers of ecosystem impacts and roles of other natural and anthropogenic stressors, including variation in climatic water deficit. Understanding the consequences of prolonged O3 exposure on both individual trees and complex forest ecosystems helps identify the hidden environmental costs of tropospheric O3 and potential benefits of cleaner air.

  15. APOE epsilon 4 allele predicts faster cognitive decline in mild Alzheimer disease.

    PubMed

    Cosentino, S; Scarmeas, N; Helzner, E; Glymour, M M; Brandt, J; Albert, M; Blacker, D; Stern, Y

    2008-05-06

    To determine whether APOE epsilon 4 predicts rate of cognitive change in incident and prevalent Alzheimer disease (AD). Individuals were recruited from two longitudinal cohort studies-the Washington Heights and Inwood Columbia Aging Project (WHICAP; population-based) and the Predictors Study (clinic-based)--and were followed for an average of 4 years. Three samples of participants diagnosed with AD, with diverse demographic characteristics and baseline cognitive functioning, were studied: 1) 199 (48%) of the incident WHICAP cases; 2) 215 (54%) of the prevalent WHICAP cases; and 3) 156 (71%) of the individuals diagnosed with AD in the Predictors Study. Generalized estimating equations were used to test whether rate of cognitive change, measured using a composite cognitive score in WHICAP and the Mini-Mental State Examination in Predictors, varied as a function of epsilon 4 status in each sample. The presence of at least one epsilon 4 allele was associated with faster cognitive decline in the incident population-based AD group (p = 0.01). Parallel results were produced for the two prevalent dementia samples only when adjusting for disease severity or excluding the most impaired participants from the analyses. APOE epsilon 4 may influence rate of cognitive decline most significantly in the earliest stages of Alzheimer disease.

  16. Characteristics of the population below the poverty level: 1984.

    PubMed

    Mcneil, J M

    1986-06-01

    This report presents detailed social and economic characteristics of the US population below the poverty level in 1984 based on the March 1985 Current Population Survey (CPS). Poverty data are cross-classified by such characteristics as race, family relationship, type of residence, education, work experience, and type of income received. The average poverty threshold for a family of 4 was $10,609 in 1984, compared with $10,178 in 1983. Reflecting the general improvement in the economy, the number of persons below the poverty level declined from 35.3 million in 1983 to 33.7 million in 1984. During the same period, the poverty rate fell from 15.2 to 14.4%. The decline in poverty was the 1st statistically significant decline since 1975-1976. The number of persons in poverty in 1977 was about the same as in 1976, but from 1978 to 1983, the number of poor persons increased from 24.5 to 35.3 million. The poverty rate declined for both whites and blacks between 1983 and 1984. The rate for whites dropped from 12.1 to 11.5%, and the rate for blacks fell from 35.7 to 33.8%. No statistically significant changes were recorded in the number or percentage of Spanish-origin persons in poverty. There was some evidence of a decline in the poverty rate among white children under 18 years old, but there were no significant changes in the rate among black or Spanish-origin children. Between 1983 and 1984, the total number of poor families declined as did the number of poor married-couple families. Among the 4 major regions, both the number of persons below the poverty level and the poverty rate declined in the South and West regions, while the Northeast and Midwest regions did not exprience any significant changes. The poverty rate for the South was 16.2%, higher than that of any other region.

  17. Recent changes in the trends of teen birth rates, 1981-2006.

    PubMed

    Wingo, Phyllis A; Smith, Ruben A; Tevendale, Heather D; Ferré, Cynthia

    2011-03-01

    To explore trends in teen birth rates by selected demographics. We used birth certificate data and joinpoint regression to examine trends in teen birth rates by age (10-14, 15-17, and 18-19 years) and race during 1981-2006 and by age and Hispanic origin during 1990-2006. Joinpoint analysis describes changing trends over successive segments of time and uses annual percentage change (APC) to express the amount of increase or decrease within each segment. For teens younger than 18 years, the decline in birth rates began in 1994 and ended in 2003 (APC: -8.03% per year for ages 10-14 years; APC: -5.63% per year for ages 15-17 years). The downward trend for 18- and 19-year-old teens began earlier (1991) and ended 1 year later (2004) (APC: -2.37% per year). For each study population, the trend was approximately level during the most recent time segment, except for continuing declines for 18- and 19-year-old white and Asian/Pacific Islander teens. The only increasing trend in the most recent time segment was for 18- and 19-year-old Hispanic teens. During these declines, the age distribution of teens who gave birth shifted to slightly older ages, and the percentage whose current birth was at least their second birth decreased. Teen birth rates were generally level during 2003/2004-2006 after the long-term declines. Rates increased among older Hispanic teens. These results indicate a need for renewed attention to effective teen pregnancy prevention programs in specific populations. Copyright © 2011. Published by Elsevier Inc.

  18. Occupational fatality risks in the United States and the United Kingdom.

    PubMed

    Mendeloff, John; Staetsky, Laura

    2014-01-01

    There are very few careful studies of differences in occupational fatality rates across countries, much less studies that try to account for those differences. We compare the rate of work injury fatalities (excluding deaths due to highway motor vehicle crashes and those due to violence) identified by the US Census of Fatal Occupational Injuries in recent years with the number reported to the Health and Safety Executive in the United Kingdom (UK) and by other European Union (EU) members through Eurostat. In 2010, the fatality rate in the UK was about 1/3 the rate in the US. In construction the rate was about ¼ the US rate, a difference that had grown substantially since the 1990s. Several other EU members had rates almost as low as the UK rate. Across EU countries, lower rates were associated with high-level management attention to safety issues and to in-house preparation of "risk assessments." Although work fatality rates have declined in the US, fatality rates are much lower and have declined faster in recent years in the UK. Efforts to find out the reasons for the much better UK outcomes could be productive. © 2013 Wiley Periodicals, Inc.

  19. The Influence of Financial, Cultural and Social Capital on the Likelihood of Success of Community College Students: A Quantitative Study Utilizing the Education Longitudinal Study of 2002-2012

    ERIC Educational Resources Information Center

    Iffland, Aaron R.

    2016-01-01

    Community colleges are an integral part of the postsecondary education system in the United States. Unfortunately, college completion rates continue to decline. Additionally, median income in the United States is also declining. The idea that each successive generation of students will do better than the previous one is quickly becoming a fantasy.…

  20. Tests for senescent decline in annual survival probabilities of common pochards, Aythya ferina

    USGS Publications Warehouse

    Nichols, J.D.; Hines, J.E.; Blums, P.

    1997-01-01

    Senescent decline in survival probabilities of animals is a topic about which much has been written but little is known. Here, we present formal tests of senescence hypotheses, using 1373 recaptures from 8877 duckling (age 0) and 504 yearling Common Pochards (Aythya ferina) banded at a Latvian study site, 1975-1992. The tests are based on capture-recapture models that explicitly incorporate sampling probabilities that, themselves, may exhibit timeand age-specific variation. The tests provided no evidence of senescent decline in survival probabilities for this species. Power of the most useful test was low for gradual declines in annual survival probability with age, but good for steeper declines. We recommend use of this type of capture-recapture modeling and analysis for other investigations of senescence in animal survival rates.

  1. Rate of Change in Renal Function and Mortality in Elderly Treated Hypertensive Patients

    PubMed Central

    Langham, Robyn G.; Ademi, Zanfina; Owen, Alice; Krum, Henry; Wing, Lindon M.H.; Nelson, Mark R.; Reid, Christopher M.

    2015-01-01

    Background and objectives Evidence relating the rate of change in renal function, measured as eGFR, after antihypertensive treatment in elderly patients to clinical outcome is sparse. This study characterized the rate of change in eGFR after commencement of antihypertensive treatment in an elderly population, the factors associated with eGFR rate change, and the rate’s association with all-cause and cardiovascular mortality. Design, setting, participants, & measurements Data from the Second Australian National Blood Pressure study were used, where 6083 hypertensive participants aged ≥65 years were enrolled during 1995–1997 and followed for a median of 4.1 years (in-trial). Following the Second Australian National Blood Pressure study, participants were followed-up for a further median 6.9 years (post-trial). The annual rate of change in the eGFR was calculated in 4940 participants using creatinine measurements during the in-trial period and classified into quintiles (Q) on the basis of the following eGFR changes: rapid decline (Q1), decline (Q2), stable (Q3), increase (Q4), and rapid increase (Q5). Results A rapid decline in eGFR in comparison with those with stable eGFRs during the in-trial period was associated with older age, living in a rural area, wider pulse pressure at baseline, receiving diuretic-based therapy, taking multiple antihypertensive drugs, and having blood pressure <140/90 mmHg during the study. However, a rapid increase in eGFR was observed in younger women and those with a higher cholesterol level. After adjustment for baseline and in-trial covariates, Cox-proportional hazard models showed a significantly greater risk for both all-cause (hazard ratio, 1.28; 95% confidence interval, 1.09 to 1.52; P=0.003) and cardiovascular (hazard ratio, 1.40; 95% confidence interval, 1.11 to 1.76; P=0.004) mortality in the rapid decline group compared with the stable group over a median of 7.2 years after the last eGFR measure. No significant association with mortality was observed for a rapid increase in eGFR. Conclusions In elderly persons with treated hypertension, a rapid decline in eGFR is associated with a higher risk of mortality. PMID:25901093

  2. Historical spatial reconstruction of a spawning-aggregation fishery.

    PubMed

    Buckley, Sarah M; Thurstan, Ruth H; Tobin, Andrew; Pandolfi, John M

    2017-12-01

    Aggregations of individual animals that form for breeding purposes are a critical ecological process for many species, yet these aggregations are inherently vulnerable to exploitation. Studies of the decline of exploited populations that form breeding aggregations tend to focus on catch rate and thus often overlook reductions in geographic range. We tested the hypothesis that catch rate and site occupancy of exploited fish-spawning aggregations (FSAs) decline in synchrony over time. We used the Spanish mackerel (Scomberomorus commerson) spawning-aggregation fishery in the Great Barrier Reef as a case study. Data were compiled from historical newspaper archives, fisher knowledge, and contemporary fishery logbooks to reconstruct catch rates and exploitation trends from the inception of the fishery. Our fine-scale analysis of catch and effort data spanned 103 years (1911-2013) and revealed a spatial expansion of fishing effort. Effort shifted offshore at a rate of 9.4 nm/decade, and 2.9 newly targeted FSAs were reported/decade. Spatial expansion of effort masked the sequential exploitation, commercial extinction, and loss of 70% of exploited FSAs. After standardizing for improvements in technological innovations, average catch rates declined by 90.5% from 1934 to 2011 (from 119.4 to 11.41 fish/vessel/trip). Mean catch rate of Spanish mackerel and occupancy of exploited mackerel FSAs were not significantly related. Our study revealed a special kind of shifting spatial baseline in which a contraction in exploited FSAs occurred undetected. Knowledge of temporally and spatially explicit information on FSAs can be relevant for the conservation and management of FSA species. © 2017 Society for Conservation Biology.

  3. Report to the nation finds continuing declines in cancer death rates

    Cancer.gov

    Death rates from all cancers combined for men, women, and children continued to decline in the United States between 2004 and 2008, according to the Annual Report to the Nation on the Status of Cancer, 1975-2008. The overall rate of new cancer diagnoses,

  4. Memory complaints and APOE-epsilon4 accelerate cognitive decline in cognitively normal elderly.

    PubMed

    Dik, M G; Jonker, C; Comijs, H C; Bouter, L M; Twisk, J W; van Kamp, G J; Deeg, D J

    2001-12-26

    To investigate to what extent subjective memory complaints and APOE-epsilon4 allele carriage predict future cognitive decline in cognitively intact elderly persons, by evaluating both their separate and combined effects. We selected 1,168 subjects from the population-based Longitudinal Aging Study Amsterdam who were 62 to 85 years of age and had no obvious cognitive impairment at baseline (Mini-Mental State Examination [MMSE] score, > or =27). Memory complaints and APOE phenotypes were assessed at baseline. MMSE, the Auditory Verbal Learning Test (memory: immediate recall and delayed recall), and the Alphabet Coding Task-15 (information processing speed) were used to study cognitive decline. Follow-up data were collected after 3 and 6 years. Data were analyzed with generalized estimating equations, adjusted for age, sex, education, and depression. Baseline memory complaints were reported by 25.5% of the cognitively intact elderly persons. Overall, 25.3% of the subjects were carriers of at least one APOE-epsilon4 allele. Memory complaints were associated with a greater rate of decline in all cognitive measures, except immediate recall. In addition, APOE-epsilon4 allele carriers had a greater rate of cognitive decline shown by MMSE scores and slower information processing speeds after 6 years. The effects of both memory complaints and APOE-epsilon4 allele carriage were additive: subjects with both factors had a two times higher cognitive decline than did subjects without both factors. Both memory complaints and APOE-epsilon4 allele carriage predict cognitive decline at an early stage. This finding highlights the importance of subjective memory complaints, which are important even at an early stage when objective tests are still unable to detect cognitive deficits and are especially important for elderly carriers of the APOE-epsilon4 allele because they have an additional risk.

  5. Multiple Antibiotic–Resistant Pseudomonas aeruginosa and Lung Function Decline in Patients with Cystic Fibrosis

    PubMed Central

    Ren, Clement L; Konstan, Michael W.; Yegin, Ashley; Rasouliyan, Lawrence; Trzaskoma, Benjamin; Morgan, Wayne J.; Regelmann, Warren

    2014-01-01

    Background The goal of this study was to determine the association of multiple antibiotic– resistant Pseudomonas aeruginosa (MARPA) acquisition with lung function decline in patients with cystic fibrosis (CF). Methods Using data from Epidemiologic Study of Cystic Fibrosis (ESCF), we identified patients with spirometry data and MARPA, defined as PA (1) resistant to gentamicin and either tobramycin or amikacin and (2) resistant to ≥1 antipseudomonal beta lactam. MARPA had to be detected in a respiratory culture after ≥ 2 years of PA-positive but MARPA-negative respiratory cultures. Multivariable piecewise linear regression was performed to model the annual rate of decline in forced expiratory volume in 1 second (FEV1) % predicted 2 calendar years before and after the index year of MARPA detection, adjusting for patient characteristics and CF therapies. Results In total, 4,349 patients with chronic PA and adequate PFT data were identified; 1,111 subsequently developed MARPA, while 3,238 patients were PA positive but MARPA negative. Compared with patients who did not acquire MARPA, MARPA-positive patients had lower FEV1 and received more oral (p<0.013) and inhaled p<0.001) antibiotic therapy. Mean FEV1 decline did not change significantly after MARPA detection (−2.22 % predicted/year before detection and −2.43 after, p=0.45). There was no relationship between persistent infection or FEV1 quartile and FEV1 decline. Conclusions Newly detected MARPA was not associated with a significant change in the rate of FEV1 decline. These results suggest that MARPA is more likely to be a marker of more severe disease and more intensive therapy, and less likely to be contributing independently to more rapid lung function decline. PMID:22445849

  6. Trends in hospitalization rates and outcomes of endocarditis among Medicare beneficiaries.

    PubMed

    Bikdeli, Behnood; Wang, Yun; Kim, Nancy; Desai, Mayur M; Quagliarello, Vincent; Krumholz, Harlan M

    2013-12-10

    The aim of this study was to determine the hospitalization rates and outcomes of endocarditis among older adults. Endocarditis is the most serious cardiovascular infection and is especially common among older adults. Little is known about recent trends for endocarditis hospitalizations and outcomes. Using Medicare inpatient Standard Analytic Files, we identified all fee-for-service beneficiaries age ≥65 years with a principal or secondary diagnosis of endocarditis from 1999 to 2010. We used Medicare Denominator Files to report hospitalizations per 100,000 person-years. Rates of 30-day and 1-year mortality were calculated using Vital Status Files. We used mixed-effects models to calculate adjusted rates of hospitalization and mortality and to compare the results before and after 2007, when the American Heart Association revised their recommendations for endocarditis prophylaxis. Overall, 262,658 beneficiaries were hospitalized with endocarditis. The adjusted hospitalization rate increased from 1999 to 2005, reaching 83.5 per 100,000 person-years in 2005, and declined during 2006 to 2007. After 2007, the decline continued, reaching 70.6 per 100,000 person-years in 2010. Adjusted 30-day and 1-year mortality rates ranged from 14.2% to 16.5% and from 32.6% to 36.2%, respectively. There were no consistent changes in adjusted rates of 30-day and 1-year mortality after 2007. Trends in rates of hospitalization and outcomes were consistent across demographic subgroups. Adjusted rates of hospitalization and mortality declined consistently in the subgroup with a principal diagnosis of endocarditis. Our study highlights the high burden of endocarditis among older adults. We did not observe an increase in adjusted rates of hospitalization or mortality associated with endocarditis after publication of the 2007 guidelines. Copyright © 2013 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  7. Population trends in northern spotted owls: Associations with climate in the Pacific Northwest

    USGS Publications Warehouse

    Glenn, E.M.; Anthony, R.G.; Forsman, E.D.

    2010-01-01

    We used reverse time capture-mark-recapture models to describe associations between rate of population change (??) and climate for northern spotted owls (Strix occidentalis caurina) at six long-term study areas in Washington and Oregon, USA. Populations in three of six areas showed strong evidence of declining populations, while populations in two additional areas were likely declining as well. At four areas, ?? was positively associated with wetter-than-normal conditions during the growing season, which likely affects prey availability. Lambda was also negatively associated with cold, wet winters and nesting seasons, and the number of hot summer days. The amount of annual variation in ?? accounted for by climate varied across study areas (3-85%). Rate of population change was more sensitive to adult survival than to recruitment; however, there was considerable variation among years and across study areas for all demographic rates. While annual survival was more closely related to regional climate conditions, recruitment was often associated with local weather. In addition to climate, declines in recruitment at four of six areas were associated with increased presence of barred owls. Climate change models predict warmer, wetter winters and hotter, drier summers for the Pacific Northwest in the first half of the 21st century. Our results indicate that these conditions have the potential to negatively affect annual survival, recruitment, and consequently population growth rates for northern spotted owls. ?? 2010 Elsevier Ltd.

  8. Reductions in neonatal listeriosis: "Collateral benefit" of Group B streptococcal prophylaxis?

    PubMed

    Lee, Brian; Newland, Jason G; Jhaveri, Ravi

    2016-03-01

    We tested the hypothesis that declines in Listeria monocytogenes in infants are related to declines in rates of early-onset Group B Streptococcus (GBS) infections associated with widespread prophylaxis using agents with Listeria activity. We performed a retrospective cohort analysis using a national administrative database Pediatric Health Information System (PHIS). We searched for ICD-9 codes for Listeriosis in infants <30 days old and for early-onset GBS infection of any kind in infants <5 days old during the study period. We identified 183 cases of Listeriosis in infants <30 days in the PHIS database from 1992 to 2013. We noted a statistically significant decline in case rates over the years studied: 4.78 cases per 10,000 admissions (1992-1995) to 2.24 (1996-2002) to 1.31 from (2003-2013) (p < 0.0001). Case rates of early-onset GBS dropped significantly over the study period: 30.10 cases per 1000 admissions (1992-1995) to 21.70 (1996-2002) to 18.57 (2003-2013) (p < 0.0001). There was a statistically significant correlation between yearly rates of Listeriosis and early-onset GBS (rho: 0.53; p = 0.01). These results support the hypothesis of a "collateral benefit" to widespread GBS prophylaxis and further support the position that empiric antibiotic regimens for febrile infants may no longer require Listeria activity. Copyright © 2016 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

  9. A parsimonious characterization of change in global age-specific and total fertility rates

    PubMed Central

    2018-01-01

    This study aims to understand trends in global fertility from 1950-2010 though the analysis of age-specific fertility rates. This approach incorporates both the overall level, as when the total fertility rate is modeled, and different patterns of age-specific fertility to examine the relationship between changes in age-specific fertility and fertility decline. Singular value decomposition is used to capture the variation in age-specific fertility curves while reducing the number of dimensions, allowing curves to be described nearly fully with three parameters. Regional patterns and trends over time are evident in parameter values, suggesting this method provides a useful tool for considering fertility decline globally. The second and third parameters were analyzed using model-based clustering to examine patterns of age-specific fertility over time and place; four clusters were obtained. A country’s demographic transition can be traced through time by membership in the different clusters, and regional patterns in the trajectories through time and with fertility decline are identified. PMID:29377899

  10. Network Prime-Time Violence Tabulations for 1975-76 Season.

    ERIC Educational Resources Information Center

    Klapper, Joseph T.

    This is an annual report on violence in prime-time television. The tabulations, based on 13 weeks of monitoring prime-time programs on three networks, indicate a decline in violence by 24% and a decline in the rate per hour of dramatic violence to 1.9 incidents per hour since last season. The study also indicated that the introduction of the…

  11. Effects of low-density thinning in a declining white pine stand in Maine

    Treesearch

    William B. Leak; Mariko. Yamasaki

    2013-01-01

    Low-density (32 ft2/acre residual basal area) and medium-low density (60 ft2/acre residual basal area) thinnings were studied over a 4-year period in a declining white pine stand on the Massabesic Experimental Forest in southern Maine. Gross basal area growth at 60 ft2 was about three-fourths the rate...

  12. The Effects of Vehicle Redesign on the Risk of Driver Death.

    PubMed

    Farmer, Charles M; Lund, Adrian K

    2015-01-01

    This study updates a 2006 report that estimated the historical effects of vehicle design changes on driver fatality rates in the United States, separate from the effects of environmental and driver behavior changes during the same period. In addition to extending the period covered by 8 years, this study estimated the effect of design changes by model year and vehicle type. Driver death rates for consecutive model years of vehicle models without design changes were used to estimate the vehicle aging effect and the death rates that would have been expected if the entire fleet had remained unchanged from the 1985 calendar year. These calendar year estimates are taken to be the combined effect of road environment and motorist behavioral changes, with the difference between them and the actual calendar year driver fatality rates reflecting the effect of changes in vehicle design and distribution of vehicle types. The effects of vehicle design changes by model year were estimated for cars, SUVs, and pickups by computing driver death rates for model years 1984-2009 during each of their first 3 full calendar years of exposure and comparing with the expected rates if there had been no design changes. As reported in the 2006 study, had there been no changes in the vehicle fleet, driver death risk would have declined during calendar years 1985-1993 and then slowly increased from 1993 to 2004. The updated results indicate that the gradual increase would have continued through 2006, after which driver fatality rates again would have declined through 2012. Overall, it is estimated that there were 7,700 fewer driver deaths in 2012 than there would have been had vehicle designs not changed. Cars were the first vehicle type whose design safety generally exceeded that of the 1984 model year (starting in model year 1996), followed by SUVs (1998 models) and pickups (2002 models). By the 2009 model year, car driver fatality risk had declined 51% from its high in 1994, pickup driver fatality risk had declined 61% from its high in 1988, and SUV risk had declined 79% from its high in 1988. The risk of driver death in 2009 model passenger vehicles was 8% lower than that in 2008 models and about half that in 1984 models. Changes in vehicles, whether from government regulations and consumer testing that led to advanced safety designs or from other factors such as consumer demand for different sizes and types of vehicles, have been key contributors to the decline in U.S. motor vehicle occupant crash death rates since the mid-1990s. Since the early 1990s, environmental and behavioral risk factors have not shown similar improvement, until the recession of 2007, even though there are many empirically proven countermeasures that have been inadequately applied.

  13. Racial and Residential Differences in U.S. Infant Death Rates: A Temporal Analysis.

    ERIC Educational Resources Information Center

    Johnson, Nan E.; Zaki, Khalida P.

    1988-01-01

    Compares annual rates of neonatal, postneonatal mortality to annual rates of low birth weight, 1963-1982. Shows that same level of decline in incidence of low birth weight is associated with greater decline in mortality rates of non-White than White infants and for nonmetro than metro infants. Contains 15 references. (Author/DHP)

  14. Linking performance decline to choking: players' perceptions in basketball.

    PubMed

    Fryer, Ashley Marie; Tenenbaum, Gershon; Chow, Graig M

    2018-02-01

    This study was aimed at examining how basketball players view unexpected performance errors in basketball, and under what conditions they perceive them as choking. Fifty-three basketball players were randomly assigned into 2 groups (game half) to evaluate the linkage between performance decline and choking as a function of game-time, score gap and game half. Within each group, players viewed 8 scenario clips, which featured a different player conducting an error, and subsequently rated the extent of performance decline, the instance of choking and the salience of various performance attributions regarding the error. The analysis revealed that choking was most salient in the 2nd half of the game, but an error was perceived as choking more saliently in the beginning of the 2nd half. This trend was also shown for players' perception of performance decline. Players' ratings of the attributions assigned to errors, however, revealed that during the end of the 2nd half, time pressure and lack of concentration were the causes of errors. Overall, the results provide evidence towards a conceptual framework linking performance decline to the perception of choking, and that errors conducted by players are perceived as choking when there is not a salient reason to suggest its occurrence.

  15. Population Group Abortion Rates and Lifetime Incidence of Abortion: United States, 2008-2014.

    PubMed

    Jones, Rachel K; Jerman, Jenna

    2017-12-01

    To assess the prevalence of abortion among population groups and changes in rates between 2008 and 2014. We used secondary data from the Abortion Patient Survey, the American Community Survey, and the National Survey of Family Growth to estimate abortion rates. We used information from the Abortion Patient Survey to estimate the lifetime incidence of abortion. Between 2008 and 2014, the abortion rate declined 25%, from 19.4 to 14.6 per 1000 women aged 15 to 44 years. The abortion rate for adolescents aged 15 to 19 years declined 46%, the largest of any group. Abortion rates declined for all racial and ethnic groups but were larger for non-White women than for non-Hispanic White women. Although the abortion rate decreased 26% for women with incomes less than 100% of the federal poverty level, this population had the highest abortion rate of all the groups examined: 36.6. If the 2014 age-specific abortion rates prevail, 24% of women aged 15 to 44 years in that year will have an abortion by age 45 years. The decline in abortion was not uniform across all population groups.

  16. Declining death rates from hyperglycemic crisis among adults with diabetes, U.S., 1985-2002.

    PubMed

    Wang, Jing; Williams, Desmond E; Narayan, K M Venkat; Geiss, Linda S

    2006-09-01

    To examine trends in death rates for hyperglycemic crisis (diabetic ketoacidosis or hyperglycemic hyperosmolar state) among adults with diabetes in the U.S. from 1985 to 2002. Deaths with hyperglycemic crisis as the underlying cause were identified from national mortality data. Death rates were calculated using estimates of adults with diabetes from the National Health Interview Survey as the denominator and age adjusted to the 2000 U.S. population. The trends from 1985 to 2002 were tested using joinpoint regression analysis. Deaths due to hyperglycemic crisis dropped from 2,989 in 1985 to 2,459 in 2002. During the time period, age-adjusted death rates decreased from 42.4 to 23.8 per 100,000 adults with diabetes (4.4% decrease per year, P for trend <0.01). Death rates declined in all age-groups, with the greatest decrease occurring among individuals aged > or =65 years. Age-adjusted death rates fell for all race-sex subgroups, with black men experiencing the smallest decline. About one-fifth of deaths occurred at home or on arrival at the hospital, and the death rates for hyperglycemic crisis occurring at these places declined only modestly over time (2.1% decrease per year, P for trend = 0.049). Overall death rates due to hyperglycemic crisis among adults with diabetes have declined in the U.S. However, scope for further improvement remains, especially to further reduce death rates among black men and to prevent deaths occurring at home.

  17. Single neuropsychological test scores associated with rate of cognitive decline in early Alzheimer disease.

    PubMed

    Parikh, Mili; Hynan, Linda S; Weiner, Myron F; Lacritz, Laura; Ringe, Wendy; Cullum, C Munro

    2014-01-01

    Alzheimer disease (AD) characteristically begins with episodic memory impairment followed by other cognitive deficits; however, the course of illness varies, with substantial differences in the rate of cognitive decline. For research and clinical purposes it would be useful to distinguish between persons who will progress slowly from persons who will progress at an average or faster rate. Our objective was to use neurocognitive performance features and disease-specific and health information to determine a predictive model for the rate of cognitive decline in participants with mild AD. We reviewed the records of a series of 96 consecutive participants with mild AD from 1995 to 2011 who had been administered selected neurocognitive tests and clinical measures. Based on Clinical Dementia Rating (CDR) of functional and cognitive decline over 2 years, participants were classified as Faster (n = 45) or Slower (n = 51) Progressors. Stepwise logistic regression analyses using neurocognitive performance features, disease-specific, health, and demographic variables were performed. Neuropsychological scores that distinguished Faster from Slower Progressors included Trail Making Test - A, Digit Symbol, and California Verbal Learning Test (CVLT) Total Learned and Primacy Recall. No disease-specific, health, or demographic variable predicted rate of progression; however, history of heart disease showed a trend. Among the neuropsychological variables, Trail Making Test - A best distinguished Faster from Slower Progressors, with an overall accuracy of 68%. In an omnibus model including neuropsychological, disease-specific, health, and demographic variables, only Trail Making Test - A distinguished between groups. Several neuropsychological performance features were associated with the rate of cognitive decline in mild AD, with baseline Trail Making Test - A performance best separating those who declined at an average or faster rate from those who showed slower progression.

  18. Reduced survival in adult cystic fibrosis despite attenuated lung function decline.

    PubMed

    Keating, Claire; Poor, Armeen D; Liu, Xinhua; Chiuzan, Codruta; Backenroth, Daniel; Zhang, Yuan; DiMango, Emily

    2017-01-01

    There is limited data on disease progression and survival in adult diagnosis cystic fibrosis (CF). This study evaluates change of lung function over time and rates of death/lung transplant in adult diagnosis CF. The CF Foundation Patient Registry was reviewed for patients diagnosed 1993-2003. Rate of FEV1 decline was calculated up to 2010 for age groups 6-11, 12-17, and 18 and above. Kaplan Meier method was used for 10 and 15year survival rate calculations for patients diagnosed as adults. Cox Proportional hazards models using predictors affecting disease progression and survival without transplant were run. Between 1993 and 2003, 11,884 patients were diagnosed with CF, of which 2848 were ages 6 and older. Annual rate of change of FEV1% predicted over 5years differed by diagnosis age group: -1.42% per year for ages 6-11, -2.04% for ages 12-17 and -1.13% for ages 18-65 (p<0.0001). Pseudomonas aeruginosa infection was associated with faster rates of lung function decline in all age groups. Survival without transplant for CF patients diagnosed at ≥18years were 76% and 65% by 10 and 15years, respectively. Of adults with FEV1 of >70% predicted at diagnosis, 95% were alive without transplant at 10years, whereas of those with FEV1<40% predicted at diagnosis, 31% were alive without transplant at 10years. Lung function declines at a slower rate in adult diagnosis CF. However, particularly in those with low lung function at diagnosis, rates of death or transplant in adult diagnosis CF after 10 and 15years is not negligible. Copyright © 2016 European Cystic Fibrosis Society. Published by Elsevier B.V. All rights reserved.

  19. Age-associated changes in cardiovascular structure and function: a fertile milieu for future disease

    PubMed Central

    Strait, James

    2015-01-01

    Important changes occur in the cardiovascular system with advancing age, even in apparently healthy individuals. Thickening and stiffening of the large arteries develop due to collagen and calcium deposition and loss of elastic fibers in the medial layer. These arterial changes cause systolic blood pressure to rise with age, while diastolic blood pressure generally declines after the sixth decade. In the left ventricle, modest concentric wall thickening occurs due to cellular hypertrophy, but cavity size does not change. Although left ventricular systolic function is preserved across the age span, early diastolic filling rate declines 30–50% between the third and ninth decades. Conversely, an age-associated increase in late diastolic filling due to atrial contraction preserves end-diastolic volume. Aerobic exercise capacity declines approximately 10% per decade in cross-sectional studies; in longitudinal studies, however, this decline is accelerated in the elderly. Reductions in peak heart rate and peripheral oxygen utilization but not stroke volume appear to mediate the age-associated decline in aerobic capacity. Deficits in both cardiac b-adrenergic receptor density and in the efficiency of postsynaptic b-adrenergic signaling contribute significantly to the reduced cardiovascular performance during exercise in older adults. Although these cardiovascular aging changes are considered “normative”, they lower the threshold for the development of cardiovascular disease, which affects the majority of older adults. PMID:21809160

  20. The influence of sex, race/ethnicity, and educational attainment on human immunodeficiency virus death rates among adults, 1993-2007.

    PubMed

    Simard, Edgar P; Fransua, Mesfin; Naishadham, Deepa; Jemal, Ahmedin

    2012-11-12

    Overall declines in human immunodeficiency virus (HIV) mortality may mask patterns for subgroups, and prior studies of disparities in mortality have used area-level vs individual-level socioeconomic status measures. The aim of this study was to examine temporal trends in HIV mortality by sex, race/ethnicity, and individual level of education (as a proxy for socioeconomic status). We examined HIV deaths among non-Hispanic white, non-Hispanic black, and Hispanic men and women aged 25 to 64 years in 26 states (1993-2007; N=91 307) reported to the National Vital Statistics System. The main outcome measures were age-standardized HIV death rates, rate differences, and rate ratios by educational attainment and between the least- and the most-educated (≤12 vs ≥16 years) individuals. Between 1993-1995 and 2005-2007, mortality declined for most men and women by race/ethnicity and educational levels, with the greatest absolute decreases for nonwhites owing to their higher baseline rates. Among men with the most education, rates per 100 000 population decreased from 117.89 (95% CI, 101.08-134.70) to 15.35 (12.08-18.62) in blacks vs from 26.42 (24.93-27.92) to 1.79 (1.50-2.08) in whites. Rates were unchanged for the least-educated black women (26.76; 95% CI, 24.30-29.23; during 2005-2007) and remained high for similarly educated black men (52.71; 48.96-56.45). Relative declines were greater with increasing levels of education (P < .001), resulting in widening disparities. Among men, the disparity rate ratio (comparing the least and the most educated) increased from 1.04 (95% CI, 0.89-1.21) during 1993-1995 to 3.43 (2.74-4.30) during 2005-2007 for blacks and from 0.98 (0.91-1.05) to 2.82 (2.34-3.40) for whites. Although absolute declines in HIV mortality were greatest for nonwhites, rates remain high among blacks, especially in the lowest educated groups, underscoring the need for additional interventions.

  1. White-tailed deer population dynamics and adult female survival in the presence of a novel predator: Deer Population Dynamics

    DOE PAGES

    Chitwood, Michael C.; Lashley, Marcus A.; Kilgo, John C.; ...

    2015-02-01

    Recent localized declines in white-tailed deer ( Odocoileus virginianus) populations in the southeastern United States have been linked to increasing predation pressure from coyotes ( Canis latrans), a novel predator to the region. Studies have documented coyotes as the leading cause of mortality for neonates, and 1 study documented coyotes as a mortality factor for adult females. However, no study has used field-based vital rates to conduct sensitivity analyses or model deer population trajectories under potential harvest or predator removal strategies. We used low, medium, and high values of fawn survival, adult female survival, and fecundity data collected from Fortmore » Bragg Military Installation, North Carolina to demonstrate the current declining population trajectory for deer (λ = 0.905; low λ = 0.788, high λ = 1.003). Consistent with other studies of ungulates, we determined adult female survival was the most sensitive and elastic vital rate. Further, for 3 potential management (“what if”) scenarios, we projected the population for 10 years using estimated vital rates. Reducing adult female harvest (λ = 0.935; low λ = 0.875, high λ = 1.002) and coyote removal (λ = 0.995; low λ = 0.898, high λ = 1.081) reduced the current population decline, whereas combining both approaches (λ = 1.024; low λ = 0.898, high λ = 1.141) resulted in population increases. Our data indicate that for low-density deer populations with heavy predation pressure on neonates, protecting adult females from harvest may not completely offset population declines. Coyote removal might be a necessary strategy because it could possibly increase very low fawn survival, which appears to be the most important vital rate influencing λ in our study. However, managers may have to start with reductions in adult female harvest because coyote removal would have to be continuous and consistently effective, making it an impractical management approach by itself.« less

  2. White-tailed deer population dynamics and adult female survival in the presence of a novel predator: Deer Population Dynamics

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

    Chitwood, Michael C.; Lashley, Marcus A.; Kilgo, John C.

    Recent localized declines in white-tailed deer ( Odocoileus virginianus) populations in the southeastern United States have been linked to increasing predation pressure from coyotes ( Canis latrans), a novel predator to the region. Studies have documented coyotes as the leading cause of mortality for neonates, and 1 study documented coyotes as a mortality factor for adult females. However, no study has used field-based vital rates to conduct sensitivity analyses or model deer population trajectories under potential harvest or predator removal strategies. We used low, medium, and high values of fawn survival, adult female survival, and fecundity data collected from Fortmore » Bragg Military Installation, North Carolina to demonstrate the current declining population trajectory for deer (λ = 0.905; low λ = 0.788, high λ = 1.003). Consistent with other studies of ungulates, we determined adult female survival was the most sensitive and elastic vital rate. Further, for 3 potential management (“what if”) scenarios, we projected the population for 10 years using estimated vital rates. Reducing adult female harvest (λ = 0.935; low λ = 0.875, high λ = 1.002) and coyote removal (λ = 0.995; low λ = 0.898, high λ = 1.081) reduced the current population decline, whereas combining both approaches (λ = 1.024; low λ = 0.898, high λ = 1.141) resulted in population increases. Our data indicate that for low-density deer populations with heavy predation pressure on neonates, protecting adult females from harvest may not completely offset population declines. Coyote removal might be a necessary strategy because it could possibly increase very low fawn survival, which appears to be the most important vital rate influencing λ in our study. However, managers may have to start with reductions in adult female harvest because coyote removal would have to be continuous and consistently effective, making it an impractical management approach by itself.« less

  3. Prognostic significance of an early decline in serum alpha-fetoprotein during chemotherapy for ovarian yolk sac tumors.

    PubMed

    de la Motte Rouge, Thibault; Pautier, Patricia; Genestie, Catherine; Rey, Annie; Gouy, Sébastien; Leary, Alexandra; Haie-Meder, Christine; Kerbrat, Pierre; Culine, Stéphane; Fizazi, Karim; Lhommé, Catherine

    2016-09-01

    The ovarian yolk sac tumor (OYST) is a very rare malignancy arising in young women. Our objective was to determine whether an early decline in serum alpha-fetoprotein (AFP) during chemotherapy has a prognostic impact. This retrospective study is based on prospectively recorded OYST cases at Gustave Roussy (Cancer Treatment Center). Survival curves were estimated using the Kaplan-Meier method. The serum AFP decline was calculated with the formula previously developed and validated in male patients with poor prognosis non-seminomatous germ cell tumors. Univariate and multivariate analyses were performed using the log-rank test and logistic regression, respectively. Data on AFP were available to calculate an early AFP decline in 57 patients. All patients had undergone surgery followed by chemotherapy. The 5-year overall survival (OS) and event-free survival (EFS) rates were 86% (95% CI: 74%-93%) and 84% (95% CI: 73%-91%), respectively. The disease stage, presence of ascites at presentation, use of the BEP regimen, serum AFP half-life and an early AFP decline were significantly predictive factors for OS and EFS in the univariate analysis. The OS rate was 100% and 49% (95% CI: 26%-72%) in patients with a favorable AFP decline and in those with an unfavorable decline, respectively (p<0.001). In the multivariate analysis, only the presence of ascites at diagnosis (RR=7.3, p=0.03) and an unfavorable early AFP decline (RR=16.9, p<0.01) were significant negative predictive factors for OS. An early AFP decline during chemotherapy is an independent prognostic factor in patients with OYSTs. No conflict of interest. Copyright © 2016. Published by Elsevier Inc.

  4. Association Between the Decline in Workers’ Compensation Claims and Workforce Composition and Job Characteristics in Ontario, Canada

    PubMed Central

    Breslin, F. Curtis; Tompa, Emile; Mustard, Cameron; Zhao, Ryan; Smith, Peter; Hogg-Johnson, Sheilah

    2007-01-01

    We examined associations between workforce demographics and job characteristics, grouped by industrial sector, and declines in workers’ compensation claim rates in Ontario, Canada, between 1990 and 2003. Gender, age, occupation, and job tenure were predictors for claim rates in 12 industrial sectors. The decline in claims was significantly associated with a decline in the proportion of employment in occupations with high physical demands. These findings should generate interest in economic incentives and regulatory policies designed to encourage investment in safer production processes. PMID:17267716

  5. Association between the decline in workers' compensation claims and workforce composition and job characteristics in Ontario, Canada.

    PubMed

    Breslin, F Curtis; Tompa, Emile; Mustard, Cameron; Zhao, Ryan; Smith, Peter; Hogg-Johnson, Sheilah

    2007-03-01

    We examined associations between workforce demographics and job characteristics, grouped by industrial sector, and declines in workers' compensation claim rates in Ontario, Canada, between 1990 and 2003. Gender, age, occupation, and job tenure were predictors for claim rates in 12 industrial sectors. The decline in claims was significantly associated with a decline in the proportion of employment in occupations with high physical demands. These findings should generate interest in economic incentives and regulatory policies designed to encourage investment in safer production processes.

  6. Trends in Cardiovascular Risk Factor Levels in the Minnesota Heart Survey (1980–2002) as Compared With the National Health and Nutrition Examination Survey (1976–2002): A Partial Explanation for Minnesota's Low Cardiovascular Disease Mortality?

    PubMed Central

    Wang, Huifen; Steffen, Lyn M.; Jacobs, David R.; Zhou, Xia; Blackburn, Henry; Berger, Alan K.; Filion, Kristian B.; Luepker, Russell V.

    2011-01-01

    The authors compared trends in and levels of coronary heart disease (CHD) risk factors between the Minneapolis-St. Paul, Minnesota, metropolitan area (Twin Cities) and the entire US population to help explain the ongoing decline in US CHD mortality rates. The study populations for risk factors were adults aged 25–74 years enrolled in 2 population-based surveillance studies: the Minnesota Heart Survey (MHS) in 1980–1982, 1985–1987, 1990–1992, 1995–1997, and 2000–2002 and the National Health and Nutrition Examination Survey (NHANES) in 1976–1980, 1988–1994, 1999–2000, and 2001–2002. The authors found a continuous decline in CHD mortality rates in the Twin Cities and nationally between 1980 and 2000. Similar decreasing rates of change in risk factors across survey years, parallel to the CHD mortality rate decline, were observed in MHS and in NHANES. Adults in MHS had generally lower levels of CHD risk factors than NHANES adults, consistent with the CHD mortality rate difference. Approximately 47% of women and 44% of men in MHS had no elevated CHD risk factors, including smoking, hypertension, high cholesterol, and obesity, versus 36% of women and 34% of men in NHANES. The better CHD risk factor profile in the Twin Cities may partly explain the lower CHD death rate there. PMID:21273396

  7. Does age modify the association between psychosocial factors at work and deterioration of self-rated health?

    PubMed

    Burr, Hermann; Hasselhorn, Hans Martin; Kersten, Norbert; Pohrt, Anne; Rugulies, Reiner

    2017-09-01

    Objectives Few epidemiological studies have examined whether associations of psychosocial working conditions with risk of poor health differ by age. Based on results from mostly cross-sectional studies, we test whether (i) psychosocial relational factors (social support) are more strongly associated with declining health of older than younger employees and (ii) psychosocial job factors (workpace, influence, possibilities for development) are more strongly associated with declining health of younger than older employees. Methods We extracted two cohorts from the Danish Work Environment Cohort Study (DWECS): the 2000-2005 and 2005-2010 cohorts. The participating 5281 employees with good self-rated health (SRH) at baseline were observed in 6585 5-year time windows. Using log-binomial regression analyses, we analysed whether psychosocial factors at work predicted 5-year deterioration of SRH. Effect modification by age was estimated by calculating relative excess risk due to interaction (RERI). Results High workpace among men, low influence at work as well as low social support from colleagues among women, and low possibilities for development and low social support from supervisors among both genders predicted 5-year decline in SRH. Of the 20 interaction analyses, only 1 was statistically significant and in the opposite direction of what was hypothesized (higher risk for declining SRH among middle-aged men with low possibilities for development compared to the young men with high possibilities for development). Conclusions Psychosocial working conditions predicted decline in SRH in this 5-year follow-up study. The model did not support our hypotheses about modifying effects by age.

  8. State Efforts to Promote Reading and Literary Activities in Communities. NGA Center for Best Practices Issue Brief

    ERIC Educational Resources Information Center

    National Governors Association, 2006

    2006-01-01

    Rates of reading in the United States have been declining for at least two decades, with the steepest decline occurring among young adults. Fewer than half of adults read literature--poetry, plays, short stories or novels--in their leisure time. At the current rate of decline, literary reading will virtually disappear in the next half-century. Few…

  9. The Wages of Older Men.

    ERIC Educational Resources Information Center

    Carliner, Geoffrey

    1982-01-01

    Net depreciation rates in human capital are estimated from wage data on a longitudinal sample of men aged 45 to 64. The results indicate that wage rates begin to decline in the early 50s at rates under one percent annually and decline at about two percent annually after age 60. (Author)

  10. Comparing Basal Area Growth Rates in Repeated Inventories: Simpson's Paradox in Forestry

    Treesearch

    Charles E. Thomas; Bernard R. Parresol

    1989-01-01

    Recent analyses of radial growth rates in southern commercial forests have shown that current rates are lower than past rates when compared diameter class by diameter class. These results have been interpreted as an indication that the growth rate of the forest is declining. In this paper, growth rates of forest populations in Alabama are studied. Basal area growth (a...

  11. Are infant mortality rate declines exponential? The general pattern of 20th century infant mortality rate decline

    PubMed Central

    Bishai, David; Opuni, Marjorie

    2009-01-01

    Background Time trends in infant mortality for the 20th century show a curvilinear pattern that most demographers have assumed to be approximately exponential. Virtually all cross-country comparisons and time series analyses of infant mortality have studied the logarithm of infant mortality to account for the curvilinear time trend. However, there is no evidence that the log transform is the best fit for infant mortality time trends. Methods We use maximum likelihood methods to determine the best transformation to fit time trends in infant mortality reduction in the 20th century and to assess the importance of the proper transformation in identifying the relationship between infant mortality and gross domestic product (GDP) per capita. We apply the Box Cox transform to infant mortality rate (IMR) time series from 18 countries to identify the best fitting value of lambda for each country and for the pooled sample. For each country, we test the value of λ against the null that λ = 0 (logarithmic model) and against the null that λ = 1 (linear model). We then demonstrate the importance of selecting the proper transformation by comparing regressions of ln(IMR) on same year GDP per capita against Box Cox transformed models. Results Based on chi-squared test statistics, infant mortality decline is best described as an exponential decline only for the United States. For the remaining 17 countries we study, IMR decline is neither best modelled as logarithmic nor as a linear process. Imposing a logarithmic transform on IMR can lead to bias in fitting the relationship between IMR and GDP per capita. Conclusion The assumption that IMR declines are exponential is enshrined in the Preston curve and in nearly all cross-country as well as time series analyses of IMR data since Preston's 1975 paper, but this assumption is seldom correct. Statistical analyses of IMR trends should assess the robustness of findings to transformations other than the log transform. PMID:19698144

  12. Impact of rotavirus vaccination on diarrhea-related hospitalizations in São Paulo State, Brazil.

    PubMed

    Fernandes, Eder Gatti; Sato, Helena Keico; Leshem, Eyal; Flannery, Brendan; Konstantyner, Thais Claudia Roma de Oliveira; Veras, Maria Amélia de Sousa Mascena; Patel, Manish M

    2014-06-05

    Following introduction of routine infant rotavirus vaccination, severe diarrhea hospitalization rates declined among children aged <5 years throughout Brazil. Ensuring equity of rotavirus vaccine impact is important in countries that self-finance immunization programs. The objective of this study was to examine rotavirus vaccine impact on diarrhea admission rates among children aged <5 years in Brazil's public health system, according to area-based measures of human development in the state of São Paulo, Brazil. Ecological analysis of public health system hospitalization rates for acute gastroenteritis among children aged <5 years in the state of São Paulo, Brazil, according to five categories of municipal development based on a modified Human Development Index for municipalities. Acute gastroenteritis hospitalization rates among children aged <5 years after national rotavirus vaccine introduction (2008-2011) were compared to rates in pre-vaccine years (2000-2005) to calculate percent decline in rates (1-rate ratio) and 95% confidence intervals (CI) for each municipal development category. Direct hospitalization costs during the two periods were compared. Annual rates declined by 40% (95% CI, 39-42%) from 631 diarrhea hospitalizations per 100,000 person years pre-rotavirus vaccination to 377 per 100,000 post-vaccination among children aged <5 years and 50% (95% CI, 48-52%) from 1009 to 505 per 100,000 among infants. Highest rates were observed in least developed municipalities. Significant declines of 26-52% among children <5 years and 41-63% among infants were observed in all categories of municipal development. Lower diarrhea hospitalization rates resulted in annual savings of approximately 2 million USD for the state of São Paulo. Savings in direct hospitalization costs benefitted municipalities in all five categories. The introduction of rotavirus vaccination was associated with substantial reductions of diarrhea-related admissions at all levels of municipal development in São Paulo State, Brazil. Copyright © 2014 Elsevier Ltd. All rights reserved.

  13. Workplace health and safety regulations: Impact of enforcement and consultation on workers' compensation claims rates in Washington State.

    PubMed

    Baggs, James; Silverstein, Barbara; Foley, Michael

    2003-05-01

    There has been considerable debate in the public policy arena about the appropriate mix of regulatory enforcement and consultation in achieving desired health and safety behavior across industries. Recently there has been a shift in federal policy toward voluntary approaches and constraining the scope of enforcement programs, although there is little evidence that this might improve health and safety outcomes. To address this, we examined changes in lost time workers compensation claims rates for Washington State employers who had (1) no OSHA State Plan (WISHA) activity, (2) enforcement, (3) consultation, and (4) both types of visits. Compensable claims rates, hours, and WISHA activity were determined for each employer account with a single business location that had payroll hours reported for every quarter from 1997-2000 and more than 10 employees. We used a generalized estimating equations (GEE) approach to Poisson regression to model the association between WISHA activity and claims rate controlling for other external factors. Controlling for previous claims rate and average size, claims rates for employers with WISHA enforcement activity declined 22.5% in fixed site industry SIC codes compared to 7% among employers with no WISHA activity (P < 0.05), and in non-fixed site SICs (e.g., construction) claims rates declined 12.8% for employers with enforcement activity compared to a 7.4% decline for those with no WISHA activity (P > 0.10). WISHA consultation activity was not associated with a greater decline in compensable claims rates (-2.3% for fixed sites and +3.5% for non-fixed sites). WISHA activity did not adversely affect worksite survivability through the study period. Enforcement inspections are significantly associated with decreasing compensable workers compensation claims rates especially for fixed site employers. We were unable to identify an association between consultation activities and decreasing claims rates. Copyright 2003 Wiley-Liss, Inc.

  14. Perceived Personal Control Buffers Terminal Decline in Well-Being

    PubMed Central

    Gerstorf, Denis; Heckhausen, Jutta; Ram, Nilam; Infurna, Frank J.; Schupp, Juergen; Wagner, Gert G.

    2015-01-01

    Recent research has repeatedly demonstrated that well-being typically evinces precipitous deterioration close to the end of life. However, the determinants of individual differences in these terminal declines are note well understood. In this study, we examine the role of perceived personal control as a potential buffer against steep terminal declines in well-being. We applied single- and multi-phase growth models to up to 25-year longitudinal data from 1,641 now deceased participants of the national German Socio-Economic Panel Study (SOEP; age at death: M = 74 years; SD = 14; 49% women). Results revealed that perceiving more personal control over one’s life was related to subsequently higher late-life well-being, less severe rates of late-life declines, and a later onset of terminal decline. Associations were independent of key predictors of mortality, including age, gender, SES, and disability. These findings suggest that feeling in control may ameliorate steep end-of-life decline in well-being. We also discuss scenarios for when and how processes of goal disengagement and giving up control may become beneficial. PMID:25244480

  15. Economic recession and fertility in the developed world.

    PubMed

    Sobotka, Tomáš; Skirbekk, Vegard; Philipov, Dimiter

    2011-01-01

    This article reviews research on the effects of economic recessions on fertility in the developed world. We study how economic downturns, as measured by various indicators, especially by declining GDP levels, falling consumer confidence, and rising unemployment, were found to affect fertility. We also discuss particular mechanisms through which the recession may have influenced fertility behavior, including the effects of economic uncertainty, falling income, changes in the housing market, and rising enrollment in higher education, and also factors that influence fertility indirectly such as declining marriage rates. Most studies find that fertility tends to be pro-cyclical and often rises and declines with the ups and downs of the business cycle. Usually, these aggregate effects are relatively small (typically, a few percentage points) and of short durations; in addition they often influence especially the timing of childbearing and in most cases do not leave an imprint on cohort fertility levels. Therefore, major long-term fertility shifts often continue seemingly uninterrupted during the recession—including the fertility declines before and during the Great Depression of the 1930s and before and during the oil shock crises of the 1970s. Changes in the opportunity costs of childbearing and fertility behavior during economic downturn vary by sex, age, social status, and number of children; childless young adults are usually most affected. Furthermore, various policies and institutions may modify or even reverse the relationship between recessions and fertility. The first evidence pertaining to the recent recession falls in line with these findings. In most countries, the recession has brought a decline in the number of births and fertility rates, often marking a sharp halt to the previous decade of rising fertility rates.

  16. Amyloid-Related Memory Decline in Preclinical Alzheimer's Disease Is Dependent on APOE ε4 and Is Detectable over 18-Months.

    PubMed

    Thai, Christine; Lim, Yen Ying; Villemagne, Victor L; Laws, Simon M; Ames, David; Ellis, Kathryn A; Rainey-Smith, Stephanie R; Martins, Ralph N; Masters, Colin L; Rowe, Christopher C; Maruff, Paul

    2015-01-01

    High levels of β-amyloid (Aβ) in the brain and carriage of the APOE ε4 allele have each been linked to cognitive impairment in cognitively normal (CN) older adults. However, the relationship between these two biomarkers and cognitive decline is unclear. The aim of this study was to investigate the relationship between cerebral Aβ level, APOE ε4 carrier status, and cognitive decline over 18 months, in 317 cognitively healthy (CN) older adults (47.6% males, 52.4% females) aged between 60 and 89 years (Mean = 69.9, SD = 6.8). Cognition was assessed using the Cogstate Brief Battery (CBB) and the California Verbal Learning Test, Second Edition (CVLT-II). Planned comparisons indicated that CN older adults with high Aβ who were also APOE ε4 carriers demonstrated the most pronounced decline in learning and working memory. In CN older adults who were APOE ε4 non-carriers, high Aβ was unrelated to cognitive decline in learning and working memory. Carriage of APOE ε4 in CN older adults with low Aβ was associated with a significantly increased rate of decline in learning and unexpectedly, improved cognitive performance on measures of verbal episodic memory over 18 months. These results suggest that Aβ and APOE ε4 interact to increase the rate of cognitive decline in CN older adults and provide further support for the use of Aβ and APOE ε4 as biomarkers of early Alzheimer's disease.

  17. Temporal decline in filling prescriptions for terfenadine closely in time with those for either ketoconazole or erythromycin.

    PubMed

    Burkhart, G A; Sevka, M J; Temple, R; Honig, P K

    1997-01-01

    Temporal changes in the rates of filling terfenadine prescriptions within 2 days of those for either oral erythromycin or oral ketoconazole were described with use of paid pharmacy claims data from 1988 through 1994 in state Medicaid programs from Michigan and Ohio and in a large health maintenance organization. There were rapid and significant declines in the rates of filling prescriptions for either erythromycin or ketoconazole within 2 days of prescriptions for terfenadine in all three databases that coincided with 1992 publicity about the cardiovascular risk of terfenadine. These findings suggest that the use of terfenadine with contraindicated medications has declined in response to relabeling and publicity concerning the safe use of terfenadine. Further study is necessary to estimate the absolute level of concurrent use of terfenadine with contraindicated medications.

  18. Can selective migration explain why health is worse in regions with population decline?: A study on migration and self-rated health in the Netherlands.

    PubMed

    Dijkstra, Aletta; Kibele, Eva U B; Verweij, Antonia; van der Lucht, Fons; Janssen, Fanny

    2015-12-01

    Health disparities between population declining and non-declining areas have received little attention, even though population decline is an established phenomenon in Europe. Selective migration, in which healthier people move out of deprived areas, can possibly explain worse health in declining regions. We assessed whether selective migration can explain the observed worse average health in declining regions as compared with non-declining regions in the Netherlands. Combining data from the Dutch Housing and Living Survey held in 2002 and 2006 with Dutch registry data, we studied the relation between health status and migration in a 5-year period at the individual level by applying logistic regression. In our sample of 130,600 participants, we compared health status, demographic and socioeconomic factors of movers and stayers from declining and non-declining regions. People in the Netherlands who migrated are healthier than those staying behind [odds ratio (OR): 1.80]. This effect is larger for persons moving out of declining regions (OR: 1.76) than those moving into declining regions (OR: 1.47). When controlled for demographic and socioeconomic characteristics, these effects are not significant. Moreover, only a small part of the population migrates out of (0.29%) or into (0.25%) declining regions in the course of 5 years. Despite the relation between health and migration, the effect of selective migration on health differences between declining and non-declining regions in the Netherlands is small. Both health and migration are complexly linked with socioeconomic and demographic factors. © The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

  19. Effect of retirement on cognitive function: the Whitehall II cohort study.

    PubMed

    Xue, Baowen; Cadar, Dorina; Fleischmann, Maria; Stansfeld, Stephen; Carr, Ewan; Kivimäki, Mika; McMunn, Anne; Head, Jenny

    2017-12-26

    According to the 'use it or lose it' hypothesis, a lack of mentally challenging activities might exacerbate the loss of cognitive function. On this basis, retirement has been suggested to increase the risk of cognitive decline, but evidence from studies with long follow-up is lacking. We tested this hypothesis in a cohort of 3433 civil servants who participated in the Whitehall II Study, including repeated measurements of cognitive functioning up to 14 years before and 14 years after retirement. Piecewise models, centred at the year of retirement, were used to compare trajectories of verbal memory, abstract reasoning, phonemic verbal fluency, and semantic verbal fluency before and after retirement. We found that all domains of cognition declined over time. Declines in verbal memory were 38% faster after retirement compared to before, after taking account of age-related decline. In analyses stratified by employment grade, higher employment grade was protective against verbal memory decline while people were still working, but this 'protective effect' was lost when individuals retired, resulting in a similar rate of decline post-retirement across employment grades. We did not find a significant impact of retirement on the other cognitive domains. In conclusion, these findings are consistent with the hypothesis that retirement accelerates the decline in verbal memory function. This study points to the benefits of cognitively stimulating activities associated with employment that could benefit older people's memory.

  20. Suicide in Canada

    PubMed Central

    McFaull, Steven; Rhodes, Anne E.; Bowes, Matthew; Rockett, Ian R. H.

    2016-01-01

    Objective: The aim of this study is to compare Canadian suicide rates with other external causes of death to examine potential poisoning misclassifications as a contributor to suicide underreporting. Method: The study used Statistics Canada mortality data from 2000 to 2011 to calculate sex-and age-specific ratios by external cause of injury codes. Results: The overall Canadian suicide rate, as well as the poisoning suicide rate, declined over the study timeframe by an average annual percentage change (AAPC) of 1.0% each year. However, unintentional and undetermined poisonings increased significantly during the timeframe. Unintentional poisoning mortality (primarily narcotics and hallucinogens, including opioids) increased in proportion to suicides for both sexes, although females were consistently higher. The undetermined death to suicide ratio was higher and increasing for females. Poisonings of undetermined intent increased over time to comprise 47% to 80% of the undetermined death category for males and females combined. Conclusions: Canadian poisoning suicide rates declined, in contrast to rising unintentional and undetermined poisoning mortality rates. This trend is similar to that of the United States, supporting the hypothesis that misclassification of poisoning deaths may also be an issue in Canada.

  1. Trends in Acute Ischemic Stroke Hospitalizations in the United States.

    PubMed

    Ramirez, Lucas; Kim-Tenser, May A; Sanossian, Nerses; Cen, Steven; Wen, Ge; He, Shuhan; Mack, William J; Towfighi, Amytis

    2016-05-11

    Population-based studies have revealed declining acute ischemic stroke (AIS) hospitalization rates in the United States, but no study has assessed recent temporal trends in race/ethnic-, age-, and sex-specific AIS hospitalization rates. Temporal trends in hospitalization for AIS from 2000 to 2010 were assessed among adults ≥25 years using the Nationwide Inpatient Sample. Age-, sex-, and race/ethnic-specific and age-adjusted stroke hospitalization rates were calculated using the weighted number of hospitalizations and US census data. From 2000 to 2010, age-adjusted stroke hospitalization rates decreased from 250 to 204 per 100 000 (overall rate reduction 18.4%). Age-specific AIS hospitalization rates decreased for individuals aged 65 to 84 years (846 to 605 per 100 000) and ≥85 years (2077 to 1618 per 100 000), but increased for individuals aged 25 to 44 years (16 to 23 per 100 000) and 45 to 64 years (149 to 156 per 100 000). Blacks had the highest age-adjusted yearly hospitalization rates, followed by Hispanics and whites (358, 170, and 155 per 100 000 in 2010). Age-adjusted AIS hospitalization rates increased for blacks but decreased for Hispanics and whites. Age-adjusted AIS hospitalization rates were lower in women and declined more steeply compared to men (272 to 212 per 100 000 in women versus 298 to 245 per 100 000 in men). Although overall stroke hospitalizations declined in the United States, the reduction was more pronounced among older individuals, women, Hispanics, and whites. Renewed efforts at targeting risk factor control among vulnerable individuals may be warranted. © 2016 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

  2. [Fertility in rural and urban areas of Mexico].

    PubMed

    Garcia Y Garma, I O

    1989-01-01

    Data from 6 fertility surveys conducted in Mexico between 1969-87 were used to compare rural and urban fertility and to determine whether a significant level of contraceptive usage could be achieved in rural areas despite their lack of socioeconomic development. Age-specific marital fertility rates were calculated for the 4 national-level and 2 rural fertility surveys. The index of fertility control developed by Coale and Trussel was calculated for rural, urban, and all areas. The marital total fertility rate in rural areas declined from 10.6 in 1970 to 7.4 in 1982, a decline of 2.5% annually. From 1982-87 the annual rate of decline in rural fertility slowed to 1.6%, reaching 6.8 children in 1987. The urban marital total fertility rate declined from 7.72 in 1976 to 5.03 in 1987, while the marital total fertility rate for Mexico as a whole declined from 9.04 in 1976 to 5.85 in 1987. The indices of fertility control showed slowly increasing use of contraception in rural areas starting from the very low level of 1969. The urban index of fertility control showed some contraceptive use for all age groups in all surveys. The increases in contraceptive usage were considerable in rural areas from 1976-82 and much less marked in urban areas. From 1982-87 the inverse was observed and the fertility decline in urban areas was more marked. The condition of natural fertility found in rural areas in 1969 subsequently disappeared. Over time, fertility decline and use of contraception have intensified. Contraception is widely practiced in urban areas and is continuing to become more prevalent. The rural fertility decline in 1976-82 suggests that at least sometimes increases in fertility control are more important in rural areas than in urban areas. The theory of modernization, which holds that fertility decline in developed countries is attributable to factors associated with the process of modernization, thus comes into question. However, it is probable that a sustained fertility decline in the most depressed rural areas will be achieved only with substantial socioeconomic change.

  3. Child Poverty Was Lower at End of 1990s.

    ERIC Educational Resources Information Center

    Rogers, Carolyn C.

    2001-01-01

    Poverty rates increased in the early 1990s, but between 1994 and 1999 the metro child poverty rate declined 6 percentage points and the nonmetro rate declined 4 percent. In 1999, the poverty rate for nonmetro Black children was about double that of nonmetro White children, but the Black-White gap in poverty narrowed between 1985 and 1999. (TD)

  4. Variations in teenage birth rates, 1991-98: national and state trends.

    PubMed

    Ventura, S J; Curtin, S C; Mathews, T J

    2000-04-24

    This report presents national birth rates for teenagers for 1991-98 and the percent change, 1991-98. State-specific teenage birth rates by age, race, and Hispanic origin for 1991 and 1998 and the percent change, 1991 to 1998, are also presented. Tabular and graphical descriptions of the trends in teenage birth rates for the Nation and each State, by age group, race, and Hispanic origin of the mother, are discussed. Birth rates for teenagers 15-19 years declined nationally between 1991 and 1998 for all age and race and Hispanic origin populations, with the steepest declines recorded for black teenagers. State-specific rates fell significantly in all States for ages 15-19 years; declines ranged from 10 to 38 percent. In general, rates by State fell more for younger than for older teenagers, ranging by State from 10 to 46 percent for ages 15-17 years. Statistically significant reductions for older teenagers ranged from 3 to 39 percent. Reductions by State were largest for black teenagers 15-19 years, with rates falling 30 percent or more in 15 States. Among the factors accounting for these declines are decreased sexual activity, increases in condom use, and the adoption of the implant and injectable contraceptives.

  5. Arterial wave reflections and kidney function decline among persons with preserved estimated glomerular filtration rate: the Multi-Ethnic Study of Atherosclerosis.

    PubMed

    Hsu, Jeffrey J; Katz, Ronit; Chirinos, Julio A; Jacobs, David R; Duprez, Daniel A; Peralta, Carmen A

    2016-05-01

    Differences in arterial wave reflections have been associated with increased risk for heart failure and mortality. Whether these measures are also associated with kidney function decline is not well established. Reflection magnitude (RM, defined as the ratio of the backward wave [Pb] to that of the forward wave [Pf]), augmentation index (AIx), and pulse pressure amplification (PPA) were derived from radial tonometry measures among 5232 participants free of cardiovascular disease who were enrolled in the Multiethnic Study of Atherosclerosis. Kidney function was estimated by creatinine and cystatin C measurements, as well as albumin-to-creatinine ratio. We evaluated the associations of Pb, Pf, RM, AIx, and PPA with annualized estimated glomerular filtration rate (eGFR) change and rapid kidney function decline over 5 years, using generalized linear mixed models and logistic regression, respectively. Of the study participants, 48% were male, mean age was 62 years, mean eGFR and median albumin-to-creatinine ratio at baseline were 84 mL/min/1.73 m(2) and 5.3 mg/g, respectively. In demographically adjusted models, both Pb and Pf had similarly strong associations with kidney function decline; compared to those in the lowest tertiles, the persons in the highest tertiles of Pb and Pf had a 1.01 and 0.99 mL/min/1.73 m(2)/year faster eGFR decline, respectively (P < .05). However, these associations were attenuated after adjustment for systolic blood pressure. We found no significant associations between RM, AIx, or PPA and kidney function decline. In conclusion, the reflected and forward wave components were similarly associated with kidney function decline, and these associations were explained by differences in systolic blood pressure. Copyright © 2016 American Society of Hypertension. Published by Elsevier Inc. All rights reserved.

  6. Declines in stillbirth and neonatal mortality rates in Europe between 2004 and 2010: results from the Euro-Peristat project

    PubMed Central

    Zeitlin, Jennifer; Mortensen, Laust; Cuttini, Marina; Lack, Nicholas; Nijhuis, Jan; Haidinger, Gerald; Blondel, Béatrice; Hindori-Mohangoo, Ashna D

    2016-01-01

    Background Stillbirth and neonatal mortality rates declined in Europe between 2004 and 2010. We hypothesised that declines might be greater for countries with higher mortality in 2004 and disproportionally affect very preterm infants at highest risk. Methods Data about live births, stillbirths and neonatal deaths by gestational age (GA) were collected using a common protocol by the Euro-Peristat project in 2004 and 2010. We analysed stillbirths at ≥28 weeks GA in 22 countries and live births ≥24 weeks GA for neonatal mortality in 18 countries. Per cent changes over time were assessed by calculating risk ratios (RR) for stillbirth, neonatal mortality and preterm birth rates in 2010 vs 2004. We used meta-analysis techniques to derive pooled RR using random-effects models overall, by GA subgroups and by mortality level in 2004. Results Between 2004 and 2010, stillbirths declined by 17% (95% CI 10% to 23%), with a range from 1% to 39% by country. Neonatal mortality declined by 29% (95% CI 23% to 35%) with a range from 9% to 67%. Preterm birth rates did not change: 0% (95% CI −3% to 3%). Mortality declines were of a similar magnitude at all GA; mortality levels in 2004 were not associated with RRs. Conclusions Stillbirths and neonatal deaths declined at all gestational ages in countries with both high and low levels of mortality in 2004. These results raise questions about how low-mortality countries achieve continued declines and highlight the importance of improving care across the GA spectrum. PMID:26719590

  7. Computational model to investigate the relative contributions of different neuromuscular properties of tibialis anterior on force generated during ankle dorsiflexion.

    PubMed

    Siddiqi, Ariba; Poosapadi Arjunan, Sridhar; Kumar, Dinesh Kant

    2018-01-16

    This study describes a new model of the force generated by tibialis anterior muscle with three new features: single-fiber action potential, twitch force, and pennation angle. This model was used to investigate the relative effects and interaction of ten age-associated neuromuscular parameters. Regression analysis (significance level of 0.05) between the neuromuscular properties and corresponding simulated force produced at the footplate was performed. Standardized slope coefficients were computed to rank the effect of the parameters. The results show that reduction in the average firing rate is the reason for the sharp decline in the force and other factors, such as number of muscle fibers, specific force, pennation angle, and innervation ratio. The fast fiber ratio affects the simulated force through two significant interactions. This study has ranked the individual contributions of the neuromuscular factors to muscle strength decline of the TA and identified firing rate decline as the biggest cause followed by decrease in muscle fiber number and specific force. The strategy for strength preservation for the elderly should focus on improving firing rate. Graphical abstract Neuromuscular properties of Tibialis Anterior on force generated during ankle dorsiflexion.

  8. Differences in quantitative methods for measuring subjective cognitive decline - results from a prospective memory clinic study.

    PubMed

    Vogel, Asmus; Salem, Lise Cronberg; Andersen, Birgitte Bo; Waldemar, Gunhild

    2016-09-01

    Cognitive complaints occur frequently in elderly people and may be a risk factor for dementia and cognitive decline. Results from studies on subjective cognitive decline are difficult to compare due to variability in assessment methods, and little is known about how different methods influence reports of cognitive decline. The Subjective Memory Complaints Scale (SMC) and The Memory Complaint Questionnaire (MAC-Q) were applied in 121 mixed memory clinic patients with mild cognitive symptoms (mean MMSE = 26.8, SD 2.7). The scales were applied independently and raters were blinded to results from the other scale. Scales were not used for diagnostic classification. Cognitive performances and depressive symptoms were also rated. We studied the association between the two measures and investigated the scales' relation to depressive symptoms, age, and cognitive status. SMC and MAC-Q were significantly associated (r = 0.44, N = 121, p = 0.015) and both scales had a wide range of scores. In this mixed cohort of patients, younger age was associated with higher SMC scores. There were no significant correlations between cognitive test performances and scales measuring subjective decline. Depression scores were significantly correlated to both scales measuring subjective decline. Linear regression models showed that age did not have a significant contribution to the variance in subjective memory beyond that of depressive symptoms. Measures for subjective cognitive decline are not interchangeable when used in memory clinics and the application of different scales in previous studies is an important factor as to why studies show variability in the association between subjective cognitive decline and background data and/or clinical results. Careful consideration should be taken as to which questions are relevant and have validity when operationalizing subjective cognitive decline.

  9. Evidence of a dose-response relationship between "truth" antismoking ads and youth smoking prevalence.

    PubMed

    Farrelly, Matthew C; Davis, Kevin C; Haviland, M Lyndon; Messeri, Peter; Healton, Cheryl G

    2005-03-01

    In early 2000, the American Legacy Foundation launched the national "truth" campaign, the first national antismoking campaign to discourage tobacco use among youths. We studied the impact of the campaign on national smoking rates among US youths (students in grades 8, 10, and 12). We used data from the Monitoring the Future survey in a pre/post quasi-experimental design to relate trends in youth smoking prevalence to varied doses of the "truth" campaign in a national sample of approximately 50000 students in grades 8, 10, and 12, surveyed each spring from 1997 through 2002. Findings indicate that the campaign accounted for a significant portion of the recent decline in youth smoking prevalence. We found that smoking prevalence among all students declined from 25.3% to 18.0% between 1999 and 2002 and that the campaign accounted for approximately 22% of this decline. This study showed that the campaign was associated with substantial declines in youth smoking and has accelerated recent declines in youth smoking prevalence.

  10. Citation rate and perceived subject bias in the amphibian-decline literature.

    PubMed

    Ohmer, Michel E; Bishop, Phillip J

    2011-02-01

    As a result of global declines in amphibian populations, interest in the conservation of amphibians has grown. This growth has been fueled partially by the recent discovery of other potential causes of declines, including chytridiomycosis (the amphibian chytrid, an infectious disease) and climate change. It has been proposed that researchers have shifted their focus to these novel stressors and that other threats to amphibians, such as habitat loss, are not being studied in proportion to their potential effects. We tested the validity of this proposal by reviewing the literature on amphibian declines, categorizing the primary topic of articles within this literature (e.g., habitat loss or UV-B radiation) and comparing citation rates among articles on these topics and impact factors of journals in which the articles were published. From 1990 to 2009, the proportion of papers on habitat loss remained fairly constant, and although the number of papers on chytridiomycosis increased after the disease was described in 1998, the number of published papers on amphibian declines also increased. Nevertheless, papers on chytridiomycosis were more highly cited than papers not on chytridiomycosis and were published in journals with higher impact factors on average, which may indicate this research topic is more popular in the literature. Our results were not consistent with a shift in the research agenda on amphibians. We believe the perception of such a shift has been supported by the higher citation rates of papers on chytridiomycosis. ©2010 Society for Conservation Biology.

  11. Changes in the distribution of high-risk births associated with changes in contraceptive prevalence.

    PubMed

    Stover, John; Ross, John

    2013-01-01

    Several birth characteristics are associated with high mortality risk: very young or old mothers, short birth intervals and high birth order. One justification for family planning programs is the health benefits associated with better spacing and timing of births. This study examines the extent to which the prevalence of these risk factors changes as a country transitions from high to low fertility. We use data from 194 national surveys to examine both cross section and within-country variation in these risk factors as they relate to the total fertility rate. Declines in the total fertility rate are associated with large declines in the proportion of high order births, those to mothers over the age of 34 and those with multiple risk factors; as well as to increasing proportions of first order births. There is little change in the proportion of births with short birth intervals except in sub-Saharan Africa. The use of family planning is strongly associated with fertility declines. The proportion of second and higher order births with demographic risk factors declines substantially as fertility declines. This creates a potential for reducing child mortality rates. Some of the reduction comes from modifying the birth interval distribution or by bringing maternal age at the time of birth into the 'safe' range of 18-35 years, and some comes from the actual elimination of births that would have a high mortality risk (high parity births).

  12. Differential effects of enriched environment at work on cognitive decline in old age.

    PubMed

    Then, Francisca S; Luck, Tobias; Luppa, Melanie; König, Hans-Helmut; Angermeyer, Matthias C; Riedel-Heller, Steffi G

    2015-05-26

    The aim of the present study was to investigate how different mentally demanding work conditions during the professional life-i.e., enriched environments at work-might influence the rate of cognitive decline in old age. Individuals (n = 1,054) of the Leipzig Longitudinal Study of the Aged, a representative population-based cohort study of individuals aged 75 years and older, underwent cognitive testing via the Mini-Mental State Examination (MMSE) in up to 6 measurement waves. Type and level of mentally demanding work conditions in the participants' former professional life were classified based on the O*NET job descriptor database. In multivariate mixed-model analyses (controlling for sociodemographic and health-related factors), a high level of mentally demanding work tasks stimulating verbal intelligence was significantly associated with a better cognitive functioning at baseline (on average 5 MMSE points higher) as well as a lower rate of cognitive decline (on average 2 MMSE points less) over the 8-year follow-up period compared with a low level. The rate of cognitive decline in old age was also significantly lower (on average 3 MMSE points less) in individuals who had a high level of mentally demanding work tasks stimulating executive functions than those who had a low level. The results suggest that a professional life enriched with work tasks stimulating verbal intelligence and executive functions may help to sustain a good cognitive functioning in old age (75+ years). The findings thus emphasize that today's challenging work conditions may also promote positive health effects. © 2015 American Academy of Neurology.

  13. Renal function decline predicted by left atrial expansion index in non-diabetic cohort with preserved systolic heart function.

    PubMed

    Hsiao, Shih-Hung; Chiou, Kuan-Rau

    2017-05-01

    Since natriuretic peptide and troponin are associated with renal prognosis and left atrial (LA) parameters are indicators of subclinical cardiovascular abnormalities, this study investigated whether LA expansion index can predict renal decline. This study analysed 733 (69% male) non-diabetic patients with sinus rhythm, preserved systolic function, and estimated glomerular filtration rate (eGFR) higher than 60 mL/min/1.73 m2. In all patients, echocardiograms were performed and LA expansion index was calculated. Renal function was evaluated annually. The endpoint was a downhill trend in renal function with a final eGFR of <60 mL/min/1.73 m2. Rapid renal decline was defined as an annual decline in eGFR >3 mL/min/1.73 m2. The median follow-up time was 5.2 years, and 57 patients (7.8%) had renal function declines (19 had rapid renal declines, and 38 had incidental renal dysfunction). Events were associated with left ventricular mass index, LA expansion index, and heart failure during the follow-up period. The hazard ratio was 1.426 (95% confidence interval, 1.276-1.671; P < 0.0001) per 10% decrease in LA expansion index and was independently associated with an increased event rate. Compared with the highest quartile for the LA expansion index, the lowest quartile had a 9.7-fold risk of renal function decline in the unadjusted model and a 6.9-fold risk after adjusting for left ventricular mass index and heart failure during the follow-up period. Left atrial expansion index is a useful early indicator of renal function decline and may enable the possibility of early intervention to prevent renal function from worsening. NCT01171040. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2017. For permissions, please email: journals.permissions@oup.com.

  14. Cerebral metabolic and cognitive decline in persons at genetic risk for Alzheimer's disease

    PubMed Central

    Small, Gary W.; Ercoli, Linda M.; Silverman, Daniel H. S.; Huang, S.-C.; Komo, Scott; Bookheimer, Susan Y.; Lavretsky, Helen; Miller, Karen; Siddarth, Prabha; Rasgon, Natalie L.; Mazziotta, John C.; Saxena, Sanjaya; Wu, H. M.; Mega, Michael S.; Cummings, Jeffrey L.; Saunders, Ann M.; Pericak-Vance, Margaret A.; Roses, Allen D.; Barrio, Jorge R.; Phelps, Michael E.

    2000-01-01

    The major known genetic risk for Alzheimer's disease (AD), apolipoprotein E-4 (APOE-4), is associated with lowered parietal, temporal, and posterior cingulate cerebral glucose metabolism in patients with a clinical diagnosis of AD. To determine cognitive and metabolic decline patterns according to genetic risk, we investigated cerebral metabolic rates by using positron emission tomography in middle-aged and older nondemented persons with normal memory performance. A single copy of the APOE-4 allele was associated with lowered inferior parietal, lateral temporal, and posterior cingulate metabolism, which predicted cognitive decline after 2 years of longitudinal follow-up. For the 20 nondemented subjects followed longitudinally, memory performance scores did not decline significantly, but cortical metabolic rates did. In APOE-4 carriers, a 4% left posterior cingulate metabolic decline was observed, and inferior parietal and lateral temporal regions demonstrated the greatest magnitude (5%) of metabolic decline after 2 years. These results indicate that the combination of cerebral metabolic rates and genetic risk factors provides a means for preclinical AD detection that will assist in response monitoring during experimental treatments. PMID:10811879

  15. Fertility and migration in the heart of the industrial revolution.

    PubMed

    Oris, M

    1996-01-01

    This study examines demographic growth and change in Tilleur in the valley of Meuse in Belgium during 1807-80 during the process of industrialization and urbanization. The proportion of immigrants (foreigners and Flemings) increased from 15% in 1807 to 65% in 1856. After 1856, population and industrial growth stabilized. During 1856-66 the proportion of natives stabilized, and the proportion of Flemings increased. It is argued that in Tilleur there were two phases: a foundation phase of industrial and population growth and a phase of maturation with decreased non-native population and greater similarity between groups. Immigrants contributed to the birth rate in greater proportions than their proportion in the population of Tilleur. During 1847-66 native population increased annually from 2.4% to 3.8%. Migrants' annual increases were diminished by the effects of mortality but expanded by the influence of in-migration. During 1857-66 the proportion of foreigners declined and marked the transition to a new phase. During 1830-66 the sex ratio grew from 93 to 119. During the Industrial Revolution in Tilleur, women shifted from outnumbering to undernumbering men. The iron and coal in the region attracted men. The sex ratio among the Flemish was 214 in 1866. In 1830 the proportion of fertile women was higher among immigrants and declined thereafter. Age at marriage rose for natives and declined for immigrants. The native population structure by sex, age, and marriage did not favor the birth rate. During 1866-80 the birth rate of foreign immigrants and rural natives declined, the birth rate of natives doubled, and the gap between these two groups narrowed. The changes among immigrants during the foundation phase led to fertility decline in the maturation phase. Marriage and migration interactions linked the industrial revolution with the demographic transition.

  16. Demography of Symbiotic Nitrogen-Fixing Trees Explains Their Rarity and Successional Decline in Temperate Forests in the United States.

    PubMed

    Liao, Wenying; Menge, Duncan N L

    2016-01-01

    Symbiotic nitrogen (N) fixation is the major N input to many ecosystems. Although temperate forests are commonly N limited, symbiotic N-fixing trees ("N fixers") are rare and decline in abundance as succession proceeds-a challenging paradox that remains unexplained. Understanding demographic processes that underlie N fixers' rarity and successional decline would provide a proximate answer to the paradox. Do N fixers grow slower, die more frequently, or recruit less in temperate forests? We quantified demographic rates of N-fixing and non-fixing trees across succession using U.S. forest inventory data. We used an individual-based model to evaluate the relative contribution of each demographic process to community dynamics. Compared to non-fixers, N fixers had lower growth rates, higher mortality rates, and lower recruitment rates throughout succession. The mortality effect contributed more than the growth effect to N fixers' successional decline. Canopy and understory N fixers experienced these demographic disadvantages, indicating that factors in addition to light limitation likely contribute to N fixers' successional decline. We show that the rarity and successional decline of N-fixing trees in temperate forests is due more to their survival disadvantage than their growth disadvantage, and a recruitment disadvantage might also play a large role.

  17. Demography of Symbiotic Nitrogen-Fixing Trees Explains Their Rarity and Successional Decline in Temperate Forests in the United States

    PubMed Central

    Liao, Wenying; Menge, Duncan N. L.

    2016-01-01

    Symbiotic nitrogen (N) fixation is the major N input to many ecosystems. Although temperate forests are commonly N limited, symbiotic N-fixing trees (“N fixers”) are rare and decline in abundance as succession proceeds–a challenging paradox that remains unexplained. Understanding demographic processes that underlie N fixers’ rarity and successional decline would provide a proximate answer to the paradox. Do N fixers grow slower, die more frequently, or recruit less in temperate forests? We quantified demographic rates of N-fixing and non-fixing trees across succession using U.S. forest inventory data. We used an individual-based model to evaluate the relative contribution of each demographic process to community dynamics. Compared to non-fixers, N fixers had lower growth rates, higher mortality rates, and lower recruitment rates throughout succession. The mortality effect contributed more than the growth effect to N fixers’ successional decline. Canopy and understory N fixers experienced these demographic disadvantages, indicating that factors in addition to light limitation likely contribute to N fixers’ successional decline. We show that the rarity and successional decline of N-fixing trees in temperate forests is due more to their survival disadvantage than their growth disadvantage, and a recruitment disadvantage might also play a large role. PMID:27780268

  18. Understanding the temporal dimension of the red-edge spectral region for forest decline detection using high-resolution hyperspectral and Sentinel-2a imagery.

    PubMed

    Zarco-Tejada, P J; Hornero, A; Hernández-Clemente, R; Beck, P S A

    2018-03-01

    The operational monitoring of forest decline requires the development of remote sensing methods that are sensitive to the spatiotemporal variations of pigment degradation and canopy defoliation. In this context, the red-edge spectral region (RESR) was proposed in the past due to its combined sensitivity to chlorophyll content and leaf area variation. In this study, the temporal dimension of the RESR was evaluated as a function of forest decline using a radiative transfer method with the PROSPECT and 3D FLIGHT models. These models were used to generate synthetic pine stands simulating decline and recovery processes over time and explore the temporal rate of change of the red-edge chlorophyll index (CI) as compared to the trajectories obtained for the structure-related Normalized Difference Vegetation Index (NDVI). The temporal trend method proposed here consisted of using synthetic spectra to calculate the theoretical boundaries of the subspace for healthy and declining pine trees in the temporal domain, defined by CI time=n /CI time=n+1 vs. NDVI time=n /NDVI time=n+1 . Within these boundaries, trees undergoing decline and recovery processes showed different trajectories through this subspace. The method was then validated using three high-resolution airborne hyperspectral images acquired at 40 cm resolution and 260 spectral bands of 6.5 nm full-width half-maximum (FWHM) over a forest with widespread tree decline, along with field-based monitoring of chlorosis and defoliation (i.e., 'decline' status) in 663 trees between the years 2015 and 2016. The temporal rate of change of chlorophyll vs. structural indices, based on reflectance spectra extracted from the hyperspectral images, was different for trees undergoing decline, and aligned towards the decline baseline established using the radiative transfer models. By contrast, healthy trees over time aligned towards the theoretically obtained healthy baseline . The applicability of this temporal trend method to the red-edge bands of the MultiSpectral Imager (MSI) instrument on board Sentinel-2a for operational forest status monitoring was also explored by comparing the temporal rate of change of the Sentinel-2-derived CI over areas with declining and healthy trees. Results demonstrated that the Sentinel-2a red-edge region was sensitive to the temporal dimension of forest condition, as the relationships obtained for pixels in healthy condition deviated from those of pixels undergoing decline.

  19. Local and global influences on population declines of coastal waders: Purple Sandpiper Calidris maritima numbers in the Moray Firth, Scotland

    NASA Astrophysics Data System (ADS)

    Summers, Ron W.; Foster, Simon; Swann, Bob; Etheridge, Brian

    2012-05-01

    Declines in numbers by several wader species in Britain have been linked to climate change, but the mechanism for the declines has rarely been explored. Britain lies at the northern end of the East Atlantic Flyway, and supports 1.3 million out of the Flyway's 8.5 million coastal waders (Charadrii) in winter and the Purple Sandpiper is one of the species whose numbers have declined. Here, we examine the dynamics of the decline as observed in the Moray Firth, northeast Scotland, investigating whether the decline was due to poorer apparent survival (return rate) or poorer recruitment of young birds. The maximum number in the Moray Firth declined from 860 in 1987/88 to 236 in 2006/07, with some increase during winters 2007/08 and 2008/09. At the three main high-tide roosts (Balintore, Lossiemouth and Buckie) the maximum combined number declined from 574 to 90. Changes in survival and recruitment (percentage of first-year birds) were examined at these roosts from captured samples, which were ringed and recaptured. There were no significant changes between winters in survival rates, nor were there differences between the survival rates of age groups (first-year and adult) or bill size groups, which represented birds of different sex and breeding origin. Annual survival estimates for the three roosts ranged from 72 to 77%. The percentage of first-year birds varied among roosts and years; the lowest values were during the late 1980s/early 1990s and early 2000s. A free-running population model incorporating varying percentages of first-year birds and constant mortality for each roost provided a plausible explanation for the decline. Although modelled numbers followed the observed pattern, a discrepancy in one year was carried forward in subsequent years, so that the fit with the observed numbers was parallel rather than similar. However, it seems that the decline in numbers was largely due to poorer recruitment. We discuss whether breeding success had declined, whether the population had responded to changes in the local sewage treatment systems, which could affect invertebrate food for Purple Sandpipers, or whether fewer birds chose to winter in Scotland. The Moray Firth population is derived from Norway and possibly Canada, and there is evidence that the Norwegian population was disproportionately affected. The reason for poor recruitment requires further study, and other wader species require examination to test if poor recruitment is a common feature of decline in numbers.

  20. Northwest Forest Plan—the first 10 years (1994–2003): status and trends of northern spotted owl populations and habitat.

    Treesearch

    Joseph Lint

    2005-01-01

    This report presents results from monitoring spotted owl (Strix occidentalis caurina) populations and habitat during the first 10 years of implementation of the Northwest Forest Plan (the Plan). Estimated population decline ranged from 0 to 10 percent across study areas (weighted average of 3.4 percent) annually. The average annual rate of decline...

  1. Association between Late-Life Social Activity and Motor Decline in Older Adults

    PubMed Central

    Buchman, Aron S.; Boyle, Patricia A.; Wilson, Robert S.; Fleischman, Debra A.; Leurgans, Sue; Bennett, David A.

    2009-01-01

    Background Loss of motor function is a common consequence of aging, but little is known about factors that predict idiopathic motor decline. Methods We studied 906 persons without dementia, history of stroke or Parkinson's disease participating in the Rush Memory and Aging Project. At baseline, they rated their frequency of participation in common social activities. Outcome was annual change in global motor function, based on nine measures of muscle strength and nine motor performances. Results Mean social activity score at baseline was 2.6 (SD=0.58), with higher scores indicating more frequent participation in social activities. In a generalized estimating equation model, controlling for age, sex and education, motor function declined by about 0.05 unit/year [Estimate, 0.016; 95%CI (-0.057, -0.041); p=0.017]. Each 1-point decrease in social activity was associated with about a 33% more rapid rate of decline in motor function [Estimate, 0.016; 95%CI (0.003, 0.029); p=0.017)]. This amount of annual motor decline was associated with a more than 40% increased risk of death (Hazard Ratio: 1.44; 95%CI: 1.30, 1.60) and 65% increased risk of incident Katz disability (Hazard Ratio: 1.65; 95%CI: 1.48, 1.83). The association of social activity with change in motor function did not vary along demographic lines and was unchanged after controlling for potential confounders including late-life physical and cognitive activity, disability, global cognition, depressive symptoms, body composition and chronic medical conditions [Estimate, 0.025; 95%CI (0.005, 0.045); p=0.010]. Conclusion Less frequent participation in social activities is associated with a more rapid rate of motor decline in old age. PMID:19546415

  2. Investigating Rates of Hunting and Survival in Declining European Lapwing Populations

    PubMed Central

    2016-01-01

    Understanding effects of harvest on population dynamics is of major interest, especially for declining species. European lapwing Vanellus vanellus populations increased from the 1960s until the 1980s and declined strongly thereafter. About 400,000 lapwings are harvested annually and it is thus of high conservation relevance to assess whether hunting was a main cause for the observed changes in lapwing population trends. We developed a multi-event cause-specific mortality model which we applied to a long-term ring-recovery data set (1960–2010) of > 360,000 records to estimate survival and cause-specific mortalities. We found no temporal change in survival over the last 50 years for first-year (FY) and older birds (after first-year; AFY) originating from different ringing areas. Mean survival was high, around 0.60 and 0.80 for FY and AFY individuals, respectively. The proportion of total mortality due to hunting was <0.10 over the study period and the estimated proportion of harvested individuals (kill rate) was <0.05 in each year. Our result of constant survival indicates that demographic processes other than survival were responsible for the pronounced change in lapwing population trends in the 1980s. Our findings lend support to the hypothesis that hunting was not a significant contributor to the large-scale decline of lapwing populations. To halt the ongoing decline of European lapwing populations management should focus on life history stages other than survival (e.g. productivity). Further analyses are required to investigate the contribution of other demographic rates to the decline of lapwings and to identify the most efficient conservation actions. PMID:27685660

  3. Suicide mortality trends in the Nordic countries 1980-2009.

    PubMed

    Titelman, David; Oskarsson, Høgni; Wahlbeck, Kristian; Nordentoft, Merete; Mehlum, Lars; Jiang, Guo-Xin; Erlangsen, Annette; Nrugham, Latha; Wasserman, Danuta

    2013-12-01

    The Nordic countries provide a suitable setting for comparing trends in suicide mortality. The aim of this report is to compare suicide trends by age, gender, region and methods in Denmark, Finland, Iceland, Norway and Sweden 1980-2009. Suicide statistics 1980-2009 were analyzed for men and women aged 15 years and above and the age group 15-24 years. Regional suicide rates in 2009 were presented in maps. The suicide rates across the Nordic countries declined from 25-50 per 100,000 in 1980 to 20-36 in 2009 for men and from 9-26 in 1980 to 8-11 in 2009 for women. The rates in Finland were consistently higher than those of the other countries. A significant increase of suicides in young women in Finland and Norway and a lack of a decline among young women in Sweden were noted. The male- female ratio of suicide converged to approximately 3:1 across the region during the study period. Rural areas in Finland, Norway and Sweden saw the highest suicide rates, whereas the rates in the capital regions of Denmark, Norway and Sweden were lower than the respective national rates. We hold that the overall decline of suicide rates in the Nordic countries reflects the socio-economic development and stability of the region, including the well-functioning healthcare. The increasing rates in Finland and Norway and the unchanged rate in Sweden of suicide in young women are an alarming trend break that calls for continued monitoring.

  4. Home Telecare for Chronic Disease Management

    DTIC Science & Technology

    2001-10-25

    in USA. Mortality rate rose 32.9% from 1979 to 1991 and age adjusted death rates for COPD rose 71% from 1966 to 1986.Over the same two decades death ... rates from all causes declined by 22% and for heart and cerebral vascular disease declined by 45% and 58% respectively. Increases in morbidity and

  5. Effects of Maine's 1981 and Massachusetts' 1982 driving-under-the-influence legislation.

    PubMed Central

    Hingson, R; Heeren, T; Kovenock, D; Mangione, T; Meyers, A; Morelock, S; Lederman, R; Scotch, N A

    1987-01-01

    In 1981, Maine passed a drunk driving law with mandatory penalties and a new civil charge to increase the conviction rate. One year later, Massachusetts increased drunk driving penalties, particularly for repeat offenders and intoxicated drivers involved in fatal crashes. In Maine, single-vehicle nighttime fatal crashes declined 22 per cent the year before passage of the law, and 33 per cent the year after. Maine's rates returned to pre-law levels by the third post-law year. Prior to Massachusetts' new law, single-vehicle nighttime and overall fatal crashes there also declined 20% and 22%, whereas after this law fatal crash rates did not decline further compared with the pre-law year or other New England states. Pre- and post-law surveys indicate that both laws were followed by some increases in public perceptions that drunk drivers stopped by police would be arrested, convicted, and receive automatic penalties. But, few believed it was very likely that drunk drivers would be stopped. For only two of three years studied after Maine's law did more people there report decisions not to drive because they had drunk too much. In Massachusetts, reported driving after heavy drinking declined as much the year before as the three years after its law. PMID:3565654

  6. In situ effects of pesticides on amphibians in the Sierra Nevada.

    PubMed

    Sparling, Donald W; Bickham, John; Cowman, Deborah; Fellers, Gary M; Lacher, Thomas; Matson, Cole W; McConnell, Laura

    2015-03-01

    For more than 20 years, conservationists have agreed that amphibian populations around the world are declining. Results obtained through laboratory or mesocosm studies and measurement of contaminant concentrations in areas experiencing declines have supported a role of contaminants in these declines. The current study examines the effects of contaminant exposure to amphibians in situ in areas actually experiencing declines. Early larval Pseudacris regilla were translocated among Lassen Volcanic, Yosemite and Sequoia National Parks, California, USA and caged in wetlands in 2001 and 2002 until metamorphosis. Twenty contaminants were identified in tadpoles with an average of 1.3-5.9 (maximum = 10) contaminants per animal. Sequoia National Park, which had the greatest variety and concentrations of contaminants in 2001, also had tadpoles that experienced the greatest mortality, slowest developmental rates and lowest cholinesterase activities. Yosemite and Sequoia tadpoles and metamorphs had greater genotoxicity than those in Lassen during 2001, as determined by flow cytometry. In 2001 tadpoles at Yosemite had a significantly higher rate of malformations, characterized as hemimelia (shortened femurs), than those at the other two parks but no significant differences were observed in 2002. Fewer differences in contaminant types and concentrations existed among parks during 2002 compared to 2001. In 2002 Sequoia tadpoles had higher mortality and slower developmental rates but there was no difference among parks in cholinesterase activities. Although concentrations of most contaminants were below known lethal concentrations, simultaneous exposure to multiple chemicals and other stressors may have resulted in lethal and sublethal effects.

  7. Application of empirical Bayes methods to predict the rate of decline in ERG at the individual level among patients with retinitis pigmentosa.

    PubMed

    Qiu, Weiliang; Sandberg, Michael A; Rosner, Bernard

    2018-05-31

    Retinitis pigmentosa is one of the most common forms of inherited retinal degeneration. The electroretinogram (ERG) can be used to determine the severity of retinitis pigmentosa-the lower the ERG amplitude, the more severe the disease is. In practice for career, lifestyle, and treatment counseling, it is of interest to predict the ERG amplitude of a patient at a future time. One approach is prediction based on the average rate of decline for individual patients. However, there is considerable variation both in initial amplitude and in rate of decline. In this article, we propose an empirical Bayes (EB) approach to incorporate the variations in initial amplitude and rate of decline for the prediction of ERG amplitude at the individual level. We applied the EB method to a collection of ERGs from 898 patients with 3 or more visits over 5 or more years of follow-up tested in the Berman-Gund Laboratory and observed that the predicted values at the last (kth) visit obtained by using the proposed method based on data for the first k-1 visits are highly correlated with the observed values at the kth visit (Spearman correlation =0.93) and have a higher correlation with the observed values than those obtained based on either the population average decline rate or those obtained based on the individual decline rate. The mean square errors for predicted values obtained by the EB method are also smaller than those predicted by the other methods. Copyright © 2018 John Wiley & Sons, Ltd.

  8. Falling teen pregnancy, birthrates: what's behind the declines?

    PubMed

    Donovan, P

    1998-10-01

    About half of the almost 1 million US teenagers who become pregnant each year carry their pregnancies to term and give birth. However, after years of steady increases, teen birthrates in the US are lower and pregnancy rates have fallen to their lowest level in 20 years. Teenage sexual activity is also declining. Over the period 1991-96, the birthrate in the US among teens declined from the 20-year high of 62.1 births/1000 females aged 15-19 to 54.4/1000. This 12% decline comes after a 24% increase in the birthrate between 1986 and 1991. Declines in the teen birthrate were observed for the nation overall, as well as in each state, ranging from 6% in Alabama to 29% in Alaska. The teen birthrate among Blacks declined 21% to reach a record low of 91.4/1000 in 1996, while the rate for Hispanic teens barely changed during 1991-95, but eventually declined 5% during 1995-96 to 101.8/1000. The birthrate among non-Hispanic White teens declined 9% during the period to 48.1/1000, while the birthrate for teens aged 15-17 fell 13% during the period and 9% for 18-19 year olds. Pregnancy rates among women aged 15-19 years declined 14% between 1990 and 1995, to 101.1/1000, the lowest level since the mid-1970s. Although researchers are unsure why teen pregnancy and birthrates have fallen, recent survey data suggest that the declines have occurred because both fewer teens are having sex and more sexually active adolescents are using contraception.

  9. Suicide by pesticide poisoning remains a priority for suicide prevention in China: Analysis of national mortality trends 2006-2013.

    PubMed

    Page, Andrew; Liu, Shiwei; Gunnell, David; Astell-Burt, Thomas; Feng, Xiaoqi; Wang, Lijun; Zhou, Maigeng

    2017-01-15

    Despite recent declines, suicide remains a priority for China. Ease of availability of high-lethality suicide methods, such as pesticides and firearms, contributes to the overall incidence and is an important target for suicide prevention. This study investigates whether changes in the distribution of methods of suicide have contributed to the recent reduction in suicide in China. Suicide rates (2006-2013) were calculated using the Chinese Disease Surveillance Points system, stratified by gender, age group, and urban-rural residence, to investigate trends in suicide over the study period. Multilevel negative binomial regression models were used to investigate associations between socio-demographic factors and method-specific suicide. The most common method of suicide in China for both males and females was pesticide poisoning, followed by hanging. All methods declined over the study period, with the exception of suicide by jumping in males. Suicide rates for pesticide poisoning and for hanging increased exponentially with age in those aged over ≥45 years in both sexes. Pesticide poisoning declined from 55% to 49% of all suicides, while hanging increased from 27% to 31%. This was an ecological study of a time series of suicide rates, with risk factor adjustment being limited to population-level point estimates derived from a single census. Suicide by pesticide poisoning and hanging remain the leading methods of suicide in China. Changes to the safe use of pesticides and targeted prevention initiatives to restrict access, along with socio-economic development and urbanisation, are likely contributors to declines in suicide by pesticide poisoning. Crown Copyright © 2016. Published by Elsevier B.V. All rights reserved.

  10. Temporal variation in survival and recovery rates of lesser scaup

    USGS Publications Warehouse

    Arnold, Todd W.; Afton, Alan D.; Anteau, Michael J.; Koons, David N.; Nicolai, Chris

    2016-01-01

    Management of lesser scaup (Aythya affinis) has been hindered by access to reliable data on population trajectories and vital rates. We conducted a Bayesian analysis of historical (1951–2011) band-recovery data throughout North America to estimate annual survival and recovery rates for juvenile and adult male and female lesser scaup to determine if increasing harvest or declining survival rates have contributed to population changes and to determine if harvest has been primarily additive or compensatory. Annual recovery rates were low, ranging from 1% to 4% for adults and 2% to 10% for juveniles during most years, with trend models indicating that recovery rates have declined through time for all age–sex classes. Annual survival (mid-Aug to mid-Aug) averaged 0.402 (σ ̂ 0.043) for juvenile males, 0.416 (σ ̂ 0.067) for juvenile females, 0.689 (σ ̂ 0.109) for adult males, and 0.602 (σ ̂ 0.115) for adult females, where σ ̂ represents an estimate of annual process variation in each survival rate. Annual survival rates exhibited no evidence of long-term declines or negative correlations with annual recovery rates (i.e., an index of harvest intensity) for any age–sex class, suggesting that declining fecundity was the most likely explanation for population declines during 1975–2005. We conclude that hunting mortality played a minor role in affecting population dynamics of lesser scaup and waterfowl managers could take a less cautious approach in managing harvest, especially if recruiting or maintaining waterfowl hunters are viewed as important management objectives.

  11. Organizations and Survey Research: Implementing Response Enhancing Strategies and Conducting Nonresponse Analyses

    ERIC Educational Resources Information Center

    Fulton, Brad R.

    2018-01-01

    Surveys provide a critical source of data for scholars, yet declining response rates are threatening the quality of data being collected. This threat is particularly acute among organizational studies that use key informants--the mean response rate for published studies is 34 percent. This article describes several response enhancing strategies…

  12. Trends in mortality from COPD among adults in the United States.

    PubMed

    Ford, Earl S

    2015-10-01

    COPD imposes a large public health burden internationally and in the United States. The objective of this study was to examine trends in mortality from COPD among US adults from 1968 to 2011. Data from the National Vital Statistics System from 1968 to 2011 for adults aged ≥ 25 years were accessed, and trends in mortality rates were examined with Joinpoint analysis. Among all adults, age-adjusted mortality rate rose from 29.4 per 100,000 population in 1968 to 67.0 per 100,000 population in 1999 and then declined to 63.7 per 100,000 population in 2011 (annual percentage change [APC] 2000-2011, -0.2%; 95% CI, -0.6 to 0.2). The age-adjusted mortality rate among men peaked in 1999 and then declined (APC 1999-2011, -1.1%; 95% CI, -1.4 to -0.7), whereas the age-adjusted mortality rate among women increased from 2000 to 2011, peaking in 2008 (APC 2000-2011, 0.4%; 95% CI, 0.0-0.9). Despite a narrowing of the sex gap, mortality rates in men continued to exceed those in women. Evidence of a decline in the APC was noted for black men (1999-2011, -1.5%; 95% CI, -2.1 to -1.0) and white men (1999-2011, -0.9%; 95% CI, -1.3 to -0.6), adults aged 55 to 64 years (1989-2011, -1.0%; 95% CI, -1.2 to -0.8), and adults aged 65 to 74 years (1999-2011, -1.2%; 95% CI, -1.6 to -0.9). In the United States, the mortality rate from COPD has declined since 1999 in men and some age groups but appears to be still rising in women, albeit at a reduced pace.

  13. Tuberculosis mortality trends in cuba, 1998 to 2007.

    PubMed

    González, Edilberto; Risco, Grisel E; Borroto, Susana; Perna, Abel; Armas, Luisa

    2009-01-01

    Introduction Tuberculosis (TB) is a major cause of illness and death throughout the world. The World Health Organization's Global Plan to Stop TB 2006-2015 proposes that countries cut TB mortality by half compared to 1990 rates. In Cuba, TB mortality declined steadily throughout the 20th century, particularly after 1960. Objective Describe TB mortality distribution and trends in Cuba from January 1998 to December 2007 by infection site, sex, age and province, and determine progress towards the WHO's 2015 target for TB mortality reduction. Methods A time series ecological study was conducted. Death certificates stating TB as cause of death were obtained from the Ministry of Public Health's National Statistics Division, and population data by age group, sex, and province were obtained from the National Statistics Bureau. Crude and specific death rate trends and variation were analyzed. Results TB mortality declined from 0.4 per 100,000 population in 1998 to 0.2 (under half the 1990 rate) in 2007. Clinical forms of the disease, both pulmonary and extrapulmonary, also declined. The highest mortality rates were found in males and in the group aged ≥ 65 years. Rates were also highest in the capital, Havana, with extreme values of 0.73 and 0.39 per 100,000 population at the beginning and end of the period, respectively. Conclusions Deaths from TB declined steadily compared to total deaths and deaths caused by infectious diseases. The Global Plan to Stop TB target was met well ahead of 2015. If this trend continues, TB is likely to become an exceptional cause of death in Cuba.

  14. Fatal occupational injuries in Taiwan, 1994-2005.

    PubMed

    Ho, Shu-Chen; Wang, Li-Yu; Ho, Chi-Kung; Yang, Chun-Yuh

    2010-04-01

    This study examines the trends in rates of fatal occupational injuries in Taiwan by demographic group and occupation for 1994-2005. Data on deaths due to injuries at work from 1994 through 2005 were obtained from the Department of Health which is responsible for the death registration system in Taiwan. Employment data, which were used as the denominators of fatality rates in this study, were retrieved from the Directorate-General of Budget and Accounting Statistics 'Employment and Earnings' database. A Poisson regression model was used to examine the trends in rates of fatal occupational injuries in various occupations while controlling for demographic characteristics. Overall fatal occupational injury rates declined during the study period among all demographic groups and occupations. Adjusted annual changes in rates of fatal injuries ranged from a decrease of 13.6% a year in machine operators/related workers to a decrease of 35.9% in clerks. The annual decrement was faster for males than for females and for older workers compared to young workers. Despite declining rates, the number of fatal occupational injuries in Taiwan remains significant because of the growing work force. Future research should focus on the disparities in fatal injury trends.

  15. Presence of the amphibian chytrid fungus Batrachochytrium dendrobatidis in threatened corroboree frog populations in the Australian Alps.

    PubMed

    Hunter, David A; Speare, Rick; Marantelli, Gerry; Mendez, Diana; Pietsch, Rod; Osborne, Will

    2010-11-01

    Since the early 1980s, the southern corroboree frog Pseudophryne corroboree and northern corroboree frog P. pengilleyi have been in a state of decline from their sub-alpine and high montane bog environments on the southern tablelands of New South Wales, Australia. To date, there has been no adequate explanation as to what is causing the decline of these species. We investigated the possibility that a pathogen associated with other recent frog declines in Australia, the amphibian chytrid fungus Batrachochytrium dendrobatidis, may have been implicated in the decline of the corroboree frogs. We used histology of toe material and real-time PCR of skin swabs to investigate the presence and infection rates with B. dendrobatidis in historic and extant populations of both corroboree frog species. Using histology, we did not detect any B. dendrobatidis infections in corroboree frog populations prior to their decline. However, using the same technique, high rates of infection were observed in populations of both species after the onset of substantial population declines. The real-time PCR screening of skin swabs identified high overall infection rates in extant populations of P. corroboree (between 44 and 59%), while significantly lower rates of infection were observed in low-altitude P. pengilleyi populations (14%). These results suggest that the initial and continued decline of the corroboree frogs may well be attributed to the emergence of B. dendrobatidis in populations of these species.

  16. Managing American Oystercatcher (Haematopus palliatus) population qrowth by targeting nesting season vital rates

    USGS Publications Warehouse

    Felton, Shilo K.; Hostetter, Nathan J.; Pollock, Kenneth H.; Simons, Theodore R.

    2017-01-01

    In populations of long-lived species, adult survival typically has a relatively high influence on population growth. From a management perspective, however, adult survival can be difficult to increase in some instances, so other component rates must be considered to reverse population declines. In North Carolina, USA, management to conserve the American Oystercatcher (Haematopus palliatus) targets component vital rates related to fecundity, specifically nest and chick survival. The effectiveness of such a management approach in North Carolina was assessed by creating a three-stage female-based deterministic matrix model. Isoclines were produced from the matrix model to evaluate minimum nest and chick survival rates necessary to reverse population decline, assuming all other vital rates remained stable at mean values. Assuming accurate vital rates, breeding populations within North Carolina appear to be declining. To reverse this decline, combined nest and chick survival would need to increase from 0.14 to ≤ 0.27, a rate that appears to be attainable based on historical estimates. Results are heavily dependent on assumptions of other vital rates, most notably adult survival, revealing the need for accurate estimates of all vital rates to inform management actions. This approach provides valuable insights for evaluating conservation goals for species of concern.

  17. Amyotrophic lateral sclerosis and parkinsonism-dementia on Guam, 1945-1972. I. Descriptive epidemiology.

    PubMed

    Reed, D M; Brody, J A

    1975-04-01

    An overview of the epidemiologic studies of amyotrophic lateral sclerosis (ALS) and parkinsonism-dementia (PD) from 1945 through 1972 is presented. During this period 350 cases of ALS were documented. PD, which is apparently unique to the native Chamorro population, was not recognized during the early years of the study. A total of 213 PD patients have now been seen. The rates of both diseases have declined by approximately 50 per cent since 1965. In the early years incidence per 100,000 for ALS males approached 60; for females it was about 40. For PD males it was about 50; for females it was close to 20. The declines in both diseases have occurred in both sexes and at all age groups and no cohort phenomenon was observed. Marked geographic differences in the distribution of the diseases were observed with southern villages having the highest rates and western villages having the lowest rates; the remainder of the island was intermediate. Recent declines have been most marked in the southern high-rate villages. Chamorros living on the island of Rota have rates similar to those on Guam; those on Saipan have lower rates. A possible excess of ALS among Filipino residents ofGuam was noted; ALS has not been seen among other ethnic groups. Geographic mapping even in high incidence areas did not reveal true clusters or foci. Extensive case-control studies did not reveal any patterns of prior illness, life-style, or exposures distinguishing patients. A tendency for patients to be of somewhat lower socioeconomic level, have less education, eat more homegrown foods and raw meats, and more contact with animals was found. No Mendelian genetic patterns were observed; males were affected more frequently than female for both diseases. Cases did not occur before age 20, reached maximum frequency between ages 55 and 65 and there-after declined. Environmental factors associated with some aspects of the traditional way of life seem to be causally involved, but, since most aspects of the traditional life have changed in the past 50 years, the specific factors remain elusive.

  18. [Fertility change in Mexico and the politics of population].

    PubMed

    Zavala De Cosio, M E

    1993-01-01

    This introduction to a detailed study of fertility change in Mexico assesses the available fertility data and describes the sources used, traces the beginning and course of the demographic transition in Mexico, and describes the work. Mexico's demographic transition began around 1930 with the acceleration of mortality decline. The considerable time lag between the mortality decline and the beginning of the fertility decline resulted in a period of very rapid growth. Between 1955 and 1975, the growth rate exceeded 3% annually. The start of the fertility decline dated to about 1970, the time of a major reform of population policy and creation of institutions to reduce growth. But the fertility decline was not solely the result of population programs. An incipient fertility decline could be observed in the metropolitan and more educated population sectors beginning in the early 1960s. The onset of the mortality decline in the 1930s resulted from the sustained social and economic progress made possible after the conclusion of the Mexican Revolution. Between 1930 and 1980, the adult illiteracy rate declined from 61.2% to 17%, while life expectancy increased from 33 years to 63.2 years. In Mexico as in other Latin American countries, the mortality decline, which disturbed the traditional balance between high mortality and high fertility, was the force setting off the demographic transition and the necessary precursor to fertility decline. The first of two main sections of the book focuses on examination of fertility variations in Mexico since around 1900 using cross-sectional and longitudinal methods of analysis. The second part describes the origins, history, and institutions involved in Mexico's population policies and the demographic programs and their principal results. The influence of population policies in demographic change is assessed, especially in the case of fertility changes induced by family planning programs. Both the first and second parts sought to place Mexican fertility trends in the context of the demographic transition and to observe the functioning and effects of demographic programs.

  19. Diabetes and Trajectories of Estimated Glomerular Filtration Rate: A Prospective Cohort Analysis of the Atherosclerosis Risk in Communities Study.

    PubMed

    Warren, Bethany; Rebholz, Casey M; Sang, Yingying; Lee, Alexandra K; Coresh, Josef; Selvin, Elizabeth; Grams, Morgan E

    2018-06-01

    Long-term kidney disease trajectories in persons with and without diabetes in a general population are largely uncharacterized. We classified 15,517 participants in the community-based Atherosclerosis Risk in Communities (ARIC) study by diabetes status at baseline (1987-1989; no diabetes, undiagnosed diabetes, and diagnosed diabetes). We used linear mixed models with random intercepts and slopes to quantify estimated glomerular filtration rate (eGFR) trajectories at four visits over 26 years. Adjusted mean eGFR decline over the full study period among participants without diabetes was -1.4 mL/min/1.73 m 2 /year (95% CI -1.5 to -1.4); with undiagnosed diabetes was -1.8 mL/min/1.73 m 2 /year (95% CI -2.0 to -1.7) (difference vs. no diabetes, P < 0.001); and with diagnosed diabetes was -2.5 mL/min/1.73 m 2 /year (95% CI -2.6 to -2.4) (difference vs. no diabetes, P < 0.001). Among participants with diagnosed diabetes, risk factors for steeper eGFR decline included African American race, APOL1 high-risk genotype, systolic blood pressure ≥140 mmHg, insulin use, and higher HbA 1c . Diabetes is an important risk factor for kidney function decline. Those with diagnosed diabetes declined almost twice as rapidly as those without diabetes. Among people with diagnosed diabetes, steeper declines were seen in those with modifiable risk factors, including hypertension and glycemic control, suggesting areas for continued targeting in kidney disease prevention. © 2018 by the American Diabetes Association.

  20. Fish Intake, Genetic Predisposition to Alzheimer Disease, and Decline in Global Cognition and Memory in 5 Cohorts of Older Persons.

    PubMed

    Samieri, Cécilia; Morris, Martha-Clare; Bennett, David A; Berr, Claudine; Amouyel, Philippe; Dartigues, Jean-François; Tzourio, Christophe; Chasman, Daniel I; Grodstein, Francine

    2018-05-01

    Fish are a primary source of long-chain omega-3 fatty acids, which may help delay cognitive aging. We pooled participants from the French Three-City study and 4 US cohorts (Nurses' Health Study, Women's Health Study, Chicago Health and Aging Project, and Rush Memory and Aging Project) for whom diet and cognitive data were available (n = 23,688 white persons, aged ≥65 years, 88% female, baseline year range of 1992-1999, and median follow-up range of 3.9-9.1 years) to investigate the relationship of fish intake to cognitive decline and examine interactions with genes related to Alzheimer disease. We estimated cohort-specific associations between fish and change in composite scores of global cognition and episodic memory using linear mixed models, and we pooled results using inverse-variance weighted meta-analysis. In multivariate analyses, higher fish intake was associated with slower decline in both global cognition and memory (P for trend ≤ 0.031). Consuming ≥4 servings/week versus <1 serving/week of fish was associated with a lower rate of memory decline: 0.018 (95% confidence interval: 0.004, 0.032) standard units, an effect estimate equivalent to that found for 4 years of age. For global cognition, no comparisons of higher versus low fish intake reached statistical significance. In this meta-analysis, higher fish intake was associated with a lower rate of memory decline. We found no evidence of effect modification by genes associated with Alzheimer disease.

  1. Declining incidence of chickenpox in the absence of universal childhood immunisation

    PubMed Central

    Lowe, G; Salmon, R; Thomas, D; Evans, M

    2004-01-01

    Objective: To examine the epidemiology of chickenpox in Wales from 1986 to 2001. Design: Descriptive analysis of chickenpox consultations reported by the Welsh general practice sentinel surveillance scheme for infectious diseases, compared with annual shingles consultation rates from the same scheme to exclude reporting fatigue and data from a general practice morbidity database to validate results. Setting: A total of 226 884 patients registered with one of 30 volunteer general practices participating in the sentinel surveillance scheme. Main outcome measures: Age standardised and age specific incidence of chickenpox. Results: Crude and age standardised consultation rates for chickenpox declined from 1986 to 2001, with loss of epidemic cycling. Rates remained stable in 0–4 year olds but declined in all older age groups, particularly those aged 5–14 years. Shingles consultation rates remained constant over the same period. Data from the morbidity database displayed similar trends. Conclusion: General practitioner consultation rates for chickenpox are declining in Wales except in pre-school children. These findings are unlikely to be a reporting artefact but may be explained either by an overall decline in transmission or increased social mixing in those under 5 years old, through formal child care and earlier school entry, and associated increasing rates of mild or subclinical infection in this age group. Further investigation, particularly by serological surveillance, is necessary before universal varicella immunisation can be considered in the UK. PMID:15383443

  2. [Peruvian demographic transition].

    PubMed

    Carbajal Chirinos, C

    1988-06-01

    The demographic transition is conceptualized as the historic change from high to low fertility and mortality rates in a population. Peru's population was reduced by an estimated 80% as a result of new diseases, destruction of the economy, and the brutal regime of colonial exploitation after the Spanish conquest. From colonial times to the least the 1940s, Peru's principal population problem was the scarcity of manpower. The population grew at an annual rate of about .03% between 1650 and 1800, increasing to about 1.3% between 1876 and 1940. High fertility throughout the 19th century and a stabilization of mortality due to reduced incidence and deadliness of epidemics contributed to the increased growth rate. In the 1940s the process of demographic transition was initiated by abrupt declines in mortality. The crude death rate declined from 27/1000 in 1940 to 16/1000 in 1961 and 9/1000 in 1988, with the rate still declining. Fertility remained high and possibly increased slightly. The crude birth rate was estimated at 45/1000 in 1940 and 45.4/1000 in 1961. Improvements in infant and general mortality rates in developing countries like Peru result from diffusion of technological advances in prevention and control of diseases and improvement in health services rather than from changes in the economic and social structure. The 3rd phase of the demographic transition began with declines in fertility from 45.4/1000 in 1961 to 42.0/1000 in 1972 and 36.0/1000 in 1981. Despite declines, mortality and fertility continue to be elevated in Peru. The theory of demographic transition views the reduction of infant mortality, improvements in health and educational conditions and the condition of women, and more equitable income distribution as essential for a true decline in birth rates. In Peru, however, fertility has declined in a context of deteriorating living conditions and in the absence of effective family planning programs. The process of demographic transition must be accelerated, which will require improvements in education, income, and availability of sanitary services among other changes.

  3. Gastric cancer mortality trends in Spain, 1976-2005, differences by autonomous region and sex

    PubMed Central

    2009-01-01

    Background Gastric cancer is the second leading cause of oncologic death worldwide. One of the most noteworthy characteristics of this tumor's epidemiology is the marked decline reported in its incidence and mortality in almost every part of the globe in recent decades. This study sought to describe gastric cancer mortality time trends in Spain's regions for both sexes. Methods Mortality data for the period 1976 through 2005 were obtained from the Spanish National Statistics Institute. Cases were identified using the International Classification of Diseases 9th and 10th revision (codes 151 and C16, respectively). Crude and standardized mortality rates were calculated by geographic area, sex, and five-year period. Joinpoint regression analyses were performed to ascertain whether changes in gastric cancer mortality trends had occurred, and to estimate the annual percent change by sex and geographic area. Results Gastric cancer mortality decreased across the study period, with the downward trend being most pronounced in women and in certain regions situated in the interior and north of mainland Spain. Across the study period, there was an overall decrease of 2.90% per annum among men and 3.65% per annum among women. Generally, regions in which the rate of decline was sharpest were those that had initially registered the highest rates. However, the rate of decline was not constant throughout the study period: joinpoint analysis detected a shift in trend for both sexes in the early 1980s. Conclusion Gastric cancer mortality displayed in both sexes a downward trend during the study period, both nationally and regionally. The different trend in rates in the respective geographic areas translated as greater regional homogeneity in gastric cancer mortality by the end of the study period. In contrast, rates in women fell more than did those in men. The increasing differences between the sexes could indicate that some risk factors may be modifying the sex-specific pattern of this tumor. PMID:19785726

  4. [Political crises in Africa and infant and child mortality].

    PubMed

    Garenne, M

    1997-01-01

    Many African countries experienced severe political crises after independence, and in a number of cases the crises had significant demographic consequences, especially for child mortality. Data based on maternity histories allowed the reconstruction of child mortality trends over the past 20-30 years in Uganda, Ghana, Rwanda, Madagascar, and Mozambique. The indicator used was the child mortality quotient (number of deaths of under-5 children per 1000 births). Uganda's child mortality declined from 227/1000 in 1960 to 154/1000 in 1970, but the trend was reversed in 1971, when Idi Amin Dada came to power, and the rate reached 204/1000 in 1982 before beginning to decline again. The level of mortality remained high, however, and was still 160/1000 in 1988. Ghana suffered a political and economic crisis during 1979-84. Child mortality rose from 130/1000 in 1978 to 175/1000 in 1983. Mortality rates began a rapid decline after structural adjustment programs were begun, possibly due to improved management of health services. The child mortality rate in Rwanda increased from around 220/1000 in 1960 to 240/1000 in 1975, before beginning a decline in the late 1970s that reached 140/1000 by 1990. The period of political stability and relative prosperity during the 15-year reign of Juvenal Habyarimana was associated with the decline. Political crises marked by student and peasant uprisings were associated with Madagascar's child mortality rate increase from about 145/1000 in 1960 to 185/1000 in 1985. Mozambique was beset by civil war after independence, in which destruction of the health infrastructure was a strategy. The child mortality rate increased from 270/1000 to 470/1000 between 1975 and 1986, a peak war year. The factors by which political crises affect mortality so profoundly remain to be explained, but particular attention should be given to studying the health sector.

  5. Simple rules can guide whether land- or ocean-based conservation will best benefit marine ecosystems.

    PubMed

    Saunders, Megan I; Bode, Michael; Atkinson, Scott; Klein, Carissa J; Metaxas, Anna; Beher, Jutta; Beger, Maria; Mills, Morena; Giakoumi, Sylvaine; Tulloch, Vivitskaia; Possingham, Hugh P

    2017-09-01

    Coastal marine ecosystems can be managed by actions undertaken both on the land and in the ocean. Quantifying and comparing the costs and benefits of actions in both realms is therefore necessary for efficient management. Here, we quantify the link between terrestrial sediment runoff and a downstream coastal marine ecosystem and contrast the cost-effectiveness of marine- and land-based conservation actions. We use a dynamic land- and sea-scape model to determine whether limited funds should be directed to 1 of 4 alternative conservation actions-protection on land, protection in the ocean, restoration on land, or restoration in the ocean-to maximise the extent of light-dependent marine benthic habitats across decadal timescales. We apply the model to a case study for a seagrass meadow in Australia. We find that marine restoration is the most cost-effective action over decadal timescales in this system, based on a conservative estimate of the rate at which seagrass can expand into a new habitat. The optimal decision will vary in different social-ecological contexts, but some basic information can guide optimal investments to counteract land- and ocean-based stressors: (1) marine restoration should be prioritised if the rates of marine ecosystem decline and expansion are similar and low; (2) marine protection should take precedence if the rate of marine ecosystem decline is high or if the adjacent catchment is relatively intact and has a low rate of vegetation decline; (3) land-based actions are optimal when the ratio of marine ecosystem expansion to decline is greater than 1:1.4, with terrestrial restoration typically the most cost-effective action; and (4) land protection should be prioritised if the catchment is relatively intact but the rate of vegetation decline is high. These rules of thumb illustrate how cost-effective conservation outcomes for connected land-ocean systems can proceed without complex modelling.

  6. Simple rules can guide whether land- or ocean-based conservation will best benefit marine ecosystems

    PubMed Central

    Bode, Michael; Atkinson, Scott; Klein, Carissa J.; Metaxas, Anna; Beher, Jutta; Beger, Maria; Mills, Morena; Giakoumi, Sylvaine; Tulloch, Vivitskaia; Possingham, Hugh P.

    2017-01-01

    Coastal marine ecosystems can be managed by actions undertaken both on the land and in the ocean. Quantifying and comparing the costs and benefits of actions in both realms is therefore necessary for efficient management. Here, we quantify the link between terrestrial sediment runoff and a downstream coastal marine ecosystem and contrast the cost-effectiveness of marine- and land-based conservation actions. We use a dynamic land- and sea-scape model to determine whether limited funds should be directed to 1 of 4 alternative conservation actions—protection on land, protection in the ocean, restoration on land, or restoration in the ocean—to maximise the extent of light-dependent marine benthic habitats across decadal timescales. We apply the model to a case study for a seagrass meadow in Australia. We find that marine restoration is the most cost-effective action over decadal timescales in this system, based on a conservative estimate of the rate at which seagrass can expand into a new habitat. The optimal decision will vary in different social–ecological contexts, but some basic information can guide optimal investments to counteract land- and ocean-based stressors: (1) marine restoration should be prioritised if the rates of marine ecosystem decline and expansion are similar and low; (2) marine protection should take precedence if the rate of marine ecosystem decline is high or if the adjacent catchment is relatively intact and has a low rate of vegetation decline; (3) land-based actions are optimal when the ratio of marine ecosystem expansion to decline is greater than 1:1.4, with terrestrial restoration typically the most cost-effective action; and (4) land protection should be prioritised if the catchment is relatively intact but the rate of vegetation decline is high. These rules of thumb illustrate how cost-effective conservation outcomes for connected land–ocean systems can proceed without complex modelling. PMID:28877168

  7. Genetic influences on cognitive decline in Parkinson's disease

    PubMed Central

    Morley, J.F.; Xie, S.X.; Hurtig, H.I.; Stern, M.B.; Colcher, A.; Horn, S.; Dahodwala, N.; Duda, J.E.; Weintraub, D.; Chen-Plotkin, A.S.; Van Deerlin, V.; Falcone, D.; Siderowf, A.

    2012-01-01

    Background The role of genetic factors in cognitive decline associated with Parkinson's disease is unclear. We examined whether variations in apolipoprotein E, microtubule-associated protein tau or catechol-O-methytransferase genotypes are associated with cognitive decline in Parkinson's disease. Methods We performed a prospective cohort study of 212 patients with a clinical diagnosis of Parkinson's disease. The primary outcome was change in Mattis Dementia Rating Scale version 2 score. Linear mixed-effects models and survival analysis were used to test for associations between genotypes and change in cognitive function over time. Results The ε4 allele of apoliporotein E was associated with more rapid decline (loss of 2.9 (95% CI, 1.7–4.1) more points/year, p<0.001) in total score and an increased risk of a ≥10 pointdrop during the follow-up period (HR 2.8, 95% CI 1.4–5.4, p=0.003). Microtubule-associated protein tau haplotype and catechol-O-methytransferase genotype were associated with measures of memory and attention, respectively, over the entire followup period but not with the overall rate of cognitive decline. Conclusion These results confirm and extend previously described genetic associations with cognitive decline in Parkinson's disease and imply that individual genes may exert effects on specific cognitive domains or at different disease stages. Carrying at least one apolipoprotein E ε4 allele is associated with more rapid cognitive decline in Parkinson's disease, supporting the idea of a component of shared etiology between Parkinson's disease dementia and Alzheimer disease. Clinically, these results suggest genotyping can provide information about the risk of future cognitive decline for Parkinson's disease patients. PMID:22344634

  8. Continued Declines in Teen Births in the United States, 2015.

    PubMed

    Hamilton, Brady E; Mathews, T J

    2016-09-01

    •The teen birth rate declined to another historic low for the United States in 2015, down 8% from 2014 to 22.3 births per 1,000 females aged 15-19. •The birth rates for teenagers aged 15-17 and 18-19 declined in 2015 to 9.9 and 40.7, respectively, which are record lows for both groups. •In 2015, birth rates declined to 6.9 for Asian or Pacific Islander, 16.0 for non-Hispanic white, 25.7 for American Indian or Alaska Native, 31.8 for non-Hispanic black, and 34.9 for Hispanic female teenagers aged 15-19. •Birth rates fell to record lows for nearly all race and Hispanic-origin groups of females aged 15-19, 15-17, and 18-19 in 2015. The birth rate for teenagers aged 15-19 has fallen almost continuously since 1991, reaching historic lows for the nation every year since 2009 (1-4). Despite declines in all racial and ethnic groups, teen birth rates continue to vary considerably by race and ethnicity. Moreover, the U.S. teen birth rate remains higher than in other industrialized countries (5). Childbearing by teenagers continues to be a matter of public concern. This report presents the recent and long-term trends and disparity in teen childbearing by race and Hispanic origin. All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.

  9. Therapeutic milestone: stroke declines from the second to the third leading organ- and disease-specific cause of death in the United States.

    PubMed

    Towfighi, Amytis; Ovbiagele, Bruce; Saver, Jeffrey L

    2010-03-01

    Stroke mortality rates declined for much of the second half of the 20th century, but recent trends and their relation to other organ- and disease-specific causes of death have not been characterized. Using the National Center for Health Statistics mortality data, leading organ- and disease-specific causes of death were assessed for the most recent 10-year period (1996 to 2005) in the United States with a specific focus on stroke deaths. Age-adjusted stroke death rates declined by 25.4%; as a result, lung cancer (which only declined by 9.2%) surpassed stroke as the second leading cause of death in 2003. Despite a 31.9% decline in age-adjusted ischemic heart disease death rates, it remains the leading cause of death. Stroke is now the fifth leading cause of death in men and the fourth leading cause of death in whites but remains the second leading cause of death in women and blacks. With stroke death rates decreasing substantially in the United States from 1996 to 2005, stroke moved from the second to the third leading organ- and disease-specific cause of death. Women and blacks may warrant attention for targeted stroke prevention and treatment because they continue to have disproportionately high stroke death rates.

  10. A new approach to define acute kidney injury in term newborns with hypoxic ischemic encephalopathy

    PubMed Central

    Gupta, Charu; Massaro, An N.

    2016-01-01

    Background Current definitions of acute kidney injury (AKI) are not sufficiently sensitive to identify all newborns with AKI during the first week of life. Methods To determine whether the rate of decline of serum creatinine (SCr) during the first week of life can be used to identify newborns with AKI, we reviewed the medical records of 106 term neonates at risk of AKI who were treated with hypothermia for hypoxic ischemic encephalopathy (HIE). Results Of the newborns enrolled in the study, 69 % showed a normal rate of decline of SCr to ≥50 % and/or reached SCr levels of ≤0.6 mg/dl before the 7th day of life, and therefore had an excellent clinical outcome (control group). Thirteen newborns with HIE (12 %) developed AKI according to an established neonatal definition (AKI–KIDGO group), and an additional 20 newborns (19 %) showed a rate of decline of SCr of <33, <40, and <46 % from birth to days 3, 5, or 7 of life, respectively (delayed rise in estimated SCr clearance group). Compared to the control group, newborns in the other two groups required more days of mechanical ventilation and vasopressor drugs and had higher gentamicin levels, more fluid overload, lower urinary epidermal growth factor levels, and a prolonged length of stay. Conclusions The rate of decline of SCr provides a sensitive approach to identify term newborns with AKI during the first week of life. PMID:26857710

  11. A new approach to define acute kidney injury in term newborns with hypoxic ischemic encephalopathy.

    PubMed

    Gupta, Charu; Massaro, An N; Ray, Patricio E

    2016-07-01

    Current definitions of acute kidney injury (AKI) are not sufficiently sensitive to identify all newborns with AKI during the first week of life. To determine whether the rate of decline of serum creatinine (SCr) during the first week of life can be used to identify newborns with AKI, we reviewed the medical records of 106 term neonates at risk of AKI who were treated with hypothermia for hypoxic ischemic encephalopathy (HIE). Of the newborns enrolled in the study, 69 % showed a normal rate of decline of SCr to ≥50 % and/or reached SCr levels of ≤0.6 mg/dl before the 7th day of life, and therefore had an excellent clinical outcome (control group). Thirteen newborns with HIE (12 %) developed AKI according to an established neonatal definition (AKI-KIDGO group), and an additional 20 newborns (19 %) showed a rate of decline of SCr of <33, <40, and <46 % from birth to days 3, 5, or 7 of life, respectively (delayed rise in estimated SCr clearance group). Compared to the control group, newborns in the other two groups required more days of mechanical ventilation and vasopressor drugs and had higher gentamicin levels, more fluid overload, lower urinary epidermal growth factor levels, and a prolonged length of stay. The rate of decline of SCr provides a sensitive approach to identify term newborns with AKI during the first week of life.

  12. Evidence for age-associated cognitive decline from Internet game scores.

    PubMed

    Geyer, Jason; Insel, Philip; Farzin, Faraz; Sternberg, Daniel; Hardy, Joseph L; Scanlon, Michael; Mungas, Dan; Kramer, Joel; Mackin, R Scott; Weiner, Michael W

    2015-06-01

    Lumosity's Memory Match (LMM) is an online game requiring visual working memory. Change in LMM scores may be associated with individual differences in age-related changes in working memory. Effects of age and time on LMM learning and forgetting rates were estimated using data from 1890 game sessions for users aged 40 to 79 years. There were significant effects of age on baseline LMM scores (β = -.31, standard error or SE = .02, P < .0001) and lower learning rates (β = -.0066, SE = .0008, P < .0001). A sample size of 202 subjects/arm was estimated for a 1-year study for subjects in the lower quartile of game performance. Online memory games have the potential to identify age-related decline in cognition and to identify subjects at risk for cognitive decline with smaller sample sizes and lower cost than traditional recruitment methods.

  13. The dynamic relationship between homicide rates and social, economic, and political factors from 1970 to 2000*.

    PubMed

    McCall, Patricia L; Parker, Karen F; MacDonald, John M

    2008-09-01

    After reaching their highest levels of the 20th century, homicide rates in the United States declined precipitously in the early 1990s. This study examines a number of factors that might have contributed to both the sharp increase and decline in homicide rates. We use a pooled cross-sectional time series model to assess the relationship between changes in structural conditions and the change in homicide rates over four decennial time points (1970, 1980, 1990, and 2000). We assess the extent to which structural covariates associated with social, economic and political conditions commonly used in homicide research (e.g., urban decay, poverty, and the weakening of family and social bonds) are related to the change in homicide rates. Along with these classic covariates, we incorporate some contemporary explanations (e.g., imprisonment rates and drug trafficking) that have been proposed to address the recent decline in urban homicide rates. Our results indicate that both classic and contemporary explanations are related to homicide trends over the last three decades of the 20th century. Specifically, changes in resource deprivation and in the relative size of the youth population are associated with changes in the homicide rate across these time points. Increased imprisonment is also significantly related to homicide changes. These findings lead us to conclude that efforts to understand the changing nature of homicide will require serious consideration, if not integration, of classic and contemporary explanations.

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

    Boettcher, M.; Czernin, J.; Sun, K.

    The {beta}{sub 1} receptor blockade reduces cardiac work and may thereby lower myocardial blood flow (MBF) at rest. The effect of {beta}{sub 1} receptor blockade on hyperemic MBF is unknown. To evaluate the effect of selective {beta}{sub 1} receptor blockade on MBF at rest and during dipyridamole induced hyperemia, 10 healthy volunteers (8 men, 2 women, mean age 24 {+-} 5 yr) were studied using {sup 13}N-ammonia PET (two-compartment model) under control conditions and again during metoprolol (50 mg orally 12 hr and 1 hr before the study). The resting rate pressure product (6628 {+-} 504 versus 5225 {+-} 807)more » and heart rate (63 {+-} 6-54 {plus_minus} 5 bpm) declined during metoprolol (p < 0.05). Similarly, heart rate and rate pressure product declined from the baseline dipyridamole study to dipyridamole plus metoprolol (p < 0.05). Resting MBF declined in proportion to cardiac work by approximately 20% from 0.61 {+-} 0.09-0.51 {+-} 0.10 ml/g/min (p < 0.05). In contrast, hyperemic MBF increased when metoprolol was added to dipyridamole (1.86 {plus_minus} 0.27 {+-} 0.45 ml/g/min; p<0.05). The decrease in resting MBF together with the increase in hyperemic MBF resulted in a significant increase in the myocardial flow reserve during metoprolol (3.14 {+-} 0.80-4.61 {+-} 0.68; p<0.01). The {beta}{sub 1} receptor blockade increases coronary vasodilatory capacity and myocardial flow reserve. However, the mechanisms accounting for this finding remain uncertain. 32 refs., 2 figs., 2 tabs.« less

  15. Evolving trends of neonatal and childhood bacterial meningitis in northern Taiwan.

    PubMed

    Lin, Meng-Chin; Chiu, Nan-Chang; Chi, Hsin; Ho, Che-Sheng; Huang, Fu-Yuan

    2015-06-01

    The epidemiology of bacterial meningitis varies in different areas, age groups, and times. To know the trend of neonatal and childhood bacterial meningitis in northern Taiwan, we performed this 29-year-long assessment. Eligible patients were aged 18 years or younger, hospitalized in Mackay Memorial Hospital between 1984 and 2012, and proven by positive cerebrospinal fluid bacterial cultures. Analysis included the patient numbers and pathogens in different age groups, periods, complications, and outcomes. Males were predominant in all the age groups through the years. Almost half of the patients were in the neonatal period. Patient numbers went up in the early study period and declined after 1993-1997. Group B Streptococcus and Escherichia coli were the most common pathogens in neonates, whereas in childhood were Streptococcus pneumoniae and Haemophilus influenzae type b (Hib). Patient numbers of Group B Streptococcus, S. pneumoniae, and Hib meningitis declined in the late study period, but E. coli meningitis increased. The mortality rate decreased but sequela rate increased. Among the four most common pathogens, S. pneumoniae had the worst outcome and had highest mortality rate. All Hib meningitis patients survived, but their sequela rate was the highest. This study provides an epidemiological data on trends of neonatal and childhood bacterial meningitis in northern Taiwan during the past 29 years, including male and neonatal predominance, decrease of total patient number in recent years, change of major pathogens, and declined mortality but raised morbidity. Copyright © 2013. Published by Elsevier B.V.

  16. Productivity, mortality, and population trends of wolves in northeastern Minnesota

    USGS Publications Warehouse

    Mech, L.D.

    1977-01-01

    Population parameters, mortality causes, and mechanisms of a population decline were studied in wolves (Canis lupus lycaon) from 1968 to 1976 in the Superior National Forest. The main method was aerial radio-tracking of 129 wolves and their packmates. Due to a decline in white-tailed deer (Odocoileus virginianus), the wolf population decreased during most of the study. Average annual productivity varied from 1.5 to 3.3 pups per litter, and annual mortality rates from 7 to 65 percent. Malnutrition and intraspecific strife accounted equally for 58 percent of the mortality; human causes accounted for the remainder. As wolf numbers began to decline, pup starvation became apparent, followed by lower pup production, and then by increased intraspecific strife. At higher densities, adult pack wolves were the most secure members of the population, but as the population declined, they became the least secure because of intraspecific strife.

  17. Teen Birth Rate. CTS Facts at a Glance.

    ERIC Educational Resources Information Center

    Moore, Kristin Anderson, Comp.; Papillo, Angela Romano, Comp.; Williams, Stephanie, Comp.; Jager, Justin, Comp.; Jones, Fanette, Comp.

    This fact sheet presents several data tables related to teen pregnancy, birth rates, abortion, contraceptive use, and sexually transmitted diseases. The data reveal that during the 1990s, rates of teen childbearing have declined, returning to the levels reached in the mid-1980s. Declines come from a lower proportion of teens having sex and a…

  18. Association between Soluble Klotho and Change in Kidney Function: The Health Aging and Body Composition Study.

    PubMed

    Drew, David A; Katz, Ronit; Kritchevsky, Stephen; Ix, Joachim; Shlipak, Michael; Gutiérrez, Orlando M; Newman, Anne; Hoofnagle, Andy; Fried, Linda; Semba, Richard D; Sarnak, Mark

    2017-06-01

    CKD appears to be a condition of soluble klotho deficiency. Despite known associations between low soluble klotho levels and conditions that promote kidney damage, such as oxidative stress and fibrosis, little information exists regarding the longitudinal association between soluble klotho levels and change in kidney function. We assayed serum soluble α -klotho in 2496 participants within the Health Aging and Body Composition study, a cohort of older adults. The associations between soluble klotho levels and decline in kidney function (relative decline: eGFR decline ≥30%; absolute decline: eGFR decline >3 ml/min per year) and incident CKD (incident eGFR <60 ml/min per 1.73 m 2 and >1 ml/min per year decline) were evaluated. We adjusted models for demographics, baseline eGFR, urine albumin-to-creatinine ratio, comorbidity, and measures of mineral metabolism. Among participants, the mean (SD) age was 75 (3) years, 52% were women, and 38% were black. Median (25th, 75th percentiles) klotho level was 630 (477, 817) pg/ml. In fully adjusted models, each two-fold higher level of klotho associated with lower odds of decline in kidney function (odds ratio, 0.78 [95% confidence interval, 0.66 to 0.93] for 30% decline in eGFR, and 0.85 [95% confidence interval, 0.73 to 0.98] for >3 ml/min per year decline in eGFR), but not of incident CKD (incident rate ratio, 0.90 [95% confidence interval, 0.78 to 1.04]). Overall, a higher soluble klotho level independently associated with a lower risk of decline in kidney function. Future studies should attempt to replicate these results in other cohorts and evaluate the underlying mechanism. Copyright © 2017 by the American Society of Nephrology.

  19. Bereavement and behavioral changes as risk factors for cognitive decline in adults with Down syndrome.

    PubMed

    Fonseca, Luciana Mascarenhas; de Oliveira, Melaine Cristina; de Figueiredo Ferreira Guilhoto, Laura Maria; Cavalheiro, Esper Abrao; Bottino, Cássio Mc

    2014-01-01

    Cognitive decline and Alzheimer's disease often affect older adults with Down syndrome (DS) much earlier than those in the general population. There is also growing evidence of the effects of negative life events on the mental health and behavior of individuals with intellectual disability. However, to our knowledge, this is the first study investigating objective cognitive decline following bereavement in aging individuals with DS. The objective of this study was to determine whether cognitive decline correlates with bereavement following the recent loss of a caregiver or with behavioral changes in a sample of adult individuals with DS who do not meet the criteria for dementia or depression, using the longitudinal assessment of the Cambridge Cognitive Examination (CAMCOG), together with the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE). We evaluated 18 subjects at baseline and over a follow-up period of 14-22 months, attempting to determine whether cognitive decline correlates with bereavement following the recent loss of the main caregiver or with behavioral changes (as assessed with the Neuropsychiatric Inventory). The mean rate of change in CAMCOG was -1.83 (standard deviation 4.51). Behavioral changes had a significant direct influence on cognitive decline. When bereavement was accompanied by behavioral changes, the probability of cognitive decline was 87% (odds ratio 3.82). The occurrence of behavioral changes attributed to bereavement following the loss of the primary caregiver significantly increases the probability of cognitive decline in individuals with DS. Longitudinal comparison of the CAMCOG and use of the IQCODE appear to enrich the analysis of cognitive decline in individuals with DS. Further studies involving larger samples are needed in order to corroborate and expand upon our findings, which can have implications for the clinical management of older adults with DS.

  20. Abrupt Decline in Tuberculosis among Foreign-Born Persons in the United States

    PubMed Central

    Baker, Brian J.; Winston, Carla A.; Liu, Yecai; France, Anne Marie; Cain, Kevin P.

    2016-01-01

    While the number of reported tuberculosis (TB) cases in the United States has declined over the past two decades, TB morbidity among foreign-born persons has remained persistently elevated. A recent unexpected decline in reported TB cases among foreign-born persons beginning in 2007 provided an opportunity to examine contributing factors and inform future TB control strategies. We investigated the relative influence of three factors on the decline: 1) changes in the size of the foreign-born population through immigration and emigration, 2) changes in distribution of country of origin among foreign-born persons, and 3) changes in the TB case rates among foreign-born subpopulations. Using data from the U.S. National Tuberculosis Surveillance System and the American Community Survey, we examined TB case counts, TB case rates, and population estimates, stratified by years since U.S. entry and country of origin. Regression modeling was used to assess statistically significant changes in trend. Among foreign-born recent entrants (<3 years since U.S. entry), we found a 39.5% decline (-1,013 cases) beginning in 2007 (P<0.05 compared to 2000–2007) and ending in 2011 (P<0.05 compared to 2011–2014). Among recent entrants from Mexico, 80.7% of the decline was attributable to a decrease in population, while the declines among recent entrants from the Philippines, India, Vietnam, and China were almost exclusively (95.5%–100%) the result of decreases in TB case rates. Among foreign-born non-recent entrants (≥3 years since U.S. entry), we found an 8.9% decline (-443 cases) that resulted entirely (100%) from a decrease in the TB case rate. Both recent and non-recent entrants contributed to the decline in TB cases; factors contributing to the decline among recent entrants varied by country of origin. Strategies that impact both recent and non-recent entrants (e.g., investment in overseas TB control) as well as those that focus on non-recent entrants (e.g., expanded targeted testing of high-risk subgroups among non-recent entrants) will be necessary to achieve further declines in TB morbidity among foreign-born persons. PMID:26863004

  1. Advanced statistical methods to study the effects of gastric tube and non-invasive ventilation on functional decline and survival in amyotrophic lateral sclerosis.

    PubMed

    Atassi, Nazem; Cudkowicz, Merit E; Schoenfeld, David A

    2011-07-01

    A few studies suggest that non-invasive ventilation (1) and gastric tube (G-tube) may have a positive impact on survival but the effect on functional decline is unclear. Confounding by indication may have produced biased estimates of the benefit seen in some of these retrospective studies. The objective of this study was to evaluate the effects of G-tube and NIV on survival and functional decline using advanced statistical models that adjust for confounding by indications. A database of 331 subjects enrolled in previous clinical trials in ALS was available for analysis. Marginal structural models (MSM) were used to compare the mortality hazards and ALSFRS-R slopes between treatment and non-treatment groups, after adjusting for confounding by indication. Results showed that the placement of a G-tube was associated with an additional 1.42 units/month decline in the ALSFRS-R slope (p < 0.0001) and increased mortality hazard of 0.28 (p = 0.02). The use of NIV had no significant effect on ALSFRS-R decline or mortality. In conclusion, marginal structural models can be used to adjust for confounding by indication in retrospective ALS studies. G-tube placement could be followed by a faster rate of functional decline and increased mortality. Our results may suffer from some of the limitations of retrospective analyses.

  2. Declines in stillbirth and neonatal mortality rates in Europe between 2004 and 2010: results from the Euro-Peristat project.

    PubMed

    Zeitlin, Jennifer; Mortensen, Laust; Cuttini, Marina; Lack, Nicholas; Nijhuis, Jan; Haidinger, Gerald; Blondel, Béatrice; Hindori-Mohangoo, Ashna D

    2016-06-01

    Stillbirth and neonatal mortality rates declined in Europe between 2004 and 2010. We hypothesised that declines might be greater for countries with higher mortality in 2004 and disproportionally affect very preterm infants at highest risk. Data about live births, stillbirths and neonatal deaths by gestational age (GA) were collected using a common protocol by the Euro-Peristat project in 2004 and 2010. We analysed stillbirths at ≥28 weeks GA in 22 countries and live births ≥24 weeks GA for neonatal mortality in 18 countries. Per cent changes over time were assessed by calculating risk ratios (RR) for stillbirth, neonatal mortality and preterm birth rates in 2010 vs 2004. We used meta-analysis techniques to derive pooled RR using random-effects models overall, by GA subgroups and by mortality level in 2004. Between 2004 and 2010, stillbirths declined by 17% (95% CI 10% to 23%), with a range from 1% to 39% by country. Neonatal mortality declined by 29% (95% CI 23% to 35%) with a range from 9% to 67%. Preterm birth rates did not change: 0% (95% CI -3% to 3%). Mortality declines were of a similar magnitude at all GA; mortality levels in 2004 were not associated with RRs. Stillbirths and neonatal deaths declined at all gestational ages in countries with both high and low levels of mortality in 2004. These results raise questions about how low-mortality countries achieve continued declines and highlight the importance of improving care across the GA spectrum. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  3. Recessions and seniors' health, health behaviors, and healthcare use: analysis of the Medicare Current Beneficiary Survey.

    PubMed

    McInerney, Melissa; Mellor, Jennifer M

    2012-09-01

    A number of studies report that U.S. state mortality rates, particularly for the elderly, decline during economic downturns. Further, several prior studies use microdata to show that as state unemployment rates rise, physical health improves, unhealthy behaviors decrease, and medical care use declines. We use data on elderly mortality rates and data from the Medicare Current Beneficiary Survey from a time period that encompasses the start of the Great Recession. We find that elderly mortality is countercyclical during most of the 1994-2008 period. Further, as unemployment rates rise, seniors report worse mental health and are no more likely to engage in healthier behaviors. We find suggestive evidence that inpatient utilization increases perhaps because of an increased physician willingness to accept Medicare patients. Our findings suggest that either elderly individuals respond differently to recessions than do working age adults, or that the relationship between unemployment and health has changed. Copyright © 2012 Elsevier B.V. All rights reserved.

  4. The rate of growth in scientific publication and the decline in coverage provided by Science Citation Index.

    PubMed

    Larsen, Peder Olesen; von Ins, Markus

    2010-09-01

    The growth rate of scientific publication has been studied from 1907 to 2007 using available data from a number of literature databases, including Science Citation Index (SCI) and Social Sciences Citation Index (SSCI). Traditional scientific publishing, that is publication in peer-reviewed journals, is still increasing although there are big differences between fields. There are no indications that the growth rate has decreased in the last 50 years. At the same time publication using new channels, for example conference proceedings, open archives and home pages, is growing fast. The growth rate for SCI up to 2007 is smaller than for comparable databases. This means that SCI was covering a decreasing part of the traditional scientific literature. There are also clear indications that the coverage by SCI is especially low in some of the scientific areas with the highest growth rate, including computer science and engineering sciences. The role of conference proceedings, open access archives and publications published on the net is increasing, especially in scientific fields with high growth rates, but this has only partially been reflected in the databases. The new publication channels challenge the use of the big databases in measurements of scientific productivity or output and of the growth rate of science. Because of the declining coverage and this challenge it is problematic that SCI has been used and is used as the dominant source for science indicators based on publication and citation numbers. The limited data available for social sciences show that the growth rate in SSCI was remarkably low and indicate that the coverage by SSCI was declining over time. National Science Indicators from Thomson Reuters is based solely on SCI, SSCI and Arts and Humanities Citation Index (AHCI). Therefore the declining coverage of the citation databases problematizes the use of this source.

  5. Decline in new psychoactive substance use disorders following legislation targeting headshops: Evidence from national addiction treatment data.

    PubMed

    Smyth, Bobby P; Lyons, Suzi; Cullen, Walter

    2017-09-01

    New psychoactive substances (NPS) have hedonic effects that may lead to dependence. Headshops selling NPS increased in number in Ireland from late 2009. Legislation was enacted in May and August of 2010 that caused their closure. It is unknown whether such events impact the rate of NPS use disorders. We conducted a population-based study using the Irish national database of episodes of addiction treatment between 2009 and 2012. We examined trends in the rate of NPS-related treatment episodes among young adults. Joinpoint trend analysis software was used to identify significant changes in trend. Of the 31 284 episodes of addiction treatment commenced by adults aged 18 to 34 years, 756 (2.4%) were NPS related. In 2012, the 12-month moving average rate had fallen 48% from its peak in 2010, from 9.0/100 000 to 4.7/100 000. Joinpoint analysis indicated that the rate of NPS related episodes increased by 218% (95% confidence interval 86 to 445, P = 0.001) every 4 months until the first third of 2010. From that point, the rate declined by 9.8% (95% confidence interval -14.1 to -5.4, P = 0.001) per 4-month period. There was no significant trend change in the rate of non-NPS related treatment episodes. Over the 2 years after the enactment of prohibition-styled legislation targeting NPS and headshops, the rate of NPS related addiction treatment episodes among young adults declined progressively and substantially. We found no coinciding trend change in the rate of episodes linked to other drug groups. [Smyth BP, Lyons S, Cullen W. Decline in new psychoactive substance use disorders following legislation targeting headshops: Evidence fromnational addiction treatment data. Drug Alcohol Rev 2017;00:000-000]. © 2017 Australasian Professional Society on Alcohol and other Drugs.

  6. The rate of growth in scientific publication and the decline in coverage provided by Science Citation Index

    PubMed Central

    von Ins, Markus

    2010-01-01

    The growth rate of scientific publication has been studied from 1907 to 2007 using available data from a number of literature databases, including Science Citation Index (SCI) and Social Sciences Citation Index (SSCI). Traditional scientific publishing, that is publication in peer-reviewed journals, is still increasing although there are big differences between fields. There are no indications that the growth rate has decreased in the last 50 years. At the same time publication using new channels, for example conference proceedings, open archives and home pages, is growing fast. The growth rate for SCI up to 2007 is smaller than for comparable databases. This means that SCI was covering a decreasing part of the traditional scientific literature. There are also clear indications that the coverage by SCI is especially low in some of the scientific areas with the highest growth rate, including computer science and engineering sciences. The role of conference proceedings, open access archives and publications published on the net is increasing, especially in scientific fields with high growth rates, but this has only partially been reflected in the databases. The new publication channels challenge the use of the big databases in measurements of scientific productivity or output and of the growth rate of science. Because of the declining coverage and this challenge it is problematic that SCI has been used and is used as the dominant source for science indicators based on publication and citation numbers. The limited data available for social sciences show that the growth rate in SSCI was remarkably low and indicate that the coverage by SSCI was declining over time. National Science Indicators from Thomson Reuters is based solely on SCI, SSCI and Arts and Humanities Citation Index (AHCI). Therefore the declining coverage of the citation databases problematizes the use of this source. PMID:20700371

  7. Apolipoprotein E e4 allele is associated with more rapid motor decline in older persons.

    PubMed

    Buchman, Aron S; Boyle, Patricia A; Wilson, Robert S; Beck, Todd L; Kelly, Jeremiah F; Bennett, David A

    2009-01-01

    We tested the hypothesis that apolipoprotein E allele status predicts the rate of motor decline in the elderly. Eight hundred seventy-six older participants without dementia underwent baseline and annual motor testing for up to 10 years. In a generalized estimating equation controlling for age, sex, and education, motor function declined by about 0.03 U/y. The presence of epsilon4 allele was associated with a 2-fold increase in rate of motor decline epsilon4 allele x time: estimate=-0.027 (SE 0.012, P=0.025)]. The association of epsilon4 allele with motor decline persisted even after controlling for cognitive status, race, body mass index, vascular risk factors, and diseases. Further analyses suggested that the association of epsilon4 with motor decline was for the most part explained by the association between epsilon4 allele and change in muscle strength. These results suggest that the presence of epsilon4 allele is a risk factor for more rapid motor decline in the elderly.

  8. Using Telephone and Informant Assessments to Estimate Missing Modified Mini-Mental State Exam Scores and Rates of Cognitive Decline

    PubMed Central

    Arnold, Alice M.; Newman, Anne B.; Dermond, Norma; Haan, Mary; Fitzpatrick, Annette

    2009-01-01

    Aim To estimate an equivalent to the Modified Mini-Mental State Exam (3MSE), and to compare changes in the 3MSE with and without the estimated scores. Methods Comparability study on a subset of 405 participants, aged ≥70 years, from the Cardiovascular Health Study (CHS), a longitudinal study in 4 United States communities. The 3MSE, the Telephone Interview for Cognitive Status (TICS) and the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) were administered within 30 days of one another. Regression models were developed to predict the 3MSE score from the TICS and/or IQCODE, and the predicted values were used to estimate missing 3MSE scores in longitudinal follow-up of 4,274 CHS participants. Results The TICS explained 67% of the variability in 3MSE scores, with a correlation of 0.82 between predicted and observed scores. The IQCODE alone was not a good estimate of 3MSE score, but improved the model fit when added to the TICS model. Using estimated 3MSE scores classified more participants with low cognition, and rates of decline were greater than when only the observed 3MSE scores were considered. Conclusions 3MSE scores can be reliably estimated from the TICS, with or without the IQCODE. Incorporating these estimates captured more cognitive decline in older adults. PMID:19407461

  9. 26 CFR 1.167(b)-2 - Declining balance method.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 26 Internal Revenue 2 2014-04-01 2014-04-01 false Declining balance method. 1.167(b)-2 Section 1... Declining balance method. (a) Application of method. Under the declining balance method a uniform rate is.... While salvage is not taken into account in determining the annual allowances under this method, in no...

  10. Aging and fertility patterns in wild chimpanzees provide insights into the evolution of menopause

    PubMed Central

    Thompson, Melissa Emery; Jones, James H.; Pusey, Anne E.; Brewer-Marsden, Stella; Goodall, Jane; Marsden, David; Matsuzawa, Tetsuro; Nishida, Toshisada; Reynolds, Vernon; Sugiyama, Yukimaru; Wrangham, Richard W.

    2008-01-01

    Summary Human menopause is remarkable in that reproductive senescence is markedly accelerated relative to somatic aging, leaving an extended post-reproductive period for a large proportion of women [1, 2]. Functional explanations for this are debated [4-11], in part because comparative data from closely-related species are inadequate. Existing studies of chimpanzees are based on very small samples and have not provided clear conclusions about the reproductive function of aging females [12-19]. These studies have not examined whether reproductive senescence in chimpanzees exceeds the pace of general aging, as in humans, or occurs in parallel with declines in overall health, as in many other animals [20, 21]. In order to remedy these problems, we examined fertility and mortality patterns in 6 free-living chimpanzee populations. Chimpanzee and human birth rates show similar patterns of decline beginning in the 4th decade, suggesting that the physiology of reproductive senescence was relatively conserved in human evolution. However, in contrast to humans, chimpanzee fertility declines are consistent with declines in survivorship, and healthy females maintain high birth rates late into life. Thus, in contrast to recent claims [16], we find no evidence that menopause is a typical characteristic of chimpanzee life histories. PMID:18083515

  11. Late-Life Decline in Well-Being Across Adulthood in Germany, the UK, and the US: Something is Seriously Wrong at the End of Life

    PubMed Central

    Gerstorf, Denis; Ram, Nilam; Mayraz, Guy; Hidajat, Mira; Lindenberger, Ulman; Wagner, Gert G.; Schupp, Jürgen

    2010-01-01

    Throughout adulthood and old age, levels of well-being appear to remain relatively stable. However, evidence is emerging that late in life well-being declines considerably. Using long-term longitudinal data of deceased participants in national samples from Germany, the UK, and the US, we examine how long this period lasts. In all three nations and across the adult age range, well-being was relatively stable over age, but declined rapidly with impending death. Articulating notions of terminal decline associated with impending death, we identified prototypical transition points in each study between three and five years prior to death, after which normative rates of decline steepened by a factor of three or more. The findings suggest that mortality-related mechanisms drive late-life changes in well-being and highlight the need for further refinement of psychological concepts about how and when late-life declines in psychosocial functioning prototypically begin. PMID:20545432

  12. The Variability of Estimated Glomerular Filtration Rate Decline in Alport Syndrome.

    PubMed

    Langsford, David; Tang, Mila; Djurdjev, Ognjenka; Er, Lee; Levin, Adeera

    2016-01-01

    A progressive trajectory toward renal failure is common in patients with Alport syndrome. Genotype-phenotype correlations have been well described; however, the natural history of the trajectory toward renal failure is not well described. The objective of this study is to describe the natural history of renal function decline in a cohort of Alport syndrome patients. Retrospective observational cohort study. British Columbia, Canada, chronic renal disease registry 1995-2012. 37 biopsy proven Alport syndrome or hematuria with family history of Alport syndrome. Serial estimated glomerular filtration rate (eGFR) Trajectory of renal decline described graphically by fitting a cubic smoothing spline to patient's eGFR measures. Various time points within a trajectory were indexed, randomly sampled, and followed for 2 years to estimate portion of progressors (>5 mL/min/1.73 m2 /y decline), stable state (0-2 mL/min/1.73 m2 /y decline), and regressors (>2 mL/min/1.73 m2 /y incline). In this retrospective observational cohort study, participants were identified through a chronic renal disease registry in British Columbia, Canada, from 1995 to 2012. Inclusion criteria were biopsy proven or hematuria with a family history of Alport syndrome. Individual patients and family group members were studied. Trajectory of renal decline described graphically by fitting a cubic smoothing spline to patient's serial estimated glomerular filtration rate (eGFR) measures. Various time points within a trajectory were indexed, randomly sampled, and followed for 2 years to estimate portion of progressors (>5 mL/min/1.73 m 2 /y decline), stable state (0-2 mL/min/1.73 m 2 /y decline), and regressors (>2 mL/min/1.73 m 2 /y incline). Histological or genetic evidence of Alport syndrome is not available in all patients. Median follow-up time was 48.2 months of 37 patients (78% male), with a median age of 36 (interquartile range [IQR], 18-47) and a median age of renal replacement therapy commencement (n = 23) of 38 (IQR = 20-52). Renal function changes were found to be heterogeneous overall, intra-individual and within families. Portion of progressors in eGFR 45-60 mL/min/1.73 m 2 was 73.7% (SD, 10.3), whereas 23.6% (SD, 11.0) remained stable. Within eGFR 30-45 mL/min/1.73 m 2 , 45.6% (SD, 7.0) were progressors, whereas 53.4% (SD, 7.4) remained stable. A large portion of eGFR 15-30 mL/min/1.73 m 2 patients were stable (54.8%; SD, 8.4), whereas 25.7% (SD, 7.1) progressed and 19.5% (SD, 5.6) regressed. The renal decline in Alport syndrome patients is heterogeneous which has implications for designing clinical trials of interventions.

  13. The Variability of Estimated Glomerular Filtration Rate Decline in Alport Syndrome

    PubMed Central

    Langsford, David; Tang, Mila; Djurdjev, Ognjenka; Er, Lee; Levin, Adeera

    2016-01-01

    Background: A progressive trajectory toward renal failure is common in patients with Alport syndrome. Genotype-phenotype correlations have been well described; however, the natural history of the trajectory toward renal failure is not well described. Objective: The objective of this study is to describe the natural history of renal function decline in a cohort of Alport syndrome patients. Design: Retrospective observational cohort study. Setting: British Columbia, Canada, chronic renal disease registry 1995-2012. Patients: 37 biopsy proven Alport syndrome or hematuria with family history of Alport syndrome. Measurements: Serial estimated glomerular filtration rate (eGFR) Trajectory of renal decline described graphically by fitting a cubic smoothing spline to patient’s eGFR measures. Various time points within a trajectory were indexed, randomly sampled, and followed for 2 years to estimate portion of progressors (>5 mL/min/1.73 m2 /y decline), stable state (0-2 mL/min/1.73 m2 /y decline), and regressors (>2 mL/min/1.73 m2 /y incline). Methods: In this retrospective observational cohort study, participants were identified through a chronic renal disease registry in British Columbia, Canada, from 1995 to 2012. Inclusion criteria were biopsy proven or hematuria with a family history of Alport syndrome. Individual patients and family group members were studied. Trajectory of renal decline described graphically by fitting a cubic smoothing spline to patient’s serial estimated glomerular filtration rate (eGFR) measures. Various time points within a trajectory were indexed, randomly sampled, and followed for 2 years to estimate portion of progressors (>5 mL/min/1.73 m2/y decline), stable state (0-2 mL/min/1.73 m2/y decline), and regressors (>2 mL/min/1.73 m2/y incline). Limitations: Histological or genetic evidence of Alport syndrome is not available in all patients. Results: Median follow-up time was 48.2 months of 37 patients (78% male), with a median age of 36 (interquartile range [IQR], 18-47) and a median age of renal replacement therapy commencement (n = 23) of 38 (IQR = 20-52). Renal function changes were found to be heterogeneous overall, intra-individual and within families. Portion of progressors in eGFR 45-60 mL/min/1.73 m2 was 73.7% (SD, 10.3), whereas 23.6% (SD, 11.0) remained stable. Within eGFR 30-45 mL/min/1.73 m2, 45.6% (SD, 7.0) were progressors, whereas 53.4% (SD, 7.4) remained stable. A large portion of eGFR 15-30 mL/min/1.73 m2 patients were stable (54.8%; SD, 8.4), whereas 25.7% (SD, 7.1) progressed and 19.5% (SD, 5.6) regressed. Conclusions: The renal decline in Alport syndrome patients is heterogeneous which has implications for designing clinical trials of interventions. PMID:28781883

  14. Association of Temporal Changes in Gestational Age With Perinatal Mortality in the United States, 2007-2015.

    PubMed

    Ananth, Cande V; Goldenberg, Robert L; Friedman, Alexander M; Vintzileos, Anthony M

    2018-05-14

    Whether the changing gestational age distribution in the United States since 2005 has affected perinatal mortality remains unknown. To examine changes in gestational age distribution and gestational age-specific perinatal mortality. This retrospective cohort study examined trends in US perinatal mortality by linking live birth and infant death data among more than 35 million singleton births from January 1, 2007, through December 31, 2015. Year of birth and changes in gestational age distribution. Changes in the proportion of births at gestational ages 20 to 27, 28 to 31, 32 to 33, 34 to 36, 37 to 38, 39 to 40, 41, and 42 to 44 weeks; changes in perinatal mortality (stillbirth at ≥20 weeks, and neonatal deaths at <28 days) rates; and contribution of gestational age changes to perinatal mortality. Trends were estimated from log-linear regression models adjusted for confounders. Among the 34 236 577 singleton live births during the study period, the proportion of births at all gestational ages declined, except at 39 to 40 weeks, which increased (54.5% in 2007 to 60.2% in 2015). Overall perinatal mortality declined from 9.0 to 8.6 per 1000 births (P < .001). Stillbirths declined from 5.7 to 5.6 per 1000 births (P < .001), and neonatal mortality declined from 3.3 to 3.0 per 1000 births (P < .001). Although the proportion of births at gestational ages 34 to 36, 37 to 38, and 42 to 44 weeks declined, perinatal mortality rates at these gestational ages showed annual adjusted relative increases of 1.0% (95% CI, 0.6%-1.4%), 2.3% (95% CI, 1.9%-2.8%), and 4.2% (95% CI, 1.5%-7.0%), respectively. Neonatal mortality rates at gestational ages 34 to 36 and 37 to 38 weeks showed a relative adjusted annual increase of 0.9% (95% CI, 0.2%-1.6%) and 3.1% (95% CI, 2.1%-4.1%), respectively. Although the proportion of births at gestational age 39 to 40 weeks increased, perinatal mortality showed an annual relative adjusted decline of -1.3% (95% CI, -1.8% to -0.9%). The decline in neonatal mortality rate was largely attributable to changes in the gestational age distribution than to gestational age-specific mortality. Although the proportion of births at gestational age 39 to 40 weeks increased, perinatal mortality at this gestational age declined. This finding may be owing to pregnancies delivered at 39 to 40 weeks that previously would have been unnecessarily delivered earlier, leaving fetuses at higher risk for mortality at other gestational ages.

  15. WCPSS High School Graduation Rates: 4-Year and 5-Year Cohort Rates 2011-12. Measuring Up. D&A Report No. 13.04

    ERIC Educational Resources Information Center

    Regan, Roger

    2013-01-01

    The Wake County Public School System (WCPSS) four-year cohort graduation rate declined slightly to 80.6% in 2011-12 from 80.9% in the previous year. Disaggregated graduation rates for most racial and ethnic groups stayed nearly the same or declined slightly in 2011-12, but the rate for African-American students rose from 67.9% to 69.6%. The other…

  16. Terminal-decline effects for select cognitive tasks after controlling for preclinical dementia.

    PubMed

    Laukka, Erika J; MacDonald, Stuart W S; Bäckman, Lars

    2008-05-01

    In a previous study, the authors found no accelerated decline in close proximity to death for a measure of global cognitive functioning, after excluding persons in a preclinical phase of dementia. However, specific cognitive tasks might be more sensitive to terminal-decline effects. The purpose of this study was to explore possible terminal-decline effects for a range of cognitive tasks after controlling for preclinical dementia. Community-based cohort study. The Kungsholmen district of Stockholm. A total of 585 persons (75+ years) were repeatedly assessed over an 11-year period. Level and change in cognitive performance were compared for three groups: persons in close proximity to death, persons in a preclinical phase of dementia, and persons who remained alive and nondemented throughout the study. Tasks assessing primary and episodic memory, verbal ability, and visuospatial skill. Compared with an analysis where all dead subjects were included in the impending-death group, removing the preclinical dementia cases resulted in markedly attenuated mortality-related effects. However, the impending-death group still declined at a faster rate relative to the comparison group on Digit Span-forward, word recognition, and category fluency. Notably, these were tasks for which the comparison group showed no significant decline. A considerable proportion of the terminal-decline effect is accounted for by the impact of preclinical dementia. However, for tasks that are relatively resistant to age-related change, such effects might be detected independently of preclinical dementia.

  17. The Decline in Mobility and Its Impact on Passenger Travel

    DOT National Transportation Integrated Search

    2017-04-01

    Residential mobility rates in the United States (US) have historically been among the highest in the world (Molloy et al, 2011); however, these rates have been in steady decline for the last two decades. While most planning models have ignored migrat...

  18. A Study of Attrition and the Use of Student Learning Communities in the Computer Science Introductory Programming Sequence

    ERIC Educational Resources Information Center

    Howles, Trudy

    2009-01-01

    Student attrition and low graduation rates are critical problems in computer science education. Disappointing graduation rates and declining student interest have caught the attention of business leaders, researchers and universities. With weak graduation rates and little interest in scientific computing, many are concerned about the USA's ability…

  19. The Older Worker. Statistical Reports on Older Americans, No. 6.

    ERIC Educational Resources Information Center

    Chan, Teresita; Fowles, Donald G.

    Trends in the labor force participation and unemployment of older workers were reviewed in a study. A declining rate of labor force participation by older men and a growth in participation by older women were noticed. Examination of labor force participation rates by race revealed a higher participation rate for minority women than for older white…

  20. Effects of cadmium chloride on oxygen consumption and gill morphology of Indian flying barb, Esomus danricus.

    PubMed

    Das, Suchismita; Gupta, Abhik

    2012-11-01

    Effects of three sub lethal concentrations of cadmium chloride (0.636, 0.063 and 0.006 mg l(-1)) on oxygen consumption and gill morphology in Indian flying barb, Esomus danricus (Hamilton-Buchanan), a teleost fish, were studied. When compared to control, 0.636 mg l(-1) of cadmium chloride after 7,14, 21 and 28 day exposure showed a significant decline in rates of oxygen consumption at 32.98, 28.40, 23.88 and 21.69 ml hr(1) 100 g(-1) of tissue, respectively; while, 0.063 mg l(-1) of cadmium chloride for the same exposure durations showed a significant decline in rates of oxygen consumption at 34.28, 29.30, 28.05 and 26.47 ml hr(1)100 g(-1) of tissue, respectively. However, significant decline in the rate of oxygen consumption at 0.006 mg l(-1) of cadmium chloride could be observed from 21st day of exposure. Gill tissue showed various histopathological changes including epithelial lifting, hyperplasia, mucous secretion, marked leucocyte infiltration in the epithelium after 28 days of cadmium chloride exposure.

  1. Impact of diet on long-term decline in gastric cancer incidence in Poland

    PubMed Central

    Jarosz, Mirosław; Sekuła, Włodzimierz; Rychlik, Ewa; Figurska, Katarzyna

    2011-01-01

    AIM: To examine the relationship between the trends in food consumption and gastric cancer morbidity in Poland. METHODS: The study was based on gastric cancer incidence rates and consumption of vegetables, fruit, vitamin C and salt in Poland between 1960 and 2006. Food consumption data were derived from the national food balance sheets or household budget surveys. Spearman correlation coefficients were used to estimate the relationship between the variables. RESULTS: A negative correlation was found between vegetables (-0.70 both for men and women; P < 0.0001), fruit (-0.65 and -0.66; P < 0.0001) and vitamin C (-0.75 and -0.74; P < 0.0001) consumption and stomach cancer incidence rates. The same applied to the availability of refrigerators in the household (-0.77 and -0.80; P < 0.0001). A decline in these rates could also be linked to reduction in salt intake. CONCLUSION: The decline of gastric cancer incidence probably resulted from increased consumption of vegetables, fruit and vitamin C and a decrease in salt consumption. PMID:21218088

  2. Occupational cognitive requirements and late-life cognitive aging.

    PubMed

    Pool, Lindsay R; Weuve, Jennifer; Wilson, Robert S; Bültmann, Ute; Evans, Denis A; Mendes de Leon, Carlos F

    2016-04-12

    To examine whether occupational cognitive requirements, as a marker of adulthood cognitive activity, are associated with late-life cognition and cognitive decline. Main lifetime occupation information for 7,637 participants aged >65 years of the Chicago Health and Aging Project (CHAP) was linked with standardized data on worker attributes and job characteristics from the Occupational Information Network (O*NET). Ratings of cognitive processes required in 10 work-related tasks were used to create a summary measure of occupational cognitive requirements (possible range 0-7). Multivariable-adjusted linear mixed models were used to estimate the association of occupational cognitive requirements score (OCRS) with cognitive function and rate of cognitive decline. Higher OCRS corresponded to significantly better late-life cognitive performance at baseline in 1993 (p < 0.001) and to slower decline in global cognitive function over time (p = 0.004). Within a genotyped subsample (n = 4,104), the associations of OCRS with rate of cognitive decline did not differ significantly by APOE ε4 carriership (p = 0.11). Findings suggest that occupational cognitive requirements are associated with better cognition and a slower rate of cognitive decline in older age. Adulthood cognitive activity may contribute to cognitive reserve in late life. © 2016 American Academy of Neurology.

  3. Terminal decline and practice effects in older adults without dementia: the MoVIES project.

    PubMed

    Dodge, Hiroko H; Wang, Chia-Ning; Chang, Chung-Chou H; Ganguli, Mary

    2011-08-23

    To track cognitive change over time in dementia-free older adults and to examine terminal cognitive decline. A total of 1,230 subjects who remained free from dementia over 14 years of follow-up were included in a population-based epidemiologic cohort study. First, we compared survivors and decedents on their trajectories of 5 cognitive functions (learning, memory, language, psychomotor speed, executive functions), dissociating practice effects which can mask clinically significant decline from age-associated cognitive decline. We used longitudinal mixed-effects models with penalized linear spline. Second, limiting the sample to 613 subjects who died during follow-up, we identified the inflection points at which the rate of cognitive decline accelerated, in relation to time of death, controlling for practice effects. We used mixed-effects model with a change point. Age-associated cognitive trajectories were similar between decedents and survivors without dementia. However, substantial differences were observed between the trajectories of practice effects of survivors and decedents, resembling those usually observed between normal and mildly cognitively impaired elderly. Executive and language functions showed the earliest terminal declines, more than 9 years prior to death, independent of practice effects. Terminal cognitive decline in older adults without dementia may reflect presymptomatic disease which does not cross the clinical threshold during life. Alternatively, cognitive decline attributed to normal aging may itself represent underlying neurodegenerative or vascular pathology. Although we cannot conclude definitively from this study, the separation of practice effects from age-associated decline could help identify preclinical dementia.

  4. Glottal volume velocity waveform characteristics in subjects with and without vocal training, related to gender, sound intensity, fundamental frequency, and age.

    PubMed

    Sulter, A M; Wit, H P

    1996-11-01

    Glottal volume velocity waveform characteristics of 224 subjects, categorized in four groups according to gender and vocal training, were determined, and their relations to sound-pressure level, fundamental frequency, intra-oral pressure, and age were analyzed. Subjects phonated at three intensity conditions. The glottal volume velocity waveforms were obtained by inverse filtering the oral flow. Glottal volume velocity waveforms were parameterized with flow-based (minimum flow, ac flow, average flow, maximum flow declination rate) and time-based parameters (closed quotient, closing quotient, speed quotient), as well as with derived parameters (vocal efficiency and glottal resistance). Higher sound-pressure levels, intra-oral pressures, and flow-parameter values (ac flow, maximum flow declination rate) were observed, when compared with previous investigations. These higher values might be the result of the specific phonation tasks (stressed /ae/ vowel in a word and a sentence) or filtering processes. Few statistically significant (p < 0.01) differences in parameters were found between untrained and trained subjects [the maximum flow declination rate and the closing quotient were higher in trained women (p < 0.001), and the speed quotient was higher in trained men (p < 0.005)]. Several statistically significant parameter differences were found between men and women [minimum flow, ac flow, average flow, maximum flow declination rate, closing quotient, glottal resistance (p < 0.001), and closed quotient (p < 0.005)]. Significant effects of intensity condition were observed on ac flow, maximum flow declination rate, closing quotient, and vocal efficiency in women (p < 0.005), and on minimum flow, ac flow, average flow, maximum flow declination rate, closed quotient, and vocal efficiency in men (p < 0.01).

  5. Abrupt Decline in Kidney Function Before Initiating Hemodialysis and All-Cause Mortality: The Chronic Renal Insufficiency Cohort (CRIC) Study.

    PubMed

    Hsu, Raymond K; Chai, Boyang; Roy, Jason A; Anderson, Amanda H; Bansal, Nisha; Feldman, Harold I; Go, Alan S; He, Jiang; Horwitz, Edward J; Kusek, John W; Lash, James P; Ojo, Akinlolu; Sondheimer, James H; Townsend, Raymond R; Zhan, Min; Hsu, Chi-Yuan

    2016-08-01

    It is not clear whether the pattern of kidney function decline in patients with chronic kidney disease (CKD) may relate to outcomes after reaching end-stage renal disease (ESRD). We hypothesize that an abrupt decline in kidney function prior to ESRD predicts early death after initiating maintenance hemodialysis therapy. Prospective cohort study. The Chronic Renal Insufficiency Cohort (CRIC) Study enrolled men and women with mild to moderate CKD. For this study, we studied 661 individuals who developed chronic kidney failure that required hemodialysis therapy initiation. The primary predictor was the presence of an abrupt decline in kidney function prior to ESRD. We incorporated annual estimated glomerular filtration rates (eGFRs) into a mixed-effects model to estimate patient-specific eGFRs at 3 months prior to initiation of hemodialysis therapy. Abrupt decline was defined as having an extrapolated eGFR≥30mL/min/1.73m(2) at that time point. All-cause mortality within 1 year after initiating hemodialysis therapy. Multivariable Cox proportional hazards. Among 661 patients with CKD initiating hemodialysis therapy, 56 (8.5%) had an abrupt predialysis decline in kidney function and 69 died within 1 year after initiating hemodialysis therapy. After adjustment for demographics, cardiovascular disease, diabetes, and cancer, abrupt decline in kidney function was associated with a 3-fold higher risk for death within the first year of ESRD (adjusted HR, 3.09; 95% CI, 1.65-5.76). Relatively small number of outcomes; infrequent (yearly) eGFR determinations; lack of more granular clinical data. Abrupt decline in kidney function prior to ESRD occurred in a significant minority of incident hemodialysis patients and predicted early death in ESRD. Copyright © 2016 National Kidney Foundation, Inc. All rights reserved.

  6. Dynamics of Severe and Non-Severe Invasive Pneumococcal Disease in Young Children in Israel Following PCV7/PCV13 Introduction.

    PubMed

    Glikman, Daniel; Dagan, Ron; Barkai, Galia; Averbuch, Diana; Guri, Alex; Givon-Lavi, Noga; Ben-Shimol, Shalom

    2018-05-10

    The introduction of the pneumococcal conjugated vaccines (PCVs) resulted in a substantial reduction of invasive pneumococcal disease (IPD) rates. However, impact on non-severe IPD (mostly occult bacteremia) has not yet been fully elucidated.We assessed severe and non-severe IPD (SIPD and NSIPD, respectively) rate dynamics in children <5 years in Israel before and after PCV7/PCV13 implementation. A prospective, population-based, nationwide surveillance. All IPD episodes recorded from 1999 through 2015, were included. NSIPD was defined as IPD episodes without meningitis, pneumonia or mastoiditis in a child with a favorable outcome (not-hospitalized or hospitalized in a non-intensive care unit <5 days, without mortality). Three sub-periods were defined: pre-PCV (1999-2008), PCV7 (2010-2011) and PCV13 (2013-2015). Incidence rate ratios (IRRs) were calculated. Overall, 4,457 IPD episodes were identified; 3,398 (76.2%) SIPD, 1,022 (22.9%) NSIPD and 37 (0.8%) unknown. In 90% of NSIPD episodes, no focus was identified.In the PCV7 period, NSIPD rates significantly declined by 52%, while SIPD rates declined less prominently by 24%. Following PCV13 introduction, compared with the PCV7 period, NSIPD rates declined non-significantly by 17% while SIPD rates declined significantly further by an additional 53%. These trends resulted in overall reductions (comparing PCV13 and pre-PCV periods) of NSIPD and SIPD of 60% (IRR=0.4; 0.32-0.51) and 64% (IRR=0.36; 0.32-0.42), respectively. Following PCV7/PCV13 introduction, SIPD and NSIPD rates substantially declined, with differences in rate-dynamics, alluding to differences in serotype distribution between the two groups. Future surveillance is warranted when considering modification in treatment protocols for suspected occult bacteremia/NSIPD cases.

  7. Decline in stroke mortality in North Carolina. Description, predictions, and a possible underlying cause.

    PubMed

    Howard, G

    1993-09-01

    Data from the National Center for Health Statistics were used to describe the decline in age-adjusted stroke mortality rates from 1962 to 1987 for North Carolina and for six regions of the state. For the state as a whole, stroke mortality decreased from 0.0050 to 0.0018 (64% decrease) for white males, 0.0039 to 0.0016 (59% decrease) for white females, 0.0072 to 0.0030 (58% decrease) for black males, and 0.0064 to 0.0025 (61% decrease) for black females. Under the hypothesis that the rate of decline in stroke mortality will slow and approach a "floor," a four-parameter logistic model was fit to the data. This model suggests that most of the decline in North Carolina stroke rates had occurred by 1987 and that the rates are now approaching the floor. For example, the estimated 1987 white male stroke mortality rate was 0.00190 and the floor 0.00176, suggesting only a 7% decline in the future. Similar percentage differences between 1987 levels and the floor were estimated for the three other race-gender groups. This analysis also suggested that while the absolute disparity by sex and race decreased between 1962 and 1987, the ratio of black to white mortality rates and the ratio of male to female mortality rates remained relatively constant. Estimates of 1-year case-fatality rates from two surveys of hospitalized stroke patients in a high-mortality five-county region of North Carolina decreased from 51% in 1970 to 38% in 1980. This decrease in stroke fatality rate is sufficient to account for 64% of the decrease in mortality estimated for this region over the same period.

  8. An Evaluative Study of the Nurse Education Program. Research Report Number 82-1.

    ERIC Educational Resources Information Center

    Capoor, Madan

    An evaluation of the nurse education program at Middlesex County College (MCC) was conducted in response to an increasing dropout rate and a decline in the passing rate of program graduates on the Licensing Board Examination (LBE). The study focused on the relationship between student background and performance and between student performance in…

  9. Crash and risky driving involvement among novice adolescent drivers and their parents.

    PubMed

    Simons-Morton, Bruce G; Ouimet, Marie Claude; Zhang, Zhiwei; Klauer, Sheila E; Lee, Suzanne E; Wang, Jing; Albert, Paul S; Dingus, Thomas A

    2011-12-01

    We compared rates of risky driving among novice adolescent and adult drivers over the first 18 months of adolescents' licensure. Data-recording systems installed in participants' vehicles provided information on driving performance of 42 newly licensed adolescent drivers and their parents. We analyzed crashes and near crashes and elevated g-force event rates by Poisson regression with random effects. During the study period, adolescents were involved in 279 crashes or near crashes (1 involving injury); parents had 34 such accidents. The incidence rate ratio (IRR) comparing adolescent and parent crash and near-crash rates was 3.91. Among adolescent drivers, elevated rates of g-force events correlated with crashes and near crashes (r = 0.60; P < .001). The IRR comparing incident rates of risky driving among adolescents and parents was 5.08. Adolescents' rates of crashes and near crashes declined with time (with a significant uptick in the last quarter), but elevated g-force event rates did not decline. Elevated g-force events among adolescents may have contributed to crash and near-crash rates that remained much higher than adult levels after 18 months of driving.

  10. Comparative Longterm Mortality Trends in Cancer vs. Ischemic Heart Disease in Puerto Rico.

    PubMed

    Torres, David; Pericchi, Luis R; Mattei, Hernando; Zevallos, Juan C

    2017-06-01

    Although contemporary mortality data are important for health assessment and planning purposes, their availability lag several years. Statistical projection techniques can be employed to obtain current estimates. This study aimed to assess annual trends of mortality in Puerto Rico due to cancer and Ischemic Heart Disease (IHD), and to predict shorterm and longterm cancer and IHD mortality figures. Age-adjusted mortality per 100,000 population projections with a 50% interval probability were calculated utilizing a Bayesian statistical approach of Age-Period-Cohort dynamic model. Multiple cause-of-death annual files for years 1994-2010 for Puerto Rico were used to calculate shortterm (2011-2012) predictions. Longterm (2013-2022) predictions were based on quinquennial data. We also calculated gender differences in rates (men-women) for each study period. Mortality rates for women were similar for cancer and IHD in the 1994-1998 period, but changed substantially in the projected 2018-2022 period. Cancer mortality rates declined gradually overtime, and the gender difference remained constant throughout the historical and projected trends. A consistent declining trend for IHD historical annual mortality rate was observed for both genders, with a substantial changepoint around 2004-2005 for men. The initial gender difference of 33% (80/100,00 vs. 60/100,000) in mortality rates observed between cancer and IHD in the 1994-1998 period increased to 300% (60/100,000 vs. 20/100,000) for the 2018-2022 period. The APC projection model accurately projects shortterm and longterm mortality trends for cancer and IHD in this population: The steady historical and projected cancer mortality rates contrasts with the substantial decline in IHD mortality rates, especially in men.

  11. Thirty-Year (1975–2005) Trends in the Incidence Rates, Clinical Features, Treatment Practices, and Short-term Outcomes of Patients < 55 Years of Age Hospitalized with an Initial Acute Myocardial Infarction

    PubMed Central

    McManus, David D.; Piacentine, Stephen M; Lessard, Darleen; Gore, Joel M.; Yarzebski, Jorge; Spencer, Frederick A.; Goldberg, Robert J.

    2011-01-01

    Sparse data are available describing recent trends in the magnitude, clinical features, treatment practices, and outcomes of comparatively young adults hospitalized with acute myocardial infarction (AMI). The objectives of this population-based study were to describe 3 decade-long trends (1975–2005) in these endpoints among adults less than 55 years old who were hospitalized with an initial AMI. The study population consisted of 1,703 residents of the Worcester (MA) metropolitan area between the ages of 25–54 years who were hospitalized with an initial AMI at all central Massachusetts medical centers during 15 annual periods between 1975 and 2005. The overall hospital incidence rate (per 100,000 persons) of initial AMI in our study population was 66 (95% confidence interval 63–69) and the incidence rates of AMI declined inconsistently over time. Patients hospitalized during the most recent study years were more likely to have important cardiovascular risk factors and comorbidities present but were less likely to have developed heart failure during their index hospitalization. In-hospital and 30-day death rates declined by approximately 50% (p = 0.04) during the years under study concomitant with increasing use of effective cardiac therapies. In conclusion, the results of this community-wide investigation provide insights into the magnitude, changing characteristics, and short-term outcomes of comparatively young patients hospitalized with a first AMI. Declining odds of developing, or dying from, an initial AMI during the 30 years under study likely reflect enhanced primary and secondary prevention and treatment efforts. PMID:21624538

  12. Participation Rates in a Worksite Wellness Program Using E-Mail Wellness Messages

    ERIC Educational Resources Information Center

    Anenson, Larry W.; Brunt, Ardith; Terbizan, Donna J.; Christensen, Bryan

    2014-01-01

    The purpose of this study was to determine which days of the work week had the largest rate of opened e-health messages, whether detailed or basic e-health messages were more likely to be opened, if motivation influenced the rate of message opening, and if the rate of opening messages declined over time. Ninety-one city employees (52 male and 39…

  13. Last call: Passive acoustic monitoring shows continued rapid decline of critically endangered vaquita.

    PubMed

    Thomas, Len; Jaramillo-Legorreta, Armando; Cardenas-Hinojosa, Gustavo; Nieto-Garcia, Edwyna; Rojas-Bracho, Lorenzo; Ver Hoef, Jay M; Moore, Jeffrey; Taylor, Barbara; Barlow, Jay; Tregenza, Nicholas

    2017-11-01

    The vaquita is a critically endangered species of porpoise. It produces echolocation clicks, making it a good candidate for passive acoustic monitoring. A systematic grid of sensors has been deployed for 3 months annually since 2011; results from 2016 are reported here. Statistical models (to compensate for non-uniform data loss) show an overall decline in the acoustic detection rate between 2015 and 2016 of 49% (95% credible interval 82% decline to 8% increase), and total decline between 2011 and 2016 of over 90%. Assuming the acoustic detection rate is proportional to population size, approximately 30 vaquita (95% credible interval 8-96) remained in November 2016.

  14. Development of ground water in the Houston District, Texas, 1970-74

    USGS Publications Warehouse

    Gabrysch, R.K.

    1977-01-01

    Total withdrawals of ground water in the Houston district, Texas , increased 9 percent from about 488 million gallons per day in 1970 to about 532 million gallons per day in 1974. The average annual rate of increase from 1960 to 1969 was about 6.3 percent. During 1970-74, increases in pumpage occurred in the Houston, Katy, and NASA areas; decreases occurred in the Pasadena and Alta Loma areas; and the pumpage in the Baytown-La Porte and Texas City areas remained almost constant. Water levels continued to decline throughout the district during 1970-74, but the rate of decline generally was not as great as in previous years. The greatest declines in the past several years were in the Houston area, but the center of decline is still in the Pasadena and Baytown-La Porte areas. The decrease in the rate of decline suggests that the aquifers in the Houston district could support the amount of pumping during 1970-74 with little, if any , further decline. Although saltwater encroachment has probably occurred in the district, particularly in Galveston County, no large increases in chloride were measured at the monitoring points. (Woodard-USGS)

  15. Decline in Cardiovascular Mortality: Possible Causes and Implications.

    PubMed

    Mensah, George A; Wei, Gina S; Sorlie, Paul D; Fine, Lawrence J; Rosenberg, Yves; Kaufmann, Peter G; Mussolino, Michael E; Hsu, Lucy L; Addou, Ebyan; Engelgau, Michael M; Gordon, David

    2017-01-20

    If the control of infectious diseases was the public health success story of the first half of the 20th century, then the decline in mortality from coronary heart disease and stroke has been the success story of the century's past 4 decades. The early phase of this decline in coronary heart disease and stroke was unexpected and controversial when first reported in the mid-1970s, having followed 60 years of gradual increase as the US population aged. However, in 1978, the participants in a conference convened by the National Heart, Lung, and Blood Institute concluded that a significant recent downtick in coronary heart disease and stroke mortality rates had definitely occurred, at least in the US Since 1978, a sharp decline in mortality rates from coronary heart disease and stroke has become unmistakable throughout the industrialized world, with age-adjusted mortality rates having declined to about one third of their 1960s baseline by 2000. Models have shown that this remarkable decline has been fueled by rapid progress in both prevention and treatment, including precipitous declines in cigarette smoking, improvements in hypertension treatment and control, widespread use of statins to lower circulating cholesterol levels, and the development and timely use of thrombolysis and stents in acute coronary syndrome to limit or prevent infarction. However, despite the huge growth in knowledge and advances in prevention and treatment, there remain many questions about this decline. In fact, there is evidence that the rate of decline may have abated and may even be showing early signs of reversal in some population groups. The National Heart, Lung, and Blood Institute, through a request for information, is soliciting input that could inform a follow-up conference on or near the 40th anniversary of the original landmark conference to further explore these trends in cardiovascular mortality in the context of what has come before and what may lie ahead. © 2017 American Heart Association, Inc.

  16. Decline in Cardiovascular Mortality: Possible Causes and Implications

    PubMed Central

    Mensah, George A.; Wei, Gina S.; Sorlie, Paul D.; Fine, Lawrence J.; Rosenberg, Yves; Kaufmann, Peter G.; Mussolino, Michael E.; Hsu, Lucy L.; Addou, Ebyan; Engelgau, Michael M.; Gordon, David

    2016-01-01

    If the control of infectious diseases was the public health success story of the first half of the 20th century, then the decline in mortality from coronary heart disease (CHD) and stroke has been the success story of the century’s last 4 decades. The early phase of this decline in CHD and stroke was unexpected and controversial when first reported in the mid-1970s, having followed 60 years of gradual increase as the U.S. population aged. However, in 1978 the participants in a conference convened by the National Heart, Lung, and Blood Institute (NHLBI) concluded that a significant recent downtick in CHD and stroke mortality rates had definitely occurred, at least in the U.S. Since 1978, a sharp decline in mortality rates from CHD and stroke has become unmistakable throughout the industrialized world, with age-adjusted mortality rates having declined to about one-third of their 1960s baseline by 2000. Models have shown that this remarkable decline has been fueled by rapid progress in both prevention and treatment, including precipitous declines in cigarette smoking, improvements in hypertension treatment and control, widespread use of statins to lower circulating cholesterol levels, and the development and timely use of thrombolysis and stents in acute coronary syndrome to limit or prevent infarction. However, despite the huge growth in knowledge and advances in prevention and treatment, there remain many questions about this decline. In fact, there is evidence that the rate of decline may have abated and may even be showing early signs of reversal in some population groups. The NHLBI, through a request for information, is soliciting input that could inform a follow-up conference on or near the 40th anniversary of the original landmark conference in order to further explore these trends in cardiovascular mortality in the context of what has come before and what may lie ahead. PMID:28104770

  17. Twenty years of work-related injury and illness among union carpenters in Washington State.

    PubMed

    McCoy, Amanda J; Kucera, Kristen L; Schoenfisch, Ashley L; Silverstein, Barbara A; Lipscomb, Hester J

    2013-04-01

    Individuals who work in the construction industry are at high risk of occupational injury. Robust surveillance systems are needed to monitor the experiences of these workers over time. We updated important surveillance data for a unique occupational cohort of union construction workers to provide information on long-term trends in their reported work-related injuries and conditions. Combining administrative data sources, we identified a dynamic cohort of union carpenters who worked in Washington State from 1989 through 2008, their hours worked by month, and their workers' compensation claims. Incidence rates of reported work-related injuries and illnesses were examined. Poisson regression was used to assess risk by categories of age, gender, time in the union, and calendar time contrasting medical only and paid lost time claims. Over the 20-year study period, 24,830 carpenters worked 192.4 million work hours. Work-related injuries resulting in medical care or paid lost time (PLT) from work occurred at a rate of 24.3 per 200,000 hr worked (95% CI: 23.5-25.0). Medical only claims declined 62% and PLT claims declined 77%; more substantive declines were seen for injuries resulting from being struck and falls to a lower level than from overexertion with lifting. Differences in risk based on union tenure and age diminished over time as well. Significant declines in rates of reported work-related injuries and illnesses were observed over the 20-year period among these union carpenters. Greater declines were observed among workers with less union tenure and for claims resulting in PLT. Copyright © 2012 Wiley Periodicals, Inc.

  18. Parental History of Premature Cardiovascular Disease, Estimated GFR, and Rate of Estimated GFR Decline: Results From the Aerobics Center Longitudinal Study

    PubMed Central

    Huang, Xiaoyan; Sui, Xuemei; Ruiz, Jonatan R.; Hirth, Victor; Ortega, Francisco B.; Blair, Steven N.; Carrero, Juan J.

    2015-01-01

    Background Despite cardiovascular disease (CVD) and chronic kidney disease (CKD) sharing similar etiologies and interplay, it remains unknown if a broader relationship between these diseases exists across generations. We investigated the association between parental CVD history and estimated glomerular filtration rate (eGFR) in the community. Study Design Cross-sectional and longitudinal analyses. Setting & Participants A total of 13,241 community-based adults with serum creatinine measurement and follow-up visits (from 1 to 8 visits, approximately 2 years apart) from the Aerobics Center Longitudinal Study. Predictors Premature parental CVD history (before age of 50 years). Outcomes eGFR, decreased eGFR (<60 mL/min/1.73m2), and rate of eGFR decline. Measurements Information of parental history was collected by protocol-standardized questionnaires. eGFR was assessed with serum creatinine. Results A total of 3,339 (25.2%) participants reported a history of parental CVD. Individuals with parental CVD had significantly lower eGFR compared with those without parental CVD (69.4 ± 12.9 vs. 74.8 ± 14.2 mL/min/1.73m2; P<0.001). After multivariable adjustment, parental CVD was independently associated with higher odds of having decreased eGFR (adjusted OR, 1.68; 95% CI, 1.52–1.86). Random-coefficient models showed that individuals with parental CVD had a faster decline in eGFR compared with those without parental CVD (sex- and ethnicity-adjusted annual change of −0.47 vs. −0.41 mL/min/1.73 m2; P=0.06). Limitations Approximately 70% of the participants did not attend a second examination. Conclusions Parental history of CVD was associated with lower baseline eGFR, higher odds of decreased eGFR, and a nominally faster rate of eGFR decline in the offspring. Such findings may imply previously unrecognized cross-generational links between both diseases and be of support in community screening programs. PMID:25600488

  19. 2006 Washington State collision data summary

    DOT National Transportation Integrated Search

    2007-06-11

    Between 1980 and 2006, the U.S. fatality rate has declined by 58% (from 3.35 to 1.42 fatalities per 100 million VMT). By comparison, during the same period, Washington states overall fatality rate has declined by 67% (from 3.43 to 1.12 fatalities ...

  20. A hybrid of monopoly and perfect competition model for hi-tech products

    NASA Astrophysics Data System (ADS)

    Yang, P. C.; Wee, H. M.; Pai, S.; Yang, H. J.; Wee, P. K. P.

    2010-11-01

    For Hi-tech products, the demand rate, the component cost as well as the selling price usually decline significantly with time. In the case of perfect competition, shortages usually result in lost sales; while in a monopoly, shortages will be completely backordered. However, neither perfect competition nor monopoly exists. Therefore, there is a need to develop a replenishment model considering a hybrid of perfect competition and monopoly when the cost, price and demand are decreasing simultaneously. A numerical example and sensitivity analysis are carried out to illustrate this model. The results show that a higher decline-rate in the component cost leads to a smaller service level and a larger replenishment interval. When the component cost decline rate increases and the selling price decline rate decreases simultaneously, the replenishment interval decreases. In perfect competition it is better to have a high service level, while for the case with monopoly, keeping a low service level is better due to complete backordering.

  1. Effects of Maternal Age and Age-Specific Preterm Birth Rates on Overall Preterm Birth Rates - United States, 2007 and 2014.

    PubMed

    Ferré, Cynthia; Callaghan, William; Olson, Christine; Sharma, Andrea; Barfield, Wanda

    2016-11-04

    Reductions in births to teens and preterm birth rates are two recent public health successes in the United States (1,2). From 2007 to 2014, the birth rate for females aged 15-19 years declined 42%, from 41.5 to 24.2 per 1,000 females. The preterm birth rate decreased 8.4%, from 10.41% to 9.54% of live births (1). Rates of preterm births vary by maternal age, being higher among the youngest and oldest mothers. It is unknown how changes in the maternal age distribution in the United States have affected preterm birth rates. CDC used birth data to assess the relative contributions of changes in the maternal age distribution and in age-specific preterm birth rates to the overall decrease in preterm birth rates. The preterm birth rate declined in all age groups. The effects of age distribution changes on the preterm birth rate decrease were different in younger and older mothers. The decrease in the proportion of births to mothers aged ≤19 and 20-24 years and reductions in age-specific preterm rates in all age groups contributed to the overall decline in the preterm birth rate. The increase in births to mothers aged ≥30 years had no effect on the overall preterm birth rate decrease. The decline in preterm births from 2007 to 2014 is related, in part, to teen pregnancy prevention and the changing maternal age distribution. Effective public health strategies for further reducing preterm birth rates need to be tailored to different age groups.

  2. Coordinated Analysis of Age, Sex, and Education Effects on Change in MMSE Scores

    PubMed Central

    2013-01-01

    Objectives. We describe and compare the expected performance trajectories of older adults on the Mini-Mental Status Examination (MMSE) across six independent studies from four countries in the context of a collaborative network of longitudinal studies of aging. A coordinated analysis approach is used to compare patterns of change conditional on sample composition differences related to age, sex, and education. Such coordination accelerates evaluation of particular hypotheses. In particular, we focus on the effect of educational attainment on cognitive decline. Method. Regular and Tobit mixed models were fit to MMSE scores from each study separately. The effects of age, sex, and education were examined based on more than one centering point. Results. Findings were relatively consistent across studies. On average, MMSE scores were lower for older individuals and declined over time. Education predicted MMSE score, but, with two exceptions, was not associated with decline in MMSE over time. Conclusion. A straightforward association between educational attainment and rate of cognitive decline was not supported. Thoughtful consideration is needed when synthesizing evidence across studies, as methodologies adopted and sample characteristics, such as educational attainment, invariably differ. PMID:23033357

  3. Coordinated analysis of age, sex, and education effects on change in MMSE scores.

    PubMed

    Piccinin, Andrea M; Muniz-Terrera, Graciela; Clouston, Sean; Reynolds, Chandra A; Thorvaldsson, Valgeir; Deary, Ian J; Deeg, Dorly J H; Johansson, Boo; Mackinnon, Andrew; Spiro, Avron; Starr, John M; Skoog, Ingmar; Hofer, Scott M

    2013-05-01

    We describe and compare the expected performance trajectories of older adults on the Mini-Mental Status Examination (MMSE) across six independent studies from four countries in the context of a collaborative network of longitudinal studies of aging. A coordinated analysis approach is used to compare patterns of change conditional on sample composition differences related to age, sex, and education. Such coordination accelerates evaluation of particular hypotheses. In particular, we focus on the effect of educational attainment on cognitive decline. Regular and Tobit mixed models were fit to MMSE scores from each study separately. The effects of age, sex, and education were examined based on more than one centering point. Findings were relatively consistent across studies. On average, MMSE scores were lower for older individuals and declined over time. Education predicted MMSE score, but, with two exceptions, was not associated with decline in MMSE over time. A straightforward association between educational attainment and rate of cognitive decline was not supported. Thoughtful consideration is needed when synthesizing evidence across studies, as methodologies adopted and sample characteristics, such as educational attainment, invariably differ.

  4. Effects of non-steroidal anti-inflammatory drug treatments on cognitive decline vary by phase of pre-clinical Alzheimer disease: findings from the randomized controlled Alzheimer's Disease Anti-inflammatory Prevention Trial.

    PubMed

    Leoutsakos, Jeannie-Marie S; Muthen, Bengt O; Breitner, John C S; Lyketsos, Constantine G

    2012-04-01

    We examined the effects of non-steroidal anti-inflammatory drugs on cognitive decline as a function of phase of pre-clinical Alzheimer disease. Given recent findings that cognitive decline accelerates as clinical diagnosis is approached, we used rate of decline as a proxy for phase of pre-clinical Alzheimer disease. We fit growth mixture models of Modified Mini-Mental State (3MS) Examination trajectories with data from 2388 participants in the Alzheimer's Disease Anti-inflammatory Prevention Trial and included class-specific effects of naproxen and celecoxib. We identified three classes: "no decline", "slow decline", and "fast decline", and examined the effects of celecoxib and naproxen on linear slope and rate of change by class. Inclusion of quadratic terms improved fit of the model (-2 log likelihood difference: 369.23; p < 0.001) but resulted in reversal of effects over time. Over 4 years, participants in the slow-decline class on placebo typically lost 6.6 3MS points, whereas those on naproxen lost 3.1 points (p-value for difference: 0.19). Participants in the fast-decline class on placebo typically lost 11.2 points, but those on celecoxib first declined and then gained points (p-value for difference from placebo: 0.04), whereas those on naproxen showed a typical decline of 24.9 points (p-value for difference from placebo: <0.0001). Our results appeared statistically robust but provided some unexpected contrasts in effects of different treatments at different times. Naproxen may attenuate cognitive decline in slow decliners while accelerating decline in fast decliners. Celecoxib appeared to have similar effects at first but then attenuated change in fast decliners. Copyright © 2011 John Wiley & Sons, Ltd.

  5. Somatic growth dynamics of West Atlantic hawksbill sea turtles: a spatio-temporal perspective

    USGS Publications Warehouse

    Bjorndal, Karen A.; Chaloupka, Milani; Saba, Vincent S.; Diez, Carlos E.; van Dam, Robert P.; Krueger, Barry H.; Horrocks, Julia A.; Santos, Armando J.B.; Bellini, Cláudio; Marcovaldi, Maria A.G.; Nava, Mabel; Willis, Sue; Godley, Brendan J.; Gore, Shannon; Hawkes, Lucy A.; McGowan, Andrew; Witt, Matthew J.; Stringell, Thomas B.; Sanghera, Amdeep; Richardson, Peter B.; Broderick, Annette C.; Phillips, Quinton; Calosso, Marta C.; Claydon, John A.B.; Blumenthal, Janice; Moncada, Felix; Nodarse, Gonzalo; Medina, Yosvani; Dunbar, Stephen G.; Wood, Lawrence D.; Lagueux, Cynthia J.; Campbell, Cathi L.; Meylan, Anne B.; Meylan, Peter A.; Burns Perez, Virginia R.; Coleman, Robin A.; Strindberg, Samantha; Guzmán-H, Vicente; Hart, Kristen M.; Cherkiss, Michael S.; Hillis-Starr, Zandy; Lundgren, Ian; Boulon, Ralf H.; Connett, Stephen; Outerbridge, Mark E.; Bolten, Alan B.

    2016-01-01

    Somatic growth dynamics are an integrated response to environmental conditions. Hawksbill sea turtles (Eretmochelys imbricata) are long-lived, major consumers in coral reef habitats that move over broad geographic areas (hundreds to thousands of kilometers). We evaluated spatio-temporal effects on hawksbill growth dynamics over a 33-yr period and 24 study sites throughout the West Atlantic and explored relationships between growth dynamics and climate indices. We compiled the largest ever data set on somatic growth rates for hawksbills – 3541 growth increments from 1980 to 2013. Using generalized additive mixed model analyses, we evaluated 10 covariates, including spatial and temporal variation, that could affect growth rates. Growth rates throughout the region responded similarly over space and time. The lack of a spatial effect or spatio-temporal interaction and the very strong temporal effect reveal that growth rates in West Atlantic hawksbills are likely driven by region-wide forces. Between 1997 and 2013, mean growth rates declined significantly and steadily by 18%. Regional climate indices have significant relationships with annual growth rates with 0- or 1-yr lags: positive with the Multivariate El Niño Southern Oscillation Index (correlation = 0.99) and negative with Caribbean sea surface temperature (correlation = −0.85). Declines in growth rates between 1997 and 2013 throughout the West Atlantic most likely resulted from warming waters through indirect negative effects on foraging resources of hawksbills. These climatic influences are complex. With increasing temperatures, trajectories of decline of coral cover and availability in reef habitats of major prey species of hawksbills are not parallel. Knowledge of how choice of foraging habitats, prey selection, and prey abundance are affected by warming water temperatures is needed to understand how climate change will affect productivity of consumers that live in association with coral reefs. Main conclusions The decadal declines in growth rates between 1997 and 2013 throughout the West Atlantic most likely resulted from warming waters through indirect negative effects on the foraging resources of hawksbills. These climatic influences are complex. With increasing temperatures, the trajectories of decline of coral cover and availability in reef habitats of major prey species of hawksbills are not parallel. Knowledge of how choice of foraging habitats, prey selection, and prey abundance are affected by warming water temperatures is needed to understand how climate change will affect productivity of consumers that live in association with coral reefs.

  6. Arterial stiffness and decline of renal function in a primary care population.

    PubMed

    van Varik, Bernard J; Vossen, Liv M; Rennenberg, Roger J; Stoffers, Henri E; Kessels, Alfons G; de Leeuw, Peter W; Kroon, Abraham A

    2017-01-01

    Arterial stiffness is an important pathophysiological factor linking cardiovascular disease and kidney disease. Controversy exists as to whether arterial stiffness causes renal function decline, or kidney dysfunction leads to stiffening or whether the association is mutual. We aimed to investigate the longitudinal association between arterial stiffness and annual rate of renal function decline. We prospectively investigated in a primary care population whether carotid-femoral pulse wave velocity (PWV) was associated with estimated glomerular filtration rate (eGFR) and annual decline in eGFR in participants aged ⩾40 years without overt kidney disease. Baseline data on PWV and eGFR were available for 587 participants; follow-up measurements with a mean duration of 5.6 years were available for 222 patients. PWV, female gender and mean arterial pressure were independently associated with eGFR at baseline, although age confounded this association. More importantly, baseline PWV, age and eGFR were independent predictors of renal function decline. Stratification for age showed that the effect of PWV on rate of eGFR decline was amplified with advancing age. On the other hand, baseline eGFR did not determine annual change in PWV, suggesting a unidirectional association between arterial stiffness and eGFR. Arterial stiffness amplifies age-related renal function decline, suggesting that arterial stiffness plays a causal role in the development of renal damage, at least at later stages of age-related renal function decline, possibly through impaired renal autoregulation and increased arterial blood pressure pulsatility.

  7. Breast cancer incidence rates in U.S. women are no longer declining.

    PubMed

    DeSantis, Carol; Howlader, Nadia; Cronin, Kathleen A; Jemal, Ahmedin

    2011-05-01

    Several publications reported breast cancer incidence rates continued to decrease among white women, following the decline of about 7% from 2002 to 2003. However, none of these reports exclusively examined the trend after 2003. In this paper, we examined breast cancer incidence rates among non-Hispanic (NH) white women from 2003 to 2007 to determine whether the decrease in breast cancer incidence rates indeed persisted through 2007. In addition, we present breast cancer incidence trends for NH black and Hispanic women and postmenopausal hormone use for all three racial/ethnic groups. Breast cancer incidence rates were calculated by race/ethnicity, age and ER status using data from the Surveillance, Epidemiology, and End Results (SEER) 12 registries for 2000 to 2007. Prevalence of postmenopausal hormone use was calculated using National Health Interview Survey data from 2000, 2005, and 2008. From 2003 to 2007, overall breast cancer incidence rates did not change significantly among NH white women in any age group. However, rates increased (2.7% per year) for ER+ breast cancers in ages 40 to 49, and decreased for ER- breast cancers in ages 40 to 49 and 60 to 69. Similarly, overall breast cancer incidence rates did not change significantly for black and Hispanic women. Hormone use continued to decrease from 2005 to 2008 in all groups, although the decreases were smaller compared to those from 2000 to 2005. The sharp decline in breast cancer incidence rates that occurred from 2002 to 2003 among NH white women did not continue through 2007. Further studies are needed to better understand the recent breast cancer trends. ©2011 AACR.

  8. Relaxation of the one child policy and trends in caesarean section rates and birth outcomes in China between 2012 and 2016: observational study of nearly seven million health facility births

    PubMed Central

    Liang, Juan; Mu, Yi; Li, Xiaohong; Tang, Wen; Wang, Yanping; Liu, Zheng; Huang, Xiaona; Scherpbier, Robert W; Guo, Sufang; Li, Mingrong; Dai, Li; Deng, Kui; Deng, Changfei; Li, Qi; Kang, Leni; Zhu, Jun

    2018-01-01

    Abstract Objective To examine how the relaxation of the one child policy and policies to reduce caesarean section rates might have affected trends over time in caesarean section rates and perinatal and pregnancy related mortality in China. Design Observational study. Setting China’s National Maternal Near Miss Surveillance System (NMNMSS). Participants 6 838 582 births at 28 completed weeks or more of gestation or birth weight ≥1000 g in 438 hospitals in the NMNMSS between 2012 and 2016. Main outcome measures Obstetric risk was defined using a modified Robson classification. The main outcome measures were changes in parity and age distributions and relative frequency of each Robson group, crude and adjusted trends over time in caesarean section rates within each risk category (using Poisson regression with a robust variance estimator), and trends in perinatal and pregnancy related mortality over time. Results Caesarean section rates declined steadily between 2012 and 2016 (crude relative risk 0.91, 95% confidence interval 0.89 to 0.93), reaching an overall hospital based rate of 41.1% in 2016. The relaxation of the one child policy was associated with an increase in the proportion of multiparous births (from 34.1% in 2012 to 46.7% in 2016), and births in women with a uterine scar nearly doubled (from 9.8% to 17.7% of all births). Taking account of these changes, the decline in caesarean sections was amplified over time (adjusted relative risk 0.82, 95% confidence interval 0.81 to 0.84). Caesarean sections declined noticeably in nulliparous women (0.75, 0.73 to 0.77) but also declined in multiparous women without a uterine scar (0.65, 0.62 to 0.77). The decrease in caesarean section rates was most pronounced in hospitals with the highest rates in 2012, consistent with the government’s policy of targeting hospitals with the highest rates. Perinatal mortality declined from 10.1 to 7.2 per 1000 births over the same period (0.87, 0.83 to 0.91), and there was no change in pregnancy related mortality over time. Conclusions China is the only country that has succeeded in reverting the rising trends in caesarean sections. China’s success is remarkable given that the changes in obstetric risk associated with the relaxation of the one child policy would have led to an increase in the need for caesarean sections. China’s experience suggests that change is possible when strategies are comprehensive and deal with the system level factors that underpin overuse as well as the various incentives at work during a clinical encounter. PMID:29506980

  9. Use of age-period-cohort models to estimate effects of vehicle age, year of crash and year of vehicle manufacture on driver injury and fatality rates in single vehicle crashes in New South Wales, 2003-2010.

    PubMed

    Anderson, R W G; Searson, D J

    2015-02-01

    A novel application of age-period-cohort methods are used to explain changes in vehicle based crash rates in New South Wales, Australia over the period 2003-2010. Models are developed using vehicle age, crash period and vehicle cohort to explain changes in the rate of single vehicle driver fatalities and injuries in vehicles less than 13 years of age. Large declines in risk are associated with vehicle cohorts built after about 1996. The decline in risk appears to have accelerated to 12 percent per vehicle cohort year for cohorts since 2004. Within each cohort, the risk of crashing appears to be a minimum at two years of age and increases as the vehicle ages beyond this. Period effects (i.e., other road safety measures) between 2003 and 2010 appear to have contributed to declines of up to about two percent per annum to the driver-fatality single vehicle crash rate, and possibly only negligible improvements to the driver-injury single vehicle crash rate. Vehicle improvements appear to have been responsible for a decline in per-vehicle crash risk of at least three percent per calendar year for both severity levels over the same period. Given the decline in risk associated with more recent vehicle cohorts and the dynamics of fleet turnover, continued declines in per-vehicle crash risk over coming years are almost certain. Copyright © 2014. Published by Elsevier Ltd.

  10. Photosynthetic declines are induced by Phytophthora ramorum infection and exposure to elicitins

    Treesearch

    Daniel K. Manter; Rick G. Kelsey; Joseph J. Karchesy

    2008-01-01

    Infection of compatible plants by Phytophthora spp. often leads to a decline in stomatal conductance and photosynthesis, although the mechanistic basis for such declines is not completely understood. In many cases, declines in leaf gas exchange rates have been linked to losses in water supply capacity associated with root and/or xylem. However, the...

  11. Body-mass dependence of age-related deterioration in human muscular function.

    PubMed

    Meltzer, D E

    1996-04-01

    Maximal anaerobic power of human muscles declines with increasing chronological age and is correlated with body mass. This study investigated whether the rate of deterioration in human muscular function among trained weight lifters is also correlated with body mass. Cross-sectional analysis of performance data of over 1,100 Masters competitors in Olympic-style weight lifting was carried out; eight body-weight classes and six age groups were represented. Two-lift total data (sum of snatch and clean and jerk lifts) were analyzed. Mean deterioration rates in the performance of athletes of widely diverse body masses were compared over the following age ranges: 42-57, 42-62, and 42-67 yr. No statistically significant correlation (P < 0.05) was found between rate of performance decline and body mass. The relationship between body mass and the magnitude of age-related variation of deterioration rate was also studied; no significant correlation was found. Previous studies have demonstrated that performance in Olympic-style weight lifting is correlated with maximal anaerobic muscular power. This leads us to suggest that the age-related deterioration rate of anaerobic power in trained subjects may not be correlated with the body mass of the individual.

  12. Rates of speciation in the fossil record

    NASA Technical Reports Server (NTRS)

    Sepkoski, J. J. Jr; Sepkoski JJ, J. r. (Principal Investigator)

    1998-01-01

    Data from palaeontology and biodiversity suggest that the global biota should produce an average of three new species per year. However, the fossil record shows large variation around this mean. Rates of origination have declined through the Phanerozoic. This appears to have been largely a function of sorting among higher taxa (especially classes), which exhibit characteristic rates of speciation (and extinction) that differ among them by nearly an order of magnitude. Secular decline of origination rates is hardly constant, however; many positive deviations reflect accelerated speciation during rebounds from mass extinctions. There has also been general decline in rates of speciation within major taxa through their histories, although rates have tended to remain higher among members in tropical regions. Finally, pulses of speciation appear sometimes to be associated with climate change, although moderate oscillations of climate do not necessarily promote speciation despite forcing changes in species' geographical ranges.

  13. Population pressures in Latin America. [Updated reprint].

    PubMed

    Merrick, T W

    1991-04-01

    This publication examines the main demographic changes in Latin America since World War II, and considers their social and economic impact on the region. The paper looks at the following demographic trends: population growth, fertility, death rate, internal migration, international migration, and age structure. It also examines other factors such as marriage and family structure, and employment and education. Furthermore, the publication provides a discussion of the relationship between population growth and economic development from both a neo-Malthusian and Structuralist view. Finally, the paper considers the region's current population policies and future population prospects. From 1950-65, annual population growth averaged 2.8%, which decreased moderately to 2.4% from 1965-85. The report identified 3 population growth patterns in the region: 1) countries which experienced early and gradual declines in birth and death rates and generally lower population growth rates (the group includes Argentina, Cuba, Uruguay, with Chile and Panama also closely fitting the description); 2) countries which underwent rapid declines in birth rate during the 1950s and which began experiencing declines in the birth rate after 1960 (Brazil, Colombia, Costa Rica, the Dominican Republic, Mexico, Paraguay, and Venezuela, with Ecuador and Peru as borderline cases); and 3) countries which didn't begin to experience declines in mortality rates until relatively late and which lag behind in fertility declines (Bolivia, Haiti, El Salvador, Guatemala, Honduras, and Nicaragua). Although population growth has slowed and will continue to fall, UN projections do not expect the population to stabilize until late in the 21st Century.

  14. Trends in rates of occupational fatal injuries in the United States (1983-92).

    PubMed

    Bailer, A J; Stayner, L T; Stout, N A; Reed, L D; Gilbert, S J

    1998-07-01

    An updated version of a national surveillance system of traumatic occupational fatalities was used to explore adjusted and unadjusted trends in rates of fatal injury. Data from the national traumatic occupational fatalities surveillance system were combined with data on employment from the United States Bureau of Labor Statistics. Poisson regression was then used to examine trends in rates of occupational fatality injuries while controlling for demographic and workplace characteristics. Adjusted annual changes in rates of fatal injuries ranged from a decline of 6.2% for workers in technical and administrative support occupations--for example, health, science, and engineering technicians, pilots, computer programmers--to an increase of 1.6% in machine operators, assemblers, and inspectors. For industries, annual changes ranged from a decline of 5.3% for workers in public administration--for example, justice, public order, and safety workers--to an increase of 2.6% for workers in the wholesale trade. By comparison, the annual decline over all industries and occupations was 3.1%. In many industries and occupations, an effect modification of annual trends by the age of the worker was also found with the oldest workers experiencing either no decline or a significant increase in rates of fatal injuries. This general pattern of decline, adjusted for the effects of demographic characteristics of the worker population, is encouraging; however, increases in rates of fatal injuries found in particular industries and occupations, suggest appropriate targets for increased injury prevention efforts.

  15. Trends in rates of occupational fatal injuries in the United States (1983-92)

    PubMed Central

    Bailer, A. J.; Stayner, L. T.; Stout, N. A.; Reed, L. D.; Gilbert, S. J.

    1998-01-01

    OBJECTIVES: An updated version of a national surveillance system of traumatic occupational fatalities was used to explore adjusted and unadjusted trends in rates of fatal injury. METHODS: Data from the national traumatic occupational fatalities surveillance system were combined with data on employment from the United States Bureau of Labor Statistics. Poisson regression was then used to examine trends in rates of occupational fatality injuries while controlling for demographic and workplace characteristics. RESULTS: Adjusted annual changes in rates of fatal injuries ranged from a decline of 6.2% for workers in technical and administrative support occupations--for example, health, science, and engineering technicians, pilots, computer programmers--to an increase of 1.6% in machine operators, assemblers, and inspectors. For industries, annual changes ranged from a decline of 5.3% for workers in public administration--for example, justice, public order, and safety workers--to an increase of 2.6% for workers in the wholesale trade. By comparison, the annual decline over all industries and occupations was 3.1%. In many industries and occupations, an effect modification of annual trends by the age of the worker was also found with the oldest workers experiencing either no decline or a significant increase in rates of fatal injuries. CONCLUSIONS: This general pattern of decline, adjusted for the effects of demographic characteristics of the worker population, is encouraging; however, increases in rates of fatal injuries found in particular industries and occupations, suggest appropriate targets for increased injury prevention efforts.   PMID:9816383

  16. A longitudinal analysis of the influence of race on cognitive performance.

    PubMed

    Castora-Binkley, Melissa; Peronto, Carol L; Edwards, Jerri D; Small, Brent J

    2015-07-01

    Whether there are racial and ethnic disparities in the rate of cognitive decline among older adults is not clear. The purpose of this study was to determine if there are differences in cognitive decline among racial and ethnic older adults. Data were from the Health and Retirement Study, waves 1998-2010. Participants were community dwelling at baseline (n = 9,492), mostly female participants (58.8%), ranged in age from 65 to 105 years (M = 74.41, SD = 6.97), and had education levels that averaged less than high school (M = 11.7, SD = 3.4). Cognition was examined using a combined score from word recall, Serial 7's, backward counting, and naming tasks. To determine changes in cognition across 12 years, we utilized mixed effects models. Results indicated that after adjusting for covariates, race or ethnicity was unrelated to changes in cognitive performance, but there were significant differences in baseline cognition and these differences were more pronounced after adjusting for age, gender, education, poverty, heart disease, diabetes, high blood pressure. It is evident that there are significant differences in baseline cognition, although the rate of cognitive decline across 12 years did not vary significantly by race. These findings support previous assertions that the rate of cognitive decline is not associated with race and suggest that it is likely that baseline cognitive performance is a better indicator of performance over time. © The Author 2013. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  17. In situ effects of pesticides on amphibians in the Sierra Nevada

    USGS Publications Warehouse

    Sparling, Donald W.; Bickham, John W.; Cowman, Deborah; Fellers, Gary M.; Lacher, Thomas E.; Matson, Cole W.; McConnell, Laura

    2015-01-01

    For more than 20 years, conservationists have agreed that amphibian populations around the world are declining. Results obtained through laboratory or mesocosm studies and measurement of contaminant concentrations in areas experiencing declines have supported a role of contaminants in these declines. The current study examines the effects of contaminant exposure to amphibians in situ in areas actually experiencing declines. Early larval Pseudacris regilla were translocated among Lassen Volcanic, Yosemite and Sequoia National Parks, California, USA and caged in wetlands in 2001 and 2002 until metamorphosis. Twenty contaminants were identified in tadpoles with an average of 1.3–5.9 (maximum = 10) contaminants per animal. Sequoia National Park, which had the greatest variety and concentrations of contaminants in 2001, also had tadpoles that experienced the greatest mortality, slowest developmental rates and lowest cholinesterase activities. Yosemite and Sequoia tadpoles and metamorphs had greater genotoxicity than those in Lassen during 2001, as determined by flow cytometry. In 2001 tadpoles at Yosemite had a significantly higher rate of malformations, characterized as hemimelia (shortened femurs), than those at the other two parks but no significant differences were observed in 2002. Fewer differences in contaminant types and concentrations existed among parks during 2002 compared to 2001. In 2002 Sequoia tadpoles had higher mortality and slower developmental rates but there was no difference among parks in cholinesterase activities. Although concentrations of most contaminants were below known lethal concentrations, simultaneous exposure to multiple chemicals and other stressors may have resulted in lethal and sublethal effects.

  18. Trends in the incidence, treatment, and outcomes of acute lower extremity ischemia in the United States Medicare population.

    PubMed

    Baril, Donald T; Ghosh, Kaushik; Rosen, Allison B

    2014-09-01

    Acute lower extremity ischemia (ALI) is a common vascular surgery emergency associated with high rates of morbidity and mortality. The purpose of this study was to assess contemporary trends in the incidence of ALI, the methods of treatment, and the associated mortality and amputation rates in the U.S. Medicare population. This was an observational study using Medicare claims data between 1998 and 2009. Outcomes examined included trends in the incidence of ALI; trends in interventions for ALI; and trends in amputation, mortality, and amputation-free survival rates. Between 1998 and 2009, the incidence of hospitalization for ALI decreased from 45.7 per 100,000 to 26.0 per 100,000 (P for trend < .001). The percentage of patients undergoing surgical intervention decreased from 57.1% to 51.6% (P for trend < .001), whereas the percentage of patients undergoing endovascular interventions increased from 15.0% to 33.1% (P for trend < .001). In-hospital mortality rates decreased from 12.0% to 9.0% (P for trend < .001), whereas 1-year mortality rates remained stable at 41.0% and 42.5% (P for trend not significant). In-hospital amputation rates remained stable at 8.1% and 6.4% (P for trend not significant), whereas 1-year amputation rates decreased from 14.8% to 11.0% (P for trend < .001). In-hospital amputation-free survival after hospitalization for ALI increased from 81.2% to 85.4% (P for trend < .001); however, 1-year amputation-free survival remained unchanged. Between 1998 and 2009, the incidence of ALI among the U.S. Medicare population declined significantly, and the percentage of patients treated with endovascular techniques markedly increased. During this time, 1-year amputation rates declined. Furthermore, although in-hospital mortality rates declined after presentation with ALI, 1-year mortality rates remained unchanged. Copyright © 2014 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved.

  19. Trends in the incidence, treatment, and outcomes of acute lower extremity ischemia in the United States Medicare population

    PubMed Central

    Baril, Donald T.; Ghosh, Kaushik; Rosen, Allison B.

    2015-01-01

    Objective Acute lower extremity ischemia (ALI) is a common vascular surgery emergency associated with high rates of morbidity and mortality. The purpose of this study was to assess contemporary trends in the incidence of ALI, the methods of treatment, and the associated mortality and amputation rates in the U.S. Medicare population. Methods This was an observational study using Medicare claims data between 1998 and 2009. Outcomes examined included trends in the incidence of ALI; trends in interventions for ALI; and trends in amputation, mortality, and amputation-free survival rates. Results Between 1998 and 2009, the incidence of hospitalization for ALI decreased from 45.7 per 100,000 to 26.0 per 100,000 (P for trend < .001). The percentage of patients undergoing surgical intervention decreased from 57.1% to 51.6% (P for trend < .001), whereas the percentage of patients undergoing endovascular interventions increased from 15.0% to 33.1% (P for trend < .001). In-hospital mortality rates decreased from 12.0% to 9.0% (P for trend < .001), whereas 1-year mortality rates remained stable at 41.0% and 42.5% (P for trend not significant). In-hospital amputation rates remained stable at 8.1% and 6.4% (P for trend not significant), whereas 1-year amputation rates decreased from 14.8% to 11.0% (P for trend < .001). In-hospital amputation-free survival after hospitalization for ALI increased from 81.2% to 85.4% (P for trend < .001); however, 1-year amputation-free survival remained unchanged. Conclusions Between 1998 and 2009, the incidence of ALI among the U.S. Medicare population declined significantly, and the percentage of patients treated with endovascular techniques markedly increased. During this time, 1-year amputation rates declined. Furthermore, although in-hospital mortality rates declined after presentation with ALI, 1-year mortality rates remained unchanged. PMID:24768362

  20. Assessing Decline: Visualising Progression in Huntington's Disease using a Clinical Dashboard with Enroll-HD Data.

    PubMed

    Walker, Thomas; Ghosh, Boyd; Kipps, Christopher

    2017-01-01

    In Huntington's disease (HD), it remains unclear how symptom severity and rate of symptomatic change relates to age and CAG repeat number (CAGn). It is often difficult for clinicians to assess whether an affected individual's symptoms are progressing at a similar rate to their affected peers, limiting their ability to intervene at the most appropriate time. To develop a clinical dashboard that compares an individual's total motor score (TMS), total functional capacity (TFC) and symbol digit modality test (SDMT) scores against a global cohort, controlling for age and CAGn. The dashboard could then be used by clinicians to identify individuals progressing at a disproportionate rate to his or her peers. Annualised longitudinal clinical assessment scores from the Enroll-HD dataset were used to generate decline trajectories of the global cohort, allowing cross-sectional (TMS n = 734; TFC n = 734; SDMT n = 694) and longitudinal (TMS n = 270; TFC n = 270; SDMT n = 247) comparison with individual clinical symptom rating scores, to assess decline relative to affected peers. An electronic dashboard with a dynamic output display was created that rapidly compares clinical symptom rating scores of a specific individual against affected peers from a global cohort of comparable CAGn. This study shows the potential for use of multi-centre trial data in allowing comparison of the individual to a larger group to facilitate improved decision-making for individual patients. Visualisation of these metrics via a clinical dashboard demonstrates how it may aid identification of those with disproportionate decline, offering potential for intervention at specific critical points in the disease course.

  1. Risk of decline and chance of improvement in olfaction among patients with post-traumatic olfactory loss.

    PubMed

    Kuo, C-L; Shu, C-H

    2015-12-01

    To evaluate the chance of improvement and risk of decline in olfaction among patients with post-traumatic olfactory loss. This study comprised 80 patients. Changes in olfaction were determined using a visual analogue scale and the 'Sniffin' Sticks' test. Logistic regression was used to identify predictors for olfactory changes. Olfactory changes were observed in 9-35 per cent of patients. The rates of improvement and decline according to visual analogue scale scores were 35 per cent and 10 per cent respectively, whereas those in the Sniffin' Sticks test were 9 per cent and 11 per cent respectively. There was a predictive link between non-anosmia and decline in Sniffin' Sticks test scores (odds ratio = 16.61, p = 0.003). A positive correlation was observed between the scores in the first and last examinations (rho = 0.532, p < 0.001). Patients should be informed that they may experience an improvement or decline in olfaction following post-traumatic olfactory dysfunction. This study provides evidence to support comprehensive counselling regarding prognosis as an integral part of management strategies.

  2. Is the apparent decrease in injury and illness rates in construction the result of changes in reporting?

    PubMed

    Welch, Laura S; Dong, Xiuwen; Carre, Francoise; Ringen, Knut

    2007-01-01

    Injury rates in all industries and in construction in particular have been declining. Inconsistencies in the information suggest some of the apparent decrease may be due to changes in the ways injuries are treated, misclassification of employees, or underreporting. Lost-time injury rates for the largest construction employers declined by as much as 92% between 1988 and 1999. Yet the rate for cases with restricted work activity actually increased from 0.7 to 1.2 per 100 full-time workers between 1990 and 2000, and fatalities among construction workers remain high. In Massachusetts, at least 14% of construction employers misclassified workers as independent contractors, with the effect that injuries to these workers are not recordable. Studies that compare OSHA logs with other data sources find that the OSHA logs do not include a significant proportion of injuries and illnesses identified elsewhere.

  3. Anabolic and catabolic biomarkers as predictors of muscle strength decline: the InCHIANTI study.

    PubMed

    Stenholm, Sari; Maggio, Marcello; Lauretani, Fulvio; Bandinelli, Stefania; Ceda, Gian Paolo; Di Iorio, Angelo; Giallauria, Francesco; Guralnik, Jack M; Ferrucci, Luigi

    2010-02-01

    Poor muscle strength is a major public health concern in older persons, predisposing to functional limitations, increased fall risk, and higher mortality. Understanding risk factors for muscle strength decline may offer opportunities for prevention and treatment. One of the possible causes of muscle strength decline is imbalance between catabolic and anabolic signaling. This study aims to examine whether high levels of multiple catabolic and low levels of multiple anabolic biomarkers predict accelerated decline of muscle strength. In a representative sample of 716 men and women aged >or=65 years in the InCHIANTI study we measured C-reactive protein, interleukin-6 (IL-6), IL-1 receptor antagonist (IL-1RA), tumor necrosis factor-alpha receptor 1 as well as dehydroepiandrosterone sulfate (DHEA-S), insulin-like growth factor-1, and bioavailable testosterone. Biomarker values were divided into tertiles and the numbers of catabolic/anabolic biomarkers in the highest/lowest tertile were calculated. Hand-grip strength was measured at baseline and 3- and 6-year follow up. In adjusted linear mixed models, higher concentration of IL-6 (p = 0.02) and IL-1RA (p = 0.04) as well as lower levels of DHEA-S (p = 0.01) predicted muscle strength decline. After combining all inflammatory markers, the rate of decline in grip strength was progressively greater with the increasing number of dysregulated catabolic biomarkers (p = 0.01). No effect on accelerated muscle strength decline was seen according to number of dysregulated anabolic hormones. Having multiple elevated catabolic biomarkers is a better predictor of muscle strength decline than a single biomarker alone, suggesting that a catabolic dysregulation is at the core of the mechanism leading to muscle strength decline with aging.

  4. Anabolic and Catabolic Biomarkers As Predictors of Muscle Strength Decline: The InCHIANTI Study

    PubMed Central

    Maggio, Marcello; Lauretani, Fulvio; Bandinelli, Stefania; Ceda, Gian Paolo; Di Iorio, Angelo; Giallauria, Francesco; Guralnik, Jack M.; Ferrucci, Luigi

    2010-01-01

    Abstract Background Poor muscle strength is a major public health concern in older persons, predisposing to functional limitations, increased fall risk, and higher mortality. Understanding risk factors for muscle strength decline may offer opportunities for prevention and treatment. One of the possible causes of muscle strength decline is imbalance between catabolic and anabolic signaling. This study aims to examine whether high levels of multiple catabolic and low levels of multiple anabolic biomarkers predict accelerated decline of muscle strength. Methods In a representative sample of 716 men and women aged ≥65 years in the InCHIANTI study we measured C-reactive protein, interleukin-6 (IL-6), IL-1 receptor antagonist (IL-1RA), tumor necrosis factor-α receptor 1 as well as dehydroepiandrosterone sulfate (DHEA-S), insulin-like growth factor-1, and bioavailable testosterone. Biomarker values were divided into tertiles and the numbers of catabolic/anabolic biomarkers in the highest/lowest tertile were calculated. Hand-grip strength was measured at baseline and 3- and 6-year follow up. Results In adjusted linear mixed models, higher concentration of IL-6 (p = 0.02) and IL-1RA (p = 0.04) as well as lower levels of DHEA-S (p = 0.01) predicted muscle strength decline. After combining all inflammatory markers, the rate of decline in grip strength was progressively greater with the increasing number of dysregulated catabolic biomarkers (p = 0.01). No effect on accelerated muscle strength decline was seen according to number of dysregulated anabolic hormones. Conclusions Having multiple elevated catabolic biomarkers is a better predictor of muscle strength decline than a single biomarker alone, suggesting that a catabolic dysregulation is at the core of the mechanism leading to muscle strength decline with aging. PMID:20230273

  5. Medicaid and Childhood Immunizations: A National Study.

    ERIC Educational Resources Information Center

    Liu, Joseph Tiang-Yau; Rosenbaum, Sara

    In recent years, falling immunization rates in the United States have resulted in an increased number of cases of preventable diseases. For example, the United States ranks behind 16 other nations in proportion of infants immunized against polio. Reasons for the decline of immunizations include skyrocketing vaccine costs, rising poverty rates,…

  6. Reproductive change in Bangladesh: evidence from recent data.

    PubMed

    Amin, R; Chowdhury, J; Ahmed, A U; Hill, R B; Kabir, M

    1993-12-01

    This analysis pertains to an examination of fertility trends, differences, contraceptive use, and fertility preferences in Bangladesh. Data were obtained from the 1969 National Impact Survey of Family Planning; the 1975 and 1989 Bangladesh Fertility Surveys; and the 1983, 1985, and 1991 Contraceptive Prevalence Surveys. Age specific fertility rates (ASFR), current pregnancy rates, and the mean number of children ever born (CEB) are the estimated fertility measures. The P/F ratios show a significant fertility decline since 1983. Total marital fertility declined from 7 births in the 1960s to 5.2 in the late 1980s. The average number of CEB declined from 4.3 in 1969 to 3.7 in 1991. The percentage of pregnant women declined from 13.3 to 10.6. The ASFR declined primarily among older married women. Fertility declined among all groups including landowners and landless, the educated and the uneducated, rural and urban populations. The extent of decline varies by group. The total marital fertility rate (TMFR) declined more for the educated and the urban populations. Chittagong region had the higher fertility regardless of the period. TMFR was lower among contraceptive users compared to nonusers. The increase in contraceptive use was from 4 to 40% between 1969 and 1991. The following factors affected the extent of fertility decline: contraceptive use, reduced child mortality concomitant with extended lactation and amenorrhea, increased malnutrition, and/or improvements in child survival. Fertility was depressed under conditions of increased poverty, which may stimulate contraceptive use and lead to malnutrition and subfecundity. The higher Chittagong fertility pattern is not explained by regional comparisons of pregnancy wastage, stillbirths, and induced abortion. Desire for no more children increased from 46 to 58% during 1969-91. The average preferred family size is declining. High density and deep-seated poverty explain fertility decline in regions other than Chittagong. Demand for contraception may increase with increases in family planning home visits and educational opportunities.

  7. P wave dispersion and maximum P wave duration are independently associated with rapid renal function decline.

    PubMed

    Su, Ho-Ming; Tsai, Wei-Chung; Lin, Tsung-Hsien; Hsu, Po-Chao; Lee, Wen-Hsien; Lin, Ming-Yen; Chen, Szu-Chia; Lee, Chee-Siong; Voon, Wen-Chol; Lai, Wen-Ter; Sheu, Sheng-Hsiung

    2012-01-01

    The P wave parameters measured by 12-lead electrocardiogram (ECG) are commonly used as noninvasive tools to assess for left atrial enlargement. There are limited studies to evaluate whether P wave parameters are independently associated with decline in renal function. Accordingly, the aim of this study is to assess whether P wave parameters are independently associated with progression to renal end point of ≥25% decline in estimated glomerular filtration rate (eGFR). This longitudinal study included 166 patients. The renal end point was defined as ≥25% decline in eGFR. We measured two ECG P wave parameters corrected by heart rate, i.e. corrected P wave dispersion (PWdisperC) and corrected P wave maximum duration (PWdurMaxC). Heart function and structure were measured from echocardiography. Clinical data, P wave parameters, and echocardiographic measurements were compared and analyzed. Forty-three patients (25.9%) reached renal end point. Kaplan-Meier curves for renal end point-free survival showed PWdisperC > median (63.0 ms) (log-rank P = 0.004) and PWdurMaxC > median (117.9 ms) (log-rank P<0.001) were associated with progression to renal end point. Multivariate forward Cox-regression analysis identified increased PWdisperC (hazard ratio [HR], 1.024; P = 0.001) and PWdurMaxC (HR, 1.029; P = 0.001) were independently associated with progression to renal end point. Our results demonstrate that increased PWdisperC and PWdurMaxC were independently associated with progression to renal end point. Screening patients by means of PWdisperC and PWdurMaxC on 12 lead ECG may help identify a high risk group of rapid renal function decline.

  8. The role of traditional organization on family planning acceptance in Indonesia.

    PubMed

    Ancok, D

    1991-01-01

    The nature of and the reasons for the decline in Indonesian fertility and the utilization of the village traditional organization, banjar, in the family planning (FP) program are discussed. The total fertility rate computed from census data shows a decline in fertility from 5.6 in the mid-1960s to 4.1 for 1981-1984, a 28% decline in 15 years. A further 23% decline evidenced in the Contraceptive Prevalence Survey appeared as 4.3 children reproductive woman in 1981-83 and 3.3 between 1984-87. The success of the FP program in contributing a major impact on the decline is attributed to a strong political commitment to antinatalist policy which meant increased allocation to FP when government income was declining, effective organizational structure, and effective strategies such as the mobilization of traditional village organizations. The impact of FP can also be seen in the increase in the number of family acceptors. Another source of the fertility decline is due to the impact of development. 1) Improvement in education has contributed to fertility decline in the increase in the number graduating from elementary and secondary school, the increased value of children, the acceptance of new ideas, the postponement of marriage, and the increase in the never-married group. 2) The decline in the infant mortality rate from 142 in 1971 to 70.2/1000 births in 1982-87 due to the improvement in health facilities and service also contributed to fertility decline. 3) The growth in the number of women participating in the nonagricultural labor force has also contributed to fertility decline. To what extent each has contributed to the decline has not been empirically tested. Molyneaux' study is cited for demonstrating that both socioeconomic variables and contraceptive use, which are affected by socioeconomic variables and family planning, have influenced the fertility decline. Households with electricity, children engaged in the labor force, and frequency of mobile medical team visits had no effect. Another study found field worker and supervisor activities and community contraceptive distributors to be significant factors affecting contraceptive prevalence. The use of traditional organizations can be effective in other countries if the community conditions are the same. The following traditional organizations are described: simpan pinjam (savings and loan associations), arisan (rotating credit association), perkumpulan kematian (burial association), lumbung paceklik (emergency rice stores), kebatinan (mysticism group), pengajian (prayer group), and banjar (a residential group of 100 household heads). The banjar takes care of every aspect of a person's life and is compulsory and meets regularly. a 1976 study indicated the banjar as ideal for use in promoting FP, particularly if dynamic. Modern organizations at the village level, which were used to involve new acceptors, are also described. The Paguyuban KB (Family Planning Acceptors Group) promoted the program and was responsible for contraceptive distribution.

  9. Temporal trends in motor vehicle fatalities in the United States, 1968 to 2010 - a joinpoint regression analysis.

    PubMed

    Bandi, Priti; Silver, Diana; Mijanovich, Tod; Macinko, James

    2015-12-01

    In the past 40 years, a variety of factors might have impacted motor vehicle (MV) fatality trends in the US, including public health policies, engineering innovations, trauma care improvements, etc. These factors varied in their timing across states/localities, and many were targeted at particular population subgroups. In order to identify and quantify differential rates of change over time and differences in trend patterns between population subgroups, this study employed a novel analytic method to assess temporal trends in MV fatalities between 1968 and 2010, by age group and sex. Cause-specific MV fatality data from traffic injuries between 1968 and 2010, based on death certificates filed in the 50 states, and DC were obtained from Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER). Long-term (1968 to 2010) and short-term (log-linear piecewise segments) trends in fatality rates were compared for males and females overall and in four separate age groups using joinpoint regression. MV fatalities declined on average by 2.4% per year in males and 2.2% per year in females between 1968 and 2010, with significant declines observed in all age groups and in both sexes. In males overall and those 25 to 64 years, sharp declines between 1968 and mid-to-late 1990s were followed by a stalling until the mid-2000s, but rates in females experienced a long-term steady decline of a lesser magnitude than males during this time. Trends in those aged <1 to 14 years and 15 to 24 years were mostly steady over time, but males had a larger decline than females in the latter age group between 1968 and the mid-2000s. In ages 65+, short-term trends were similar between sexes. Despite significant long-term declines in MV fatalities, the application of Joinpoint Regression found that progress in young adult and middle-aged adult males stalled in recent decades and rates in males declined relatively more than in females in certain age groups. Future research is needed to establish the causes of these observed trends, including the potential role of contemporaneous MV-related policies and their repeal. Such research is needed in order to better inform the design and evaluation of future population interventions addressing MV fatalities nationally.

  10. What's behind the Good News: The Decline in Teen Pregnancy Rates during the 1990s.

    ERIC Educational Resources Information Center

    Flanigan, Christine

    Noting that rates of teen pregnancies and births have declined over the past decade, this analysis examined how much of the progress is due to fewer teens having sex and how much to lower rates of pregnancy among sexually active teens. The analysis drew on data from the federal government's National Survey of Family Growth (NSFG), a large,…

  11. Docosahexaenoic Acid Supplementation and Cognitive Decline in Alzheimer Disease

    PubMed Central

    Quinn, Joseph F.; Raman, Rema; Thomas, Ronald G.; Yurko-Mauro, Karin; Nelson, Edward B.; Van Dyck, Christopher; Galvin, James E.; Emond, Jennifer; Jack, Clifford R.; Weiner, Michael; Shinto, Lynne; Aisen, Paul S.

    2011-01-01

    Context Docosahexaenoic acid (DHA) is the most abundant long-chain polyunsaturated fatty acid in the brain. Epidemiological studies suggest that consumption of DHA is associated with a reduced incidence of Alzheimer disease. Animal studies demonstrate that oral intake of DHA reduces Alzheimer-like brain pathology. Objective To determine if supplementation with DHA slows cognitive and functional decline in individuals with Alzheimer disease. Design, Setting, and Patients A randomized, double-blind, placebo-controlled trial of DHA supplementation in individuals with mild to moderate Alzheimer disease (Mini-Mental State Examination scores, 14–26) was conducted between November 2007 and May 2009 at 51 US clinical research sites of the Alzheimer’s Disease Cooperative Study. Intervention Participants were randomly assigned to algal DHA at a dose of 2 g/d or to identical placebo (60% were assigned to DHA and 40% were assigned to placebo). Duration of treatment was 18 months. Main Outcome Measures Change in the cognitive subscale of the Alzheimer’s Disease Assessment Scale (ADAS-cog) and change in the Clinical Dementia Rating (CDR) sum of boxes. Rate of brain atrophy was also determined by volumetric magnetic resonance imaging in a subsample of participants (n = 102). Results A total of 402 individuals were randomized and a total of 295 participants completed the trial while taking study medication (DHA: 171; placebo: 124). Supplementation with DHA had no beneficial effect on rate of change on ADAS-cog score, which increased by a mean of 7.98 points (95% confidence interval [CI], 6.51–9.45 points) for the DHA group during 18 months vs 8.27 points (95% CI, 6.72–9.82 points) for the placebo group (linear mixed-effects model: P = .41). The CDR sum of boxes score increased by 2.87 points (95% CI, 2.44–3.30 points) for the DHA group during 18 months compared with 2.93 points (95% CI, 2.44–3.42 points) for the placebo group (linear mixed-effects model: P = .68). In the subpopulation of participants (DHA: 53; placebo: 49), the rate of brain atrophy was not affected by treatment with DHA. Individuals in the DHA group had a mean decline in total brain volume of 24.7 cm3 (95% CI, 21.4–28.0 cm3) during 18 months and a 1.32% (95% CI, 1.14%–1.50%) volume decline per year compared with 24.0 cm3 (95% CI, 20–28 cm3) for the placebo group during 18 months and a 1.29% (95% CI, 1.07%–1.51%) volume decline per year (P = .79). Conclusion Supplementation with DHA compared with placebo did not slow the rate of cognitive and functional decline in patients with mild to moderate Alzheimer disease. PMID:21045096

  12. Time trends in incidence and prevalence of carpal tunnel syndrome over eight years according to multiple data sources: Pays de la Loire study.

    PubMed

    Roquelaure, Yves; Chazelle, Emilie; Gautier, Ludivine; Plaine, Julie; Descatha, Alexis; Evanoff, Bradley; Bodin, Julie; Fouquet, Natacha; Catherine, Buisson

    2017-01-01

    Objective The aim of this study was to describe time trends of incidence/prevalence of carpal tunnel syndrome (CTS), one of the most common musculoskeletal disorders, in a French region over an 8-year period. Methods Three independent data sources were analyzed for the population of the Pays de la Loire region aged 20-59 between 2004 and 2011: hospital discharge records for "surgically treated CTS" (SURG-CTS), the social insurance data on "CTS compensated for as an occupational disease" (OD-CTS), and the regional surveillance program of "work-related diseases" (WRD-CTS). Case counts were analyzed using negative binomial regression models and cubic spline curves with year as the main covariate. Results The annual incidence rates of SURG-CTS decreased from 3.35 to 2.98 per 1000 person-years over the 8-year period, with an overall declining trend [-2.00%, 95% confidence interval (95% CI) -3.07- -0.91%), P<0.001]. The annual incidence rate of OD-CTS per 1000 person-years decreased (from 1.52 to 1.01) between 2004 and 2007 and increased after 2007 (from 1.45 to 2.34), with an overall gain of 54% during the study period. The prevalence rate of WRD-CTS decreased from 5.04 (95% CI 3.90-6.13) to 3.08 (95% CI 2.11-4.06) per 1000 employed person-years, with a non-significant trend between 2004 and 2011. Conclusion The study showed declining rates of SURG-CTS and WRD-CTS in the population of working age between 2004 and 2011, contrasting with increasing rate of OD-CTS after 2007. More research and surveillance data are needed to assess whether and to what extent the declining rates of CTS are actually attributable to improvement in working conditions and/or to non-occupational factors.

  13. Marked Campylobacteriosis Decline after Interventions Aimed at Poultry, New Zealand

    PubMed Central

    Sears, Ann; Wilson, Nick; Marshall, Jonathan; Muellner, Petra; Campbell, Donald M.; Lake, Robin J.; French, Nigel P.

    2011-01-01

    Beginning in the 1980s, New Zealand experienced rising annual rates of campylobacteriosis that peaked in 2006. We analyzed notification, hospitalization, and other data to explore the 2007–2008 drop in campylobacteriosis incidence. Source attribution techniques based on genotyping of Campylobacter jejuni isolates from patients and environmental sources were also used to examine the decline. In 2008, the annual campylobacteriosis notification rate was 161.5/100,000 population, representing a 54% decline compared with the average annual rate of 353.8/100,000 for 2002–2006. A similar decline was seen for hospitalizations. Source attribution findings demonstrated a 74% (95% credible interval 49%–94%) reduction in the number of cases attributed to poultry. These reductions coincided with the introduction of a range of voluntary and regulatory interventions to reduce Campylobacter spp. contamination of poultry. The apparent success of these interventions may inform approaches other countries could consider to help control foodborne campylobacteriosis. PMID:21749761

  14. Hepatic steatosis and non-alcoholic fatty liver disease are not associated with decline in renal function in people with Type 2 diabetes.

    PubMed

    Jenks, S J; Conway, B R; Hor, T J; Williamson, R M; McLachlan, S; Robertson, C; Morling, J R; Strachan, M W J; Price, J F

    2014-09-01

    We aimed to determine whether the presence of hepatic steatosis and/or non-alcoholic fatty liver disease was associated with decline in renal function or onset of microalbuminuria in a cohort of people with Type 2 diabetes, including those managed in both primary and secondary care. Nine hundred and thirty-three patients from the Edinburgh Type 2 Diabetes Study, a cohort of Scottish men and women aged 60-74 years with Type 2 diabetes, underwent assessment for hepatic steatosis by liver ultrasonography 1 year after recruitment. Non-alcoholic fatty liver disease was defined as the presence of steatosis following exclusion of secondary causes of liver disease. Patients were followed for 4 years and decline in renal function was assessed by the change in estimated glomerular filtration rate over time. Of the 933 subjects, 530 had hepatic steatosis and, of those with hepatic steatosis, 388 had non-alcoholic fatty liver disease. Neither hepatic steatosis nor non-alcoholic fatty liver disease were significantly associated with rate of decline in renal function, with the mean rate of decline in estimated glomerular filtration rate being -1.55 ml min(-1) 1.73 m(-2) per year for participants with hepatic steatosis compared with -1.84 ml min(-1) 1.73 m(-2) for those without steatosis (P = 0.19). Similar results were obtained when the analysis was restricted to participants with and without non-alcoholic fatty liver disease (-1.44 vs. -1.64 ml min(-1) 1.73 m(-2) per year, respectively; P = 0.44). Additionally, neither hepatic steatosis nor non-alcoholic fatty liver disease were associated with the onset or regression of albuminuria during follow-up (all P ≥ 0.05). The presence of hepatic steatosis/non-alcoholic fatty liver disease was not associated with decline in renal function during a 4-year follow-up in our cohort of older people with Type 2 diabetes. © 2014 The Authors. Diabetic Medicine © 2014 Diabetes UK.

  15. Terminal decline of episodic memory and perceptual speed in a biracial population.

    PubMed

    Wilson, Robert S; Rajan, Kumar B; Barnes, Lisa L; Jansen, Willemijn; Amofa, Priscilla; Weuve, Jennifer; Evans, Denis A

    2018-05-01

    We compared trajectories of terminal cognitive decline in older Black (n = 3372) and White (n = 1756) persons from a defined population who completed tests of episodic memory and perceptual speed at 3-year intervals for up to 18 years. During a mean of 9.9 years of observation, 1608 Black persons and 902 White persons died. Preterminal decline of episodic memory did not differ by race. Terminal episodic memory decline began earlier in Black persons (mean of 4.3 years before death) than in White persons (mean = 3.9 years) and progressed more slowly. By contrast, terminal decline of perceptual speed began earlier in White persons (mean = 5.0 years) than in Black persons (mean = 4.5 years). Rate of perceptual speed decline was more rapid in White persons than in Black persons in both the preterminal and terminal periods. The results indicate that terminal cognitive decline occurs in Black persons but suggest that the rate of cognitive decline during the terminal period is less rapid in Black persons than in White persons.

  16. The MMSE orientation for time domain is a strong predictor of subsequent cognitive decline in the elderly.

    PubMed

    Guerrero-Berroa, Elizabeth; Luo, Xiaodong; Schmeidler, James; Rapp, Michael A; Dahlman, Karen; Grossman, Hillel T; Haroutunian, Vahram; Beeri, Michal Schnaider

    2009-12-01

    The mini-mental state exam (MMSE) has been used to address questions such as determination of appropriate cutoff scores for differentiation of individuals with intact cognitive function from patients with dementia and rate of cognitive decline. However, little is known about the relationship of performance in specific cognitive domains to subsequent overall decline. To examine the specific and/or combined contribution of four MMSE domains (orientation for time, orientation for place, delayed recall, and attention) to prediction of overall cognitive decline on the MMSE. Linear mixed models were applied to 505 elderly nursing home residents (mean age = 85, > 12 years education = 27%; 79% F, mean follow-up = 3.20 years) to examine the relationship between baseline scores of these domains and total MMSE scores over time. Orientation for time was the only domain significantly associated with MMSE decline over time. Combination of poor delayed recall with either attention or orientation for place was associated with significantly increased decline on the MMSE. The MMSE orientation for time predicts overall decline on MMSE scores over time. A good functioning domain added to good functioning delayed recall was associated with slower rate of decline. Copyright (c) 2009 John Wiley & Sons, Ltd.

  17. Age-related Changes in Energy Intake and Weight in Community-dwelling Middle-aged and Elderly Japanese.

    PubMed

    Otsuka, R; Kato, Y; Nishita, Y; Tange, C; Tomida, M; Nakamoto, M; Imai, T; Ando, F; Shimokata, H

    2016-04-01

    This study attempts to describe trends in energy intake and weight change over 12 years according to age at first participation in the study. Prospective cohort study. The National Institute for Longevity Sciences - Longitudinal Study of Aging (NILS-LSA), a community-based study. Participants included 922 men and 879 women who participated in the first study-wave (age 40-79 years) and also participated in at least one study-wave from the second to seventh study-wave. Each study-wave was conducted biennially. For individuals, the entire follow-up period was 12 years. Energy intake was calculated from 3-day dietary records with photographs. Weight and height were measured under a fasting state. To estimate linear changes in energy intake and weight over 12 years according to age at first study-wave, we used the mixed-effects model. Mean (SD) follow-up time and number of study-wave visits were 9.5 (3.7) years and 5.4 (1.8) times, respectively. The fixed effect of the interaction of age and time in energy intake and weight was statistically or marginally statistically significant both in men (p<0.01) and in women (p<0.06). In men, when energy intake was estimated according to age, the rate of decrease in energy intake increased from -6.8 to -33.8 kcal/year for ages 40-79 years. In women, the rate of decrease in energy intake slightly increased in older age groups (-9.1 to -16.7 kcal/year for ages 40-79 years). Weight increased in males in their 40s (0.07 kg/year from age 40) and started to decline by age 53. In women, weight started to decline around age 47 (-0.04 kg/year). Twelve-year longitudinal data showed energy intake declined both in men and women in their 40s, and the rate of decrease increased in older males. Weight started to decline in men in their mid-50s and women in their late 40s. Further studies that focus on energy intake and weight reduction are needed to prevent weight loss or underweight in an increasingly aging society.

  18. Comparing kinematic changes between a finger-tapping task and unconstrained finger flexion-extension task in patients with Parkinson's disease.

    PubMed

    Teo, W P; Rodrigues, J P; Mastaglia, F L; Thickbroom, G W

    2013-06-01

    Repetitive finger tapping is a well-established clinical test for the evaluation of parkinsonian bradykinesia, but few studies have investigated other finger movement modalities. We compared the kinematic changes (movement rate and amplitude) and response to levodopa during a conventional index finger-thumb-tapping task and an unconstrained index finger flexion-extension task performed at maximal voluntary rate (MVR) for 20 s in 11 individuals with levodopa-responsive Parkinson's disease (OFF and ON) and 10 healthy age-matched controls. Between-task comparisons showed that for all conditions, the initial movement rate was greater for the unconstrained flexion-extension task than the tapping task. Movement rate in the OFF state was slower than in controls for both tasks and normalized in the ON state. The movement amplitude was also reduced for both tasks in OFF and increased in the ON state but did not reach control levels. The rate and amplitude of movement declined significantly for both tasks under all conditions (OFF/ON and controls). The time course of rate decline was comparable for both tasks and was similar in OFF/ON and controls, whereas the tapping task was associated with a greater decline in MA, both in controls and ON, but not OFF. The findings indicate that both finger movement tasks show similar kinematic changes during a 20-s sustained MVR, but that movement amplitude is less well sustained during the tapping task than the unconstrained finger movement task. Both movement rate and amplitude improved with levodopa; however, movement rate was more levodopa responsive than amplitude.

  19. Decline in male circumcision in South Korea.

    PubMed

    Kim, DaiSik; Koo, Sung-Ae; Pang, Myung-Geol

    2012-12-11

    To investigate the changing circumcision rate in South Korea in the last decade and to propose underlying causes for this change, in the context of the present fluctuating world-wide trends in circumcision. From 2009 to 2011, 3,296 South Korean males (or their parents) aged 0-64 years were asked about their circumcision status, their age at circumcision, and their information level regarding circumcision. We employed non-probability sampling considering the sensitive questions on the study theme. Currently the age-standardized circumcision rate for South Korean males aged 14-29 is found to be 75.8%. In an earlier study performed in 2002, the rate for the same age group was 86.3%. Of particular interest, males aged 14-16 show a circumcision rate of 56.4%, while the same age group 10 years ago displayed a much higher percentage, at 88.4%. In addition, the extraordinarily high circumcision rate of 95.2% found 10 years ago for the 17-19 age group is now reduced to 74.4%. Interestingly, of the circumcised males, the percentage circumcised in the last decade was only 25.2%; i.e., the majority of the currently circumcised males had undergone the operation prior to 2002, indicating that the actual change in the last decade is far greater. Consistent with this conjecture, the 2002 survey showed that the majority of circumcised males (75.7%) had undergone the operation in the decade prior to that point. Focusing on the flagship age group of 14-16, this drop suggests that, considering the population structure of Korean males, approximately one million fewer circumcision operations have been performed in the last decade relative to the case of non-decline. This decline is strongly correlated with the information available through internet, newspapers, lectures, books, and television: within the circumcised population, both the patients and their parents had less prior knowledge regarding circumcision, other than information obtained from person to person by oral communication. Within the uncircumcised population, the prior knowledge was far greater, suggesting that information discouraging circumcision played an important role. South Korean male circumcision is likely to be undergoing a steep decline. The cause for this decline seems to be the increase in information available on the pros and cons of circumcision.

  20. Pilot error in air carrier mishaps: longitudinal trends among 558 reports, 1983-2002.

    PubMed

    Baker, Susan P; Qiang, Yandong; Rebok, George W; Li, Guohua

    2008-01-01

    Many interventions have been implemented in recent decades to reduce pilot error in flight operations. This study aims to identify longitudinal trends in the prevalence and patterns of pilot error and other factors in U.S. air carrier mishaps. National Transportation Safety Board investigation reports were examined for 558 air carrier mishaps during 1983-2002. Pilot errors and circumstances of mishaps were described and categorized. Rates were calculated per 10 million flights. The overall mishap rate remained fairly stable, but the proportion of mishaps involving pilot error decreased from 42% in 1983-87 to 25% in 1998-2002, a 40% reduction. The rate of mishaps related to poor decisions declined from 6.2 to 1.8 per 10 million flights, a 71% reduction; much of this decrease was due to a 76% reduction in poor decisions related to weather. Mishandling wind or runway conditions declined by 78%. The rate of mishaps involving poor crew interaction declined by 68%. Mishaps during takeoff declined by 70%, from 5.3 to 1.6 per 10 million flights. The latter reduction was offset by an increase in mishaps while the aircraft was standing, from 2.5 to 6.0 per 10 million flights, and during pushback, which increased from 0 to 3.1 per 10 million flights. Reductions in pilot errors involving decision making and crew coordination are important trends that may reflect improvements in training and technological advances that facilitate good decisions. Mishaps while aircraft are standing and during pushback have increased and deserve special attention.

  1. Pilot Error in Air Carrier Mishaps: Longitudinal Trends Among 558 Reports, 1983–2002

    PubMed Central

    Baker, Susan P.; Qiang, Yandong; Rebok, George W.; Li, Guohua

    2009-01-01

    Background Many interventions have been implemented in recent decades to reduce pilot error in flight operations. This study aims to identify longitudinal trends in the prevalence and patterns of pilot error and other factors in U.S. air carrier mishaps. Method National Transportation Safety Board investigation reports were examined for 558 air carrier mishaps during 1983–2002. Pilot errors and circumstances of mishaps were described and categorized. Rates were calculated per 10 million flights. Results The overall mishap rate remained fairly stable, but the proportion of mishaps involving pilot error decreased from 42% in 1983–87 to 25% in 1998–2002, a 40% reduction. The rate of mishaps related to poor decisions declined from 6.2 to 1.8 per 10 million flights, a 71% reduction; much of this decrease was due to a 76% reduction in poor decisions related to weather. Mishandling wind or runway conditions declined by 78%. The rate of mishaps involving poor crew interaction declined by 68%. Mishaps during takeoff declined by 70%, from 5.3 to 1.6 per 10 million flights. The latter reduction was offset by an increase in mishaps while the aircraft was standing, from 2.5 to 6.0 per 10 million flights, and during pushback, which increased from 0 to 3.1 per 10 million flights. Conclusions Reductions in pilot errors involving decision making and crew coordination are important trends that may reflect improvements in training and technological advances that facilitate good decisions. Mishaps while aircraft are standing and during push-back have increased and deserve special attention. PMID:18225771

  2. Species-specific responses to climate change and community composition determine future calcification rates of Florida Keys reefs.

    PubMed

    Okazaki, Remy R; Towle, Erica K; van Hooidonk, Ruben; Mor, Carolina; Winter, Rivah N; Piggot, Alan M; Cunning, Ross; Baker, Andrew C; Klaus, James S; Swart, Peter K; Langdon, Chris

    2017-03-01

    Anthropogenic climate change compromises reef growth as a result of increasing temperatures and ocean acidification. Scleractinian corals vary in their sensitivity to these variables, suggesting species composition will influence how reef communities respond to future climate change. Because data are lacking for many species, most studies that model future reef growth rely on uniform scleractinian calcification sensitivities to temperature and ocean acidification. To address this knowledge gap, calcification of twelve common and understudied Caribbean coral species was measured for two months under crossed temperatures (27, 30.3 °C) and CO 2 partial pressures (pCO 2 ) (400, 900, 1300 μatm). Mixed-effects models of calcification for each species were then used to project community-level scleractinian calcification using Florida Keys reef composition data and IPCC AR5 ensemble climate model data. Three of the four most abundant species, Orbicella faveolata, Montastraea cavernosa, and Porites astreoides, had negative calcification responses to both elevated temperature and pCO 2 . In the business-as-usual CO 2 emissions scenario, reefs with high abundances of these species had projected end-of-century declines in scleractinian calcification of >50% relative to present-day rates. Siderastrea siderea, the other most common species, was insensitive to both temperature and pCO 2 within the levels tested here. Reefs dominated by this species had the most stable end-of-century growth. Under more optimistic scenarios of reduced CO 2 emissions, calcification rates throughout the Florida Keys declined <20% by 2100. Under the most extreme emissions scenario, projected declines were highly variable among reefs, ranging 10-100%. Without considering bleaching, reef growth will likely decline on most reefs, especially where resistant species like S. siderea are not already dominant. This study demonstrates how species composition influences reef community responses to climate change and how reduced CO 2 emissions can limit future declines in reef calcification. © 2016 John Wiley & Sons Ltd.

  3. Decline in offspring viability as a manifestation of aging in Drosophila melianogaster.

    PubMed

    Kern, S; Ackermann, M; Stearns, S C; Kawecki, T J

    2001-09-01

    The evolutionary explanation of senescence proposes that selection against alleles with deleterious effects manifested only late in life is weak because most individuals die earlier for extrinsic reasons. This argument also applies to alleles whose deleterious effects are nongenetically transmitted from mother to progeny, that is, that affect the performance of progeny produced at late ages rather than of the aging individuals themselves. We studied the effect of maternal age on offspring viability (egg hatching success and larva-to-adult survival) in two sets of Drosophila melanogaster lines (HAM/LAM and YOUNG/OLD), originating from two long-term selection experiments. In each set, some lines (HAM and YOUNG, respectively) have been selected for early reproduction, whereas later reproduction was favored in their counterparts (LAM and OLD). In the HAM and LAM lines, both egg hatching success and larval viability declined with mother's age and did so with accelerating rates. The hatching success declined significantly faster with maternal age in HAM than in LAM lines, according to one of two statistical approaches used. Egg hatching success also declined with maternal age in YOUNG and OLD lines, with no difference between the selection regimes. However, the relationship between mother's age and offspring larva-to-adult viability differed significantly between these two selection regimes: a decline of larval viability with maternal age occurred in YOUNG lines but not in OLD lines. This suggests that the rate with which offspring viability declines with mother's age responded to selection for early versus late reproduction. We suggest broadening the evolutionary concept of senescence to include intrinsically caused declines in offspring quality with maternal age.

  4. Occurrence, temporal trends, and half-lives of perfluoroalkyl acids (PFAAs) in occupational workers in China

    PubMed Central

    Fu, Jianjie; Gao, Yan; Cui, Lin; Wang, Thanh; Liang, Yong; Qu, Guangbo; Yuan, Bo; Wang, Yawei; Zhang, Aiqian; Jiang, Guibin

    2016-01-01

    Paired serum and urine samples were collected from workers in a fluorochemical plant from 2008 to 2012 (n = 302) to investigate the level, temporal trends, and half-lives of PFAAs in workers of a fluorochemical plant. High levels of perfluorohexane sulfonate (PFHxS), perfluorooctanoic acid (PFOA), and perfluorooctanesulfonate (PFOS) were detected in serum with median concentrations of 764, 427, and 1725 ng mL−1, respectively. The half-lives of PFAAs in workers were estimated by daily clearance rates and annual decline rates of PFAAs in serum by a first-order model. The geometric mean and median value for PFHxS, PFOA, and PFOS were 14.7 and 11.7, 4.1 and 4.0, 32.6 and 21.6 years, respectively, by the daily clearance rates, and they were 3.6, 1.7, and 1.9 years estimated by annual decline rates. The half-lives estimated by the limited clearance route information could be considered as the upper limits for PFAAs, however, the huge difference between two estimated approaches indicated that there were other important elimination pathways of PFAAs other than renal clearance in human. The half-lives estimated by annual decline rates in the present study were the shortest values ever reported, and the intrinsic half-lives might even shorter due to the high levels of ongoing exposure to PFAAs. PMID:27905562

  5. Occurrence, temporal trends, and half-lives of perfluoroalkyl acids (PFAAs) in occupational workers in China

    NASA Astrophysics Data System (ADS)

    Fu, Jianjie; Gao, Yan; Cui, Lin; Wang, Thanh; Liang, Yong; Qu, Guangbo; Yuan, Bo; Wang, Yawei; Zhang, Aiqian; Jiang, Guibin

    2016-12-01

    Paired serum and urine samples were collected from workers in a fluorochemical plant from 2008 to 2012 (n = 302) to investigate the level, temporal trends, and half-lives of PFAAs in workers of a fluorochemical plant. High levels of perfluorohexane sulfonate (PFHxS), perfluorooctanoic acid (PFOA), and perfluorooctanesulfonate (PFOS) were detected in serum with median concentrations of 764, 427, and 1725 ng mL-1, respectively. The half-lives of PFAAs in workers were estimated by daily clearance rates and annual decline rates of PFAAs in serum by a first-order model. The geometric mean and median value for PFHxS, PFOA, and PFOS were 14.7 and 11.7, 4.1 and 4.0, 32.6 and 21.6 years, respectively, by the daily clearance rates, and they were 3.6, 1.7, and 1.9 years estimated by annual decline rates. The half-lives estimated by the limited clearance route information could be considered as the upper limits for PFAAs, however, the huge difference between two estimated approaches indicated that there were other important elimination pathways of PFAAs other than renal clearance in human. The half-lives estimated by annual decline rates in the present study were the shortest values ever reported, and the intrinsic half-lives might even shorter due to the high levels of ongoing exposure to PFAAs.

  6. The relationship between social stratification and all-cause mortality among children in the United States: 1968-1992.

    PubMed

    DiLiberti, J H

    2000-01-01

    US childhood poverty rates have increased for most of the past 2 decades. Although overall mortality among children has apparently fallen during this interval, these aggregate mortality rates may hide a disproportionate burden imposed on the least advantaged. This study assessed the impact of social stratification on long-term US childhood mortality rates and examined the temporal relationship between mortality attributable to social stratification and childhood poverty rates. Using US childhood mortality data obtained from the Compressed Mortality File (National Center for Health Statistics) and a county-level measure of social stratification (residential telephone availability), I evaluated the impact of social stratification on long-term trends (1968-1992) in age-adjusted mortality and compared the resulting attributable proportions to trends in childhood poverty rates. Between 1968 and 1987 the proportion of US childhood deaths attributable to social stratification decreased from.22 to.17. Subsequently, it increased to.24 in 1992, despite continuous declines in overall childhood mortality rates. These proportions correlated strongly with earlier childhood poverty rates, taking into account an apparent 9-year lag. Among black children comparable trends were not observed, although throughout this time period their mortality rates were far higher than among the rest of the population and declined more slowly. Despite declining childhood mortality rates between 1968 and 1992, children living in the least advantaged counties continued to die at higher rates than those living in the most advantaged counties. This differential worsened considerably after 1987, and by 1992 had a substantive impact on US life expectancy at birth, resulting in perhaps the most significant (in terms of years of life lost) reversal in the health of the US public in the 20th century.

  7. Trends in Hospitalization Rates and Outcomes of Endocarditis among Medicare Beneficiaries

    PubMed Central

    Bikdeli, Behnood; Wang, Yun; Kim, Nancy; Desai, Mayur M.; Quagliarello, Vincent; Krumholz, Harlan M.

    2015-01-01

    Objectives To determine the hospitalization rates and outcomes of endocarditis among older adults. Background Endocarditis is the most serious cardiovascular infection and is especially common among older adults. Little is known about recent trends for endocarditis hospitalizations and outcomes. Methods Using Medicare inpatient Standard Analytic Files, we identified all Fee-For-Service beneficiaries aged ≥65 years with a principal or secondary diagnosis of endocarditis from 1999-2010. We used Medicare Denominator Files to report hospitalizations per 100,000 person-years. Rates of 30-day and 1-year mortality were calculated using Vital Status Files. We used mixed-effects models to calculate adjusted rates of hospitalization and mortality and to compare the results before and after 2007, when the American Heart Association revised recommendations for endocarditis prophylaxis. Results Overall, 262,658 beneficiaries were hospitalized with endocarditis. The adjusted hospitalization rate increased from 1999-2005, reaching 83.5 per 100,000 person-years in 2005, and declined during 2006-2007. After 2007, the decline continued, reaching 70.6 per 100,000 person-years in 2010. Adjusted 30-day and 1-year mortality rates ranged from 14.2% to 16.5% and from 32.6% to 36.2%, respectively. There were no consistent changes in adjusted rates of 30-day and 1-year mortality after 2007. Trends in rates of hospitalization and outcomes were consistent across demographic subgroups. Adjusted rates of hospitalization and mortality declined consistently in the subgroup with principal diagnosis of endocarditis. Conclusions Our study highlights the high burden of endocarditis among older adults. We did not observe an increase in adjusted rates of hospitalization or mortality associated with endocarditis after publication of the 2007 guidelines. PMID:23994421

  8. Monitoring survival rates of Swainson's Thrush Catharus ustulatus at multiple spatial scales

    USGS Publications Warehouse

    Rosenberg, D.K.; DeSante, D.F.; McKelvey, K.S.; Hines, J.E.

    1999-01-01

    We estimated survival rates of Swainson's Thrush, a common, neotropical, migratory landbird, at multiple spatial scales, using data collected in the western USA from the Monitoring Avian Productivity and Survivorship Programme. We evaluated statistical power to detect spatially heterogeneous survival rates and exponentially declining survival rates among spatial scales with simulated populations parameterized from results of the Swainson's Thrush analyses. Models describing survival rates as constant across large spatial scales did not fit the data. The model we chose as most appropriate to describe survival rates of Swainson's Thrush allowed survival rates to vary among Physiographic Provinces, included a separate parameter for the probability that a newly captured bird is a resident individual in the study population, and constrained capture probability to be constant across all stations. Estimated annual survival rates under this model varied from 0.42 to 0.75 among Provinces. The coefficient of variation of survival estimates ranged from 5.8 to 20% among Physiographic Provinces. Statistical power to detect exponentially declining trends was fairly low for small spatial scales, although large annual declines (3% of previous year's rate) were likely to be detected when monitoring was conducted for long periods of time (e.g. 20 years). Although our simulations and field results are based on only four years of data from a limited number and distribution of stations, it is likely that they illustrate genuine difficulties inherent to broadscale efforts to monitor survival rates of territorial landbirds. In particular, our results suggest that more attention needs to be paid to sampling schemes of monitoring programmes, particularly regarding the trade-off between precision and potential bias of parameter estimates at varying spatial scales.

  9. Monitoring survival rates of Swainson's Thrush Catharus ustulatus at multiple spatial scales

    USGS Publications Warehouse

    Rosenberg, D.K.; DeSante, D.F.; McKelvey, K.S.; Hines, J.E.

    1999-01-01

    We estimated survival rates of Swainson's Thrush, a common, neotropical, migratory landbird, at multiple spatial scales, using data collected in the western USA from the Monitoring Avian Productivity and Survivorship Programme. We evaluated statistical power to detect spatially heterogeneous survival rates and exponentially declining survival rates among spatial scales with simulated populations parameterized from results of the Swainson's Thrush analyses. Models describing survival rates as constant across large spatial scales did not fit the data. The model we chose as most appropriate to describe survival rates of Swainson's Thrush allowed survival rates to vary among Physiographic Provinces, included a separate parameter for the probability that a newly captured bird is a resident individual in the study population, and constrained capture probability to be constant across all stations. Estimated annual survival rates under this model varied from 0.42 to 0.75 among Provinces. The coefficient of variation of survival estimates ranged from 5.8 to 20% among Physiographic Provinces. Statistical power to detect exponentially declining trends was fairly low for small spatial scales, although large annual declines (3% of previous year's rate) were likely to be detected when monitoring was conducted for long periods of time (e.g. 20 years). Although our simulations and field results are based on only four years of date from a limited number and distribution of stations, it is likely that they illustrate genuine difficulties inherent to broadscale efforts to monitor survival rates of territorial landbirds. In particular, our results suggest that more attention needs to be paid to sampling schemes of monitoring programmes particularly regarding the trade-off between precison and potential bias o parameter estimates at varying spatial scales.

  10. A decade of changes in brain volume and cognition.

    PubMed

    Aljondi, Rowa; Szoeke, Cassandra; Steward, Chris; Yates, Paul; Desmond, Patricia

    2018-05-09

    Brain atrophy can occur several decades prior to onset of cognitive impairments. However, few longitudinal studies have examined the relationship between brain volume changes and cognition over a long follow-up period in healthy elderly women. In the present study we investigate the relationship between whole brain and hippocampal atrophy rates and longitudinal changes in cognition, including verbal episodic memory and executive function, in older women. We also examine whether baseline brain volume predicts subsequent changes in cognitive performance over a 10-year period. A total of 60 individuals from the population-based Women's Healthy Ageing Project with a mean age at baseline of 59 years underwent 3T MRI. Of these, 40 women completed follow-up cognitive assessments, 23 of whom had follow-up MRI scans. Linear regression analysis was used to examine the relationship between brain atrophy and changes in verbal episodic memory and executive function over a 10-year period. The results show that baseline measurements of frontal and temporal grey matter volumes predict changes in verbal episodic memory performance, whereas hippocampal volume at baseline is associated with changes in executive function performance over a 10-year period of follow-ups. In addition, higher whole brain and hippocampal atrophy rates are correlated with a decline in verbal episodic memory. These findings indicate that in addition to atrophy rate, smaller regional grey matter volumes even 10 years prior is associated with increased rates of cognitive decline. This study suggests useful neuroimaging biomarkers for the prediction of cognitive decline in healthy elderly women.

  11. Trends and racial differences in birth weight and related survival.

    PubMed

    Alexander, G R; Tompkins, M E; Allen, M C; Hulsey, T C

    1999-06-01

    In the past two decades, infant mortality rates in the United States declined in African-American and White populations. Despite this, racial disparities in infant mortality rates have increased and rates of low birth weight deliveries have shown little change. In this study, we examine temporal changes in birth weight distributions, birth weight specific neonatal mortality, and the birth weight threshold for an adverse risk of survival within both racial groups in order to explore the mechanisms for the disparities in infant mortality rates. Single live births born to South Carolina resident mothers between 1975 and 1994 and considered White or African-American based on the mother's report of maternal race on the birth certificate were selected for investigation. We define the birth weight threshold for adverse survival odds as the birth weight at which 50% or more of infants in the population died within the first month of life. Despite significant increases in very low birth weight percentages, neonatal mortality rates markedly declined. Birth weight specific neonatal mortality decreased for both races, although greater reductions accrued to White low birth weight infants. By the end of the study period, the birth weight at which over 50% of newborns died within the first month of life was 696 g for Whites and 673 g for African-Americans. The ongoing decline in neonatal mortality is mainly due to reductions in birth weight specific neonatal mortality, probably related to high-risk obstetric and neonatal care. Technological developments in these areas may have differentially benefited Whites, resulting in an increasing racial disparity in mortality rates. Moreover, the relatively greater and increasing mortality risk from postmaturity and macrosomia in infants of African-America mothers may further exacerbate the racial gap in infant mortality.

  12. Is passenger vehicle incompatibility still a problem?

    PubMed

    Teoh, Eric R; Nolan, Joseph M

    2012-01-01

    Passenger cars often are at a disadvantage when colliding with light trucks (sport utility vehicles [SUVs] and pickups) due to differences in mass, vehicle structural alignment, and stiffness. In 2003, vehicle manufacturers agreed to voluntary measures to improve compatibility, especially in front-to-front and front-to-side crashes, with full adherence to be achieved by September 2009. This study examined whether fatality rates are consistent with the expected benefit of this agreement. Analyses examined 2 death rates for 1- to 4-year-old passenger vehicles during 2000-2001 and 2008-2009 in the United States: occupant deaths per million registered vehicle years in these vehicles and deaths in other cars that collided with these vehicles in 2-vehicle crashes per million registered vehicle years. These rates were computed for each study period and for cars/minivans (referred to as cars), SUVs, and pickups by curb weight (in 500-pound increments). The latter death rate, referred to as the car crash partner death rate, also was computed for front-to-front crashes and front-to-side crashes where the front of the 1- to 4-year-old vehicle struck the side of the partner car. In both study periods, occupant death rates generally decreased for each vehicle type both with increasing curb weight and over time. SUVs experienced the greatest declines compared with cars and pickups. This is due in part to the early fitment of electronic stability control in SUVs, which drastically reduced the incidence of single-vehicle rollover crashes. Pickups had the highest death rates in both study periods. Car crash partner death rates generally declined over time for all vehicle categories but more steeply for SUVs and pickups colliding with cars than for cars colliding with cars. In fact, the car crash partner death rates for SUVs and cars were nearly identical during 2008-2009, suggesting that the voluntary design changes for compatibility have been effective. Car crash partner death rates also declined for pickups, but their rates were consistently the highest in both study periods. It is impossible to disentangle the individual contributions of the compatibility agreement, improved crashworthiness of cars, and other factors in reducing car crash partner fatality rates. However, the generally larger reductions in car crash partner death rates for SUVs and pickups indicate the likely benefits of the agreement. Overall, this study finds that the system of regulatory testing, voluntary industry initiatives, and consumer information testing has led to a passenger vehicle fleet that is much more compatible in crashes.

  13. Teenage childbearing in the United States, 1960-1997.

    PubMed

    Ventura, S J; Freedman, M A

    2000-07-01

    Teenage childbearing in the United States has declined significantly in the 1990s. Still the U.S. teen birth rate is higher than in other developed countries; in 1997 it was 52.3 births per 1000 women aged 15 to 19. A steep rise in teen birth rates in the late 1980s generated a great deal of public concern and a variety of initiatives targeted to reducing teen births. Data from the National Center for Health Statistics' National Vital Statistics System are used to review and describe trends and variations in births and birth rates for teenagers for the period 1960-1997. Teen birth rates were much higher in the early 1960s than at present; in fact, rates for 18- to 19-year-olds were double what they are currently. In the 1990s, birth rates for teenagers dropped for younger and older teenagers, with greater declines recorded for younger teens. While rates have fallen in all population groups, the greatest declines have been experienced by black teenagers, whose rates have dropped 24% on average. %Trends in teen births and birth rates since 1960 have been affected by a variety of factors. These include wide swings in the number of female teenagers, substantial declines in marriage among older teens, falling birth rates for married teens concurrent with rapidly rising birth rates for unmarried teens, and sharp increases in sexual activity among teens that have abated only recently, according to the National Center for Health Statistics' National Survey of Family Growth. This review article also tracks changes in contraceptive practice and abortion rates.

  14. Geriatric Conditions in Acutely Hospitalized Older Patients: Prevalence and One-Year Survival and Functional Decline

    PubMed Central

    Buurman, Bianca M.; Hoogerduijn, Jita G.; de Haan, Rob J.; Abu-Hanna, Ameen; Lagaay, A. Margot; Verhaar, Harald J.; Schuurmans, Marieke J.; Levi, Marcel; de Rooij, Sophia E.

    2011-01-01

    Background To study the prevalence of eighteen geriatric conditions in older patients at admission, their reporting rate in discharge summaries and the impact of these conditions on mortality and functional decline one year after admission. Method A prospective multicenter cohort study conducted between 2006 and 2008 in two tertiary university teaching hospitals and one regional teaching hospital in the Netherlands. Patients of 65 years and older, acutely admitted and hospitalized for at least 48 hours, were invited to participate. Eighteen geriatric conditions were assessed at hospital admission, and outcomes (mortality, functional decline) were assessed one year after admission. Results 639 patients were included, with a mean age of 78 years. IADL impairment (83%), polypharmacy (61%), mobility difficulty (59%), high levels of primary caregiver burden (53%), and malnutrition (52%) were most prevalent. Except for polypharmacy and cognitive impairment, the reporting rate of the geriatric conditions in discharge summaries was less than 50%. One year after admission, 35% had died and 33% suffered from functional decline. A high Charlson comorbidity index score, presence of malnutrition, high fall risk, presence of delirium and premorbid IADL impairment were associated with mortality and overall poor outcome (mortality or functional decline). Obesity lowered the risk for mortality. Conclusion Geriatric conditions were highly prevalent and associated with poor health outcomes after admission. Early recognition of these conditions in acutely hospitalized older patients and improving the handover to the general practitioner could lead to better health outcomes and reduce the burden of hospital admission for older patients. PMID:22110598

  15. Environment, behavior and physiology: do birds use barometric pressure to predict storms?

    PubMed

    Breuner, Creagh W; Sprague, Rachel S; Patterson, Stephen H; Woods, H Arthur

    2013-06-01

    Severe storms can pose a grave challenge to the temperature and energy homeostasis of small endothermic vertebrates. Storms are accompanied by lower temperatures and wind, increasing metabolic expenditure, and can inhibit foraging, thereby limiting energy intake. To avoid these potential problems, most endotherms have mechanisms for offsetting the energetic risks posed by storms. One possibility is to use cues to predict oncoming storms and to alter physiology and behavior in ways that make survival more likely. Barometric pressure declines predictably before inclement weather, and several lines of evidence indicate that animals alter behavior based on changes in ambient pressure. Here we examined the effects of declining barometric pressure on physiology and behavior in the white-crowned sparrow, Zonotrichia leucophrys. Using field data from a long-term study, we first evaluated the relationship between barometric pressure, storms and stress physiology in free-living white-crowned sparrows. We then manipulated barometric pressure experimentally in the laboratory and determined how it affects activity, food intake, metabolic rates and stress physiology. The field data showed declining barometric pressure in the 12-24 h preceding snowstorms, but we found no relationship between barometric pressure and stress physiology. The laboratory study showed that declining barometric pressure stimulated food intake, but had no effect on metabolic rate or stress physiology. These data suggest that white-crowned sparrows can sense and respond to declining barometric pressure, and we propose that such an ability may be common in wild vertebrates, especially small ones for whom individual storms can be life-threatening events.

  16. Demographic response of northern spotted owls to barred owl removal

    USGS Publications Warehouse

    Diller, V. Lowell; Hamm, Keith A; Early, Desiree A; Lamphear, David W; Dugger, Katie M.; Yackulic, Charles B.; Schwarz, Carl J.; Carlson, Peter C.; McDonald, Trent L.

    2016-01-01

    Federally listed as threatened in 1990 primarily because of habitat loss, the northern spotted owl (Strix occidentalis caurina) has continued to decline despite conservation efforts resulting in forested habitat being reserved throughout its range. Recently, there is growing evidence the congeneric invasive barred owl (Strix varia) may be responsible for the continued decline primarily by excluding spotted owls from their preferred habitat. We used a long-term demographic study for spotted owls in coastal northern California as the basis for a pilot barred owl removal experiment. Our demography study used capture–recapture, reproductive output, and territory occupancy data collected from 1990 to 2013 to evaluate trends in vital rates and populations. We used a classic before-after-control-impact (BACI) experimental design to investigate the demographic response of northern spotted owls to the lethal removal of barred owls. According to the best 2-species dynamic occupancy model, there was no evidence of differences in barred or northern spotted owl occupancy prior to the initiation of the treatment (barred owl removal). After treatment, barred owl occupancy was lower in the treated relative to the untreated areas and spotted owl occupancy was higher relative to the untreated areas. Barred owl removal decreased spotted owl territory extinction rates but did not affect territory colonization rates. As a result, spotted owl occupancy increased in the treated area and continued to decline in the untreated areas. Prior to and after barred owl removal, there was no evidence that average fecundity differed on the 2 study areas. However, the greater number of occupied spotted owl sites on the treated areas resulted in greater productivity in the treated areas based on empirical counts of fledged young. Prior to removal, survival was declining at a rate of approximately 0.2% per year for treated and untreated areas. Following treatment, estimated survival was 0.859 for the treated areas and 0.822 for the untreated areas. Derived estimates of population change on both study areas showed the same general decline before removal with an estimated slope of –0.0036 per year. Following removal, the rate of population change on the treated areas increased to an average of 1.029 but decreased to an average of 0.870 on the untreated areas. The results from this first experiment demonstrated that lethal removal of barred owls allowed the recovery of northern spotted owl populations in the treated portions of our study area. If additional federally funded barred owl removal experiments provide similar results, this could be the foundation for development of a long-term conservation strategy for northern spotted owls.

  17. QuickStats: Age-Adjusted Death Rates* for Males Aged 15-44 Years, by the Five Leading Causes of Death(†) - United States, 1999 and 2014.

    PubMed

    2016-08-12

    The age-adjusted death rate for males aged 15-44 years was 10% lower in 2014 (156.6 per 100,000 population) than in 1999 (174.1). Among the five leading causes of death, the age-adjusted rates for three were lower in 2014 than in 1999: cancer (from 17.1 to 12.8; 25% decline), heart disease (20.1 to 17.0; 15% decline), and homicide (15.7 to 13.8; 12% decline). The age-adjusted death rates for two of the five causes were higher in 2014 than in 1999: suicide (20.1 to 22.5; 12% increase), and unintentional injuries (from 48.7 to 51.0; 5% increase).

  18. Temporal associations with declining Trichomonas vaginalis diagnosis rates among women in the state of Victoria, Australia, 1947 to 2005.

    PubMed

    Marrone, John; Fairley, Christopher K; Saville, Marian; Bradshaw, Catriona; Bowden, Francis J; Horvath, Leonie B; Donovan, Basil; Chen, Marcus; Hocking, Jane S

    2008-06-01

    To investigate the temporal associations between Trichomonas vaginalis (TV) diagnoses in women at a large urban sexual health clinic and a major Papanicolaou (Pap) smear screening laboratory in Victoria, Australia with Pap smear screening rates and the introduction of nitroimidazole treatments. An ecological analysis of TV diagnosis rates at the Melbourne Sexual Health Centre and the Victorian Cytology Service, Pap smear screening rates and nitroimidazole prescription data. Diagnoses of TV at the Melbourne Sexual Health Centre peaked in the 1950s at 20% to 30% and then rapidly declined through the 1960s and 1970s to below 1% in 1990. A similar pattern was observed at the Victorian Cytology Service. Metronidazole prescribing and opportunistic Pap smear screening began in Victoria in the 1960s coinciding with declining TV. The availability of tinidazole in 1976 led to further declines in TV in the late 1970s. A national cervical screening program introduced in 1991 was temporally associated with further declines in TV. Our analyses suggest that the introduction of metronidazole was associated with a large reduction in TV among Victorian women in the 1960s. The subsequent availability of tinidazole and increased Pap smear screening may have contributed to the current low TV prevalence in Victoria.

  19. Neuropsychological changes following deep brain stimulation surgery for Parkinson's disease: comparisons of treatment at pallidal and subthalamic targets versus best medical therapy.

    PubMed

    Rothlind, Johannes C; York, Michele K; Carlson, Kim; Luo, Ping; Marks, William J; Weaver, Frances M; Stern, Matthew; Follett, Kenneth; Reda, Domenic

    2015-06-01

    Deep brain stimulation (DBS) improves motor symptoms in Parkinson's disease (PD), but questions remain regarding neuropsychological decrements sometimes associated with this treatment, including rates of statistically and clinically meaningful change, and whether there are differences in outcome related to surgical target. Neuropsychological functioning was assessed in patients with Parkinson's disease (PD) at baseline and after 6 months in a prospective, randomised, controlled study comparing best medical therapy (BMT, n=116) and bilateral deep brain stimulation (DBS, n=164) at either the subthalamic nucleus (STN, n=84) or globus pallidus interna (GPi, n=80), using standardised neuropsychological tests. Measures of functional outcomes were also administered. Comparison of the two DBS targets revealed few significant group differences. STN DBS was associated with greater mean reductions on some measures of processing speed, only one of which was statistically significant in comparison with stimulation of GPi. GPi DBS was associated with lower mean performance on one measure of learning and memory that requires mental control and cognitive flexibility. Compared to the group receiving BMT, the combined DBS group had significantly greater mean reductions at 6-month follow-up in performance on multiple measures of processing speed and working memory. After calculating thresholds for statistically reliable change from data obtained from the BMT group, the combined DBS group also displayed higher rates of decline in neuropsychological test performance. Among study completers, 18 (11%) study participants receiving DBS displayed reliable decline by multiple indicators in two or more cognitive domains, a significantly higher rate than in the BMT group (3%). This multi-domain cognitive decline was associated with less beneficial change in subjective ratings of everyday functioning and quality of life (QOL). The multi-domain cognitive decline group continued to function at a lower level at 24-month follow-up. In those with PD, the likelihood of significant decline in neuropsychological functioning increases with DBS, affecting a small minority of patients who also appear to respond less optimally to DBS by other indicators of QOL. NCT00056563 and NCT01076452. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  20. Dynamic changes in scope for heart rate and cardiac autonomic control during warm acclimation in rainbow trout.

    PubMed

    Ekström, Andreas; Hellgren, Kim; Gräns, Albin; Pichaud, Nicolas; Sandblom, Erik

    2016-04-15

    Time course studies are critical for understanding regulatory mechanisms and temporal constraints in ectothermic animals acclimating to warmer temperatures. Therefore, we investigated the dynamics of heart rate and its neuro-humoral control in rainbow trout ( ITALIC! Onchorhynchus mykissL.) acclimating to 16°C for 39 days after being acutely warmed from 9°C. Resting heart rate was 39 beats min(-1)at 9°C, and increased significantly when fish were acutely warmed to 16°C ( ITALIC! Q10=1.9), but then declined during acclimation ( ITALIC! Q10=1.2 at day 39), mainly due to increased cholinergic inhibition while the intrinsic heart rate and adrenergic tone were little affected. Maximum heart rate also increased with warming, although a partial modest decrease occurred during the acclimation period. Consequently, heart rate scope exhibited a complex pattern with an initial increase with acute warming, followed by a steep decline and then a subsequent increase, which was primarily explained by cholinergic inhibition of resting heart rate. © 2016. Published by The Company of Biologists Ltd.

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