Sample records for population-based long-term study

  1. Management and Prevalence of Long-Term Conditions in Primary Health Care for Adults with Intellectual Disabilities Compared with the General Population: A Population-Based Cohort Study

    ERIC Educational Resources Information Center

    Cooper, Sally-Ann; Hughes-McCormack, Laura; Greenlaw, Nicola; McConnachie, Alex; Allan, Linda; Baltzer, Marion; McArthur, Laura; Henderson, Angela; Melville, Craig; McSkimming, Paula; Morrison, Jill

    2018-01-01

    Background: In the UK, general practitioners/family physicians receive pay for performance on management of long-term conditions, according to best-practice indicators. Method: Management of long-term conditions was compared between 721 adults with intellectual disabilities and the general population (n = 764,672). Prevalence of long-term…

  2. Simulated effects of recruitment variability, exploitation, and reduced habitat area on the muskellunge population in Shoepack Lake, Voyageurs National Park, Minnesota

    USGS Publications Warehouse

    Frohnauer, N.K.; Pierce, C.L.; Kallemeyn, L.W.

    2007-01-01

    The genetically unique population of muskellunge Esox masquinongy inhabiting Shoepack Lake in Voyageurs National Park, Minnesota, is potentially at risk for loss of genetic variability and long-term viability. Shoepack Lake has been subject to dramatic surface area changes from the construction of an outlet dam by beavers Castor canadensis and its subsequent failure. We simulated the long-term dynamics of this population in response to recruitment variation, increased exploitation, and reduced habitat area. We then estimated the effective population size of the simulated population and evaluated potential threats to long-term viability, based on which we recommend management actions to help preserve the long-term viability of the population. Simulations based on the population size and habitat area at the beginning of a companion study resulted in an effective population size that was generally above the threshold level for risk of loss of genetic variability, except when fishing mortality was increased. Simulations based on the reduced habitat area after the beaver dam failure and our assumption of a proportional reduction in population size resulted in an effective population size that was generally below the threshold level for risk of loss of genetic variability. Our results identified two potential threats to the long-term viability of the Shoepack Lake muskellunge population, reduction in habitat area and exploitation. Increased exploitation can be prevented through traditional fishery management approaches such as the adoption of no-kill, barbless hook, and limited entry regulations. Maintenance of the greatest possible habitat area and prevention of future habitat area reductions will require maintenance of the outlet dam built by beavers. Our study should enhance the long-term viability of the Shoepack Lake muskellunge population and illustrates a useful approach for other unique populations. ?? Copyright by the American Fisheries Society 2007.

  3. Long-term metapopulation study of the Glanville fritillary butterfly (Melitaea cinxia): survey methods, data management, and long-term population trends.

    PubMed

    Ojanen, Sami P; Nieminen, Marko; Meyke, Evgeniy; Pöyry, Juha; Hanski, Ilkka

    2013-10-01

    Long-term observational studies conducted at large (regional) spatial scales contribute to better understanding of landscape effects on population and evolutionary dynamics, including the conditions that affect long-term viability of species, but large-scale studies are expensive and logistically challenging to keep running for a long time. Here, we describe the long-term metapopulation study of the Glanville fritillary butterfly (Melitaea cinxia) that has been conducted since 1991 in a large network of 4000 habitat patches (dry meadows) within a study area of 50 by 70 km in the Åland Islands in Finland. We explain how the landscape structure has been described, including definition, delimitation, and mapping of the habitat patches; methods of field survey, including the logistics, cost, and reliability of the survey; and data management using the EarthCape biodiversity platform. We describe the long-term metapopulation dynamics of the Glanville fritillary based on the survey. There has been no long-term change in the overall size of the metapopulation, but the level of spatial synchrony and hence the amplitude of fluctuations in year-to-year metapopulation dynamics have increased over the years, possibly due to increasing frequency of exceptional weather conditions. We discuss the added value of large-scale and long-term population studies, but also emphasize the need to integrate more targeted experimental studies in the context of long-term observational studies. For instance, in the case of the Glanville fritillary project, the long-term study has produced an opportunity to sample individuals for experiments from local populations with a known demographic history. These studies have demonstrated striking differences in dispersal rate and other life-history traits of individuals from newly established local populations (the offspring of colonizers) versus individuals from old, established local populations. The long-term observational study has stimulated the development of metapopulation models and provided an opportunity to test model predictions. This combination of empirical studies and modeling has facilitated the study of key phenomena in spatial dynamics, such as extinction threshold and extinction debt.

  4. Long-term metapopulation study of the Glanville fritillary butterfly (Melitaea cinxia): survey methods, data management, and long-term population trends

    PubMed Central

    Ojanen, Sami P; Nieminen, Marko; Meyke, Evgeniy; Pöyry, Juha; Hanski, Ilkka

    2013-01-01

    Long-term observational studies conducted at large (regional) spatial scales contribute to better understanding of landscape effects on population and evolutionary dynamics, including the conditions that affect long-term viability of species, but large-scale studies are expensive and logistically challenging to keep running for a long time. Here, we describe the long-term metapopulation study of the Glanville fritillary butterfly (Melitaea cinxia) that has been conducted since 1991 in a large network of 4000 habitat patches (dry meadows) within a study area of 50 by 70 km in the Åland Islands in Finland. We explain how the landscape structure has been described, including definition, delimitation, and mapping of the habitat patches; methods of field survey, including the logistics, cost, and reliability of the survey; and data management using the EarthCape biodiversity platform. We describe the long-term metapopulation dynamics of the Glanville fritillary based on the survey. There has been no long-term change in the overall size of the metapopulation, but the level of spatial synchrony and hence the amplitude of fluctuations in year-to-year metapopulation dynamics have increased over the years, possibly due to increasing frequency of exceptional weather conditions. We discuss the added value of large-scale and long-term population studies, but also emphasize the need to integrate more targeted experimental studies in the context of long-term observational studies. For instance, in the case of the Glanville fritillary project, the long-term study has produced an opportunity to sample individuals for experiments from local populations with a known demographic history. These studies have demonstrated striking differences in dispersal rate and other life-history traits of individuals from newly established local populations (the offspring of colonizers) versus individuals from old, established local populations. The long-term observational study has stimulated the development of metapopulation models and provided an opportunity to test model predictions. This combination of empirical studies and modeling has facilitated the study of key phenomena in spatial dynamics, such as extinction threshold and extinction debt. PMID:24198935

  5. Long-term benefits of full-day kindergarten: a longitudinal population-based study

    PubMed Central

    Brownell, M.D.; Nickel, N.C.; Chateau, D.; Martens, P.J.; Taylor, C.; Crockett, L.; Katz, A.; Sarkar, J.; Burland, E.; Goh, C.Y.

    2015-01-01

    In the first longitudinal, population-based study of full-day kindergarten (FDK) outcomes beyond primary school in Canada, we used linked administrative data to follow 15 kindergarten cohorts (n ranging from 112 to 736) up to grade 9. Provincial assessments conducted in grades 3, 7, and 8 and course marks and credits earned in grade 9 were compared between FDK and half-day kindergarten (HDK) students in both targeted and universal FDK programmes. Propensity score matched cohort and stepped-wedge designs allowed for stronger causal inferences than previous research on FDK. We found limited long-term benefits of FDK, specific to the type of programme, outcomes examined, and subpopulations. FDK programmes targeted at low-income areas showed long-term improvements in numeracy for lower income girls. Our results suggest that expectations for wide-ranging long-term academic benefits of FDK are unwarranted. PMID:25632172

  6. Bowel, Urinary, and Sexual Problems Among Long-Term Prostate Cancer Survivors: A Population-Based Study

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

    Mols, Floortje; Comprehensive Cancer Centre South; Korfage, Ida J.

    Purpose: To obtain insight into the long-term (5- to 10-year) effects of prostate cancer and treatment on bowel, urinary, and sexual function, we performed a population-based study. Prostate-specific function was compared with an age-matched normative population without prostate cancer. Methods and Materials: Through the population-based Eindhoven Cancer Registry, we selected all men diagnosed with prostate cancer between 1994 and 1998 in the southern Netherlands. In total, 964 patients, alive in November 2004, received questionnaire; 780 (81%) responded. Results: Urinary problems were most common after a prostatectomy; bowel problems were most common after radiotherapy. Compared with an age-matched normative population bothmore » urinary and bowel functioning and bother were significantly worse among survivors. Urinary incontinence was reported by 23-48% of survivors compared with 4% of the normative population. Bowel leakage occurred in 5-14% of patients compared with 2% of norms. Erection problems occurred in 40-74% of patients compared with 18% of norms. Conclusions: These results form an important contribution to the limited information available on prostate-specific problems in the growing group of long-term prostate cancer survivors. Bowel, urinary, and sexual problems occur more often among long-term survivors compared with a reference group and cannot be explained merely by age. Because these problems persist for many years, urologists should provide patients with adequate information before treatment. After treatment, there should be an appropriate focus on these problems.« less

  7. Individual based, long term monitoring of acacia trees in hyper arid zone: Integration of a field survey and a remote sensing approach

    NASA Astrophysics Data System (ADS)

    Isaacson, Sivan; Blumberg, Dan G.; Ginat, Hanan; Shalmon, Benny

    2013-04-01

    Vegetation in hyper arid zones is very sparse as is. Monitoring vegetation changes in hyper arid zones is important because any reduction in the vegetation cover in these areas can lead to a considerable reduction in the carrying capacity of the ecological system. This study focuses on the impact of climate fluctuations on the acacia population in the southern Arava valley, Israel. The period of this survey includes a sequence of dry years with no flashfloods in most of the plots that ended in two years with vast floods. Arid zone acacia trees play a significant role in the desert ecosystem by moderating the extreme environmental conditions including radiation, temperature, humidity and precipitation. The trees also provide nutrients for the desert dwellers. Therefore, acacia trees in arid zones are considered to be `keystone species', because they have major influence over both plants and animal species, i.e., biodiversity. Long term monitoring of the acacia tree population in this area can provide insights into long term impacts of climate fluctuations on ecosystems in arid zones. Since 2000, a continuous yearly based survey on the three species of acacia population in seven different plots is conducted in the southern Arava (established by Shalmon, ecologist of the Israel nature and parks authority). The seven plots representing different ecosystems and hydrological regimes. A yearly based population monitoring enabled us to determine the mortality and recruitment rate of the acacia populations as well as growing rates of individual trees. This survey provides a unique database of the acacia population dynamics during a sequence of dry years that ended in a vast flood event during the winter of 2010. A lack of quantitative, nondestructive methods to estimate and monitor stress status of the acacia trees, led us to integrate remote sensing tools (ground and air-based) along with conventional field measurements in order to develop a long term monitoring of acacia trees in hyper arid zones. This study includes further work on the development of ground based remote sensing as a new tool to monitor stress indicators as part of long term ecological research. Since acacia trees are long lived, we were able to identify individual trees in satellite images from 1968 (corona) and expand our monitoring "into the past". Remote sensing expands the spatial and temporal database and is thus a powerful tool for long term monitoring in arid zones, where access is limited and long-term ground data are rare.

  8. Management and prevalence of long-term conditions in primary health care for adults with intellectual disabilities compared with the general population: A population-based cohort study.

    PubMed

    Cooper, Sally-Ann; Hughes-McCormack, Laura; Greenlaw, Nicola; McConnachie, Alex; Allan, Linda; Baltzer, Marion; McArthur, Laura; Henderson, Angela; Melville, Craig; McSkimming, Paula; Morrison, Jill

    2018-01-01

    In the UK, general practitioners/family physicians receive pay for performance on management of long-term conditions, according to best-practice indicators. Management of long-term conditions was compared between 721 adults with intellectual disabilities and the general population (n = 764,672). Prevalence of long-term conditions was determined, and associated factors were investigated via logistic regression analyses. Adults with intellectual disabilities received significantly poorer management of all long-term conditions on 38/57 (66.7%) indicators. Achievement was high (75.1%-100%) for only 19.6% of adults with intellectual disabilities, compared with 76.8% of the general population. Adults with intellectual disabilities had higher rates of epilepsy, psychosis, hypothyroidism, asthma, diabetes and heart failure. There were no clear associations with neighbourhood deprivation. Adults with intellectual disabilities receive poorer care, despite conditions being more prevalent. The imperative now is to find practical, implementable means of supporting the challenges that general practices face in delivering equitable care. © 2017 John Wiley & Sons Ltd.

  9. Long-term effective population size dynamics of an intensively monitored vertebrate population

    PubMed Central

    Mueller, A-K; Chakarov, N; Krüger, O; Hoffman, J I

    2016-01-01

    Long-term genetic data from intensively monitored natural populations are important for understanding how effective population sizes (Ne) can vary over time. We therefore genotyped 1622 common buzzard (Buteo buteo) chicks sampled over 12 consecutive years (2002–2013 inclusive) at 15 microsatellite loci. This data set allowed us to both compare single-sample with temporal approaches and explore temporal patterns in the effective number of parents that produced each cohort in relation to the observed population dynamics. We found reasonable consistency between linkage disequilibrium-based single-sample and temporal estimators, particularly during the latter half of the study, but no clear relationship between annual Ne estimates () and census sizes. We also documented a 14-fold increase in between 2008 and 2011, a period during which the census size doubled, probably reflecting a combination of higher adult survival and immigration from further afield. Our study thus reveals appreciable temporal heterogeneity in the effective population size of a natural vertebrate population, confirms the need for long-term studies and cautions against drawing conclusions from a single sample. PMID:27553455

  10. The association between alcohol use and long-term care placement among older Canadians: A 14-year population-based study

    PubMed Central

    Kaplan, Mark S.; Huguet, Nathalie; Feeny, David; McFarland, Bentson H.; Caetano, Raul; Bernier, Julie; Giesbrecht, Norman; Oliver, Lisa; Ramage-Morin, Pamela; Ross, Nancy A.

    2013-01-01

    Studies have shown that moderate alcohol use confers protection against some of the dominant predictors of long-term care placement, including diminished cognitive functioning, physical disability, and injury. But little is known about the association between alcohol use and the likelihood of placement in long-term care facilities. A nationally representative sample of 5,404 community-dwelling Canadians ages 50 years and older at baseline (1994/95) was obtained from the longitudinal National Population Health Survey. Alcohol use categories were developed based on the quantity and frequency of use in the 12 months before the interview. Cox proportional hazards models were used to estimate the association between alcohol use at baseline and subsequent placement in long-term care facilities after adjusting for covariates measured at baseline. During the 14-year follow-up period, 14% of lifetime abstainers, 10% of former drinkers, 7% of infrequent drinkers, 4% of moderate drinkers, and 3% of heavy drinkers were placed in long-term care facilities. Furthermore, the multivariate analysis revealed that abstainers, former drinkers, and infrequent drinkers were more than twice as likely to be placed in long-term care as moderate drinkers. Moderate drinking was protective against placement in long-term care facilities even after adjusting for an array of well-known confounders. The strong protective effect of moderate alcohol use on long-term care entry is likely due to a complex mix of physical, cognitive and psychosocial health factors. PMID:24169370

  11. Addictive behaviors related to opioid use for chronic pain: a population-based study.

    PubMed

    Højsted, Jette; Ekholm, Ola; Kurita, Geana Paula; Juel, Knud; Sjøgren, Per

    2013-12-01

    The growing body of research showing increased opioid use in patients with chronic pain coupled with concerns regarding addiction encouraged the development of this population-based study. The goal of the study was to investigate the co-occurrence of indicators of addictive behaviors in patients with chronic non-cancer pain in long-term opioid treatment. The study combined data from the individual-based Danish Health Survey in 2010 and the official Danish health and socio-economic, individual-based registers. From a simple random sample of 25,000 adults (16 years or older) living in Denmark, 13,281 individuals were analyzed through multiple logistic regression analyses to assess the association between chronic pain (lasting ≥6 months), opioid use, health behavior, and body mass index. Six potential addictive behaviors were identified: daily smoking; high alcohol intake; illicit drug use in the past year; obesity; long-term use of benzodiazepines; and long-term use of benzodiazepine-related drugs. At least 2 of the 6 addictive behaviors were observed in 22.6% of the long-term opioid users with chronic pain compared with 11.5% of the non-opioid users with chronic pain and 8.9% of the individuals without chronic pain. Thus, a strong association was demonstrated between long-term opioid use and the clustering of addictive behaviors. An intricate relationship between chronic pain, opioid use, and addictive behaviors was observed in this study, which deserves both clinical attention and further research. Copyright © 2013 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

  12. Closer to home (or home alone?) The British Columbia long-term care system in transition.

    PubMed Central

    Brody, B L; Simon, H J; Stadler, K L

    1997-01-01

    Finding ways to organize and deliver long-term care that provides for quality of life at an affordable price is of increasing importance as the population ages, family size decreases, and women enter the workforce. For the past 2 decades, British Columbia has provided a model system that has apparently avoided disruptive conflicts. Although formal users' complaints are rare, this study--based on focus groups and interviews with users, their families, and advocates--identified problems users encountered toward resolving concerns about the structure, process, and outcome of long-term care. We present these findings in the context of British Columbia's current devolution from provincial to regional control that aims to save costs and keep disabled elderly persons in the community. British Columbia may be continuing to lead the way in meeting the needs of its burgeoning elderly population for long-term care. Study findings have implications for the development of US long-term care policy by pointing to the value of obtaining users' views of long-term care to identify both obvious and more subtle trouble spots. PMID:9392982

  13. Recent range expansion of a terrestrial orchid corresponds with climate-driven variation in its population dynamics.

    PubMed

    van der Meer, Sascha; Jacquemyn, Hans; Carey, Peter D; Jongejans, Eelke

    2016-06-01

    The population dynamics and distribution limits of plant species are predicted to change as the climate changes. However, it remains unclear to what extent climate variables affect population dynamics, which vital rates are most sensitive to climate change, and whether the same vital rates drive population dynamics in different populations. In this study, we used long-term demographic data from two populations of the terrestrial orchid Himantoglossum hircinum growing at the northern edge of their geographic range to quantify the influence of climate change on demographic vital rates. Integral projection models were constructed to study how climate conditions between 1991 and 2006 affected population dynamics and to assess how projected future climate change will affect the long-term viability of this species. Based on the parameterised vital rate functions and the observed climatic conditions, one of the studied populations had an average population growth rate above 1 (λ = 1.04), while the other was declining at ca. 3 % year(-1) (λ = 0.97). Variation in temperature and precipitation mainly affected population growth through their effect on survival and fecundity. Based on UK Climate Projection 2009 estimates of future climate conditions for three greenhouse gas emission scenarios, population growth rates are expected to increase in one of the studied populations. Overall, our results indicate that the observed changes in climatic conditions appeared to be beneficial to the long-term survival of the species in the UK and suggest that they may have been the driving force behind the current range expansion of H. hircinum in England.

  14. Long- and short-term exposure to PM2.5 and mortality: using novel exposure models.

    PubMed

    Kloog, Itai; Ridgway, Bill; Koutrakis, Petros; Coull, Brent A; Schwartz, Joel D

    2013-07-01

    Many studies have reported associations between ambient particulate matter (PM) and adverse health effects, focused on either short-term (acute) or long-term (chronic) PM exposures. For chronic effects, the studied cohorts have rarely been representative of the population. We present a novel exposure model combining satellite aerosol optical depth and land-use data to investigate both the long- and short-term effects of PM2.5 exposures on population mortality in Massachusetts, United States, for the years 2000-2008. All deaths were geocoded. We performed two separate analyses: a time-series analysis (for short-term exposure) where counts in each geographic grid cell were regressed against cell-specific short-term PM2.5 exposure, temperature, socioeconomic data, lung cancer rates (as a surrogate for smoking), and a spline of time (to control for season and trends). In addition, for long-term exposure, we performed a relative incidence analysis using two long-term exposure metrics: regional 10 × 10 km PM2.5 predictions and local deviations from the cell average based on land use within 50 m of the residence. We tested whether these predicted the proportion of deaths from PM-related causes (cardiovascular and respiratory diseases). For short-term exposure, we found that for every 10-µg/m increase in PM 2.5 exposure there was a 2.8% increase in PM-related mortality (95% confidence interval [CI] = 2.0-3.5). For the long-term exposure at the grid cell level, we found an odds ratio (OR) for every 10-µg/m increase in long-term PM2.5 exposure of 1.6 (CI = 1.5-1.8) for particle-related diseases. Local PM2.5 had an OR of 1.4 (CI = 1.3-1.5), which was independent of and additive to the grid cell effect. We have developed a novel PM2.5 exposure model based on remote sensing data to assess both short- and long-term human exposures. Our approach allows us to gain spatial resolution in acute effects and an assessment of long-term effects in the entire population rather than a selective sample from urban locations.

  15. Labour market participation and sick leave among patients diagnosed with myasthenia gravis in Denmark 1997-2011: a Danish nationwide cohort study.

    PubMed

    Frost, Asger; Svendsen, Marie Louise; Rahbek, Jes; Stapelfeldt, Christina Malmose; Nielsen, Claus Vinther; Lund, Thomas

    2016-11-17

    To examine labour market participation and long-term sick leave following a diagnosis with myasthenia gravis (MG) compared with the general Danish population and for specific subgroups of MG patients. A nationwide matched cohort study from 1997 to 2011 using data from population-based medical and social registries. The study includes 330 MG patients aged 18 to 65 years old identified from hospital diagnoses and dispensed prescriptions, and twenty references from the Danish population matching each MG patient on age, gender, and profession. Main outcome measures are labour market participation (yes/no) and long-term sick leave ≥9 weeks (yes/no) with follow-up at 1- and 2 years after the time of MG diagnosis or match. Based on complete person-level information on all public transfer payments in Denmark, persons having no labour market participation are defined as individuals receiving social benefits for severely reduced workability, flexijob, and disability pension. MG is consistently associated with higher odds of having no labour market participation and long-term sick leave compared with the general Danish population (no labour market participation & ≥9 weeks sick leave at 2-year follow-up, adjusted OR (95% CI): 5.76 (4.13 to 8.04) & 8.60 (6.60 to 11.23)). Among MG patients, females and patients treated with both acetylcholinesterase inhibitors and immunosuppression have higher odds of lost labour market participation and long-term sick leave. This study suggests that MG patients have almost 6 times higher odds of no labour market participation and almost 9 times higher odds of long-term sick leave 2 years after diagnosis compared with the general Danish population. In particular female MG patients and patients treated with both acetylcholinesterase and immunosuppression have high odds of a negative labour market outcome. Future research should focus on predictors in workplace and labour market policy of labour market participation among MG patients.

  16. Association between hyperglycaemic crisis and long-term major adverse cardiovascular events: a nationwide population-based, propensity score-matched, cohort study

    PubMed Central

    Chang, Li-Hsin; Lin, Liang-Yu; Tsai, Ming-Tsun; How, Chorng-Kuang; Chiang, Jen-Huai; Hsieh, Vivian Chia-Rong; Hu, Sung-Yuan; Hsieh, Ming-Shun

    2016-01-01

    Objective Hyperglycaemic crisis was associated with significant intrahospital morbidity and mortality. However, the association between hyperglycaemic crisis and long-term cardiovascular outcomes remained unknown. This study aimed to investigate the association between hyperglycaemic crisis and subsequent long-term major adverse cardiovascular events (MACEs). Participants and methods This population-based cohort study was conducted using data from Taiwan's National Health Insurance Research Database for the period of 1996–2012. A total of 2171 diabetic patients with hyperglycaemic crisis fit the inclusion criteria. Propensity score matching was used to match the baseline characteristics of the study cohort to construct a comparison cohort which comprised 8684 diabetic patients without hyperglycaemic crisis. The risk of long-term MACEs was compared between the two cohorts. Results Six hundred and seventy-six MACEs occurred in the study cohort and the event rate was higher than that in the comparison cohort (31.1% vs 24.1%, p<0.001). Patients with hyperglycaemic crisis were associated with a higher risk of long-term MACEs even after adjusting for all baseline characteristics and medications (adjusted HR=1.76, 95% CI 1.62 to 1.92, p<0.001). Acute myocardial infarction had the highest adjusted HR (adjusted HR=2.19, 95% CI 1.75 to 2.75, p<0.001) in the four types of MACEs, followed by congestive heart failure (adjusted HR=1.97, 95% CI 1.70 to 2.28, p<0.001). Younger patients with hyperglycaemic crisis had a higher risk of MACEs than older patients (adjusted HR=2.69 for patients aged 20–39 years vs adjusted HR=1.58 for patients aged >65 years). Conclusions Hyperglycaemic crisis was significantly associated with long-term MACEs, especially in the young population. Further prospective longitudinal study should be conducted for validation. PMID:27554106

  17. Association between hyperglycaemic crisis and long-term major adverse cardiovascular events: a nationwide population-based, propensity score-matched, cohort study.

    PubMed

    Chang, Li-Hsin; Lin, Liang-Yu; Tsai, Ming-Tsun; How, Chorng-Kuang; Chiang, Jen-Huai; Hsieh, Vivian Chia-Rong; Hu, Sung-Yuan; Hsieh, Ming-Shun

    2016-08-23

    Hyperglycaemic crisis was associated with significant intrahospital morbidity and mortality. However, the association between hyperglycaemic crisis and long-term cardiovascular outcomes remained unknown. This study aimed to investigate the association between hyperglycaemic crisis and subsequent long-term major adverse cardiovascular events (MACEs). This population-based cohort study was conducted using data from Taiwan's National Health Insurance Research Database for the period of 1996-2012. A total of 2171 diabetic patients with hyperglycaemic crisis fit the inclusion criteria. Propensity score matching was used to match the baseline characteristics of the study cohort to construct a comparison cohort which comprised 8684 diabetic patients without hyperglycaemic crisis. The risk of long-term MACEs was compared between the two cohorts. Six hundred and seventy-six MACEs occurred in the study cohort and the event rate was higher than that in the comparison cohort (31.1% vs 24.1%, p<0.001). Patients with hyperglycaemic crisis were associated with a higher risk of long-term MACEs even after adjusting for all baseline characteristics and medications (adjusted HR=1.76, 95% CI 1.62 to 1.92, p<0.001). Acute myocardial infarction had the highest adjusted HR (adjusted HR=2.19, 95% CI 1.75 to 2.75, p<0.001) in the four types of MACEs, followed by congestive heart failure (adjusted HR=1.97, 95% CI 1.70 to 2.28, p<0.001). Younger patients with hyperglycaemic crisis had a higher risk of MACEs than older patients (adjusted HR=2.69 for patients aged 20-39 years vs adjusted HR=1.58 for patients aged >65 years). Hyperglycaemic crisis was significantly associated with long-term MACEs, especially in the young population. Further prospective longitudinal study should be conducted for validation. 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/

  18. POPULATION-LEVEL RESPONSE OF THE MYSID, AMERICAMYSIS BAHIA, TO VARYING THIOBENCARB CONCENTRATIONS BASED ON AGE-STRUCTURED POPULATION MODELS

    EPA Science Inventory

    To fully understand the potential long-term ecological impacts a pollutant has on a species, population-level effects must be estimated. Since long-term field experiments are typically not feasible, vital rates such as survival, growth, and reproduction of individual organisms ar...

  19. An explorative, population-based study of female disability pensioners: the role of childhood conditions and alcohol abuse/dependence.

    PubMed

    Upmark, Marianne; Thundal, Kajsa-Lena

    2002-01-01

    This study investigates the association in women between conditions during childhood and adolescence and alcohol dependence or abuse in adulthood on the one hand, and disability pensions and long-term sickness absence on the other. A stratified population-based sample of women in Göteborg was interviewed. For analyses in this study the following variables were selected from the interview protocol: childhood and adolescence, education, employment, social class, self-rated physical health and alcohol dependence or abuse (ADA), with diagnoses assessed according to DSM-III-R. Information on disability pension and sickness absence was obtained from the local Social Insurance Office. Unfavourable conditions during childhood and adolescence and school difficulties as well as early deviant behaviours predicted disability pension and long-term sickness absence in adulthood. For most risk factors ADA could explain only a minor part of the odds ratios found in crude and age-adjusted analyses. It is concluded that conditions early in life are predictors in women of disability pension and long-term incapacity to work. There are similarities in the pattern of early risk factors for later alcohol dependence or abuse and for disability pension/long-term sickness absence.

  20. Long-Term Economic and Labor Forecast Trends for Washington. 1996.

    ERIC Educational Resources Information Center

    Lefberg, Irv; And Others

    This publication provides actual historical and long-term forecast data on labor force, total wage and salary employment, industry employment, and personal income for the state of Washington. The data are based upon the Washington Office of Financial Management long-term population forecast. Chapter 1 presents long-term forecasts of Washington…

  1. Aspects of Quality of Life in Adults Diagnosed with Autism in Childhood: A Population-Based Study

    ERIC Educational Resources Information Center

    Billstedt, Eva; Gillberg, I. Carina; Gillberg, Christopher

    2011-01-01

    The present study is a long-term prospective follow-up study of a population-based cohort of 120 individuals diagnosed with autism in childhood, followed into late adolescence/early adulthood. Specific aims of the study were to attempt to measure and study social aspects/quality of life in those 108 individuals with autism alive and available for…

  2. Using dynamic population simulations to extend resource selection analyses and prioritize habitats for conservation

    USGS Publications Warehouse

    Heinrichs, Julie; Aldridge, Cameron L.; O'Donnell, Michael; Schumaker, Nathan

    2017-01-01

    Prioritizing habitats for conservation is a challenging task, particularly for species with fluctuating populations and seasonally dynamic habitat needs. Although the use of resource selection models to identify and prioritize habitat for conservation is increasingly common, their ability to characterize important long-term habitats for dynamic populations are variable. To examine how habitats might be prioritized differently if resource selection was directly and dynamically linked with population fluctuations and movement limitations among seasonal habitats, we constructed a spatially explicit individual-based model for a dramatically fluctuating population requiring temporally varying resources. Using greater sage-grouse (Centrocercus urophasianus) in Wyoming as a case study, we used resource selection function maps to guide seasonal movement and habitat selection, but emergent population dynamics and simulated movement limitations modified long-term habitat occupancy. We compared priority habitats in RSF maps to long-term simulated habitat use. We examined the circumstances under which the explicit consideration of movement limitations, in combination with population fluctuations and trends, are likely to alter predictions of important habitats. In doing so, we assessed the future occupancy of protected areas under alternative population and habitat conditions. Habitat prioritizations based on resource selection models alone predicted high use in isolated parcels of habitat and in areas with low connectivity among seasonal habitats. In contrast, results based on more biologically-informed simulations emphasized central and connected areas near high-density populations, sometimes predicted to be low selection value. Dynamic models of habitat use can provide additional biological realism that can extend, and in some cases, contradict habitat use predictions generated from short-term or static resource selection analyses. The explicit inclusion of population dynamics and movement propensities via spatial simulation modeling frameworks may provide an informative means of predicting long-term habitat use, particularly for fluctuating populations with complex seasonal habitat needs. Importantly, our results indicate the possible need to consider habitat selection models as a starting point rather than the common end point for refining and prioritizing habitats for protection for cyclic and highly variable populations.

  3. Long-term mortality among older adults with burn injury: a population-based study in Australia

    PubMed Central

    Boyd, James H; Rea, Suzanne; Randall, Sean M; Wood, Fiona M

    2015-01-01

    Abstract Objective To assess if burn injury in older adults is associated with changes in long-term all-cause mortality and to estimate the increased risk of death attributable to burn injury. Methods We conducted a population-based matched longitudinal study – based on administrative data from Western Australia’s hospital morbidity data system and death register. A cohort of 6014 individuals who were aged at least 45 years when hospitalized for a first burn injury in 1980–2012 was identified. A non-injury comparison cohort, randomly selected from Western Australia’s electoral roll (n = 25 759), was matched to the patients. We used Kaplan–Meier plots and Cox proportional hazards regression to analyse the data and generated mortality rate ratios and attributable risk percentages. Findings For those hospitalized with burns, 180 (3%) died in hospital and 2498 (42%) died after discharge. Individuals with burn injury had a 1.4-fold greater mortality rate than those with no injury (95% confidence interval, CI: 1.3–1.5). In this cohort, the long-term mortality attributable to burn injury was 29%. Mortality risk was increased by both severe and minor burns, with adjusted mortality rate ratios of 1.3 (95% CI: 1.1–1.9) and 2.1 (95% CI: 1.9–2.3), respectively. Conclusion Burn injury is associated with increased long-term mortality. In our study population, sole reliance on data on in-hospital deaths would lead to an underestimate of the true mortality burden associated with burn injury. PMID:26240461

  4. Early Seizure Frequency and Aetiology Predict Long-Term Medical Outcome in Childhood-Onset Epilepsy

    ERIC Educational Resources Information Center

    Sillanpaa, Matti; Schmidt, Dieter

    2009-01-01

    In clinical practice, it is important to predict as soon as possible after diagnosis and starting treatment, which children are destined to develop medically intractable seizures and be at risk of increased mortality. In this study, we determined factors predictive of long-term seizure and mortality outcome in a population-based cohort of 102…

  5. Same-Sex Couples' Decisions and Experiences of Marriage in the Context of Minority Stress: Interviews From a Population-Based Longitudinal Study.

    PubMed

    Rostosky, Sharon S; Riggle, Ellen D B; Rothblum, Esther D; Balsam, Kimberly F

    2016-08-01

    In the emerging context of marriage equality, it is important to explore the reasons for and experience of marriage for long-term same-sex couples, including the role of minority stress. In Wave 3 of the population-based, longitudinal CUPPLES Study we interviewed 21 long-term same-sex couples (14 female, 7 male) who resided in 12 different states and who were legally married. Couple members ranged in age from 37 to 84 and reported being together as a couple from 15 to 41 years. Seven couples lived in states that did not recognize their marriage at the time of the interview. Legal protection and social validation emerged as the two primary domains that captured couples' lived experiences of marriage. Minority stress experiences emerged in the narratives in the context of couples' long-term commitment, the availability of civil marriage, and couples' participation in activist efforts on behalf of marriage equality for themselves and others.

  6. Long-Term Benefits of Full-Day Kindergarten: A Longitudinal Population-Based Study

    ERIC Educational Resources Information Center

    Brownell, M. D.; Nickel, N. C.; Chateau, D.; Martens, P. J.; Taylor, C.; Crockett, L.; Katz, A.; Sarkar, J.; Burland, E.; Goh, C. Y.

    2015-01-01

    In the first longitudinal, population-based study of full-day kindergarten (FDK) outcomes beyond primary school in Canada, we used linked administrative data to follow 15 kindergarten cohorts (n ranging from 112 to 736) up to grade 9. Provincial assessments conducted in grades 3, 7, and 8 and course marks and credits earned in grade 9 were…

  7. Dilution as a Model of Long-Term Forgetting

    ERIC Educational Resources Information Center

    Lansdale, Mark; Baguley, Thom

    2008-01-01

    This article presents a model of long term forgetting based on 3 ideas: (a) Memory for a stimulus can be described by a population of accessible traces; (b) probability of retrieval after a delay is predicted by the proportion of traces in this population that will be defined as correct if sampled; and (c) this population is diluted over time by…

  8. Addressing long-term physical healthcare needs in a forensic mental health inpatient population using the UK primary care Quality and Outcomes Framework (QOF): an audit.

    PubMed

    Ivbijaro, Go; Kolkiewicz, LA; McGee, Lsf; Gikunoo, M

    2008-03-01

    Objectives This audit aims to evaluate the effectiveness of delivering an equivalent primary care service to a long-term forensic psychiatric inpatient population, using the UK primary care national Quality and Outcomes Framework (QOF).Method The audit compares the targets met by the general practitioner with special interest (GPwSI) service, using local and national QOF benchmarks (2005-2006), and determines the prevalence of chronic disease in a long-term inpatient forensic psychiatry population.Results The audit results show that the UK national QOF is a useful tool for assessment and evaluation of physical healthcare needs in a non-community based population. It shows an increased prevalence of all QOF-assessed long-term physical conditions when compared to the local East London population and national UK population, confirming previously reported elevated levels of physical healthcare need in psychiatric populations.Conclusions This audit shows that the UK General Practice QOF can be used as a standardised instrument for commissioning and monitoring the delivery of physical health services to in-patient psychiatric populations, and for the evaluation of the effectiveness of clinical interventions in long-term physical conditions. The audit also demonstrates the effectiveness of using a GPwSI in healthcare delivery in non-community based settings. We suggest that the findings may be generalisable to other long-term inpatient psychiatric and prison populations in order to further the objective of delivering an equivalent primary care service to all populations.The QOF is a set of national primary care audit standards and is freely available on the British Medical Association website or the UK Department of Health website. We suggest that primary care workers in health economies who have not yet developed their own national primary care standards can access and adapt these standards in order to improve the clinical standards of care given to the primary care populations that they serve.

  9. Addressing long-term physical healthcare needs in a forensic mental health inpatient population using the UK primary care Quality and Outcomes Framework (QOF): an audit

    PubMed Central

    2008-01-01

    Objectives This audit aims to evaluate the effectiveness of delivering an equivalent primary care service to a long-term forensic psychiatric inpatient population, using the UK primary care national Quality and Outcomes Framework (QOF). Method The audit compares the targets met by the general practitioner with special interest (GPwSI) service, using local and national QOF benchmarks (2005–2006), and determines the prevalence of chronic disease in a long-term inpatient forensic psychiatry population. Results The audit results show that the UK national QOF is a useful tool for assessment and evaluation of physical healthcare needs in a non-community based population. It shows an increased prevalence of all QOF-assessed long-term physical conditions when compared to the local East London population and national UK population, confirming previously reported elevated levels of physical healthcare need in psychiatric populations. Conclusions This audit shows that the UK General Practice QOF can be used as a standardised instrument for commissioning and monitoring the delivery of physical health services to in-patient psychiatric populations, and for the evaluation of the effectiveness of clinical interventions in long-term physical conditions. The audit also demonstrates the effectiveness of using a GPwSI in healthcare delivery in non-community based settings. We suggest that the findings may be generalisable to other long-term inpatient psychiatric and prison populations in order to further the objective of delivering an equivalent primary care service to all populations. The QOF is a set of national primary care audit standards and is freely available on the British Medical Association website or the UK Department of Health website. We suggest that primary care workers in health economies who have not yet developed their own national primary care standards can access and adapt these standards in order to improve the clinical standards of care given to the primary care populations that they serve. PMID:22477846

  10. Long-term mortality rates (>8-year) improve as compared to the general and obese population following bariatric surgery.

    PubMed

    Telem, Dana A; Talamini, Mark; Shroyer, A Laurie; Yang, Jie; Altieri, Maria; Zhang, Qiao; Gracia, Gerald; Pryor, Aurora D

    2015-03-01

    Sparse data are available on long-term patient mortality following bariatric surgery as compared to the general population. The purpose of this study was to assess long-term mortality rates and identify risk factors for all-cause mortality following bariatric surgery. New York State (NYS) Planning and Research Cooperative System (SPARCS) longitudinal administrative data were used to identify 7,862 adult patients who underwent a primary laparoscopic bariatric surgery from 1999 to 2005. The Social Security Death Index database identified >30-day mortalities. Risk factors for mortality were screened using a univariate Cox proportional hazard (PH) model and analyzed using a multiple PH model. Based on age, gender, and race/ethnicity, actuarial projections for NYS mortality rates obtained from Centers of Disease Control were compared to the actual post-bariatric surgery mortality rates observed. The mean bariatric mortality rate was 2.5 % with 8-14 years of follow-up. Mean time to death ranged from 4 to 6 year and did not differ by operation (p = 0.073). From 1999 to 2010, the actuarial mortality rate predicted for the general NYS population was 2.1 % versus the observed 1.5 % for the bariatric surgery population (p = 0.005). Extrapolating to 2013, demonstrated the actuarial mortality predictions at 3.1 % versus the bariatric surgery patients' observed morality rate of 2.5 % (p = 0.01). Risk factors associated with an earlier time to death included: age, male gender, Medicare/Medicaid insurance, congestive heart failure, rheumatoid arthritis, pulmonary circulation disorders, and diabetes. No procedure-specific or perioperative complication impact for time-to-death was found. Long-term mortality rate of patients undergoing bariatric surgery significantly improves as compared to the general population regardless of bariatric operation performed. Additionally, perioperative complications do not increase long-term mortality risk. This study did identify specific patient risk factors for long-term mortality. Special attention and consideration should be given to these "at risk" patient sub-populations.

  11. Fatigue among short- and long-term thyroid cancer survivors: results from the population-based PROFILES registry.

    PubMed

    Husson, Olga; Nieuwlaat, Willy-Anne; Oranje, Wilma A; Haak, Harm R; van de Poll-Franse, Lonneke V; Mols, Floortje

    2013-10-01

    The aims of this study were (i) to obtain insight into the prevalence of fatigue among short- and long-term thyroid cancer (TC) survivors, by comparing a sample of TC survivors with an age- and sex-matched normative population, and (ii) to investigate which demographic, clinical, and TC-specific health-related quality of life (HRQoL) characteristics were associated with fatigue. All patients found to have TC between 1990 and 2008, as registered in the Eindhoven Cancer Registry, received a cross-sectional survey on fatigue (Fatigue Assessment Scale), TC-specific HRQoL (THYCA-QoL), and psychological distress (Hospital Anxiety and Depression Scale). The fatigue scores were compared with those of an age- and sex-matched normative population (n=530). Multiple logistic regression analyses were conducted to investigate the independent associations between clinical and demographic characteristics, TC-specific HRQoL, and psychological distress with fatigue. Eighty-six percent (n=306) responded. TC survivors were more often classified as fatigued or very fatigued (short-term <5 years: 43%; long-term 5-10 years: 44%; long-term 10-15 years: 47%; long-term >15 years: 39%) compared to the normative population (25%; p<0.001). Anxiety (odds ratio (OR) 1.15, 95% confidence interval [CI] 1.03-1.28) and depression (OR 1.43 [CI 1.22-1.68]) were associated with fatigue, as was also the case for TC-specific neuromuscular (OR 1.03 [CI 1.01-1.06]), concentration (OR 1.03 [CI 1.01-1.06]), and psychological TC-specific HRQoL (OR 1.06 [CI 1.02-1.10]). Short- and long-term TC survivors report higher levels of fatigue than an age- and sex-matched normative population do. Both TC-specific HRQoL and psychological distress were associated with fatigue.

  12. Individuals and populations: the role of long-term, individual-based studies of animals in ecology and evolutionary biology.

    PubMed

    Clutton-Brock, Tim; Sheldon, Ben C

    2010-10-01

    Many important questions in ecology and evolutionary biology can only be answered with data that extend over several decades and answering a substantial proportion of questions requires records of the life histories of recognisable individuals. We identify six advantages that long-term, individual based studies afford in ecology and evolution: (i) analysis of age structure; (ii) linkage between life history stages; (iii) quantification of social structure; (iv) derivation of lifetime fitness measures; (v) replication of estimates of selection; (vi) linkage between generations, and we review their impact on studies in six key areas of evolution and ecology. Our review emphasises the unusual opportunities and productivity of long-term, individual-based studies and documents the important role that they play in research on ecology and evolutionary biology as well as the difficulties they face. Copyright © 2010 Elsevier Ltd. All rights reserved.

  13. Limitations of basing screening policies on screening trials: The US Preventive Services Task Force and Prostate Cancer Screening.

    PubMed

    Etzioni, Ruth; Gulati, Roman; Cooperberg, Matt R; Penson, David M; Weiss, Noel S; Thompson, Ian M

    2013-04-01

    The US Preventive Services Task Force recently recommended against prostate-specific antigen screening for prostate cancer based primarily on evidence from the European Randomized Study of Screening for Prostate Cancer (ERSPC) and the US Prostate, Lung, Colorectal, and Ovarian (PLCO) cancer screening trial. : To examine limitations of basing screening policy on evidence from screening trials. We reviewed published modeling studies that examined population and trial data. The studies (1) project the roles of screening and changes in primary treatment in the US mortality decline; (2) extrapolate the ERSPC mortality reduction to the long-term US setting; (3) estimate overdiagnosis based on US incidence trends; and (4) quantify the impact of control arm screening on PLCO mortality results. Screening plausibly explains 45% and changes in primary treatment can explain 33% of the US prostate cancer mortality decline. Extrapolating the ERSPC results to the long-term US setting implies an absolute mortality reduction at least 5 times greater than that observed in the trial. Approximately 28% of screen-detected cases are overdiagnosed in the United States versus 58% of screen-detected cases suggested by the ERSPC results. Control arm screening can explain the null result in the PLCO trial. Modeling studies indicate that population trends and trial results extended to the long-term population setting are consistent with greater benefit of prostate-specific antigen screening-and more favorable harm-benefit tradeoffs-than has been suggested by empirical trial evidence.

  14. Correlates of preferences for autonomy in long-term care: results of a population-based survey among older individuals in Germany.

    PubMed

    Hajek, André; Lehnert, Thomas; Wegener, Annemarie; Riedel-Heller, Steffi G; König, Hans-Helmut

    2018-01-01

    Thus far, there is little evidence concerning the factors associated with preferences for autonomy in long-term care. Therefore, the aim of the present study was to investigate the correlates of preferences for autonomy in long-term care among older individuals in Germany. Data were gathered from a population-based survey of the German population aged ≥65 years in 2015 (N=1,006). Multiple logistic regressions revealed that preferences for freedom of choice for foods were positively associated with living with partner or spouse (OR: 1.5 [1.0-2.2]), being born in Germany (OR: 1.9 [1.1-3.3]), and lower self-rated health (OR: 1.3 [1.1-1.6]). Preferences for freedom in choosing bedtime and sleep duration were positively associated with lower age (OR: 1.1 [1.0-1.1]) and having children (OR: 2.2 [1.0-4.9]). Preferences for customized living space were positively associated with being female (OR: 2.5 [1.4-4.5]) and being born in Germany (OR: 3.7 [1.9-7.1]). Neither preferences for decent and sanitary housing nor preferences for shared decision-making were associated with any of the independent variables. Various independent variables were associated with preferences for autonomy in long-term care. This suggests that preferences for care-related autonomy are complex. Knowing these might help refine long-term care health services.

  15. Quantitative Properties of the Macro Supply and Demand Structure for Care Facilities for Elderly in Japan.

    PubMed

    Nishino, Tatsuya

    2017-12-01

    As the Asian country with the most aged population, Japan, has been modifying its social welfare system. In 2000, the Japanese social care vision turned towards meeting the elderly's care needs in their own homes with proper formal care services. This study aims to understand the quantitative properties of the macro supply and demand structure for facilities for the elderly who require support or long-term care throughout Japan and present them as index values. Additionally, this study compares the targets for establishing long-term care facilities set by Japan's Ministry of Health, Labor and Welfare for 2025. In 2014, approximately 90% of all the people who were certified as requiring support and long-term care and those receiving preventive long-term care or long-term care services, were 75 years or older. The target increases in the number of established facilities by 2025 (for the 75-years-or-older population) were calculated to be 3.3% for nursing homes; 2.71% for long-term-care health facilities; 1.7% for group living facilities; and, 1.84% for community-based multi-care facilities. It was revealed that the establishment targets for 2025 also increase over current projections with the expected increase of the absolute number of users of group living facilities and community-based multi-care facilities. On the other hand, the establishment target for nursing homes remains almost the same as the current projection, whereas that for long-term-care health facilities decreases. These changes of facility ratios reveal that the Japanese social care system is shifting to realize 'Ageing in Place'. When considering households' tendencies, the target ratios for established facilities are expected to be applied to the other countries in Asia.

  16. Quantitative Properties of the Macro Supply and Demand Structure for Care Facilities for Elderly in Japan

    PubMed Central

    Nishino, Tatsuya

    2017-01-01

    As the Asian country with the most aged population, Japan, has been modifying its social welfare system. In 2000, the Japanese social care vision turned towards meeting the elderly’s care needs in their own homes with proper formal care services. This study aims to understand the quantitative properties of the macro supply and demand structure for facilities for the elderly who require support or long-term care throughout Japan and present them as index values. Additionally, this study compares the targets for establishing long-term care facilities set by Japan’s Ministry of Health, Labor and Welfare for 2025. In 2014, approximately 90% of all the people who were certified as requiring support and long-term care and those receiving preventive long-term care or long-term care services, were 75 years or older. The target increases in the number of established facilities by 2025 (for the 75-years-or-older population) were calculated to be 3.3% for nursing homes; 2.71% for long-term-care health facilities; 1.7% for group living facilities; and, 1.84% for community-based multi-care facilities. It was revealed that the establishment targets for 2025 also increase over current projections with the expected increase of the absolute number of users of group living facilities and community-based multi-care facilities. On the other hand, the establishment target for nursing homes remains almost the same as the current projection, whereas that for long-term-care health facilities decreases. These changes of facility ratios reveal that the Japanese social care system is shifting to realize ‘Ageing in Place’. When considering households’ tendencies, the target ratios for established facilities are expected to be applied to the other countries in Asia. PMID:29194405

  17. Variation of genetic diversity in a rapidly expanding population of the greater long-tailed hamster (Tscherskia triton) as revealed by microsatellites.

    PubMed

    Xu, Laixiang; Xue, Huiliang; Song, Mingjing; Zhao, Qinghua; Dong, Jingping; Liu, Juan; Guo, Yu; Xu, Tongqin; Cao, Xiaoping; Wang, Fusheng; Wang, Shuqing; Hao, Shushen; Yang, Hefang; Zhang, Zhibin

    2013-01-01

    Genetic diversity is essential for persistence of animal populations over both the short- and long-term. Previous studies suggest that genetic diversity may decrease with population decline due to genetic drift or inbreeding of small populations. For oscillating populations, there are some studies on the relationship between population density and genetic diversity, but these studies were based on short-term observation or in low-density phases. Evidence from rapidly expanding populations is lacking. In this study, genetic diversity of a rapidly expanding population of the Greater long-tailed hamsters during 1984-1990, in the Raoyang County of the North China Plain was studied using DNA microsatellite markers. Results show that genetic diversity was positively correlated with population density (as measured by % trap success), and the increase in population density was correlated with a decrease of genetic differentiation between the sub-population A and B. The genetic diversity tended to be higher in spring than in autumn. Variation in population density and genetic diversity are consistent between sub-population A and B. Such results suggest that dispersal is density- and season-dependent in a rapidly expanding population of the Greater long-tailed hamster. For typically solitary species, increasing population density can increase intra-specific attack, which is a driving force for dispersal. This situation is counterbalanced by decreasing population density caused by genetic drift or inbreeding as the result of small population size. Season is a major factor influencing population density and genetic diversity. Meanwhile, roads, used to be considered as geographical isolation, have less effect on genetic differentiation in a rapidly expanding population. Evidences suggest that gene flow (Nm) is positively correlated with population density, and it is significant higher in spring than that in autumn.

  18. Impact of the Tips From Former Smokers Campaign on Population-Level Smoking Cessation, 2012–2015

    PubMed Central

    Davis, Kevin C.; Beistle, Diane; King, Brian A.; Duke, Jennifer; Rodes, Robert; Graffunder, Corinne

    2018-01-01

    This study provides estimates of the long-term cumulative impact of the Centers for Disease Control and Prevention’s national tobacco education campaign, Tips From Former Smokers (Tips), on population-level smoking cessation. We used recently published estimates of the association between increased Tips campaign media doses and quit attempts to calculate campaign-attributable population sustained (6-month) quits during 2012–2015. Tips led to approximately 522,000 sustained quits during 2012–2015. These findings indicate that the Tips campaign’s comprehensive approach to combining evidence-based messages with the promotion of cessation resources was successful in achieving substantial long-term cigarette cessation at the population level over multiple years. PMID:29862960

  19. Standardizing flow cytometric assays in long-term population-based studies

    NASA Astrophysics Data System (ADS)

    Melzer, Susanne; Bocsi, Jozsef; Tárnok, Attila

    2015-03-01

    Quantification of leukocyte subpopulations and characterization of antigen-expression pattern on the cellular surface can play an important role in diagnostics. The state of cellular immunology on the single-cell level was analyzed by polychromatic flow cytometry in a recent comparative study within the average Leipzig population (LIFE - Leipzig Research Centre for Civilization Diseases). Data of 1699 subjects were recorded over a long-time period of three years (in a total of 1126 days). To ensure compatibility of such huge data sets, quality-controls on many levels (stability of instrumentation, low intra-laboratory variance and reader independent data analysis) are essential. The LIFE study aims to analyze various cytometric pattern to reveal the relationship between the life-style, the environmental effects and the individual health. We therefore present here a multi-step quality control procedure for long-term comparative studies.

  20. The Effects of Occupational Stress, Work-Centrality, Self-Efficacy, and Job Satisfaction on Intent to Quit Among Long-Term Care Workers in Korea.

    PubMed

    Park, Jeongkyu; Yoon, Seokwon; Moon, Sung Seek; Lee, Kyoung Hag; Park, Jueun

    2017-01-01

    A large and growing population of elderly Koreans with chronic conditions necessitates an increase in long-term care. This study is aimed at investigating the effects of occupational stress, work-centrality, self-efficacy, and job satisfaction on intent to leave among long-term care workers in Korea. We tested the hypothesized structural equation model predicting the intention to quit among long-term care workers in Korea. Survey data were collected from 532 long-term care workers in Seoul, Korea. Results showed that occupational stress was positively associated with intention to leave the job. The study also identified several possible mediators (self-efficacy, work-centrality, job satisfaction) in the relationship between stress and intent to quit. Evidence-based stress management interventions are suggested to help the workers better cope with stressors. Mentoring programs should also be considered for new workers.

  1. Examining Long-Term Global Climate Change on the Web.

    ERIC Educational Resources Information Center

    Huntoon, Jacqueline E.; Ridky, Robert K.

    2002-01-01

    Describes a web-based, inquiry-oriented activity that enables students to examine long-term global climate change. Supports instruction in other topics such as population growth. (Contains 34 references.) (DDR)

  2. Methotrexate is not associated with increased liver cirrhosis in a population-based cohort of rheumatoid arthritis patients with chronic hepatitis B

    PubMed Central

    Tang, Kuo-Tung; Hung, Wei-Ting; Chen, Yi-Hsing; Lin, Ching-Heng; Chen, Der-Yuan

    2016-01-01

    A few studies showed that long-term methotrexate (MTX) use exacerbates liver fibrosis and even leads to liver cirrhosis in rheumatoid arthritis (RA) patients. We therefore conducted a population-based cohort study to investigate the impact of long-term MTX use on the risk of chronic hepatitis B (CHB)-related cirrhosis among RA patients. We analyzed data from the National Health Insurance Research Database in Taiwan and identified 631 incident cases of RA among CHB patients (358 MTX users and 273 MTX non-users) from January 1, 1998 to December 31, 2007. After a median follow-up of more than 6 years since the diagnosis of CHB, a total of 41 (6.5%) patients developed liver cirrhosis. We did not find an increased risk of liver cirrhosis among CHB patients with long-term MTX use for RA. Furthermore, there was no occurrence of liver cirrhosis among 56 MTX users with a cumulative dose ≧3 grams after 97 months’ treatment. In conclusion, our data showed that long-term MTX use is not associated with an increased risk for liver cirrhosis among RA patients with CHB. However, interpretation of the results should be cautious due to potential bias in the cohort. PMID:26928373

  3. Modeling the population dynamics of Pacific yew.

    Treesearch

    Richard T. Busing; Thomas A. Spies

    1995-01-01

    A study of Pacific yew (Taxus brevifolia Nutt.) population dynamics in the mountains of western Oregon and Washington was based on a combination of long-term population data and computer modeling. Rates of growth and mortality were low in mature and old-growth forest stands. Diameter growth at breast height ranged from 0 to 3 centimeters per decade...

  4. Long-term outcomes of epilepsy surgery in Sweden

    PubMed Central

    Edelvik, Anna; Rydenhag, Bertil; Olsson, Ingrid; Flink, Roland; Kumlien, Eva; Källén, Kristina

    2013-01-01

    Objective: To investigate prospective, population-based long-term outcomes concerning seizures and antiepileptic drug (AED) treatment after resective epilepsy surgery in Sweden. Methods: Ten- and 5-year follow-ups were performed in 2005 to 2007 for 278/327 patients after resective epilepsy surgery from 1995 to 1997 and 2000 to 2002, respectively. All patients had been prospectively followed in the Swedish National Epilepsy Surgery Register. Ninety-three patients, who were presurgically evaluated but not operated, served as controls. Results: In the long term (mean 7.6 years), 62% of operated adults and 50% of operated children were seizure-free, compared to 14% of nonoperated adults (p < 0.001) and 38% of nonoperated children (not significant). Forty-one percent of operated adults and 44% of operated children had sustained seizure freedom since surgery, compared to none of the controls (p < 0.0005). Multivariate analysis identified ≥30 seizures/month at baseline and long epilepsy duration as negative predictors and positive MRI to be a positive predictor of long-term seizure-free outcome. Ten years after surgery, 86% of seizure-free children and 43% of seizure-free adults had stopped AEDs in the surgery groups compared to none of the controls (p < 0.0005). Conclusions: This population-based, prospective study shows good long-term seizure outcomes after resective epilepsy surgery. The majority of the patients who are seizure-free after 5 and 10 years have sustained seizure freedom since surgery. Many patients who gain seizure freedom can successfully discontinue AEDs, more often children than adults. Classification of evidence: This study provides Class III evidence that more patients are seizure-free and have stopped AED treatment in the long term after resective epilepsy surgery than nonoperated epilepsy patients. PMID:23966252

  5. Preferences for long-term care services: willingness to pay estimates derived from a discrete choice experiment.

    PubMed

    Nieboer, Anna P; Koolman, Xander; Stolk, Elly A

    2010-05-01

    Ageing populations increase pressure on long-term care. Optimal resource allocation requires an optimal mix of care services based on costs and benefits. Contrary to costs, benefits remain largely unknown. This study elicits preferences in the general elderly population for long-term care services for varying types of patients. A discrete choice experiment was conducted in a general population subsample aged 50-65 years (N = 1082) drawn from the Dutch Survey Sampling International panel. To ascertain relative preferences for long-term care and willingness to pay for these, participants were asked to choose the best of two care scenarios for four groups of hypothetical patients: frail and demented elderly, with and without partner. The scenarios described long-term care using ten attributes based on Social Production Function theory: hours of care, organized social activities, transportation, living situation, same person delivering care, room for individual preferences, coordination of services, punctuality, time on waiting list, and co-payments. We found the greatest value was attached to same person delivering care and transportation services. Low value was attached to punctuality and room for individual preferences. Nursing homes were generally considered to be detrimental for well-being except for dementia patients without a partner. Overall, long-term care services were thought to produce greatest well-being for the patients 'without a partner' and those 'with dementia'. Individuals combining these two risk factors would benefit the most from all services except transportation which was considered more important for the frail elderly. The results support the notion that long-term care services represent different value for different types of patients and that the value of a service depends upon the social context. Examination of patient profiles confirmed the notion that physical, mental and social vulnerability affect valuation of the services. Policy-making would profit from allocation models in which budgetary requirements of different services can be balanced against the well-being they produce for individuals. Copyright 2010 Elsevier Ltd. All rights reserved.

  6. Sex differences in lung cancer survival: long-term trends using population-based cancer registry data in Osaka, Japan.

    PubMed

    Kinoshita, Fukuaki Lee; Ito, Yuri; Morishima, Toshitaka; Miyashiro, Isao; Nakayama, Tomio

    2017-09-01

    Several studies of sex differences in lung cancer survival have been reported. However, large-size population-based studies based on long-term observation are scarce. We investigated long-term trends in sex differences in lung cancer survival using population-based cancer registry data from Osaka, Japan. We analyzed 79 330 cases from the Osaka Cancer Registry (OCR) diagnosed between 1975 and 2007. We calculated 5-year relative survival in the six periods (1975-1980, 1981-1986, 1987-1992, 1993-1997, 1998-2002 and 2003-2007). To estimate the trends in sex differences in lung cancer survival throughout the study period, we applied a multivariate excess hazard model to control for confounders. The proportion of adenocarcinoma (ADC) and 5-year relative relative survival have increased for both sexes. Sex differences in lung cancer survival have widened over the period, especially in ADC and since the late 1990s. The excess hazard ratio of death within 5 years for males was 1.19 (95% CI: 1.16-1.21), adjusting for period at diagnosis, histologic type, stage, age group and treatment. We reported that females have better prognosis in lung cancer than males and the sex differences in lung cancer survival have become wider in Osaka, Japan. This can be partly explained by the sex differences in the proportions of histologic type and stage. Further studies considering other factors that influence sex differences in lung cancer survival are needed. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  7. Intravenous lipid emulsions in term infants: impact on laboratory and clinical outcomes and long-term consequences.

    PubMed

    Hartman, Corina; Shamir, Raanan

    2015-01-01

    Parenteral nutrition (PN) in term newborns and older infants is often required for nutritional support for temporary or permanent intestinal failure from any reason. Lipid emulsions (LEs) are an essential source of high-density energy, essential fatty acids, and fat-soluble vitamins. Depending on the fatty acid type, LEs may also have significant immunomodulatory effects. All LEs, starting with soybean oil-based LE and subsequently with medium-chain triglycerides-, olive oil- and fish oil-based LEs, have been investigated in newborns and infants. Laboratory data (mainly liver enzymes, plasma lipid profiles and some metabolic markers) have been investigated for some LEs. The outcome of intestinal failure-associated liver disease after switching to new fish oil-based LEs has been sporadically reported. Long-term outcome data have only looked at the relationship between PN and mortality/morbidity, especially liver disease, and a few studies have looked at growth. There are no controlled studies in this age group that investigated the relationship between different types of LEs and long-term outcomes. In spite of their contribution to understanding the use and indications of various LEs as well as their advantages and adverse effects, most studies in newborns and infants have been observational or retrospective, and the investigated population has been heterogeneous, either in terms of the degree of maturation, age or diagnoses. High-quality studies, preferably randomized and controlled, in this particular population are needed, especially with the widespread use of PN and the emergence of new LEs. © 2015 S. Karger AG, Basel.

  8. Correlates of preferences for autonomy in long-term care: results of a population-based survey among older individuals in Germany

    PubMed Central

    Hajek, André; Lehnert, Thomas; Wegener, Annemarie; Riedel-Heller, Steffi G; König, Hans-Helmut

    2018-01-01

    Purpose Thus far, there is little evidence concerning the factors associated with preferences for autonomy in long-term care. Therefore, the aim of the present study was to investigate the correlates of preferences for autonomy in long-term care among older individuals in Germany. Methods Data were gathered from a population-based survey of the German population aged ≥65 years in 2015 (N=1,006). Results Multiple logistic regressions revealed that preferences for freedom of choice for foods were positively associated with living with partner or spouse (OR: 1.5 [1.0–2.2]), being born in Germany (OR: 1.9 [1.1–3.3]), and lower self-rated health (OR: 1.3 [1.1–1.6]). Preferences for freedom in choosing bedtime and sleep duration were positively associated with lower age (OR: 1.1 [1.0–1.1]) and having children (OR: 2.2 [1.0–4.9]). Preferences for customized living space were positively associated with being female (OR: 2.5 [1.4–4.5]) and being born in Germany (OR: 3.7 [1.9–7.1]). Neither preferences for decent and sanitary housing nor preferences for shared decision-making were associated with any of the independent variables. Conclusion Various independent variables were associated with preferences for autonomy in long-term care. This suggests that preferences for care-related autonomy are complex. Knowing these might help refine long-term care health services. PMID:29379274

  9. Long-Term Associations of Childhood Suicide Ideation

    ERIC Educational Resources Information Center

    Herba, Catherine M.; Ferdinand, Robert F.; van der Ende, Jan; Verhulst, Frank C.

    2007-01-01

    A population-based study examined whether suicide ideation in childhood adversely affects mental health in adulthood. It was observed that childhood suicide ideation could lead to worrying mental health consequences in adulthood.

  10. Factors associated with preferences for long-term care settings in old age: evidence from a population-based survey in Germany.

    PubMed

    Hajek, André; Lehnert, Thomas; Wegener, Annemarie; Riedel-Heller, Steffi G; König, Hans-Helmut

    2017-02-21

    Long-term care is one of the most pressing health policy issues in Germany. It is expected that the need for long-term care will increase markedly in the next decades due to demographic shifts. The purpose of this study was to investigate the factors associated with preferences for long-term care settings in old age individuals in Germany. Based on expert interviews and a systematic review, a questionnaire was developed to quantify long-term care preferences. Data were drawn from a population-based survey of the German population aged 65 and over in 2015 (n = 1006). In multiple logistic regressions, preferences for home care were positively associated with providing care for family/friends [OR: 1.6 (1.0-2.5)], lower self-rated health [OR: 1.3 (1.0-1.6)], and no current need of care [OR: 5.5 (1.2-25.7)]. Preferences for care in relatives' homes were positively associated with being male [OR: 2.0 (1.4-2.7)], living with partner or spouse [OR: 1.8 (1.3-2.4)], having children [OR: 1.6 (1.0-2.5)], private health insurance [OR: 1.6 (1.1-2.3)], providing care for family/friends [OR: 1.5 (1.1-2.0)], and higher self-rated health [OR: 1.2 (1.0-1.4)]. Preferences for care in assisted living were positively associated with need of care [OR: 1.9 (1.0-3.5)] and higher education [for example, University, OR: 3.5 (1.9-6.5)]. Preferences for care in nursing home/old age home were positively associated with being born in Germany [OR: 1.8 (1.0-3.1)] and lower self-rated health [OR: 1.2 (1.0-1.4)]. Preferences for care in a foreign country were positively associated with lower age [OR: 1.1 (1.0-1.2)] and being born abroad [OR: 5.5 (2.7-11.2)]. Numerous variables used are sporadically significant, underlining the complex nature of long-term care preferences. A better understanding of factors associated with preferences for care settings might contribute to improving long-term care health services.

  11. Predicting the response of populations to environmental change

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

    Ives, A.R.

    1995-04-01

    When subject to long-term directional environmental perturbations, changes in population densities depend on the positive and negative feedbacks operating through interactions within and among species in a community. This paper develops techniques to predict the long-term responses of population densities to environmental changes using data on short-term population fluctuations driven by short-term environmental variability. In addition to giving quantitative predictions, the techniques also reveal how different qualitative patterns of species interactions either buffer or accentuate population responses to environmental trends. All of the predictions are based on regression coefficients extracted from time series data, and they can therefore be appliedmore » with a minimum of mathematical and statistical gymnastics. 48 refs., 10 figs., 4 tabs.« less

  12. Fatigue Among Short- and Long-Term Thyroid Cancer Survivors: Results from the Population-Based PROFILES Registry

    PubMed Central

    Nieuwlaat, Willy-Anne; Oranje, Wilma A.; Haak, Harm R.; van de Poll-Franse, Lonneke V.; Mols, Floortje

    2013-01-01

    Background The aims of this study were (i) to obtain insight into the prevalence of fatigue among short- and long-term thyroid cancer (TC) survivors, by comparing a sample of TC survivors with an age- and sex-matched normative population, and (ii) to investigate which demographic, clinical, and TC-specific health-related quality of life (HRQoL) characteristics were associated with fatigue. Methods All patients found to have TC between 1990 and 2008, as registered in the Eindhoven Cancer Registry, received a cross-sectional survey on fatigue (Fatigue Assessment Scale), TC-specific HRQoL (THYCA-QoL), and psychological distress (Hospital Anxiety and Depression Scale). The fatigue scores were compared with those of an age- and sex-matched normative population (n=530). Multiple logistic regression analyses were conducted to investigate the independent associations between clinical and demographic characteristics, TC-specific HRQoL, and psychological distress with fatigue. Results Eighty-six percent (n=306) responded. TC survivors were more often classified as fatigued or very fatigued (short-term <5 years: 43%; long-term 5–10 years: 44%; long-term 10–15 years: 47%; long-term >15 years: 39%) compared to the normative population (25%; p<0.001). Anxiety (odds ratio (OR) 1.15, 95% confidence interval [CI] 1.03–1.28) and depression (OR 1.43 [CI 1.22–1.68]) were associated with fatigue, as was also the case for TC-specific neuromuscular (OR 1.03 [CI 1.01–1.06]), concentration (OR 1.03 [CI 1.01–1.06]), and psychological TC-specific HRQoL (OR 1.06 [CI 1.02–1.10]). Conclusion Short- and long-term TC survivors report higher levels of fatigue than an age- and sex-matched normative population do. Both TC-specific HRQoL and psychological distress were associated with fatigue. PMID:23578315

  13. Does long-term care use within primary health care reduce hospital use among older people in Norway? A national five-year population-based observational study

    PubMed Central

    2011-01-01

    Background Population ageing may threaten the sustainability of future health care systems. Strengthening primary health care, including long-term care, is one of several measures being taken to handle future health care needs and budgets. There is limited and inconsistent evidence on the effect of long-term care on hospital use. We explored the relationship between the total use of long-term care within public primary health care in Norway and the use of hospital beds when adjusting for various effect modifiers and confounders. Methods This national population-based observational study consists of all Norwegians (59% women) older than 66 years (N = 605676) (13.2% of total population) in 2002-2006. The unit of analysis was defined by municipality, age and sex. The association between total number of recipients of long-term care per 1000 inhabitants (LTC-rate) and hospital days per 1000 inhabitants (HD-rate) was analysed in a linear regression model. Modifying and confounding effects of socioeconomic, demographic and geographic variables were included in the final model. We defined a difference in hospitalization rates of more than 1000 days per 1000 inhabitants as clinically important. Results Thirty-one percent of women and eighteen percent of men were long-term care users. Men had higher HD-rates than women. The crude association between LTC-rate and HD-rate was weakly negative. We identified two effect modifiers (age and sex) and two strong confounders (travel time to hospital and mortality). Age and sex stratification and adjustments for confounders revealed a positive statistically significant but not clinically important relationship between LTC-rates and hospitalization for women aged 67-79 years and all men. For women 80 years and over there was a weak but negative relationship which was neither statistically significant nor clinically important. Conclusions We found a weak positive adjusted association between LTC-rates and HD-rates. Opposite to common belief, we found that increased volume of LTC by itself did not reduce pressure on hospitals. There still is a need to study integrated care models for the elderly in the Norwegian setting and to explore further why municipalities far away from hospital achieve lower use of hospital beds. PMID:22029775

  14. Enhancing health care professionals' and trainees' knowledge of physical activity guidelines for adults with and without SCI.

    PubMed

    Shirazipour, Celina H; Tomasone, Jennifer R; Martin Ginis, Kathleen A

    2018-01-11

    Health care providers (HCPs) are preferred sources of physical activity (PA) information; however, minimal research has explored HCPs' knowledge of spinal cord injury (SCI) PA guidelines, and no research has examined HCP trainees' PA guideline knowledge. The current study explored HCPs' and trainees' initial knowledge of PA guidelines for both adults with SCI and the general population, and the utility of an event-based intervention for improving this knowledge. Participants (HCPs n = 129; trainees n = 573) reported guideline knowledge for both sets of guidelines (SCI and general population) immediately after, one-month, and six-months following the intervention. Frequencies determined guideline knowledge at each timepoint, while chi-squared tests examined differences in knowledge of both guidelines, as well as knowledge differences in the short- and long-term. Results demonstrated that HCPs and trainees lack knowledge of PA guidelines, particularly guidelines for adults with SCI. The results further suggest that a single event-based intervention is not effective for improving long-term guideline knowledge. Suggestions are made for future research with the aim of improving interventions that target HCP and HCP trainees' long-term guideline knowledge for adults with SCI and the general population.

  15. Estimating the breeding population of long-billed curlew in the United States

    USGS Publications Warehouse

    Stanley, T.R.; Skagen, S.K.

    2007-01-01

    Determining population size and long-term trends in population size for species of high concern is a priority of international, national, and regional conservation plans. Long-billed curlews (Numenius americanus) are a species of special concern in North America due to apparent declines in their population. Because long-billed curlews are not adequately monitored by existing programs, we undertook a 2-year study with the goals of 1) determining present long-billed curlew distribution and breeding population size in the United States and 2) providing recommendations for a long-term long-billed curlew monitoring protocol. We selected a stratified random sample of survey routes in 16 western states for sampling in 2004 and 2005, and we analyzed count data from these routes to estimate detection probabilities and abundance. In addition, we evaluated habitat along roadsides to determine how well roadsides represented habitat throughout the sampling units. We estimated there were 164,515 (SE = 42,047) breeding long-billed curlews in 2004, and 109,533 (SE = 31,060) breeding individuals in 2005. These estimates far exceed currently accepted estimates based on expert opinion. We found that habitat along roadsides was representative of long-billed curlew habitat in general. We make recommendations for improving sampling methodology, and we present power curves to provide guidance on minimum sample sizes required to detect trends in abundance.

  16. Official statistics and claims data records indicate non-response and recall bias within survey-based estimates of health care utilization in the older population

    PubMed Central

    2013-01-01

    Background The validity of survey-based health care utilization estimates in the older population has been poorly researched. Owing to data protection legislation and a great number of different health care insurance providers, the assessment of recall and non-response bias is challenging to impossible in many countries. The objective of our study was to compare estimates from a population-based study in older German adults with external secondary data. Methods We used data from the German KORA-Age study, which included 4,127 people aged 65–94 years. Self-report questions covered the utilization of long-term care services, inpatient services, outpatient services, and pharmaceuticals. We calculated age- and sex-standardized mean utilization rates in each domain and compared them with the corresponding estimates derived from official statistics and independent statutory health insurance data. Results The KORA-Age study underestimated the use of long-term care services (−52%), in-hospital days (−21%) and physician visits (−70%). In contrast, the assessment of drug consumption by postal self-report questionnaires yielded similar estimates to the analysis of insurance claims data (−9%). Conclusion Survey estimates based on self-report tend to underestimate true health care utilization in the older population. Direct validation studies are needed to disentangle the impact of recall and non-response bias. PMID:23286781

  17. Long-term low-level arsenic exposure is associated with poorer neuropsychological functioning: a Project FRONTIER study.

    PubMed

    O'Bryant, Sid E; Edwards, Melissa; Menon, Chloe V; Gong, Gordon; Barber, Robert

    2011-03-01

    Exposure to elements in groundwater (toxic or beneficial) is commonplace yet, outside of lead and mercury, little research has examined the impact of many commonly occurring environmental exposures on mental abilities during the aging process. Inorganic arsenic is a known neurotoxin that has both neurodevelopmental and neurocognitive consequences. The aim of this study was to examine the potential association between current and long-term arsenic exposure and detailed neuropsychological functioning in a sample of rural-dwelling adults and elders. Data were analyzed from 434 participants (133 men and 301 women) of Project FRONTIER, a community-based participatory research study of the epidemiology of health issues of rural-dwelling adults and elders. The results of the study showed that GIS-based groundwater arsenic exposure (current and long-term) was significantly related to poorer scores in language, visuospatial skills, and executive functioning. Additionally, long-term low-level exposure to arsenic was significantly correlated to poorer scores in global cognition, processing speed and immediate memory. The finding of a correlation between arsenic and the domains of executive functioning and memory is of critical importance as these are cognitive domains that reflect the earliest manifestations of Alzheimer's disease. Additional work is warranted given the population health implications associated with long-term low-level arsenic exposure.

  18. Forced migration in childhood: are there long-term health effects?

    PubMed

    Saarela, Jan M; Elo, Irma T

    2016-12-01

    Studies on the health of migrants have increased considerably in number in recent years, but little is still known about the long-term health effects associated with forced migration, and particularly for people who were forced to migrate as children. Data shortcomings together with the methodological challenges of studying migrant populations limit the ability to disentangle the roles of various factors that influence migrant health outcomes. Finland provides an unusual opportunity to study long-term health consequences associated with forced migration. During World War II, twelve per cent of the Finnish population was forced to leave the region nowadays referred to as Ceded Karelia. After the war, these Karelians could not return home because the area was relinquished to the Soviet Union. Using high quality, linked register-based data for the period 1988-2012, we investigate whether this forced migration had long-term health consequences for those who were forced to migrate as children. Comparison groups are non-displaced persons born on the adjacent side of the new border, and people born elsewhere in Finland. Health at ages 43-65 years is measured by receipt of sickness benefit, which is an indicator of short-term illness, and receipt of disability pension, which reflects long-term illness or permanent disability. All-cause and cause-specific mortality is analysed at ages 43-84 years. We find no support for the hypothesis that the traumatic event of being forced to migrate during childhood has long-term negative health consequences. The forced child migrants have lower odds for receipt of sickness benefit, and women also have lower odds for receipt of disability pension. The mortality results are largely driven by patterns specific for eastern-born populations of Finland. A likely reason behind the absence of negative health consequences is that these migrants seem to have integrated well into post-war Finnish society.

  19. Mode of Delivery and Long-Term Health-Related Quality-of-Life Outcomes: A Prospective Population-Based Study.

    PubMed

    Petrou, Stavros; Kim, Sung Wook; McParland, Penny; Boyle, Elaine M

    2017-06-01

    Relatively little is known about the effects of mode of delivery on long-term health-related quality-of-life outcomes. Furthermore, no previous study has expressed these outcomes in preference-based (utility) metrics. The study population comprised 2,161 mothers recruited from a prospective population-based study in the East Midlands of England encompassing live births and stillbirths between 32 +0 and 36 +6 weeks' gestation and a sample of term-born controls. Perinatal data were extracted from the mothers' maternity records. Health-related quality-of-life outcomes were assessed at 12 months postpartum, using the EuroQol Five Dimensions (EQ-5D) measure with responses to the EQ-5D descriptive system converted into health utility scores. Descriptive statistics and multivariable analyses were used to estimate the relationship between the mode of delivery and health-related quality-of-life outcomes. The overall health-related quality-of-life profile of the women in the study cohort mirrored that of the English adult population as revealed by national health surveys. A significantly higher proportion of women delivering by cesarean delivery reported some, moderate, severe, or extreme pain or discomfort at 12 months postpartum than women undergoing spontaneous vaginal delivery. Multivariable analyses, using the Ordinary Least Squares estimator revealed that, after controlling for maternal sociodemographic characteristics, cesarean delivery without maternal or fetal compromise was associated with a significant EQ-5D utility decrement in comparison to spontaneous vaginal delivery among all women (-0.026; p = 0.038) and among mothers of term-born infants (-0.062; p < 0.001). Among mothers of term-born infants, this result was replicated in models that controlled for all maternal and infant characteristics (utility decrement of -0.061; p < 0.001). The results were confirmed by sensitivity analyses that varied the categorization of the main exposure variable (mode of delivery) and the econometric strategy. Among mothers of term-born infants, cesarean delivery without maternal or fetal compromise is associated with poorer long-term health-related quality of life in comparison to spontaneous vaginal delivery. Further longitudinal studies are needed to understand the magnitude, trajectory, and underpinning mechanisms of health-related quality-of-life outcomes following different modes of delivery. © 2016 Wiley Periodicals, Inc.

  20. A population-based cohort study defines prognoses in severe chronic kidney disease.

    PubMed

    Tonelli, Marcello; Wiebe, Natasha; James, Matthew T; Klarenbach, Scott W; Manns, Braden J; Ravani, Pietro; Strippoli, Giovanni F M; Hemmelgarn, Brenda R

    2018-05-01

    In older people with chronic kidney disease (CKD) and comorbidities, the risk of death or disability may overshadow the risk of kidney failure. To help refine this we did a retrospective population-based cohort study to evaluate the relative likelihood of adverse outcomes as functions of age and comorbidity burden among 47,228 adults with severe non-dialysis dependent CKD. We identified comorbidities using 29 validated algorithms applied to administrative data and assessed death, end-stage renal disease (ESRD), cardiovascular disease (CVD) events, and long-term care. Over five years of follow-up, 53.4% of participants died, 24.1% had a CVD event, 14.3% were placed into long-term care and 5.3% developed ESRD. Death was 145 times more likely and 11 times more likely than ESRD for participants aged 80 years or more and 60-79 years, respectively; long-term care was 30 times more likely and 1.7 times as likely as ESRD for participants aged 80 years or more and 60-79 years, respectively. Increasing comorbidity burden was similarly associated with increased risk of death and long-term care placement but reduced the likelihood of ESRD, and the risks of increasing age were similarly incremental. Thus, among patients with severe CKD, older age and/or higher comorbidity burden, death and long-term care placement are markedly more likely than ESRD. Hence, clinicians, patients and families should all consider the relative magnitude of these risks when making decisions about renal replacement. Copyright © 2018 International Society of Nephrology. Published by Elsevier Inc. All rights reserved.

  1. Trait-specific long-term consequences of genomic selection in beef cattle.

    PubMed

    de Rezende Neves, Haroldo Henrique; Carvalheiro, Roberto; de Queiroz, Sandra Aidar

    2018-02-01

    Simulation studies allow addressing consequences of selection schemes, helping to identify effective strategies to enable genetic gain and maintain genetic diversity. The aim of this study was to evaluate the long-term impact of genomic selection (GS) in genetic progress and genetic diversity of beef cattle. Forward-in-time simulation generated a population with pattern of linkage disequilibrium close to that previously reported for real beef cattle populations. Different scenarios of GS and traditional pedigree-based BLUP (PBLUP) selection were simulated for 15 generations, mimicking selection for female reproduction and meat quality. For GS scenarios, an alternative selection criterion was simulated (wGBLUP), intended to enhance long-term gains by attributing more weight to favorable alleles with low frequency. GS allowed genetic progress up to 40% greater than PBLUP, for female reproduction and meat quality. The alternative criterion wGBLUP did not increase long-term response, although allowed reducing inbreeding rates and loss of favorable alleles. The results suggest that GS outperforms PBLUP when the selected trait is under less polygenic background and that attributing more weight to low-frequency favorable alleles can reduce inbreeding rates and loss of favorable alleles in GS.

  2. The Effects of Cannabis Among Adults With Chronic Pain and an Overview of General Harms: A Systematic Review.

    PubMed

    Nugent, Shannon M; Morasco, Benjamin J; O'Neil, Maya E; Freeman, Michele; Low, Allison; Kondo, Karli; Elven, Camille; Zakher, Bernadette; Motu'apuaka, Makalapua; Paynter, Robin; Kansagara, Devan

    2017-09-05

    Cannabis is increasingly available for the treatment of chronic pain, yet its efficacy remains uncertain. To review the benefits of plant-based cannabis preparations for treating chronic pain in adults and the harms of cannabis use in chronic pain and general adult populations. MEDLINE, Cochrane Database of Systematic Reviews, and several other sources from database inception to March 2017. Intervention trials and observational studies, published in English, involving adults using plant-based cannabis preparations that reported pain, quality of life, or adverse effect outcomes. Two investigators independently abstracted study characteristics and assessed study quality, and the investigator group graded the overall strength of evidence using standard criteria. From 27 chronic pain trials, there is low-strength evidence that cannabis alleviates neuropathic pain but insufficient evidence in other pain populations. According to 11 systematic reviews and 32 primary studies, harms in general population studies include increased risk for motor vehicle accidents, psychotic symptoms, and short-term cognitive impairment. Although adverse pulmonary effects were not seen in younger populations, evidence on most other long-term physical harms, in heavy or long-term cannabis users, or in older populations is insufficient. Few methodologically rigorous trials; the cannabis formulations studied may not reflect commercially available products; and limited applicability to older, chronically ill populations and patients who use cannabis heavily. Limited evidence suggests that cannabis may alleviate neuropathic pain in some patients, but insufficient evidence exists for other types of chronic pain. Among general populations, limited evidence suggests that cannabis is associated with an increased risk for adverse mental health effects. U.S. Department of Veterans Affairs. (PROSPERO: CRD42016033623).

  3. Lithium in drinking water and the incidence of bipolar disorder: A nation-wide population-based study.

    PubMed

    Kessing, Lars V; Gerds, Thomas A; Knudsen, Nikoline N; Jørgensen, Lisbeth F; Kristiansen, Søren M; Voutchkova, Denitza; Ernstsen, Vibeke; Schullehner, Jörg; Hansen, Birgitte; Andersen, Per K; Ersbøll, Annette K

    2017-11-01

    Animal data suggest that subtherapeutic doses, including micro doses, of lithium may influence mood, and lithium levels in drinking water have been found to correlate with the rate of suicide. It has never been investigated whether consumption of lithium may prevent the development of bipolar disorder (primary prophylaxis). In a nation-wide population-based study, we investigated whether long-term exposure to micro levels of lithium in drinking water correlates with the incidence of bipolar disorder in the general population, hypothesizing an inverse association in which higher long-term lithium exposure is associated with lower incidences of bipolar disorder. We included longitudinal individual geographical data on municipality of residence, data from drinking water lithium measurements and time-specific data from all cases with a hospital contact with a diagnosis of mania/bipolar disorder from 1995 to 2013 (N=14 820) and 10 age- and gender-matched controls from the Danish population (N= 140 311). Average drinking water lithium exposure was estimated for all study individuals. The median of the average lithium exposure did not differ between cases with a diagnosis of mania/bipolar disorder (12.7 μg/L; interquartile range [IQR]: 7.9-15.5 μg/L) and controls (12.5 μg/L; IQR: 7.6-15.7 μg/L; P=.2). Further, the incidence rate ratio of mania/bipolar disorder did not decrease with higher long-term lithium exposure, overall, or within age categories (0-40, 41-60 and 61-100 years of age). Higher long-term lithium exposure from drinking water was not associated with a lower incidence of bipolar disorder. The association should be investigated in areas with higher lithium levels than in Denmark. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  4. The Long-Term Relationship between Population Growth and Vegetation Cover: An Empirical Analysis Based on the Panel Data of 21 Cities in Guangdong Province, China

    PubMed Central

    Li, Chao; Kuang, Yaoqiu; Huang, Ningsheng; Zhang, Chao

    2013-01-01

    It is generally believed that there is an inverse relationship between population growth and vegetation cover. However, reports about vegetation protection and reforestation around the World have been continuously increasing in recent decades, which seems to indicate that this relationship may not be true. In this paper, we have taken 21 cities in Guangdong Province, China as the study area to test the long-term relationship between population growth and vegetation cover, using an AVHRR NDVI data set and the panel cointegrated regression method. The results show that there is a long-term inverted N-shaped curve relationship between population growth and vegetation cover in the region where there are frequent human activities and the influence of climate change on vegetation cover changes is relatively small. The two turning points of the inverted N-shaped curve for the case of Guangdong Province correspond to 2,200 persons·km−2 and 3,820 persons·km−2, and they can provide a reference range for similar regions of the World. It also states that the population urbanization may have a negative impact on the vegetation cover at the early stage, but have a positive impact at the later stage. In addition, the Panel Error Correction Model (PECM) is used to investigate the causality direction between population growth and vegetation cover. The results show that not only will the consuming destruction effect and planting construction effect induced by the population growth have a great impact on vegetation cover changes, but vegetation cover changes in turn will also affect the population growth in the long term. PMID:23435589

  5. How Immunocontraception Can Contribute to Elephant Management in Small, Enclosed Reserves: Munyawana Population as a Case Study

    PubMed Central

    Druce, Heleen C.; Mackey, Robin L.; Slotow, Rob

    2011-01-01

    Immunocontraception has been widely used as a management tool to reduce population growth in captive as well as wild populations of various fauna. We model the use of an individual-based rotational immunocontraception plan on a wild elephant, Loxodonta africana, population and quantify the social and reproductive advantages of this method of implementation using adaptive management. The use of immunocontraception on an individual, rotational basis stretches the inter-calving interval for each individual female elephant to a management-determined interval, preventing exposing females to unlimited long-term immunocontraception use (which may have as yet undocumented negative effects). Such rotational immunocontraception can effectively lower population growth rates, age the population, and alter the age structure. Furthermore, such structured intervention can simulate natural process such as predation or episodic catastrophic events (e.g., drought), which regulates calf recruitment within an abnormally structured population. A rotational immunocontraception plan is a feasible and useful elephant population management tool, especially in a small, enclosed conservation area. Such approaches should be considered for other long-lived, social species in enclosed areas where the long-term consequences of consistent contraception may be unknown. PMID:22174758

  6. The influence of pregnancy on disability from multiple sclerosis: a population-based study in Middlesex County, Ontario.

    PubMed

    Weinshenker, B G; Hader, W; Carriere, W; Baskerville, J; Ebers, G C

    1989-11-01

    We analyzed the effect of pregnancy on long-term disability resulting from multiple sclerosis in 185 women ascertained through a retrospective population-based survey of MS in Middlesex County, Ontario, Canada. There was no association between disability and total number of term pregnancies, timing of pregnancy relative to onset of MS, or either onset or worsening of MS in relation to a pregnancy. The mean number of pregnancies both before and after onset of MS was no different among groups stratified according to disability. This study addresses some of the difficulties inherent in studying the effect of pregnancy on disability resulting from MS.

  7. Employment and insurance outcomes and factors associated with employment among long-term thyroid cancer survivors: a population-based study from the PROFILES registry.

    PubMed

    Tamminga, S J; Bültmann, U; Husson, O; Kuijpens, J L P; Frings-Dresen, M H W; de Boer, A G E M

    2016-04-01

    To obtain insight into employment and insurance outcomes of thyroid cancer survivors and to examine the association between not having employment and other factors including quality of life. In this cross-sectional population-based study, long-term thyroid cancer survivors from the Netherlands participated. Clinical data were collected from the cancer registry. Information on employment, insurance, socio-demographic characteristics, long-term side effects, and quality of life was collected with questionnaires. Of the 223 cancer survivors (response rate 87 %), 71 % were employed. Of the cancer survivors who tried to obtain insurance, 6 % reported problems with obtaining health care insurance, 62 % with life insurance, and 16 % with a mortgage. In a multivariate logistic regression analysis, higher age (OR 1.07, CI 1.02-1.11), higher level of fatigue (OR 1.07, CI 1.01-1.14), and lower educational level (OR 3.22, CI 1.46-7.09) were associated with not having employment. Employment was associated with higher quality of life. Many thyroid cancer survivors face problems when obtaining a life insurance, and older, fatigued, and lower educated thyroid cancer survivors may be at risk for not having employment.

  8. Placenta previa and long-term morbidity of the term offspring.

    PubMed

    Walfisch, Asnat; Beharier, Ofer; Shoham-Vardi, Ilana; Sergienko, Ruslan; Landau, Daniella; Sheiner, Eyal

    2016-08-01

    The long-term impact of placenta previa on term infants is unknown. We aimed to investigate whether abnormal placentation increases the risk for long-term morbidity of the term offspring. A population-based cohort study compared the incidence of long-term hospitalizations up to the age of 18 due to cardiovascular, endocrine, neurological, hematological, respiratory and urinary morbidity of children born at term in pregnancies diagnosed with placenta previa and those without. Deliveries occurred between the years 1991-2013 in a tertiary medical center. Multiple pregnancies, and fetal congenital malformations were excluded. Kaplan-Meier survival curves were used to compare cumulative morbidity incidence over time. A multivariable generalized estimating equation (GEE) logistic regression model analysis was used to control for confounders and for maternal clusters. During the study period 233,123 term deliveries met the inclusion criteria; 0.2% (n=502) of the children were born to mothers with placenta previa. During the follow-up period, children born to mothers with placenta previa did not have an increased risk for long-term cardiovascular, endocrine, hematological, neurological, respiratory, and urinary morbidity. Term offsprings of mothers diagnosed with placenta previa do not appear to be at an increased risk for long-term morbidity up to the age of 18. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  9. Future trends in the prevalence of severe activity limitations among older adults in Europe: a cross-national population study using EU-SILC

    PubMed Central

    Scherbov, Sergei; Weber, Daniela

    2017-01-01

    Objective To project the proportion of population 65+ years with severe long-term activity limitations from 2017 to 2047. Design Large population study. Setting Population living in private households of the European Union (EU) and neighbouring countries. Participants Participants from the EU Statistics on Income and Living Conditions aged 55 years and older and living in one of 26 EU and neighbouring countries, who answered the health section of the questionnaire. Outcome measures Prevalence of severe long-term activity limitations of particular subpopulations (ie, 55+, 65+, 75+ and 85+ years) by sex and country. Results We find a huge variation in the prevalence of self-reported severe long-term limitations across Europe for both sexes. However, in 2017, about 20% of the female population aged 65 years and above and about 16% of their male counterparts are expected to report severe long-term activity limitations after accounting for differences in reporting. Accounting for cultural differences in reporting, we expect that European countries will have about 21% (decile 1: 19.5%; decile 9: 22.9%) of female and about 16.8% (decile 1: 15.4%; decile 9: 18.1%) of male 65+ years population with severe long-term activity limitations by 2047. Conclusions Overall, despite the expected increase of life expectancy in European countries, our results suggest almost constant shares of older adults with severe long-term activity limitations within the next 30 years. PMID:29061570

  10. Hepameta-- prevalence of hepatitis B/C and metabolic syndrome in population living in separated and segregated Roma settlements: a methodology for a cross-sectional population-based study using community-based approach.

    PubMed

    Gecková, Andrea Madarasová; Jarcuska, Peter; Mareková, Mária; Pella, Daniel; Siegfried, Leonard; Jarcuska, Pavol; Halánová, Monika

    2014-03-01

    Roma represent one of the largest and oldest minorities in Europe. Health of many of them, particularly those living in settlements, is heavily compromised by poor dwelling, low educational level, unemployment, and poverty rooted in generational poverty, segregation and discrimination. The cross-sectional population-based study using community based approach aimed to map the prevalence of viral hepatitis B/C and metabolic syndrome in the population living in separated and segregated Roma settlements and to compare it with the occurrence of the same health indicators in the majority population, considering selected risk and protective factors of these health indicators. The sample consisted of 452 Roma (mean age = 34.7; 35.2% men) and 403 non-Roma (mean age = 33.5; 45.9% men) respondents. Data were collected in 2011 via questionnaire, anthropometric measures and analysed blood and urine samples. A methodology used in the study as well as in the following scientific papers is described in the Methods section (i.e. study design, procedures, samples, methods including questionnaire, anthropometric measurements, physical measurements, blood and urine measurements). There are regions of declining prosperity due to high unemployment, long-term problems with poverty and depleted resources. Populations living in these areas, i.e. in Central and Eastern Europe in Roma settlements, are at risk of poverty, social exclusion and other factors affecting health. Therefore, we should look for successful long-term strategies and tools (e.g. Roma mediators, terrain work) in order to improve the future prospects of these minorities.

  11. Increased uptake of social security benefits among long-term survivors of cancer in childhood, adolescence and young adulthood: a Norwegian population-based cohort study.

    PubMed

    Ghaderi, S; Engeland, A; Moster, D; Ruud, E; Syse, A; Wesenberg, F; Bjørge, T

    2013-04-16

    As the number of cancer survivors increases, their health and welfare have come into focus. Thus, long-term medical consequences of cancer at a young age (<25 years), obtained from social security benefit records, were studied. Standardised incidence ratios (SIRs) of long-term medical consequences for 5-year cancer survivors, born during 1965-1985, were explored by linking population-based registries in Norway. Among the 5-year cancer survivors (4031 individuals), 29.7% received social security benefits. The survivors had an overall 4.4 times (95% confidence interval (95% CI): 4.1-4.6) higher risk of social security benefit uptake than the cancer-free population. Survivors of malignancies of bone and connective tissues (SIR: 10.8; 95% CI: 9.1-12.9), CNS tumours (SIR: 7.7; 95% CI: 6.9-8.6) and malignancies of the haematopoietic system (SIR: 6.1; 95% CI: 5.3-7.0) had the highest risks of social security benefits uptake. The most notified causes of social security benefit uptake were diseases of the nervous system, and injury and poisoning. The uptake of social security benefits among 5-year cancer survivors increased substantially and it may represent a solid outcome measure for the burden of the most severe late effects, especially in countries with comparable social welfare systems.

  12. [Ophthalmologic healthcare utilization of people in need of long-term care : Analyses of health insurance data of the AOK Baden-Württemberg].

    PubMed

    Schuster, Alexander K; Pick, Julia; Saalmann, Frauke; Pfeiffer, Norbert

    2018-04-10

    Eye diseases causing visual impairment increase with age. Thus, seeking eye care has a higher probability in older people. In this study, the rate of utilization of outpatient eye care services in Germany was analyzed. The analyses focused on older persons and persons in need of either home-based or facility-based long-term care. A descriptive secondary data analysis of health insurance data of the AOK Baden-Württemberg from 2016 was conducted. The study population comprised all insured persons on 1 January 2016. The cohort of older persons (60 years+) was further stratified by the type of care (home-based/facility-based) and the level of care (0-3). The utilization of outpatient eye care services was defined by the reimbursement for an ophthalmologist's provision of service. While 39.3% of the study population 60+ years old sought eye care, the utilization rate was lower among people in need of home-based (33.0%) and facility-based care (19.3%). The utilization rates showed comparable age-dependent patterns, except for persons in need of facility-based care where rates were similar for all age groups. Utilization rates were negatively associated with increasing care levels. Only people with care level 0 showed lower utilization rates than people with care level 1. Utilization rates of eye healthcare services among older persons are considerably influenced by the need of long-term care, by the form of care as well as by the level of care.

  13. Operational studies on the control of Taenia solium taeniasis/cysticercosis in Ecuador.

    PubMed

    Cruz, M; Davis, A; Dixon, H; Pawlowski, Z S; Proano, J

    1989-01-01

    A large-scale study in Loja and El Oro Provinces, Ecuador, demonstrated that population-based treatment of human taeniasis with a low dose of praziquantel is feasible and effective for the short-term control of transmission of Taenia solium in hyperendemic areas. Chemotherapeutic intervention also effectively promoted local preventive measures and contributed greatly to the elaboration of a long-term control programme.

  14. Collembola population levels 7 years after installation of the North Carolina long term soil productivity study

    Treesearch

    Robert J. Eaton

    2006-01-01

    Collembola are among the most abundant microarthropods in terrestrial ecosystems and have been shown to affect litter decomposition and nutrient release rates. Previous work 0-n the Croatan National Forest Long Term Soil Productivity (LTSP) study indicated organic matter removal and vegetation control treatments affected collembolan populations. The present study...

  15. Demographic collapse and low genetic diversity of the Irrawaddy dolphin population inhabiting the Mekong River

    PubMed Central

    Beasley, Isabel; Ackermann, Corinne Y.; Lieckfeldt, Dietmar; Ludwig, Arne; Ryan, Gerard E.; Bejder, Lars; Parra, Guido J.; Wolfensberger, Rebekka; Spencer, Peter B. S.

    2018-01-01

    In threatened wildlife populations, it is important to determine whether observed low genetic diversity may be due to recent anthropogenic pressure or the consequence of historic events. Historical size of the Irrawaddy dolphin (Orcaella brevirostris) population inhabiting the Mekong River is unknown and there is significant concern for long-term survival of the remaining population as a result of low abundance, slow reproduction rate, high neonatal mortality, and continuing anthropogenic threats. We investigated population structure and reconstructed the demographic history based on 60 Irrawaddy dolphins samples collected between 2001 and 2009. The phylogenetic analysis indicated reciprocal monophyly of Mekong River Orcaella haplotypes with respect to haplotypes from other populations, suggesting long-standing isolation of the Mekong dolphin population from other Orcaella populations. We found that at least 85% of all individuals in the two main study areas: Kratie and Stung Treng, bore the same mitochondrial haplotype. Out of the 21 microsatellite loci tested, only ten were polymorphic and exhibited very low levels of genetic diversity. Both individual and frequency-based approaches suggest very low and non-significant genetic differentiation of the Mekong dolphin population. Evidence for recent bottlenecks was equivocal. Some results suggested a recent exponential decline in the Mekong dolphin population, with the current size being only 5.2% of the ancestral population. In order for the Mekong dolphin population to have any potential for long-term survival, it is imperative that management priorities focus on preventing any further population fragmentation or genetic loss, reducing or eliminating anthropogenic threats, and promoting connectivity between all subpopulations. PMID:29298312

  16. China’s Rapidly Aging Population Creates Policy Challenges In Shaping A Viable Long-Term Care System

    PubMed Central

    Feng, Zhanlian; Liu, Chang; Guan, Xinping; Mor, Vincent

    2013-01-01

    In China, formal long-term care services for the large aging population have increased to meet escalating demands as demographic shifts and socioeconomic changes have eroded traditional elder care. We analyze China’s evolving long-term care landscape and trace major government policies and private-sector initiatives shaping it. Although home and community-based services remain spotty, institutional care is booming with little regulatory oversight. Chinese policy makers face mounting challenges overseeing the rapidly growing residential care sector, given the tension arising from policy inducements to further institutional growth, a weak regulatory framework, and the lack of enforcement capacity. We recommend addressing the following pressing policy issues: building a balanced system of services and avoiding an “institutional bias” that promotes rapid growth of elder care institutions over home or community-based care; strengthening regulatory oversight and quality assurance with information systems; and prioritizing education and training initiatives to grow a professionalized long-term care workforce. PMID:23213161

  17. Validation of the Long-term Difficulties Inventory (LDI) and the List of Threatening Experiences (LTE) as measures of stress in epidemiological population-based cohort studies.

    PubMed

    Rosmalen, J G M; Bos, E H; de Jonge, P

    2012-12-01

    Stress questionnaires are included in many epidemiological cohort studies but the psychometric characteristics of these questionnaires are largely unknown. The aim of this study was to describe these characteristics for two short questionnaires measuring the lifetime and past year occurrence of stress: the List of Threatening Events (LTE) as a measure of acute stress and the Long-term Difficulties Inventory (LDI) as a measure of chronic stress. This study was performed in a general population cohort consisting of 588 females (53.7%) and 506 males (46.3%), with a mean age of 53.5 years (s.d.=11.3 years). Respondents completed the LTE and the LDI for the past year, and for the age categories of 0-12, 13-18, 19-39, 40-60, and >60 years. They also completed questionnaires on perceived stress, psychological distress (the General Health Questionnaire, GHQ-12), anxiety and depression (the Symptom Checklist, SCL-8) and neuroticism (the Eysenck Personality Questionnaire - Revised Short Scale, EPQ-RSS-N). Approximately 2 years later, 976 respondents (89%) completed these questionnaires for a second time. The stability of the retrospective reporting of long-term difficulties and life events was satisfactory: 0.7 for the lifetime LDI and 0.6 for the lifetime LTE scores. The construct validity of these lists is indicated by their positive associations with psychological distress, mental health problems and neuroticism. This study in a large population-based sample shows that the LDI and LTE have sufficient validity and stability to include them in major epidemiological cohort studies.

  18. Impact of Preoperative Radiotherapy on General and Disease-Specific Health Status of Rectal Cancer Survivors: A Population-Based Study

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

    Thong, Melissa S.Y., E-mail: M.Thong@uvt.nl; Comprehensive Cancer Centre South, Eindhoven; Mols, Floortje

    Purpose: To date, few studies have evaluated the impact of preoperative radiotherapy (pRT) on long-term health status of rectal cancer survivors. Using a population-based sample, we assessed the impact of pRT on general and disease-specific health status of rectal cancer survivors up to 10 years postdiagnosis. The health status of older ({>=}75 years old at diagnosis) pRT survivors was also compared with that of younger survivors. Methods and Materials: Survivors identified from the Eindhoven Cancer Registry treated with surgery only (SU) or with pRT between 1998 and 2007 were included. Survivors completed the Short Form-36 (SF-36) health survey questionnaire andmore » the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Colorectal 38 (EORTC QLQ-CR38) questionnaire. The SF-36 and EORTC QLQ-CR38 (sexuality subscale) scores of the survivors were compared to an age- and sex-matched Dutch normal population. Results: A total of 340 survivors (response, 85%; pRT survivors, 71%) were analyzed. Overall, survivors had similar general health status. Both short-term (<5 years) and long-term ({>=}5 years) pRT survivors had significantly poorer body image and more problems with gastrointestinal function, male sexual dysfunction, and defecation than SU survivors. Survivors had comparable general health status but greater sexual dysfunction than the normal population. Older pRT survivors had general and disease-specific health status comparable to that of younger pRT survivors. Conclusions: For better survivorship care, rectal cancer survivors could benefit from increased clinical and psychological focus on the possible long-term morbidity of treatment and its effects on health status.« less

  19. Long-term survival among older patients with myocardial infarction differs by educational level: results from the MONICA/KORA myocardial infarction registry

    PubMed Central

    2014-01-01

    Background Socioeconomic disparities in survival after acute myocardial infarction (AMI) have been found in many countries. However, population-based results from Germany are lacking so far. Thus, the objective of this study was to examine the association between educational status and long-term mortality in a population-based sample of people with AMI. Methods The sample consisted of 2,575 men and 844 women, aged 28–74 years, hospitalized with a first-time AMI between 1 January 2000 and 31 December 2008, recruited from a population-based AMI registry. Patients were followed up until December 2011. Data on education, risk factors and co-morbidities were collected by individual interviews; data on clinical characteristics and AMI treatment by chart review. Cox proportional hazards models were used to assess the relationship between educational status and long-term mortality. Results During follow-up, 19.1% of the patients with poor education died compared with 13.1% with higher education. After adjustment for covariates, no effect of education on mortality was found for the total sample and for patients aged below 65 years. In older people, however, low education level was significantly associated with increased mortality (hazard ratio (HR) 1.44, 95% confidence interval (CI) 1.05–1.98, p = 0.023). Stratified analyses showed that women older than 64 years with poor education were significantly more likely to die than women in the same age group with higher education (HR 1.57, 95% CI 1.02–2.41, p = 0.039). Conclusions Elderly, poorly educated patients with AMI, and particularly women, have poorer long-term survival than their better educated peers. Further research is required to illuminate the reasons for this finding. PMID:24552463

  20. Self-reported work ability in long-term breast cancer survivors. A population-based questionnaire study in Denmark.

    PubMed

    Carlsen, Kathrine; Jensen, Anette Jung; Rugulies, Reiner; Christensen, Jane; Bidstrup, Pernille Envold; Johansen, Christoffer; Huitfeldt Madsen, Ida Elisabeth; Dalton, Susanne O

    2013-02-01

    Although up to 80% of women can return to work after treatment for breast cancer, maintaining an affiliation to the labour market may be a challenge, as shown by the fact that the risks for unemployment and early retirement are increased in the years after treatment of cancer. It is important to understand the work problems experienced by cancer survivors, including their ability to work. The aim of this study was to determine whether the ability of long-term breast cancer survivors to work was different from that of a cancer-free control group. In this population-based cross-sectional questionnaire study, 776 breast cancer survivors were matched with 1552 cancer-free women. Women with breast cancer diagnosed in 1997-2000 were identified in the Danish Cancer Registry, and the cancer-free controls were sampled from the Central Population Registry. Work ability was measured from a single question on the 'work ability index'. Furthermore, the questionnaire contained questions on socioeconomic factors, health-related factors and factors related to the workplace. The overall response rate was 57% (493 survivors and 830 controls). After exclusions, the study population consisted of 170 survivors and 391 controls. Women with a diagnosis of breast cancer who had survived at least five years and had returned to work reported significantly poorer work ability than cancer-free controls. In models with adjustment for socioeconomic factors, health-related factors and support at work, the factors most strongly associated with impaired work ability were low income, fatigue and little help and support from a supervisor. Our findings indicate that the work ability of long-term breast cancer survivors who are disease-free and back in work is impaired in comparison with that of cancer-free women.

  1. Irritable bowel symptoms, use of healthcare, costs, sickness and disability pension benefits: A long-term population-based study.

    PubMed

    Poulsen, Chalotte H; Eplov, Lene F; Hjorthøj, Carsten; Hastrup, Lene H; Eliasen, Marie; Dantoft, Thomas M; Schröder, Andreas; Jørgensen, Torben

    2018-05-01

    Irritable bowel syndrome (IBS) is associated with increased healthcare use and work absenteeism. We aimed to investigate long-term use of healthcare services and social benefits across IBS symptom groups. Additionally, we estimated excess healthcare costs. A longitudinal population-based study comprising two 5-year follow-up studies: The Danish part of the Multinational Monitoring of Trends and Determinants in Cardiovascular Disease (Dan-MONICA) 1 (1982-1987) and Inter99 (1999-2004) recruited from the western part of Copenhagen County. The total study population ( n = 7278) was divided into symptom groups according to degree of IBS definition fulfillment at baseline and/or 5-year follow-up and was followed until 31 December 2013 in Danish central registries. Poisson regression was used for the analyses adjusting for age, sex, length of education, comorbidity, cohort membership and mental vulnerability. IBS symptom groups compared to no IBS symptoms were associated with an increased number of contacts with primary and secondary healthcare, as well as weeks on sickness and disability benefits. Accounting for mental vulnerability decreased the estimates and all but two associations between IBS symptom groups and outcomes remained statistically significant. The two associations that became insignificant were contacts with psychiatric hospitals and weeks on disability pension. The excess unadjusted healthcare costs for IBS were 680 Euros per year and the overall association between symptom groups and total healthcare costs were statistically significant. IBS symptoms influence the long-term use and costs of healthcare, as well as the use of social benefits in the general population. Mental vulnerability explained some, but not all, of the use of healthcare and social benefits.

  2. Childhood Neurodevelopmental Disorders and Violent Criminality: A Sibling Control Study

    ERIC Educational Resources Information Center

    Lundström, Sebastian; Forsman, Mats; Larsson, Henrik; Kerekes, Nora; Serlachius, Eva; Långström, Niklas; Lichtenstein, Paul

    2014-01-01

    The longitudinal relationship between attention deficit hyperactivity disorder (ADHD) and violent criminality has been extensively documented, while long-term effects of autism spectrum disorders (ASDs), tic disorders (TDs), and obsessive compulsive disorder (OCD) on criminality have been scarcely studied. Using population-based registers of all…

  3. Cancer morbidity among methyl isocyanate exposed long- term survivors and their offspring: a hospital-based five year descriptive study (2006 - 2011) and future directions to predict cancer risk in the affected population.

    PubMed

    Senthilkumar, Chinnu Sugavanam; Malla, Tahir Mohi-ud-Din; Sah, Nand Kishore; Ganesh, Narayanan

    2011-01-01

    The purpose of this study was to update both researchers and clinicians about the cancer incidence in methyl isocyanate (MIC) exposed long-term survivors and in their offspring, focusing on the etiological plausibility. In the time period 2006-2011, cancer morbidity was evaluated in the population surviving after exposure to (MIC) on December 3rd, 1984, in Bhopal. This descriptive study is based on hospital registration of 1261 cancer patients those are MIC gas victims and their subsequently born offspring. Morbidity status was studied on the basis of gender, age, organ and site with relative percentages. Cancers on specific sites, with special reference to breast (n=231) (18.31%), lung (n=103) (8.16%), tongue (n=103) (8.16%), buccal mucosa (n=94) (7.45%), cervix (n=72) (5.70%), and esophagus (n=68) (5.39%) were found in high proportions. Ovary (n=43) (3.40%), brain (n=42) (3.33%), larynx (n=40) (3.17%), non-Hodgkin's (n=31) (2.45%), gallbladder (n=29) (2.29%), stomach (n=28) (2.22%), head and neck (n=28) (2.22%), liver (n=27) (2.14%), acute lymphoid leukemia (n=24) (1.90%), rectum (n=20) (1.58%), colon (n=20) (1.58%), chronic myeloid leukemia (n=17) (1.34%), alveolus (n=17) (1.34%), Hodgkin's (n=14) (1.11%), uterus (n=14) (1.11%), multiple myeloma (n=14) (1.11%), and prostate (n=11) (0.87%) lesions were observed less frequently. Remarkably, gradual increase of cancers on different organs and sites were observed in the long- term survivors and their offspring. The present study observed some cancers which were not previously reported in this population. In addition, we also present the future research directions with systematic approaches to predict cancer risk in long-term survivors and their future generations. On the basis of this morbidity report, we suggest the need of biological surveillance through immune system biomonitoring and cytogenetic screening to predict the cancer risk in the MIC exposed population and their offspring.

  4. NuSTAR view of the central region of M31

    NASA Astrophysics Data System (ADS)

    Stiele, H.; Kong, A. K. H.

    2018-04-01

    Our neighbouring large spiral galaxy, the Andromeda galaxy (M31 or NGC 224), is an ideal target to study the X-ray source population of a nearby galaxy. NuSTAR observed the central region of M31 in 2015 and allows studying the population of X-ray point sources at energies higher than 10 keV. Based on the source catalogue of the large XMM-Newton survey of M31, we identified counterparts to the XMM-Newton sources in the NuSTAR data. The NuSTAR data only contain sources of a brightness comparable (or even brighter) than the selected sources that have been detected in XMM-Newton data. We investigate hardness ratios, spectra, and long-term light curves of individual sources obtained from NuSTAR data. Based on our spectral studies, we suggest four sources as possible X-ray binary candidates. The long-term light curves of seven sources that have been observed more than once show low (but significant) variability.

  5. Long-term mortality of acetaminophen poisoning: a nationwide population-based cohort study with 10-year follow-up in Taiwan.

    PubMed

    Huang, Hung-Sheng; Ho, Chung-Han; Weng, Shih-Feng; Hsu, Chien-Chin; Wang, Jhi-Joung; Su, Shih-Bin; Lin, Hung-Jung; Huang, Chien-Cheng

    2018-01-08

    The long-term mortality of acetaminophen (APAP) poisoning has not yet been well studied; hence, we conducted this study to gain understanding of this issue. We conducted a nationwide population-based cohort study by identifying 3235 participants with APAP poisoning and 9705 participants without APAP poisoning in Taiwan between 2003 and 2012 in the Nationwide Poisoning Database and Longitudinal Health Insurance Database 2000. Participants with APAP poisoning and control subjects were compared for the risk of all-cause mortality by follow-up until 2013. Two hundred forty-one participants with APAP poisoning (7.5%) and ninety-four control subjects (1.0%) died during the follow-up. Participants with APAP poisoning had a higher risk of all-cause mortality than the control subjects (incidence rate ratio [IRR], 8.1; 95% confidence interval [CI], 6.3-10.2), especially in the subgroup aged 20 years and younger (IRR, 27.3; 95% CI, 3.5-215.5) and in the first 12 months after poisoning (IRR, 16.0; 95% CI, 9.9-25.7). The increased risk of all-cause mortality was found even up to 2 years after the index poisoning. APAP poisoning was associated with increased long-term mortality. Early referral for intensive aftercare and associated interventions are suggested; however, further studies of the method are needed for clarification.

  6. Increased risk of acute pancreatitis in patients with chronic hemodialysis: a 4-year follow-up study.

    PubMed

    Hou, Sheng-Wen; Lee, Yi-Kung; Hsu, Chen-Yang; Lee, Ching-Chih; Su, Yung-Cheng

    2013-01-01

    The risk of acute pancreatitis in patients on long-term peritoneal dialysis is higher as compared to the general population. However, the relationship between long-term hemodialysis and acute pancreatitis has never been established. We investigated the incidence of acute pancreatitis among patients on long-term hemodialysis in Taiwan to evaluate if there is a higher risk of acute pancreatitis in comparison to the general population. We utilized a National Health Insurance (NHI) claims data sample containing one million beneficiaries. We followed all adult beneficiaries from January 1, 2007 until December 31, 2010 to see if they had been hospitalized for acute pancreatitis during this period. We further identified patients on chronic hemodialysis and compared their risk of acute pancreatitis with the general population. This study included 2603 patients with long-term hemodialysis and 773,140 patients without hemodialysis. After controlling for age, gender, Charlson Comorbidity Index Score, geographic region, socioeconomic status and urbanization level, the adjusted hazard ratio was 3.44 (95% Confidence interval, 2.5-4.7). The risk of acute pancreatitis in patients on long-term hemodialysis is significantly higher in comparison to the general population.

  7. Germany's long-term-care insurance: putting a social insurance model into practice.

    PubMed

    Geraedts, M; Heller, G V; Harrington, C A

    2000-01-01

    A growing population of elderly has intensified the demand for long-term care (LTC) services. In response to the mounting need, Germany put into effect a LTC Insurance Act in 1995 that introduced mandatory public or private LTC insurance for the entire population of 82 million. The program was based on the organizational principles that define the German social insurance system. Those individuals in the public system and their employers each pay contributions equal to 0.85 percent of each employee's gross wages or salary. Ten percent of the population with the highest incomes have chosen the option of purchasing private long term care insurance. Provisions were made for uniform eligibility criteria, benefits based on level of care needs, cost containment, and quality assurance. Over the first four years of its operation, the system has proved financially sound and has expanded access to organized LTC services. The German system thus may serve as an example for other countries that are planning to initiate social LTC insurance systems in other nations.

  8. Conservation of the Yellowstone grizzly bear

    USGS Publications Warehouse

    Mattson, David J.; Reid, Matthew M.

    1991-01-01

    We review literature relevant to the conservation of Yellowstone's grizzly bear population and appraise the bear's long-term viability. We conclude that the population is isolated and vulnerable to epidemic perturbation and that the carrying capacity of the habitat is likely to shift downward under conditions of climate change. Viability analyses based on the assumption that future habitats will closely resemble those existing at present have limited applicability; more information is needed on the autecology of important bear foods and on the implications of landscape-scale changes for bear population dynamics. Optimism over prospects of long-term persistence for Yellowstone's grizzly bears does not seem to be warranted and management of this population should be conservative and not unduly swayed on short-term positive trends.

  9. A fall prevention guideline for older adults living in long-term care facilities.

    PubMed

    Jung, D; Shin, S; Kim, H

    2014-12-01

    Falls are among the most frequent critical health problems for older adults over 65 years of age and often result in consequential injuries. This study developed a guideline covering risk factors and interventions for falls in order to prevent them from occurring in long-term care facilities. This study was grounded in the methodological approach of the Scottish Intercollegiate Guideline Network for establishing evidence-based guidelines: (1) establishment of the target population and scope of the guideline, (2) systematic literature review and critical analysis, (3) determination of the recommendation grade, (4) development of a draft nursing intervention guideline and algorithm, (5) expert evaluation of the draft nursing intervention guideline, and (6) confirmation of the final intervention guideline and completion of the algorithm. The resulting evidence-based fall prevention guideline consists of a three-step factor assessment and a three-step intervention approach. The resulting guideline was based on the literature and clinical experts. Further research is required to test the guideline's feasibility in across long term care facilities. This guideline can be used by nurses to screen patients who are at a high risk of falling to provide patient interventions to help prevent falls. Considering the high rate of falls at long-term care facilities and the absence of evidence-based guidelines to prevent them, additional studies on falls at long-term care facilities are necessary. Meanwhile, given prior research that indicates the importance of human resources in the application of such guidelines, continuous investigations are needed as to whether the research outcomes are actually conveyed to nurses. © 2014 International Council of Nurses.

  10. Management of long-term conditions in a prison setting.

    PubMed

    Perry, J

    This article, the fourth in a five-part series, explores the management of long-term conditions in the prison population, as well as patient-centred approaches to care and the challenges this may present. It discusses the effective management of chronic diseases and the importance of evidence-based practice in improving offender health care. The need for an understanding of the sociological and psychological perspectives of living with a long-term condition is explained.

  11. Population Parameters of Blainvilles and Cuviers Beaked Whales

    DTIC Science & Technology

    2015-09-30

    cetacean populations. Long-term monitoring of beaked whale populations in El Hierro , a nearly pristine habitat far from areas of sonar testing or...marine industry, enables valuable studies of demographic trends and life history dictated mainly by natural parameters. El Hierro is in process of...functioning (expected in 2018-2019), it is essential to continue monitoring the populations in El Hierro to obtain an uninterrupted long-term dataset of

  12. Operational studies on the control of Taenia solium taeniasis/cysticercosis in Ecuador.

    PubMed Central

    Cruz, M.; Davis, A.; Dixon, H.; Pawlowski, Z. S.; Proano, J.

    1989-01-01

    A large-scale study in Loja and El Oro Provinces, Ecuador, demonstrated that population-based treatment of human taeniasis with a low dose of praziquantel is feasible and effective for the short-term control of transmission of Taenia solium in hyperendemic areas. Chemotherapeutic intervention also effectively promoted local preventive measures and contributed greatly to the elaboration of a long-term control programme. PMID:2805217

  13. Epidemiological evidence for a health risk from mobile phone base stations.

    PubMed

    Khurana, Vini G; Hardell, Lennart; Everaert, Joris; Bortkiewicz, Alicja; Carlberg, Michael; Ahonen, Mikko

    2010-01-01

    Human populations are increasingly exposed to microwave/radiofrequency (RF) emissions from wireless communication technology, including mobile phones and their base stations. By searching PubMed, we identified a total of 10 epidemiological studies that assessed for putative health effects of mobile phone base stations. Seven of these studies explored the association between base station proximity and neurobehavioral effects and three investigated cancer. We found that eight of the 10 studies reported increased prevalence of adverse neurobehavioral symptoms or cancer in populations living at distances < 500 meters from base stations. None of the studies reported exposure above accepted international guidelines, suggesting that current guidelines may be inadequate in protecting the health of human populations. We believe that comprehensive epidemiological studies of long-term mobile phone base station exposure are urgently required to more definitively understand its health impact.

  14. Modeling the effects of trophy selection and environmental disturbance on a simulated population of African lions.

    PubMed

    Whitman, Karyl L; Starfield, Anthony M; Quadling, Henley; Packer, Craig

    2007-06-01

    Tanzania is a premier destination for trophy hunting of African lions (Panthera leo) and is home to the most extensive long-term study of unhunted lions. Thus, it provides a unique opportunity to apply data from a long-term field study to a conservation dilemma: How can a trophy-hunted species whose reproductive success is closely tied to social stability be harvested sustainably? We used an individually based, spatially explicit, stochastic model, parameterized with nearly 40 years of behavioral and demographic data on lions in the Serengeti, to examine the separate effects of trophy selection and environmental disturbance on the viability of a simulated lion population in response to annual harvesting. Female population size was sensitive to the harvesting of young males (> or = 3 years), whereas hunting represented a relatively trivial threat to population viability when the harvest was restricted to mature males (> or = 6 years). Overall model performance was robust to environmental disturbance and to errors in age assessment based on nose coloration as an index used to age potential trophies. Introducing an environmental disturbance did not eliminate the capacity to maintain a viable breeding population when harvesting only older males, and initially depleted populations recovered within 15-25 years after the disturbance to levels comparable to hunted populations that did not experience a catastrophic event. These results are consistent with empirical observations of lion resilience to environmental stochasticity.

  15. Internet-Based Programs Incorporating Behavior Change Techniques Are Associated With Increased Smoking Cessation in the General Population: A Systematic Review and Meta-analysis.

    PubMed

    McCrabb, Sam; Baker, Amanda L; Attia, John; Skelton, Eliza; Twyman, Laura; Palazzi, Kerrin; McCarter, Kristen; Ku, Dominic; Bonevski, Billie

    2018-05-10

    This study aims to (i) examine the effectiveness of internet-based smoking cessation programs; (ii) describe the number and type of behavior change techniques (BCTs) employed; and (iii) explore whether BCTs included in internet-based smoking cessation programs are related to program effectiveness. MEDLINE, CINAHL, EMBASE, PsycINFO, and CENTRAL databases were searched. Randomized controlled trials were included if they described the study of a smoking cessation program delivered via the internet; included current adult tobacco smokers from the general population; and were written in English. Random effects meta-analyses and meta-regressions were used to examine program effectiveness (pooled odds ratios, by outcome measure, i.e., 7 day point prevalence abstinence [PPA], 30 day PPA, other abstinence measure) in short- and long-term outcomes, and examine the associations between BCT number and type (individual BCTs and BCT domain) and program effectiveness. Results from 45 studies were included (n = 65,736). Intervention effectiveness was found in the short term for all outcome measures (OR = 1.29, 95% CI 1.12, 1.50, p = .001), for "prolonged abstinence" (OR = 1.43, 95% CI 1.09, 1.87, p = .009), and "30 day PPA" (OR = 1.75, 95% CI 1.13, 2.72, p = .013). Internet-based programs were effective in the long term for all outcome measures (OR = 1.19, 95% CI = 1.06, 1.35, p = .004) and for "prolonged abstinence" (OR = 1.40, 95% CI 1.19, 1.63, p < .001). On average, interventions used more BCTs than comparison groups (6.6 vs. 3.1, p = .0002). The impact of specific individual BCTs and BCT domains on effectiveness was examined and is reported. Internet-based smoking cessation interventions increased the odds of cessation by 29 per cent in the short term and by 19 per cent in the long term. Internet-based smoking cessation intervention development should incorporate BCTs to increase effectiveness. CRD42015014676.

  16. Long-term neighborhood poverty trajectories and obesity in a sample of california mothers.

    PubMed

    Sheehan, Connor M; Cantu, Phillip A; Powers, Daniel A; Margerison-Zilko, Claire E; Cubbin, Catherine

    2017-07-01

    Neighborhoods (and people) are not static, and are instead shaped by dynamic long-term processes of change (and mobility). Using the Geographic Research on Wellbeing survey, a population-based sample of 2339 Californian mothers, we characterize then investigate how long-term latent neighborhood poverty trajectories predict the likelihood of obesity, taking into account short-term individual residential mobility. We find that, net of individual and neighborhood-level controls, living in or moving to tracts that experienced long-term low poverty was associated with lower odds of being obese relative to living in tracts characterized by long-term high poverty. Copyright © 2017 Elsevier Ltd. All rights reserved.

  17. Context-dependence of long-term responses of terrestrial gastropod populations to large-scale disturbance.

    Treesearch

    Christopher P. Bloch; Michael R. Willi

    2006-01-01

    Large-scale natural disturbances, such as hurricanes, can have profound effects on animal populations. Nonetheless, generalizations about the effects of disturbance are elusive, and few studies consider long-term responses of a single population or community to multiple large-scale disturbance events. In the last 20 y, twomajor hurricanes (Hugo and Georges) have struck...

  18. Short- and Long-Term Outcomes of Student Field Research Experiences in Special Populations.

    PubMed

    Soliman, Amr S; Chamberlain, Robert M

    2016-06-01

    Global health education and training of biomedical students in international and minority health research is expending through U.S. academic institutions. This study addresses the short- and long-term outcomes of an NCI-funded R25 short-term summer field research training program. This program is designed for MPH and Ph.D. students in cancer epidemiology and related disciplines, in international and minority settings (special populations) in a recent 7-year period. Positive short-term outcome of 73 students was measured as publishing a manuscript from the field research data and having a job in special populations. Positive long-term outcome was measured as having a post-doc position, being in a doctoral program, and/or employment in special populations at least 3 years from finishing the program. Significant factors associated with both short- and long-term success included resourcefulness of the student and compatibility of personalities and interests between the student and the on-campus and off-campus mentors. Short-term-success of students who conducted international filed research was associated with visits of the on-campus mentor to the field site. Short-term success was also associated with extent of mentorship in the field site and with long-term success. Future studies should investigate how field research sites could enhance careers of students, appropriateness of the sites for specific training competencies, and how to maximize the learning experience of students in international and minority research sites.

  19. Population momentum across vertebrate life histories

    USGS Publications Warehouse

    Koons, D.N.; Grand, J.B.; Arnold, J.M.

    2006-01-01

    Population abundance is critically important in conservation, management, and demographic theory. Thus, to better understand how perturbations to the life history affect long-term population size, we examined population momentum for four vertebrate classes with different life history strategies. In a series of demographic experiments we show that population momentum generally has a larger effect on long-term population size for organisms with long generation times than for organisms with short generation times. However, patterns between population momentum and generation time varied across taxonomic groups and according to the life history parameter that was changed. Our findings indicate that momentum may be an especially important aspect of population dynamics for long-lived vertebrates, and deserves greater attention in life history studies. Further, we discuss the importance of population momentum in natural resource management, pest control, and conservation arenas. ?? 2006 Elsevier B.V. All rights reserved.

  20. Biogeography and organic matter removal shape long-term effects of timber harvesting on forest soil microbial communities.

    PubMed

    Wilhelm, Roland C; Cardenas, Erick; Maas, Kendra R; Leung, Hilary; McNeil, Larisa; Berch, Shannon; Chapman, William; Hope, Graeme; Kranabetter, J M; Dubé, Stephane; Busse, Matt; Fleming, Robert; Hazlett, Paul; Webster, Kara L; Morris, David; Scott, D Andrew; Mohn, William W

    2017-11-01

    The growing demand for renewable, carbon-neutral materials and energy is leading to intensified forest land-use. The long-term ecological challenges associated with maintaining soil fertility in managed forests are not yet known, in part due to the complexity of soil microbial communities and the heterogeneity of forest soils. This study determined the long-term effects of timber harvesting, accompanied by varied organic matter (OM) removal, on bacterial and fungal soil populations in 11- to 17-year-old reforested coniferous plantations at 18 sites across North America. Analysis of highly replicated 16 S rRNA gene and ITS region pyrotag libraries and shotgun metagenomes demonstrated consistent changes in microbial communities in harvested plots that included the expansion of desiccation- and heat-tolerant organisms and decline in diversity of ectomycorrhizal fungi. However, the majority of taxa, including the most abundant and cosmopolitan groups, were unaffected by harvesting. Shifts in microbial populations that corresponded to increased temperature and soil dryness were moderated by OM retention, which also selected for sub-populations of fungal decomposers. Biogeographical differences in the distribution of taxa as well as local edaphic and environmental conditions produced substantial variation in the effects of harvesting. This extensive molecular-based investigation of forest soil advances our understanding of forest disturbance and lays the foundation for monitoring long-term impacts of timber harvesting.

  1. Increased uptake of social security benefits among long-term survivors of cancer in childhood, adolescence and young adulthood: a Norwegian population-based cohort study

    PubMed Central

    Ghaderi, S; Engeland, A; Moster, D; Ruud, E; Syse, A; Wesenberg, F; Bjørge, T

    2013-01-01

    Background: As the number of cancer survivors increases, their health and welfare have come into focus. Thus, long-term medical consequences of cancer at a young age (<25 years), obtained from social security benefit records, were studied. Methods: Standardised incidence ratios (SIRs) of long-term medical consequences for 5-year cancer survivors, born during 1965–1985, were explored by linking population-based registries in Norway. Results: Among the 5-year cancer survivors (4031 individuals), 29.7% received social security benefits. The survivors had an overall 4.4 times (95% confidence interval (95% CI): 4.1–4.6) higher risk of social security benefit uptake than the cancer-free population. Survivors of malignancies of bone and connective tissues (SIR: 10.8; 95% CI: 9.1–12.9), CNS tumours (SIR: 7.7; 95% CI: 6.9–8.6) and malignancies of the haematopoietic system (SIR: 6.1; 95% CI: 5.3–7.0) had the highest risks of social security benefits uptake. The most notified causes of social security benefit uptake were diseases of the nervous system, and injury and poisoning. Conclusion: The uptake of social security benefits among 5-year cancer survivors increased substantially and it may represent a solid outcome measure for the burden of the most severe late effects, especially in countries with comparable social welfare systems. PMID:23481179

  2. Using a full annual cycle model to evaluate long-term population viability of the conservation-reliant Kirtland's warbler after successful recovery

    USGS Publications Warehouse

    Brown, Donald J.; Ribic, Christine; Donner, Deahn M.; Nelson, Mark D.; Bocetti, Carol I.; Deloria-Sheffield, Christie M.

    2017-01-01

    Long-term management planning for conservation-reliant migratory songbirds is particularly challenging because habitat quality in different stages and geographic locations of the annual cycle can have direct and carry-over effects that influence the population dynamics. The Neotropical migratory songbird Kirtland's warbler Setophaga kirtlandii (Baird 1852) is listed as endangered under the U.S. Endangered Species Act and Near Threatened under the IUCN Red List. This conservation-reliant species is being considered for U.S. federal delisting because the species has surpassed the designated 1000 breeding pairs recovery threshold since 2001.To help inform the delisting decision and long-term management efforts, we developed a population simulation model for the Kirtland's warbler that incorporated both breeding and wintering grounds habitat dynamics, and projected population viability based on current environmental conditions and potential future management scenarios. Future management scenarios included the continuation of current management conditions, reduced productivity and carrying capacity due to the changes in habitat suitability from the creation of experimental jack pine Pinus banksiana (Lamb.) plantations, and reduced productivity from alteration of the brown-headed cowbird Molothrus ater (Boddaert 1783) removal programme.Linking wintering grounds precipitation to productivity improved the accuracy of the model for replicating past observed population dynamics. Our future simulations indicate that the Kirtland's warbler population is stable under two potential future management scenarios: (i) continuation of current management practices and (ii) spatially restricting cowbird removal to the core breeding area, assuming that cowbirds reduce productivity in the remaining patches by ≤41%. The additional future management scenarios we assessed resulted in population declines.Synthesis and applications. Our study indicates that the Kirtland's warbler population is stable under current management conditions and that the jack pine plantation and cowbird removal programmes continue to be necessary for the long-term persistence of the species. This study represents one of the first attempts to incorporate full annual cycle dynamics into a population viability analysis for a migratory bird, and our results indicate that incorporating wintering grounds dynamics improved the model performance.

  3. Techniques and results of nongame bird monitoring in North America

    USGS Publications Warehouse

    Robbins, C.S.; Bystrak, D.; Geissler, P.H.; Oelke, H.

    1980-01-01

    Long-term bird population trends based on accumulated ratios (proportional change) sometimes give a very misleading view of population change. Alternate methods of representing population change, based on the weighted means for the individual years, avoid the dangers of using ratios. Some advantages and disadvantages of various weighting techniques are discussed.

  4. Maternal smoking during pregnancy and the risk of pediatric cardiovascular diseases of the offspring: A population-based cohort study with up to 18-years of follow up.

    PubMed

    Leybovitz-Haleluya, Noa; Wainstock, Tamar; Landau, Daniella; Sheiner, Eyal

    2018-06-01

    Cigarette smoke is a well-known reproductive toxicant. We aimed to study the long-term effect of cigarette smoking during pregnancy on the risk for childhood cardiovascular morbidity of the offspring. A population-based cohort analysis was performed comparing total and subtypes of cardiovascular related pediatric hospitalizations among offspring of smoking mothers versus offspring of non-smoking mothers. The analysis included all singletons born between the years 1999-2014.A Kaplan-Meier survival curve was used to compare the cumulative cardiovascular morbidity, and a Cox proportional hazards model was constructed to adjust for confounders. The study population included 242,342 newborns which met inclusion criteria; among them 2861 were born to smoking mothers. Offspring of smoking mothers had higher rates of cardiovascular-related hospitalizations (1.3% vs. 0.6%, OR 2.1, 95% CI 1.5-2.9; p < 0.001; Kaplan-Meier log-rank test p < 0.001). Smoking exposure during pregnancy is associated with an increased risk for long-term pediatric cardiovascular morbidity of the offspring. Copyright © 2018 Elsevier Inc. All rights reserved.

  5. A Health Services Research Agenda for Bariatric Surgery Within the Veterans Health Administration.

    PubMed

    Funk, L M; Gunnar, W; Dominitz, J A; Eisenberg, D; Frayne, S; Maggard-Gibbons, M; Kalarchian, M A; Livingston, E; Sanchez, V; Smith, B R; Weidenbacher, H; Maciejewski, Matthew L

    2017-04-01

    In 2016, the Veterans Health Administration (VHA) held a Weight Management State of the Art conference to identify evidence gaps and develop a research agenda for population-based weight management for veterans. Included were behavioral, pharmacologic, and bariatric surgery workgroups. This article summarizes the bariatric surgery workgroup (BSWG) findings and recommendations for future research. The BSWG agreed that there is evidence from randomized trials and large observational studies suggesting that bariatric surgery is superior to medical therapy for short- and intermediate-term remission of type 2 diabetes, long-term weight loss, and long-term survival. Priority evidence gaps include long-term comorbidity remission, mental health, substance abuse, and health care costs. Evidence of the role of endoscopic weight loss options is also lacking. The BSWG also noted the limited evidence regarding optimal timing for bariatric surgery referral, barriers to bariatric surgery itself, and management of high-risk bariatric surgery patients. Clinical trials of pre- and post-surgery interventions may help to optimize patient outcomes. A registry of overweight and obese veterans and a workforce assessment to determine the VHA's capacity to increase bariatric surgery access were recommended. These will help inform policy modifications and focus the research agenda to improve the ability of the VHA to deliver population-based weight management.

  6. Socioeconomic conditions among long-term gynaecological cancer survivors--a population-based case-control study.

    PubMed

    Platou, Toril Forbord; Skjeldestad, Finn Egil; Rannestad, Toril

    2010-03-01

    The population of gynaecological cancer survivors is growing, yet little is known about the effects of cancer and treatment on socioeconomic conditions well beyond the completion of therapy. The aim of this study was to investigate the socioeconomic conditions in long-term survivors of gynaecological cancer compared with a representative group of women from the general population. The study comprises women aged 32-75 residing in central part of Norway and who were treated as primary cases of gynaecological cancer at the University Hospital in Trondheim, Norway (n=160), and a control group from the general population (n=493). All analyses were done by chi(2) test and logistic regression. Gynaecological cancer survivors scored lower on a Socioeconomic Condition Index than the control group. They had on the average a complete remission period of 12 years. Compared with the control group, they were more often disabled (p<0.01) and had lower annual household income (p<0.01). No difference was detected between the groups in ability to pay bills. More cases than controls had experienced problems assigning personal insurance (p<0.03). Long-term gynaecological cancer survivors lived under poorer socioeconomic conditions, were more often disabled and had lower annual household income than the women in the control group, whereas no difference in ability to pay bills were found between the groups. In spite of poorer socioeconomic conditions, the gynaecological cancer survivors seem to adapt well to their financial situation.

  7. Long-term treatment of deep-vein thrombosis with low-molecular-weight heparin: an update of the evidence.

    PubMed

    Hull, Russell D; Townshend, Grace

    2013-07-01

    This article reviews updated evidence-based knowledge on long-term treatment of deep-vein thrombosis (DVT) with low-molecular-weight heparin (LMWH) or vitamin K antagonists (VKAs). Eleven trials were identified comparing the two treatments in a broad spectrum of patients with DVT and with >100 study participants. Four comparative trials were identified in patients with cancer and DVT (in whom anticoagulation treatment is more complex and bleeding complications more frequent). In the 11 trials in broad patient populations, LMWHs were as effective as VKAs in preventing recurrent venous thromboembolism (VTE), and there were no consistent differences in the incidence of bleeding complications during long-term treatment. In patients with cancer, VTE recurrence was significantly reduced with LMWH versus VKA in two studies, while major bleeding complications did not differ between groups in any of the four trials. Current evidence-based European and American guidelines recommend LMWH over VKA for the long-term treatment of DVT in patients with cancer. LMWH and VKA are recommended over the new oral anticoagulant drugs, for which there are limited data on use in long-term treatment. Post-thrombotic syndrome (PTS), a common complication of DVT, causes considerable morbidity. Long-term use of tinzaparin reduced the risk of PTS compared with VKA in one trial, and a meta-analysis of nine studies in total demonstrated a consistently favourable effect of LMWHs versus VKA on PTS-related outcomes. Given the limited treatment options available for PTS, this suggests that LMWHs provide a useful therapeutic option in any patient particularly at risk of developing PTS.

  8. Long-Term Orientation and Educational Performance. Working Paper 174

    ERIC Educational Resources Information Center

    Figlio, David; Giuliano, Paola; Özek, Umut; Sapienza, Paola

    2017-01-01

    We use remarkable population-level administrative education and birth records from Florida to study the role of Long-Term Orientation on the educational attainment of immigrant students living in the US. Controlling for the quality of schools and individual characteristics, students from countries with long-term oriented attitudes perform better…

  9. Trends and drivers of marine debris on the Atlantic coast of the United States 1997-2007

    USGS Publications Warehouse

    Ribic, C.A.; Sheavly, S.B.; Rugg, D.J.; Erdmann, Eric S.

    2010-01-01

    For the first time, we documented regional differences in amounts and long-term trends of marine debris along the US Atlantic coast. The Southeast Atlantic had low land-based and general-source debris loads as well as no increases despite a 19% increase in coastal population. The Northeast (8% population increase) also had low land-based and general-source debris loads and no increases. The Mid-Atlantic (10% population increase) fared the worst, with heavy land-based and general-source debris loads that increased over time. Ocean-based debris did not change in the Northeast where the fishery is relatively stable; it declined over the Mid-Atlantic and Southeast and was correlated with declining regional fisheries. Drivers, including human population, land use status, fishing activity, and oceanic current systems, had complex relationships with debris loads at local and regional scales. Management challenges remain undeniably large but solid information from long-term programs is one key to addressing this pressing pollution issue. ?? 2010.

  10. Trends and drivers of marine debris on the Atlantic coast of the United States 1997-2007.

    PubMed

    Ribic, Christine A; Sheavly, Seba B; Rugg, David J; Erdmann, Eric S

    2010-08-01

    For the first time, we documented regional differences in amounts and long-term trends of marine debris along the US Atlantic coast. The Southeast Atlantic had low land-based and general-source debris loads as well as no increases despite a 19% increase in coastal population. The Northeast (8% population increase) also had low land-based and general-source debris loads and no increases. The Mid-Atlantic (10% population increase) fared the worst, with heavy land-based and general-source debris loads that increased over time. Ocean-based debris did not change in the Northeast where the fishery is relatively stable; it declined over the Mid-Atlantic and Southeast and was correlated with declining regional fisheries. Drivers, including human population, land use status, fishing activity, and oceanic current systems, had complex relationships with debris loads at local and regional scales. Management challenges remain undeniably large but solid information from long-term programs is one key to addressing this pressing pollution issue. Published by Elsevier Ltd.

  11. Long-Term Fine Particulate Matter Exposure and Major Depressive Disorder in a Community-Based Urban Cohort

    PubMed Central

    Kim, Kyoung-Nam; Lim, Youn-Hee; Bae, Hyun Joo; Kim, Myounghee; Jung, Kweon; Hong, Yun-Chul

    2016-01-01

    Background: Previous studies have associated short-term air pollution exposure with depression. Although an animal study showed an association between long-term exposure to particulate matter ≤ 2.5 μm (PM2.5) and depression, epidemiological studies assessing the long-term association are scarce. Objective: We aimed to determine the association between long-term PM2.5 exposure and major depressive disorder (MDD). Methods: A total of 27,270 participants 15–79 years of age who maintained an address within the same districts in Seoul, Republic of Korea, throughout the entire study period (between 2002 and 2010) and without a previous MDD diagnosis were analyzed. We used three district-specific exposure indices as measures of long-term PM2.5 exposure. Cox proportional hazards models adjusted for potential confounding factors and measured at district and individual levels were constructed. We further conducted stratified analyses according to underlying chronic diseases such as diabetes mellitus, cardiovascular disease, and chronic obstructive pulmonary disease. Results: The risk of MDD during the follow-up period (2008–2010) increased with an increase of 10 μg/m3 in PM2.5 in 2007 [hazard ratio (HR) = 1.44; 95% CI: 1.17, 1.78], PM2.5 between 2007 and 2010 (HR = 1.59; 95% CI: 1.02, 2.49), and 12-month moving average of PM2.5 until an event or censor (HR = 1.47; 95% CI: 1.14, 1.90). The association between long-term PM2.5 exposure and MDD was greater in participants with underlying chronic diseases than in participants without these diseases. Conclusion: Long-term PM2.5 exposure increased the risk of MDD among the general population. Individuals with underlying chronic diseases are more vulnerable to long-term PM2.5 exposure. Citation: Kim KN, Lim YH, Bae HJ, Kim M, Jung K, Hong YC. 2016. Long-term fine particulate matter exposure and major depressive disorder in a community-based urban cohort. Environ Health Perspect 124:1547–1553; http://dx.doi.org/10.1289/EHP192 PMID:27129131

  12. Ten-year health service use outcomes in a population-based cohort of 21,000 injured adults: the Manitoba injury outcome study.

    PubMed Central

    Cameron, C. M.; Purdie, D. M.; Kliewer, E. V.; McClure, R. J.

    2006-01-01

    OBJECTIVE: To quantify long-term health service use (HSU) following non-fatal injury in adults. METHODS: A retrospective, population-based, matched cohort study identified an inception cohort (1988-91) of injured people who had been hospitalized (ICD-9-CM 800-995) aged 18-64 years (n = 21 032) and a matched non-injured comparison group (n = 21 032) from linked administrative data from Manitoba, Canada. HSU data (on hospitalizations, cumulative length of stay, physician claims and placements in extended care services) were obtained for the 12 months before and 10 years after the injury. Negative binomial and Poisson regressions were used to quantify associations between injury and long-term HSU. FINDINGS: Statistically significant differences in the rates of HSU existed between the injured and non-injured cohorts for the pre-injury year and every year of the follow-up period. After controlling for pre-injury HSU, the attributable risk percentage indicated that 38.7% of all post-injury hospitalizations (n = 25 183), 68.9% of all years spent in hospital (n = 1031), 21.9% of physician claims (n = 269 318) and 77.1% of the care home placements (n = 189) in the injured cohort could be attributed to being injured. CONCLUSION: Many people who survive the initial period following injury, face long periods of inpatient care (and frequent readmissions), high levels of contact with physicians and an increased risk of premature placement in institutional care. Population estimates of the burden of injury could be refined by including long-term non-fatal health consequences and controlling for the effect of pre-injury comorbidity. PMID:17128360

  13. Interaction between air pollution exposure and genes in relation to levels of inflammatory markers and risk of myocardial infarction

    PubMed Central

    Panasevich, Sviatlana; Leander, Karin; Ljungman, Petter; Bellander, Tom; de Faire, Ulf; Pershagen, Göran; Nyberg, Fredrik

    2013-01-01

    Objectives Air pollution exposure induces cardiovascular effects, possibly via systemic inflammation and coagulation misbalance. Genetic variation may determine individual susceptibility. Our aim was to investigate effect modification by inflammation (Interleukin6 (IL6), tumour necrosis factor-α (TNF-α)) and coagulation (fibrinogen Bβ, plasminogen activator inhibitor-1 (PAI-1)) gene variants on the effect of long-term or short-term air pollution exposure on both blood marker levels and non-fatal myocardial infarction (MI) risk. Design Population-based case–control study with a nested case-crossover study. Gene-environment interactions for short-term and long-term air pollution on blood marker levels were studied in population controls, for long-term exposure on MI risk using case–control design, and for short-term exposure on MI onset using case-crossover design. Setting The Stockholm Heart Epidemiology Programme (SHEEP) conducted in 1992–1994 in Stockholm, Sweden. Spatial modelling was used to assess long-term (up to 30 years retrospectively) air pollution exposure to traffic-NO2 and heating-SO2 emissions at home addresses. Urban background NO2, SO2, PM10 and O3 measurements were used to estimate short-term (up to 5 days) air pollution exposure. Participants 1192 MI cases and 1506 population controls aged 45–70 years. Outcomes The levels of blood markers of inflammation (IL-6, TNF-α) and coagulation (fibrinogen, PAI-1) and MI risk. Results We observed gene–environment interaction for several IL6 and TNF SNPs in relation to inflammation blood marker levels. One-year traffic-NO2 exposure was associated with higher IL-6 levels with each additional IL6-174C allele, and 1-year heating-SO2 exposure with higher levels of TNF-α in TNF-308AA homozygotes versus −308G carriers. Short-term air pollution exposure also interacted with IL6 and TNF in relation to marker levels. The risk of MI followed the effect on blood markers in each genotype group. Conclusions Genetic variants in IL6 and TNF may modify effects of long-term and short-term air pollution exposure on inflammatory marker levels and MI risk. PMID:24056475

  14. Monitoring of a Southern Giant Petrel Macronectes giganteus population on the Frazier Islands, Wilkes Land, Antarctica

    USGS Publications Warehouse

    Creuwels, J.C.S.; Stark, J.S.; Woehler, Eric J.; Van Franeker, J. A.; Ribic, C.A.

    2005-01-01

    Since 1956, Southern Giant Petrels on the Frazier Islands, East Antarctica, have been counted with different census techniques, sometimes varying within seasons and among islands, which hindered analysis of the data. Protective measures for the islands from 1986 onwards have increased the need for reliable long-term census data, but reduced the ways to collect these data. Published and unpublished data were re-examined, and population trends were reconstructed based on two relatively standardised techniques: the number of active chicks (AC) and the number of apparently occupied nests (AON) around hatching. AC-values from Nelly Island from 1959 to 1998 indicate substantial periodic fluctuations, but no consistent long-term change. Since the late 1970s, AC-values on the other two islands and AON-values suggest that the breeding population may have grown by 35%. This recent growth, however, is within the extent of periodic fluctuations observed in Southern Giant Petrel population that is stable over the long term. ?? Springer-Verlag 2004.

  15. Long-term outcomes after severe shock.

    PubMed

    Pratt, Cristina M; Hirshberg, Eliotte L; Jones, Jason P; Kuttler, Kathryn G; Lanspa, Michael J; Wilson, Emily L; Hopkins, Ramona O; Brown, Samuel M

    2015-02-01

    Severe shock is a life-threatening condition with very high short-term mortality. Whether the long-term outcomes among survivors of severe shock are similar to long-term outcomes of other critical illness survivors is unknown. We therefore sought to assess long-term survival and functional outcomes among 90-day survivors of severe shock and determine whether clinical predictors were associated with outcomes. Seventy-six patients who were alive 90 days after severe shock (received ≥1 μg/kg per minute of norepinephrine equivalent) were eligible for the study. We measured 3-year survival and long-term functional outcomes using the Medical Outcomes Study 36-Item Short-Form Health Survey, the EuroQOL 5-D-3L, the Hospital Anxiety and Depression Scale, the Impact of Event Scale-Revised, and an employment instrument. We also assessed the relationship between in-hospital predictors and long-term outcomes. The mean long-term survival was 5.1 years; 82% (62 of 76) of patients survived, of whom 49 were eligible for follow-up. Patients who died were older than patients who survived. Thirty-six patients completed a telephone interview a mean of 5 years after hospital admission. The patients' Physical Functioning scores were below U.S. population norms (P < 0.001), whereas mental health scores were similar to population norms. Nineteen percent of the patients had symptoms of depression, 39% had symptoms of anxiety, and 8% had symptoms of posttraumatic stress disorder. Thirty-six percent were disabled, and 17% were working full-time. Early survivors of severe shock had a high 3-year survival rate. Patients' long-term physical and psychological outcomes were similar to those reported for cohorts of less severely ill intensive care unit survivors. Anxiety and depression were relatively common, but only a few patients had symptoms of posttraumatic stress disorder. This study supports the observation that acute illness severity does not determine long-term outcomes. Even extremely critically ill patients have similar outcomes to general intensive care unit survivor populations.

  16. Who Lives Where and Does It Matter? Changes in the Health Profiles of Older People Living in Long Term Care and the Community over Two Decades in a High Income Country.

    PubMed

    Matthews, Fiona E; Bennett, Holly; Wittenberg, Raphael; Jagger, Carol; Dening, Tom; Brayne, Carol

    2016-01-01

    There have been fundamental shifts in the attitude towards, access to and nature of long term care in high income countries. The proportion and profile of the older population living in such settings varies according to social, cultural, and economic characteristics as well as governmental policies. Changes in the profiles of people in different settings are important for policy makers and care providers. Although details will differ, how change occurs across time is important to all, including lower and middle income countries developing policies themselves. Here change is examined across two decades in England. Using the two Cognitive Function and Ageing Studies (CFAS I: 77% response, CFAS II: 56% response), two population based studies of older people carried out in the same areas conducted two decades apart, the study diagnosis of dementia using the Automated Geriatric Examination for Computer Assisted Taxonomy, health and wellbeing were examined, focusing on long term care. The proportion of individuals with three or more health conditions increased for everyone living in long term care between CFAS I (47.6%, 95% CI: 42.3-53.1) and CFAS II (62.7%, 95% CI: 54.8-70.0) and was consistently higher in those without dementia compared to those with dementia in both studies. Functional impairment measured by activities of daily living increased in assisted living facilities from 48% (95% CI: 44%-52%) to 67% (95% CI: 62%-71%). Health profiles of residents in long term care have changed dramatically over time. Dementia prevalence and reporting multiple health conditions have increased. Receiving care in the community puts pressure on unpaid carers and formal services; these results have implications for policies about supporting people at home as well as for service provision within long term care including quality of care, health management, cost, and the development of a skilled, caring, and informed workforce.

  17. The long-term physical and psychological health impacts of flooding: A systematic mapping.

    PubMed

    Zhong, Shuang; Yang, Lianping; Toloo, Sam; Wang, Zhe; Tong, Shilu; Sun, Xiaojie; Crompton, David; FitzGerald, Gerard; Huang, Cunrui

    2018-06-01

    Flooding has caused significant and wide ranging long-term health impacts for affected populations. However, until now, the long-term health outcomes, epidemiological trends and specific impact factors of flooding had not been identified. In this study, the relevant literature was systematically mapped to create the first synthesis of the evidence of the long-term health impacts of flooding. The systematic mapping method was used to collect and categorize all the relevant literature. A study was included if it had a description or measurement of health impacts over six months after flooding. The search was limited to peer reviewed articles and grey literature written in English, published from 1996 to 2016. A total of 56 critical articles were extracted for the final map, including 5 qualitative and 51 quantitative studies. Most long-term studies investigated the psychological impacts of flooding, including PTSD, depression, anxiety, psychiatric disorders, sleep disorder and suicide. Others investigated the physiological impacts, including health-related quality of life, acute myocardial infarction, chronic diseases, and malnutrition. Social support was proved to be protective factors that can improve health outcomes in the long-term after flooding. To date, there have been relatively few reviews had focused on the long-term health impacts of flooding. This study coded and catalogued the existing evidence across a wide range of variables and described the long-term health consequences within a conceptual map. Although there was no boundary between the short-term and the long-term impacts of flooding, the identified health outcomes in this systematic mapping could be used to define long-term health impacts. The studies showed that the prevalence of psychological diseases had a reversed increasing trend occurred even in the long-term in relatively poor post-flooding environments. Further cohort or longitudinal research focused on disability, chronic diseases, relocation population, and social interventions after flooding, are urgently required. Copyright © 2018 Elsevier B.V. All rights reserved.

  18. Low Dynamics, High Longevity and Persistence of Sessile Structural Species Dwelling on Mediterranean Coralligenous Outcrops

    PubMed Central

    Teixidó, Núria; Garrabou, Joaquim; Harmelin, Jean-George

    2011-01-01

    There is still limited understanding of the processes underlying benthic species dynamics in marine coastal habitats, which are of disproportionate importance in terms of productivity and biodiversity. The life-history traits of long-lived benthic species in these habitats are particularly poorly documented. In this study, we assessed decadal patterns of population dynamics for ten sponge and anthozoan species that play key structural roles in coralligenous outcrops (∼25 m depth) in two areas of the NW Mediterranean Sea. This study was based on examination of a unique long-term photographic series, which allowed analysis of population dynamics over extensive spatial and time spans for the very first time. Specifically, 671 individuals were censused annually over periods of 25-, 15-, and 5-years. This long-term study quantitatively revealed a common life-history pattern among the ten studied species, despite the fact they present different growth forms. Low mortality rates (3.4% yr−1 for all species combined) and infrequent recruitment events (mean value of 3.1±0.5 SE recruits yr−1) provided only a very small fraction of the new colonies required to maintain population sizes. Overall, annual mortality and recruitment rates did not differ significantly among years; however, some species displayed important mortality events and recruitment pulses, indicating variability among species. Based on the growth rates of these 10 species, we projected their longevity and, obtained a mean estimated age of 25–200 years. Finally, the low to moderate turnover rates (mean value 0.80% yr−1) observed among the coralligenous species were in agreement with their low dynamics and persistence. These results offer solid baseline data and reveal that these habitats are among the most vulnerable to the current increases of anthropogenic disturbances. PMID:21887308

  19. Interest in Long-Term Care among Health Services Administration Students

    ERIC Educational Resources Information Center

    Temple, April; Thompson, Jon M.

    2011-01-01

    The aging of the population has created increased opportunities for health administrators in long-term care. This study consisted of a cross-sectional survey of 68 undergraduate health services administration students to explore factors related to interest in a career in long-term care administration. One third expressed interest working in the…

  20. Long-term effects of tetanus toxoid inoculation on the demography and life expectancy of the Cayo Santiago rhesus macaques.

    PubMed

    Kessler, Matthew J; Hernández Pacheco, Raisa; Rawlins, Richard G; Ruiz-Lambrides, Angelina; Delgado, Diana L; Sabat, Alberto M

    2015-02-01

    Tetanus was a major cause of mortality in the free-ranging population of rhesus monkeys on Cayo Santiago prior to 1985 when the entire colony was given its first dose of tetanus toxoid. The immediate reduction in mortality that followed tetanus toxoid inoculation (TTI) has been documented, but the long-term demographic effects of eliminating tetanus infections have not. This study uses the Cayo Santiago demographic database to construct comparative life tables 12 years before, and 12 years after, TTI. Life tables and matrix projection models are used to test for differences in: (i) survival among all individuals as well as among social groups, (ii) long-term fitness of the population, (iii) age distribution, (iv) reproductive value, and (v) life expectancy. A retrospective life table response experiment (LTRE) was performed to determine which life cycle transition contributed most to observed changes in long-term fitness of the population post-TTI. Elimination of clinical tetanus infections through mass inoculation improved the health and well-being of the monkeys. It also profoundly affected the population by increasing survivorship and long-term fitness, decreasing the differences in survival rates among social groups, shifting the population's age distribution towards older individuals, and increasing reproductive value and life expectancy. These findings are significant because they demonstrate the long-term effects of eradicating a major cause of mortality at a single point in time on survival, reproduction, and overall demography of a naturalistic population of primates. © 2014 Wiley Periodicals, Inc.

  1. Occupational class and the changing patterns of hospitalization for affective and neurotic disorders: a nationwide register-based study of the Finnish working-age population, 1976-2010.

    PubMed

    Varje, Pekka; Kouvonen, Anne; Kokkinen, Lauri; Koskinen, Aki; Väänänen, Ari

    2018-02-01

    This study aimed to examine the long-term changes and socioeconomic disparities in hospitalization for affective and neurotic disorders among the Finnish working-age population from 1976 to 2010. Register-based study, consisting of a 5-year follow-up of 3,223,624 Finnish working-age (18-64-year old) individuals in seven consecutive cohorts. We calculated the hazard ratios of psychiatric hospitalization for different occupational classes using Cox regression models. The risk of hospitalization for affective and neurotic disorders increased in all occupational classes after the economic recession in the 1990s, and then decreased in the 2000s. Before the 2000s, the risk was the highest among manual workers. In the 2000s the disparities between upper-level non-manual employees and other occupational classes increased. Hospitalization rates remained high among female manual workers and non-manual lower-level employees. This study revealed important similarities and differences between occupational classes in terms of long-term changes in hospitalization for affective and neurotic disorders. The results suggest that the labor market changes and healthcare reforms during the 1990s and 2000s in Finland have been more beneficial for higher than for lower occupational classes.

  2. Long-Term Effects of Tetanus Toxoid Inoculation on the Demography and Life Expectancy of the Cayo Santiago Rhesus Macaques

    PubMed Central

    KESSLER, MATTHEW J.; PACHECO, RAISA HERNÁNDEZ; RAWLINS, RICHARD G.; RUIZ-LAMBRIDES, ANGELINA; DELGADO, DIANA L.; SABAT, ALBERTO M.

    2014-01-01

    Tetanus was a major cause of mortality in the free-ranging population of rhesus monkeys on Cayo Santiago prior to 1985 when the entire colony was given its first dose of tetanus toxoid. The immediate reduction in mortality that followed tetanus toxoid inoculation (TTI) has been documented, but the long-term demographic effects of eliminating tetanus infections have not. This study uses the Cayo Santiago demographic database to construct comparative life tables 12 years before, and 12 years after, TTI. Life tables and matrix projection models are used to test for differences in: (i) survival among all individuals as well as among social groups, (ii) long-term fitness of the population, (iii) age distribution, (iv) reproductive value, and (v) life expectancy. A retrospective life table response experiment (LTRE) was performed to determine which life cycle transition contributed most to observed changes in long-term fitness of the population post-TTI. Elimination of clinical tetanus infections through mass inoculation improved the health and well-being of the monkeys. It also profoundly affected the population by increasing survivorship and long-term fitness, decreasing the differences in survival rates among social groups, shifting the population’s age distribution towards older individuals, and increasing reproductive value and life expectancy. These findings are significant because they demonstrate the long-term effects of eradicating a major cause of mortality at a single point in time on survival, reproduction, and overall demography of a naturalistic population of primates. PMID:25230585

  3. The initial tolerance to sub-lethal Cd exposure is the same among ten naïve pond populations of Daphnia magna, but their micro-evolutionary potential to develop resistance is very different.

    PubMed

    Messiaen, Marlies; Janssen, Colin Roger; De Meester, Luc; De Schamphelaere, Karel André Clara

    2013-11-15

    Genetic variation complicates predictions of both the initial tolerance and the long-term (micro-evolutionary) response of natural Daphnia populations to chemical stressors from results of standard single-clone laboratory ecotoxicity tests. In order to investigate possible solutions to this problem, we aimed to compare the initial sub-lethal tolerance to Cd of 10 naïve natural pond populations of Daphnia magna as well as their evolutionary potential to develop increased resistance. We did so by measuring reproductive performance of 120 clones, i.e. 12 clones hatched from the recent dormant egg bank of each of 10 populations, both in absence (Cd-free control) and presence of 4.4 μg Cd/L. We show that the initial tolerance, defined as the reproductive performance of individuals of the first generation exposed to Cd relative to that in a Cd-free control was not significantly different among the 10 studied pond populations and averaged 0.82 ± 0.04 over these populations. Moreover, these populations' initial tolerances were also not significantly different from the mean initial tolerance of 0.87 ± 0.08 at 4.0 μg Cd/L measured for a group of 7 often-used laboratory clones, collected from a range of European ecotoxicity testing laboratories. This indicates that the initial response of naïve natural pond populations to sub-lethal Cd can be relatively accurately predicted from ecotoxicity test data from only a handful of laboratory clones. We then used estimates of broad-sense heritability of Cd tolerance (H(2)) - based on the same dataset - as a proxy of these populations' capacities to evolutionarily respond to Cd in terms of the development of increased resistance, which is here defined as the increase with time of the frequency of clones with a higher Cd tolerance in the population (accompanied with an increase of mean Cd-tolerance of the population above the initial tolerance). We show that the populations' estimated H(2) values of Cd-tolerance cover almost the entire theoretically possible range, ranging from not significantly different from zero (for five populations) to between 0.48 and 0.81 (for the five other populations). This indicates that, unlike the initial tolerance to Cd, the (long-term) micro-evolutionary response to Cd may be very different among natural pond populations. Therefore, we conclude that it may be very difficult to predict the long-term response of an unstudied population to chemical stress from tolerance data on a sample of other populations. It is therefore suggested that new methods for forecasting long-term responses should be explored, such as the development of predictive models based on the combination of population-genomic and tolerance time-series data. Copyright © 2013 Elsevier B.V. All rights reserved.

  4. Long-term effects of parental divorce timing on depression: A population-based longitudinal study.

    PubMed

    Chun, Sung-Youn; Jang, Suk-Yong; Choi, Jae-Woo; Shin, Jaeyong; Park, Eun-Cheol

    2016-09-08

    We examined the long-term effects of parental divorce timing on depression using longitudinal data from the Korean Welfare Panel Study. Depression symptoms were measured using the 11 items of Center for Epidemiologic Scale for Depression (CES-D-11), and we categorized parental divorce timing into 'early childhood', 'adolescent' and 'none'. Although participants who experienced parental divorce during adolescence exhibited a significantly higher CES-D-11 score (p = .0468), 'early childhood' participants displayed the most increased CES-D-11 score compared to the control group (p = .0007). Conversely, among participants who were unsatisfied with their marriage, those who experienced parental divorce in early childhood showed lower CES-D-11 scores, while 'adolescent period' participants exhibited significantly higher CES-D-11 scores (p = .0131). We concluded that timing of parental divorce exerts substantial yet varied effects on long-term depression symptoms and future marriage satisfaction. © The Author(s) 2016.

  5. Change in Receptive Vocabulary from Childhood to Adulthood: Associated Mental Health, Education and Employment Outcomes

    ERIC Educational Resources Information Center

    Armstrong, Rebecca; Arnott, Wendy; Copland, David A.; McMahon, Katie; Khan, Asaduzzaman; Najman, Jake M.; Scott, James G.

    2017-01-01

    Background: Population-based studies have found that early language delays are associated with poorer long-term outcomes in adolescence and adulthood. Few studies have explored the influence of change in language ability over time on adult outcomes. Aim: To examine the educational, vocational and mental health outcomes for adults accounting for…

  6. The determinants of long-term care utilization and equity of access to care among older adults in Dong-Ku of Incheon Metropolitan city, South Korea.

    PubMed

    Park, J M

    2005-01-01

    Under the current health care system, around three percent of the elderly remain uninsured. Based on the 2003 Dong-Ku Health Status Survey and the Aday and Andersen Access Framework, the present study examined the social and behavioral determinants of long-term care utilization and the extent to which equity in the use of long-term care services for the elderly has been achieved. The results indicate that universal health insurance system has not yielded a fully equitable distribution of services. Type of coverage and resource availability do not remain predictors of long-term care utilization. The data suggest that a universal health insurance system exists in South Korea with significant access problems for the population without insurance. Access differences also arise from obstacles in expanding the scope and level of plan benefits due to financial disparity among insurers. Health policy reforms must continue to concentrate on extending insurance coverage to the uninsured and establishing long-term insurance system for the elderly.

  7. Long-term neuromuscular outcomes of west nile virus infection: A clinical and electromyographic evaluation of patients with a history of infection.

    PubMed

    Athar, Parveen; Hasbun, Rodrigo; Nolan, Melissa S; Salazar, Lucrecia; Woods, Steven P; Sheikh, Kazim; Murray, Kristy O

    2018-01-01

    Neuromuscular clinical manifestations during acute West Nile virus (WNV) infection are well documented; however, long-term neurologic outcomes still require investigation. We conducted a long-term follow-up study in patients with history of WNV infection. Of the 117 patients who participated in neurologic and neurocognitive evaluations, 30 were referred for neuromuscular and electrodiagnostic evaluation based on abnormal findings. We found that 33% of these patients (10 of 30) showed abnormalities on nerve conduction and/or needle electromyography due to primary or secondary outcomes of WNV infection. Most common electrodiagnostic findings and causes of long-term disability were related to anterior horn cell poliomyelitis (WNV poliomyelitis). Electrical data on these patient populations were similar to those observed in chronic poliomyelitis. With more than 16,000 cases of WNV neuroinvasive disease reported across the USA since 1999, understanding clinical outcomes from infection will provide a resource for physicians managing long-term care of these patients. Muscle Nerve 57: 77-82, 2018. © 2017 Wiley Periodicals, Inc.

  8. Comparison of public and private care management agencies under public long-term care insurance in Japan: a cross-sectional study.

    PubMed

    Yoshioka, Yoji; Tamiya, Nanako; Kashiwagi, Masayo; Sato, Mikiya; Okubo, Ichiro

    2010-01-01

    Long-Term Care Insurance (LTCI), which started in April 2000, allowed private business corporations to provide long-term care services which had been provided by social welfare corporations or public agencies in the previous long-term care scheme. This study compared differences in care management plans for community-dwelling frail elderly people between public care management agencies and private care management agencies. The subjects were 309 community-dwelling frail elderly people living in a suburban city with a population of approximately 55,000 and who had been using community-based long-term care services of the LTCI for 6 months from April 2000. The characteristics of the care management agencies (public/private) were identified using a claims database. After comparing profiles of users and their care mix between those managed by public agencies and by private agencies, the effect of the characteristics of care management agencies on LTCI service use was examined. Public care management agencies favored younger subjects (P = 0.003), male subjects (P = 0.006) and people with a higher need for care (P = 0.02) than private agencies. The number of service items used was significantly larger in public agencies than in their private counterparts. In multivariate regression analysis, the utilization of community-based long-term care service was significantly greater among beneficiaries managed by private agencies than those managed by public agencies (P = 0.02). Private care management agencies play an important role in promoting the use of care services, but their quality of care plans might be questionable.

  9. Acute Anticholinesterase Pesticide Poisoning Caused a Long-Term Mortality Increase: A Nationwide Population-Based Cohort Study.

    PubMed

    Huang, Hung-Sheng; Hsu, Chien-Chin; Weng, Shih-Feng; Lin, Hung-Jung; Wang, Jhi-Joung; Su, Shih-Bin; Huang, Chien-Cheng; Guo, How-Ran

    2015-07-01

    Acute anticholinesterase pesticide (organophosphate and carbamate) poisoning (ACPP) often produces severe complications, and sometimes death. We investigated the long-term mortality of patients with ACPP because it is not sufficiently understood. In this retrospective nationwide population-based cohort study, 818 patients with ACPP and 16,360 healthy comparisons from 1999 to 2010 were selected from Taiwan's National Health Insurance Research Database. They were followed until 2011. Ninety-four (11.5%) ACPP patients and 793 (4.9%) comparisons died (P < 0.01) during follow-up. The incidence rate ratios (IRRs) of death were 2.5 times higher in ACPP patients than in comparisons (P < 0.01). The risk of death was particularly high in the first month after ACPP (IRR: 92.7; 95% confidence interval [CI]: 45.0-191.0) and still high for ~6 months (IRR: 3.8; 95% CI: 1.9-7.4). After adjusting for age, gender, selected comorbidities, geographic area, and monthly income, the hazard ratio of death for ACPP patients was still 2.4 times higher than for comparisons. Older age (≥35 years), male gender, diabetes mellitus, coronary artery disease, hypertension, stroke, mental disorder, and lower monthly income also predicted death. ACPP significantly increased long-term mortality. In addition to early follow-up after acute treatment, comorbidity control and socioeconomic assistance are needed for patients with ACPP.

  10. [Public spending on health and population health in Algeria: an econometric analysis].

    PubMed

    Messaili, Moussa; Kaïd Tlilane, Nouara

    2017-07-10

    Objective: The objective of this study was to estimate the impact of public spending on health, among other determinants of health, on the health of the population in Algeria, using life expectancy (men and women) and infant mortality rates as indicators of health status. Methods: We conducted a longitudinal study over the period from 1974 to 2010 using the ARDL (Autoregressive Distributed Lags) approach to co-integration to estimate the short-term and long-term relationship. Results: Public spending on health has a positive, but not statistically significant impact, in the long and short term, on life expectancy (men and women). However, public spending significantly reduces the infant mortality rate. The long-term impact of the number of hospital beds is significant for the life expectancy of men, but not for women and infant mortality, but is significant for all indicators in the short-term relationship. The most important variables in improving the health of the population are real GDP per capita and fertility rate.

  11. Development of a cell-based treatment for long-term neurotrophin expression and spiral ganglion neuron survival.

    PubMed

    Zanin, M P; Hellström, M; Shepherd, R K; Harvey, A R; Gillespie, L N

    2014-09-26

    Spiral ganglion neurons (SGNs), the target cells of the cochlear implant, undergo gradual degeneration following loss of the sensory epithelium in deafness. The preservation of a viable population of SGNs in deafness can be achieved in animal models with exogenous application of neurotrophins such as brain-derived neurotrophic factor (BDNF) and neurotrophin-3. For translation into clinical application, a suitable delivery strategy that provides ongoing neurotrophic support and promotes long-term SGN survival is required. Cell-based neurotrophin treatment has the potential to meet the specific requirements for clinical application, and we have previously reported that Schwann cells genetically modified to express BDNF can support SGN survival in deafness for 4 weeks. This study aimed to investigate various parameters important for the development of a long-term cell-based neurotrophin treatment to support SGN survival. Specifically, we investigated different (i) cell types, (ii) gene transfer methods and (iii) neurotrophins, in order to determine which variables may provide long-term neurotrophin expression and which, therefore, may be the most effective for supporting long-term SGN survival in vivo. We found that fibroblasts that were nucleofected to express BDNF provided the most sustained neurotrophin expression, with ongoing BDNF expression for at least 30 weeks. In addition, the secreted neurotrophin was biologically active and elicited survival effects on SGNs in vitro. Nucleofected fibroblasts may therefore represent a method for safe, long-term delivery of neurotrophins to the deafened cochlea to support SGN survival in deafness. Copyright © 2014 IBRO. Published by Elsevier Ltd. All rights reserved.

  12. Examining the relationship between neighbourhood deprivation and mental health service use of immigrants in Ontario, Canada: a cross-sectional study

    PubMed Central

    Durbin, Anna; Moineddin, Rahim; Lin, Elizabeth; Steele, Leah S; Glazier, Richard H

    2015-01-01

    Objective While newcomers are often disproportionately concentrated in disadvantaged areas, little attention is given to the effects of immigrants’ postimmigration context on their mental health and care use. Intersectionality theory suggests that understanding the full impact of disadvantage requires considering the effects of interacting factors. This study assessed the inter-relationship between recent immigration status, living in deprived areas and service use for non-psychotic mental health disorders. Study design Matched population-based cross-sectional study. Setting Ontario, Canada, where healthcare use data for 1999–2012 were linked to immigration data and area-based material deprivation scores. Participants Immigrants in urban Ontario, and their age-matched and sex-matched long-term residents (a group of Canadian-born or long-term immigrants, n=501 417 pairs). Primary and secondary outcome measures For immigrants and matched long-term residents, contact with primary care, psychiatric care and hospital care (emergency department visits or inpatient admissions) for non-psychotic mental health disorders was followed for 5 years and examined using conditional logistic regression models. Intersectionality was investigated by including a material deprivation quintile by immigrant status (immigrant vs long-term resident) interaction. Results Recent immigrants in urban Ontario were more likely than long-term residents to live in most deprived quintiles (immigrants—males: 22.8%, females: 22.3%; long-term residents—both sexes: 13.1%, p<0.001). Living in more deprived circumstances was associated with greater use of mental health services, but increases were smaller for immigrants than for long-term residents. Immigrants used less mental health services than long-term residents. Conclusions This study adds to existing research by suggesting that immigrant status and deprivation have a combined effect on recent immigrants’ care use for non-psychotic mental health disorders. In settings where immigrants are over-represented in deprived areas, policymakers focused on increasing immigrants’ access of mental health services should broadly address the influence of structural and cultural factors beyond the disadvantage. PMID:25770230

  13. Genetic diversity of European cattle breeds highlights the conservation value of traditional unselected breeds with high effective population size.

    PubMed

    Medugorac, Ivica; Medugorac, Ana; Russ, Ingolf; Veit-Kensch, Claudia E; Taberlet, Pierre; Luntz, Bernhard; Mix, Henry M; Förster, Martin

    2009-08-01

    In times of rapid global and unforeseeable environmental changes, there is an urgent need for a sustainable cattle breeding policy, based on a global view. Most of the indigenous breeds are specialized in a particular habitat or production system but are rapidly disappearing. Thus, they represent an important resource to meet present and future breeding objectives. Based on 105 microsatellites, we obtained thorough information on genetic diversity and population structure of 16 cattle breeds that cover a geographical area from the domestication centre near Anatolia, through the Balkan and alpine regions, to the North-West of Europe. Breeds under strict artificial selection and indigenous breeds under traditional breeding schemes were included. The overall results showed that the genetic diversity is widespread in Busa breeds in the Anatolian and Balkan areas, when compared with the alpine and north-western European breeds. Our results reflect long-term evolutionary and short-term breeding events very well. The regular pattern of allele frequency distribution in the entire cattle population studied clearly suggests conservation of rare alleles by conservation of preferably unselected traditional breeds with large effective population sizes. From a global and long-term conservation genetics point of view, the native and highly variable breeds closer to the domestication centre could serve as valuable sources of genes for future needs, not only for cattle but also for other farm animals.

  14. An integrated modeling approach to estimating Gunnison Sage-Grouse population dynamics: combining index and demographic data.

    USGS Publications Warehouse

    Davis, Amy J.; Hooten, Mevin B.; Phillips, Michael L.; Doherty, Paul F.

    2014-01-01

    Evaluation of population dynamics for rare and declining species is often limited to data that are sparse and/or of poor quality. Frequently, the best data available for rare bird species are based on large-scale, population count data. These data are commonly based on sampling methods that lack consistent sampling effort, do not account for detectability, and are complicated by observer bias. For some species, short-term studies of demographic rates have been conducted as well, but the data from such studies are typically analyzed separately. To utilize the strengths and minimize the weaknesses of these two data types, we developed a novel Bayesian integrated model that links population count data and population demographic data through population growth rate (λ) for Gunnison sage-grouse (Centrocercus minimus). The long-term population index data available for Gunnison sage-grouse are annual (years 1953–2012) male lek counts. An intensive demographic study was also conducted from years 2005 to 2010. We were able to reduce the variability in expected population growth rates across time, while correcting for potential small sample size bias in the demographic data. We found the population of Gunnison sage-grouse to be variable and slightly declining over the past 16 years.

  15. Long-Term Climate Forcing in Loggerhead Sea Turtle Nesting

    PubMed Central

    Van Houtan, Kyle S.; Halley, John M.

    2011-01-01

    The long-term variability of marine turtle populations remains poorly understood, limiting science and management. Here we use basin-scale climate indices and regional surface temperatures to estimate loggerhead sea turtle (Caretta caretta) nesting at a variety of spatial and temporal scales. Borrowing from fisheries research, our models investigate how oceanographic processes influence juvenile recruitment and regulate population dynamics. This novel approach finds local populations in the North Pacific and Northwest Atlantic are regionally synchronized and strongly correlated to ocean conditions—such that climate models alone explain up to 88% of the observed changes over the past several decades. In addition to its performance, climate-based modeling also provides mechanistic forecasts of historical and future population changes. Hindcasts in both regions indicate climatic conditions may have been a factor in recent declines, but future forecasts are mixed. Available climatic data suggests the Pacific population will be significantly reduced by 2040, but indicates the Atlantic population may increase substantially. These results do not exonerate anthropogenic impacts, but highlight the significance of bottom-up oceanographic processes to marine organisms. Future studies should consider environmental baselines in assessments of marine turtle population variability and persistence. PMID:21589639

  16. Long-term climate forcing in loggerhead sea turtle nesting.

    PubMed

    Van Houtan, Kyle S; Halley, John M

    2011-04-27

    The long-term variability of marine turtle populations remains poorly understood, limiting science and management. Here we use basin-scale climate indices and regional surface temperatures to estimate loggerhead sea turtle (Caretta caretta) nesting at a variety of spatial and temporal scales. Borrowing from fisheries research, our models investigate how oceanographic processes influence juvenile recruitment and regulate population dynamics. This novel approach finds local populations in the North Pacific and Northwest Atlantic are regionally synchronized and strongly correlated to ocean conditions--such that climate models alone explain up to 88% of the observed changes over the past several decades. In addition to its performance, climate-based modeling also provides mechanistic forecasts of historical and future population changes. Hindcasts in both regions indicate climatic conditions may have been a factor in recent declines, but future forecasts are mixed. Available climatic data suggests the Pacific population will be significantly reduced by 2040, but indicates the Atlantic population may increase substantially. These results do not exonerate anthropogenic impacts, but highlight the significance of bottom-up oceanographic processes to marine organisms. Future studies should consider environmental baselines in assessments of marine turtle population variability and persistence.

  17. Association between Long-Term Exposure to Particulate Matter Air Pollution and Mortality in a South Korean National Cohort: Comparison across Different Exposure Assessment Approaches

    PubMed Central

    Kim, Sun-Young; Kim, Ho

    2017-01-01

    Increasing numbers of cohort studies have reported that long-term exposure to ambient particulate matter is associated with mortality. However, there has been little evidence from Asian countries. We aimed to explore the association between long-term exposure to particulate matter with a diameter ≤10 µm (PM10) and mortality in South Korea, using a nationwide population-based cohort and an improved exposure assessment (EA) incorporating time-varying concentrations and residential addresses (EA1). We also compared the association across different EA approaches. We used information from 275,337 people who underwent health screening from 2002 to 2006 and who had follow-up data for 12 years in the National Health Insurance Service-National Sample Cohort. Individual exposures were computed as 5-year averages using predicted residential district-specific annual-average PM10 concentrations for 2002–2006. We estimated hazard ratios (HRs) of non-accidental and five cause-specific mortalities per 10 µg/m3 increase in PM10 using the Cox proportional hazards model. Then, we compared the association of EA1 with three other approaches based on time-varying concentrations and/or addresses: predictions in each year and addresses at baseline (EA2); predictions at baseline and addresses in each year (EA3); and predictions and addresses at baseline (EA4). We found a marginal association between long-term PM10 and non-accidental mortality. The HRs of five cause-specific mortalities were mostly higher than that of non-accidental mortality, but statistically insignificant. In the comparison between EA approaches, the HRs of EA1 were similar to those of EA2 but higher than EA3 and EA4. Our findings confirmed the association between long-term exposure to PM10 and mortality based on a population-representative cohort in South Korea, and suggested the importance of assessing individual exposure incorporating air pollution changes over time. PMID:28946613

  18. Changes in microbial populations of WPC34 and WPC80 whey protein during long term storage

    USDA-ARS?s Scientific Manuscript database

    The use of whey protein (WPC34 and WPC80) as a food ingredient and as a base for making biodegradable products is increasing. The need to alleviate world hunger in arid and semi-arid regions demands that we investigate the behavior of native bacteria in these products, especially during long term st...

  19. Accelerated forgetting? An evaluation on the use of long-term forgetting rates in patients with memory problems

    PubMed Central

    Geurts, Sofie; van der Werf, Sieberen P.; Kessels, Roy P. C.

    2015-01-01

    The main focus of this review was to evaluate whether long-term forgetting rates (delayed tests, days, to weeks, after initial learning) are more sensitive measures than standard delayed recall measures to detect memory problems in various patient groups. It has been suggested that accelerated forgetting might be characteristic for epilepsy patients, but little research has been performed in other populations. Here, we identified eleven studies in a wide range of brain injured patient groups, whose long-term forgetting patterns were compared to those of healthy controls. Signs of accelerated forgetting were found in three studies. The results of eight studies showed normal forgetting over time for the patient groups. However, most of the studies used only a recognition procedure, after optimizing initial learning. Based on these results, we recommend the use of a combined recall and recognition procedure to examine accelerated forgetting and we discuss the relevance of standard and optimized learning procedures in clinical practice. PMID:26106343

  20. Long-term mental wellbeing of adolescents and young adults diagnosed with venous thromboembolism: results from a multistage mixed methods study.

    PubMed

    Højen, A A; Sørensen, E E; Dreyer, P S; Søgaard, M; Larsen, T B

    2017-12-01

    Essentials Long-term mental wellbeing of adolescents and young adults with venous thromboembolism is unclear. This multistage mixed methods study was based on Danish nationwide registry data and interviews. Mental wellbeing is negatively impacted in the long-term and uncertainty of recurrence is pivotal. The perceived health threat is more important than disease severity for long-term mental wellbeing. Background Critical and chronic illness in youth can lead to impaired mental wellbeing. Venous thromboembolism (VTE) is a potentially traumatic and life-threatening condition. Nonetheless, the long-term mental wellbeing of adolescents and young adults (AYAS) with VTE is unclear. Objectives To investigate the long-term mental wellbeing of AYAS (aged 13-33 years) diagnosed with VTE. Methods We performed a multistage mixed method study based on data from the Danish nationwide health registries, and semistructured interviews with 12 AYAS diagnosed with VTE. An integrated mixed methods interpretation of the findings was conducted through narrative weaving and joint displays. Results The integrated mixed methods interpretation showed that the mental wellbeing of AYAS with VTE had a chronic perspective, with a persistently higher risk of psychotropic drug purchase among AYAS with a first-time diagnosis of VTE than among sex-matched and age-matched population controls and AYAS with a first-time diagnosis of insulin-dependent diabetes mellitus. Impaired mental wellbeing was largely connected to a fear of recurrence and concomitant uncertainty. Therefore, it was important for the long-term mental wellbeing to navigate uncertainty. The perceived health threat played a more profound role in long-term mental wellbeing than disease severity, as the potential life threat was the pivot which pointed back to the initial VTE and forward to the perception of future health threat and the potential risk of dying of a recurrent event. Conclusion Our findings show that the long-term mental wellbeing of AYAS diagnosed with VTE is negatively affected, and highlights these patients' need for adequate support. © 2017 International Society on Thrombosis and Haemostasis.

  1. EXTINCTION DEBT OF PROTECTED AREAS IN DEVELOPING LANDSCAPES

    EPA Science Inventory

    To conserve biological diversity, protected-area networks must be based not only upon current species distributions but also the landscape's long-term capacity to support populations. We used spatially-explicit population models requiring detailed habitat and demographic data to ...

  2. Long-term dynamics of Typha populations

    USGS Publications Warehouse

    Grace, J.B.; Wetzel, R.G.

    1998-01-01

    The zonation of Typha populations in an experimental pond in Michigan was re-examined 15 years after the original sampling to gain insight into the long-term dynamics. Current distributions of Typha populations were also examined in additional experimental ponds at the site that have been maintained for 23 years. The zonation between T. latifolia and T. angustifolia in the previously studied pond 15 years after the initial sampling revealed that the density and distribution of shoots had not changed significantly. Thus, it appears that previously reported results (based on 7- year old populations) have remained consistent over time. Additional insight into the interaction between these two taxa was sought by comparing mixed and monoculture stands in five experimental ponds that have remained undisturbed for their 23-year history. The maximum depth of T. latifolia, the shallow- water species, was not significantly reduced when growing in the presence of the more flood tolerant T. angustifolia. In contrast, the minimum depth of T. angustifolia was reduced from 0 to 37 cm when in the presence of T. latifolia. When total populations were compared between monoculture and mixed stands, the average density of T. angustifolia shoots was 59.4 percent lower in mixed stands while the density of T. latifolia was 32 percent lower, with T. angustifolia most affected at shallow depths (reduced by 92 percent) and T. latifolia most affected at the deepest depths (reduced by 60 percent). These long-term observations indicate that competitive displacement between Typha taxa has remained stable over time.

  3. Maintenance of smoking cessation in the postpartum period: which interventions work best in the long-term?

    PubMed

    Su, Anny; Buttenheim, Alison M

    2014-04-01

    Smoking during pregnancy has been linked to a variety of adverse outcomes for both maternal and child health. Decades of studies have sought to increase cessation antepartum and reduce relapse postpartum. A number of effective interventions exist to significantly reduce smoking rates during pregnancy; however, less is known about how to prevent relapse in the postpartum period. This review investigates interventions to prevent relapse in the long-term postpartum period. We focus specifically on nonspontaneous quitters (individuals who quit smoking as a result of an external intervention) to reveal differences in long-term response to interventions for this population compared to spontaneous quitters. A systematic literature search yielded 32 relevant studies of pharmacological, behavioral, and incentives-based interventions. Results were compiled, analyzed, and compared in order to evaluate success factors in maintaining cessation postpartum. Though intervention groups showed consistently higher quit rates during pregnancy than control groups, none of the intervention types were effective at preventing relapse in the longer-term postpartum period. One study maintained significantly higher abstinence in the longer-term period postpartum using a mix of behavioral and incentives strategies. Additional research in this area is needed to identify optimal intervention strategies to reduce long-term postpartum relapse, particularly for nonspontaneous quitters.

  4. Acoustic Studies of the Effects of Environmental Stresses on Marine Mammals in Large Ocean Basins

    NASA Astrophysics Data System (ADS)

    Sidorovskaia, N.; Ma, B.; Ackleh, A. S.; Tiemann, C.; Ioup, G. E.; Ioup, J. W.

    2014-12-01

    Effects of environmental stresses on deep-diving marine mammal populations have not been studied systematically. Long-term regional passive acoustic monitoring of phonating marine mammals opens opportunities for such studies. This paper presents a unique multi-year study conducted by the Littoral Acoustic Demonstration Center (LADC) in the Northern Gulf of Mexico to understand short-term and long-term effects of anthropogenic stresses on resident populations of endangered sperm and elusive beaked whales. Both species spend many hours each day in deep dives which last about one hour each, so any visual observations for population estimates and behavioral responses are very limited. However, much more cost-efficient acoustic recordings of the phonations during dives on bottom-mounted hydrophones are not skewed by weather conditions or daylight requirements. Broadband passive acoustic data were collected by LADC in 2007 and 2010 at three ranges, 15, 40, and 80 km away from the 2010 Deep Water Horizon oil spill site. Pre-spill and post-spill data processing and comparison allow observing responses of both species to local short-term environmental condition changes and long-term responses to the spill. The short-term effects are studied by correlating daily activity cycles with anthropogenic noise curve daily and weekly cycles at different sites. The strong correlation between the decrease in overall daily activity and the increase in anthropogenic noise level associated with seismic exploration signals can be seen. After streaming raw acoustic data through detection algorithms and detailed assessment of false detection rates, the temporal densities of acoustic phonations are passed into statistical algorithms for resident population estimations. The statistically significant results have shown different regional abundance trends, associated with long-term responses to environmental stresses, for these two species.

  5. Quality geriatric care as perceived by nurses in long-term and acute care settings.

    PubMed

    Barba, Beth Ellen; Hu, Jie; Efird, Jimmy

    2012-03-01

    This study focused on differences in nurses' satisfaction with the quality of care of older people and with organisational characteristics and work environment in acute care and long-term care settings. Numerous studies have explored links between nurses' satisfaction with care and work environments on the one hand and a variety of physical, behavioural and psychological reactions of nurses on the other. One key to keeping nurses in the workplace is a better understanding of nurses' satisfaction with the quality of care they provide. Descriptive design. The self-selected sample included 298 registered nurses and licensed practical nurses who provide care to minority, underserved and disadvantaged older populations in 89 long-term care and <100 bed hospitals in 38 rural counties and eight metropolitan areas in a Southern state. All completed the Agency Geriatric Nursing Care survey, which consisted of a 13-item scale measuring nurses' satisfaction with the quality of geriatric care in their practice settings and an 11-item scale examining obstacles to providing quality geriatric care. Demographic variables were compared with chi-square. Independent t-tests were used to examine differences between nurses in long-term care and acute care settings. Significant differences were found in level of satisfaction and perceived obstacles to providing quality care to older adults between participants from acute and long-term care. Participants in long-term care had greater satisfaction with the quality of geriatric care than those in acute facilities. Nurses in long-term care were more satisfied that care was evidence-based; specialised to individual needs of older adults; promoted autonomy and independence of elders; and was continuous across settings. Participants in acute facilities perceived more obstacles to providing quality geriatric care than nurses in long-term care facilities. Modification of hospital geriatric practice environments and leadership commitment to evidence-based practice guidelines that promote autonomy and independence of patients and staff could improve acute care nurses' perceptions of quality of geriatric care. © 2011 Blackwell Publishing Ltd.

  6. Air pollution and subclinical airway inflammation in the SALIA cohort study

    PubMed Central

    2014-01-01

    Background The association between long-term exposure to air pollution and local inflammation in the lung has rarely been investigated in the general population of elderly subjects before. We investigated this association in a population-based cohort of elderly women from Germany. Methods In a follow-up examination of the SALIA cohort study in 2008/2009, 402 women aged 68 to 79 years from the Ruhr Area and Borken (Germany) were clinically examined. Inflammatory markers were determined in exhaled breath condensate (EBC) and in induced sputum (IS). We used traffic indicators and measured air pollutants at single monitoring stations in the study area to assess individual traffic exposure and long-term air pollution background exposure. Additionally long-term residential exposure to air pollution was estimated using land-use regression (LUR) models. We applied multiple logistic and linear regression analyses adjusted for age, indoor mould, smoking, passive smoking and socio-economic status and additionally conducted sensitivity analyses. Results Inflammatory markers showed a high variability between the individuals and were higher with higher exposure to air pollution. NO derivatives, leukotriene (LT) B4 and tumour necrosis factor-α (TNF-α) showed the strongest associations. An increase of 9.42 μg/m3 (interquartile range) in LUR modelled NO2 was associated with measureable LTB4 level (level with values above the detection limit) in EBC (odds ratio: 1.38, 95% CI: 1.02 -1.86) as well as with LTB4 in IS (%-change: 19%, 95% CI: 7% - 32%). The results remained consistent after exclusion of subpopulations with risk factors for inflammation (smoking, respiratory diseases, mould infestation) and after extension of models with additional adjustment for season of examination, mass of IS and urban/rural living as sensitivity analyses. Conclusions In this analysis of the SALIA study we found that long-term exposure to air pollutants from traffic and industrial sources was associated with an increase of several inflammatory markers in EBC and in IS. We conclude that long-term exposure to air pollution might lead to changes in the inflammatory marker profile in the lower airways in an elderly female population. PMID:24645673

  7. Association between home-visit nursing utilization and all-cause hospitalization among long-term care insurance beneficiaries: A retrospective cohort study.

    PubMed

    Ju, Yeong Jun; Lee, Hyo Jung; Kim, Woorim; Lee, Sang Ah; Han, Kyu-Tae; Park, Eun-Cheol

    2017-10-01

    Ensuring and improving long-term care services that use limited healthcare resources more efficiently is a major concern for many aging societies. The aim of this study was to investigate the relationship between use of home-visit nursing services and all-cause hospitalization in a home-visit nursing-recommended group. A retrospective cohort study. Population-based sample of long-term care insurance beneficiaries from the long-term care insurance 2002-2013 claims database in South Korea. Long-term care insurance beneficiaries who need one or more types of nursing care were defined as the home-visit nursing -recommended group (n=4173). The dependent variable in this study was all-cause hospitalization in the home-visit nursing-recommended population. Multivariate Cox proportional hazards regression analysis was used to identify the association between home-visit nursing service use and all-cause hospitalization. A total of 3.8% of the subjects used home-visit nursing services. When participants who used home-visit nursing services were set as the reference group, participants who did not use home-visit nursing services had a higher risk of hospitalization (hazard ratio [HR]=1.25, 95% confidence interval [CI]=1.07-1.47). Additionally, participants who did not use home-visit nursing services and who did not have a caregiver showed a marked increase in the risk of hospitalization (HR=6.81, 95% CI=1.17-39.66). Participants who did not use home-visit nursing services with greater comorbidity showed a considerable increase in risk of hospitalization (HR=1.36, 95% CI=1.09-1.70). Non-use of home-visit nursing services was associated with an increased risk of all-cause hospitalization in the home-visit nursing-recommended population. The present results suggest that the use of home-visit nursing services reduced the risk of hospitalization. Moreover, home-visit nursing may play an essential role in reducing hospitalization risk in the absence of caregiver support. Copyright © 2017 Elsevier Ltd. All rights reserved.

  8. Effectiveness of psychological interventions to improve quality of life in people with long-term conditions: rapid systematic review of randomised controlled trials.

    PubMed

    Anderson, Niall; Ozakinci, Gozde

    2018-03-27

    Long-term conditions may negatively impact multiple aspects of quality of life including physical functioning and mental wellbeing. The rapid systematic review aimed to examine the effectiveness of psychological interventions to improve quality of life in people with long-term conditions to inform future healthcare provision and research. EBSCOhost and OVID were used to search four databases (PsychInfo, PBSC, Medline and Embase). Relevant papers were systematically extracted by one researcher using the predefined inclusion/exclusion criteria based on titles, abstracts, and full texts. Randomized controlled trial psychological interventions conducted between 2006 and February 2016 to directly target and assess people with long-term conditions in order to improve quality of life were included. Interventions without long-term condition populations, psychological intervention and/or patient-assessed quality of life were excluded. From 2223 citations identified, 6 satisfied the inclusion/exclusion criteria. All 6 studies significantly improved at least one quality of life outcome immediately post-intervention. Significant quality of life improvements were maintained at 12-months follow-up in one out of two studies for each of the short- (0-3 months), medium- (3-12 months), and long-term (≥ 12 months) study duration categories. All 6 psychological intervention studies significantly improved at least one quality of life outcome immediately post-intervention, with three out of six studies maintaining effects up to 12-months post-intervention. Future studies should seek to assess the efficacy of tailored psychological interventions using different formats, durations and facilitators to supplement healthcare provision and practice.

  9. Fractures as an independent predictor of functional decline in older people: a population-based study with an 8-year follow-up.

    PubMed

    Piirtola, Maarit; Löppönen, Minna; Vahlberg, Tero; Isoaho, Raimo; Kivelä, Sirkka-Liisa; Räihä, Ismo

    2012-01-01

    Fractures among older people are common, but there is scant evidence about the impact of fractures on functional decline in an unselected older population. The objective of this study was to analyze the impact of lower and upper body fractures on functional performance among older adults during an 8-year follow-up. A population-based cohort of 616 Finnish persons aged 65 and over was followed for up to 8 years, and the association between fractures and the risk of short-term (0-2 years) and long-term (up to 8 years) functional decline was analyzed. Fractures were categorized according their functional influence on mobility and activities of daily living (ADL) into lower and upper body fractures. Multivariate cumulative logistic regression model was used in the analyses. During the 8-year follow-up, 112 (18%) persons sustained at least one fracture. In the multivariate analyses, lower body fractures predicted both short-term and long-term decline in mobility [cumulative odds ratio (COR) 4.7, 95% confidence interval (95% CI) 1.9-11.7 and COR 2.6, 95% CI 1.1-6.2, respectively] and in ADL performance (COR 3.1, 95% CI 1.3-7.6 and COR 4.7, 95% CI 2.0-11.4, respectively). Upper body fractures predicted decline in ADL performance during the long-term follow-up (COR 2.5, 95% CI 1.3-4.8). Pre-fracture functional decline and inactivity in leisure time physical exercise were independently associated with the risk of decline in extensive activities. Fractures have an independent influence on the development of functional decline in older persons regardless of the pre-fracture health. Prevention of falls and fractures and improvement of treatment, rehabilitation and follow-up process after fractures are needed. Copyright © 2011 S. Karger AG, Basel.

  10. Adolescent Borderline Symptoms in the Community: Prognosis for Functioning over 20 Years

    ERIC Educational Resources Information Center

    Winograd, Greta; Cohen, Patricia; Chen, Henian

    2008-01-01

    Background: The long-term prognosis associated with adolescent symptoms of borderline personality disorder (BPD) in the general population is virtually unknown. In this study, the relationship of early borderline symptoms to subsequent psychosocial functioning and attainment was investigated based on data from the Children in the Community cohort.…

  11. Replication: A "Model" Approach to the Healthy Development of Young Children

    ERIC Educational Resources Information Center

    Krieg, Iris; Lewis, Jan

    2005-01-01

    The authors, directors of the Chicago-based Pritzker Early Childhood Foundation, advocate "replication," the adaptation of a successful model program or practice to new locations or to new populations. Studies have shown that successful replications of early childhood programs that help at-risk children and their families can have long-term,…

  12. Evaluation of the colorectal cancer screening Programme in the Basque Country (Spain) and its effectiveness based on the Miscan-colon model.

    PubMed

    Idigoras, I; Arrospide, A; Portillo, I; Arana-Arri, E; Martínez-Indart, L; Mar, J; de Koning, H J; Lastra, R; Soto-Gordoa, M; van der Meulen, M; Lansdorp-Vogelaar, I

    2017-08-01

    The population-based Basque Colorectal Cancer (CRC) Screening Programme started in 2009 with a biennial immunochemical quantitative test (FIT) biennial and colonoscopy under sedation in positive cases. The population target of 586,700 residents was from 50 to 69 years old and the total coverage was reached at the beginning of 2014. The aim of our study was to determine possible scenarios in terms of incidence, mortality and reduction of Life-years-Lost (L-y-L) in the medium and long term of CRC. Invitations were sent out by the Programme from 2009 to 2014, with combined organizational strategies. Simulation was done by MISCAN-colon (Microsimulation Screening Analysis) over 30 years comparing the results of screening vs no-screening, taking the population-based Cancer Registry into account. Lifetime population and real data from the Programme were used from 2008 to 2012. The model was run differentially for men and women. 924,416 invitations were sent out from 2009 to 2014. The average participation rate was 68.4%, CRC detection rate was 3.4% and the Advanced Adenoma detection rate was 24.0‰, with differences observed in sex and age. Future scenarios showed a higher decrease of incidence (17.2% vs 14.7%), mortality (28.1% vs 22.4%) and L-y-L (22.6% vs 18.4%) in men than women in 2030. The Basque Country CRC Programme results are aligned to its strategy and comparable to other programmes. MISCAN model was found to be a useful tool to predict the benefits of the programme in the future. The effectiveness of the Programme has not been formally established as case control studies are required to determine long term benefits from the screening strategy.

  13. Sick leave and the impact of job-to-job mobility on the likelihood of remaining on the labour market--a longitudinal Swedish register study.

    PubMed

    Nordström, Karin; Ekberg, Kerstin; Hemmingsson, Tomas; Johansson, Gun

    2014-04-03

    Change of job could be a strategy in vocational rehabilitation when return to the original job is not possible, but research is very limited concerning the effects of job mobility on the future vocational situation. The aim of the study was to investigate whether job-to-job mobility affects the likelihood of remaining on the labour market over time among persons who are employed and have experienced long-term sick leave. In a longitudinal register study, cohorts from three base years (1994, 1999 and 2004) were created, based on the Swedish population who were 20-60 years old, had sickness allowance insurance, and were employed in the base year and the following year (n>3,000,000). The likelihood that individuals on long-term sick leave were employed later depending on whether or not they changed workplace during the present or next year of long-term sick leave was analyzed using logistic regression analysis. Age, sector, industry, children, marital status, education, income, rate of sick leave and earlier sick leave and earlier mobility were taken into consideration. Women with more than 180 days' sick leave who changed workplaces were more likely to have a job later compared with those who did not change jobs. For men, the association was statistically significant with 1994 and 2004 as base years, but not in the cohort from 1999. The present study indicates that for those on long-term sick leave that changed workplaces, the opportunities to stay on the labour market might increase. However, the study has methodological limitations and the results for men are ambiguous. We do not therefore have enough evidence for recommending job change as a strategy for vocational rehabilitation.

  14. Promoting hand hygiene and prudent use of antimicrobials in long-term care facilities.

    PubMed

    Rummukainen, Maija; Jakobsson, Aino; Karppi, Pertti; Kautiainen, Hannu; Lyytikäinen, Outi

    2009-03-01

    A multidisciplinary team visited all long-term care facilities (n = 123) for elderly persons in the Central Finland health care district (population, 265,000) during 2004-2005. Use of alcohol-based hand rubs and ongoing systematic antimicrobials were assessed. Thereafter, regional guidelines for prudent use of antimicrobials were published. One year after the visits, a significant increase in the mean amount of alcohol-based hand rubs used was detected while usage of antimicrobials for the prevention of urinary tract reinfections had decreased.

  15. Long-term safety and effectiveness of lopinavir/ritonavir in antiretroviral-experienced HIV-1-infected children.

    PubMed

    Rudin, Christoph; Wolbers, Marcel; Nadal, David; Rickenbach, Martin; Bucher, Heiner C

    2010-06-01

    To evaluate the long-term safety and effectiveness of lopinavir/ritonavir (LPV/r) in a population-based cohort of HIV-1-infected children. All children enrolled in the Swiss Mother and Child HIV Cohort Study, treated with LPV/r-based combination antiretroviral treatment (cART) between November 2000 and October 2008, were included. 88 children (25 (28%) protease inhibitor (PI)-naive, 16 (18%) ART-naive) were analysed (251 patient-years on LPV/r). After 48 weeks on LPV/r, 70 children had a median (interquartile range (IQR)) decrease in HIV-1 viral load of 4.25 log (5.45-3.17; PI-naive, n=17) and 2.53 (3.68-1.38; PI-experienced, n=53). Median (IQR) increase in CD4 count was 429 (203-593; PI-naive) and 177 (21-331; PI-experienced) cells/microl. These effects remained stable throughout 192 weeks for 25 children. Treatment was stopped for viral rebound in seven and suspected toxicity in 12 children. Long-term treatment with LPV/r-based cART is safe and effective in HIV-1-infected children.

  16. Modeling Developmental Language Difficulties from School Entry into Adulthood: Literacy, Mental Health, and Employment Outcomes

    ERIC Educational Resources Information Center

    Law, James; Rush, Robert; Schoon, Ingrid; Parsons, Samantha

    2009-01-01

    Purpose: Understanding the long-term outcomes of developmental language difficulties is key to knowing what significance to attach to them. To date, most prognostic studies have tended to be clinical rather than population-based, which necessarily affects the interpretation. This study sought to address this issue using data from a U.K. birth…

  17. A Population-Based Study of Childhood Sexual Contact in China: Prevalence and Long-Term Consequences

    ERIC Educational Resources Information Center

    Luo, Ye; Parish, William L.; Laumann, Edward O.

    2008-01-01

    Objectives: This study provides national estimates of the prevalence of childhood sexual contact and its association with sexual well-being and psychological distress among adults in China. Method: A national stratified probability sample of 1,519 women and 1,475 men aged 20-64 years in urban China completed a computer-administered survey in…

  18. Air Pollution and Mortality in China.

    PubMed

    Lin, Hualiang; Wang, Xiaojie; Liu, Tao; Li, Xing; Xiao, Jianpeng; Zeng, Weilin; Ma, Wenjun

    2017-01-01

    Ambient air pollution has been an important environmental issue in most areas of China. This chapter summarized the mortality effects of short-term and long-term exposures to various air pollutants among Chinese population. The literature review identified sufficient information to support significant short-term mortality effects of various air pollutants from time series analyses and case-crossover studies, such as PM 10 , PM 2.5 , SO 2 , NO 2 , and O 3 . On the other hand, though the literature review suggested a positive effect of long-term exposure to air pollution on mortality and lung cancer risk, the evidence has been limited among Chinese population, indicating that more studies, especially cohort studies, are warranted.

  19. Educational attainment among long-term survivors of cancer in childhood and adolescence: a Norwegian population-based cohort study.

    PubMed

    Ghaderi, Sara; Engeland, Anders; Gunnes, Maria Winther; Moster, Dag; Ruud, Ellen; Syse, Astri; Wesenberg, Finn; Bjørge, Tone

    2016-02-01

    The number of young cancer survivors has increased over the past few decades due to improvement in treatment regimens, and understanding of long-term effects among the survivors has become even more important. Educational achievements and choice of educational fields were explored here. Five-year cancer survivors born in Norway during 1965-1985 (diagnosed <19 years) were included in our analysis by linking Norwegian population-based registries. Cox regression was applied to study the educational attainment among survivors of central nervous system (CNS) tumours, those assumed to have received CNS-directed therapy, and other cancer survivors relative to the cancer-free population. Logistic regression was used to compare the choice of educational fields between the cancer survivors at undergraduate and graduate level and the cancer-free population. Overall, a lower proportion of the cancer survivors completed intermediate (67 vs. 70 %), undergraduate (31 vs. 35 %) and graduate education (7 vs. 9 %) compared with the cancer-free population. Deficits in completion of an educational level were mainly observed among survivors of CNS-tumours and those assumed to have received CNS-directed therapy. Choices of educational fields among cancer survivors were in general similar with the cancer-free population at both undergraduate and graduate levels. Survivors of CNS-tumours and those assumed to have received CNS-directed therapy were at increased risk for educational impairments compared with the cancer-free population. Choices of educational fields were in general similar. Careful follow-up of the survivors of CNS-tumours and those assumed to have received CNS-directed therapy is important at each level of education.

  20. A Review of Teen Dating Violence Prevention Research: What About Hispanic Youth?

    PubMed

    Malhotra, Krithika; Gonzalez-Guarda, Rosa M; Mitchell, Emma M

    2015-10-01

    The purpose of this article is to provide a critical review of the literature on evidence-based teen dating violence (TDV) prevention programs with a particular focus on highlighting gaps in the literature with regard to prevention efforts targeting Hispanic teens. The target populations, characteristics, designs, and results of TDV prevention studies reported in the scientific literature for the last 20 years were reviewed and analyzed according to cultural and contextual factors associated with TDV among Hispanic teens. To date, three studies have focused on a predominantly Hispanic population with only one study looking at the long-term effects of a TDV intervention. There is a growing need to develop and evaluate immediate and long-term effects of TDV prevention programs that address ethnic pride, acculturation and acculturative stress, familism, and gender norms within the context of Hispanic communities (e.g., machismo and marianismo). The authors discuss the implications for research, prevention practice, and policy regarding TDV prevention for Hispanic teens. © The Author(s) 2014.

  1. Preoperative atrial fibrillation and long-term survival after open heart surgery in a rural tertiary heart institute.

    PubMed

    O'Neal, Wesley T; Efird, Jimmy T; Davies, Stephen W; Choi, Yuk Ming; Anderson, Curtis A; Kindell, Linda C; O'Neal, Jason B; Ferguson, T Bruce; Chitwood, W Randolph; Kypson, Alan P

    2013-01-01

    Preoperative atrial fibrillation (AF) is associated with increased morbidity and mortality after open heart surgery. However, the impact of preoperative AF on long-term survival after open heart surgery has not been widely examined in rural populations. Patients from rural regions are less likely to receive treatment for cardiac conditions and to have adequate medical insurance coverage. To examine the influence of preoperative AF on long-term survival following open heart surgery in rural eastern North Carolina. Long-term survival was compared in patients with and without preoperative AF after coronary artery bypass grafting (CABG) and CABG plus valve (CABG + V) surgery between 2002 and 2011. Hazard ratios (HR) and 95% confidence intervals (CI) were computed using a Cox regression model. The study population consisted of 5438 patients. A total of 263 (5%) patients had preoperative AF. Preoperative AF was an independent predictor of long-term survival (open heart surgery: adjusted HR = 1.6, 95% CI = 1.3-2.0; CABG: adjusted HR = 1.6, 95% CI = 1.3-2.1; CABG + V: adjusted HR = 1.6, 95% CI = 1.1-2.3). Preoperative AF is an important predictor of long-term survival after open heart surgery in this rural population. Copyright © 2013 Elsevier Inc. All rights reserved.

  2. Medicare Long-Term CPAP Coverage Policy: A Cost-Utility Analysis

    PubMed Central

    Billings, Martha E.; Kapur, Vishesh K.

    2013-01-01

    Study Objectives: CPAP is an effective treatment for OSA that may reduce health care utilization and costs. Medicare currently reimburses the costs of long-term CPAP therapy only if the patient is adherent during a 90-day trial. If not, Medicare requires a repeat polysomnogram (PSG) and another trial which seems empirically not cost-effective. We modeled the cost-effectiveness of current Medicare policy compared to an alternative policy (clinic-only) without the adherence criterion and repeat PSG. Design: Cost-utility and cost-effectiveness analysis. Setting: U.S. Medicare Population. Patients or Participants: N/A. Interventions: N/A. Measurements and Results: We created a decision tree modeling (1) clinic only follow-up vs. (2) current Medicare policy. Costs were assigned based on Medicare reimbursement rates in 2012. Sensitivity analyses were conducted to test our assumptions. We estimated cumulative costs, overall adherence, and QALY gained for a 5-year time horizon from the perspective of Medicare as the payer. Current Medicare policy is more costly than the clinic-only policy but has higher net adherence and improved utility. Current Medicare policy compared to clinic-only policy costs $30,544 more per QALY. Conclusions: Current CMS policy promotes early identification of those more likely to adhere to CPAP therapy by requiring strict adherence standards. The policy effect is to deny coverage to those unlikely to use CPAP long-term and prevent wasted resources. Future studies are needed to measure long-term adherence in an elderly population with and without current adherence requirements to verify the cost-effectiveness of a policy change. Citation: Billings ME; Kapur VK. Medicare long-term CPAP coverage policy: a cost-utility analysis. J Clin Sleep Med 2013;9(10):1023-1029. PMID:24127146

  3. Long-term observations of Boreal Toads at an ARMI apex site

    USGS Publications Warehouse

    Corn, Paul Stephen; Muths, Erin L.; Pilliod, David S.

    2011-01-01

    The U.S. Geological Survey’s Amphibian Research and Monitoring Initiative (ARMI) is a national project with goals to monitor the status and trends of amphibians, conduct research on causes of declines, and provide information and support to management agencies for conservation of amphibian populations. ARMI activities are organized around extensive inventories and place-based monitoring (such as collaboration with the Greater Yellowstone Inventory and Monitoring Network), and intensive population studies and research at selected locations (apex sites). One such site is an oxbow pond on the Buffalo Fork near the Black Rock Ranger Station east of Grand Teton National Park. We have been conducting mark-recapture of boreal toads (Anaxyrus boreas) at Black Rock since 2002. In concert with studies of other toad populations in the Rocky Mountains, we have documented a high rate of incidence of the chytrid fungus Batrachochytrium dendrobatidis (Bd) and a negative rate of growth of the toad population, but not the population crash or extinction observed in other populations with high prevalence of Bd. Long-term observations at other ARMI apex sites have proven invaluable for studying effects of climate change on amphibian behavior, and the Black Rock site has been upgraded with onsite recording of weather data and auditory monitoring of other amphibian species. Continued research at Black Rock will be critical for understanding the interrelated effects of climate and disease on amphibians in the Greater Yellowstone Ecosystem.

  4. Cardiovascular Disease Mortality After Chemotherapy or Surgery for Testicular Nonseminoma: A Population-Based Study

    PubMed Central

    Fung, Chunkit; Fossa, Sophie D.; Milano, Michael T.; Sahasrabudhe, Deepak M.; Peterson, Derick R.; Travis, Lois B.

    2015-01-01

    Purpose Increased risks of incident cardiovascular disease (CVD) in patients with testicular cancer (TC) given chemotherapy in European studies were largely restricted to long-term survivors and included patients from the 1960s. Few population-based investigations have quantified CVD mortality during, shortly after, and for two decades after TC diagnosis in the era of cisplatin-based chemotherapy. Patients and Methods Standardized mortality ratios (SMRs) for CVD and absolute excess risks (AERs; number of excess deaths per 10,000 person-years) were calculated for 15,006 patients with testicular nonseminoma reported to the population-based Surveillance, Epidemiology, and End Results program (1980 to 2010) who initially received chemotherapy (n = 6,909) or surgery (n = 8,097) without radiotherapy and accrued 60,065 and 81,227 person-years of follow-up, respectively. Multivariable modeling evaluated effects of age, treatment, extent of disease, and other factors on CVD mortality. Results Significantly increased CVD mortality occurred after chemotherapy (SMR, 1.36; 95% CI, 1.03 to 1.78; n = 54) but not surgery (SMR, 0.81; 95% CI, 0.60 to 1.07; n = 50). Significant excess deaths after chemotherapy were restricted to the first year after TC diagnosis (SMR, 5.31; AER, 13.90; n = 11) and included cerebrovascular disease (SMR, 21.72; AER, 7.43; n = 5) and heart disease (SMR, 3.45; AER, 6.64; n = 6). In multivariable analyses, increased CVD mortality after chemotherapy was confined to the first year after TC diagnosis (hazard ratio, 4.86; 95% CI, 1.25 to 32.08); distant disease (P < .05) and older age at diagnosis (P < .01) were independent risk factors. Conclusion This is the first population-based study, to our knowledge, to quantify short- and long-term CVD mortality after TC diagnosis. The increased short-term risk of CVD deaths should be further explored in analytic studies that enumerate incident events and can serve to develop comprehensive evidence-based approaches for risk stratification and application of preventive and interventional efforts. PMID:26240226

  5. Long-term survival after ablation of the atrioventricular node and implantation of a permanent pacemaker in patients with atrial fibrillation.

    PubMed

    Ozcan, C; Jahangir, A; Friedman, P A; Patel, P J; Munger, T M; Rea, R F; Lloyd, M A; Packer, D L; Hodge, D O; Gersh, B J; Hammill, S C; Shen, W K

    2001-04-05

    In patients with atrial fibrillation that is refractory to drug therapy, radio-frequency ablation of the atrioventricular node and implantation of a permanent pacemaker are an alternative therapeutic approach. The effect of this procedure on long-term survival is unknown. We studied all patients who underwent ablation of the atrioventricular node and implantation of a permanent pacemaker at the Mayo Clinic between 1990 and 1998. Observed survival was compared with the survival rates in two control populations: age- and sex-matched members of the Minnesota population between 1970 and 1990 and consecutive patients with atrial fibrillation who received drug therapy in 1993. A total of 350 patients (mean [+/-SD] age, 68+/-11 years) were studied. During a mean of 36+/-26 months of follow-up, 78 patients died. The observed survival rate was significantly lower than the expected survival rate based on the general Minnesota population (P<0.001). Previous myocardial infarction (P<0.001), a history of congestive heart failure (P=0.02), and treatment with cardiac drugs after ablation (P=0.03) were independent predictors of death. Observed survival among patients without these three risk factors was similar to expected survival (P=0.43). None of the 26 patients with lone atrial fibrillation died during follow-up (37+/-27 months). The observed survival rate among patients who underwent ablation was similar to that among 229 controls with atrial fibrillation (mean age, 67+/-12 years) who received drug therapy (P=0.44). In the absence of underlying heart disease, survival among patients with atrial fibrillation after ablation of the atrioventricular node is similar to expected survival in the general population. Long-term survival is similar for patients with atrial fibrillation, whether they receive ablation or drug therapy. Control of the ventricular rate by ablation of the atrioventricular node and permanent pacing does not adversely affect long-term survival.

  6. Traffic-related particulate air pollution exposure in urban areas

    NASA Astrophysics Data System (ADS)

    Borrego, C.; Tchepel, O.; Costa, A. M.; Martins, H.; Ferreira, J.; Miranda, A. I.

    In the last years, there has been an increase of scientific studies confirming that long- and short-term exposure to particulate matter (PM) pollution leads to adverse health effects. The development of a methodology for the determination of accumulated human exposure in urban areas is the main objective of the current work, combining information on concentrations at different microenvironments and population time-activity pattern data. A link between a mesoscale meteorological and dispersion model and a local scale air quality model was developed to define the boundary conditions for the local scale application. The time-activity pattern of the population was derived from statistical information for different sub-population groups and linked to digital city maps. Finally, the hourly PM 10 concentrations for indoor and outdoor microenvironments were estimated for the Lisbon city centre, which was chosen as the case-study, based on the local scale air quality model application for a selected period. This methodology is a first approach to estimate population exposure, calculated as the total daily values above the thresholds recommended for long- and short-term health effects. Obtained results reveal that in Lisbon city centre a large number of persons are exposed to PM levels exceeding the legislated limit value.

  7. Extreme umbilical cord lengths, cord knot and entanglement: Risk factors and risk of adverse outcomes, a population-based study

    PubMed Central

    Kessler, Jörg

    2018-01-01

    Objectives To determine risk factors for short and long umbilical cord, entanglement and knot. Explore their associated risks of adverse maternal and perinatal outcome, including risk of recurrence in a subsequent pregnancy. To provide population based gestational age and sex and parity specific reference ranges for cord length. Design Population based registry study. Setting Medical Birth Registry of Norway 1999–2013. Population All singleton births (gestational age>22weeks<45 weeks) (n = 856 300). Methods Descriptive statistics and odds ratios of risk factors for extreme cord length and adverse outcomes based on logistic regression adjusted for confounders. Main outcome measures Short or long cord (<10th or >90th percentile), cord knot and entanglement, adverse pregnancy outcomes including perinatal and intrauterine death. Results Increasing parity, maternal height and body mass index, and diabetes were associated with increased risk of a long cord. Large placental and birth weight, and fetal male sex were factors for a long cord, which again was associated with a doubled risk of intrauterine and perinatal death, and increased risk of adverse neonatal outcome. Anomalous cord insertion, female sex, and a small placenta were associated with a short cord, which was associated with increased risk of fetal malformations, placental complications, caesarean delivery, non-cephalic presentation, perinatal and intrauterine death. At term, cord knot was associated with a quadrupled risk of perinatal death. The combination of a cord knot and entanglement had a more than additive effect to the association to perinatal death. There was a more than doubled risk of recurrence of a long or short cord, knot and entanglement in a subsequent pregnancy of the same woman. Conclusion Cord length is influenced both by maternal and fetal factors, and there is increased risk of recurrence. Extreme cord length, entanglement and cord knot are associated with increased risk of adverse outcomes including perinatal death. We provide population based reference ranges for umbilical cord length. PMID:29584790

  8. Integrating housing and long-term care services for the elderly: a social marketing approach.

    PubMed

    Moore, S T

    1991-01-01

    Subsidized senior high-rise apartments have tended to neglect the needs of an increasingly aged and frail resident population. Research demonstrates that this population has greater unmet needs than elderly who reside in traditional community housing. This paper makes the case for a vertically integrated marketing approach to serving the elderly. Such an approach would combine housing and community based long-term care services into a single system of care. Enriched senior high-rise apartments are a viable alternative for elders who need assistance in order to maintain an independent lifestyle.

  9. Predicting long-term graft survival in adult kidney transplant recipients.

    PubMed

    Pinsky, Brett W; Lentine, Krista L; Ercole, Patrick R; Salvalaggio, Paolo R; Burroughs, Thomas E; Schnitzler, Mark A

    2012-07-01

    The ability to accurately predict a population's long-term survival has important implications for quantifying the benefits of transplantation. To identify a model that can accurately predict a kidney transplant population's long-term graft survival, we retrospectively studied the United Network of Organ Sharing data from 13,111 kidney-only transplants completed in 1988- 1989. Nineteen-year death-censored graft survival (DCGS) projections were calculated and compared with the population's actual graft survival. The projection curves were created using a two-part estimation model that (1) fits a Kaplan-Meier survival curve immediately after transplant (Part A) and (2) uses truncated observational data to model a survival function for long-term projection (Part B). Projection curves were examined using varying amounts of time to fit both parts of the model. The accuracy of the projection curve was determined by examining whether predicted survival fell within the 95% confidence interval for the 19-year Kaplan-Meier survival, and the sample size needed to detect the difference in projected versus observed survival in a clinical trial. The 19-year DCGS was 40.7% (39.8-41.6%). Excellent predictability (41.3%) can be achieved when Part A is fit for three years and Part B is projected using two additional years of data. Using less than five total years of data tended to overestimate the population's long-term survival, accurate prediction of long-term DCGS is possible, but requires attention to the quantity data used in the projection method.

  10. Implementation process and challenges for the community-based integrated care system in Japan

    PubMed Central

    Tsutsui, Takako

    2014-01-01

    Background Since 10 years ago, Japan has been creating a long-term vision to face its peak in the number of older people that will be reached in 2025 when baby boomers will turn 75 years of age. In 2003, the government set up a study group called “Caring for older people in 2015” which led to a first reform of the Long-Term Care Insurance System in 2006. This study group was the first to suggest the creation of a community-based integrated care system. Reforms Three measures were taken in 2006: ‘Building an active ageing society: implementation of preventive care services’, ‘Improve sustainability: revision of the remuneration of facilities providing care’ and ‘Integration: establishment of a new service system’. These reforms are at the core of the community-based integrated care system. Discussion The socialization of long-term care that came along with the ageing of the population, and the second shift in Japan towards an increased reliance on the community can provide useful information for other ageing societies. As a super ageing society, the attempts from Japan to develop a rather unique system based on the widely spread concept of integrated care should also become an increasing focus of attention. PMID:24478614

  11. Cardiovascular Effects of Long-Term Exposure to Air Pollution: A Population-Based Study With 900 845 Person-Years of Follow-up.

    PubMed

    Kim, Hyeanji; Kim, Joonghee; Kim, Sunhwa; Kang, Si-Hyuck; Kim, Hee-Jun; Kim, Ho; Heo, Jongbae; Yi, Seung-Muk; Kim, Kyuseok; Youn, Tae-Jin; Chae, In-Ho

    2017-11-08

    Studies have shown that long-term exposure to air pollution such as fine particulate matter (≤2.5 μm in aerodynamic diameter [PM 2.5 ]) increases the risk of all-cause and cardiovascular mortality. To date, however, there are limited data on the impact of air pollution on specific cardiovascular diseases. This study aimed to evaluate cardiovascular effects of long-term exposure to air pollution among residents of Seoul, Korea. Healthy participants with no previous history of cardiovascular disease were evaluated between 2007 and 2013. Exposure to air pollutants was estimated by linking the location of outdoor monitors to the ZIP code of each participant's residence. Crude and adjusted analyses were performed using Cox regression models to evaluate the risk for composite cardiovascular events including cardiovascular mortality, acute myocardial infarction, congestive heart failure, and stroke. A total of 136 094 participants were followed for a median of 7.0 years (900 845 person-years). The risk of major cardiovascular events increased with higher mean concentrations of PM 2.5 in a linear relationship, with a hazard ratio of 1.36 (95% confidence interval, 1.29-1.43) per 1 μg/m 3 PM 2.5 . Other pollutants including PM 2.5-10 of CO, SO 2 , and NO 2 , but not O 3 , were significantly associated with increased risk of cardiovascular events. The burden from air pollution was comparable to that from hypertension and diabetes mellitus. This large-scale population-based study demonstrated that long-term exposure to air pollution including PM 2.5 increases the risk of major cardiovascular disease and mortality. Air pollution should be considered an important modifiable environmental cardiovascular risk factor. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

  12. Budget impact analysis of switching to digital mammography in a population-based breast cancer screening program: a discrete event simulation model.

    PubMed

    Comas, Mercè; Arrospide, Arantzazu; Mar, Javier; Sala, Maria; Vilaprinyó, Ester; Hernández, Cristina; Cots, Francesc; Martínez, Juan; Castells, Xavier

    2014-01-01

    To assess the budgetary impact of switching from screen-film mammography to full-field digital mammography in a population-based breast cancer screening program. A discrete-event simulation model was built to reproduce the breast cancer screening process (biennial mammographic screening of women aged 50 to 69 years) combined with the natural history of breast cancer. The simulation started with 100,000 women and, during a 20-year simulation horizon, new women were dynamically entered according to the aging of the Spanish population. Data on screening were obtained from Spanish breast cancer screening programs. Data on the natural history of breast cancer were based on US data adapted to our population. A budget impact analysis comparing digital with screen-film screening mammography was performed in a sample of 2,000 simulation runs. A sensitivity analysis was performed for crucial screening-related parameters. Distinct scenarios for recall and detection rates were compared. Statistically significant savings were found for overall costs, treatment costs and the costs of additional tests in the long term. The overall cost saving was 1,115,857€ (95%CI from 932,147 to 1,299,567) in the 10th year and 2,866,124€ (95%CI from 2,492,610 to 3,239,638) in the 20th year, representing 4.5% and 8.1% of the overall cost associated with screen-film mammography. The sensitivity analysis showed net savings in the long term. Switching to digital mammography in a population-based breast cancer screening program saves long-term budget expense, in addition to providing technical advantages. Our results were consistent across distinct scenarios representing the different results obtained in European breast cancer screening programs.

  13. Budget Impact Analysis of Switching to Digital Mammography in a Population-Based Breast Cancer Screening Program: A Discrete Event Simulation Model

    PubMed Central

    Comas, Mercè; Arrospide, Arantzazu; Mar, Javier; Sala, Maria; Vilaprinyó, Ester; Hernández, Cristina; Cots, Francesc; Martínez, Juan; Castells, Xavier

    2014-01-01

    Objective To assess the budgetary impact of switching from screen-film mammography to full-field digital mammography in a population-based breast cancer screening program. Methods A discrete-event simulation model was built to reproduce the breast cancer screening process (biennial mammographic screening of women aged 50 to 69 years) combined with the natural history of breast cancer. The simulation started with 100,000 women and, during a 20-year simulation horizon, new women were dynamically entered according to the aging of the Spanish population. Data on screening were obtained from Spanish breast cancer screening programs. Data on the natural history of breast cancer were based on US data adapted to our population. A budget impact analysis comparing digital with screen-film screening mammography was performed in a sample of 2,000 simulation runs. A sensitivity analysis was performed for crucial screening-related parameters. Distinct scenarios for recall and detection rates were compared. Results Statistically significant savings were found for overall costs, treatment costs and the costs of additional tests in the long term. The overall cost saving was 1,115,857€ (95%CI from 932,147 to 1,299,567) in the 10th year and 2,866,124€ (95%CI from 2,492,610 to 3,239,638) in the 20th year, representing 4.5% and 8.1% of the overall cost associated with screen-film mammography. The sensitivity analysis showed net savings in the long term. Conclusions Switching to digital mammography in a population-based breast cancer screening program saves long-term budget expense, in addition to providing technical advantages. Our results were consistent across distinct scenarios representing the different results obtained in European breast cancer screening programs. PMID:24832200

  14. Long-term mortality in children diagnosed with Haemophilus influenzae meningitis: a Danish nationwide cohort study.

    PubMed

    Roed, Casper; Engsig, Frederik Neess; Omland, Lars Haukali; Skinhoj, Peter; Obel, Niels

    2011-08-01

    The long-term mortality in children diagnosed with Haemophilus influenzae meningitis is poorly documented. We performed a nationwide, population-based cohort study including all Danish children diagnosed at the age between 0 and <5 years with H. influenzae meningitis from 1977 through 1996 and who were alive 1 year after diagnosis. Data were retrieved from medical databases in Denmark. For each H. influenzae meningitis patient, 6 age- and gender-matched population controls were indentified. We constructed Kaplan-Meier survival curves and used Cox regression analysis to estimate mortality rate ratios (MRR) and analyze causes of death. The risk of inpatient admission and of requiring hospital outpatient services during follow-up was calculated. We identified 1242 H. influenzae meningitis patients and 7452 population controls, with a median follow-up time of 21.3 years. The MRR for patients with H. influenzae meningitis was 1.08 (95% confidence interval, 0.57-2.05), adjusted MRR was 0.97 (95% confidence interval, 0.50-1.89). No increased mortality due to infections, respiratory diseases, or cancer was observed. The overall risk of inpatient admission and of requiring hospital outpatient services for the H. influenzae meningitis patients was increased the first 15 years of follow-up, mainly due to the nervous system diseases and ear diseases, thereafter the risk decreased to that of the population controls. In a developed country, children younger than 5 years surviving the acute phase of H. influenzae meningitis have no increased long-term mortality and only moderately increased morbidity.

  15. [Blood component donors and recipients as linked study objects in epidemiological population-based surveys].

    PubMed

    Garmaeva, T Ts; Kulikov, S M

    2015-01-01

    A population of hematological cancer patients as recipients of many blood components and that of donors of blood components and bone marrow are related to the common event of contamination with viruses of blood-borne infections; which occurs and is detectable during long-term treatment and follow-up. They share interaction traits and diverse communication mechanisms, which call for complex interrelated trials in both groups with a mandatory epidemiological evidenced-based investigation of all cases of posttransfusion hepatitis B and/or C. The identity of infection with hepatitis B and C viruses, human immunodeficiency virus, and their association should be simultaneously studied in the populations of both donors and recipients of blood components and bone marrow.

  16. The influence of disturbance events on survival and dispersal rates of Florida box turtles

    USGS Publications Warehouse

    Dodd, C.K.; Ozgul, A.; Oli, M.K.

    2006-01-01

    Disturbances have the potential to cause long-term effects to ecosystem structure and function, and they may affect individual species in different ways. Long-lived vertebrates such as turtles may be at risk from such events, inasmuch as their life histories preclude rapid recovery should extensive mortality occur. We applied capture–mark–recapture models to assess disturbance effects on a population of Florida box turtles (Terrapene carolina bauri) on Egmont Key, Florida, USA. Near the midpoint of the study, a series of physical disturbances affected the island, from salt water overwash associated with several tropical storms to extensive removal of nonindigenous vegetation. These disturbances allowed us to examine demographic responses of the turtle population and to determine if they affected dispersal throughout the island. Adult survival rates did not vary significantly either between sexes or among years of the study. Survival rates did not vary significantly between juvenile and adult turtles, or among years of the study. Furthermore, neither adult nor juvenile survival rates differed significantly between pre- and post-disturbance. However, dispersal rates varied significantly among the four major study sites, and dispersal rates were higher during the pre-disturbance sampling periods compared to post-disturbance. Our results suggest few long-term effects on the demography of the turtle population. Florida box turtles responded to tropical storms and vegetation control by moving to favorable habitats minimally affected by the disturbances and remaining there. As long as turtles and perhaps other long-lived vertebrates can disperse to non-disturbed habitat, and high levels of mortality do not occur in a population, a long life span may allow them to wait out the impact of disturbance with potentially little effect on long-term population processes.

  17. Accelerating the translation of research into practice in long term services and supports: a critical need for federal infrastructure at the nexus of aging and disability.

    PubMed

    Washko, Michelle M; Campbell, Margaret; Tilly, Jane

    2012-01-01

    The nexus of aging and disability, characterized by the phenomenon of aging with a disability, will become more visible as the population ages and the number of people with disabilities surviving to midlife increases. This article addresses 3 interrelated issues critical to the fields of aging and disability: increasing demand for community-based long-term services and supports, a paucity of evidence-based programs demonstrating effectiveness in facilitating independence for those aging with a disability, and lack of a federal infrastructure to support coordinated investments in research-to-practice for this population. Suggestions for federal interagency collaborations are given, along with roles for key stakeholders.

  18. Registration for deceased organ and tissue donation among Ontario immigrants: a population-based cross-sectional study

    PubMed Central

    Li, Alvin Ho-ting; Lam, Ngan N.; Dhanani, Sonny; Weir, Matthew; Prakash, Versha; Kim, Joseph; Knoll, Greg; Garg, Amit X.

    2016-01-01

    Background: Canada has low rates of deceased organ and tissue donation. Immigrants to Canada may differ in their registered support for deceased organ donation based on their country of origin. Methods: We used linked administrative databases in Ontario (about 11 million residents aged ≥ 16 yr) to study the proportion of immigrants and long-term residents registered for deceased organ and tissue donation as of October 2013. We used modified Poisson regression to identify and quantify predictors of donor registration. Results: Compared with long-term residents (n = 9 244 570), immigrants (n = 1 947 646) were much less likely to register for deceased organ and tissue donation (11.9% v. 26.5%). Immigrants from the United States, Australia and New Zealand had the highest registration rate (40.0%), whereas immigrants with the lowest registration rates were from Eastern Europe and Central Asia (9.4%), East Asia and Pacific (8.4%) and sub-Saharan Africa (7.9%). The largest numbers of unregistered immigrants were from India (n = 202 548), China (n = 186 678) and the Philippines (n = 125 686). Characteristics among the immigrant population associated with a higher likelihood of registration included economic immigrant status, living in a rural area (population < 10 000), living in an area with a lower ethnic concentration, less material deprivation, a higher education, ability to speak English and French, and more years residing in Canada. Interpretation: Immigrants in Ontario were less likely to register for deceased organ and tissue donation than long-term residents. There is a need to better understand reasons for lower registration rates among Canadian immigrants and to create culture-sensitive materials to build support for deceased organ and tissue donation. PMID:28443265

  19. Uveitis in the elderly: epidemiological data from the National Long-term Care Survey Medicare Cohort.

    PubMed

    Reeves, Sherman W; Sloan, Frank A; Lee, Paul P; Jaffe, Glenn J

    2006-02-01

    There is a paucity of population-based data on the epidemiology of uveitis in the elderly. In the past 40 years, only 2 U.S. population-based studies have examined the epidemiology of uveitis. The conclusions of these studies on the burden of uveitis in the elderly differ greatly. In this analysis, we use Medicare claims data to define the population-based incidence and prevalence of uveitis in the United States elderly population. Cohort study. A cohort of 21644 Medicare beneficiaries drawn for the National Long-term Care Survey, a random sample of U.S. adults 65 years and older, was followed up from 1991 through 1999. The International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis codes specific to uveitis were queried. To decrease the inclusion of uveitis caused by surgery, diagnoses occurring within 3 months of intraocular surgery were excluded. The incidence and prevalence of uveitis by anatomic location was calculated for each year in the study. The onset of uveitis during a given year and its presence in subsequent years. The cumulative yearly incidence of uveitis ranged from 302/100000 to 424/100000 persons per year and averaged 340.9/100000 persons per year. Anterior uveitis was the most common form of uveitis in this population, with a mean incidence of 243.6 cases per 100000 persons per year. The incidence of posterior uveitis averaged 76.6/100000 and the incidence of panuveitis/endophthalmitis averaged 41.7/100000. Only 2 cases of intermediate uveitis occurred during the study period. The cumulative prevalence of uveitis doubled from 511/100000 in 1991 to 1231/100000 in 1999, with anterior uveitis accounting for most prevalent cases in every year. The burden of uveitis in the elderly is substantial and is higher than previously thought. Longitudinal analysis of Medicare claims data may provide a useful tool for monitoring uncommon diseases, such as uveitis, in the elderly population.

  20. Interventions for preventing obesity in children.

    PubMed

    Summerbell, C D; Waters, E; Edmunds, L D; Kelly, S; Brown, T; Campbell, K J

    2005-07-20

    Obesity prevention is an international public health priority. The prevalence of obesity and overweight is increasing in child populations throughout the world, impacting on short and long-term health. Obesity prevention strategies for children can change behaviour but efficacy in terms of preventing obesity remains poorly understood. To assess the effectiveness of interventions designed to prevent obesity in childhood through diet, physical activity and/or lifestyle and social support. MEDLINE, PsycINFO, EMBASE, CINAHL and CENTRAL were searched from 1990 to February 2005. Non-English language papers were included and experts contacted. Randomised controlled trials and controlled clinical trials with minimum duration twelve weeks. Two reviewers independently extracted data and assessed study quality. Twenty-two studies were included; ten long-term (at least 12 months) and twelve short-term (12 weeks to 12 months). Nineteen were school/preschool-based interventions, one was a community-based intervention targeting low-income families, and two were family-based interventions targeting non-obese children of obese or overweight parents. Six of the ten long-term studies combined dietary education and physical activity interventions; five resulted in no difference in overweight status between groups and one resulted in improvements for girls receiving the intervention, but not boys. Two studies focused on physical activity alone. Of these, a multi-media approach appeared to be effective in preventing obesity. Two studies focused on nutrition education alone, but neither were effective in preventing obesity. Four of the twelve short-term studies focused on interventions to increase physical activity levels, and two of these studies resulted in minor reductions in overweight status in favour of the intervention. The other eight studies combined advice on diet and physical activity, but none had a significant impact. The studies were heterogeneous in terms of study design, quality, target population, theoretical underpinning, and outcome measures, making it impossible to combine study findings using statistical methods. There was an absence of cost-effectiveness data. The majority of studies were short-term. Studies that focused on combining dietary and physical activity approaches did not significantly improve BMI, but some studies that focused on dietary or physical activity approaches showed a small but positive impact on BMI status. Nearly all studies included resulted in some improvement in diet or physical activity. Appropriateness of development, design, duration and intensity of interventions to prevent obesity in childhood needs to be reconsidered alongside comprehensive reporting of the intervention scope and process.

  1. Long term and transitional intermittent smokers: a longitudinal study

    PubMed Central

    Lindstrom, M; Isacsson, S

    2002-01-01

    Objective: To investigate differences in snuff consumption, sociodemographic and psychosocial characteristics between baseline intermittent smokers that had become daily smokers, stopped smoking or remained intermittent smokers at the one year follow up. Design/setting/participants/measurements: A population of 12 507 individuals interviewed at baseline in 1992-94 and at a one year follow up, aged 45–69 years, was investigated in a longitudinal study. The three groups of baseline intermittent smokers were compared to the reference population (all others) according to sociodemographic, psychosocial, and snuff consumption characteristics. A multivariate logistic regression model was used to assess differences in psychosocial conditions, adjusting for age, sex, country of origin, marital status, education, and snuff consumption. Results: 60% of all baseline intermittent smokers had remained intermittent smokers, 16% had become daily smokers, and 24% had stopped smoking at the one year follow up. The long term intermittent smokers and those who had stopped smoking were young, unmarried, highly educated, and snuff consumers to a higher extent than the reference population. They also had more psychosocial resources than the reference population, while the psychosocial resources of those who had become daily smokers were poorer. Conclusions: The majority of intermittent smokers are long term intermittent smokers. The results suggest that long term intermittent smokers have other psychosocial characteristics than daily smokers. PMID:11891370

  2. Activities and sources of income after a period of long-term sick leave--a population-based prospective cohort study.

    PubMed

    Wikman, Anders; Wiberg, Michael; Marklund, Staffan; Alexanderson, Kristina

    2012-09-06

    There is limited knowledge about what happens to people after long-term sick leave. The aim of this report was to conduct a prospective study of individuals who were on prolonged sick leave during a particular year, considering their activities and sources of income during subsequent years. To enable comparison of different time periods, we used three cohorts of individuals with different starting years. Using data from national registers, three separate cohorts were constructed that included all people living in Sweden who were 20-64 years of age (>5 million) in the years 1995, 2000 and 2005, respectively. The individual members of the cohorts were classified into the following groups based on their main source of income and activity in 1995-2008: on long-term sick leave, employed, old-age pensioner, long-term unemployed, disability pensioner, on parental leave, social assistance recipient, student allowance recipient, deceased, or emigrated. Most individuals on long-term (> 6 months) sick leave in 1995 were not employed 13 years later. Only 11% of the women and 13% of the men were primarily in employment after 13 years. Instead, a wide range of alternatives existed, for example, many had been granted disability pension, and about 10% of the women and 17% of the men had died during the follow-up period. A larger proportion of those with long-term sick leave were back in employment when 2005 was the starting year for the follow-up. The low future employment rates for people on long-term sick leave may seem surprising. There are several possible explanations for the finding: The disorders these people may have, might have entailed longstanding difficulties on the labor market. Besides, long-term absence from work, no matter what its causes were, might have worsen the chances of further employment. The economic cycles may also have been of importance. The improving labor market during later years seems to have improved the chances for employment among those earlier on long-term sick leave.

  3. Long-Term Natural History of Adult Wolff-Parkinson-White Syndrome Patients Treated With and Without Catheter Ablation.

    PubMed

    Bunch, T Jared; May, Heidi T; Bair, Tami L; Anderson, Jeffrey L; Crandall, Brian G; Cutler, Michael J; Jacobs, Victoria; Mallender, Charles; Muhlestein, Joseph B; Osborn, Jeffrey S; Weiss, J Peter; Day, John D

    2015-12-01

    There are a paucity of data about the long-term natural history of adult Wolff-Parkinson-White syndrome (WPW) patients in regard to risk of mortality and atrial fibrillation. We sought to describe the long-term outcomes of WPW patients and ascertain the impact of ablation on the natural history. Three groups of patients were studied: 2 WPW populations (ablation: 872, no ablation: 1461) and a 1:5 control population (n=11 175). Long-term mortality and atrial fibrillation rates were determined. The average follow-up for the WPW group was 7.9±5.9 (median: 6.9) years and was similar between the ablation and nonablation groups. Death rates were similar between the WPW group versus the control group (hazard ratio, 0.96; 95% confidence interval, 0.83-1.11; P=0.56). Nonablated WPW patients had a higher long-term death risk compared with ablated WPW patients (hazard ratio, 2.10; 95% confidence interval: 1.50-20.93; P<0.0001). Incident atrial fibrillation risk was higher in the WPW group compared with the control population (hazard ratio, 1.55; 95% confidence interval, 1.29-1.87; P<0.0001). Nonablated WPW patients had lower risk than ablated patients (hazard ratio, 0.39; 95% confidence interval, 0.28-0.53; P<0.0001). Long-term mortality rates in WPW patients are low and similar to an age-matched and gender-matched control population. WPW patients that underwent the multifactorial process of ablation had a lower mortality compared to nonablated WPW patients. Atrial fibrillation rates are high long-term, and ablation does not reduce this risk. © 2015 American Heart Association, Inc.

  4. Long-term observation of amphibian populations inhabiting urban and forested areas in Yekaterinburg, Russia

    NASA Astrophysics Data System (ADS)

    Vershinin, Vladimir L.; Vershinina, Svetlana D.; Berzin, Dmitry L.; Zmeeva, Darya V.; Kinev, Alexander V.

    2015-05-01

    This article presents data derived from a 36 year-long uninterrupted observational study of amphibian populations living in the city and vicinity of Yekaterinburg, Russia. This area is inhabited by six amphibian species. Based on a degree of anthropogenic transformation, the urban territory is divided into five highly mosaic zones characterized by vegetation, temperature, and a distinctive water pollution profile. Population data is presented year-by-year for the number of animals, sex ratio, and species-specific fecundity including the number and quality of spawns for the following amphibian species: Salamandrella keyserligii, Rana arvalis, R. temporaria, Lissotriton vulgaris, and Pelophylax ridibundus. These data provide an excellent opportunity to assess an urban environment from an animal population-wide perspective, as well as revealing the forces driving animal adaptation to the anthropogenic transformation of habitats.

  5. Perceived service quality, perceived value, overall satisfaction and happiness of outlook for long-term care institution residents.

    PubMed

    Lin, Jesun; Hsiao, Chih-Tung; Glen, Robert; Pai, Jar-Yuan; Zeng, Sin-Huei

    2014-06-01

    To investigate the psychometric properties and relationships of perceived service quality, perceived value and overall satisfaction for residents with respect to their long-term care institutions. The five-point Likert scale questionnaire administered through facetoface interviews. Fourteen long-term care institutions located in central and southern Taiwan stratified according to services and accommodation population. One hundred and eighty long-term institutional care residents. Perceived service quality (the SERVPERF model), perceived value and overall satisfaction (models based on the literature on perceived value and satisfaction). Student's t-test on institutional location shows a significant difference between overall satisfaction for central and southern institution long-term care recipients. The correlation test revealed that the higher a resident's level of education, the higher the scores for perceived value. The factor loading results of confirmation factor analysis show acceptable levels of reliability and index-of-model fits for perceived service, perceived value and overall satisfaction. In addition, the results suggest that an additional construct, a positive attitude (happiness of outlook) towards long-term care institutions, is also an important factor in residents' overall satisfaction. The primary goal of long-term institutional care policy in Taiwan, as in other countries, is to provide residents with practical, cost-effective but high-quality care. On the basis of the results of in-depth interviews with long-term institutional care residents, this study suggests long-term care institutions arrange more family visit days to increase the accessibility and interaction of family and residents and thereby increase the happiness of outlook of the residents. © 2012 John Wiley & Sons Ltd.

  6. The coevolution of long-term pair bonds and cooperation.

    PubMed

    Song, Z; Feldman, M W

    2013-05-01

    The evolution of social traits may not only depend on but also change the social structure of the population. In particular, the evolution of pairwise cooperation, such as biparental care, depends on the pair-matching distribution of the population, and the latter often emerges as a collective outcome of individual pair-bonding traits, which are also under selection. Here, we develop an analytical model and individual-based simulations to study the coevolution of long-term pair bonds and cooperation in parental care, where partners play a Snowdrift game in each breeding season. We illustrate that long-term pair bonds may coevolve with cooperation when bonding cost is below a threshold. As long-term pair bonds lead to assortative interactions through pair-matching dynamics, they may promote the prevalence of cooperation. In addition to the pay-off matrix of a single game, the evolutionarily stable equilibrium also depends on bonding cost and accidental divorce rate, and it is determined by a form of balancing selection because the benefit from pair-bond maintenance diminishes as the frequency of cooperators increases. Our findings highlight the importance of ecological factors affecting social bonding cost and stability in understanding the coevolution of social behaviour and social structures, which may lead to the diversity of biological social systems. © 2013 The Authors. Journal of Evolutionary Biology © 2013 European Society For Evolutionary Biology.

  7. What is healthy work for women and men? - A case-control study of gender- and sector-specific effects of psycho-social working conditions on long-term sickness absence.

    PubMed

    Lidwall, Ulrik; Marklund, Staffan

    2006-01-01

    The aim of the study was to investigate the relevance of the demand-control model and social support in predicting long-term sickness absence (LTSA). Identifying gender- and sector- (private vs. public) specific patterns was in focus. The study uses a cross-sectional design with a case and a control group. The cases are a sample of 2 327 long-term sick listed (>60 days) and the controls are a Swedish population-based sample of 2 063. Data on sickness absence were retrieved from the Swedish national social insurance registers. Data on health, working and living conditions were gathered through a self-administered questionnaire. The results show that employed women have a notably higher risk for LTSA than employed men. High-strain jobs increase the odds for LTSA among both women and men. Active jobs were also associated with LTSA among women. The study confirms the demand-control model (job strain hypothesis) and social support and their associations with LTSA. However, the job strain hypothesis is more evident in the private sector. Active jobs with high psychological demands and high decision latitude seem to be problematic for many women, especially in the private sector. Thus, the active learning hypothesis receives no support for women in the Swedish working population in general.

  8. Who Lives Where and Does It Matter? Changes in the Health Profiles of Older People Living in Long Term Care and the Community over Two Decades in a High Income Country

    PubMed Central

    Matthews, Fiona E.; Bennett, Holly; Wittenberg, Raphael; Jagger, Carol; Dening, Tom; Brayne, Carol

    2016-01-01

    Background There have been fundamental shifts in the attitude towards, access to and nature of long term care in high income countries. The proportion and profile of the older population living in such settings varies according to social, cultural, and economic characteristics as well as governmental policies. Changes in the profiles of people in different settings are important for policy makers and care providers. Although details will differ, how change occurs across time is important to all, including lower and middle income countries developing policies themselves. Here change is examined across two decades in England. Methods and Findings Using the two Cognitive Function and Ageing Studies (CFAS I: 77% response, CFAS II: 56% response), two population based studies of older people carried out in the same areas conducted two decades apart, the study diagnosis of dementia using the Automated Geriatric Examination for Computer Assisted Taxonomy, health and wellbeing were examined, focusing on long term care. The proportion of individuals with three or more health conditions increased for everyone living in long term care between CFAS I (47.6%, 95% CI: 42.3–53.1) and CFAS II (62.7%, 95% CI: 54.8–70.0) and was consistently higher in those without dementia compared to those with dementia in both studies. Functional impairment measured by activities of daily living increased in assisted living facilities from 48% (95% CI: 44%-52%) to 67% (95% CI: 62%-71%). Conclusions Health profiles of residents in long term care have changed dramatically over time. Dementia prevalence and reporting multiple health conditions have increased. Receiving care in the community puts pressure on unpaid carers and formal services; these results have implications for policies about supporting people at home as well as for service provision within long term care including quality of care, health management, cost, and the development of a skilled, caring, and informed workforce. PMID:27589586

  9. Kit fox population trends at the Naval Petroleum Reserves in California

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

    Kato, T.T.; Scrivner, J.H.; Warrick, G.

    The San Joaquin kit fox was listed as an endangered subspecies following passage of the Endangered Species Protection Act of 1966, and further classified as rare under the California Endangered Species Act of 1970. The San Joaquin kit fox occurs on the Naval Petroleum Reserves in California administered by the Department of Energy (DOE). A long term kit fox population monitoring program was initiated as part of DOE's mitigation strategy to comply with the Endangered Species Act. In addition to monitoring kit fox populations, the program includes assessments of kit fox prey density and assessments of predator abundance. The objectivesmore » of this study were to: describe the long term changes in the kit fox population on the Reserves and assess the roles of coyotes and lagomorphs in kit fox population dynamics. When the fox population on NPR-1 declined between 1980 and 1984, it appeared to have been negatively impacted by a declining prey base (lagomorphs) and an increasing coyote population. Declining lagomorph densities may have been a more important factor because as coyote numbers declined between 1985 and 1990, the kit fox population remained stable. The fox population on NPR-2 remained at a higher and more stable level than the population on NPR-1. The factors determining the higher densities and greater stability of the fox population on NPR-2 are unknown.« less

  10. Protocols for long-term monitoring of seabird ecology in the Gulf of Alaska

    USGS Publications Warehouse

    Piatt, John F.; Byrd, G. Vernon; Harding, Ann M.A.; Kettle, Arthur B.; Kitaysky, Sasha; Litzow, Michael A.; Roseneau, David G.; Shultz, Michael T.; van Pelt, Thomas I.

    2003-01-01

    Seabird populations will need to be monitored for many years to assess both recovery and ecological conditions affecting recovery. Detailed studies of individual seabird colonies and marine ecosystems in the Gulf of Alaska have been conducted by the U.S. Geological Survey and U.S. Fish and Wildlife Service under the auspices of damage assessment and restoration programs of the Trustee Council. Much has been learned about factors influencing seabird populations and their capacity to recover from the spill in the Gulf of Alaska. As the restoration program moves toward long-term monitoring of populations, however, protocols and long-term monitoring strategies that focus on key parameters of interest and that are inexpensive, practical, and applicable over a large geographic area need to be developed.

  11. Auckland Stroke Outcomes Study. Part 1: Gender, stroke types, ethnicity, and functional outcomes 5 years poststroke.

    PubMed

    Feigin, V L; Barker-Collo, S; Parag, V; Senior, H; Lawes, C M M; Ratnasabapathy, Y; Glen, E

    2010-11-02

    Studying long-term stroke outcomes including body functioning (neurologic and neuropsychological impairments) and activity limitations and participation is essential for long-term evidence-based rehabilitation and service planning, resource allocation, and improving health outcomes in stroke. However, reliable data to address these issues is lacking. This study (February 2007-December 2008) sourced its participants from the population-based incidence study conducted in Auckland in 2002-2003. Participants completed structured self-administered questionnaires, and a face-to-face interview including a battery of neuropsychological tests. Logistic regression analysis was used to analyze associations between and within functional outcomes and their potential predictors. Of 418 5-year stroke survivors, two-thirds had good functional outcome in terms of neurologic impairment and disability (defined as modified Rankin Score <3), 22.5% had cognitive impairment indicative of dementia, 20% had experienced a recurrent stroke, almost 15% were institutionalized, and 29.6% had symptoms suggesting depression. Highly significant correlations were found between and within various measurements of body functioning (especially neuropsychological impairments), activity, and participation. Age, dependency, and depression were independently associated with most outcomes analyzed. The strong associations between neuropsychological impairment and other functional outcomes and across various measurements of body functioning, activity, and participation justify utilizing a multidisciplinary approach to studying and managing long-term stroke outcomes. Observed gender and ethnic differences in some important stroke outcomes warrant further investigations.

  12. Long-term prescribing of antidepressants in the older population: a qualitative study

    PubMed Central

    Dickinson, Rebecca; Knapp, Peter; House, Allan O; Dimri, Vandana; Zermansky, Arnold; Petty, Duncan; Holmes, John; Raynor, David K

    2010-01-01

    Background High rates of long-term antidepressant prescribing have been identified in the older population. Aims To explore the attitudes of older patients and their GPs to taking long-term antidepressant therapy, and their accounts of the influences on long-term antidepressant use. Design of study Qualitative study using in-depth semi-structured interviews. Setting One primary care trust in North Bradford. Method Thirty-six patients aged ≥75 years and 10 GPs were interviewed. Patients were sampled to ensure diversity in age, sex, antidepressant type, and home circumstances. Results Participants perceived significant benefits and expressed little apprehension about taking long-term antidepressants, despite being aware of the psychological and social factors involved in onset and persistence of depression. Barriers to discontinuation were identified following four themes: pessimism about the course and curability of depression; negative expectations and experiences of ageing; medicine discontinuation perceived by patients as a threat to stability; and passive (therapeutic momentum) and active (therapeutic maintenance) decisions to accept the continuing need for medication. Conclusion There is concern at a public health level about high rates of long-term antidepressant prescribing, but no evidence was found of a drive for change either from the patients or the doctors interviewed. Any apprehension was more than balanced by attitudes and behaviours supporting continuation. These findings will need to be incorporated into the planning of interventions aimed at reducing long-term antidepressant prescribing in older people. PMID:20353660

  13. Genetic variation facilitates seedling establishment but not population growth rate of a perennial invader

    PubMed Central

    Li, Shou-Li; Vasemägi, Anti; Ramula, Satu

    2016-01-01

    Background and Aims Assessing the demographic consequences of genetic variation is fundamental to invasion biology. However, genetic and demographic approaches are rarely combined to explore the effects of genetic variation on invasive populations in natural environments. This study combined population genetics, demographic data and a greenhouse experiment to investigate the consequences of genetic variation for the population fitness of the perennial, invasive herb Lupinus polyphyllus. Methods Genetic and demographic data were collected from 37 L. polyphyllus populations representing different latitudes in Finland, and genetic variation was characterized based on 13 microsatellite loci. Associations between genetic variation and population size, population density, latitude and habitat were investigated. Genetic variation was then explored in relation to four fitness components (establishment, survival, growth, fecundity) measured at the population level, and the long-term population growth rate (λ). For a subset of populations genetic variation was also examined in relation to the temporal variability of λ. A further assessment was made of the role of natural selection in the observed variation of certain fitness components among populations under greenhouse conditions. Key Results It was found that genetic variation correlated positively with population size, particularly at higher latitudes, and differed among habitat types. Average seedling establishment per population increased with genetic variation in the field, but not under greenhouse conditions. Quantitative genetic divergence (QST) based on seedling establishment in the greenhouse was smaller than allelic genetic divergence (F′ST), indicating that unifying selection has a prominent role in this fitness component. Genetic variation was not associated with average survival, growth or fecundity measured at the population level, λ or its variability. Conclusions The study suggests that although genetic variation may facilitate plant invasions by increasing seedling establishment, it may not necessarily affect the long-term population growth rate. Therefore, established invasions may be able to grow equally well regardless of their genetic diversity. PMID:26420202

  14. Obesity, diabetes, hypertension, and vegetarian status among Seventh-Day Adventists in Barbados: preliminary results.

    PubMed

    Brathwaite, Noel; Fraser, Henry S; Modeste, Naomi; Broome, Hedy; King, Rosaline

    2003-01-01

    A population-based sample of Seventh-Day Adventists was studied to determine the relationship between vegetarian status, body mass index (BMI), obesity, diabetes mellitus (DM), and hypertension, in order to gain a better understanding of factors influencing chronic diseases in Barbados. A systematic sampling from a random start technique was used to select participants for the study. A standard questionnaire was used to collect data on demographic and lifestyle characteristics, to record anthropometrics and blood pressure measurements, and to ascertain the hypertension and diabetes status of participants. The sample population consisted of 407 Barbadian Seventh-Day Adventists (SDAs), who ranged in age from 25 to 74 years. One hundred fifty-three (37.6%) participants were male, and 254 (62.4%) were female, and 43.5% were vegetarians. The prevalence rates of diabetes and hypertension were lower among long-term vegetarians, compared to non-vegetarians, and long-term vegetarians were, on average, leaner than non-vegetarians within the same cohort. A significant association was observed between a vegetarian diet and obesity (vegetarian by definition P=.04, self-reported vegetarian P=.009) in this population. Other components of the study population lifestyle should be further analyzed to determine the roles they may plan in lessening the prevalence rates of obesity, diabetes, and hypertension.

  15. Impact of preoperative chronic renal failure on liver transplantation: a population-based cohort study

    PubMed Central

    Chung, Peter Chi-Ho; Chen, Hsiu-Pin; Lin, Jr-Rung; Liu, Fu-Chao; Yu, Huang-Ping

    2016-01-01

    Purpose The purpose of this study was to assess whether preoperative chronic renal failure (CRF) affects the rates of postoperative complications and survival after liver transplantation. Methods This population-based retrospective cohort study included 2,931 recipients of liver transplantation performed between 1998 and 2012, enrolled from the Taiwan National Health Insurance Research Database. Patients were divided into two groups, based on the presence or absence of preoperative CRF. Results The overall estimated survival rate of liver transplantation recipients (LTRs) with preoperative CRF was significantly lower than that of patients without preoperative CRF (P=0.0085). There was no significant difference between the groups in terms of duration of intensive care unit stay, total hospital stay, bacteremia, postoperative bleeding, and pneumonia during hospitalization. Long-term adverse effects, including cerebrovascular disease and coronary heart disease, were not different between patients with versus without CRF. Conclusion These findings suggest that LTRs with preoperative CRF have a higher rate of mortality. PMID:28008264

  16. Enhancing emotion-based learning in decision-making under uncertainty.

    PubMed

    Alarcón, David; Amián, Josué G; Sánchez-Medina, José A

    2015-01-01

    The Iowa Gambling Task (IGT) is widely used to study decision-making differences between several clinical and healthy populations. Unlike the healthy participants, clinical participants have difficulty choosing between advantageous options, which yield long-term benefits, and disadvantageous options, which give high immediate rewards but lead to negative profits. However, recent studies have found that healthy participants avoid the options with a higher frequency of losses regardless of whether or not they are profitable in the long run. The aim of this study was to control for the confounding effect of the frequency of losses between options to improve the performance of healthy participants on the IGT. Eighty healthy participants were randomly assigned to the original IGT or a modified version of the IGT that diminished the gap in the frequency of losses between options. The participants who used the modified IGT version learned to make better decisions based on long-term profit, as indicated by an earlier ability to discriminate good from bad options, and took less time to make their choices. This research represents an advance in the study of decision making under uncertainty by showing that emotion-based learning is improved by controlling for the loss-frequency bias effect.

  17. Global climate change, war, and population decline in recent human history

    PubMed Central

    Zhang, David D.; Brecke, Peter; Lee, Harry F.; He, Yuan-Qing; Zhang, Jane

    2007-01-01

    Although scientists have warned of possible social perils resulting from climate change, the impacts of long-term climate change on social unrest and population collapse have not been quantitatively investigated. In this study, high-resolution paleo-climatic data have been used to explore at a macroscale the effects of climate change on the outbreak of war and population decline in the preindustrial era. We show that long-term fluctuations of war frequency and population changes followed the cycles of temperature change. Further analyses show that cooling impeded agricultural production, which brought about a series of serious social problems, including price inflation, then successively war outbreak, famine, and population decline successively. The findings suggest that worldwide and synchronistic war–peace, population, and price cycles in recent centuries have been driven mainly by long-term climate change. The findings also imply that social mechanisms that might mitigate the impact of climate change were not significantly effective during the study period. Climate change may thus have played a more important role and imposed a wider ranging effect on human civilization than has so far been suggested. Findings of this research may lend an additional dimension to the classic concepts of Malthusianism and Darwinism. PMID:18048343

  18. Global climate change, war, and population decline in recent human history.

    PubMed

    Zhang, David D; Brecke, Peter; Lee, Harry F; He, Yuan-Qing; Zhang, Jane

    2007-12-04

    Although scientists have warned of possible social perils resulting from climate change, the impacts of long-term climate change on social unrest and population collapse have not been quantitatively investigated. In this study, high-resolution paleo-climatic data have been used to explore at a macroscale the effects of climate change on the outbreak of war and population decline in the preindustrial era. We show that long-term fluctuations of war frequency and population changes followed the cycles of temperature change. Further analyses show that cooling impeded agricultural production, which brought about a series of serious social problems, including price inflation, then successively war outbreak, famine, and population decline successively. The findings suggest that worldwide and synchronistic war-peace, population, and price cycles in recent centuries have been driven mainly by long-term climate change. The findings also imply that social mechanisms that might mitigate the impact of climate change were not significantly effective during the study period. Climate change may thus have played a more important role and imposed a wider ranging effect on human civilization than has so far been suggested. Findings of this research may lend an additional dimension to the classic concepts of Malthusianism and Darwinism.

  19. Invasive Group A Streptococcal Infection in Older Adults in Long-term Care Facilities and the Community, United States, 1998–20031

    PubMed Central

    Richards, Chesley L.; Lynfield, Ruth; Barrett, Nancy L.; Harrison, Lee H.; Arnold, Kathryn E.; Reingold, Arthur; Bennett, Nancy M.; Craig, Allen S.; Gershman, Ken; Cieslak, Paul R.; Lewis, Paige; Greene, Carolyn M.; Beall, Bernard; Van Beneden, Chris A.

    2007-01-01

    Limited information exists on the incidence and characteristics of invasive group A streptococcal (GAS) infections among residents of long-term care facilities (LTCFs). We reviewed cases of invasive GAS infections occurring among persons >65 years of age identified through active, population-based surveillance from 1998 through 2003. We identified 1,762 invasive GAS cases among persons >65 years, including 1,662 with known residence type (LTCF or community). Incidence of invasive GAS infection among LTCF residents compared to community-based elderly was 41.0 versus 6.9 cases per 100,000 population. LTCF case-patients were 1.5 times as likely to die from the infection as community-based case-patients (33% vs. 21%, p<0.01) but were less often hospitalized (90% vs. 95%, p<0.01). In multivariate logistic regression modeling, LTCF residence remained an independent predictor of death. Additional prevention strategies against GAS infection in this high-risk population are urgently needed. PMID:18258035

  20. The direct and indirect costs of long bone fractures in a working age US population.

    PubMed

    Bonafede, Machaon; Espindle, Derek; Bower, Anthony G

    2013-01-01

    Information regarding the burden of fractures is limited, especially among working age patients. The objective of this study was to evaluate the direct and indirect costs associated with long bone fractures in a working age population using real-world claims data. This was a claims-based retrospective analysis, comparing adult patients in the 6 months before and 6 months after a long bone fracture between 1/1/2001 and 12/31/2008 using the MarketScan Research Databases. Outcomes included direct medical costs and utilization, as well as work absenteeism and short term disability, which was available for a sub-set of the patients. Observed and adjusted incremental costs (i.e., the difference in costs before and after a fracture) were evaluated and reported in 2008 US$. A total of 208,094 patients with at least one fracture were included in the study. Six, mutually exclusive fracture cohorts were evaluated: tibia shaft (n = 49,839), radius (n = 97,585), hip (n = 11,585), femur (n = 6788), humerus (n = 29,884), and those with multiple long bone fractures (n = 12,413). Average unadjusted direct costs in the 6-months before a long bone fracture ranged from $3291 (radius) to $12,923 (hip). The average incremental direct cost increase in the 6-months following a fracture ranged from $5707 (radius) to $39,041 (multiple fractures). Incremental absenteeism costs ranged from $950 (radius) to $2600 (multiple fractures), while incremental short-term disability costs ranged from $2050 (radius) to $4600 (multiple fractures). The results of this study indicate that long bone fractures are costly, both in terms of direct medical costs and lost productivity. Workplace absences and short-term disability represent a significant component of the burden of long bone fractures. These results may not be generalizable to all patients with fractures in the US, and do not reflect the burden of undiagnosed or sub-clinical fractures.

  1. Response of common murres to the Exxon Valdez Oil Spill and long-term changes in the Gulf of Alaska marine ecosystem

    USGS Publications Warehouse

    Piatt, John F.; Anderson, Paul; Rice, S.D.; Spies, R.B.; Wolfe, D.A.; Wright, B.A.

    1996-01-01

    Short-term effects of the 1989 TV Exxon Valdez oil spill on seabirds were dramatic and well documented. Seabird populations at sea in the spill zone were immediately depressed, and more than 30,000 dead, oiled seabirds were recovered from beaches within months of the spill. It is estimated that 250,000 seabirds were killed by oil, of which 74% were murres. Based on comparisons of prespill (1970s) and postspill (1989-1994) data, long-term effects on murres attributed to oil pollution included population declines, reduced breeding success, and delayed breeding phenology. Populations remained depressed, but breeding success phenology gradually returned to normal levels by 1993. An alternative hypothesis to explain these long-term effects is that murres were responding to natural events in their marine environment. Flow of the Alaska Coastal Current (ACC) was at an all-time low in 1989, and this may have reduced and delayed biological productivity in the ACC. On a broader time scale, marked changes in marine fish communities have occurred during the past 20 years. Coincident with cyclical fluctuations in seawater temperatures, the abundance of small forage species (e.g., humpy shrimp, capelin, and Pacific sandfish) declined precipitously in the late 1970s while populations of large predatory fish (e.g., walleye pollock, Pacific cod, and flatfish) increased dramatically. Correspondingly, seabird diets shifted from mostly capelin in the 1970s to mostly Pacific sand land and juvenile pollock in the late 1980s. Furthermore, a variety of seabirds and marine mammals both inside and outside of the oil spill zone exhibited signs of food stress (population declines, reduced productivity, die-offs) throughout the 1980s and early 1990s. We conclude that available data are inadequate to distinguish between long-term effects of the Exxon Valdez oil spill on murres and a natural response of murres to long-term changes in their marine environment.

  2. Inferring microevolution from museum collections and resampling: lessons learned from Cepaea.

    PubMed

    Ożgo, Małgorzata; Liew, Thor-Seng; Webster, Nicole B; Schilthuizen, Menno

    2017-01-01

    Natural history collections are an important and largely untapped source of long-term data on evolutionary changes in wild populations. Here, we utilize three large geo-referenced sets of samples of the common European land-snail Cepaea nemoralis stored in the collection of Naturalis Biodiversity Center in Leiden, the Netherlands. Resampling of these populations allowed us to gain insight into changes occurring over 95, 69, and 50 years. Cepaea nemoralis is polymorphic for the colour and banding of the shell; the mode of inheritance of these patterns is known, and the polymorphism is under both thermal and predatory selection. At two sites the general direction of changes was towards lighter shells (yellow and less heavily banded), which is consistent with predictions based on on-going climatic change. At one site no directional changes were detected. At all sites there were significant shifts in morph frequencies between years, and our study contributes to the recognition that short-term changes in the states of populations often exceed long-term trends. Our interpretation was limited by the few time points available in the studied collections. We therefore stress the need for natural history collections to routinely collect large samples of common species, to allow much more reliable hind-casting of evolutionary responses to environmental change.

  3. A population-based study of hospital care costs during five years after TIA and stroke

    PubMed Central

    Luengo-Fernandez, Ramon; Gray, Alastair M.; Rothwell, Peter M.

    2016-01-01

    Background and Purpose Few studies have evaluated long-term costs after stroke onset, with almost no cost data for TIA. We studied hospital costs during the 5 years after TIA or stroke in a population-based study. Methods Patients from a UK population-based cohort study (Oxford Vascular Study) were recruited from 2002 to 2007. Analysis was based on follow-up until 2010. Hospital resource usage was obtained from patients’ hospital records and valued using 2008/09 unit costs. As not all patients had full 5-year follow-up, we used non-parametric censoring techniques. Results Among 485 TIA and 729 stroke patients ascertained and included, mean censor-adjusted 5-year hospital costs after index stroke were $25,741 (95% CI: 23,659-27,914), with costs varying considerably by severity: $21,134 after minor stroke, $33,119 after moderate stroke, and $28,552 after severe stroke. For the 239 surviving stroke patients who had reached final follow-up, mean costs were $24,383 (20,156-28,595), with over half of costs ($12,972) being incurred in the first year after the event. After index TIA, the mean censor-adjusted 5-year costs were $18,091 (15,947-20,258). A multivariate analysis showed that event severity, recurrent stroke and coronary events after the index event were independent predictors of 5-year costs. Differences by stroke subtype were mostly explained by stroke severity and subsequent events. Conclusions Long-term hospital costs after TIA and stroke are considerable, but are mainly incurred over the first year after the index event. Event severity and suffering subsequent stroke and coronary events after the index event accounted for much of the increase in costs. PMID:23160884

  4. Long-Term Effects of Untreated Adolescent Idiopathic Scoliosis: A Review of the Literature

    PubMed Central

    Karavidas, Nikos; Moramarco, Marc; Moramarco, Kathryn

    2016-01-01

    Currently, adolescent idiopathic scoliosis (AIS) is principally regarded as benign, but some researchers have cited serious or extreme effects, including severe pain, cardiopulmonary compromise, social isolation, and even early death. Therefore, exploration of the long-term effects of AIS, the most common type of idiopathic scoliosis, is warranted. The purpose of this review was to examine the long-term studies on the natural history of AIS and/or reviews concerning the long-term effects of untreated AIS. A PubMed search was conducted using the key words idiopathic scoliosis, long-term effects and idiopathic scoliosis, natural history. For further analysis, references cited in those studies were reviewed for additional, related evidence not retrieved in the initial PubMed search. A review of the pertinent bibliography showed that older natural history studies did not distinguish between late-onset scoliosis (referred to in this paper as AIS) and early-onset scoliosis (EOS). The more recent studies offer such important distinction and reach to the general conclusion that untreated AIS does not lead to severe consequences with respect to signs and symptoms of scoliosis. It is possible that earlier studies may have included patient populations with EOS, leading to the perception of untreated scoliosis as having an unusually high morbidity rate. Studies on the long-term effects of AIS that specifically excluded EOS patients conclude that AIS is a benign disorder. This indicates that for research and reporting purposes, it is important to distinguishing between AIS and EOS. This will allow the practitioner and patient and their families to decide on an optimal treatment plan based on the most appropriate prognosis. PMID:27994795

  5. Temporal dynamics of genetic variability in a mountain goat (Oreamnos americanus) population.

    PubMed

    Ortego, Joaquín; Yannic, Glenn; Shafer, Aaron B A; Mainguy, Julien; Festa-Bianchet, Marco; Coltman, David W; Côté, Steeve D

    2011-04-01

    The association between population dynamics and genetic variability is of fundamental importance for both evolutionary and conservation biology. We combined long-term population monitoring and molecular genetic data from 123 offspring and their parents at 28 microsatellite loci to investigate changes in genetic diversity over 14 cohorts in a small and relatively isolated population of mountain goats (Oreamnos americanus) during a period of demographic increase. Offspring heterozygosity decreased while parental genetic similarity and inbreeding coefficients (F(IS) ) increased over the study period (1995-2008). Immigrants introduced three novel alleles into the population and matings between residents and immigrants produced more heterozygous offspring than local crosses, suggesting that immigration can increase population genetic variability. The population experienced genetic drift over the study period, reflected by a reduced allelic richness over time and an 'isolation-by-time' pattern of genetic structure. The temporal decline of individual genetic diversity despite increasing population size probably resulted from a combination of genetic drift due to small effective population size, inbreeding and insufficient counterbalancing by immigration. This study highlights the importance of long-term genetic monitoring to understand how demographic processes influence temporal changes of genetic diversity in long-lived organisms. © 2011 Blackwell Publishing Ltd.

  6. The Adult Respiratory Distress Syndrome Cognitive Outcomes Study

    PubMed Central

    Christie, Jason D.; Lanken, Paul N.; Biester, Rosette C.; Thompson, B. Taylor; Bellamy, Scarlett L.; Localio, A. Russell; Demissie, Ejigayehu; Hopkins, Ramona O.; Angus, Derek C.

    2012-01-01

    Rationale: Cognitive and psychiatric morbidity is common and potentially modifiable after acute lung injury (ALI). However, practical measures of neuropsychological function for use in multicenter trials are lacking. Objectives: To determine whether a validated telephone-based neuropsychological test battery is feasible in a multicenter trial. To determine the frequency and risk factors for long-term neuropsychological impairment. Methods: As an adjunct study to the Acute Respiratory Distress Syndrome Clinical Trials Network Fluid and Catheter Treatment Trial, we assessed neuropsychological function at 2 and 12 months post–hospital discharge. Measurements and Main Results: Of 406 eligible survivors, we approached 261 to participate and 213 consented. We tested 122 subjects at least once, including 102 subjects at 12 months. Memory, verbal fluency, and executive function were impaired in 13% (12 of 92), 16% (15 of 96), and 49% (37 of 76) of long-term survivors. Long-term cognitive impairment was present in 41 of the 75 (55%) survivors who completed cognitive testing. Depression, post-traumatic stress disorder, or anxiety was present in 36% (37 of 102), 39% (40 of 102), and 62% (63 of 102) of long-term survivors. Enrollment in a conservative fluid-management strategy (P = 0.005) was associated with cognitive impairment and lower partial pressure of arterial oxygen during the trial was associated with cognitive (P = 0.02) and psychiatric impairment (P = 0.02). Conclusions: Neuropsychological function can be assessed by telephone in a multicenter trial. Long-term neuropsychological impairment is common in survivors of ALI. Hypoxemia is a risk factor for long-term neuropsychological impairment. Fluid management strategy is a potential risk factor for long-term cognitive impairment; however, given the select population studied and an unclear mechanism, this finding requires confirmation. PMID:22492988

  7. Agriculture, population growth, and statistical analysis of the radiocarbon record.

    PubMed

    Zahid, H Jabran; Robinson, Erick; Kelly, Robert L

    2016-01-26

    The human population has grown significantly since the onset of the Holocene about 12,000 y ago. Despite decades of research, the factors determining prehistoric population growth remain uncertain. Here, we examine measurements of the rate of growth of the prehistoric human population based on statistical analysis of the radiocarbon record. We find that, during most of the Holocene, human populations worldwide grew at a long-term annual rate of 0.04%. Statistical analysis of the radiocarbon record shows that transitioning farming societies experienced the same rate of growth as contemporaneous foraging societies. The same rate of growth measured for populations dwelling in a range of environments and practicing a variety of subsistence strategies suggests that the global climate and/or endogenous biological factors, not adaptability to local environment or subsistence practices, regulated the long-term growth of the human population during most of the Holocene. Our results demonstrate that statistical analyses of large ensembles of radiocarbon dates are robust and valuable for quantitatively investigating the demography of prehistoric human populations worldwide.

  8. The long-term demographic role of community-based family planning in rural Bangladesh.

    PubMed

    Phillips, J F; Hossain, M B; Arends-Kuenning, M

    1996-01-01

    Experimental studies demonstrating the effectiveness of nonclinical distribution of contraceptives are typically conducted in settings where contraceptive use is low and unmet need is extensive. Determining the long-term role of active outreach programs after initial demand is met represents an increasingly important policy issue in Asia, where contraceptive prevalence is high and fixed service points are conveniently available. This article examines the long-term rationale for household family planning in Bangladesh-where growing use of contraceptives, rapid fertility decline, and normative change in reproductive preferences are in progress, bringing into question the rationale for large-scale deployment of paid outreach workers. Longitudinal data are analyzed that record outreach encounters and contraceptive use dynamics in a large rural population. Findings demonstrate that outreach has a continuing impact on program effectiveness, even after a decade of household visitation. The policy implications of this finding are reviewed.

  9. Initiation and long-term use of benzodiazepines and Z-drugs in bipolar disorder.

    PubMed

    Wingård, Louise; Taipale, Heidi; Reutfors, Johan; Westerlund, Anna; Bodén, Robert; Tiihonen, Jari; Tanskanen, Antti; Andersen, Morten

    2018-02-16

    Increasing evidence points to the harmful effects of long-term benzodiazepine treatment. Our objective was to study the incidence of, and predictors for, long-term use of benzodiazepines and Z-drugs in bipolar disorder. We conducted a population-based cohort study, using data from Swedish national registers. Swedish residents aged 18-75 years with a recorded diagnosis of bipolar disorder or mania between July 2006 and December 2012, and no history of benzodiazepine/Z-drug use in the past year, were included. Patients were followed for 1 year with regard to prescription fills of benzodiazepines/Z-drugs. Initiators were followed for another year during which continuous use for >6 months was defined as "long-term". Patient and prescription characteristics were investigated as potential predictors for long-term use in multivariate logistic regression models. Out of the 21 883 patients included, 29% started benzodiazepine/Z-drug treatment, of whom one in five became long-term users. Patients who were prescribed clonazepam or alprazolam had high odds for subsequent long-term use (adjusted odds ratios [aORs] 3.78 [95% confidence interval (CI) 2.24-6.38] and 2.03 [95% CI 1.30-3.18], respectively), compared to those prescribed diazepam. Polytherapy with benzodiazepines/Z-drugs also predicted long-term use (aOR 2.46, 95% CI 1.79-3.38), as did age ≥60 years (aOR 1.93, 95% CI 1.46-2.53, compared to age <30 years), and concomitant treatment with psychostimulants (aOR 1.78, 95% CI 1.33-2.39). The incidence of subsequent long-term use among bipolar benzodiazepine initiators is high. Patients on clonazepam, alprazolam or benzodiazepine/Z-drug polytherapy have the highest risk of becoming long-term users, suggesting that these treatments should be used restrictively. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  10. A cluster-randomized effectiveness trial of a physician-pharmacist collaborative model to improve blood pressure control.

    PubMed

    Carter, Barry L; Clarke, William; Ardery, Gail; Weber, Cynthia A; James, Paul A; Vander Weg, Mark; Chrischilles, Elizabeth A; Vaughn, Thomas; Egan, Brent M

    2010-07-01

    Numerous studies have demonstrated the value of team-based care to improve blood pressure (BP) control, but there is limited information on whether these models would be adopted in diverse populations. The purpose of this study was to evaluate whether a collaborative model between physicians and pharmacists can improve BP control in multiple primary care medical offices with diverse geographic and patient characteristics and whether long-term BP control can be sustained. This study is a randomized prospective trial in 27 primary care offices first stratified by the percentage of underrepresented minorities and the level of clinical pharmacy services within the office. Each office is then randomized to either a 9- or 24-month intervention or a control group. Patients will be enrolled in this study until 2012. The results of this study should provide information on whether this model can be implemented in large numbers of diverse offices, if it is effective in diverse populations, and whether BP control can be sustained long term. URL: http://www.clinicaltrials.gov. Unique identifier: NCT00935077.

  11. Who is at risk for long-term sickness absence? A prospective cohort study of Danish employees.

    PubMed

    Lund, Thomas; Labriola, Merete; Villadsen, Ebbe

    2007-01-01

    The aim of this study was to identify who is at risk for long-term sickness absence according to occupation, gender, education, age, business sector, agency size and ownership. The study is based on a sample of 5357 employees aged 18-69, interviewed in 2000. The cohort was followed up in a national register from January 1st 2001 to June 30th 2003, to identify cases with sickness absences that exceeded 8 weeks. During follow-up 486 persons (9.1%) experienced one or more periods of absence that exceeded 8 weeks. Higher risk of long-term sickness absence was associated with gender, age, educational level, and the municipal employment sector. Kindergarten teachers and people employed in day care, health care, janitorial work, food preparation, and unskilled workers were at greatest risk. Managers, computer professionals, technicians and designers, and professionals had lower risks. The health care and social service sectors were also in the high risk category, whereas the private administration sector had a lower risk. The study identifies specific occupational target populations and documents the need to perform job-specific research and tailor interventions if the intended policy of decreasing long-term sickness absence within the Danish labour market is to be realized.

  12. Economic status and temperature-related mortality in Asia

    NASA Astrophysics Data System (ADS)

    Lim, Youn-Hee; Bell, Michelle L.; Kan, Haidong; Honda, Yasushi; Guo, Yue-Liang Leon; Kim, Ho

    2015-10-01

    In developed countries, low latitude and high temperature are positively associated with the population's ability to adapt to heat. However, few studies have examined the effect of economic status on the relationship between long-term exposure to high temperature and health. We compared heterogeneous temperature-related mortality effects relative to the average summer temperature in high-socioeconomic-status (SES) cities to temperature-related effects in low-SES cities. In the first stage of the research, we conducted a linear regression analysis to quantify the mortality effects of high temperature (at or above the 95th percentile) in 32 cities in Taiwan, China, Japan, and Korea. In the second stage, we used a meta-regression to examine the association between mortality risk with average summer temperature and gross domestic product (GDP) per capita. In cities with a low GDP per capita (less than 20,000 USD), the effects of temperature were detrimental to the population if the long-term average summer temperature was high. In contrast, in cities with a high GDP per capita, temperature-related mortality risk was not significantly related to average summer temperature. The relationship between long-term average summer temperature and the short-term effects of high temperatures differed based on the city-level economic status.

  13. Disturbance frequency and vertical distribution of seeds affect long-term population dynamics: a mechanistic seed bank model.

    PubMed

    Eager, Eric Alan; Haridas, Chirakkal V; Pilson, Diana; Rebarber, Richard; Tenhumberg, Brigitte

    2013-08-01

    Seed banks are critically important for disturbance specialist plants because seeds of these species germinate only in disturbed soil. Disturbance and seed depth affect the survival and germination probability of seeds in the seed bank, which in turn affect population dynamics. We develop a density-dependent stochastic integral projection model to evaluate the effect of stochastic soil disturbances on plant population dynamics with an emphasis on mimicking how disturbances vertically redistribute seeds within the seed bank. We perform a simulation analysis of the effect of the frequency and mean depth of disturbances on the population's quasi-extinction probability, as well as the long-term mean and variance of the total density of seeds in the seed bank. We show that increasing the frequency of disturbances increases the long-term viability of the population, but the relationship between the mean depth of disturbance and the long-term viability of the population are not necessarily monotonic for all parameter combinations. Specifically, an increase in the probability of disturbance increases the long-term viability of the total seed bank population. However, if the probability of disturbance is too low, a shallower mean depth of disturbance can increase long-term viability, a relationship that switches as the probability of disturbance increases. However, a shallow disturbance depth is beneficial only in scenarios with low survival in the seed bank.

  14. The role of gender in long-term sickness absence and transition to permanent disability benefits. Results from a multiregister based, prospective study in Norway 1990-1995.

    PubMed

    Gjesdal, Sturla; Bratberg, Espen

    2002-09-01

    The aim of the study was to identify predictors for the transition from long-term sickness absence into disability pension with a special focus on gender. The study used data from a national database containing a 10% random sample of the Norwegian adult population (The KIRUT database). The study population were all individuals in the database who on 1 January 1990 were eligible for sick pay from the Norwegian National Insurance System: 83,398 men and 75,586 women. Individuals below 60 years with long-term sickness absence starting in 1990 and 1991 were identified, 6,434 men and 8,233 women, and followed up for three years. Background data were used as independent variables in a logistic regression of the probability for receiving disability pension during follow-up. Annual cumulative incidence of long-term sickness absence was 6.5% for women and 4.9% for men. During follow-up, 12.4% of the women and 12.6% of the men received disability pension. Among full-time employed women only 10.3% had become disability pensioners, while the corresponding proportion for women working part-time was 15.5%. For men the figures were 12.1% (full-time) and 18.1% (part-time). In the logistic regression of the whole sample the female odds ratio was insignificant. The dominant predictive factors for disability pension were age and duration of the sickness spells. Working part-time also increased the risk. Higher levels of education and having children below 7 years reduced the probability for disability pension. Separate regressions for men and women showed that the 'protective' effect of having small children only remained for women.

  15. Heart diseases and long-term risk of dementia and Alzheimer's disease: a population-based CAIDE study.

    PubMed

    Rusanen, Minna; Kivipelto, Miia; Levälahti, Esko; Laatikainen, Tiina; Tuomilehto, Jaakko; Soininen, Hilkka; Ngandu, Tiia

    2014-01-01

    Many cardiovascular risk factors are shown to increase the risk of dementia and Alzheimer's disease (AD), but the impact of heart disease on later development of dementia is still unclear. The aim of the study was to investigate the long-term risk of dementia and Alzheimer's disease (AD) related to midlife and late-life atrial fibrillation (AF), heart failure (HF), and coronary artery disease (CAD) in a population-based study with a follow-up of over 25 years. Cardiovascular Risk Factors, Aging and Dementia (CAIDE) study includes 2000 participants who were randomly selected from four separate, population-based samples originally studied in midlife (1972, 1977, 1982, or 1987). Re-examinations were carried out in 1998 and 2005-2008. Altogether 1,510 (75.5%) persons participated in at least one re-examination, and 127 (8.4%) persons were diagnosed with dementia (of which 102 had AD). AF in late-life was an independent risk factor for dementia (HR 2.61, 95% CI 1.05-6.47; p = 0.039) and AD (HR 2.54, 95% CI 1.04-6.16; p = 0.040) in the fully adjusted analyses. The association was even stronger among the apolipoprotein E (APOE) ε4 non-carriers. Late-life HF, but not CAD, tended to increase the risks as well. Heart diseases diagnosed at midlife did not increase the risk of later dementia and AD. Late-life heart diseases increase the subsequent risk of dementia and AD. Prevention and effective treatment of heart diseases may be important also from the perspective of brain health and cognitive functioning.

  16. [The electromagnetic fields of the base stations of mobile radio communication and ecology. The estimation of danger of the base station EMF for population and for bioecosystems].

    PubMed

    Grigor'ev, Iu G; Grigor'ev, K A

    2005-01-01

    The estimation of the danger for the population and for the bioecosistems of the electromagnetic conditions around of the base stations was given. The insufficiency of the scientific knowledge does not allow to guarantee the safety of the population and of the bioecosystems in the conditions of a round-the-clock long-term influence of EMF RF. WHO recommends to use "Precautionary principle".

  17. Cost effectiveness of interpersonal community psychiatric treatment for people with long-term severe non-psychotic mental disorders: protocol of a multi-centre randomized controlled trial.

    PubMed

    van Veen, Mark; Koekkoek, Bauke; Mulder, Niels; Postulart, Debby; Adang, Eddy; Teerenstra, Steven; Schoonhoven, Lisette; van Achterberg, Theo

    2015-05-02

    This study aims for health gain and cost reduction in the care for people with long-term non-psychotic psychiatric disorders. Present care for this population has a limited evidence base, is often open ended, little effective, and expensive. Recent epidemiological data shows that 43.5% of the Dutch are affected by mental illness during their life. About 80% of all patients receiving mental health services (MHS) have one or more non-psychotic disorders. Particularly for this group, long-term treatment and care is poorly developed. Care As Usual (CAU) currently is a form of low-structured treatment/care. Interpersonal Community Psychiatric Treatment (ICPT) is a structured treatment for people with long-term, non-psychotic disorders, developed together with patients, professionals, and experts. ICPT uses a number of evidence-based techniques and was positively evaluated in a controlled pilot study. Multi-centre cluster-randomized clinical trial: 36 professionals will be randomly allocated to either ICPT or CAU for an intervention period of 12 months, and a follow-up of 6 months. 180 Patients between 18-65 years of age will be included, who have been diagnosed with a non-psychotic psychiatric disorder (depressive, anxiety, personality or substance abuse disorder), have long-term (>2 years) or high care use (>1 outpatient contact per week or >2 crisis contacts per year or >1 inpatient admission per year), and who receive treatment in a specialized mental health care setting. The primary outcome variable is quality of life; secondary outcomes are costs, recovery, general mental health, therapeutic alliance, professional-perceived difficulty of patient, care needs and social contacts. No RCT, nor cost-effectiveness study, has been conducted on ICPT so far. The empirical base for current CAU is weak, if not absent. This study will fill this void, and generate data needed to improve daily mental health care. Netherlands Trial Register (NTR): 3988 . Registered 13th of May 2013.

  18. Familial Consent for Deceased Organ Donation Among Immigrants and Long-term Residents in Ontario, Canada: A Population-Based Retrospective Cohort Study

    PubMed Central

    Li, Alvin Ho-ting; Al-Jaishi, Ahmed A.; Weir, Matthew; Lam, Ngan N.; Maclean, Janet; Dhanani, Sonny; Kim, S. Joseph; Knoll, Greg; Garg, Amit X.

    2017-01-01

    Background: Many families choose not to consent to organ donation at the time of their loved one’s death. In Ontario, Canada, whether these decisions vary by ethnicity remains unclear. Objective: To compare the proportion of families of immigrants who consented for deceased organ donation with families of long-term residents. Design: Population-based retrospective cohort study. Setting: Potential donors in Ontario, Canada, between November 2008 and March 2013. Methods: We used linked administrative databases to study the proportion of families who consented for deceased organ donation. Results: Overall, of the 2873 families of potential donors approached, 1912 (67%) provided consent for deceased organ donation. Families of immigrants were less likely to provide consent compared with families of long-term residents (46% [135 of 291] vs 69% [1777 of 2582]; adjusted rate ratio (RR): 0.72; 95% confidence interval [CI]: 0.63-0.81). When examined by the country of birth, families of immigrants from the following regions were less likely to consent to organ donation compared with long-term residents: South Asia (RR: 0.71; 95% CI: 0.55-0.91), East Asia and Pacific (RR: 0.68; 95% CI: 0.53-0.88) and Middle East, North Africa, and sub-Saharan Africa (RR: 0.58; 95% CI: 0.37-0.91). Limitations: We could not determine why consent was not obtained. We had a small sample of immigrants. We only had access to the potential donors’ information and not the family member who was approached for consent. Many characteristics that we examined were nonmodifiable (eg, age, sex). Conclusions: In Ontario, families of immigrants are less likely to consent to deceased organ donation. There is an opportunity to better understand the reasons for lower consent among certain immigrant groups. PMID:29093824

  19. Hip protector compliance: a 13-month study on factors and cost in a long-term care facility.

    PubMed

    Burl, Jeffrey B; Centola, James; Bonner, Alice; Burque, Colleen

    2003-01-01

    To determine if a high compliance rate for wearing external hip protectors could be achieved and sustained in a long-term care population. A 13-month prospective study of daytime use of external hip protectors in an at-risk long-term care population. One hundred-bed not-for-profit long-term care facility. Thirty-eight ambulatory residents having at least 1 of 4 risk factors (osteoporosis, recent fall, positive fall screen, previous fracture). The rehabilitation department coordinated an implementation program. Members of the rehabilitation team met with eligible participants, primary caregivers, families, and other support staff for educational instruction and a description of the program. The rehabilitation team assumed overall responsibility for measuring and ordering hip protectors and monitoring compliance. By the end of the third month, hip protector compliance averaged greater than 90% daily wear. The average number of falls per month in the hip protector group was 3.9 versus 1.3 in nonparticipants. Estimated total indirect staff time was 7.75 hours. The total cost of the study (hip protectors and indirect staff time) was 6,300 US dollars. High hip protector compliance is both feasible and sustainable in an at-risk long-term care population. Achieving high compliance requires an interdisciplinary approach with one department acting as a champion. The cost of protectors could be a barrier to widespread use. Facilities might be unable to cover the cost until the product is paid for by third-party payers.

  20. Population delineation of polar bears using satellite collar data

    USGS Publications Warehouse

    Bethke, R.; Taylor, Mitchell K.; Amstrup, Steven C.; Messier, François

    1996-01-01

    To produce reliable estimates of the size or vital rates of a given population, it is important that the boundaries of the population under study are clearly defined. This is particularly critical for large, migratory animals where levels of sustainable harvest are based on these estimates, and where small errors may have serious long-term consequences for the population. Once populations are delineated, rates of exchange between adjacent populations can be determined and accounted/corrected for when calculating abundance (e.g., based on mark-recapture data). Using satellite radio-collar locations for polar bears in the western Canadian Arctic, we illustrate one approach to delineating wildlife populations that integrates cluster analysis methods for determining group membership with home range plotting procedures to define spatial utilization. This approach is flexible with respect to the specific procedures used and provides an objective and quantitative basis for defining population boundaries.

  1. [Epidemic Vitamin D Deficiency in Prisoners Compared to the German Population: An Analysis Based on Laboratory Results].

    PubMed

    Pürner, Friedrich; Böhmer, Merle M; Wildner, Manfred

    2018-04-20

    Effects of long-term imprisonment on the vitamin D (vitD) status of prison inmates in Germany have not been systematically assessed so far. Special circumstances in prisons - little sunlight exposure combined with restricted outdoor activities - may lead to vitD deficiency among prisoners. The aim of this study was to assess the vitD status of prisoners and the general population in order to quantify the extent of vitD deficiency in both groups. VitD status (25(OH)D in blood serum samples) was assessed in female inmates of a prison in southern Germany between May 2012-June 2013. Suboptimal vitD status was defined as levels of 10-<20 µg/l, severe deficiency as<10 µg/l. A systematic literature search in PubMed was conducted in order to compare study results with vitD levels in the general population. Blood sera of 84 inmates (median age: 43 years; range: 19-75) were analyzed. Thirty women (36%) showed severe vitD deficiency, 47 (56%) suboptimal vitD levels. The literature search identified 10 studies which reported considerable vitD deficiency in the general population in Germany. VitD deficiency is very common in both prison inmates and the general population. Unlike prison inmates, the population is able to decide whether, when and how long they want to exposure to sunlight. Moreover, they can counteract deficiency via a nutrition rich in vitD. This is not possible for inmates. To prevent long-term effects of vitD deficiency, intake of vitD supplements during duration of imprisonment seems reasonable. © Georg Thieme Verlag KG Stuttgart · New York.

  2. Social context of preterm delivery in France in 2011 and impact on short-term health outcomes: the EPIPAGE 2 cohort study.

    PubMed

    Germany, Laurence; Saurel-Cubizolles, Marie-Josèphe; Ehlinger, Virginie; Napoletano, Anthony; Alberge, Corine; Guyard-Boileau, Beatrice; Pierrat, Veronique; Genolini, Christophe; Ancel, Pierre-Yves; Arnaud, Catherine

    2015-05-01

    Low socio-economic context increases the risk of preterm delivery and may affect short-term outcomes in children born preterm. We described the social context of preterm delivery in France in 2011 and compared it with the general population of deliveries over the same period. We also studied how social context influenced pregnancy and delivery characteristics in the preterm population, and how it affected mortality and short-term morbidity in liveborn preterm children (<35 weeks). We created an individual socio-economic vulnerability index, derived from multiple correspondence analysis based on maternal social information in the French National Perinatal Survey (NPS-2010). Weighted coordinates were applied to families from the EPIPAGE 2 study, a population-based cohort of preterm infants born in 2011, to quantify the infant's exposure to socio-economic vulnerability. Multivariable logistic models were used to relate the socio-economic context to pregnancy and delivery characteristics, and to assess its impact on short-term outcomes of the infants. Among mothers of preterm infants, gestational age decreased as socio-economic conditions worsened. In the most deprived group, women had more irregular pregnancy care, a higher prevalence of infection during pregnancy, and a lower rate of antenatal corticosteroid administration. The most deprived group was associated with a higher risk of severe morbidity for the preterm neonates. Our results emphasise the need for a large population-based surveillance system to identify the most deprived mothers, and to propose appropriate follow-up and care to these women and their infants in order to enhance long-term health. © 2015 John Wiley & Sons Ltd.

  3. Long-Term Exposure to Ambient Air Pollution and Subclinical Cerebrovascular Disease in NOMAS (the Northern Manhattan Study).

    PubMed

    Kulick, Erin R; Wellenius, Gregory A; Kaufman, Joel D; DeRosa, Janet T; Kinney, Patrick L; Cheung, Ying Kuen; Wright, Clinton B; Sacco, Ralph L; Elkind, Mitchell S

    2017-07-01

    Long-term exposure to ambient air pollution is associated with higher risk of cardiovascular disease and stroke. We hypothesized that long-term exposure to air pollution would be associated with magnetic resonance imaging markers of subclinical cerebrovascular disease. Participants were 1075 stroke-free individuals aged ≥50 years drawn from the magnetic resonance imaging subcohort of the Northern Manhattan Study who had lived at the same residence for at least 2 years before magnetic resonance imaging. Cross-sectional associations between ambient air pollution and subclinical cerebrovascular disease were analyzed. We found an association between distance to roadway, a proxy for residential exposure to traffic pollution, and white matter hyperintensity volume; however, after adjusting for risk factors, this relationship was no longer present. All other associations between pollutant measures and white matter hyperintensity volume were null. There was no clear association between exposure to air pollutants and subclinical brain infarcts or total cerebral brain volume. We found no evidence that long-term exposure to ambient air pollution is independently associated with subclinical cerebrovascular disease in an urban population-based cohort. © 2017 American Heart Association, Inc.

  4. Weight Changes in General Practice.

    PubMed

    Køster-Rasmussen, Rasmus

    2017-06-01

    This PhD thesis is about weight changes. What determines long-term weight changes in the adult general population? Is it possible that weight loss may not always be healthy? The present clinical guidelines for general practice advice most overweight persons and patients with type 2 diabetes to lose weight. Are the guidelines based on firm evidence?   METHODS: The back-bone of the thesis is constituted by three scientific articles based on three different population based cohort studies. Multivariable modeling and other epidemiological methods were used.   RESULTS: Article 1 examined weight changes in the general population in relation to smoking status, and proposed a graphical 'smoking cessation weight change model', demonstrating the importance of time, age and smoking status in relation to long-term weight changes. Article 2 suggested new methods to improve the processing of dietary data. It was demonstrated how median imputation for missing values and assumptions about standard portion sizes were inferior to stochastic methods conditioning on information about physiology of the individual. Article 3 evaluated the influence of prospectively planned intentional weight loss on long-term morbidity and mortality in patients with type 2 diabetes. Therapeutic intentional weight loss supervised by a medical doctor was not associated with reduced morbidity or mortality. In the general population the dietary intake of fructose and soft drinks sweetened with sugar was not associated with weight change over 9 years. Weight gain rates were large in young adults and incrementally smaller in middle aged adults. Subjects more than 60 years lost weight on average. Historical weight data suggest that the body weight increases throughout life to the age of 60-65years. A study with simulated data indicates that bias in baseline BMI may misleadingly have favored weight loss in earlier cohort studies of intentional weight loss and mortality.   DISCUSSION: The findings regarding weight loss and mortality in patients with type 2 diabetes are in opposition to the prevailing observational literature. Harrington's meta-analysis of intentional weight loss and the underlying studies are evaluated along with the Look AHEAD trial and a number of diabetes prevention studies. Difficulties in conducting and interpreting weight change studies are discussed.   CONCLUSIONS: Surprisingly, intentional therapeutic weight loss in patients with type 2 diabetes, supervised by a medical doctor, did not seem to reduce the long-term risk for CVD, CVD-mortality or all-cause mortality. The contradictions between our results and the prevailing observational evidence may be explained by methodological weaknesses favoring weight loss in earlier studies. Consequently, there is no good evidence to support that intentional weight loss will reduce the risk of CVD or mortality in any group of patients in general practice or in the general population. Age was a powerful determinant of weight changes and the 'normal weight development' can be taken into consideration when evaluating weight studies, and when general practitioners are following their patients over time. Compared with age, sex, education, and comorbidity, lifestyle factors like the dietary intake and physical activity seemed to be of less importance for long-term weight development. An exception to this was smoking or smoking cessation. Based on the scientific literature in the field and on the results of article 3, it seems uncertain whether weight loss is beneficial or harmful in terms of mortality and cardiovascular morbidity in patients with diabetes and in overweight people in general. Improvements in for instance psychosocial factors and diabetes prevention may well be short term as only few are able to a maintain weight loss. Rather than going for weight loss in overweight high risk patients, it seems more rational for general practitioners to focus on other lifestyle changes like for instance Mediterranean diet and increased exercise. Articles published in the Danish Medical Journal are “open access”. This means that the articles are distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits any non-commercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.

  5. ANALYSIS OF TRENDS IN LIFE EXPECTANCIES AND PER CAPITA GROSS DOMESTIC PRODUCT AS WELL AS PHARMACEUTICAL AND NON-PHARMACEUTICAL HEALTHCARE EXPENDITURES.

    PubMed

    Hermanowski, Tomasz; Bystrov, Victor; Staszewska-Bystrova, Anna; Szafraniec-Buryło, Sylwia I; Rabczenko, Daniel; Kolasa, Katarzyna; Orlewska, Ewa

    2015-01-01

    Life expectancy is a common measure of population health. Macro-perspective based on aggregated data makes it possible to approximate the impact of different levels of pharmaceutical expenditure on general population health status and is often used in cross-country comparisons. The aim of the study was to determine whether there are long-run relations between life expectancy, total healthcare expenditures, and pharmaceutical expenditures in OECD countries. Common trends in per capita gross domestic products (GDPs) (excluding healthcare expenditures), per capita healthcare expenditures (excluding pharmaceutical expenditures), per capita pharmaceutical expenditures, and life expectancies of women and men aged 60 and 65 were analyzed across OECD countries. Short-term effect of pharmaceutical expenditure onto life expectancy was also estimated by regressing the deviations of life expectancies from their long-term trends onto the deviations of pharmaceutical and non-pharmaceutical health expenditures, as well as GDP from their trends. The dataset was created on the basis of OECD Health Data for 34 countries and the years 1991-2010. Life expectancy variables were used as proxies for the health outcomes, whereas the pharmaceutical and healthcare expenditures represented drug and healthcare consumption, respectively. In general, both expenditures and life expectancies tended to increase in all of the analyzed countries; however, the growth rates differed across the countries. The analysis of common trends indicated the existence of common long-term trends in life expectancies and per capita GDP as well as pharmaceutical and non-pharmaceutical healthcare expenditures. However, there was no evidence that pharmaceutical expenditures provided additional information about the long-term trends in life expectancies beyond that contained in the GDP series. The analysis based on the deviations of variables from their long-term trends allowed concluding that pharmaceutical expenditures significantly influenced life expectancies in the short run. Non-pharmaceutical healthcare expenditures were found to be significant in one out of four models (for life expectancy of women aged 65), while GDPs were found to be insignificant in all four models. The results of the study indicate that there are common long-term trends in life expectancies and per capita GDP as well as pharmaceutical and non-pharmaceutical healthcare expenditures. The available data did not reveal any cause- effect relationship. Other factors, for which the systematic data were not available, may have determined the increase in life expectancy in OECD countries. Significant positive short-term relations between pharmaceutical expenditures and life expectancies in OECD countries were found. The significant short-term effect of pharmaceutical expenditures onto life expectancy means that an increase of pharmaceutical expenditures above long-term trends would lead to a temporary increase in life expectancy above its corresponding long-term trend. However, this effect would not persist as pharmaceutical expenditures and life expectancy would converge to levels determined by the long-term trends.

  6. A systematic review of the evidence regarding efficacy of obesity prevention interventions among adults.

    PubMed

    Lemmens, V E P P; Oenema, A; Klepp, K I; Henriksen, H B; Brug, J

    2008-09-01

    In the past, interventions aimed at reducing obesity have mainly targeted at weight loss treatment in obese adults, with limited long-term effects. With the increasing number of people being obese and being at risk for obesity, there has been a shift in focus towards prevention of obesity. We conducted a systematic review of the peer-reviewed literature on the efficacy of obesity prevention interventions in adults in order to identify effective interventions and intervention elements. Pubmed, OVID, and Web of Science databases were searched from January 1996 to June 2006. Interventions aimed at primary prevention of weight gain among adults achieved by focusing on dietary intake, physical activity or the combination of both were included. The outcome measure had to be difference in change in body mass index or body weight between the intervention and the control groups. Nine studies were included, five long-term studies (at least 1 year) and four short-term (3 months to 1 year). Seven studies evaluated an intervention that focused on a combination of diet and physical activity to prevent weight gain, one on diet only and one on physical activity only. One dietary intervention (long-term), and three combined dietary and physical activity interventions (one long-term and two short-term) produced significantly positive results at end of follow-up. The two long-term, effective interventions consisted of intensive and long-term intervention implementation, including groups sessions designed to promote behavioural changes. The current evidence of efficacy of obesity prevention interventions is based on a very small number of studies. Some studies showed a positive impact on body mass index or weight status, but there was too much heterogeneity in terms of study design, theoretical underpinning and target population to draw firm conclusions about which intervention approaches are more effective than others. More research is urgently needed to extend the body of evidence.

  7. Long-term follow up of astronaut health indices

    NASA Technical Reports Server (NTRS)

    Nicogossian, A. E.; Moseley, E.; Leach-Huntoon, C.; Pool, S.

    1988-01-01

    Ground-based research and reevaluation of flight data is currently in progress in order to develop suitable and operationally acceptable medical standards for extended-duration manned space missions. The large amount of data obtained thus far constitutes a unique data base representative of the astronaut population. In this paper, preliminary 10-year findings of prospective studies established in 1977 are described, and results obtained from retrospective studies conducted on data accumulated prior to the 1977 establishment of medical selection standards are summarized.

  8. Approaches to reduce the long-term burden of treatment-related complications in survivors of childhood cancer.

    PubMed

    Armenian, Saro H; Kremer, Leontien C; Sklar, Charles

    2015-01-01

    Advances in diagnostics, treatment strategies, and supportive care have contributed to a marked improvement in outcomes for children with cancer. This has resulted in a growing number of long-term childhood cancer survivors. Currently there are over 360,000 individuals who are survivors of childhood cancer in the United States. However, treatment for patients with childhood cancer with chemotherapy, radiation, and/or hematopoietic stem cell transplantation can result in health-related complications that may not become evident until years after completion of treatment. As a result, several initiatives have been established to help standardize the surveillance for treatment-related late effects in childhood cancer survivors. This review highlights emerging concepts related to commonly reported late effects, such as subsequent malignant neoplasms, cardiovascular disease, and endocrinopathies. It also discusses relevant population-based screening strategies to mitigate the long-term health-related burden in vulnerable populations of survivors.

  9. The health-related quality of life in long-term colorectal cancer survivors study: objectives, methods and patient sample.

    PubMed

    Mohler, M Jane; Coons, Stephen Joel; Hornbrook, Mark C; Herrinton, Lisa J; Wendel, Christopher S; Grant, Marcia; Krouse, Robert S

    2008-07-01

    The objective of this paper is to describe the complex mixed-methods design of a study conducted to assess health-related quality of life (HRQOL) outcomes and ostomy-related obstacles and adjustments among long-term (>5 years) colorectal cancer (CRC) survivors with ostomies (cases) and without ostomies (controls). In addition, details are provided regarding the study sample and the psychometric properties of the quantitative data collection measures used. Subsequent manuscripts will present the study findings. The study design involved a cross-sectional mail survey for collecting quantitative data and focus groups for collecting qualitative data. The study subjects were individuals identified as long-term CRC survivors within a community-based health maintenance organization's enrolled population. Focus groups comprised of cases were conducted. The groups were divided by gender and HRQOL high and low quartile contrasts (based on the mail survey data). The modified City of Hope Quality of Life (mCOH-QOL)-Ostomy and SF-36v2 questionnaires were used in the mail survey. An abridged version of the mCOH-QOL-Ostomy was used for the control subjects. Focus groups explored ostomy-related barriers to self-care, adaptation methods/skills, and advice for others with an ostomy. The survey response rate was 52% (679/1308) and 34 subjects participated in focus groups. The internal consistency reliability estimates for the mCOH-QOL-Ostomy and SF-36v2 questionnaires were very acceptable for group comparisons. In addition, evidence supports the construct validity of the abridged version of the mCOH-QOL-Ostomy. Study limitations include potential non-response bias and limited minority participation. We were able to successfully recruit long-term CRC survivors into this study and the psychometric properties of the quantitative measures used were quite acceptable. Mixed-methods designs, such as the one used in this study, may be useful in identification and further elucidation of common problems, coping strategies, and HRQOL outcomes among long-term cancer survivors.

  10. Interventions for preventing obesity in children.

    PubMed

    Campbell, K; Waters, E; O'Meara, S; Kelly, S; Summerbell, C

    2002-01-01

    The prevalence of obesity and overweight is increasing in both adult and child populations throughout the world. Obesity in children impacts on their health in both the short and longer term, and obesity prevention is an international public health priority. However, the efficacy of prevention strategies is poorly understood. To assess the effectiveness of educational, health promotion and/or psychological/family/behavioural therapy/counselling/management interventions that focussed on diet, physical activity and/or lifestyle and social support, and were designed to prevent obesity in childhood. The following databases were searched: MEDLINE, Psyclit, EMBASE, Science Citation Index, Social Science Citation Index, CINAHL, Cochrane Controlled Trials Register (CCTR) and the Cochrane Heart Group's specialised register from 1985 to July 2001. Non English language papers were included. Experts were contacted to seek additional references or unpublished studies. RCTs and non-randomised trials with concurrent control group that observed participants for a minimum of three months were included Two reviewers independently extracted data and assessed study quality. Ten studies were included; seven were long-term (children observed for at least one year), three were shorter term (at least 3 months). Eight were school/nursery-based interventions, one was a community-based intervention targeting low-income African-American families, and one was a family-based intervention that targeted non-obese children of obese parents. The studies included were diverse in terms of study design and quality, target population, theoretical underpinning of intervention approach, and outcome measures, so it was not possible to combine study findings using statistical methods. Three of the four long-term studies that combined dietary education and physical activity interventions resulted in no difference in overweight, whereas one study reported an improvement in favour of the intervention group. In two studies of dietary education alone, a multimedia action strategy appeared to be effective but other strategies did not. The one long term study that only focussed on physical activity resulted in a slightly greater reduction in overweight in favour of the intervention group, as did two short term studies of physical activity. There is limited high quality data on the effectiveness of obesity prevention programs and no generalisable conclusions can be drawn. However, concentration on strategies that encourage reduction in sedentary behaviours and increase in physical activity may be fruitful. The need for well-designed studies that examine a range of interventions remains a priority, although a number of important studies are underway.

  11. Factors affecting long-term-care residents' decision-making processes as they formulate advance directives.

    PubMed

    Lambert, Heather C; McColl, Mary Ann; Gilbert, Julie; Wong, Jiahui; Murray, Gale; Shortt, Samuel E D

    2005-10-01

    The purpose of this study was to describe factors contributing to the decision-making processes of elderly persons as they formulate advance directives in long-term care. This study was qualitative, based on grounded theory. Recruitment was purposive and continued until saturation was reached. Nine residents of a long-term-care facility were interviewed by use of a semistructured format. Open and axial coding of interview transcripts were carried out and the factors contributing to the decision process were defined. Elders based their decisions primarily on information gathered from personal experiences with death and illness. They obtained very little information from professionals or the media. Major factors considered by elders as they weighed information included spiritual, emotional, and social considerations. The factors considered during the decision-making process were oriented more toward the individual's experiences and less on contributions from objective sources than anticipated. Decision making for advance directives is a highly personalized process. The approach of health professionals when assisting with end-of-life decision making should be planned with these contributing factors in mind, so that the services offered to the individuals in this population best meet their needs.

  12. Realized population change for long-term monitoring: California spotted owl case study

    Treesearch

    Mary M. Conner; John J. Keane; Claire V. Gallagher; Gretchen Jehle; Thomas E. Munton; Paula A. Shaklee; Ross A. Gerrard

    2013-01-01

    The annual rate of population change (λt) is a good metric for evaluating population performance because it summarizes survival and recruitment rates and can be used for open populations. Another measure of population performance, realized population change (Δt...

  13. Impact of Remote Monitoring on Long-Term Prognosis in Heart Failure Patients in a Real-World Cohort: Results From All-Comers COMMIT-HF Trial.

    PubMed

    Kurek, Anna; Tajstra, Mateusz; Gadula-Gacek, Elzbieta; Buchta, Piotr; Skrzypek, Michal; Pyka, Lukasz; Wasiak, Michal; Swietlinska, Malgorzata; Hawranek, Michal; Polonski, Lech; Gasior, Mariusz; Kosiuk, Jedrzej

    2017-04-01

    Randomized controlled trials demonstrate that remote monitoring (RM) of implantable cardioverter-defibrillators (ICDs) and cardiac resynchronization therapy devices (CRT-Ds) may improve quality of care and prognosis in heart failure (HF) patients. However, the impact of RM on long-term mortality in a real-world cohort is still not well examined. This study was designed as a matched cohort study based on the COMMIT-HF trial--a single-center, ongoing prospective observational registry (NCT02536443). Complete patient demographics, medical history, in-hospital results, hospitalizations, and mortality data were collected based on institutional registries and healthcare providers' records. Patients were divided into 2 groups based on RM presence and matched by means of propensity scores according to clinical characteristics. The primary endpoint of this study was the long-term all-cause mortality. Out of 1,429 consecutive patients, 822 patients with a first implantation of an ICD/CRT-D were included in the analysis. The final matched study population contained 574 patients in RM and in a control group. Although demographic and echocardiographic parameters as well as pharmacological treatments were similar in both groups, a significantly lower 1-year mortality was detected in the RM group (2.1% vs. 11.5%, P < 0.0001). This was also maintained during a 3-year follow-up (4.9% vs. 22.3%, P < 0.0001). Multivariate analysis showed that RM was associated with an improved prognosis (hazard ratio 0.187, 95% confidence interval 0.075-0.467, P = 0.0003). RM of HF patients with ICDs/CRT-Ds significantly reduced long-term mortality in a real-world clinical condition. © 2017 Wiley Periodicals, Inc.

  14. Overall mortality among patients surviving an episode of peptic ulcer bleeding

    PubMed Central

    Ruigomez, A.; Rodriguez, L. A.; Hasselgren, G.; Johansson, S.; Wallander, M.

    2000-01-01

    STUDY OBJECTIVE—The authors investigated whether patients who have survived an acute episode of peptic ulcer bleeding (PUB) have an excess long term all cause mortality compared with the general population free of PUB.
DESIGN—Follow up study of previously identified cohort of patients with a PUB episode and a general population cohort.
SETTING—The source population included all people aged 30 to 89 years, registered with general practitioners in the United Kingdom.
PATIENTS—All patients alive one month after the PUB episode constituted the cohort of PUB patients (n=978). A control group of 5000 people was randomly sampled from the source population. The same eligibility criteria as for patients with PUB were applied to the control series. Also, controls had to be free of PUB before start date.
MAIN RESULTS—Relative risk of mortality among PUB patients was 2.1, 95%CI: 1.7, 2.6) compared with the general population. This increased mortality risk occurred mainly in the patients less than 60 years old. No difference was observed between men and women. The excess mortality was not only circumscribed to deaths attributable to recurrent gastrointestinal bleed, but also cardiovascular, cancer and other causes.
CONCLUSIONS—People who have survived an acute episode of PUB have a reduced long term survival compared with the general population.This reduction was stronger among middle age patients than in the elderly.


Keywords: cohort study; mortality; peptic ulcer; bleeding; population-based study PMID:10715746

  15. Absence of oncogenic transformation despite acquisition of cytogenetic aberrations in long-term cultured telomerase-immortalized human fetal hepatocytes.

    PubMed

    Haker, Björn; Fuchs, Sigrid; Dierlamm, Judith; Brümmendorf, Tim H; Wege, Henning

    2007-10-18

    As a culture model to study hepatocarcinogenesis, telomerase-immortalized human fetal hepatocytes were monitored for karyotype changes evolving in long-term culture and development of functional defects in DNA damage response. G-banding revealed acquisition of characteristic karyotype abnormalities, e.g., trisomy 7 and monosomy X, in two independently immortalized and cultured populations after 80-100 population doublings. Interestingly, the detected aneuploidies resemble some of the genetic events observed in hepatocellular cancer. However, these genetic changes were not sufficient to induce oncogenic transformation reflected by absence of anchorage-independent growth. Furthermore, long-term cultured telomerase-immortalized cells preserved p53 expression levels and effective p53-mediated damage response.

  16. The influence of solid rocket motor retro-burns on the space debris environment

    NASA Astrophysics Data System (ADS)

    Stabroth, Sebastian; Homeister, Maren; Oswald, Michael; Wiedemann, Carsten; Klinkrad, Heiner; Vörsmann, Peter

    The ESA space debris population model MASTER (Meteoroid and Space Debris Terrestrial Environment Reference) considers firings of solid rocket motors (SRM) as a debris source with the associated generation of slag and dust particles. The resulting slag and dust population is a major contribution to the sub-millimetre size debris environment in Earth orbit. The current model version, MASTER-2005, is based on the simulation of 1076 orbital SRM firings which contributed to the long-term debris environment. A comparison of the modelled flux with impact data from returned surfaces shows that the shape and quantity of the modelled SRM dust distribution matches that of recent Hubble Space Telescope (HST) solar array measurements very well. However, the absolute flux level for dust is under-predicted for some of the analysed Long Duration Exposure Facility (LDEF) surfaces. This points into the direction of some past SRM firings not included in the current event database. The most suitable candidates for these firings are the large number of SRM retro-burns of return capsules. Objects released by those firings have highly eccentric orbits with perigees in the lower regions of the atmosphere. Thus, they produce no long-term effect on the debris environment. However, a large number of those firings during the on-orbit time frame of LDEF might lead to an increase of the dust population for some of the LDEF surfaces. In this paper, the influence of SRM retro-burns on the short- and long-term debris environment is analysed. The existing firing database is updated with gathered information of some 800 Russian retro-firings. Each firing is simulated with the MASTER population generation module. The resulting population is compared against the existing background population of SRM slag and dust particles in terms of spatial density and flux predictions.

  17. A Long-Term Population-Based Clinical and Morbidity Review of Prader-Willi Syndrome in Western Australia

    ERIC Educational Resources Information Center

    Thomson, A. K.; Glasson, E. J.; Bittles, A. H.

    2006-01-01

    Background: An investigation of the clinical morbidity and genetic profiles of individuals with Prader?Willi syndrome (PWS) in Western Australia (WA) was undertaken as part of a wider study into the effects of intellectual disability (ID) on the life course of individuals. Methods: All persons with a diagnosis of PWS were identified from the…

  18. Seizure Clustering during Drug Treatment Affects Seizure Outcome and Mortality of Childhood-Onset Epilepsy

    ERIC Educational Resources Information Center

    Sillanpaa, Matti; Schmidt, Dieter

    2008-01-01

    To provide evidence of whether seizure clustering is associated with drug resistance and increased mortality in childhood-onset epilepsy, a prospective, long-term population-based study was performed. One hundred and twenty patients who had been followed since disease onset (average age 37.0 years, SD 7.1, median 40.0, range 11-42; incident cases)…

  19. Population structure in the Island of Ugljan--demographic processes and marital migration.

    PubMed

    Malnar, Ana

    2008-12-01

    This research on the basic demographic processes and marital migrations of the population on Ugljan Island in the period from 1857 to 2001 was conducted within the context of the long-term anthropological research of the population structure of Croatia's islands. The analysis was based on the study of the origin of 5 244 married couples from Preko, Kali, Kukljica, Lukoran and Ugljan and carried out using data preserved in the old Registers of Marriages. The results show a high level of endogamy and reproductive isolation of the population in all the villages and they also confirm the importance of using historical and demographic sources for researching the shaping of population structures.

  20. Approaches to long-term conditions management and care for older people: similarities or differences?

    PubMed

    Tullett, Michael; Neno, Rebecca

    2008-03-01

    In the past few years, there has been an increased emphasis both on the care for older people and the management of long-term conditions within the United Kingdom. Currently, the Department of Health and the Scottish Executive identify and manage these two areas as separate entities. The aim of this article is to examine the current approaches to both of these areas of care and identify commonalities and articulate differences. The population across the world and particularly within the United Kingdom is ageing at an unprecedented rate. The numbers suffering long-term illness conditions has also risen sharply in recent years. As such, nurses need to be engaged at a strategic level in the design of robust and appropriate services for this increasing population group. A comprehensive literature review on long-term conditions and the care of older people was undertaken in an attempt to identify commonalities and differences in strategic and organizational approaches. A policy analysis was conducted to support the paper and establish links that may inform local service development. Proposing service development based on identified needs rather than organizational boundaries after the establishment of clear links between health and social care for those with long-term conditions and the ageing population. Nurse Managers need to be aware of the similarities and differences in political and theoretical approaches to the care for older people and the management of long-term conditions. By adopting this view, creativity in the service redesign and service provision can be fostered and nurtured as well as achieving a renewed focus on partnership working across organizational boundaries. With the current renewed political focus on health and social care, there is an opportunity in the UK to redefine the structure of care. This paper proposes similarities between caring for older people and for those with long-term conditions, and it is proposed these encapsulate the wider issues that need to be debated to achieve a truly joint approach to care.

  1. Evaluation of outdoor human thermal sensation of local climate zones based on long-term database

    NASA Astrophysics Data System (ADS)

    Unger, János; Skarbit, Nóra; Gál, Tamás

    2018-02-01

    This study gives a comprehensive picture on the diurnal and seasonal general outdoor human thermal sensation levels in different urban quarters based on long-term (almost 3 years) data series from urban and rural areas of Szeged, Hungary. It is supplemented with a case study dealing with an extreme heat wave period which is more and more frequent in the last decades in the study area. The intra-urban comparison is based on a thermal aspect classification of the surface, namely, the local climate zone (LCZ) system, on an urban meteorological station network and on the utilization of the physiologically equivalent temperature (PET) comfort index with categories calibrated to the local population. The selected stations represent sunlit areas well inside the LCZ areas. The results show that the seasonal and annual average magnitudes of the thermal load exerted by LCZs in the afternoon and evening follow their LCZ numbers. It is perfectly in line with the LCZ concept originally concentrating only on air temperature ( T air) differences between the zones. Our results justified the subdivision of urban areas into LCZs and give significant support to the application possibilities of the LCZ concept as a broader term covering different thermal phenomena.

  2. Depression among family caregivers of community-dwelling older people who used services under the Long Term Care Insurance program: a large-scale population-based study in Japan.

    PubMed

    Arai, Yumiko; Kumamoto, Keigo; Mizuno, Yoko; Washio, Masakazu

    2014-01-01

    To identify predictors for depression among family caregivers of community-dwelling older people under the Long Term Care Insurance (LTCI) program in Japan through a large-scale population-based survey. All 5938 older people with disabilities, using domiciliary services under the LTCI in the city of Toyama, and their family caregivers participated in this study. Caregiver depression was defined as scores of ≥16 on the Center for Epidemiological Studies Depression Scale (CES-D). Other caregiver measures included age, sex, hours spent caregiving, relationship to the care recipient, income adequacy, living arrangement, self-rated health, and work status. Care recipient measures included age, sex, level of functional disability, and severity of dementia. The data from 4128 pairs of the care recipients and their family caregivers were eligible for further analyses. A multiple logistic regression analysis was used to examine the predictors associated with being at risk of clinical depression (CES-D of ≥16). Overall, 34.2% of caregivers scored ≥16 on the CES-D. The independent predictors for depression by logistic regression analysis were six caregiver characteristics (female, income inadequacy, longer hours spent caregiving, worse subjective health, and co-residence with the care recipient) and one care-recipient characteristic (moderate dementia). This is one of the first population-based examinations of caregivers of older people who are enrolled in a national service system that provides affordable access to services. The results highlighted the importance of monitoring caregivers who manifest the identified predictors to attenuate caregiver depression at the population level under the LTCI.

  3. A nutritional intervention programme at a worksite canteen to promote a healthful lifestyle inspired by the traditional Mediterranean diet.

    PubMed

    Vitale, Marilena; Bianchi, Marta A; Rapetti, Valeria; Pepe, Josè M; Giacco, Angela; Giacco, Rosalba; Riccardi, Gabriele

    2018-02-01

    This study investigates the effectiveness and long-term impact on the composition of the habitual diet of a nutritional intervention programme - undertaken through panels, totems, and table mats or handout leaflets - based on the promotion at a worksite canteen of healthy food-choices resembling the traditional Mediterranean diet. A significantly higher choice of dishes based on wholegrain cereals, legumes, white meat and fish, and a lower choice of dishes based on refined cereals, red and processed meat, eggs and cheese was observed at the end of the intervention and after six months and three years of follow-ups. A significantly better adherence to the nutritional recommendations for saturated-fat, cholesterol, sugars and fibre was observed. This study reveals that a nutritional intervention programme promoting the traditional Mediterranean diet and utilising a minimally intensive approach is feasible and effective to modify in a beneficial way the dietary habits of a working population and keep these changes in the long-term.

  4. Long-Term Persistence of Prevalently Detected Human Papillomavirus Infections in the Absence of Detectable Cervical Precancer and Cancer

    PubMed Central

    Rodríguez, Ana Cecilia; Burk, Robert D.; Herrero, Rolando; Wacholder, Sholom; Hildesheim, Allan; Morales, Jorge; Rydzak, Greg; Schiffman, Mark

    2011-01-01

    Background. Detailed descriptions of long-term persistence of human papillomavirus (HPV) in the absence of cervical precancer are lacking. Methods. In a large, population-based natural study conducted in Guanacaste, Costa Rica, we studied a subset of 810 initially HPV-positive women with ≥3 years of active follow-up with ≥3 screening visits who had no future evidence of cervical precancer. Cervical specimens were tested for >40 HPV genotypes using a MY09/11 L1-targeted polymerase chain reaction method. Results. Seventy-two prevalently-detected HPV infections (5%) in 58 women (7%) persisted until the end of the follow-up period (median duration of follow-up, 7 years) without evidence of cervical precancer. At enrollment, women with long-term persistence were more likely to have multiple prevalently-detected HPV infections (P <.001) than were women who cleared their baseline HPV infections during follow-up. In a logistic regression model, women with long-term persistence were more likely than women who cleared infections to have another newly-detected HPV infection detectable at ≥3 visits (odds ratio, 2.6; 95% confidence interval, 1.2–5.6). Conclusions. Women with long-term persistence of HPV infection appear to be generally more susceptible to other HPV infections, especially longer-lasting infections, than are women who cleared their HPV infections. PMID:21343148

  5. Long-term benthic monitoring studies in the freshwater portion of the Potomac River - first annual report. Volume 3. Appendices. Report for September 1982-December 1983

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

    Vannote, R.L.; Sweeney, B.W.

    1985-02-28

    The report summarizes the results of the first year of a long-term study of the benthic macroinvertebrate fauna of the freshwater portion of the Potomac River extending from Dam No.5 near Williamsport, Maryland downstream to Seneca Pool near Seneca, Maryland. The primary objective of the study was to evaluate long-term trends in the distribution, abundance, and biomass of benthic macroinvertebrates and identify factors controlling the benthic populations, with particular emphasis on factors associated with existing power plant effluents within the study area.

  6. Long-term benthic monitoring studies in the freshwater portion of the Potomac River - first annual report. Volume 1. Text. Report for September 1982-December 1983

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

    Vannote, R.L.; Sweeney, B.W.

    1985-02-28

    The report summarizes the results of the first year of a long-term study of the benthic macroinvertebrate fauna of the freshwater portion of the Potomac River extending from Dam No. 5 near Williamsport, Maryland downstream to Seneca Pool near Seneca, Maryland. The primary objective of the study was to evaluate long-term trends in the distribution, abundance, and biomass of benthic macroinvertebrates and identify factors controlling the benthic populations, with particular emphasis on factors associated with existing power plant effluents within the study area.

  7. Population dynamics and angler exploitation of the unique muskellunge population in Shoepack Lake, Voyageurs National Park, Minnesota

    USGS Publications Warehouse

    Frohnauer, N.K.; Pierce, C.L.; Kallemeyn, L.W.

    2007-01-01

    A unique population of muskellunge Esox masquinongy inhabits Shoepack Lake in Voyageurs National Park, Minnesota. Little is known about its status, dynamics, and angler exploitation, and there is concern for the long-term viability of this population. We used intensive sampling and mark-recapture methods to quantify abundance, survival, growth, condition, age at maturity and fecundity and angler surveys to quantify angler pressure, catch rates, and exploitation. During our study, heavy rain washed out a dam constructed by beavers Castor canadensis which regulates the water level at the lake outlet, resulting in a nearly 50% reduction in surface area. We estimated a population size of 1,120 adult fish at the beginning of the study. No immediate reduction in population size was detected in response to the loss of lake area, although there was a gradual, but significant, decline in population size over the 2-year study. Adults grew less than 50 mm per year, and relative weight (W r) averaged roughly 80. Anglers were successful in catching, on average, two fish during a full day of angling, but harvest was negligible. Shoepack Lake muskellunge exhibit much slower growth rates and lower condition, but much higher densities and angler catch per unit effort (CPUE), than other muskellunge populations. The unique nature, limited distribution, and location of this population in a national park require special consideration for management. The results of this study provide the basis for assessing the long-term viability of the Shoepack Lake muskellunge population through simulations of long-term population dynamics and genetically effective population size. ?? Copyright by the American Fisheries Society 2007.

  8. Statewide Longitudinal Follow-up Study of Former Secondary Level Vocational Education Students (Project SEE). Report of Accomplishments.

    ERIC Educational Resources Information Center

    Wright, Calvin E.; Kim, Yungho

    A longitudinal followup study, entitled Project Student Employment Experiences (SEE), examined the long-term employment experiences of former vocational education students, especially special needs population students, and the long-term effects of their training. During the project, researchers collected a 3-year followup information file on their…

  9. Long-Term Chinese Students' Transitional Experiences in UK Higher Education: A Particular Focus on Their Academic Adjustment

    ERIC Educational Resources Information Center

    Wang, Isobel Kai-Hui

    2018-01-01

    The global population of students pursuing studies abroad continues to grow, and consequently their intercultural experiences are receiving greater research attention. However, research into long-term student sojourners' academic development and personal growth is still in its infancy. A parallel mixed method study was designed to investigate the…

  10. On the decline of the Rusty Blackbird and the use of ornithological literature to document long-term population trends

    USGS Publications Warehouse

    Greenberg, R.; Droege, S.

    1999-01-01

    Unlike most North American blackbirds, Rusty Blackbirds (Euphagus carolensis) have shown steep population declines. Declines of approximately 90% are indicated for three recent decades from the Breeding Bird Survey, Christmas Bird Counts, and Quebec Checklist Program. Analyses of abundance classifications in bird distribution books and annotated checklists reveal an overlooked but long-term decline dating back to at least the early part of this century. Rusty Blackbirds were described as very common to abundant in 5656 of the pre-192O published accounts, 19% of the 1921-1950 accounts, and only 7% of the post-1950 accounts. Rusty Blackbirds were described as uncommon in none of the pre-1950 accounts, 18% of the 1951-1980 accounts, and 43% of the post-1980 accounts. A similar pattern was found for analyses based on local checklists. Destruction of wooded wetlands on wintering grounds, acid precipitation, and the conversion of boreal forest wetlands could have contributed to these declines. Systematic analysis of regional guides and checklists provides a valuable tool for examining large-scale and long-term population changes in birds.

  11. The effect of physical rehabilitation on activities of daily living in older residents of long-term care facilities: systematic review with meta-analysis.

    PubMed

    Crocker, Tom; Young, John; Forster, Anne; Brown, Lesley; Ozer, Seline; Greenwood, Darren C

    2013-11-01

    the worldwide population is ageing. One expected consequence of this is an increase in morbidity and an associated increased demand for long-term care. Physical rehabilitation is beneficial in older people, but relatively little is known about effects in residents of long-term care facilities. to examine the effects of physical rehabilitation on activities of daily living (ADL) in elderly residents of long-term care facilities. systematic review with meta-analysis of randomised controlled trials. We included studies that compared the effect of a physical rehabilitation intervention on independence in ADL with either no intervention or an alternative intervention in older people (over 60 years) living in long-term care facilities. We searched 19 databases including the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, CINAHL, AMED, Web of Knowledge and Google Scholar. Two researchers independently screened papers and extracted data. Outcomes of included studies were combined in a standardised mean difference random-effects meta-analysis. thirteen of 14 studies identified were included in the meta-analysis. Independence in ADL was improved by 0.24 standard units (95% CI: 0.11-0.38; P = 0.0005). This is equivalent to 1.3 points on the Barthel Index (0-20 scale). No significant differences in effect were found based on participant or intervention characteristics. Larger sample size and low attrition were associated with smaller estimates of effect. All studies were assessed to be at risk of bias. physical rehabilitation may improve independence for elderly long-term care facility residents, but mean effects are small. It is unclear which interventions are most appropriate.

  12. Long-term effects of wildfire on greater sage-grouse - integrating population and ecosystem concepts for management in the Great Basin

    USGS Publications Warehouse

    Coates, Peter S.; Ricca, Mark A.; Prochazka, Brian G.; Doherty, Kevin E.; Brooks, Matthew L.; Casazza, Michael L.

    2015-09-10

    Greater sage-grouse (Centrocercus urophasianus; hereinafter, sage-grouse) are a sagebrush obligate species that has declined concomitantly with the loss and fragmentation of sagebrush ecosystems across most of its geographical range. The species currently is listed as a candidate for federal protection under the Endangered Species Act (ESA). Increasing wildfire frequency and changing climate frequently are identified as two environmental drivers that contribute to the decline of sage-grouse populations, yet few studies have rigorously quantified their effects on sage-grouse populations across broad spatial scales and long time periods. To help inform a threat assessment within the Great Basin for listing sage-grouse in 2015 under the ESA, we conducted an extensive analysis of wildfire and climatic effects on sage-grouse population growth derived from 30 years of lek-count data collected across the hydrographic Great Basin of Western North America. Annual (1984–2013) patterns of wildfire were derived from an extensive dataset of remotely sensed 30-meter imagery and precipitation derived from locally downscaled spatially explicit data. In the sagebrush ecosystem, underlying soil conditions also contribute strongly to variation in resilience to disturbance and resistance to plant community changes (R&R). Thus, we developed predictions from models of post-wildfire recovery and chronic effects of wildfire based on three spatially explicit R&R classes derived from soil moisture and temperature regimes. We found evidence of an interaction between the effects of wildfire (chronically affected burned area within 5 kilometers of a lek) and climatic conditions (spring through fall precipitation) after accounting for a consistent density-dependent effect. Specifically, burned areas near leks nullifies population growth that normally follows years with relatively high precipitation. In models, this effect results in long-term population declines for sage-grouse despite cyclic periods of high precipitation. Based on 30-year projections of burn and recovery rates, our population model predicted steady and substantial long-term declines in population size across the Great Basin. Further, example management scenarios that may help offset adverse wildfire effects are provided by models of varying levels of fire suppression and post-wildfire restoration that focus on areas especially important to sage-grouse populations. These models illustrate how sage-grouse population persistence likely will be compromised as sagebrush ecosystems and sage-grouse habitat are degraded by wildfire, especially in a warmer and drier climate, and by invasion of annual grasses that can increase wildfire frequency and size in the Great Basin.

  13. Psychosocial working conditions and self-reported long-term illness: a population-based study of Swedish-born and foreign-born employed persons.

    PubMed

    Sundquist, Jan; Ostergren, Per-Olof; Sundquist, Kristina; Johansson, Sven-Erik

    2003-11-01

    Knowledge pertaining to the relationship between migration status and psychosocial job characteristics and long-term illness is not readily available in the international literature. The aim of this study is to analyse the cross-sectional associations between high psychological job demands and low decision latitude (high job strain), work-related social support and long-term illness among foreign-born and Swedish-born people. The present study combines four annual simple random samples covering 1994-97 from the Swedish Annual Level of Living Survey (SALLS). A sub-sample, including only employed persons and consisting of 10,072 Swedish-born persons, 710 labour migrants and 333 refugees aged 25-64 years, was analysed using logistic regression. Refugees had a higher risk (OR=1.33; 95% CI: 1.05-1.69) of long-term illness than Swedes. Moreover, those experiencing both high job demands and a low decision latitude ran an increased risk (OR=1.74; 95% CI: 1.42-2.13) of long-term illness. About 63% of the refugees among the unskilled/skilled manual workers had low decision latitudes in comparison with 17% of the intermediate and senior salaried employees. There were only small differences in job demands between labour immigrants, refugees and Swedes. There was no interaction between migration status and high job strain. However, refugees with low social support had nearly twice as high a risk of long-term illness as Swedes with high-level work-related social support. Refugees ran a higher risk of long-term illness than Swedes. Although there were no differences in risk between labour immigrants, refugees and Swedes under job strain, refugees with low work-related social support had a high risk of long-term illness. Unskilled/skilled refugee workers had lower decision latitudes than Swedes.

  14. Integration of long-term research into a GIS-based landscape habitat model for the red-cockaded Woodpecker

    Treesearch

    Kathleen E. Franzreb; F. Thomas Lloyd

    2000-01-01

    The red-cockaded woodpecker (Picoides borealis) population at the Savannah River Site in South Carolina has been the subject of intensive management and research activities designed to restore the population. By late 1985, the population was on the verge of being extirpated with only four individuals remaining. Older live pine trees that red...

  15. Association of Long-Term Exposure to Traffic-Related Air Pollution with Blood Pressure and Hypertension in an Adult Population–Based Cohort in Spain (the REGICOR Study)

    PubMed Central

    Basagaña, Xavier; Aguilera, Inmaculada; Rivera, Marcela; Agis, David; Bouso, Laura; Deltell, Alexandre; Marrugat, Jaume; Ramos, Rafel; Sunyer, Jordi; Vila, Joan; Elosua, Roberto; Künzli, Nino

    2014-01-01

    Background: Long-term exposure to traffic-related air pollution may increase blood pressure (BP) and induce hypertension. However, evidence supporting these associations is limited, and they may be confounded by exposure to traffic noise and biased due to inappropriate control for use of BP-lowering medications. Objectives: We evaluated the associations of long-term traffic-related air pollution with BP and prevalent hypertension, adjusting for transportation noise and assessing different methodologies to control for BP-lowering medications. Methods: We measured systolic (SBP) and diastolic BP (DBP) at baseline (years 2003–2005) in 3,700 participants, 35–83 years of age, from a population-based cohort in Spain. We estimated home outdoor annual average concentrations of nitrogen dioxide (NO2) with a land-use regression model. We used multivariate linear and logistic regression. Results: A 10-μg/m3 increase in NO2 levels was associated with 1.34 mmHg (95% CI: 0.14, 2.55) higher SBP in nonmedicated individuals, after adjusting for transportation noise. Results were similar in the entire population after adjusting for medication, as commonly done, but weaker when other methods were used to account for medication use. For example, when 10 mmHg were added to the measured SBP levels of medicated participants, the association was β = 0.78 (95% CI: –0.43, 2.00). NO2 was not associated with hypertension. Associations of NO2 with SBP and DBP were stronger in participants with cardiovascular disease, and the association with SBP was stronger in those exposed to high traffic density and traffic noise levels ≥ 55 dB(A). Conclusions: We observed a positive association between long-term exposure to NO2 and SBP, after adjustment for transportation noise, which was sensitive to the methodology used to account for medication. Citation: Foraster M, Basagaña X, Aguilera I, Rivera M, Agis D, Bouso L, Deltell A, Marrugat J, Ramos R, Sunyer J, Vila J, Elosua R, Künzli N. 2014. Association of long-term exposure to traffic-related air pollution with blood pressure and hypertension in an adult population–based cohort in Spain (the REGICOR study). Environ Health Perspect 122:404–411; http://dx.doi.org/10.1289/ehp.1306497 PMID:24531056

  16. Maternal Work Absence: A Longitudinal Study of Language Impairment and Behavior Problems in Preschool Children

    PubMed Central

    Nes, Ragnhild B.; Hauge, Lars J.; Kornstad, Tom; Landolt, Markus A.; Irgens, Lorentz; Eskedal, Leif; Kristensen, Petter; Vollrath, Margarete E.

    2015-01-01

    Combining work and family responsibilities is challenging when children have special needs, and mothers commonly make employment-related adjustments. In this study, the authors examined associations between maternal work absence and child language impairment and behavior problems in preschool children. Questionnaire data at child age 3 years from 33,778 mothers participating in the prospective population-based Norwegian Mother and Child Cohort Study were linked to national register data on employment and long-term physician-certified sick leave at child age 3–5 years. Mothers who reported having a child with language impairment had a consistently higher risk of not being employed and were at increased risk of taking long-term sick leave at child age 5 years. Co-occurring problems were associated with excess risk. Language impairments in preschool children, in particular when they are co-occurring with behavior problems, are likely to have a range of negative short- and long-term consequences for the financial and overall health and well-being of mothers and their families. PMID:27087703

  17. Abundance fluctuations among benthic invertebrates in two pacific estuaries

    USGS Publications Warehouse

    Nichols, Frederic H.

    1985-01-01

    Long-term studies were used to examine (1) contrasting time scales and mechanisms of structural variations within two benthic communities and (2) the usefulness of long data sets for evaluating human impact. A 10-year study of a San Francisco Bay mudflat, the details of which are reported elsewhere, has revealed large short-term (on the order of months) variations in species abundances within a community composed predominantly of opportunistic species. The study site, located in a highly urbanized estuary, is subject to the influence of a nearby sewage-treatment facility. However, rapid changes in population size of the common species, in part due to periodic natural habitat disturbance, impedes the detection of anthropogenic influences on community composition. Only a very long-term data set may provide evidence of progressive change. Data collected for a 20-year period on the benthic community at 200 m depth in the main basin of Puget Sound, an environment subject to little apparent habitat disturbance show that numerical abundance of the common species can also change markedly. Here, however, numerical dominance shifts from one species to another at irregular, multiyear intervals. Recent increases in two heretofore rare species, and a significant increase in total numbers of individuals suggest that long-term changes may be occurring in this community. These two long-term data sets demonstrate the importance of measuring both the amplitude and the periodicity of fluctuations in population size of aquatic species as well as long-term fluctuations and patterns in environmental factors before attempting to demonstrate the effect of anthropogenic influences on aquatic communities. The results of these studies also demonstrate the usefulness of long-term data sets for revealing the potential importance of interactions among species in determining abundance patterns in the soft-bottom benthos.

  18. Medication use in pregnancy: a cross-sectional, multinational web-based study.

    PubMed

    Lupattelli, A; Spigset, O; Twigg, M J; Zagorodnikova, K; Mårdby, A C; Moretti, M E; Drozd, M; Panchaud, A; Hämeen-Anttila, K; Rieutord, A; Gjergja Juraski, R; Odalovic, M; Kennedy, D; Rudolf, G; Juch, H; Passier, A; Björnsdóttir, I; Nordeng, H

    2014-02-17

    Intercountry comparability between studies on medication use in pregnancy is difficult due to dissimilarities in study design and methodology. This study aimed to examine patterns and factors associated with medications use in pregnancy from a multinational perspective, with emphasis on type of medication utilised and indication for use. Cross-sectional, web-based study performed within the period from 1 October 2011 to 29 February 2012. Uniform collection of drug utilisation data was performed via an anonymous online questionnaire. Multinational study in Europe (Western, Northern and Eastern), North and South America and Australia. Pregnant women and new mothers with children less than 1 year of age. Prevalence of and factors associated with medication use for acute/short-term illnesses, chronic/long-term disorders and over-the-counter (OTC) medication use. The study population included 9459 women, of which 81.2% reported use of at least one medication (prescribed or OTC) during pregnancy. Overall, OTC medication use occurred in 66.9% of the pregnancies, whereas 68.4% and 17% of women reported use of at least one medication for treatment of acute/short-term illnesses and chronic/long-term disorders, respectively. The extent of self-reported medicated illnesses and types of medication used by indication varied across regions, especially in relation to urinary tract infections, depression or OTC nasal sprays. Women with higher age or lower educational level, housewives or women with an unplanned pregnancy were those most often reporting use of medication for chronic/long-term disorders. Immigrant women in Western (adjusted OR (aOR): 0.55, 95% CI 0.34 to 0.87) and Northern Europe (aOR: 0.50, 95% CI 0.31 to 0.83) were less likely to report use of medication for chronic/long-term disorders during pregnancy than non-immigrants. In this study, the majority of women in Europe, North America, South America and Australia used at least one medication during pregnancy. There was a substantial inter-region variability in the types of medication used.

  19. Systematic Review of Biofeedback Interventions for Addressing Anxiety and Depression in Children and Adolescents with Long-Term Physical Conditions.

    PubMed

    Thabrew, Hiran; Ruppeldt, Philip; Sollers, John J

    2018-06-26

    Children and adolescents with long-term physical conditions are at increased risk of psychological problems, particularly anxiety and depression, and they have limited access to evidence-based treatment for these issues. Biofeedback interventions may be useful for treating symptoms of both psychological and physical conditions. A systematic review of studies of biofeedback interventions that addressed anxiety or depression in this population was undertaken via MEDLINE, EMBASE, PsycINFO, CINAHL and the Cochrane Central Register of Controlled Trials databases. Primary outcomes included changes in anxiety and depression symptoms and 'caseness'. Secondary outcomes included changes in symptoms of the associated physical condition and acceptability of the biofeedback intervention. Of 1876 identified citations, 9 studies (4 RCTs, 5 non-RCTs; of which all measured changes in anxiety and 3 of which measured changes in depression) were included in the final analysis and involved participants aged 8-25 years with a range of long-term physical conditions. Due to the heterogeneity of study design and reporting, risk of bias was judged as unclear for all studies and meta-analysis of findings was not undertaken. Within the identified sample, multiple modalities of biofeedback including heart rate variability (HRV), biofeedback assisted relaxation therapy and electroencephalography were found to be effective in reducing symptoms of anxiety. HRV was also found to be effective in reducing symptoms of depression in two studies. A range of modalities was effective in improving symptoms of long-term physical conditions. Two studies that assessed acceptability provided generally positive feedback. There is currently limited evidence to support the use of biofeedback interventions for addressing anxiety and depression in children and adolescents with long-term physical conditions. Although promising, further research using more stringent methodology and reporting is required before biofeedback interventions can be recommended for clinical use instead or in addition to existing evidence-based modalities of treatment.

  20. A register-based 13-year to 43-year follow-up of 70 patients with obsessive-compulsive disorder treated with capsulotomy.

    PubMed

    Rück, Christian; Larsson, Johan K; Mataix-Cols, David; Ljung, Rickard

    2017-06-06

    Little is known about the long-term medical status of patients with severe obsessive-compulsive disorder (OCD) undergoing capsulotomy, a neurosurgical last-resort treatment. The present study used national registers to identify all operated patients with OCD in Sweden and evaluated their long-term medical status, including mortality, hospital admissions and psychotropic medication after capsulotomy for OCD. Register-based long-term follow-up cohort study. We used the procedural and diagnostic codes in the Swedish National Patient Register to define the study population between 1970 and March 2013. Verification by manual review of medical records of the indication for surgery in those identified by the register yielded the final study cohort of 70 patients, followed 13-43 years after surgery. The sensitivity of the case selection method was 86%. We studied hospitalisation 5 years before and after surgery. Mortality data were derived from the Causes of Death Register. The Prescribed Drug Register was used to study psychotropic drug utilisation. By March 2013, 29 of the 70 patients were deceased. Their mean age at the time of death was 68 years (SD=14). Two patients had committed suicide and one had died of suspected suicide. Seventy per cent had been admitted to a psychiatric ward in the 5 years preceding surgery, and 84% in the first five postoperative years. Seventy-five per cent of those alive in 2012 were prescribed at least two psychotropic medications, often at high doses, the most common being antidepressants. Malignant OCD has a poor long-term prognosis. Patients who are candidates for surgery should be informed that, while OCD symptoms may be ameliorated with surgery, they should not expect long-term freedom from medication and psychiatric care. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  1. Medicare long-term CPAP coverage policy: a cost-utility analysis.

    PubMed

    Billings, Martha E; Kapur, Vishesh K

    2013-10-15

    CPAP is an effective treatment for OSA that may reduce health care utilization and costs. Medicare currently reimburses the costs of long-term CPAP therapy only if the patient is adherent during a 90-day trial. If not, Medicare requires a repeat polysomnogram (PSG) and another trial which seems empirically not cost-effective. We modeled the cost-effectiveness of current Medicare policy compared to an alternative policy (clinic-only) without the adherence criterion and repeat PSG. Cost-utility and cost-effectiveness analysis. U.S. Medicare Population. N/A. N/A. We created a decision tree modeling (1) clinic only follow-up vs. (2) current Medicare policy. Costs were assigned based on Medicare reimbursement rates in 2012. Sensitivity analyses were conducted to test our assumptions. We estimated cumulative costs, overall adherence, and QALY gained for a 5-year time horizon from the perspective of Medicare as the payer. Current Medicare policy is more costly than the clinic-only policy but has higher net adherence and improved utility. Current Medicare policy compared to clinic-only policy costs $30,544 more per QALY. Current CMS policy promotes early identification of those more likely to adhere to CPAP therapy by requiring strict adherence standards. The policy effect is to deny coverage to those unlikely to use CPAP long-term and prevent wasted resources. Future studies are needed to measure long-term adherence in an elderly population with and without current adherence requirements to verify the cost-effectiveness of a policy change.

  2. Long-term cost-effectiveness of disease management in systolic heart failure.

    PubMed

    Miller, George; Randolph, Stephen; Forkner, Emma; Smith, Brad; Galbreath, Autumn Dawn

    2009-01-01

    Although congestive heart failure (CHF) is a primary target for disease management programs, previous studies have generated mixed results regarding the effectiveness and cost savings of disease management when applied to CHF. We estimated the long-term impact of systolic heart failure disease management from the results of an 18-month clinical trial. We used data generated from the trial (starting population distributions, resource utilization, mortality rates, and transition probabilities) in a Markov model to project results of continuing the disease management program for the patients' lifetimes. Outputs included distribution of illness severity, mortality, resource consumption, and the cost of resources consumed. Both cost and effectiveness were discounted at a rate of 3% per year. Cost-effectiveness was computed as cost per quality-adjusted life year (QALY) gained. Model results were validated against trial data and indicated that, over their lifetimes, patients experienced a lifespan extension of 51 days. Combined discounted lifetime program and medical costs were $4850 higher in the disease management group than the control group, but the program had a favorable long-term discounted cost-effectiveness of $43,650/QALY. These results are robust to assumptions regarding mortality rates, the impact of aging on the cost of care, the discount rate, utility values, and the targeted population. Estimation of the clinical benefits and financial burden of disease management can be enhanced by model-based analyses to project costs and effectiveness. Our results suggest that disease management of heart failure patients can be cost-effective over the long term.

  3. Long-term exposure to acidification disrupts reproduction in a marine invertebrate

    PubMed Central

    Hattich, Giannina S. I.; Heinrichs, Mara E.; Pansch, Andreas; Zagrodzka, Zuzanna; Havenhand, Jonathan N.

    2018-01-01

    Climate change research is advancing to more complex and more comprehensive studies that include long-term experiments, multiple life-history stages, multi-population, and multi-trait approaches. We used a population of the barnacle Balanus improvisus known to be sensitive to short-term acidification to determine its potential for long-term acclimation to acidification. We reared laboratory-bred individuals (as singles or pairs), and field-collected assemblages of barnacles, at pH 8.1 and 7.5 (≈ 400 and 1600 μatm pCO2 respectively) for up to 16 months. Acidification caused strong mortality and reduced growth rates. Acidification suppressed respiration rates and induced a higher feeding activity of barnacles after 6 months, but this suppression of respiration rate was absent after 15 months. Laboratory-bred barnacles developed mature gonads only when they were held in pairs, but nonetheless failed to produce fertilized embryos. Field-collected barnacles reared in the laboratory for 8 months at the same pH’s developed mature gonads, but only those in pH 8.1 produced viable embryos and larvae. Because survivors of long-term acidification were not capable of reproducing, this demonstrates that B. improvisus can only partially acclimate to long-term acidification. This represents a clear and significant bottleneck in the ontogeny of this barnacle population that may limit its potential to persist in a future ocean. PMID:29408893

  4. Risk factors for nursing- and healthcare-associated urinary tract infection.

    PubMed

    Sugishita, Keiji; Saito, Toshiaki; Iwamoto, Takashi

    2018-05-17

    In concordance with population aging, the number of patients living in long-term care facilities or who require nursing care has been increasing in Japan. However, little is known about the characteristics of urinary tract infection in these patients. The present study aimed to clarify the background or risk factors for multidrug-resistant urinary tract infection in this patient population. A retrospective study was carried out of patients aged ≥65 years who presented to Kesennuma City Municipal Motoyoshi Hospital from April 2014 to July 2017 with suspected urinary tract infection and a positive urine culture. Among a total of 76 patients, 20 (26%) had multidrug-resistant bacteriuria. The prevalence of multidrug-resistant bacteriuria was 40% among the long-term care facility residents, 34% among the patients who were certified as requiring care under the long-term care system in Japan and 47% among those with antibiotic prescription within 90 days. By multivariate analysis, long-term care facility residency was an independent risk factor for multidrug-resistant bacteriuria (odds ratio 4.1, 95% confidence interval 1.2-14.3). Long-term care facility residency was found to be a significant predictor of multidrug-resistant bacteriuria. Nursing- and healthcare-associated urinary tract infection, which has different characteristics from those of community- or hospital-acquired infections, should be considered when deciding treatment in this population. Geriatr Gerontol Int 2018; ••: ••-••. © 2018 Japan Geriatrics Society.

  5. Juvenile myasthenia gravis in Norway: Clinical characteristics, treatment, and long-term outcome in a nationwide population-based cohort.

    PubMed

    Popperud, T H; Boldingh, M I; Rasmussen, M; Kerty, E

    2017-09-01

    This study aimed to characterize juvenile myasthenia gravis in a national population-based cohort in Norway, and to evaluate long-term outcome and potential differences correlated with prepubertal versus postpubertal disease onset. Patients with onset of myasthenia gravis aged ≤18 years were identified through multiple strategies. Retrospective clinical data were collected by means of medical charts. All patients had an updated clinical examination. Cases were divided into prepubertal and postpubertal onset using age 12 years as the cut off. In total, 75 patients were identified of whom 63 were included in the study: 21 in the prepubertal and 42 in the postpubertal onset group. There was a female preponderance in both groups. In total, 59% presented with ocular symptoms, but the great majority of patients in both groups generalized during the two first years of the disease. Myasthenic crisis was more frequent in the prepubertal onset group. All patients were initially treated with pyridostigmine, 26 with steroids, and 17 with other immunosuppressive treatment. The postpubertal cases were more often treated with immunosuppressive therapy. Fifty patients (79%) underwent thymectomy. The general outcome was favourable: 57% became asymptomatic and only four subjects failed to attain clinical improvement. One-third had at least one additional autoimmune disease. Despite frequent symptom generalization and a subgroup of prepubertal onset with severe disease, the long-term outcome was good, especially in the thymectomized prepubertal onset group. Polyautoimmunity occurred in both groups in one-third. Copyright © 2017 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

  6. Identifying Feasible Physical Activity Programs for Long-Term Care Homes in the Ontario Context

    PubMed Central

    Shakeel, Saad; Newhouse, Ian; Malik, Ali; Heckman, George

    2015-01-01

    Background Structured exercise programs for frail institutionalized seniors have shown improvement in physical, functional, and psychological health of this population. However, the ‘feasibility’ of implementation of such programs in real settings is seldom discussed. The purpose of this systematic review was to gauge feasibility of exercise and falls prevention programs from the perspective of long-term care homes in Ontario, given the recent changes in funding for publically funded physiotherapy services. Method Six electronic databases were searched by two independent researchers for randomized controlled trials that targeted long-term care residents and included exercise as an independent component of the intervention. Results A total of 39 studies were included in this review. A majority of these interventions were led by physiotherapist(s), carried out three times per week for 30–45 minutes per session. However, a few group-based interventions that were led by long-term care staff, volunteers, or trained non-exercise specialists were identified that also required minimal equipment. Conclusion This systematic review has identified ‘feasible’ physical activity and falls prevention programs that required minimal investment in staff and equipment, and demonstrated positive outcomes. Implementation of such programs represents cost-effective means of providing long-term care residents with meaningful gains in physical, psychological, and social health. PMID:26180563

  7. Sick leave and the impact of job-to-job mobility on the likelihood of remaining on the labour market - a longitudinal Swedish register study

    PubMed Central

    2014-01-01

    Background Change of job could be a strategy in vocational rehabilitation when return to the original job is not possible, but research is very limited concerning the effects of job mobility on the future vocational situation. The aim of the study was to investigate whether job-to-job mobility affects the likelihood of remaining on the labour market over time among persons who are employed and have experienced long-term sick leave. Methods In a longitudinal register study, cohorts from three base years (1994, 1999 and 2004) were created, based on the Swedish population who were 20–60 years old, had sickness allowance insurance, and were employed in the base year and the following year (n > 3,000,000). The likelihood that individuals on long-term sick leave were employed later depending on whether or not they changed workplace during the present or next year of long-term sick leave was analyzed using logistic regression analysis. Age, sector, industry, children, marital status, education, income, rate of sick leave and earlier sick leave and earlier mobility were taken into consideration. Results Women with more than 180 days’ sick leave who changed workplaces were more likely to have a job later compared with those who did not change jobs. For men, the association was statistically significant with 1994 and 2004 as base years, but not in the cohort from 1999. Conclusions The present study indicates that for those on long-term sick leave that changed workplaces, the opportunities to stay on the labour market might increase. However, the study has methodological limitations and the results for men are ambiguous. We do not therefore have enough evidence for recommending job change as a strategy for vocational rehabilitation. PMID:24694029

  8. New Long-Term Care Policies in Latin America: The National System of Care in Uruguay.

    PubMed

    Matus-Lopez, Mauricio; Pedraza, Camilo Cid

    2016-07-01

    Uruguay is the Latin American country with the largest share of elderly population and it has the greatest pressure for formal long-term care services in the region. For this reason, last year the government approved a law creating a National System of Care. This article describes and analyzes the long-term care policy in the recently created National System of Care of Uruguay. The Director of the National System of Care was asked to complete a questionnaire with a description and management of long-term care programs. This information was completed with official information and peer-reviewed articles of long-term care in Uruguay. The National System of Care includes long-term care services. The main services are carried out through a cash-for-care system for home-based services, but in the future the benefits will expand to day centers and residential and nursing homes. The system follows international trends in terms of universality, services, and regulations dealing with care. However, the current and future financing is low, and this condition could undermine its development capacity. Copyright © 2016 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

  9. Stochastic foundations in nonlinear density-regulation growth

    NASA Astrophysics Data System (ADS)

    Méndez, Vicenç; Assaf, Michael; Horsthemke, Werner; Campos, Daniel

    2017-08-01

    In this work we construct individual-based models that give rise to the generalized logistic model at the mean-field deterministic level and that allow us to interpret the parameters of these models in terms of individual interactions. We also study the effect of internal fluctuations on the long-time dynamics for the different models that have been widely used in the literature, such as the theta-logistic and Savageau models. In particular, we determine the conditions for population extinction and calculate the mean time to extinction. If the population does not become extinct, we obtain analytical expressions for the population abundance distribution. Our theoretical results are based on WKB theory and the probability generating function formalism and are verified by numerical simulations.

  10. An example of population-level risk assessments for small mammals using individual-based population models.

    PubMed

    Schmitt, Walter; Auteri, Domenica; Bastiansen, Finn; Ebeling, Markus; Liu, Chun; Luttik, Robert; Mastitsky, Sergey; Nacci, Diane; Topping, Chris; Wang, Magnus

    2016-01-01

    This article presents a case study demonstrating the application of 3 individual-based, spatially explicit population models (IBMs, also known as agent-based models) in ecological risk assessments to predict long-term effects of a pesticide to populations of small mammals. The 3 IBMs each used a hypothetical fungicide (FungicideX) in different scenarios: spraying in cereals (common vole, Microtus arvalis), spraying in orchards (field vole, Microtus agrestis), and cereal seed treatment (wood mouse, Apodemus sylvaticus). Each scenario used existing model landscapes, which differed greatly in size and structural complexity. The toxicological profile of FungicideX was defined so that the deterministic long-term first tier risk assessment would result in high risk to small mammals, thus providing the opportunity to use the IBMs for risk assessment refinement (i.e., higher tier risk assessment). Despite differing internal model design and scenarios, results indicated in all 3 cases low population sensitivity unless FungicideX was applied at very high (×10) rates. Recovery from local population impacts was generally fast. Only when patch extinctions occured in simulations of intentionally high acute toxic effects, recovery periods, then determined by recolonization, were of any concern. Conclusions include recommendations for the most important input considerations, including the selection of exposure levels, duration of simulations, statistically robust number of replicates, and endpoints to report. However, further investigation and agreement are needed to develop recommendations for landscape attributes such as size, structure, and crop rotation to define appropriate regulatory risk assessment scenarios. Overall, the application of IBMs provides multiple advantages to higher tier ecological risk assessments for small mammals, including consistent and transparent direct links to specific protection goals, and the consideration of more realistic scenarios. © 2015 SETAC.

  11. Population pharmacokinetic model of THC integrates oral, intravenous, and pulmonary dosing and characterizes short- and long-term pharmacokinetics.

    PubMed

    Heuberger, Jules A A C; Guan, Zheng; Oyetayo, Olubukayo-Opeyemi; Klumpers, Linda; Morrison, Paul D; Beumer, Tim L; van Gerven, Joop M A; Cohen, Adam F; Freijer, Jan

    2015-02-01

    Δ(9)-Tetrahydrocannobinol (THC), the main psychoactive compound of Cannabis, is known to have a long terminal half-life. However, this characteristic is often ignored in pharmacokinetic (PK) studies of THC, which may affect the accuracy of predictions in different pharmacologic areas. For therapeutic use for example, it is important to accurately describe the terminal phase of THC to describe accumulation of the drug. In early clinical research, the THC challenge test can be optimized through more accurate predictions of the dosing sequence and the wash-out between occasions in a crossover setting, which is mainly determined by the terminal half-life of the compound. The purpose of this study is to better quantify the long-term pharmacokinetics of THC. A population-based PK model for THC was developed describing the profile up to 48 h after an oral, intravenous, and pulmonary dose of THC in humans. In contrast to earlier models, the current model integrates all three major administration routes and covers the long terminal phase of THC. Results show that THC has a fast initial and intermediate half-life, while the apparent terminal half-life is long (21.5 h), with a clearance of 38.8 L/h. Because the current model characterizes the long-term pharmacokinetics, it can be used to assess the accumulation of THC in a multiple-dose setting and to forecast concentration profiles of the drug under many different dosing regimens or administration routes. Additionally, this model could provide helpful insights into the THC challenge test used for the development of (novel) compounds targeting the cannabinoid system for different therapeutic applications and could improve decision making in future clinical trials.

  12. Digitalis use and lung cancer risk by histological type in men.

    PubMed

    Li, Wentao; Xie, Shao-Hua; Tse, Lap-Ah; Lagergren, Jesper

    2017-11-15

    Lung cancer risk and tumor characteristics differ between sexes. Estrogen has been suggested to counteract lung cancer development. We aimed to test the hypothesis that digitalis use decreases lung cancer risk due to its estrogenic and other anticancer properties in men. This was a nationwide Swedish population-based cohort study between July 1, 2005 and December 31, 2013. Data on the use of digitalis and organic nitrates in all male individuals were derived from the Swedish Prescribed Drug Registry. New lung cancer diagnoses among cohort participants were identified from the Swedish Cancer Registry. Cox proportional hazards regression was employed to estimate hazard ratios (HRs) with 95% confidence intervals (CIs) of lung cancer in digitalis users (exposed participants) compared to users of organic nitrates without digitalis medication (unexposed participants). The study cohort contained 74,437 digitalis users and 297,301 organic nitrates users. Long-term use (≥2 years) of digitalis was associated with decreased HRs of total lung cancer (HR 0.55, 95% CI 0.39-0.79) and squamous cell carcinoma (HR 0.40, 95% CI 0.19-0.87). This large and population-based study suggests decreased risks of lung cancer overall and squamous cell carcinoma associated with long-term use of digitalis in men. © 2017 UICC.

  13. Preferences for home- and community-based long-term care services in Germany: a discrete choice experiment.

    PubMed

    Lehnert, T; Günther, O H; Hajek, A; Riedel-Heller, S G; König, H H

    2018-04-06

    Most people prefer to "age in place" and to remain in their homes for as long as possible even in case they require long-term care. While informal care is projected to decrease in Germany, the use of home- and community-based services (HCBS) can be expected to increase in the future. Preference-based data on aspects of HCBS is needed to optimize person-centered care. To investigate preferences for home- and community-based long-term care services packages. Discrete choice experiment conducted in mailed survey. Randomly selected sample of the general population aged 45-64 years in Germany (n = 1.209). Preferences and marginal willingness to pay (WTP) for HCBS were assessed with respect to five HCBS attributes (with 2-4 levels): care time per day, service level of the HCBS provider, quality of care, number of different caregivers per month, co-payment. Quality of care was the most important attribute to respondents and small teams of regular caregivers (1-2) were preferred over larger teams. Yet, an extended range of services of the HCBS provider was not preferred over a more narrow range. WTP per hour of HCBS was €8.98. Our findings on preferences for HCBS in the general population in Germany add to the growing international evidence of preferences for LTC. In light of the great importance of high care quality to respondents, reimbursement for services by HCBS providers could be more strongly linked to the quality of services.

  14. Clinical outcomes of a diabetes education program for patients with diabetes mellitus in the Micronesian community in Hawaii.

    PubMed

    Chong, Mok Thoong

    2016-01-01

    Hawaii has diverse population made up of a cultural mix of different races. Due to different cultural and social influences and language barrier, many of the under-served population who migrated to Hawaii and having diabetes mellitus may be susceptible to long-term complications due to uncontrolled hyperglycemia and medication nonadherence. The purpose of this study was to evaluate the impact of a diabetes education program on the clinical outcomes in patients with diabetes mellitus in the Micronesian community of Hawaii. This study included patients over age 18 years, with a diagnosis of type 2 diabetes mellitus. The diabetes education program was customized for its weekly classes to fit to the under-served population. Data were collected on participants on the 1(st) day and then 6 months after attending the education program. Data on primary and secondary endpoints were collected and analyzed. The mean glycosylated hemoglobin A1c, fasting blood glucose, and triglyceride levels of participants fell significantly from baseline after attending the diabetes education program for 6 months. No significant changes were observed in other secondary outcomes during the study time period. Based on our findings, the diabetes education program that was tailored to the Micronesian population was successful in achieving glycemic goals, enhancing medication adherence, improving clinical outcomes, and also preventing long-term complications among its participants.

  15. Scientific Understanding from Long Term Observations: Insights from the Long Term Ecological Research (LTER) Program

    NASA Astrophysics Data System (ADS)

    Gosz, J.

    2001-12-01

    The network dedicated to Long Term Ecological Research (LTER) in the United States has grown to 24 sites since it was formed in 1980. Long-term research and monitoring are performed on parameters thatare basic to all ecosystems and are required to understand patterns, processes, and relationship to change. Collectively, the sites in the LTER Network provide opportunities to contrast marine, coastal, and continental regions, the full range of climatic gradients existing in North America, and aquatic and terrestrial habitats in a range of ecosystem types. The combination of common core areas and long-term research and monitoring in many habitats have allowed unprecedented abilities to understand and compare complex temporal and spatial dynamics associated with issues like climate change, effects of pollution, biodiversity and landuse. For example, McMurdo Dry Valley in the Antarctic has demonstrated an increase in glacier mass since 1993 which coincides with a period of cooler than normal summers and more than average snowfall. In contrast, the Bonanza Creek and Toolik Lake sites in Alaska have recorded a warming period unprecedented in the past 200 years. Nitrogen deposition effects have been identified through long-term watershed studies on biogeochemical cycles, especially at Coweeta Hydrological Lab, Harvard Forest, and the Hubbard Brook Experimental Forest. In aquatic systems, such as the Northern Temperate Lakes site, long-term data revealed time lags in effects of invaders and disturbance on lake communities. Biological recovery from an effect such as lake acidification was shown to lag behind chemical recovery. The long-term changes documented over 2 decades have been instrumental in influencing management practices in many of the LTER areas. In Puerto Rico, the Luquillo LTER demonstrated that dams obstruct migrations of fish and freshwater shrimp and water abstraction at low flows can completely obliterate downstream migration of juveniles and damage estuaries below by removing all incoming freshwater. At Toolik Lake, long-term experiments of removing top predators from the good web of lakes showed dramatic alterations of lake populations of small fish and zooplankton. In New Mexico, LTER research on small mammal populations is successfully predicting rodent increases and the potential for increased zoonotic diseases such as Hantavirus and bubonic plague. This ability to forecast based on El Nino prediction is being used to increase scientific awareness and public health awareness through media based communication with the public. In Oregon, the Andrews Forest LTER program has had long, strong links with natural resource policy and management. Basic understanding of forest-stream interactions, characteristics of old-growth forests, roles of woody debris in temperate forest ecosystems, invertebrate biodiversity and ecosystem function have been incorporated in management guidelines, plans and regulations for public and private lands throughout the Pacific Northwest. Other examples of the values of long-term research and monitoring will be presented.

  16. Wildlife population management: are contraceptive vaccines a feasible proposition?

    PubMed

    Gupta, Satish Kumar; Minhas, Vidisha

    2017-06-01

    To minimize human-animal conflicts for habitation and burden of zoonotic diseases, it is imperative to develop new strategies for wildlife population management. In this direction, contraceptive vaccines eliciting immune response against hormones/proteins critical for reproduction have emerged as one of the promising options. Contraceptive vaccines based on neutralization of gonadotropin releasing hormone (GnRH) have been used for inhibition of fertility in various species such as wild horses, white-tailed deer, pigs, cats, dogs etc. It has been used for immunocastration of male pigs to improve meat quality. However, additional safety studies of GnRH vaccine will be needed in light of presence of its receptor at extra-pituitary sites. Native porcine zona pellucida (PZP)-based contraceptive vaccines have shown their utility in the management of the population of both captive and free-ranging wild horses and white-tailed deer. Long-term use of the PZP-based contraceptive vaccines has also demonstrated their safety. Ideally single injection of the contraceptive vaccine should elicit long lasting immune response and desired contraceptive efficacy, which will require development of novel vaccine delivery platforms and more potent adjuvants.

  17. Investigating the historic long-term population health impact of the US National School Lunch Program.

    PubMed

    Peterson, Cora

    2014-12-01

    The present research aimed to compare historic participation in the US National School Lunch Program (NSLP) during childhood and subsequent prevalence of overweight and obesity among adults at the population level. Regression models examined cross-sectional, state- and age-based panel data constructed from multiple sources, including the Behavioural Risk Factor Surveillance System, US Congressional Record, US Census and the US Department of Agriculture. Models controlled for cohorts' racial/ethnic composition and state poverty rates. Adult-age cohorts (18-34, 35-49, 50-64 and 18-64 years) by US state over a 25-year period (1984-2008). The cohorts' prevalence of overweight and obesity was compared with the cohorts' estimated NSLP participation during schooling (1925-2007; the NSLP began in 1946). Among adults aged 18-64 years, a one percentage-point increase in estimated NSLP participation during schooling between 1925 and 2007 was significantly associated with a 0·29 percentage-point increase in the cohort's later prevalence of overweight and obesity. Analysis of narrower age cohorts and different schooling periods produced mixed results. The NSLP might have influenced population health historically. Longitudinal analysis of individuals from studies now underway will likely facilitate more robust conclusions about the NSLP's long-term health impact based on more recent experiences.

  18. Towards Personal Exposures: How Technology Is Changing Air Pollution and Health Research.

    PubMed

    Larkin, A; Hystad, P

    2017-12-01

    We present a review of emerging technologies and how these can transform personal air pollution exposure assessment and subsequent health research. Estimating personal air pollution exposures is currently split broadly into methods for modeling exposures for large populations versus measuring exposures for small populations. Air pollution sensors, smartphones, and air pollution models capitalizing on big/new data sources offer tremendous opportunity for unifying these approaches and improving long-term personal exposure prediction at scales needed for population-based research. A multi-disciplinary approach is needed to combine these technologies to not only estimate personal exposures for epidemiological research but also determine drivers of these exposures and new prevention opportunities. While available technologies can revolutionize air pollution exposure research, ethical, privacy, logistical, and data science challenges must be met before widespread implementations occur. Available technologies and related advances in data science can improve long-term personal air pollution exposure estimates at scales needed for population-based research. This will advance our ability to evaluate the impacts of air pollution on human health and develop effective prevention strategies.

  19. Weight gain and nutritional efficacy in anorexia nervosa.

    PubMed

    Dempsey, D T; Crosby, L O; Pertschuk, M J; Feurer, I D; Buzby, G P; Mullen, J L

    1984-02-01

    To evaluate the usefulness of interval weight change in assessing nutritional support efficacy, we studied four anorexia nervosa patients (52% ideal body weight) requiring long-term total parenteral nutrition (TPN) for 63 +/- 18 days. Fluid and electrolyte deficits were corrected before the initiation of nutritional support. Resting energy expenditure was measured before the initiation of TPN and weekly thereafter, using indirect calorimetry. Daily caloric expenditure was estimated at 1.1 X resting energy expenditure, based on previous studies of continuous heart rate monitoring in this patient population. Daily excess calories were calculated as caloric intake minus caloric expenditure. Each patient was weighed daily and linear regression analysis (excess calories versus weight change) was performed for individual patients and the group over intervals of varying length. There was no individual or group correlation between excess calories and weight gain on a daily or weekly interval basis. Cumulative weight changes over the long-term course of TPN correlated significantly with cumulative excess calories for each patient and the whole group (r = +0.82, p less than 0.01). The excess calories required to gain a kilogram body weight ranged from 5569 to 15619 kcal/kg with a mean of 9768. Cumulative long-term weight changes during nutritional repletion in anorexia nervosa are meaningful indicators of caloric balance, but short interval weight changes (daily, weekly) are not. The caloric cost of weight gain is variable in this population.

  20. Long-term study of Sarcoptes scabiei infection in Norwegian red foxes (Vulpes vulpes) indicating host/parasite adaptation.

    PubMed

    Davidson, Rebecca K; Bornstein, Set; Handeland, Kjell

    2008-10-01

    The red fox (Vulpes vulpes) population, in Norway, was naïve to Sarcoptes scabiei prior to the late 1970s when this parasite was first recorded and a still ongoing epidemic started. During the course of this protracted epidemic some degree of host/parasite adaptation, with the occurrence of healthy antibody positive foxes, might be expected. In the present study the prevalence of sarcoptic mange and serologically identified S. scabiei exposure was investigated in 363 Norwegian red foxes, shot by hunters during two different study periods (1994-1995 and 2002-2005). The sarcoptic mange diagnosis was based upon the presence of clearly visible lesions in the skin of the cadaver with confirmatory demonstration of S. scabiei. The serodiagnosis was based on an indirect-ELISA. There was a significant decrease in prevalence of both mange cases and seropositive animals from the first to the second study period. Whilst the mange prevalence fell more than threefold, from 30.0% to 6.6%, the seroprevalence dropped less dramatically from 53.3% to 19.1%. The smaller decrease in seroprevalence compared to mange cases reflected a significantly higher ratio of seropositive-mange negative versus seropositive-mange positive foxes, during the second study period, 40:18, compared to the first, 14:18. These findings indicate that the red fox population is adapting to live with the parasite and that low-grade or sub-clinical infections, and even recoveries, occur amongst exposed foxes. Mange positive foxes had significantly poorer body condition than those without sarcoptic mange. No significant difference in body condition was seen between seropositive-mange negative versus seronegative-mange negative foxes. The ELISA sensitivity was found to be 95% and proved a useful tool for investigating the exposure to S. scabiei in wild foxes. This study is believed to be the first pointing to a long-term Sarcoptes/fox adaptation, combining long-term prevalence studies of clinical sarcoptic mange and serological evidence of exposure to the parasite in the general fox population.

  1. Associations between ambient fine particulate air pollution and hypertension: A nationwide cross-sectional study in China.

    PubMed

    Liu, Cong; Chen, Renjie; Zhao, Yaohui; Ma, Zongwei; Bi, Jun; Liu, Yang; Meng, Xia; Wang, Yafeng; Chen, Xinxin; Li, Weihua; Kan, Haidong

    2017-04-15

    Limited evidence is available regarding the long-term effects of fine particulate (PM 2.5 ) air pollution on hypertension in developing countries. This study aimed to explore the associations of long-term exposure to PM 2.5 with hypertension prevalence and blood pressure (BP) in China. We conducted a cross-sectional study based on a nationally representative survey (13,975 participants). We estimated the long-term average exposure to PM 2.5 for all subjects during the study period (June 2011 to March 2012) by a satellite-based model with a spatial resolution of 10×10km. We applied multivariable logistic regression models to evaluate the associations between PM 2.5 and hypertension prevalence and linear regression models for the associations between PM 2.5 and systolic BP and diastolic BP. We also explored potential effect modification by stratification analyses. There were 5715 cases of hypertension, accounting for 40.9% of the study population in this analysis. The annual mean exposure to PM 2.5 for all participants was 72.8μg/m 3 on average. An interquartile range increase (IQR, 41.7μg/m 3 ) in PM 2.5 was associated with higher prevalence of hypertension with an odds ratio of 1.11 [95% confidence interval (CI): 1.05, 1.17]. Systolic BP increased by 0.60mmHg (95% CI: 0.05, 1.15) per an IQR increase in PM 2.5 . The effects of PM 2.5 on hypertension prevalence were stronger among middle-aged, obese and urban participants. This national study indicated that long-term exposure to PM 2.5 was associated with increased prevalence of hypertension and slightly higher systolic BP in China. Copyright © 2017 Elsevier B.V. All rights reserved.

  2. The effects of landscape modifications on the long-term persistence of animal populations.

    PubMed

    Nabe-Nielsen, Jacob; Sibly, Richard M; Forchhammer, Mads C; Forbes, Valery E; Topping, Christopher J

    2010-01-28

    The effects of landscape modifications on the long-term persistence of wild animal populations is of crucial importance to wildlife managers and conservation biologists, but obtaining experimental evidence using real landscapes is usually impossible. To circumvent this problem we used individual-based models (IBMs) of interacting animals in experimental modifications of a real Danish landscape. The models incorporate as much as possible of the behaviour and ecology of four species with contrasting life-history characteristics: skylark (Alauda arvensis), vole (Microtus agrestis), a ground beetle (Bembidion lampros) and a linyphiid spider (Erigone atra). This allows us to quantify the population implications of experimental modifications of landscape configuration and composition. Starting with a real agricultural landscape, we progressively reduced landscape complexity by (i) homogenizing habitat patch shapes, (ii) randomizing the locations of the patches, and (iii) randomizing the size of the patches. The first two steps increased landscape fragmentation. We assessed the effects of these manipulations on the long-term persistence of animal populations by measuring equilibrium population sizes and time to recovery after disturbance. Patch rearrangement and the presence of corridors had a large effect on the population dynamics of species whose local success depends on the surrounding terrain. Landscape modifications that reduced population sizes increased recovery times in the short-dispersing species, making small populations vulnerable to increasing disturbance. The species that were most strongly affected by large disturbances fluctuated little in population sizes in years when no perturbations took place. Traditional approaches to the management and conservation of populations use either classical methods of population analysis, which fail to adequately account for the spatial configurations of landscapes, or landscape ecology, which accounts for landscape structure but has difficulty predicting the dynamics of populations living in them. Here we show how realistic and replicable individual-based models can bridge the gap between non-spatial population theory and non-dynamic landscape ecology. A major strength of the approach is its ability to identify population vulnerabilities not detected by standard population viability analyses.

  3. Glomerular filtration rate and kidney size in type 2 (non-insulin-dependent) diabetes mellitus.

    PubMed

    Wirta, O R; Pasternack, A I

    1995-07-01

    The objective of the present study was to estimate glomerular filtration rate and kidney size in recently diagnosed and long-term type 2 (non-insulin-dependent) diabetic subjects. The study design comprised of a population-based controlled cross-sectional survey of middle-aged type 2 diabetic subjects in the City of Tampere, Southwest Finland. One hundred and fifty consecutive recently diagnosed and 146 long-term middle-aged type 2 diabetic subjects with a disease duration of at least five years and one hundred and fifty age- and sex-matched (to recent diabetic subjects) non-diabetic control subjects were recruited. The glomerular filtration rate by single-shot 51Cr-EDTA clearance and kidney size by native X-ray tomography were measured. The glomerular filtration rate (ml/min/1.73 m2) was increased in both recently diagnosed (males 121 [27] and females 112 [27]) and long-term (males 123 [24] and females 102 [36]) diabetic subjects (corrected for age) compared to control subjects (males 111 [26] and females 93 [17]). The kidney areas (cm2) were greater in both recent diabetic (males 116.6 [15.4] and females 99.1 [15.3] and long-term diabetic (males 118.3 [15.8] and females 100.4 [15.2]) subjects than in the control group (males 104.3 [12.0] and females 88.6 [12.0]). All differences between diabetic subjects and non-diabetic subjects were statistically significant (p < 0.05), except that between long-term diabetic and non-diabetic females for glomerular filtration rate (p = 0.07). Analyzed by linear regression glomerular filtration rate was related to kidney area in all study groups and to hemoglobin A1c in long-term diabetic males.(ABSTRACT TRUNCATED AT 250 WORDS)

  4. Wildlife disease ecology from the individual to the population: Insights from a long-term study of a naturally infected European badger population.

    PubMed

    McDonald, Jenni L; Robertson, Andrew; Silk, Matthew J

    2018-01-01

    Long-term individual-based datasets on host-pathogen systems are a rare and valuable resource for understanding the infectious disease dynamics in wildlife. A study of European badgers (Meles meles) naturally infected with bovine tuberculosis (bTB) at Woodchester Park in Gloucestershire (UK) has produced a unique dataset, facilitating investigation of a diverse range of epidemiological and ecological questions with implications for disease management. Since the 1970s, this badger population has been monitored with a systematic mark-recapture regime yielding a dataset of >15,000 captures of >3,000 individuals, providing detailed individual life-history, morphometric, genetic, reproductive and disease data. The annual prevalence of bTB in the Woodchester Park badger population exhibits no straightforward relationship with population density, and both the incidence and prevalence of Mycobacterium bovis show marked variation in space. The study has revealed phenotypic traits that are critical for understanding the social structure of badger populations along with mechanisms vital for understanding disease spread at different spatial resolutions. Woodchester-based studies have provided key insights into how host ecology can influence infection at different spatial and temporal scales. Specifically, it has revealed heterogeneity in epidemiological parameters; intrinsic and extrinsic factors affecting population dynamics; provided insights into senescence and individual life histories; and revealed consistent individual variation in foraging patterns, refuge use and social interactions. An improved understanding of ecological and epidemiological processes is imperative for effective disease management. Woodchester Park research has provided information of direct relevance to bTB management, and a better appreciation of the role of individual heterogeneity in disease transmission can contribute further in this regard. The Woodchester Park study system now offers a rare opportunity to seek a dynamic understanding of how individual-, group- and population-level processes interact. The wealth of existing data makes it possible to take a more integrative approach to examining how the consequences of individual heterogeneity scale to determine population-level pathogen dynamics and help advance our understanding of the ecological drivers of host-pathogen systems. © 2017 The Authors. Journal of Animal Ecology published by John Wiley & Sons Ltd on behalf of British Ecological Society.

  5. Long-term Cardiovascular Outcomes Among Endometrial Cancer Survivors in a Large, Population-Based Cohort Study.

    PubMed

    Soisson, Sean; Ganz, Patricia A; Gaffney, David; Rowe, Kerry; Snyder, John; Wan, Yuan; Deshmukh, Vikrant; Newman, Mike; Fraser, Alison; Smith, Ken; Herget, Kimberly; Hanson, Heidi A; Wu, Yelena P; Stanford, Joseph; Al-Sarray, Ali; Werner, Theresa L; Setiawan, Veronica W; Hashibe, Mia

    2018-05-08

    Endometrial cancer is the second most common cancer among female cancer survivors in the United States. Cardiovascular disease is the leading cause of death among endometrial cancer survivors. Studies that examine long-term cardiovascular outcomes among endometrial cancer survivors are critical. Cohorts of 2648 endometrial cancer survivors diagnosed between 1997 and 2012 and 10 503 age-matched women from the general population were identified. Cardiovascular disease diagnoses were identified from electronic medical records and statewide ambulatory surgery and statewide inpatient data. Cox regression models were used to estimate hazard ratios (HRs) at one to five years, more than five to 10 years, and more than 10 years after cancer diagnosis. Between one and five years after diagnosis, increased cardiovascular risks among endometrial cancer survivors were observed for phlebitis, thrombophlebitis, and thromboembolism (HR = 2.07, 99% confidence interval [CI] = 1.57 to 2.72), pulmonary heart disease (HR = 1.74, 99% CI = 1.26 to 2.40), and atrial fibrillation (HR = 1.50, 99% CI = 1.07 to 2.11). At more than five to 10 years, some elevated risk persisted for cardiovascular diseases. Compared with patients who had surgery, patients who additionally had radiation therapy and/or chemotherapy were at increased risk for heart and circulatory system disorders between one and five years after cancer diagnosis. Older age and obesity were also risk factors for hypertension and heart disease among endometrial cancer survivors. Endometrial cancer survivors are at higher risk for various adverse long-term cardiovascular outcomes compared with women from the general population. This study suggests that increased monitoring for cardiovascular diseases may be necessary for endometrial cancer patients for 10 years after cancer diagnosis.

  6. Causes of morbidity in wild raptor populations admitted at a wildlife rehabilitation centre in Spain from 1995-2007: a long term retrospective study.

    PubMed

    Molina-López, Rafael A; Casal, Jordi; Darwich, Laila

    2011-01-01

    Morbidity studies complement the understanding of hazards to raptors by identifying natural or anthropogenic factors. Descriptive epidemiological studies of wildlife have become an important source of information about hazards to wildlife populations. On the other hand, data referenced to the overall wild population could provide a more accurate assessment of the potential impact of the morbidity/mortality causes in populations of wild birds. The present study described the morbidity causes of hospitalized wild raptors and their incidence in the wild populations, through a long term retrospective study conducted at a wildlife rehabilitation centre of Catalonia (1995-2007). Importantly, Seasonal Cumulative Incidences (SCI) were calculated considering estimations of the wild population in the region and trend analyses were applied among the different years. A total of 7021 birds were analysed: 7 species of Strigiformes (n = 3521) and 23 of Falconiformes (n = 3500). The main causes of morbidity were trauma (49.5%), mostly in the Falconiformes, and orphaned/young birds (32.2%) mainly in the Strigiformes. During wintering periods, the largest morbidity incidence was observed in Accipiter gentillis due to gunshot wounds and in Tyto alba due to vehicle trauma. Within the breeding season, Falco tinnunculus (orphaned/young category) and Bubo bubo (electrocution and metabolic disorders) represented the most affected species. Cases due to orphaned/young, infectious/parasitic diseases, electrocution and unknown trauma tended to increase among years. By contrast, cases by undetermined cause, vehicle trauma and captivity decreased throughout the study period. Interestingly, gunshot injuries remained constant during the study period. Frequencies of morbidity causes calculated as the proportion of each cause referred to the total number of admitted cases, allowed a qualitative assessment of hazards for the studied populations. However, cumulative incidences based on estimated wild raptor population provided a more accurate approach to the potential ecological impact of the morbidity causes in the wild populations.

  7. Causes of Morbidity in Wild Raptor Populations Admitted at a Wildlife Rehabilitation Centre in Spain from 1995-2007: A Long Term Retrospective Study

    PubMed Central

    Molina-López, Rafael A.; Casal, Jordi; Darwich, Laila

    2011-01-01

    Background Morbidity studies complement the understanding of hazards to raptors by identifying natural or anthropogenic factors. Descriptive epidemiological studies of wildlife have become an important source of information about hazards to wildlife populations. On the other hand, data referenced to the overall wild population could provide a more accurate assessment of the potential impact of the morbidity/mortality causes in populations of wild birds. Methodology/Principal Findings The present study described the morbidity causes of hospitalized wild raptors and their incidence in the wild populations, through a long term retrospective study conducted at a wildlife rehabilitation centre of Catalonia (1995–2007). Importantly, Seasonal Cumulative Incidences (SCI) were calculated considering estimations of the wild population in the region and trend analyses were applied among the different years. A total of 7021 birds were analysed: 7 species of Strigiformes (n = 3521) and 23 of Falconiformes (n = 3500). The main causes of morbidity were trauma (49.5%), mostly in the Falconiformes, and orphaned/young birds (32.2%) mainly in the Strigiformes. During wintering periods, the largest morbidity incidence was observed in Accipiter gentillis due to gunshot wounds and in Tyto alba due to vehicle trauma. Within the breeding season, Falco tinnunculus (orphaned/young category) and Bubo bubo (electrocution and metabolic disorders) represented the most affected species. Cases due to orphaned/young, infectious/parasitic diseases, electrocution and unknown trauma tended to increase among years. By contrast, cases by undetermined cause, vehicle trauma and captivity decreased throughout the study period. Interestingly, gunshot injuries remained constant during the study period. Conclusions/Significance Frequencies of morbidity causes calculated as the proportion of each cause referred to the total number of admitted cases, allowed a qualitative assessment of hazards for the studied populations. However, cumulative incidences based on estimated wild raptor population provided a more accurate approach to the potential ecological impact of the morbidity causes in the wild populations. PMID:21966362

  8. Long-term benthic monitoring studies in the freshwater portion of the Potomac River - first annual report. Volume 2. Tables and figures. Report for September 1982-December 1983

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

    Vannote, R.L.; Sweeney, B.W.

    1985-02-28

    The report summarizes the results of the first year of a long-term study of the benthic macroinvertebrate fauna of the freshwater portion of the Potomac River extending from Dam No. 5 near Williamsport, Maryland downstream to Seneca Pool near Seneca, Maryland. The primary objective of the study was to evaluate long-term trends in the distribution, abundance, and biomass of benthic macroinvertebrates and identify factors controlling the benthic populations, with particular emphasis on factors associated with existing power plant effluents within the study area.

  9. Long-Term Effects of Habitual Barefoot Running and Walking: A Systematic Review.

    PubMed

    Hollander, Karsten; Heidt, Christoph; VAN DER Zwaard, Babette C; Braumann, Klaus-Michael; Zech, Astrid

    2017-04-01

    Barefoot locomotion is widely believed to be beneficial for motor development and biomechanics but are implied to be responsible for foot pathologies and running-related injuries. Although most of available studies focused on acute effects of barefoot running and walking little is known regarding the effects of long-term barefoot versus shod locomotion. The purpose of this study was to systematically review the literature to evaluate current evidence of habitual barefoot (HB) versus habitual shod locomotion on foot anthropometrics, biomechanics, motor performance, and pathologies. Four electronic databases were searched using terms related to habitually barefoot locomotion. Relevant studies were identified based on title, abstract, and full text, and a forward (citation tracking) and backward (references) search was performed. Risk of bias was assessed, data pooling, and meta-analysis (random effects model) performed and finally levels of evidence determined. Fifteen studies with 8399 participants were included. Limited evidence was found for a reduced ankle dorsiflexion at footstrike (pooled effect size, -3.47; 95% confidence interval [CI], -5.18 to -1.76) and a lower pedobarographically measured hallux angle (-1.16; 95% CI, -1.64 to -0.68). HB populations had wider (0.55; 95% CI, 0.06-1.05) but no shorter (-0.22; 95% CI, -0.51 to 0.08) feet compared with habitual shod populations. No differences in relative injury rates were found, with limited evidence for a different body part distribution of musculoskeletal injuries and more foot pathologies and less foot deformities and defects in HB runners. Only limited or very limited evidence is found for long-term effects of HB locomotion regarding biomechanics or health-related outcomes. Moreover, no evidence exists for motor performance. Future research should include prospective study designs.

  10. Feasibility, acceptance and long-term exercise behaviour in cancer patients: an exercise intervention by using a swinging-ring system.

    PubMed

    Crevenna, Richard; Cenik, Fadime; Galle, Anton; Komanadj, Tanya Sedghi; Keilani, Mohammad

    2015-10-01

    Aim of this pilot study was to describe feasibility and acceptance of an exercise intervention by using an unique swinging-ring system with the goal to promote long-term exercise behaviour in cancer patients. The included cancer patients (n = 13, male:f emale (m:f) = 7:6, age = 56 ± 11, range 38-74a) were invited to perform a home-based exercise intervention. All participants of this pilot study were instructed how to use the smovey® Vibroswing. They could choose how to use the swinging-ring system, for example only indoor or only outdoor (single or in a group) or both. Feasibility and acceptance were assessed after 12 months (T2). Handgrip strength (Jamar hand dynamometer) and health-related quality of life (QOL, SF-36 Health survey) were assessed at baseline (T1) and after 12 months (T2). A total of 10 (77%) patients (m:f = 5:5, 59 ± 9 years, range = 46-74) could be assessed at baseline and after 12 months. The exercise intervention showed no adverse events and was well accepted. Approximately 77% of patients of the study population have been exercising for more than 12 months. Furthermore, this intervention was able to increase handgrip strength in the participants. QOL improved as well in all domains. The results of this small pilot study indicate that regular physical exercise with this swinging-ring system seems to be safe, and to promote long-term exercise behaviour of the included patients. Furthermore, this study population showed benefits in terms of increased handgrip strength and of improved QOL.

  11. Effect of HSV-2 on population-level trends in HIV incidence in Uganda between 1990 and 2007

    PubMed Central

    Biraro, Samuel; Kamali, Anatoli; White, Richard; Karabarinde, Alex; Nsiimire Ssendagala, Juliet; Grosskurth, Heiner; Weiss, Helen A

    2013-01-01

    Objective To assess the long-term effects of population-level HSV-2 infection on HIV incidence. Methods Data from a population-based cohort in south-western Uganda were used to estimate HIV incidence from 1990 to 2007. Stored blood samples were tested for HSV-2, and the impact of HSV-2 prevalence and incidence on HIV incidence was estimated by calculating population attributable fractions (PAFs). The association between population-level annual HIV incidence and annual HSV-2 incidence/prevalence was analysed using linear regression. Results HIV incidence declined over time among men, from 8.72/1000 person-years (pyr) in 1990 to 4.85/1000 pyr in 2007 (P-trend <0.001). In contrast, there was no decline in HIV incidence among women (4.86/1000 pyr in 1990 to 6.74/1000 pyr in 2007, P-trend = 0.18). PAFs of incident HIV attributable to HSV-2 were high (60% in males; 70% in females). There was no evidence of an association between long-term trends in HIV incidence and HSV-2 prevalence or incidence. Conclusion Assuming a causal relationship, a substantial proportion of new HIV infections in this population are attributable to HSV-2. The study did not find an effect of HSV-2 prevalence/incidence on trends in HIV incidence. HIV incidence did not vary much during the study period. This may partly explain the lack of association. PMID:24016032

  12. The potential of smoking cessation programmes and a smoking ban in public places: comparing gain in life expectancy and cost effectiveness.

    PubMed

    Højgaard, Betina; Olsen, Kim Rose; Pisinger, Charlotta; Tønnesen, Hanne; Gyrd-Hansen, Dorte

    2011-12-01

    Interventions aimed at reducing the number of smokers are generally believed to be cost effective. However as the cost of the interventions should be paid up front whereas the gains in life years only appear in the future--the budgetary consequences might be a barrier to implementing such interventions. The aim of the present paper was to assess the long-term cost effectiveness as well as the short-term (10 years) budget consequences of cessation programmes and a smoking ban in enclosed public places. We develop a population-based Markov model capable of analyzing both interventions and assess long-term costs effectiveness as well as short-term budgetary consequences and outcome gains. The smoking cessation programme model was based on data from the Danish National Smoking Cessation Database (SCDB), while the model of the smoking ban was based on effect estimates found in the literature. On a population level the effect of a smoking ban has the largest potential compared with the effect of smoking cessation programmes. Our results suggest that smoking cessation programmes are cost saving and generate life-years, whereas the costs per life-year gained by a smoking ban are 40,645 to 64,462 DKK (100 DKK = €13.4). These results are conservative as they do not include the healthcare cost saving related to reduced passive smoking. Our results indicate that smoking cessation programmes and a smoking ban in enclosed public places both in the short term and the long term are cost-effective strategies compared with the status quo.

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

    PubMed Central

    Sloan, Frank A.; Hanrahan, Brian W.

    2014-01-01

    Importance Exudative age-related macular degeneration (AMD) is the major cause of blindness among U.S. elderly. Developing effective therapies for this disease has been difficult. Objective This study assessed the impacts of introducing new therapies for treating exudative AMD on vision of the affected population and other outcomes among newly diagnosed Medicare beneficiaries. Design The study used data from a 5% sample of Medicare claims and enrollment data with a combination of a regression continuity design and propensity score matching (PSM) to assess the impacts on introduction/receipt of new technologies on study outcomes during a two-year follow-up period. Setting The analysis was based on longitudinal data for the U.S., 1994–2011, for Medicare beneficiaries with fee-for-service coverage. Participants The sample was limited to beneficiaries aged 68+ newly diagnosed with exudative AMD as indicated by beneficiaries having no claims with this diagnosis in a three-year look-back period. Exposures The comparisons with vision outcomes were after versus before introduction of photodynamic therapy (PDT) and anti-VEGF therapy. The comparisons for depression and long-term care facility admission were between beneficiaries newly diagnosed with exudative AMD who received PDT or anti-VEGF therapy compared to beneficiaries with the diagnosis receiving no therapy for this disease. Main Outcome and Measure Onset of decrease in vision, vision loss or blindness, depression, and admission to long term care facilities. Results Introduction of anti-VEGF therapy reduced vision loss and onset of severe vision loss and blindness of beneficiaries newly diagnosed with exudative AMD by 43% [0.50 0.66] on average. Such beneficiaries who received anti-VEGF therapy and were not admitted to a long-term care facility during the look-back period were 19% less likely on average to be admitted to a long-term care facility during follow-up. Conclusions and Relevance This study demonstrates gains in population vision from the introduction of anti-VEGF therapy for patients with an exudative AMD diagnosis aged 68+ in community-based settings in the U.S. PMID:24458013

  14. Female-Bias in a Long-Term Study of a Species with Temperature-Dependent Sex Determination: Monitoring Sex Ratios for Climate Change Research.

    PubMed

    Braun McNeill, Joanne; Avens, Larisa; Goodman Hall, April; Goshe, Lisa R; Harms, Craig A; Owens, David W

    2016-01-01

    Alterations have occurred and continue to manifest in the Earth's biota as a result of climate change. Animals exhibiting temperature dependent sex determination (TSD), including sea turtles, are perhaps most vulnerable to a warming of the Earth as highly skewed sex ratios can result, potentially leading to population extinction resulting from decreased male recruitment. Recent studies have begun to quantify climate change impacts to sea turtle populations, especially in terms of predicting effects on hatchling sex ratios. However, given the inherent difficulty in studying sex ratios at this life stage, a more accurate assessment of changes in population sex ratios might be derived by evaluating the juvenile portion of foraging aggregations. We investigated the long-term trend in sex ratio of a juvenile loggerhead (Caretta caretta) sea turtle population inhabiting Pamlico and Core Sounds, North Carolina, USA. We used plasma testosterone reference ranges measured using radioimmunoassay (RIA) to assign sex for 959 turtles and confirmed sex assignment of a subset (N = 58) of the sampled turtles through laparoscopic examination of their gonads. Our results demonstrate that for this particular population of loggerheads, sex ratios (3Females:1Male) had not significantly changed over a 10 year period (1998-2007), nor showed any significant difference among 5-cm straight carapace length (SCL) size classes. Ultimately, these findings provide a basis for comparison with future sex ratios, and highlight the importance of establishing similar long-term studies monitoring secondary, rather than primary, sex ratios, so that needed mitigation measures to climate change impacts can be implemented.

  15. Long-term dynamics of Mycoplasma conjunctivae at the wildlife-livestock interface in the Pyrenees

    PubMed Central

    Cabezón, Oscar; Frey, Joachim; Velarde, Roser; Serrano, Emmanuel; Colom-Cadena, Andreu; Gelormini, Giuseppina; Marco, Ignasi; Mentaberre, Gregorio; Lavín, Santiago; López-Olvera, Jorge Ramón

    2017-01-01

    Functional roles of domestic and wild host populations in infectious keratoconjunctivitis (IKC) epidemiology have been extensively discussed claiming a domestic reservoir for the more susceptible wild hosts, however, based on limited data. With the aim to better assess IKC epidemiology in complex host-pathogen alpine systems, the long-term infectious dynamics and molecular epidemiology of Mycoplasma conjunctivae was investigated in all host populations from six study areas in the Pyrenees and one in the Cantabrian Mountains (Northern Spain). Detection of M. conjunctivae was performed by qPCR on 3600 eye swabs collected during seven years from hunted wild ungulates and sympatric domestic sheep (n = 1800 animals), and cluster analyses of the strains were performed including previous reported local strains. Mycoplasma conjunctivae was consistently detected in three Pyrenean chamois (Rupicapra p. pyrenaica) populations, as well as in sheep flocks (17.0% of sheep) and occasionally in mouflon (Ovis aries musimon) from the Pyrenees (22.2% in one year/area); statistically associated with ocular clinical signs only in chamois. Chamois populations showed different infection dynamics with low but steady prevalence (4.9%) and significant yearly fluctuations (0.0%– 40.0%). Persistence of specific M. conjunctivae strain clusters in wild host populations is demonstrated for six and nine years. Cross-species transmission between chamois and sheep and chamois and mouflon were also sporadically evidenced. Overall, independent M. conjunctivae sylvatic and domestic cycles occurred at the wildlife-livestock interface in the alpine ecosystems from the Pyrenees with sheep and chamois as the key host species for each cycle, and mouflon as a spill-over host. Host population characteristics and M. conjunctivae strains resulted in different epidemiological scenarios in chamois, ranging from the fading out of the mycoplasma to the epidemic and endemic long-term persistence. These findings highlight the capacity of M. conjunctivae to establish diverse interactions and persist in host populations, also with different transmission conditions. PMID:29016676

  16. Cost-effectiveness of rosuvastatin 20 mg for the prevention of cardiovascular morbidity and mortality: a Swedish economic evaluation of the JUPITER trial.

    PubMed

    Ohsfeldt, Robert L; Olsson, Anders G; Jensen, Marie M; Gandhi, Sanjay K; Paulsson, Thomas

    2012-01-01

    This study estimated the long-term health outcomes, healthcare costs, and cost-effectiveness of rosuvastatin 20 mg therapy in primary prevention of major cardiovascular disease (CVD) in a Swedish population. Based on data from the JUPITER trial, long-term CVD outcomes with rosuvastatin vs no active treatment were estimated for patients with an elevated baseline CVD risk (Framingham CVD score >20%, sub-population of JUPITER population) and for a population similar to the total JUPITER population. Using a decision-analytic model, trial CVD event rates were combined with epidemiological and cost data specific for Sweden. First and subsequent CVD events and death were estimated over a lifetime perspective. The observed relative risk reduction was extrapolated beyond the trial duration. Incremental effectiveness was measured as life-years gained (LYG) and quality-adjusted life-years (QALYs) gained. Treating 100,000 patients with rosuvastatin 20 mg was estimated to avoid 14,692 CVD events over the lifetime (8021 non-fatal MIs, 3228 non-fatal strokes, and 4924 CVD deaths) compared to placebo. This translated into an estimated gain of 42,122 QALYs and 36,865 total life years (LYG). Rosuvastatin was both more effective and less costly over a lifetime perspective, and rosuvastatin is subsequently a dominant alternative compared to no treatment in the assessed population. Using the overall JUPITER population, rosuvastatin was dominant for the lifetime horizon. In the sensitivity analysis, rosuvastatin was the dominant treatment strategy over a 20-year time horizon, and cost-effective with an incremental cost-effectiveness ratio (cost per QALY) of SEK 1783 over a 10-year time horizon. Some model inputs were derived from literature or other data sources, but uncertainty was controlled by sensitivity analyses. Results indicate that rosuvastatin 20 mg treatment is a cost-effective option vs no-treatment in patients with Framingham CVD risk >20% in Sweden and might even be cost saving if taking a long-term perspective.

  17. Improving long-term prediction of first cardiovascular event: the contribution of family history of coronary heart disease and social status.

    PubMed

    Veronesi, G; Gianfagna, F; Giampaoli, S; Chambless, L E; Mancia, G; Cesana, G; Ferrario, M M

    2014-07-01

    The aim of this study is to assess whether family history of coronary heart disease (CHD) and education as proxy of social status improve long-term cardiovascular disease risk prediction in a low-incidence European population. The 20-year risk of first coronary or ischemic stroke events was estimated using sex-specific Cox models in 3956 participants of three population-based surveys in northern Italy, aged 35-69 years and free of cardiovascular disease at enrollment. The additional contribution of education and positive family history of CHD was defined as change in discrimination and Net Reclassification Improvement (NRI) over the model including 7 traditional risk factors. Kaplan-Meier 20-year risk was 16.8% in men (254 events) and 6.4% in women (102 events). Low education (hazard ratio=1.35, 95%CI 0.98-1.85) and family history of CHD (1.55; 1.19-2.03) were associated with the endpoint in men, but not in women. In men, the addition of education and family history significantly improved discrimination by 1%; NRI was 6% (95%CI: 0.2%-15.2%), raising to 20% (0.5%-44%) in those at intermediate risk. NRI in women at intermediate risk was 7%. In low-incidence populations, family history of CHD and education, easily assessed in clinical practice, should be included in long-term cardiovascular disease risk scores, at least in men. Copyright © 2014 Elsevier Inc. All rights reserved.

  18. Preparing Tomorrow’s Nursing Home Nurses: The Wisconsin-Long Term Care Clinical Scholars Program

    PubMed Central

    Nolet, Kim; Roberts, Tonya; Gilmore-Bykovskyi, Andrea; Roiland, Rachel; Gullickson, Colleen; Ryther, Brenda; Bowers, Barbara J.

    2014-01-01

    Preparing future nurses to care for the growing population of older adults has become a national priority. The demand for long term care services is expected to double between 2000 and 2040, yet the field remains stigmatized as an undesirable place for highly-skilled nurses to work. Recent efforts to increase student preparation in geriatrics have been shown to improve student attitudes toward working with older adults and increase knowledge, but long term care settings remain unattractive to students. This paper reports on development, implementation and evaluation of The Wisconsin Long Term Care Clinical Scholars Program, a nursing home internship for baccalaureate nursing students. The program couples a paid nursing home work experience with an evidence-based long term care nursing curriculum. The program increased student preparation and interest in working with older adults and in nursing homes, while concurrently increasing the capacity of nursing homes to provide a positive student experience. PMID:25162659

  19. Are Antarctic minke whales unusually abundant because of 20th century whaling?

    PubMed

    Ruegg, Kristen C; Anderson, Eric C; Scott Baker, C; Vant, Murdoch; Jackson, Jennifer A; Palumbi, Stephen R

    2010-01-01

    Severe declines in megafauna worldwide illuminate the role of top predators in ecosystem structure. In the Antarctic, the Krill Surplus Hypothesis posits that the killing of more than 2 million large whales led to competitive release for smaller krill-eating species like the Antarctic minke whale. If true, the current size of the Antarctic minke whale population may be unusually high as an indirect result of whaling. Here, we estimate the long-term population size of the Antarctic minke whale prior to whaling by sequencing 11 nuclear genetic markers from 52 modern samples purchased in Japanese meat markets. We use coalescent simulations to explore the potential influence of population substructure and find that even though our samples are drawn from a limited geographic area, our estimate reflects ocean-wide genetic diversity. Using Bayesian estimates of the mutation rate and coalescent-based analyses of genetic diversity across loci, we calculate the long-term population size of the Antarctic minke whale to be 670,000 individuals (95% confidence interval: 374,000-1,150,000). Our estimate of long-term abundance is similar to, or greater than, contemporary abundance estimates, suggesting that managing Antarctic ecosystems under the assumption that Antarctic minke whales are unusually abundant is not warranted.

  20. Life-style characteristics and cardiovascular risk factors in regular downhill skiers: an observational study

    PubMed Central

    2013-01-01

    Background Downhill skiing is part of active life style in many residents of Alpine regions. However, only very little information is available whether downhill skiing on a regular basis is associated with a healthier life style resulting in the reduction of major risk factors for cardiovascular diseases and memory deficits when compared to the general population. Thus, the aim of the study was to compare life-style characteristics and cardiovascular risk factors between regular downhill skiers and the general population. Methods Self-reported health and life-style data were collected by questionnaire from 1259 long-term downhill skiers (971 males, aged 57.3 ± 14.6 years; 288 females, aged 47.7 ± 16.4 years) and compared with data from the general population. Results Long-term skiers showed more favourable life-style characteristics and a better health status than the general population. Prevalences of hypercholesterolemia, systemic hypertension, diabetes, the frequency of mental stress and the occurrence of memory deficits declined with increasing yearly skiing frequency. Conclusion Long-term alpine skiing on a regular basis may contribute to healthy aging by its association with a healthier life style. PMID:23987102

  1. Climate Change and Macro-Economic Cycles in Pre-Industrial Europe

    PubMed Central

    Pei, Qing; Zhang, David D.; Lee, Harry F.; Li, Guodong

    2014-01-01

    Climate change has been proven to be the ultimate cause of social crisis in pre-industrial Europe at a large scale. However, detailed analyses on climate change and macro-economic cycles in the pre-industrial era remain lacking, especially within different temporal scales. Therefore, fine-grained, paleo-climate, and economic data were employed with statistical methods to quantitatively assess the relations between climate change and agrarian economy in Europe during AD 1500 to 1800. In the study, the Butterworth filter was adopted to filter the data series into a long-term trend (low-frequency) and short-term fluctuations (high-frequency). Granger Causality Analysis was conducted to scrutinize the associations between climate change and macro-economic cycle at different frequency bands. Based on quantitative results, climate change can only show significant effects on the macro-economic cycle within the long-term. In terms of the short-term effects, society can relieve the influences from climate variations by social adaptation methods and self-adjustment mechanism. On a large spatial scale, temperature holds higher importance for the European agrarian economy than precipitation. By examining the supply-demand mechanism in the grain market, population during the study period acted as the producer in the long term, whereas as the consumer in the short term. These findings merely reflect the general interactions between climate change and macro-economic cycles at the large spatial region with a long-term study period. The findings neither illustrate individual incidents that can temporarily distort the agrarian economy nor explain some specific cases. In the study, the scale thinking in the analysis is raised as an essential methodological issue for the first time to interpret the associations between climatic impact and macro-economy in the past agrarian society within different temporal scales. PMID:24516601

  2. Climate change and macro-economic cycles in pre-industrial europe.

    PubMed

    Pei, Qing; Zhang, David D; Lee, Harry F; Li, Guodong

    2014-01-01

    Climate change has been proven to be the ultimate cause of social crisis in pre-industrial Europe at a large scale. However, detailed analyses on climate change and macro-economic cycles in the pre-industrial era remain lacking, especially within different temporal scales. Therefore, fine-grained, paleo-climate, and economic data were employed with statistical methods to quantitatively assess the relations between climate change and agrarian economy in Europe during AD 1500 to 1800. In the study, the Butterworth filter was adopted to filter the data series into a long-term trend (low-frequency) and short-term fluctuations (high-frequency). Granger Causality Analysis was conducted to scrutinize the associations between climate change and macro-economic cycle at different frequency bands. Based on quantitative results, climate change can only show significant effects on the macro-economic cycle within the long-term. In terms of the short-term effects, society can relieve the influences from climate variations by social adaptation methods and self-adjustment mechanism. On a large spatial scale, temperature holds higher importance for the European agrarian economy than precipitation. By examining the supply-demand mechanism in the grain market, population during the study period acted as the producer in the long term, whereas as the consumer in the short term. These findings merely reflect the general interactions between climate change and macro-economic cycles at the large spatial region with a long-term study period. The findings neither illustrate individual incidents that can temporarily distort the agrarian economy nor explain some specific cases. In the study, the scale thinking in the analysis is raised as an essential methodological issue for the first time to interpret the associations between climatic impact and macro-economy in the past agrarian society within different temporal scales.

  3. Maintaining evaluation designs in long term community based health promotion programmes: Heartbeat Wales case study.

    PubMed Central

    Nutbeam, D; Smith, C; Murphy, S; Catford, J

    1993-01-01

    STUDY OBJECTIVE--To examine the difficulties of developing and maintaining outcome evaluation designs in long term, community based health promotion programmes. DESIGN--Semistructured interviews of health promotion managers. SETTING--Wales and two reference health regions in England. PARTICIPANTS--Nine health promotion managers in Wales and 18 in England. MEASUREMENTS AND MAIN RESULTS--Information on selected heart health promotion activity undertaken or coordinated by health authorities from 1985-90 was collected. The Heartbeat Wales coronary heart disease prevention programme was set up in 1985, and a research and evaluation strategy was established to complement the intervention. A substantial increase in the budget occurred over the period. In the reference health regions in England this initiative was noted and rapidly taken up, thus compromising their use as control areas. CONCLUSION--Information on large scale, community based health promotion programmes can disseminate quickly and interfere with classic intervention/evaluation control designs through contamination. Alternative experimental designs for assessing the effectiveness of long term intervention programmes need to be considered. These should not rely solely on the use of reference populations, but should balance the measurement of outcome with an assessment of the process of change in communities. The development and use of intervention exposure measures together with well structured and comprehensive process evaluation in both the intervention and reference areas is recommended. PMID:8326270

  4. Sublethal Ciprofloxacin Treatment Leads to Rapid Development of High-Level Ciprofloxacin Resistance during Long-Term Experimental Evolution of Pseudomonas aeruginosa

    PubMed Central

    Jørgensen, Karin Meinike; Wassermann, Tina; Jensen, Peter Østrup; Hengzuang, Wang; Molin, Søren; Høiby, Niels

    2013-01-01

    The dynamics of occurrence and the genetic basis of ciprofloxacin resistance were studied in a long-term evolution experiment (940 generations) in wild-type, reference strain (PAO1) and hypermutable (PAOΔmutS and PAOMY-Mgm) P. aeruginosa populations continuously exposed to sub-MICs (1/4) of ciprofloxacin. A rapid occurrence of ciprofloxacin-resistant mutants (MIC of ≥12 μg/ml, representing 100 times the MIC of the original population) were observed in all ciprofloxacin-exposed lineages of PAOΔmutS and PAOMY-Mgm populations after 100 and 170 generations, respectively, and in one of the PAO1 lineages after 240 generations. The genetic basis of resistance was mutations in gyrA (C248T and G259T) and gyrB (C1397A). Cross-resistance to beta-lactam antibiotics was observed in the bacterial populations that evolved during exposure to sublethal concentrations of ciprofloxacin. Our study shows that mutants with high-level ciprofloxacin resistance are selected in P. aeruginosa bacterial populations exposed to sub-MICs of ciprofloxacin. This can have implications for the long-term persistence of resistant bacteria and spread of antibiotic resistance by exposure of commensal bacterial flora to low antibiotic concentrations. PMID:23774442

  5. Forecasting human exposure to atmospheric pollutants in Portugal - A modelling approach

    NASA Astrophysics Data System (ADS)

    Borrego, C.; Sá, E.; Monteiro, A.; Ferreira, J.; Miranda, A. I.

    2009-12-01

    Air pollution has become one main environmental concern because of its known impact on human health. Aiming to inform the population about the air they are breathing, several air quality modelling systems have been developed and tested allowing the assessment and forecast of air pollution ambient levels in many countries. However, every day, an individual is exposed to different concentrations of atmospheric pollutants as he/she moves from and to different outdoor and indoor places (the so-called microenvironments). Therefore, a more efficient way to prevent the population from the health risks caused by air pollution should be based on exposure rather than air concentrations estimations. The objective of the present study is to develop a methodology to forecast the human exposure of the Portuguese population based on the air quality forecasting system available and validated for Portugal since 2005. Besides that, a long-term evaluation of human exposure estimates aims to be obtained using one-year of this forecasting system application. Additionally, a hypothetical 50% emission reduction scenario has been designed and studied as a contribution to study emission reduction strategies impact on human exposure. To estimate the population exposure the forecasting results of the air quality modelling system MM5-CHIMERE have been combined with the population spatial distribution over Portugal and their time-activity patterns, i.e. the fraction of the day time spent in specific indoor and outdoor places. The population characterization concerning age, work, type of occupation and related time spent was obtained from national census and available enquiries performed by the National Institute of Statistics. A daily exposure estimation module has been developed gathering all these data and considering empirical indoor/outdoor relations from literature to calculate the indoor concentrations in each one of the microenvironments considered, namely home, office/school, and other indoors (leisure activities like shopping areas, gym, theatre/cinema and restaurants). The results show how this developed modelling system can be useful to anticipate air pollution episodes and to estimate their effects on human health on a long-term basis. The two metropolitan areas of Porto and Lisbon are identified as the most critical ones in terms of air pollution effects on human health over Portugal in a long-term as well as in a short-term perspective. The coexistence of high concentration values and high population density is the key factor for these stressed areas. Regarding the 50% emission reduction scenario, the model results are significantly different for both pollutants: there is a small overall reduction in the individual exposure values of PM 10 (<10 μg m -3 h), but for O 3, in contrast, there is an extended area where exposure values increase with emission reduction. This detailed knowledge is a prerequisite for the development of effective policies to reduce the foreseen adverse impact of air pollution on human health and to act on time.

  6. Genetic variation facilitates seedling establishment but not population growth rate of a perennial invader.

    PubMed

    Li, Shou-Li; Vasemägi, Anti; Ramula, Satu

    2016-01-01

    Assessing the demographic consequences of genetic variation is fundamental to invasion biology. However, genetic and demographic approaches are rarely combined to explore the effects of genetic variation on invasive populations in natural environments. This study combined population genetics, demographic data and a greenhouse experiment to investigate the consequences of genetic variation for the population fitness of the perennial, invasive herb Lupinus polyphyllus. Genetic and demographic data were collected from 37 L. polyphyllus populations representing different latitudes in Finland, and genetic variation was characterized based on 13 microsatellite loci. Associations between genetic variation and population size, population density, latitude and habitat were investigated. Genetic variation was then explored in relation to four fitness components (establishment, survival, growth, fecundity) measured at the population level, and the long-term population growth rate (λ). For a subset of populations genetic variation was also examined in relation to the temporal variability of λ. A further assessment was made of the role of natural selection in the observed variation of certain fitness components among populations under greenhouse conditions. It was found that genetic variation correlated positively with population size, particularly at higher latitudes, and differed among habitat types. Average seedling establishment per population increased with genetic variation in the field, but not under greenhouse conditions. Quantitative genetic divergence (Q(ST)) based on seedling establishment in the greenhouse was smaller than allelic genetic divergence (F'(ST)), indicating that unifying selection has a prominent role in this fitness component. Genetic variation was not associated with average survival, growth or fecundity measured at the population level, λ or its variability. The study suggests that although genetic variation may facilitate plant invasions by increasing seedling establishment, it may not necessarily affect the long-term population growth rate. Therefore, established invasions may be able to grow equally well regardless of their genetic diversity. © The Author 2015. Published by Oxford University Press on behalf of the Annals of Botany Company. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  7. Long-term musculoskeletal morbidity after adult burn injury: a population-based cohort study

    PubMed Central

    Randall, Sean M; Fear, Mark W; Wood, Fiona M; Rea, Suzanne; Boyd, James H; Duke, Janine M

    2015-01-01

    Objective To investigate if adults who are hospitalised for a burn injury have increased long-term hospital use for musculoskeletal diseases. Design A population-based retrospective cohort study using linked administrative health data from the Western Australian Data Linkage System. Subjects Records of 17 753 persons aged at least 20 years when hospitalised for a first burn injury in Western Australia during the period 1980–2012, and 70 758 persons who were age and gender-frequency matched with no injury admissions randomly selected from Western Australia's electoral roll. Main outcome measures Admission rates and cumulative length of stay for musculoskeletal diseases. Negative binomial and Cox proportional hazards regression modelling were used to generate incidence rate ratios (IRR) and HRs with 95% CIs, respectively. Results After adjustment for pre-existing health status and demographic characteristics, the burn cohort had almost twice the hospitalisation rate for a musculoskeletal condition (IRR, 95% CI 1.98, 1.86 to 2.10), and spent 3.70 times as long in hospital with a musculoskeletal diagnosis (95% CI 3.10 to 4.42) over the 33-year period, than the uninjured comparison cohort. Adjusted survival analyses of incident post-burn musculoskeletal disease admissions found significant increases for the 15-year post burn discharge period (0–6 months: HR, 95% CI 2.51, 2.04 to 3.11; 6 months–2 years: HR, 95% CI 1.77, 1.53 to 2.05; 2–15 years: HR, 95% CI 1.32, 1.23 to 1.42). Incident admission rates were significantly elevated for 20 years post-burn for minor and severe burn injury for a range of musculoskeletal diseases that included arthropathies, dorsopathies, osteopathies and soft tissue disorders. Conclusions Minor and severe burn injuries were associated with significantly increased post-burn incident admission rates, long-term hospital use and prolonged length of stay for a range of musculoskeletal diseases. Further research is required that facilitates identification of at-risk patients and appropriate treatment pathways, to reduce the long-term morbidity associated with burns. PMID:26362668

  8. The Alsea Watershed Study: a comparison with other multi-year investigations in the Pacific Northwest

    Treesearch

    Peter A. Bisson; Stanley V. Gregory; Thomas E. Nickelson; James D. Hall

    2008-01-01

    The Alsea Watershed Study (AWS) was the first long-term fisheries research project to address the effects of forestry operations on salmonid populations in the Pacific Northwest using a watershed approach. To this day it remains one of a very limited number of investigations that have provided long-term information on salmon and trout responses to forestry operations....

  9. Marital history, health and mortality among older men and women in England and Wales.

    PubMed

    Grundy, Emily M D; Tomassini, Cecilia

    2010-09-15

    Health benefits of marriage have long been recognised and extensively studied but previous research has yielded inconsistent results for older people, particularly older women. At older ages accumulated benefits or disadvantages of past marital experience, as well as current marital status, may be relevant, but fewer studies have considered effects of marital history. Possible effects of parity, and the extent to which these may contribute to marital status differentials in health, have also been rarely considered. We use data from the Office for National Statistics Longitudinal Study, a large record linkage study of 1% of the population of England & Wales, to analyse associations between marital history 1971-1991 and subsequent self-reported limiting long-term illness and mortality in a cohort of some 75,000 men and women aged 60-79 in 1991. We investigate whether prior marital status and time in current marital status influenced risks of mortality or long term illness using Poisson regression to analyse mortality differentials 1991-2001 and logistic regression to analyse differences in proportions reporting limiting long-term illness in 1991 and 2001. Co-variates included indicators of socio-economic status at two or three points of the adult life course and, for women, number of children borne (parity). Relative to men in long-term first marriages, never-married men, widowers with varying durations of widowerhood, men divorced for between 10 and twenty years, and men in long-term remarriages had raised mortality 1991-2001. Men in long-term remarriages and those divorced or widowed since 1971 had higher odds of long-term illness in 1991; in 2001 the long-term remarried were the only group with significantly raised odds of long-term illness. Among women, the long-term remarried also had higher odds of reporting long-term illness in 1991 and in 2001 and those remarried and previously divorced had raised odds of long-term illness and raised mortality 1991-2001; this latter effect was not significant in models including parity. All widows had raised mortality 1991-2001 but associations between widowhood of varying durations and long-term illness in 1991 or 2001 were not significant once socio-economic status was controlled. Some groups of divorced women had higher mortality risks 1991-2001 and raised odds of long-term illness in 1991. Results for never-married women showed a divergence between associations with mortality and with long-term illness. In models controlling for socio-economic status, mortality risk was raised but the association with 1991 long-term illness was not significant and in 2001 never-married women had lower odds of reporting long-term illness than women in long-term first marriages. Formally taking account of selective survival in the 20 years prior to entry to the study population had minor effects on results. Results were consistent with previous studies in showing that the relationship between marital experience and later life health and mortality is considerably modified by socio-economic factors, and additionally showed that taking women's parity into account further moderated associations. Considering marital history rather than simply current marital status provided some insights into differentials between, for example, remarried people according to prior marital status and time remarried, but these groups were relatively small and there were some disadvantages of the approach in terms of loss of statistical power. Consideration of past histories is likely to be more important for later born cohorts whose partnership experiences have been less stable and more heterogeneous.

  10. The Promoting Effective Advance Care for Elders (PEACE) randomized pilot study: theoretical framework and study design.

    PubMed

    Allen, Kyle R; Hazelett, Susan E; Radwany, Steven; Ertle, Denise; Fosnight, Susan M; Moore, Pamela S

    2012-04-01

    Practice guidelines are available for hospice and palliative medicine specialists and geriatricians. However, these guidelines do not adequately address the needs of patients who straddle the 2 specialties: homebound chronically ill patients. The purpose of this article is to describe the theoretical basis for the Promoting Effective Advance Care for Elders (PEACE) randomized pilot study. PEACE is an ongoing 2-group randomized pilot study (n=80) to test an in-home interdisciplinary care management intervention that combines palliative care approaches to symptom management, psychosocial and emotional support, and advance care planning with geriatric medicine approaches to optimizing function and addressing polypharmacy. The population comprises new enrollees into PASSPORT, Ohio's community-based, long-term care Medicaid waiver program. All PASSPORT enrollees have geriatric/palliative care crossover needs because they are nursing home eligible. The intervention is based on Wagner's Chronic Care Model and includes comprehensive interdisciplinary care management for these low-income frail elders with chronic illnesses, uses evidence-based protocols, emphasizes patient activation, and integrates with community-based long-term care and other community agencies. Our model, with its standardized, evidence-based medical and psychosocial intervention protocols, will transport easily to other sites that are interested in optimizing outcomes for community-based, chronically ill older adults. © Mary Ann Liebert, Inc.

  11. Population Dynamics of Genetic Regulatory Networks

    NASA Astrophysics Data System (ADS)

    Braun, Erez

    2005-03-01

    Unlike common objects in physics, a biological cell processes information. The cell interprets its genome and transforms the genomic information content, through the action of genetic regulatory networks, into proteins which in turn dictate its metabolism, functionality and morphology. Understanding the dynamics of a population of biological cells presents a unique challenge. It requires to link the intracellular dynamics of gene regulation, through the mechanism of cell division, to the level of the population. We present experiments studying adaptive dynamics of populations of genetically homogeneous microorganisms (yeast), grown for long durations under steady conditions. We focus on population dynamics that do not involve random genetic mutations. Our experiments follow the long-term dynamics of the population distributions and allow to quantify the correlations among generations. We focus on three interconnected issues: adaptation of genetically homogeneous populations following environmental changes, selection processes on the population and population variability and expression distributions. We show that while the population exhibits specific short-term responses to environmental inputs, it eventually adapts to a robust steady-state, largely independent of external conditions. Cycles of medium-switch show that the adapted state is imprinted in the population and that this memory is maintained for many generations. To further study population adaptation, we utilize the process of gene recruitment whereby a gene naturally regulated by a specific promoter is placed under a different regulatory system. This naturally occurring process has been recognized as a major driving force in evolution. We have recruited an essential gene to a foreign regulatory network and followed the population long-term dynamics. Rewiring of the regulatory network allows us to expose their complex dynamics and phase space structure.

  12. Spiritually Based Resources in Adaptation to Long-Term Prostate Cancer Survival: Perspectives of Elderly Wives

    ERIC Educational Resources Information Center

    Ka'opua, Lana Sue I.; Gotay, Carolyn C.; Boehm, Patricia S.

    2007-01-01

    Spiritually based resources (SBR) generally have a salutary effect on coping with cancer diagnosis and treatment. Few studies address this relationship in long-term cancer survivorship, however. As part of a study on long-term prostate cancer survivorship, wives' ways of coping with cancer-related issues were explored through longitudinal…

  13. The Role of Mindfulness in Reducing the Adverse Effects of Childhood Stress and Trauma

    PubMed Central

    Ortiz, Robin; Sibinga, Erica M.

    2017-01-01

    Research suggests that many children are exposed to adverse experiences in childhood. Such adverse childhood exposures may result in stress and trauma, which are associated with increased morbidity and mortality into adulthood. In general populations and trauma-exposed adults, mindfulness interventions have demonstrated reduced depression and anxiety, reduced trauma-related symptoms, enhanced coping and mood, and improved quality of life. Studies in children and youth also demonstrate that mindfulness interventions improve mental, behavioral, and physical outcomes. Taken together, this research suggests that high-quality, structured mindfulness instruction may mitigate the negative effects of stress and trauma related to adverse childhood exposures, improving short- and long-term outcomes, and potentially reducing poor health outcomes in adulthood. Future work is needed to optimize implementation of youth-based mindfulness programs and to study long-term outcomes into adulthood. PMID:28264496

  14. The practical side of immunocontraception: zona proteins and wildlife.

    PubMed

    Kirkpatrick, J F; Rowan, A; Lamberski, N; Wallace, R; Frank, K; Lyda, R

    2009-12-01

    With shrinking habitat, the humane control of certain wildlife populations is relevant. The contraceptive vaccine based on native porcine zona pellucida (PZP) has been applied to various wildlife populations for 20 years. Prominent efforts include wild horses, urban deer, zoo animals and African elephants, among others. This approach has been successful in managing entire populations and to date, no significant debilitating short- or long-term health effects have been documented.

  15. Conservation genetics of the rare Pyreneo-Cantabrian endemic Aster pyrenaeus (Asteraceae)

    PubMed Central

    Escaravage, Nathalie; Cambecèdes, Jocelyne; Largier, Gérard; Pornon, André

    2011-01-01

    Background and aims Aster pyrenaeus (Asteraceae) is an endangered species, endemic to the Pyrenees and Cantabrian Mountain ranges (Spain). For its long-term persistence, this taxon needs an appropriate conservation strategy to be implemented. In this context, we studied the genetic structure over the entire geographical range of the species and then inferred the genetic relationships between populations. Methodology Molecular diversity was analysed for 290 individuals from 12 populations in the Pyrenees and the Cantabrian Mountains using inter simple sequence repeats (ISSRs). Bayesian-based analysis was applied to examine population structure. Principal results Analysis of genetic similarity and diversity, based on 87 polymorphic ISSR markers, suggests that despite being small and isolated, populations have an intermediate genetic diversity level (P % = 52.8 %, HE = 0.21 ± 0.01, genetic similarity between individuals = 49.6 %). Genetic variation was mainly found within populations (80–84 %), independently of mountain ranges, whereas 16–18 % was found between populations and <5 % between mountain ranges. Analyses of molecular variance indicated that population differentiation was highly significant. However, no significant correlation was found between the genetic and geographical distances among populations (Rs = 0.359, P = 0.140). Geographical structure based on assignment tests identified five different gene pools that were independent of any particular structure in the landscape. Conclusions The results suggest that population isolation is probably relatively recent, and that the outbreeding behaviour of the species maintains a high within-population genetic diversity. We assume that some long-distance dispersal, even among topographically remote populations, may be determinant for the pattern of genetic variation found in populations. Based on these findings, strategies are proposed for genetic conservation and management of the species. PMID:22476499

  16. The conservation relevance of epidemiological research into carnivore viral diseases in the serengeti.

    PubMed

    Cleaveland, Sarah; Mlengeya, Titus; Kaare, Magai; Haydon, Dan; Lembo, Tiziana; Laurenson, M Karen; Packer, Craig

    2007-06-01

    Recent outbreaks of rabies and canine distemper in wildlife populations of the Serengeti show that infectious disease constitutes a significant cause of mortality that can result in regional extirpation of endangered species even within large, well-protected areas. Nevertheless, effective management of an infectious disease depends critically on understanding the epidemiological dynamics of the causative pathogen. Pathogens with short infection cycles cannot persist in small populations in the absence of a more permanent reservoir of infection. Development of appropriate interventions requires detailed data on transmission pathways between reservoirs and wildlife populations of conservation concern. Relevant data can be derived from long-term population monitoring, epidemic and case-surveillance patterns, genetic analyses of rapidly evolving pathogens, serological surveys, and intervention studies. We examined studies of carnivore diseases in the Serengeti. Epidemiological research contributes to wildlife conservation policy in terms of management of endangered populations and the integration of wildlife conservation with public health interventions. Long-term, integrative, cross-species research is essential for formulation of effective policy for disease control and optimization of ecosystem health.

  17. Genetic and phenotypic correlations of quantitative traits in two long-term randomly mated soybean populations

    USDA-ARS?s Scientific Manuscript database

    The genetic effects of long term random mating and natural selection aided by genetic male sterility (gms) were evaluated in two soybean [Glycine max (L.) Merr.] populations designated: RSII and RSIII. These populations were evaluated in the field at three locations each with two replications. Genot...

  18. Postdispersal seed predation limits the abundance of a long-lived perennial forb (Lithospermum ruderale).

    PubMed

    Bricker, Mary; Maron, John

    2012-03-01

    Loss of seeds to consumers is common in plant communities, but the degree to which these losses influence plant abundance or population growth is often unclear. This is particularly the case for postdispersal seed predation by rodents, as most studies of rodent seed predation have focused on the sources of spatiotemporal variation in seed loss but not quantified the population consequences of this loss. In previous work we showed that seed predation by deer mice (Peromyscus maniculatus) substantially reduced seedling recruitment and establishment of Lithospermum ruderale (Boraginaceae), a long-lived perennial forb. To shed light on how rodent seed predation and the near-term effects on plant recruitment might influence longer-term patterns of L. ruderale population growth, we combined experimental results with demographic data in stage-based population models. Model outputs revealed that rodent seed predation had a significant impact on L. ruderale population growth rate (lambda). With the removal of postdispersal seed predation, the projected population growth rates increased between 0.06 and 0.12, depending on site (mean deltalambda across sites = 0.08). Seed predation shifted the projected stable stage distribution of populations from one with a high proportion of young plants to one in which larger adult size classes dominate. Elasticities of vital rates also changed, with germination and growth of seedlings and young plants becoming more important with the removal of seed predation. Simulations varying the magnitude of seed predation pressure while holding other vital rates constant showed that seed predation could lower lambda even if only 40% of available seeds were consumed. These results demonstrate that rodent granivory can be a potent force limiting the abundance of a long-lived perennial forb.

  19. Long-Term Impact of Valid Case Criterion on Capturing Population-Level Growth under Item Response Theory Equating. Research Report. ETS RR-17-17

    ERIC Educational Resources Information Center

    Deng, Weiling; Monfils, Lora

    2017-01-01

    Using simulated data, this study examined the impact of different levels of stringency of the valid case inclusion criterion on item response theory (IRT)-based true score equating over 5 years in the context of K-12 assessment when growth in student achievement is expected. Findings indicate that the use of the most stringent inclusion criterion…

  20. Prolonged Dye Release from Mesoporous Silica-Based Imaging Probes Facilitates Long-Term Optical Tracking of Cell Populations In Vivo.

    PubMed

    Rosenholm, Jessica M; Gulin-Sarfraz, Tina; Mamaeva, Veronika; Niemi, Rasmus; Özliseli, Ezgi; Desai, Diti; Antfolk, Daniel; von Haartman, Eva; Lindberg, Desiré; Prabhakar, Neeraj; Näreoja, Tuomas; Sahlgren, Cecilia

    2016-03-23

    Nanomedicine is gaining ground worldwide in therapy and diagnostics. Novel nanoscopic imaging probes serve as imaging tools for studying dynamic biological processes in vitro and in vivo. To allow detectability in the physiological environment, the nanostructure-based probes need to be either inherently detectable by biomedical imaging techniques, or serve as carriers for existing imaging agents. In this study, the potential of mesoporous silica nanoparticles carrying commercially available fluorochromes as self-regenerating cell labels for long-term cellular tracking is investigated. The particle surface is organically modified for enhanced cellular uptake, the fluorescence intensity of labeled cells is followed over time both in vitro and in vivo. The particles are not exocytosed and particles which escaped cells due to cell injury or death are degraded and no labeling of nontargeted cell populations are observed. The labeling efficiency is significantly improved as compared to that of quantum dots of similar emission wavelength. Labeled human breast cancer cells are xenotransplanted in nude mice, and the fluorescent cells can be detected in vivo for a period of 1 month. Moreover, ex vivo analysis reveals fluorescently labeled metastatic colonies in lymph node and rib, highlighting the capability of the developed probes for tracking of metastasis. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  1. Influence of local demography on asymptotic and transient dynamics of a yellow-bellied marmot metapopulation.

    PubMed

    Ozgul, Arpat; Oli, Madan K; Armitage, Kenneth B; Blumstein, Daniel T; Van Vuren, Dirk H

    2009-04-01

    Despite recent advances in biodemography and metapopulation ecology, we still have limited understanding of how local demographic parameters influence short- and long-term metapopulation dynamics. We used long-term data from 17 local populations, along with the recently developed methods of matrix metapopulation modeling and transient sensitivity analysis, to investigate the influence of local demography on long-term (asymptotic) versus short-term (transient) dynamics of a yellow-bellied marmot metapopulation in Colorado. Both long- and short-term dynamics depended primarily on a few colony sites and were highly sensitive to changes in demography at these sites, particularly in survival of reproductive adult females. Interestingly, the relative importance of sites differed between long- and short-term dynamics; the spatial structure and local population sizes, while insignificant for asymptotic dynamics, were influential on transient dynamics. However, considering the spatial structure was uninformative about the relative influence of local demography on metapopulation dynamics. The vital rates that were the most influential on local dynamics were also the most influential on both long- and short-term metapopulation dynamics. Our results show that an explicit consideration of local demography is essential for a complete understanding of the dynamics and persistence of spatially structured populations.

  2. Antipathogen genes and the replacement of disease-vectoring mosquito populations: a model-based evaluation

    PubMed Central

    Robert, Michael A; Okamoto, Kenichi W; Gould, Fred; Lloyd, Alun L

    2014-01-01

    Recently, genetic strategies aimed at controlling populations of disease-vectoring mosquitoes have received considerable attention as alternatives to traditional measures. Theoretical studies have shown that female-killing (FK), antipathogen (AP), and reduce and replace (R&R) strategies can each decrease the number competent vectors. In this study, we utilize a mathematical model to evaluate impacts on competent Aedes aegypti populations of FK, AP, and R&R releases as well as hybrid strategies that result from combinations of these three approaches. We show that while the ordering of efficacy of these strategies depends upon population life history parameters, sex ratio of releases, and switch time in combination strategies, AP-only and R&R/AP releases typically lead to the greatest long-term reduction in competent vectors. R&R-only releases are often less effective at long-term reduction of competent vectors than AP-only releases or R&R/AP releases. Furthermore, the reduction in competent vectors caused by AP-only releases is easier to maintain than that caused by FK-only or R&R-only releases even when the AP gene confers a fitness cost. We discuss the roles that density dependence and inclusion of females play in the order of efficacy of the strategies. We anticipate that our results will provide added impetus to continue developing AP strategies. PMID:25558284

  3. The Health-Related Quality of Life in Long-Term Colorectal Cancer Survivors Study: objectives, methods, and patient sample

    PubMed Central

    Mohler, M. Jane; Coons, Stephen Joel; Hornbrook, Mark C.; Herrinton, Lisa J.; Wendel, Christopher S.; Grant, Marcia; Krouse, Robert S.

    2008-01-01

    Objectives The objective of this paper is to describe the complex mixed-methods design of a study conducted to assess health-related quality of life (HRQOL) outcomes and ostomy-related obstacles and adjustments among long-term (>five years) colorectal cancer (CRC) survivors with ostomies (cases) and without ostomies (controls). In addition, details are provided regarding the study sample and the psychometric properties of the quantitative data collection measures used. Subsequent manuscripts will present the study findings. Research Design and Methods The study design involved a cross-sectional mail survey for collecting quantitative data and focus groups for collecting qualitative data. The study subjects were individuals identified as long-term CRC survivors within a community-based health maintenance organization's enrolled population. Focus groups comprised of cases and divided by gender and HRQOL high and low quartile contrasts (based on the mail survey data) were conducted. Main Outcome Measures The modified City of Hope Quality of Life (mCOH-QOL)-Ostomy and SF-36v2 questionnaires were used in the mail survey. An abridged version of the mCOH-QOL-Ostomy was used for the control subjects. Focus groups explored ostomy-related barriers to self-care, adaptation methods/skills, and advice for others with an ostomy. Results The survey response rate was 52% (679/1308) and 34 subjects participated in focus groups. The internal consistency reliability estimates for the mCOH-QOL-Ostomy and SF-36v2 questionnaires were very acceptable for group comparisons. In addition, evidence supports the construct validity of the abridged version of the mCOH-QOL-Ostomy. Study limitations include potential non-response bias and limited minority participation. Conclusions We were able to successfully recruit long-term CRC survivors into this study and the psychometric properties of the quantitative measures used were quite acceptable. Mixed-methods designs, such as the one used in this study, may be useful in identification and further elucidation of common problems, coping strategies, and HRQOL outcomes among long-term cancer survivors. PMID:18544186

  4. Survival models for harvest management of mourning dove populations

    USGS Publications Warehouse

    Otis, D.L.

    2002-01-01

    Quantitative models of the relationship between annual survival and harvest rate of migratory game-bird populations are essential to science-based harvest management strategies. I used the best available band-recovery and harvest data for mourning doves (Zenaida macroura) to build a set of models based on different assumptions about compensatory harvest mortality. Although these models suffer from lack of contemporary data, they can be used in development of an initial set of population models that synthesize existing demographic data on a management-unit scale, and serve as a tool for prioritization of population demographic information needs. Credible harvest management plans for mourning dove populations will require a long-term commitment to population monitoring and iterative population analysis.

  5. End of Life Strategies Among Patients with Advanced Chronic Obstructive Pulmonary Disease (COPD).

    PubMed

    Gershon, Andrea S; Maclagan, Laura C; Luo, Jin; To, Teresa; Kendzerska, Tetyana; Stanbrook, Matthew B; Bourbeau, Jean; Etches, Jacob; Aaron, Shawn D

    2018-06-11

    The burden of advanced COPD is high globally; however, little is known about how often end of life strategies are used by this population. To describe trends in the use of end of life care strategies by people with advanced COPD in Ontario, Canada. A population-based repeated cross-sectional study examining end of life care strategies in individuals with advanced COPD was conducted. Annual proportions of individuals who received formal palliative care, long-term oxygen therapy or opioids from 2004 to 2014 were determined. Results were age- and sex- standardized as well as stratified by age, sex, socioeconomic status, urban/rural residence and immigrant status. Measurement/Main Results: There were 151,912 persons with advanced COPD in Ontario between 2004 and 2014. Use of formal palliative care services increased 1% per year from 5.3% in 2004 to 14.3% in 2014 (p value for trend <0.001), while use of long-term oxygen therapy increased 1.1% per year from 26.4% in 2004 to 35.3% in 2013 (p value for trend <0.001). The use of opioids was relatively stable (40.0% in 2004 and 41.8% in 2014, p value for trend=0.08). Younger individuals were less likely to use formal palliative care services and long-term oxygen therapy. Males were less likely than females to receive long-term oxygen therapy and opioids. The proportion of people with advanced COPD using end of life strategies, although increasing, remains low. Efforts should focus on increasing access to such strategies as well as educating patients and providers of their benefits.

  6. Hair as a Biomarker of Long Term Mercury Exposure in Brazilian Amazon: A Systematic Review

    PubMed Central

    de Oliveira Lima, Marcelo

    2018-01-01

    Many studies have assessed mercury (Hg) exposure in the Amazonian population. This article performs a literature search of the studies that used hair as a biomarker of Hg exposure in the Brazilian Amazonian population. The search covered the period from 1996 to 2016 and included articles which matched the following criteria: (1) articles related to Hg exposure into Brazilian Amazon; (2) articles that used hair as a biomarker of Hg exposure; (3) articles that used analytical tools to measure the Hg content on hair and (4) articles that presented arithmetic mean and/or minimum and maximum values of Hg. 36 studies were selected. The findings show that most of the studies were performed along margins of important rivers, such as Negro, Tapajós and Madeira. All the population presented mean levels of Hg on hair above 6 µg g−1 and general population, adults, not determined and men presented levels of Hg on hair above 10 µg g−1. The results show that most of the studies were performed by Brazilian institutions/researchers and the majority was performed in the State of Pará. The present study identified that Amazonian population has long-term been exposed to Hg. In terms of future perspectives, this study suggests the implementation of a strategic plan for environmental health surveillance in the region in order to promote health and benefit Amazonian population. PMID:29534534

  7. [Psychosocial issues of long-term cancer survivors].

    PubMed

    Weis, J; Faller, H

    2012-04-01

    Although cancer incidence rates are increasing, recent statistical studies suggest that cancer patients are showing higher cure rates as well as improved overall survival rates for most cancer locations. These advances are explained by improved strategies in early diagnoses as well as improved cancer therapies. Therefore, the number of long-term cancer survivors has also increased, but only few studies, especially within the last years, have focused on psychosocial issues of this subgroup. Some studies show that overall quality of life of long-term cancer survivors is quite high and comparable to that of the normal population. Nevertheless, a substantial percentage of former patients shows reduced quality of life and suffers from various sequelae of cancer and its treatment. This review focuses on the most common psychosocial issue of long-term survivors such as reduced psychological wellbeing, neuropsychological deficits and cancer-related fatigue syndrome. Finally, recommendations for problem-oriented interventions as well as improvement of psychosocial care of long-term survivors are given.

  8. Does the Risk of Metabolic Syndrome Increase in Thyroid Cancer Survivors?

    PubMed

    Kim, Min-Hee; Huh, Jin-Young; Lim, Dong-Jun; Kang, Moo-Il

    2017-07-01

    The steep rise in thyroid cancer observed in recent decades has caused an increase in the population of long-term thyroid cancer survivors. Other than recurrences of cancer, the long-term health consequences of surviving thyroid cancer, particularly metabolic syndrome, have not yet been determined. The aim of this study was to estimate the risk of metabolic syndrome in thyroid cancer survivors. Population-based data from the Korean National Health and Nutrition Examination Survey (KNHANES) were used for the analysis. The data of KNHANES IV-VI from 2007-2014 were obtained. After excluding subjects who were under 19 years old, whose fasting interval was less than 8 hours, and whose data for predefined variables including metabolic syndrome components were incomplete, 34,347 subjects were analyzed. The incidence of metabolic syndrome and its components were evaluated in three groups: subjects with no history of thyroid cancer, subjects diagnosed with thyroid cancer within 3 years of the survey date, and subjects diagnosed more than 3 years before the survey date. Thyroid cancer diagnoses were made within 3 years of the survey date for 95 subjects (group 1, short-term survivors) and more than 3 years earlier than the survey date for 60 subjects (group 2, long-term survivors). Metabolic syndrome was frequently observed with clinical significance (odds ratio [OR] 1.986 [95% confidence interval [CI] 1.0-3.70], p = 0.030) in short-term survivors compared with subjects with no thyroid cancer history. Risks for having high blood pressure and high fasting glucose were estimated to be higher in the short-term survivor group (OR 2.115 [CI 1.23-3.64], p = 0.006 and OR 1.792 [CI 1.03-3.11], p = 0.038, respectively). No significant associations were noticed in the long-term survivor group when compared with the group with no thyroid cancer history. Risks for metabolic syndrome, especially high blood pressure and high fasting glucose, were increased in short-term survivors of thyroid cancer but not in long-term survivors when compared with subjects with no history of thyroid cancer.

  9. Coral proxy record of decadal-scale reduction in base flow from Moloka'i, Hawaii

    USGS Publications Warehouse

    Prouty, Nancy G.; Jupiter, Stacy D.; Field, Michael E.; McCulloch, Malcolm T.

    2009-01-01

    Groundwater is a major resource in Hawaii and is the principal source of water for municipal, agricultural, and industrial use. With a growing population, a long-term downward trend in rainfall, and the need for proper groundwater management, a better understanding of the hydroclimatological system is essential. Proxy records from corals can supplement long-term observational networks, offering an accessible source of hydrologic and climate information. To develop a qualitative proxy for historic groundwater discharge to coastal waters, a suite of rare earth elements and yttrium (REYs) were analyzed from coral cores collected along the south shore of Moloka'i, Hawaii. The coral REY to calcium (Ca) ratios were evaluated against hydrological parameters, yielding the strongest relationship to base flow. Dissolution of REYs from labradorite and olivine in the basaltic rock aquifers is likely the primary source of coastal ocean REYs. There was a statistically significant downward trend (−40%) in subannually resolved REY/Ca ratios over the last century. This is consistent with long-term records of stream discharge from Moloka'i, which imply a downward trend in base flow since 1913. A decrease in base flow is observed statewide, consistent with the long-term downward trend in annual rainfall over much of the state. With greater demands on freshwater resources, it is appropriate for withdrawal scenarios to consider long-term trends and short-term climate variability. It is possible that coral paleohydrological records can be used to conduct model-data comparisons in groundwater flow models used to simulate changes in groundwater level and coastal discharge.

  10. Sardasht-Iran cohort study of chemical warfare victims: design and methods.

    PubMed

    Ghazanfari, Tooba; Faghihzadeh, Soghrat; Aragizadeh, Hassan; Soroush, Mohammad-Reza; Yaraee, Roya; Mohammad Hassan, Zuhair; Foroutan, Abbas; Vaez-Mahdavi, Mohammad-Reza; Javadi, Mohammad-Ali; Moaiedmohseni, Sakine; Azizi, Fereidoun; Panahi, Yunes; Mostafaie, Ali; Ghasemi, Hassan; Shams, Jalaleddin; Pourfarzam, Shahryar; Jalali-Nadoushan, Mohammad-Reza; Fallahi, Faramarz; Ebtekar, Massoumeh; Davoudi, Seyyed-Masoud; Ghazanfari, Zeinab; Ardestani, Sussan K; Shariat-Panahi, Shamsa; Moin, Athar; Rezaei, Abbas; Kariminia, Amina; Ajdary, Soheila; Mahmoudi, Mahmoud; Roshan, Rasoul; Ghaderi, Sulayman; Babai, Mahmoud; Naghizadeh, Mohammad-Mehdi; Ghanei, Mohammad-Mostafa

    2009-01-01

    Insights into long-term clinical consequences of sulfur mustard have emerged from some investigations but less is known about the basic and molecular mechanisms of these complications. Sardasht-Iran Cohort Study is a comprehensive historical cohort study on Sardasht chemical victims' population which was designed to find out the long-term complications of sulfur mustard exposure and the basic mechanisms underlying clinical manifestations. This paper describes the design and methodology of Sardasht-Iran Cohort Study. In Sardasht-Iran Cohort Study, 500 individuals including 372 subjects from Sardasht, as the exposed group, and 128 subjects from Rabat, as the unexposed age-matched control group were evaluated. The exposed group was divided into two groups based on the severity of clinical complications at the time of exposure. Different samples including blood, sputum, saliva, tear, urine, and semen were collected for immunologic, hematologic, biochemical, and other laboratory analysis. Data were gathered from medical records, clinical examinations, laboratory tests, and questionnaires for psychological and lifestyle situations. The important distinctions setting this study apart from the previous ones are discussed. The Sardasht-Iran Cohort Study provides important information on various aspects of long-term consequences of sulfur mustard exposure. This database will provide a better position to suggest guidelines for the diagnosis, treatment, and prevention of delayed complications in the patients exposed to sulfur mustard.

  11. Ark and Archive: Making a Place for Long-Term Research on Barro Colorado Island, Panama.

    PubMed

    Raby, Megan

    2015-12-01

    Barro Colorado Island (BCI), Panama, may be the most studied tropical forest in the world. A 1,560-hectare island created by the flooding of the Panama Canal, BCI became a nature reserve and biological research station in 1923. Contemporaries saw the island as an "ark" preserving a sample of primeval tropical nature for scientific study. BCI was not simply "set aside," however. The project of making it a place for science significantly reshaped the island through the twentieth century. This essay demonstrates that BCI was constructed specifically to allow long-term observation of tropical organisms--their complex behaviors, life histories, population dynamics, and changing species composition. An evolving system of monitoring and information technology transformed the island into a living scientific "archive," in which the landscape became both an object and a repository of scientific knowledge. As a research site, BCI enabled a long-term, place-based form of collective empiricism, focused on the study of the ecology of a single tropical island. This essay articulates tropical ecology as a "science of the archive" in order to examine the origins of practices of environmental surveillance that have become central to debates about global change and conservation.

  12. Clostridium difficile in the Long-Term Care Facility: Prevention and Management

    PubMed Central

    Jump, Robin L. P.; Donskey, Curtis J.

    2014-01-01

    Residents of long-term care facilities are at high risk for Clostridium difficile infection due to frequent antibiotic exposure in a population already rendered vulnerable to infection due to advanced age, multiple comorbid conditions and communal living conditions. Moreover, asymptomatic carriage of toxigenic C. difficile and recurrent infections are prevalent in this population. Here, we discuss epidemiology and management of C. difficile infection among residents of long-term care facilities. Also, recognizing that both the population and culture differs significantly from that of hospitals, we also address prevention strategies specific to LTCFs. PMID:25685657

  13. Pain and mean absorbed dose to the pubic bone after radiotherapy among gynecological cancer survivors.

    PubMed

    Waldenström, Ann-Charlotte; Olsson, Caroline; Wilderäng, Ulrica; Dunberger, Gail; Lind, Helena; al-Abany, Massoud; Palm, Åsa; Avall-Lundqvist, Elisabeth; Johansson, Karl-Axel; Steineck, Gunnar

    2011-07-15

    To analyze the relationship between mean absorbed dose to the pubic bone after pelvic radiotherapy for gynecological cancer and occurrence of pubic bone pain among long-term survivors. In an unselected, population-based study, we identified 823 long-term gynecological cancer survivors treated with pelvic radiotherapy during 1991-2003. For comparison, we used a non-radiation-treated control population of 478 matched women from the Swedish Population Register. Pain, intensity of pain, and functional impairment due to pain in the pubic bone were assessed with a study-specific postal questionnaire. We analyzed data from 650 survivors (participation rate 79%) with median follow-up of 6.3 years (range, 2.3-15.0 years) along with 344 control women (participation rate, 72 %). Ten percent of the survivors were treated with radiotherapy; ninety percent with surgery plus radiotherapy. Brachytherapy was added in 81%. Complete treatment records were recovered for 538/650 survivors, with dose distribution data including dose-volume histograms over the pubic bone. Pubic bone pain was reported by 73 survivors (11%); 59/517 (11%) had been exposed to mean absorbed external beam doses <52.5 Gy to the pubic bone and 5/12 (42%) to mean absorbed external beam doses ≥ 52.5 Gy. Thirty-three survivors reported pain affecting sleep, a 13-fold increased prevalence compared with control women. Forty-nine survivors reported functional impairment measured as pain walking indoors, a 10-fold increased prevalence. Mean absorbed external beam dose above 52.5 Gy to the pubic bone increases the occurrence of pain in the pubic bone and may affect daily life of long-term survivors treated with radiotherapy for gynecological cancer. Copyright © 2011 Elsevier Inc. All rights reserved.

  14. Pain and Mean Absorbed Dose to the Pubic Bone After Radiotherapy Among Gynecological Cancer Survivors

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

    Waldenstroem, Ann-Charlotte, E-mail: ann-charlotte.waldenstrom@oncology.gu.se; Department of Oncology, Sahlgrenska University Hospital, Gothenburg; Olsson, Caroline

    Purpose: To analyze the relationship between mean absorbed dose to the pubic bone after pelvic radiotherapy for gynecological cancer and occurrence of pubic bone pain among long-term survivors. Methods and Materials: In an unselected, population-based study, we identified 823 long-term gynecological cancer survivors treated with pelvic radiotherapy during 1991-2003. For comparison, we used a non-radiation-treated control population of 478 matched women from the Swedish Population Register. Pain, intensity of pain, and functional impairment due to pain in the pubic bone were assessed with a study-specific postal questionnaire. Results: We analyzed data from 650 survivors (participation rate 79%) with median follow-upmore » of 6.3 years (range, 2.3-15.0 years) along with 344 control women (participation rate, 72 %). Ten percent of the survivors were treated with radiotherapy; ninety percent with surgery plus radiotherapy. Brachytherapy was added in 81%. Complete treatment records were recovered for 538/650 survivors, with dose distribution data including dose-volume histograms over the pubic bone. Pubic bone pain was reported by 73 survivors (11%); 59/517 (11%) had been exposed to mean absorbed external beam doses <52.5 Gy to the pubic bone and 5/12 (42%) to mean absorbed external beam doses {>=}52.5 Gy. Thirty-three survivors reported pain affecting sleep, a 13-fold increased prevalence compared with control women. Forty-nine survivors reported functional impairment measured as pain walking indoors, a 10-fold increased prevalence. Conclusions: Mean absorbed external beam dose above 52.5 Gy to the pubic bone increases the occurrence of pain in the pubic bone and may affect daily life of long-term survivors treated with radiotherapy for gynecological cancer.« less

  15. POPULATION DYNAMICS OF AMBIENT AND ALTERED EARTHWORM COMMUNITIES IN ROW-CROP AGROECOSYSTEMS IN OHIO, USA

    EPA Science Inventory

    Although earthworms are known to influence agroecosystem processes, there are relatively few long-term studies addressing population dynamics under cropping systems in which earthworm populations were intentionally altered. We assessed earthworm communities from fall 1994 to spr...

  16. Prospective memory deficits in illicit polydrug users are associated with the average long-term typical dose of ecstasy typically consumed in a single session.

    PubMed

    Gallagher, Denis T; Hadjiefthyvoulou, Florentia; Fisk, John E; Montgomery, Catharine; Robinson, Sarita J; Judge, Jeannie

    2014-01-01

    Neuroimaging evidence suggests that ecstasy-related reductions in SERT densities relate more closely to the number of tablets typically consumed per session rather than estimated total lifetime use. To better understand the basis of drug related deficits in prospective memory (p.m.) we explored the association between p.m. and average long-term typical dose and long-term frequency of use. Study 1: Sixty-five ecstasy/polydrug users and 85 nonecstasy users completed an event-based, a short-term and a long-term time-based p.m. task. Study 2: Study 1 data were merged with outcomes on the same p.m. measures from a previous study creating a combined sample of 103 ecstasy/polydrug users, 38 cannabis-only users, and 65 nonusers of illicit drugs. Study 1: Ecstasy/polydrug users had significant impairments on all p.m. outcomes compared with nonecstasy users. Study 2: Ecstasy/polydrug users were impaired in event-based p.m. compared with both other groups and in long-term time-based p.m. compared with nonillicit drug users. Both drug using groups did worse on the short-term time-based p.m. task compared with nonusers. Higher long-term average typical dose of ecstasy was associated with poorer performance on the event and short-term time-based p.m. tasks and accounted for unique variance in the two p.m. measures over and above the variance associated with cannabis and cocaine use. The typical ecstasy dose consumed in a single session is an important predictor of p.m. impairments with higher doses reflecting increasing tolerance giving rise to greater p.m. impairment.

  17. Long-term follow-up observation of the safety, immunogenicity, and effectiveness of Gardasil™ in adult women.

    PubMed

    Luna, Joaquin; Plata, Manuel; Gonzalez, Mauricio; Correa, Alfonso; Maldonado, Ivete; Nossa, Claudia; Radley, David; Vuocolo, Scott; Haupt, Richard M; Saah, Alfred

    2013-01-01

    Previous analyses from a randomized trial in women aged 24-45 have shown the quadrivalent HPV vaccine to be efficacious in the prevention of infection, cervical intraepithelial neoplasia (CIN) and external genital lesions (EGL) related to HPV 6/11/16/18 through 4 years. In this report we present long term follow-up data on the efficacy, safety and immunogenicity of the quadrivalent HPV vaccine in adult women. Follow-up data are from a study being conducted in 5 sites in Colombia designed to evaluate the long-term immunogenicity, effectiveness, and safety of the qHPV vaccine in women who were vaccinated at 24 to 45 years of age (in the original vaccine group during the base study [n = 684]) or 29 to 50 years of age (in the original placebo group during the base study [n = 651]). This analysis summarizes data collected as of the year 6 post-vaccination visit relative to day 1 of the base study (median follow-up of 6.26 years) from both the original base study and the Colombian follow-up. There were no cases of HPV 6/11/16/18-related CIN or EGL during the extended follow-up phase in the per-protocol population. Immunogenicity persists against vaccine-related HPV types, and no evidence of HPV type replacement has been observed. No new serious adverse experiences have been reported. Vaccination with qHPV vaccine provides generally safe and effective protection from HPV 6-, 11-, 16-, and 18-related genital warts and cervical dysplasia through 6 years following administration to 24-45 year-old women. Clinicaltrials.govNCT00090220.

  18. Long-Term Follow-up Observation of the Safety, Immunogenicity, and Effectiveness of Gardasil™ in Adult Women

    PubMed Central

    Luna, Joaquin; Plata, Manuel; Gonzalez, Mauricio; Correa, Alfonso; Maldonado, Ivete; Nossa, Claudia; Radley, David; Vuocolo, Scott; Haupt, Richard M.; Saah, Alfred

    2013-01-01

    Background Previous analyses from a randomized trial in women aged 24–45 have shown the quadrivalent HPV vaccine to be efficacious in the prevention of infection, cervical intraepithelial neoplasia (CIN) and external genital lesions (EGL) related to HPV 6/11/16/18 through 4 years. In this report we present long term follow-up data on the efficacy, safety and immunogenicity of the quadrivalent HPV vaccine in adult women. Methods Follow-up data are from a study being conducted in 5 sites in Colombia designed to evaluate the long-term immunogenicity, effectiveness, and safety of the qHPV vaccine in women who were vaccinated at 24 to 45 years of age (in the original vaccine group during the base study [n = 684]) or 29 to 50 years of age (in the original placebo group during the base study [n = 651]). This analysis summarizes data collected as of the year 6 post-vaccination visit relative to day 1 of the base study (median follow-up of 6.26 years) from both the original base study and the Colombian follow-up. Results There were no cases of HPV 6/11/16/18-related CIN or EGL during the extended follow-up phase in the per-protocol population. Immunogenicity persists against vaccine-related HPV types, and no evidence of HPV type replacement has been observed. No new serious adverse experiences have been reported. Conclusions Vaccination with qHPV vaccine provides generally safe and effective protection from HPV 6-, 11-, 16-, and 18-related genital warts and cervical dysplasia through 6 years following administration to 24–45 year-old women. Trial Registration Clinicaltrials.gov NCT00090220 PMID:24391768

  19. Association between use of contraband tobacco and smoking cessation outcomes: a population-based cohort study

    PubMed Central

    Mecredy, Graham C.; Diemert, Lori M.; Callaghan, Russell C.; Cohen, Joanna E.

    2013-01-01

    Background: High tobacco prices, typically achieved through taxation, are an evidence-based strategy to reduce tobacco use. However, the presence of inexpensive contraband tobacco could undermine this effective intervention by providing an accessible alternative to quitting. We assessed whether the use of contraband tobacco negatively affects smoking cessation outcomes. Methods: We evaluated data from 2786 people who smoked, aged 18 years or older, who participated in the population-based longitudinal Ontario Tobacco Survey. We analyzed associations between use of contraband tobacco and smoking cessation outcomes (attempting to quit, 30-d cessation and long-term cessation at 1 yr follow-up). Results: Compared with people who smoked premium or discount cigarettes, people who reported usually smoking contraband cigarettes at baseline were heavier smokers, perceived greater addiction, identified more barriers to quitting and were more likely to have used pharmacotherapy for smoking cessation. People who smoked contraband cigarettes were less likely to report a period of 30-day cessation during the subsequent 6 months (adjusted relative risk [RR] 0.23, 95% confidence interval [CI] 0.09–0.61) and 1 year (adjusted RR 0.30, 95% CI 0.14–0.61), but they did not differ significantly from other people who smoked regarding attempts to quit (at 6 mo, adjusted RR 0.74, 95% CI 0.43–1.20) or long-term cessation (adjusted RR 0.24, 95% CI 0.04–1.34). Interpretation: Smoking contraband cigarettes was negatively associated with short-term smoking cessation. Access to contraband tobacco may therefore undermine public health efforts to reduce the use of tobacco at the population level. PMID:23460630

  20. A Population-Based Study of Long-term Outcomes of Cryptogenic Focal Epilepsy in Childhood: Cryptogenic Epilepsy is NOT Probably Symptomatic Epilepsy

    PubMed Central

    Wirrell, Elaine C; Grossardt, Brandon R; So, Elson L; Nickels, Katherine C

    2011-01-01

    Purpose To compare long-term outcome in a population-based group of children with cryptogenic vs symptomatic focal epilepsy diagnosed from 1980–2004 and to define the course of epilepsy in the cryptogenic group. Methods We identified all children residing in Olmsted County, MN, 1 month through 17 years with newly diagnosed, non-idiopathic focal epilepsy from 1980–2004. Children with idiopathic partial epilepsy syndromes were excluded. Medical records were reviewed to determine etiology, results of imaging and EEG studies, treatments used, and long-term outcome. Children were defined as having symptomatic epilepsy if they had a known genetic or structural/metabolic etiology, and as cryptogenic if they did not. Key Findings Of 359 children with newly-diagnosed epilepsy, 215 (60%) had non-idiopathic focal epilepsy. Of these, 206 (96%) were followed for more than 12 months. Ninety five children (46%) were classified as symptomatic. Median follow-up from diagnosis was similar in both groups, being 157 months (25%ile, 75%ile 89, 233) in the cryptogenic group vs 134 months (25%ile, 75%ile 78, 220) in the symptomatic group (p=0.26). Of 111 cryptogenic cases, 66% had normal cognition. Long-term outcome was significantly better in those with cryptogenic vs symptomatic etiology (intractable epilepsy at last follow-up, 7% vs 40%, p<0.001; seizure-freedom at last follow-up, 81% vs 55%, p<0.001). Of those who achieved seizure-freedom at final follow-up, 68% of the cryptogenic group versus only 46% of the symptomatic group were off antiepileptic medications (p=0.01). One third of the cryptogenic group had a remarkably benign disorder, with no seizures seen after initiation of medication, or in those who were untreated, after the second afebrile seizure. A further 5% had seizures within the first year but remained seizure-free thereafter. With the exception of perinatal complications, which predicted against seizure remission, no other factors were found to significantly predict outcome in the cryptogenic group. Significance More than half of childhood non-idiopathic localization-related epilepsy is cryptogenic. This group has a significantly better long-term outcome than those with a symptomatic etiology, and should be distinguished from it. PMID:21320114

  1. Matchmaker, Matchmaker, Make Me a Match: Migration of Populations via Marriages in the Past

    NASA Astrophysics Data System (ADS)

    Lee, Sang Hoon; Ffrancon, Robyn; Abrams, Daniel M.; Kim, Beom Jun; Porter, Mason A.

    2014-10-01

    The study of human mobility is both of fundamental importance and of great potential value. For example, it can be leveraged to facilitate efficient city planning and improve prevention strategies when faced with epidemics. The newfound wealth of rich sources of data—including banknote flows, mobile phone records, and transportation data—has led to an explosion of attempts to characterize modern human mobility. Unfortunately, the dearth of comparable historical data makes it much more difficult to study human mobility patterns from the past. In this paper, we present an analysis of long-term human migration, which is important for processes such as urbanization and the spread of ideas. We demonstrate that the data record from Korean family books (called "jokbo") can be used to estimate migration patterns via marriages from the past 750 years. We apply two generative models of long-term human mobility to quantify the relevance of geographical information to human marriage records in the data, and we find that the wide variety in the geographical distributions of the clans poses interesting challenges for the direct application of these models. Using the different geographical distributions of clans, we quantify the "ergodicity" of clans in terms of how widely and uniformly they have spread across Korea, and we compare these results to those obtained using surname data from the Czech Republic. To examine population flow in more detail, we also construct and examine a population-flow network between regions. Based on the correlation between ergodicity and migration in Korea, we identify two different types of migration patterns: diffusive and convective. We expect the analysis of diffusive versus convective effects in population flows to be widely applicable to the study of mobility and migration patterns across different cultures.

  2. KIR and HLA-C Interactions Promote Differential Dendritic Cell Maturation and Is a Major Determinant of Graft Failure following Kidney Transplantation

    PubMed Central

    Hanvesakul, Raj; Kubal, Chandrashekhar; Moore, Jason; Neil, Desley; Cook, Mark; Ball, Simon; Briggs, David; Moss, Paul; Cockwell, Paul

    2011-01-01

    Background HLA-C is an important ligand for killer immunoglobulin like receptors (KIR) that regulate natural killer (NK) cell function. Based on KIR specificity HLA-C molecules are allocated into two groups, HLA-C1 or HLA-C2; HLA-C2 is more inhibiting to NK cell function than HLA-C1. We studied the clinical importance of HLA-C genotypes on the long-term graft survival of 760 kidney transplants performed at our centre utilising a population based genetic study and cell culture model to define putative mechanisms. Methods and Findings Genotyping was performed using conventional DNA PCR techniques and correlations made to clinical outcomes. We found that transplant recipients with HLA-C2 had significantly better long-term graft survival than transplant recipients with HLA-C1 (66% versus 44% at 10 years, log-rank p = 0.002, HR = 1.51, 95%CI = 1.16–1.97). In in-vitro NK and dendritic cell (DC) co-culture model we made several key observations that correlated with the population based genetic study. We observed that donor derived NK cells, on activation with IL-15, promoted differential HLA-C genotype dependent DC maturation. In NK-DC co-culture, the possession of HLA-C2 by DC was associated with anti-inflammatory cytokine production (IL-1RA/IL-6), diminished DC maturation (CD86, HLA-DR), and absent CCR7 expression. Conversely, possession of HLA-C1 by DC was associated with pro-inflammatory cytokine synthesis (TNF-α, IL-12p40/p70), enhanced DC maturation and up-regulation of CCR7 expression. By immunohistochemistry the presence of donor NK cells was confirmed in pre-transplant kidneys. Conclusions We propose that after kidney transplantation IL-15 activated donor derived NK cells interact with recipient DC with less activation of indirect allo-reactivity in HLA-C2 positive recipients than HLA-C1 positive recipients; this has implications for long-term graft survival. Early events following kidney transplantation involving NK-DC interaction via KIR and HLA-C immune synapse may have a central role in long-term kidney transplant outcomes. PMID:21912600

  3. The potential of disease management for neuromuscular hereditary disorders.

    PubMed

    Chouinard, Maud-Christine; Gagnon, Cynthia; Laberge, Luc; Tremblay, Carmen; Côté, Charlotte; Leclerc, Nadine; Mathieu, Jean

    2009-01-01

    Neuromuscular hereditary disorders require long-term multidisciplinary rehabilitation management. Although the need for coordinated healthcare management has long been recognized, most neuromuscular disorders are still lacking clinical guidelines about their long-term management and structured evaluation plan with associated services. One of the most prevalent adult-onset neuromuscular disorders, myotonic dystrophy type 1, generally presents several comorbidities and a variable clinical picture, making management a constant challenge. This article presents a healthcare follow-up plan and proposes a nursing case management within a disease management program as an innovative and promising approach. This disease management program and model consists of eight components including population identification processes, evidence-based practice guidelines, collaborative practice, patient self-management education, and process outcomes evaluation (Disease Management Association of America, 2004). It is believed to have the potential to significantly improve healthcare management for neuromuscular hereditary disorders and will prove useful to nurses delivering and organizing services for this population.

  4. Long-term intake of nuts in relation to cognitive function in older women.

    PubMed

    O'Brien, J; Okereke, O; Devore, E; Rosner, B; Breteler, M; Grodstein, F

    2014-05-01

    Nuts contain nutrients that may benefit brain health; thus, we examined long-term intake of nuts in relation to cognition in older women. Population-based prospective cohort study. Academic research using data from the Nurses' Health Study. Nut intake was assessed in a food-frequency questionnaire beginning in1980, and approximately every four years thereafter. Between 1995-2001, 16,010 women age 70 or older (mean age = 74 years) without a history of stroke were administered 4 repeated telephone-based cognitive interviews over 6 years. Our final sample included 15,467 women who completed an initial cognitive interview and had complete information on nut intake. The Telephone Interview for Cognitive Status (TICS), a global score averaging the results of all tests (TICS, immediate and delayed verbal recall, category fluency, and attention), and a verbal memory score averaging the results of tests of verbal recall. In multivariable-adjusted linear regression models, higher long-term total nut intake was associated with better average cognitive status for all cognitive outcomes. For the global composite score combining all tests, women consuming at least 5 servings of nuts/week had higher scores than non-consumers (mean difference=0.08 standard units, 95% confidence interval 0.00-0.15; p-trend=0.003). This mean difference of 0.08 is equivalent to the mean difference we find between women 2 years apart in age. Long-term intake of nuts was not associated with rates of cognitive decline. Higher nut intake may be related to better overall cognition at older ages, and could be an easily-modifiable public health intervention.

  5. Advancing the long view of ecological change in tundra systems

    PubMed Central

    Post, Eric; Høye, Toke T.

    2013-01-01

    Despite uncertainties related to sustained funding, ideological rivalries and the turnover of research personnel, long-term studies and studies espousing a long-term perspective in ecology have a history of contributing landmark insights into fundamental topics, such as population- and community dynamics, species interactions and ecosystem function. They also have the potential to reveal surprises related to unforeseen events and non-stationary dynamics that unfold over the course of ongoing observation and experimentation. The unprecedented rate and magnitude of current and expected abiotic changes in tundra environments calls for a synthetic overview of the scope of ecological responses these changes have elicited. In this special issue, we present a series of contributions that advance the long view of ecological change in tundra systems, either through sustained long-term research, or through retrospective or prospective modelling. Beyond highlighting the value of long-term research in tundra systems, the insights derived herein should also find application to the study of ecological responses to environmental change in other biomes as well. PMID:23836784

  6. Advancing the long view of ecological change in tundra systems. Introduction.

    PubMed

    Post, Eric; Høye, Toke T

    2013-08-19

    Despite uncertainties related to sustained funding, ideological rivalries and the turnover of research personnel, long-term studies and studies espousing a long-term perspective in ecology have a history of contributing landmark insights into fundamental topics, such as population- and community dynamics, species interactions and ecosystem function. They also have the potential to reveal surprises related to unforeseen events and non-stationary dynamics that unfold over the course of ongoing observation and experimentation. The unprecedented rate and magnitude of current and expected abiotic changes in tundra environments calls for a synthetic overview of the scope of ecological responses these changes have elicited. In this special issue, we present a series of contributions that advance the long view of ecological change in tundra systems, either through sustained long-term research, or through retrospective or prospective modelling. Beyond highlighting the value of long-term research in tundra systems, the insights derived herein should also find application to the study of ecological responses to environmental change in other biomes as well.

  7. The Association between Natural Amenities, Rural Population Growth, and Long-Term Residents' Economic Well-Being

    ERIC Educational Resources Information Center

    Hunter, Lori M; Boardman, Jason D.; Saint Onge, Jarron M.

    2005-01-01

    Population growth in rural areas characterized by high levels of natural amenities has recently received substantial research attention. A noted concern with amenity-driven rural population growth is its potential to raise local costs-of-living while yielding only low-wage service sector employment for long-term residents. The work presented here…

  8. Reflections on psychoanalytic treatment of Lubavitch Chassidim couples: working with a culturally divergent population.

    PubMed

    Schulman, Martin A; Kaplan, Ricki S

    2014-08-01

    Chassidic Jews create separate developmental lines for males and females beginning at three years of age. Since early marriages are encouraged and there is minimal contact between the sexes prior to marriage, problems inevitably arise in relationships. This article discusses both newlywed and long-term married Lubavitch Chassidim in couples treatment with secular analysts, parameters necessary for successful treatment, and countertransferences that arise. It is part of an ongoing series of publications based on the authors' decade-long psychoanalytic work with this population.

  9. Female-Bias in a Long-Term Study of a Species with Temperature-Dependent Sex Determination: Monitoring Sex Ratios for Climate Change Research

    PubMed Central

    Braun McNeill, Joanne; Avens, Larisa; Goodman Hall, April; Goshe, Lisa R.; Harms, Craig A.; Owens, David W.

    2016-01-01

    Alterations have occurred and continue to manifest in the Earth’s biota as a result of climate change. Animals exhibiting temperature dependent sex determination (TSD), including sea turtles, are perhaps most vulnerable to a warming of the Earth as highly skewed sex ratios can result, potentially leading to population extinction resulting from decreased male recruitment. Recent studies have begun to quantify climate change impacts to sea turtle populations, especially in terms of predicting effects on hatchling sex ratios. However, given the inherent difficulty in studying sex ratios at this life stage, a more accurate assessment of changes in population sex ratios might be derived by evaluating the juvenile portion of foraging aggregations. We investigated the long-term trend in sex ratio of a juvenile loggerhead (Caretta caretta) sea turtle population inhabiting Pamlico and Core Sounds, North Carolina, USA. We used plasma testosterone reference ranges measured using radioimmunoassay (RIA) to assign sex for 959 turtles and confirmed sex assignment of a subset (N = 58) of the sampled turtles through laparoscopic examination of their gonads. Our results demonstrate that for this particular population of loggerheads, sex ratios (3Females:1Male) had not significantly changed over a 10 year period (1998–2007), nor showed any significant difference among 5-cm straight carapace length (SCL) size classes. Ultimately, these findings provide a basis for comparison with future sex ratios, and highlight the importance of establishing similar long-term studies monitoring secondary, rather than primary, sex ratios, so that needed mitigation measures to climate change impacts can be implemented. PMID:27579608

  10. Testing predictions of forest succession using long-term measurements: 100 yrs of observations in the Oregon Cascades

    Treesearch

    Mark E. Harmon; Robert J. Pabst

    2015-01-01

    Question: Many predictions about forest succession have been based on chronosequences. Are these predictions – at the population, community and ecosystemlevel – consistent with long-termmeasurements in permanent plots? Location: Pseudotsuga menziesii (Mirb.) Franco dominated forest in western Oregon, US.Methods: Over a 100-yr period,...

  11. School Dropout Prevention: What Arts-Based Community and Out-of-School-Time Programs Can Contribute

    ERIC Educational Resources Information Center

    Charmaraman, Linda; Hall, Georgia

    2011-01-01

    Out-of-school-time programs, especially arts-based programs, can be critical players in a community's efforts to prevent school dropout. This research review suggests the following approaches for arts-based programs: (1) recruitment and retention of target populations with multiple risk factors; (2) long-term skill development that engages youth…

  12. Long-term memory for verbal and visual information in Down syndrome and Williams syndrome: performance on the Doors and People test.

    PubMed

    Jarrold, Christopher; Baddeley, Alan D; Phillips, Caroline

    2007-02-01

    Previous studies have suggested that Williams syndrome and Down syndrome may be associated with specific short-term memory deficits. Individuals with Williams syndrome perform relatively poorly on tests of visuo-spatial short-term memory and individuals with Down syndrome show a relative deficit on verbal short-term memory tasks. However, these patterns of impairments may reflect the impact of generally impaired visuo-spatial processing skills in Williams syndrome, and verbal abilities in Down syndrome. The current study explored this possibility by assessing long-term memory among 15 individuals with Williams syndrome and 20 individuals with Down syndrome using the Doors and People test, a battery which assesses recall and recognition of verbal and visual information. Individuals' performance was standardised for age and level of intellectual ability with reference to that shown by a sample of 110 typically developing children. The results showed that individuals with Down syndrome have no differential deficits in long-term memory for verbal information, implying that verbal short-term memory deficits in this population are relatively selective. Instead both individuals with Down syndrome and with Williams syndrome showed some evidence of relatively poor performance on tests of long-term memory for visual information. It is therefore possible that visuo-spatial short-term memory deficits that have previously been demonstrated in Williams syndrome may be secondary to more general problems in visuo-spatial processing in this population.

  13. Range position and climate sensitivity: The structure of among-population demographic responses to climatic variation

    USGS Publications Warehouse

    Amburgey, Staci M.; Miller, David A. W.; Grant, Evan H. Campbell; Rittenhouse, Tracy A. G.; Benard, Michael F.; Richardson, Jonathan L.; Urban, Mark C.; Hughson, Ward; Brand, Adrianne B,; Davis, Christopher J.; Hardin, Carmen R.; Paton, Peter W. C.; Raithel, Christopher J.; Relyea, Rick A.; Scott, A. Floyd; Skelly, David K.; Skidds, Dennis E.; Smith, Charles K.; Werner, Earl E.

    2018-01-01

    Species’ distributions will respond to climate change based on the relationship between local demographic processes and climate and how this relationship varies based on range position. A rarely tested demographic prediction is that populations at the extremes of a species’ climate envelope (e.g., populations in areas with the highest mean annual temperature) will be most sensitive to local shifts in climate (i.e., warming). We tested this prediction using a dynamic species distribution model linking demographic rates to variation in temperature and precipitation for wood frogs (Lithobates sylvaticus) in North America. Using long-term monitoring data from 746 populations in 27 study areas, we determined how climatic variation affected population growth rates and how these relationships varied with respect to long-term climate. Some models supported the predicted pattern, with negative effects of extreme summer temperatures in hotter areas and positive effects on recruitment for summer water availability in drier areas. We also found evidence of interacting temperature and precipitation influencing population size, such as extreme heat having less of a negative effect in wetter areas. Other results were contrary to predictions, such as positive effects of summer water availability in wetter parts of the range and positive responses to winter warming especially in milder areas. In general, we found wood frogs were more sensitive to changes in temperature or temperature interacting with precipitation than to changes in precipitation alone. Our results suggest that sensitivity to changes in climate cannot be predicted simply by knowing locations within the species’ climate envelope. Many climate processes did not affect population growth rates in the predicted direction based on range position. Processes such as species-interactions, local adaptation, and interactions with the physical landscape likely affect the responses we observed. Our work highlights the need to measure demographic responses to changing climate.

  14. Long-term mortality and causes of death associated with Staphylococcus aureus bacteremia. A matched cohort study.

    PubMed

    Gotland, N; Uhre, M L; Mejer, N; Skov, R; Petersen, A; Larsen, A R; Benfield, T

    2016-10-01

    Data describing long-term mortality in patients with Staphylococcus aureus bacteremia (SAB) is scarce. This study investigated risk factors, causes of death and temporal trends in long-term mortality associated with SAB. Nationwide population-based matched cohort study. Mortality rates and ratios for 25,855 cases and 258,547 controls were analyzed by Poisson regression. Hazard ratio of death was computed by Cox proportional hazards regression analysis. The majority of deaths occurred within the first year of SAB (44.6%) and a further 15% occurred within the following 2-5 years. The mortality rate was 14-fold higher in the first year after SAB and 4.5-fold higher overall for cases compared to controls. Increasing age, comorbidity and hospital contact within 90 days of SAB was associated with an increased risk of death. The overall relative risk of death decreased gradually by 38% from 1992-1995 to 2012-2014. Compared to controls, SAB patients were more likely to die from congenital malformation, musculoskeletal/skin disease, digestive system disease, genitourinary disease, infectious disease, endocrine disease, injury and cancer and less likely to die from respiratory disease, nervous system disease, unknown causes, psychiatric disorders, cardiovascular disease and senility. Over time, rates of death decreased or were stable for all disease categories except for musculoskeletal and skin disease where a trend towards an increase was seen. Long-term mortality after SAB was high but decreased over time. SAB cases were more likely to die of eight specific causes of death and less likely to die of five other causes of death compared to controls. Causes of death decreased for most disease categories. Risk factors associated with long-term mortality were similar to those found for short-term mortality. To improve long-term survival after SAB, patients should be screened for comorbidity associated with SAB. Copyright © 2016 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

  15. Long-term persistence, density dependence and effects of climate change on rosyside dace (Cyprinidae)

    Treesearch

    Gary D. Grossman; Gary Sundin; Robert E. Ratajczak

    2016-01-01

    SummaryWe used long-term population data for rosyside dace (Clinostomus funduloides), a numerically dominant member of a stochastically organised fish assemblage, to evaluate the relative importance of density-dependent and density-independent processes to population...

  16. High polymorphism in MHC-DRB genes in golden snub-nosed monkeys reveals balancing selection in small, isolated populations.

    PubMed

    Zhang, Pei; Huang, Kang; Zhang, Bingyi; Dunn, Derek W; Chen, Dan; Li, Fan; Qi, Xiaoguang; Guo, Songtao; Li, Baoguo

    2018-03-13

    Maintaining variation in immune genes, such as those of the major histocompatibility complex (MHC), is important for individuals in small, isolated populations to resist pathogens and parasites. The golden snub-nosed monkey (Rhinopithecus roxellana), an endangered primate endemic to China, has experienced a rapid reduction in numbers and severe population fragmentation over recent years. For this study, we measured the DRB diversity among 122 monkeys from three populations in the Qinling Mountains, and estimated the relative importance of different agents of selection in maintaining variation of DRB genes. We identified a total of 19 DRB sequences, in which five alleles were novel. We found high DRB variation in R. roxellana and three branches of evidence suggesting that balancing selection has contributed to maintaining MHC polymorphism over the long term in this species: i) different patterns of both genetic diversity and population differentiation were detected at MHC and neutral markers; ii) an excess of non-synonymous substitutions compared to synonymous substitutions at antigen binding sites, and maximum-likelihood-based random-site models, showed significant positive selection; and iii) phylogenetic analyses revealed a pattern of trans-species evolution for DRB genes. High levels of DRB diversity in these R. roxellana populations may reflect strong selection pressure in this species. Patterns of genetic diversity and population differentiation, positive selection, as well as trans-species evolution, suggest that pathogen-mediated balancing selection has contributed to maintaining MHC polymorphism in R. roxellana over the long term. This study furthers our understanding of the role pathogen-mediated balancing selection has in maintaining variation in MHC genes in small and fragmented populations of free-ranging vertebrates.

  17. A neurovascular perspective for long-term changes after brain trauma.

    PubMed

    Pop, V; Badaut, J

    2011-12-01

    Traumatic brain injury (TBI) affects all age groups in a population and is an injury generating scientific interest not only as an acute event, but also as a complex brain disease with several underlying neurobehavioral and neuropathological characteristics. We review early and long-term alterations after juvenile and adult TBI with a focus on changes in the neurovascular unit (NVU), including neuronal interactions with glia and blood vessels at the blood-brain barrier (BBB). Post-traumatic changes in cerebral blood-flow, BBB structures and function, as well as mechanistic pathways associated with brain aging and neurodegeneration are presented from clinical and experimental reports. Based on the literature, increased attention on BBB changes should be integrated in studies characterizing TBI outcome and may provide a meaningful therapeutic target to resolve detrimental post-traumatic dysfunction.

  18. Spatial and temporal dynamics of fucoid populations (Ascophyllum nodosum and Fucus serratus): a comparison between central and range edge populations.

    PubMed

    Araújo, Rita M; Serrão, Ester A; Sousa-Pinto, Isabel; Åberg, Per

    2014-01-01

    Persistence of populations at range edges relies on local population dynamics and fitness, in the case of geographically isolated populations of species with low dispersal potential. Focusing on spatial variations in demography helps to predict the long-term capability for persistence of populations across the geographical range of species' distribution. The demography of two ecological and phylogenetically close macroalgal species with different life history characteristics was investigated by using stochastic, stage-based matrix models. Populations of Ascophyllum nodosum and Fucus serratus were sampled for up to 4 years at central locations in France and at their southern range limits in Portugal. The stochastic population growth rate (λ(s)) of A. nodosum was lower and more variable in central than in southern sites whilst for F. serratus this trend was reversed with λ(s) much lower and more variable in southern than in central populations. Individuals were larger in central than in southern populations for both species, which was reflected in the lower transition probabilities of individuals to larger size classes and higher probability of shrinkage in the southern populations. In both central and southern populations elasticity analysis (proportional sensitivity) of population growth rate showed that fertility elements had a small contribution to λ(s) that was more sensitive to changes in matrix transitions corresponding to survival. The highest elasticities were found for loop transitions in A. nodosum and for growth to larger size classes in F. serratus. Sensitivity analysis showed high selective pressure on individual growth for both species at both locations. The results of this study highlight the deterministic role of species-specific life-history traits in population demography across the geographical range of species. Additionally, this study demonstrates that individuals' life-transitions differ in vulnerability to environmental variability and shows the importance of vegetative compared to reproductive stages for the long-term persistence of populations.

  19. Bayesian Modeling of Prion Disease Dynamics in Mule Deer Using Population Monitoring and Capture-Recapture Data

    PubMed Central

    Geremia, Chris; Miller, Michael W.; Hoeting, Jennifer A.; Antolin, Michael F.; Hobbs, N. Thompson

    2015-01-01

    Epidemics of chronic wasting disease (CWD) of North American Cervidae have potential to harm ecosystems and economies. We studied a migratory population of mule deer (Odocoileus hemionus) affected by CWD for at least three decades using a Bayesian framework to integrate matrix population and disease models with long-term monitoring data and detailed process-level studies. We hypothesized CWD prevalence would be stable or increase between two observation periods during the late 1990s and after 2010, with higher CWD prevalence making deer population decline more likely. The weight of evidence suggested a reduction in the CWD outbreak over time, perhaps in response to intervening harvest-mediated population reductions. Disease effects on deer population growth under current conditions were subtle with a 72% chance that CWD depressed population growth. With CWD, we forecasted a growth rate near one and largely stable deer population. Disease effects appear to be moderated by timing of infection, prolonged disease course, and locally variable infection. Long-term outcomes will depend heavily on whether current conditions hold and high prevalence remains a localized phenomenon. PMID:26509806

  20. Prospective evaluation of behavioral scales in the behavioral variant of frontotemporal dementia.

    PubMed

    Boutoleau-Bretonnière, Claire; Lebouvier, Thibaud; Volteau, Christelle; Jaulin, Philippe; Lacomblez, Lucette; Damier, Philippe; Thomas-Anterion, Catherine; Vercelletto, Martine

    2012-01-01

    The Neuropsychiatric Inventory (NPI) and the Frontal Behavioral Inventory (FBI) are widely used in patients with the behavioral variant of frontotemporal dementia (bvFTD). Yet, few data are available on the long-term relevance of these scales. Based on a bvFTD population that participated in the Memantine Clinical Trial (NCT00200538), we studied the evolution and correlation between scores obtained on behavioral scales (NPI and FBI), cognitive scales [Mini-Mental State Examination (MMSE) and Mattis Dementia Rating Scale (MDRS)] and a burden scale [Zarit Burden Inventory (ZBI)]. The assessments were performed at 1 year in 41 patients and at 2 years in 23 patients who agreed to participate in this open-label study. The 2-year scores obtained on the FBI were significantly higher than the scores at inclusion while those obtained on the NPI did not change. There were significant correlations between the FBI, and the MDRS and MMSE, especially regarding the negative items. The ZBI correlated with behavioral scales at all stages for positive items. This study based on a large population shows that the FBI is a better tool than the NPI for the long-term assessment of bvFTD patients. Moreover, the FBI allows a distinction to be made between behavioral disturbances that involve cognitive functions from those which have an important impact on caregiver burden. Copyright © 2012 S. Karger AG, Basel.

  1. Impact of totally laparoscopic combined management of colorectal cancer with synchronous hepatic metastases on severity of complications: a propensity-score-based analysis.

    PubMed

    Ratti, Francesca; Catena, Marco; Di Palo, Saverio; Staudacher, Carlo; Aldrighetti, Luca

    2016-11-01

    Thanks to widespread diffusion of minimally invasive approach in the setting of both colorectal and hepatic surgeries, the interest in combined resections for colorectal cancer and synchronous liver metastases (SCLM) by totally laparoscopic approach (TLA) has increased. Aim of this study was to compare outcome of combined resections for SCLM performed by TLA or by open approach, in a propensity-score-based study. All 25 patients undergoing combined TLA for SCLM at San Raffaele Hospital in Milano were compared in a case-matched analysis with 25 out of 91 patients undergoing totally open approach (TOA group). Groups were matched with 1:2 ratio using propensity scores based on covariates representing disease severity. Main endpoints were postoperative morbidity and long-term outcome. The Modified Accordion Severity Grading System was used to quantify complications. The groups resulted comparable in terms of patients and disease characteristics. The TLA group, as compared to the TOA group, had lower blood loss (350 vs 600 mL), shorter postoperative stay (9 vs 12 days), lower postoperative morbidity index (0.14 vs 0.20) and severity score for complicated patients (0.60 vs 0.85). Colonic anastomosis leakage had the highest fractional complication burden in both groups. In spite of comparable long-term overall survival, the TLA group had better recurrence-free survival. TLA for combined resections is feasible, and its indications can be widened to encompass a larger population of patients, provided its benefits in terms of reduced overall risk and severity of complications, rapid functional recovery and favorable long-term outcomes.

  2. Long-term course of opioid addiction.

    PubMed

    Hser, Yih-Ing; Evans, Elizabeth; Grella, Christine; Ling, Walter; Anglin, Douglas

    2015-01-01

    Opioid addiction is associated with excess mortality, morbidities, and other adverse conditions. Guided by a life-course framework, we review the literature on the long-term course of opioid addiction in terms of use trajectories, transitions, and turning points, as well as other factors that facilitate recovery from addiction. Most long-term follow-up studies are based on heroin addicts recruited from treatment settings (mostly methadone maintenance treatment), many of whom are referred by the criminal justice system. Cumulative evidence indicates that opioid addiction is a chronic disorder with frequent relapses. Longer treatment retention is associated with a greater likelihood of abstinence, whereas incarceration is negatively related to subsequent abstinence. Over the long term, the mortality rate of opioid addicts (overdose being the most common cause) is about 6 to 20 times greater than that of the general population; among those who remain alive, the prevalence of stable abstinence from opioid use is low (less than 30% after 10-30 years of observation), and many continue to use alcohol and other drugs after ceasing to use opioids. Histories of sexual or physical abuse and comorbid mental disorders are associated with the persistence of opioid use, whereas family and social support, as well as employment, facilitates recovery. Maintaining opioid abstinence for at least five years substantially increases the likelihood of future stable abstinence. Recent advances in pharmacological treatment options (buprenorphine and naltrexone) include depot formulations offering longer duration of medication; their impact on the long-term course of opioid addiction remains to be assessed.

  3. The Chronicity of Self-Injurious Behaviour: A Long-Term Follow-Up of a Total Population Study

    ERIC Educational Resources Information Center

    Taylor, Lorne; Oliver, Chris; Murphy, Glynis

    2011-01-01

    Background: Self-injurious behaviour (SIB) is a relatively common problem for people with intellectual disabilities and it is known to be associated with various risk markers, such as degree of disability, sensory impairments, and autism (McClintock "et al." 2003). Less is known about its long-term course however. Method: The present…

  4. Long-term safety in living kidney donors for paediatric transplantation. Single-centre prospective study.

    PubMed

    Martin Benlloch, J; Román Ortiz, E; Mendizabal Oteiza, S

    There is enough evidence concerning the short-term safety of living donors after kidney transplantation. However, long-term complications continue to be studied, with a particular interest in young donors. Previous studies have been conducted in older donors for adult renal patients. We present a study of long-term complications in kidney donors for our paediatric population. We carried out a long-term donor study for the 54 living kidney-donor transplantations performed at our department from 1979 to June 2014. We monitored the glomerular filtration rate (GFR) on the basis of 24-hour urine creatinine clearance, 24-hour proteinuria and the development of arterial hypertension in the 48 donors who were followed up for more than one year. Only the 39 patients who were exclusively followed up by our department have been included in the results analysis. GFR through creatinine clearance was stable after an initial decrease. No proteinuria was observed in any of the cases. One patient developed chronic kidney disease (CKD), which resulted in a cumulative incidence of 2%. GFR below 60mL/min/1.73 m 2 was not reported in any other patients. Arterial hypertension was diagnosed in 25% of donors, 90% of which were treated with antihypertensives. Risk of CKD and hypertension in living kidney donors for paediatric recipients, who are carefully monitored throughout their evolution, is similar to that of the general population. Therefore, this technique appears to be safe in both the short and long term. Copyright © 2016 Sociedad Española de Nefrología. Published by Elsevier España, S.L.U. All rights reserved.

  5. Unveiling an ancient biological invasion: molecular analysis of an old European alien, the crested porcupine (Hystrix cristata).

    PubMed

    Trucchi, Emiliano; Sbordoni, Valerio

    2009-05-18

    Biological invasions can be considered one of the main threats to biodiversity, and the recognition of common ecological and evolutionary features among invaders can help developing a predictive framework to control further invasions. In particular, the analysis of successful invasive species and of their autochthonous source populations by means of genetic, phylogeographic and demographic tools can provide novel insights into the study of biological invasion patterns. Today, long-term dynamics of biological invasions are still poorly understood and need further investigations. Moreover, distribution and molecular data on native populations could contribute to the recognition of common evolutionary features of successful aliens. We analyzed 2,195 mitochondrial base pairs, including Cytochrome b, Control Region and rRNA 12S, in 161 Italian and 27 African specimens and assessed the ancient invasive origin of Italian crested porcupine (Hystrix cristata) populations from Tunisia. Molecular coalescent-based Bayesian analyses proposed the Roman Age as a putative timeframe of introduction and suggested a retention of genetic diversity during the early phases of colonization. The characterization of the native African genetic background revealed the existence of two differentiated clades: a Mediterranean group and a Sub-Saharan one. Both standard population genetic and advanced molecular demography tools (Bayesian Skyline Plot) did not evidence a clear genetic signature of the expected increase in population size after introduction. Along with the genetic diversity retention during the bottlenecked steps of introduction, this finding could be better described by hypothesizing a multi-invasion event. Evidences of the ancient anthropogenic invasive origin of the Italian Hystrix cristata populations were clearly shown and the native African genetic background was preliminary described. A more complex pattern than a simple demographic exponential growth from a single propagule seems to have characterized this long-term invasion.

  6. Observational data on the effects of infection by the copepod Salmincola californiensis on the short- and long-term viability of juvenile Chinook salmon (Oncorhynchus tshawytscha) implanted with telemetry tags

    USGS Publications Warehouse

    Beeman, John W.; Hansen, Amy C.; Sprando, Jamie M.

    2015-01-01

    Infection with Salmincola californiensis is common in juvenile Chinook salmon in western USA reservoirs and may affect the viability of fish used in studies of telemetered animals. Our limited assessment suggests infection by Salmincola californiensis affects the short-term morality of tagged fish and may affect long-term viability of tagged fish after release; however, the intensity of infection in the sample population did not represent the source population due to the observational nature of the data. We suggest these results warrant further study into the effects of infection bySalmincola californiensis on the results obtained through active telemetry and perhaps other methods requiring handling of infected fish.

  7. Psychosocial and organizational risk factors for doctor-certified sick leave: a prospective study of female health and social workers in Norway.

    PubMed

    Aagestad, Cecilie; Tyssen, Reidar; Johannessen, Håkon A; Gravseth, Hans Magne; Tynes, Tore; Sterud, Tom

    2014-09-29

    Doctor-certified sick leave differs substantially across sectors, and among health and social workers, in particular, there is an increased risk. Previous studies have shown that work environmental factors contribute to sick leave. Hence, the identification of specific organizational and psychosocial risk factors for long- term sick leave, taking into account potential confounding related to mechanical risk factors such as lifting and awkward body postures, will be of importance in the work of prevention. A randomly drawn population sample of Norwegian residents was interviewed about working conditions in 2009 (n = 12,255; response rate 60.9%). Female health and social care workers (n = 925) were followed in a national registry for subsequent sickness absence during 2010. The outcome of interest was doctor-certified sick leave of 21 days or more (long-term sick leave). Eleven work-related psychosocial and organizational factors were evaluated. In total, 186 persons (20.1%) were classified with subsequent long-term sick leave. After thoroughly adjusting for competing explanatory variables, the most consistent predictors for long-term sick leave were violence and threats of violence (OR = 1.67; 95% CI 1.14-2.45). The estimated population attributable risk for violence and threats of violence was 13%. The present study among female health and social care workers revealed a substantial relationship between self-reported violence and threats of violence and subsequent long- term sick leave.

  8. Medication use in pregnancy: a cross-sectional, multinational web-based study

    PubMed Central

    Lupattelli, A; Spigset, O; Twigg, M J; Zagorodnikova, K; Mårdby, A C; Moretti, M E; Drozd, M; Panchaud, A; Hämeen-Anttila, K; Rieutord, A; Gjergja Juraski, R; Odalovic, M; Kennedy, D; Rudolf, G; Juch, H; Passier, A; Björnsdóttir, I; Nordeng, H

    2014-01-01

    Objectives Intercountry comparability between studies on medication use in pregnancy is difficult due to dissimilarities in study design and methodology. This study aimed to examine patterns and factors associated with medications use in pregnancy from a multinational perspective, with emphasis on type of medication utilised and indication for use. Design Cross-sectional, web-based study performed within the period from 1 October 2011 to 29 February 2012. Uniform collection of drug utilisation data was performed via an anonymous online questionnaire. Setting Multinational study in Europe (Western, Northern and Eastern), North and South America and Australia. Participants Pregnant women and new mothers with children less than 1 year of age. Primary and secondary outcome measures Prevalence of and factors associated with medication use for acute/short-term illnesses, chronic/long-term disorders and over-the-counter (OTC) medication use. Results The study population included 9459 women, of which 81.2% reported use of at least one medication (prescribed or OTC) during pregnancy. Overall, OTC medication use occurred in 66.9% of the pregnancies, whereas 68.4% and 17% of women reported use of at least one medication for treatment of acute/short-term illnesses and chronic/long-term disorders, respectively. The extent of self-reported medicated illnesses and types of medication used by indication varied across regions, especially in relation to urinary tract infections, depression or OTC nasal sprays. Women with higher age or lower educational level, housewives or women with an unplanned pregnancy were those most often reporting use of medication for chronic/long-term disorders. Immigrant women in Western (adjusted OR (aOR): 0.55, 95% CI 0.34 to 0.87) and Northern Europe (aOR: 0.50, 95% CI 0.31 to 0.83) were less likely to report use of medication for chronic/long-term disorders during pregnancy than non-immigrants. Conclusions In this study, the majority of women in Europe, North America, South America and Australia used at least one medication during pregnancy. There was a substantial inter-region variability in the types of medication used. PMID:24534260

  9. Trends in Streamflow Characteristics at Long-Term Gaging Stations, Hawaii

    USGS Publications Warehouse

    Oki, Delwyn S.

    2004-01-01

    The surface-water resources of Hawaii have significant cultural, aesthetic, ecologic, and economic importance. Proper management of the surface-water resources of the State requires an understanding of the long- and short-term variability in streamflow characteristics that may occur. The U.S. Geological Survey maintains a network of stream-gaging stations in Hawaii, including a number of stations with long-term streamflow records that can be used to evaluate long-term trends and short-term variability in flow characteristics. The overall objective of this study is to obtain a better understanding of long-term trends and variations in streamflow on the islands of Hawaii, Maui, Molokai, Oahu, and Kauai, where long-term stream-gaging stations exist. This study includes (1) an analysis of long-term trends in flows (both total flow and estimated base flow) at 16 stream-gaging stations, (2) a description of patterns in trends within the State, and (3) discussion of possible regional factors (including rainfall) that are related to the observed trends and variations. Results of this study indicate the following: 1. From 1913 to 2002 base flows generally decreased in streams for which data are available, and this trend is consistent with the long-term downward trend in annual rainfall over much of the State during that period. 2. Monthly mean base flows generally were above the long-term average from 1913 to the early 1940s and below average after the early 1940s to 2002, and this pattern is consistent with the detected downward trends in base flows from 1913 to 2002. 3. Long-term downward trends in base flows of streams may indicate a reduction in ground-water discharge to streams caused by a long-term decrease in ground-water storage and recharge. 4. From 1973 to 2002, trends in streamflow were spatially variable (up in some streams and down in others) and, with a few exceptions, generally were not statistically significant. 5. Short-term variability in streamflow is related to the seasons and to the EL Ni?o-Southern Oscillation phenomenon that may be partly modulated by the phase of the Pacific Decadal Oscillation. 6. At almost all of the long-term stream-gaging stations considered in this study, average total flow (and to a lesser extent average base flow) during the winter months of January to March tended to be low following El Ni?o periods and high following La Ni?a periods, and this tendency was accentuated during positive phases of the Pacific Decadal Oscillation. 7. The El Ni?o-Southern Oscillation phenomenon occurs at a relatively short time scale (a few to several years) and appears to be more strongly related to processes controlling rainfall and direct runoff than ground-water storage and base flow. Long-term downward trends in base flows of streams may indicate a reduction in ground-water storage and recharge. Because ground water provides about 99 percent of Hawaii's domestic drinking water, a reduction in ground-water storage and recharge has serious implications for drinking-water availability. In addition, reduction in stream base flows may reduce habitat availability for native stream fauna and water availability for irrigation purposes. Further study is needed to determine (1) whether the downward trends in base flows from 1913 to 2002 will continue or whether the observed pattern is part of a long-term cycle in which base flows may eventually return to levels measured during 1913 to the early 1940s, (2) the physical causes for the detected trends and variations in streamflow, and (3) whether regional climate indicators successfully can be used to predict streamflow trends and variations throughout the State. These needs for future study underscore the importance of maintaining a network of long-term-trend stream-gaging stations in Hawaii.

  10. Rifaximin is safe and well tolerated for long-term maintenance of remission from overt hepatic encephalopathy.

    PubMed

    Mullen, Kevin D; Sanyal, Arun J; Bass, Nathan M; Poordad, Fred F; Sheikh, Muhammad Y; Frederick, R Todd; Bortey, Enoch; Forbes, William P

    2014-08-01

    Rifaximin is a gut-selective, oral antimicrobial agent shown to reduce the recurrence of overt hepatic encephalopathy (HE) and HE-related hospitalizations in a 6-month, randomized, controlled trial (RCT). We performed a phase 3, open-label maintenance study to assess the safety and rate of hospitalization with long-term rifaximin use. We conducted a 24-month, open-label maintenance study of rifaximin (550 mg, twice daily) in patients with HE who participated in the previous RCT of rifaximin or new patients enrolled from March 2007 to December 2010. Safety was assessed (adverse events, clinical laboratory parameters) for the integrated population of all patients, who were given rifaximin 550 mg twice daily (all-rifaximin population, N = 392). Safety and hospitalization data were compared between the group given placebo in the original RCT (n = 159) and those given rifaximin (n = 140). In the all-rifaximin population, the median exposure to rifaximin was 427.0 days (range, 2-1427 d), with 510.5 person-years of exposure. The profile and rate of adverse events with long-term rifaximin treatment were similar to those of the original RCT. There was no increase in the rate of infections, including with Clostridium difficile, or development of bacterial antibiotic resistance. Rates of hospitalizations with long-term rifaximin administration remained low: the HE-related hospitalization rate, normalized for exposure (0.21; all-rifaximin population), was similar to that of the rifaximin group in the original RCT (0.30), and lower than that for the placebo group (0.72). Long-term treatment (≥24 mo) with rifaximin (550 mg, twice daily) appears to provide a continued reduction in the rate of HE-related and all-cause hospitalization, without an increased rate of adverse events. ClinicalTrials.gov number: NCT00686920. Copyright © 2014 AGA Institute. Published by Elsevier Inc. All rights reserved.

  11. Long-term imaging of circadian locomotor rhythms of a freely crawling C. elegans population

    PubMed Central

    Winbush, Ari; Gruner, Matthew; Hennig, Grant W.; van der Linden, Alexander M.

    2016-01-01

    Background Locomotor activity is used extensively as a behavioral output to study the underpinnings of circadian rhythms. Recent studies have required a populational approach for the study of circadian rhythmicity in Caenorhabditis elegans locomotion. New method We describe an imaging system for long-term automated recording and analysis of locomotion data of multiple free-crawling C. elegans animals on the surface of an agar plate. We devised image analysis tools for measuring specific features related to movement and shape to identify circadian patterns. Results We demonstrate the utility of our system by quantifying circadian locomotor rhythms in wild-type and mutant animals induced by temperature cycles. We show that 13 °C:18 °C (12:12 h) cycles are sufficient to entrain locomotor activity of wild-type animals, which persist but are rapidly damped during 13 °C free-running conditions. Animals with mutations in tax-2, a cyclic nucleotide-gated (CNG) ion channel, significantly reduce locomotor activity during entrainment and free-running. Comparison with existing method(s) Current methods for measuring circadian locomotor activity is generally restricted to recording individual swimming animals of C. elegans, which is a distinct form of locomotion from crawling behavior generally observed in the laboratory. Our system works well with up to 20 crawling adult animals, and allows for a detailed analysis of locomotor activity over long periods of time. Conclusions Our population-based approach provides a powerful tool for quantification of circadian rhythmicity of C. elegans locomotion, and could allow for a screening system of candidate circadian genes in this model organism. PMID:25911068

  12. ESRD among Immigrants to Ontario, Canada: A Population-Based Study.

    PubMed

    Perl, Jeffrey; McArthur, Eric; Tan, Vivian S; Nash, Danielle M; Garg, Amit X; Harel, Ziv; Li, Alvin H; Sood, Manish M; Ray, Joel G; Wald, Ron

    2018-05-02

    Background The epidemiology of ESRD requiring maintenance dialysis (ESRD-D) in large, diverse immigrant populations is unclear. Methods We estimated ESRD-D prevalence and incidence among immigrants in Ontario, Canada. Adults residing in Ontario in 2014 were categorized as long-term Canadian residents or immigrants according to administrative health and immigration datasets. We determined ESRD-D prevalence among these adults and calculated age-adjusted prevalence ratios (PRs) comparing immigrants to long-term residents. Among those who immigrated to Ontario between 1991 and 2012, age-adjusted ESRD-D incidence was calculated by world region and country of birth, with immigrants from Western nations as the referent group. Results Among 1,902,394 immigrants and 8,860,283 long-term residents, 1700 (0.09%) and 8909 (0.10%), respectively, presented with ESRD-D. Age-adjusted ESRD-D prevalence was higher among immigrants from sub-Saharan Africa (PR, 2.17; 95% confidence interval [95% CI], 1.84 to 2.57), Latin America and the Caribbean (PR, 2.11; 95% CI, 1.90 to 2.34), South Asia (PR, 1.45; 95% CI, 1.32 to 1.59), and East Asia and the Pacific (PR, 1.34; 95% CI, 1.22 to 1.46). Immigrants from Somalia (PR, 4.18; 95% CI, 3.11 to 5.61), Trinidad and Tobago (PR, 2.88; 95% CI, 2.23 to 3.73), Jamaica (PR, 2.88; 95% CI, 2.40 to 3.44), Sudan (PR, 2.84; 95% CI, 1.53 to 5.27), and Guyana (PR, 2.69; 95% CI, 2.19 to 3.29) had the highest age-adjusted ESRD-D PRs relative to long-term residents. Immigrants from these countries also exhibited higher age-adjusted ESKD-D incidence relative to Western Nations immigrants. Conclusions Among immigrants in Canada, those from sub-Saharan Africa and the Caribbean have the highest ESRD-D risk. Tailored kidney-protective interventions should be developed for these susceptible populations. Copyright © 2018 by the American Society of Nephrology.

  13. Simulating the selfing and migration of Luehea divaricata populations in the Pampa biome to investigate the conservation potential of their genetic resources.

    PubMed

    Serrote, C M L; Reiniger, L R S; Stefenon, V M; Curti, A R; Costa, L S; Paim, A F

    2016-08-29

    Computer simulations are an important tool for developing conservation strategies for forest species. This study used simulations to investigate the genetic, ecological, and reproductive patterns that contribute to the genetic structure of the tree Luehea divaricata Mart. & Zucc. in five forest fragments in the Brazilian Pampa biome. Using the EASYPOP model, we determined the selfing and migration rates that would match the corresponding genetic structure of microsatellite marker data (based on observed and expected heterozygosity parameters). The simulated reproductive mode was mixed, with a high rate of outcrossing (rate = 0.7). This was consistent with a selfing-incompatible system in this species, which reduced, but did not prevent, selfing. The simulated migration rate was 0.02, which implied that the forest fragments were isolated by distance, and that the inbreeding coefficients were high. Based on Nei's gene diversity analysis, 94% of the genetic variability was distributed within the forest fragments, and only 6% of the genetic diversity was caused by differences between them. Furthermore, the minimum viable population and minimum viable area genetic conservation parameters (which determine conservation potential in the short and long term) suggested that only the Inhatinhum forest fragment had the short-term potential to maintain its genetic diversity. However, in the long term, none of the forest fragments proved to be sustainable, indicating that the populations will require intervention to prevent a decline in genetic variability. The creation of ecological corridors could be a useful solution to connect forest fragments and enhance gene flow between them.

  14. Restoration longevity in an Australian Defence Force population.

    PubMed

    Dawson, A S; Smales, R J

    1992-06-01

    Replacement of restorations comprises a considerable portion of the work of most dentists. Consequently, factors that affect restoration longevity can influence the pattern of dental practice in a given community. Based on the results of research into treatment provision in the General Dental Service in Scotland, it was considered possible that factors such as the frequency with which patients were examined, and the frequency with which they changed dentists, might influence restoration longevity in other populations. Therefore, the present study was initiated to investigate the effects of these two factors in a population of 100 long-term members of the Royal Australian Air Force. No statistically significant relationship could be found between examination frequency, or frequent changes in dental practitioner, and restoration longevity. It is proposed that the large differences found in restoration longevity between this study and the Scottish study upon which it was based, may be due in part to the differing modes of remuneration of the dentists in the two studies.

  15. Long-term effect of faecal occult blood screening on incidence and mortality from colorectal cancer.

    PubMed

    Hamza, Samia; Cottet, Vanessa; Touillon, Nassime; Dancourt, Vincent; Bonithon-Kopp, Claire; Lepage, Côme; Faivre, Jean

    2014-12-01

    Several randomized trials have shown a reduction of colorectal cancer mortality by screening using guaiac-based faecal occult blood tests. However, little is known on the long-term effect of screening at the population level in everyday practice. Small-sized geographic areas including a total of 91,199 individuals were allocated to either biennal screening using the Hemoccult-II test or no screening. The expected mortality and incidence in the cohort invited to screening was determined using mortality and incidence in the non-screened population. Colorectal cancer mortality was significantly lower in the population invited to screening than in the non-screened population after 11 screening rounds (standardized mortality ratio: 0.87; 0.80-0.94). The standardized mortality ratio remained significant whatever the duration of follow-up. This reduction in colorectal cancer mortality was more pronounced in those who participated in the first screening campaign, who were regular participants in screening rounds (standardized mortality ratio: 0.67; 0.59-0.76). In contrast, colorectal cancer incidence was not different between the screened and non-screened populations (standardized incidence ratio: 1.01; 0.96-1.06). Our findings confirm, in the long term, that screening with Hemoccult can reduce colorectal cancer mortality. The data also highlight the benefit of regular participation in screening and the absence of effect of screening on colorectal cancer incidence. Copyright © 2014 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  16. Migration, sexual networks, and HIV in Agbogbloshie, Ghana

    PubMed Central

    Cassels, Susan; Jenness, Samuel M.; Biney, Adriana A. E.; Ampofo, William Kwabena; Dodoo, F. Nii-Amoo

    2014-01-01

    BACKGROUND HIV is spread through structured sexual networks, which are influenced by migration patterns, but network-oriented studies of mobility and HIV risk behavior have been limited. OBJECTIVE We present a comprehensive description and initial results from our Migration & HIV in Ghana (MHG) study in Agbogbloshie, an urban slum area within Accra, Ghana. METHODS The MHG study was a population-based cross-sectional study of adults aged 18–49 in Agbogbloshie in 2012. We used a one-year retrospective relationship history calendar to collect egocentric network data on sexual partners as well as migration and short-term mobility, and tested for prevalent HIV-1/2 infection. RESULTS HIV prevalence was 5.5%, with prevalence among women (7.2%) over twice that of men (2.8%). Three-quarters of residents were born outside the Greater Accra region, but had lived in Agbogbloshie an average of 10.7 years. Only 7% had moved housing structures within the past year. However, short-term mobility was common. Residents had an average of 7.3 overnight trips in the last year, with women reporting more travel than men. Thirty-seven percent of men and 9% of women reported more than one sexual partner in the last year. CONCLUSIONS Population-based surveys of migration and sexual risk behavior using relationship history calendars in low-resource settings can produce high quality data. Residents in Agbogbloshie are disproportionately affected by HIV, and have high levels of short-term mobility. HIV prevention interventions targeted to highly mobile populations in high prevalence settings may have far-reaching and long-term implications. PMID:25364298

  17. Neuraxial anesthesia improves long-term survival after total joint replacement: a retrospective nationwide population-based study in Taiwan.

    PubMed

    Chen, Wei-Hung; Hung, Kuo-Chuan; Tan, Ping-Heng; Shi, Hon-Yi

    2015-04-01

    This study explored the effects of general (GA) and neuraxial (NA) anesthesia on the outcomes of primary total joint replacement (TJR) in terms of postoperative mortality, length of stay (LOS), and hospital treatment costs. From 1997 to 2010, this nationwide population-based study retrospectively evaluated 7,977 patients in Taiwan who underwent primary total hip or knee replacement. We generated two propensity-score-matched subgroups, each containing an equal number of patients who underwent TJR with either GA or NA. Of the 7,977 patients, 2,990 (37.5%) underwent GA and 4,987 (62.5%) underwent NA. Propensity-score matching was used to create comparable GA and NA groups adjusted for age, sex, comorbidities, surgery type, hospital volume, and surgeon volume. Survival over the first three years following surgery was similar. The proportion of patients alive up to 14 years postoperatively for those undergoing NA was 58.2% (95% confidence interval [CI] 50.4 to 66.0), and for those undergoing GA it was 57.3% (95% CI 51.4 to 63.2). Neuraxial anesthesia was associated with lower median [interquartile range; IQR] hospital treatment cost ($4,079 [3,805-4,444] vs $4,113 [3,812-4,568]; P < 0.001) and shorter median [IQR] LOS (8 [7-10] days vs 8 [6-10] days, respectively; P = 0.024). Our results support the use of NA for primary TJR. The improvements in hospital costs persist even when anesthesia costs are removed. The mechanism underlying the association between NA and long-term survival is unknown.

  18. Prevalence of chronic kidney disease and comorbidities in isolated African descent communities (PREVRENAL): methodological design of a cohort study.

    PubMed

    Salgado-Filho, Natalino; Lages, Joyce Santos; Brito, Dyego José; Salgado, João Victor; Silva, Gyl Eanes; Santos, Alcione Miranda; Monteiro-Júnior, Francisco Chagas; Santos, Elisangela Milhomen; Silva, Antônio Augusto; Araújo, Denizar Vianna; Sesso, Ricardo Castro

    2018-02-26

    Chronic kidney disease (CKD) is considered a serious public health problem, both in Brazil and worldwide, with an increasing number of cases observed inrecent years. Especially, CKD has been reported to be highly prevalent in those of African descent. However, Brazil lacks data from early-stage CKD population studies, and the prevalence of CKD is unknown for both the overall and African descent populations. Hence, the present study aimsto estimate the prevalence of early-stage CKD and its associated risk factors in African-Brazilians from isolated African-descent communities. Herein, the detailed methodology design of the study is described. This population-based, prospective, longitudinal, cohort study (PREVRENAL) is performed in three stages: first, clinical, nutritional, and anthropometric evaluations; measurements of serum and urinary markers; and examinations of comorbiditieswere performed. Second, repeated examinations of individuals with CKD, systemic arterial hypertension, and/or diabetes mellitus; image screening; and cardiac risk assessment were performed. Third, long-term monitoring of all selected individuals will be conducted (ongoing). Using probability sampling, 1539 individuals from 32 communities were selected. CKD was defined asaglomerular filtration rate (GFR) ≤60 mL/min/1.73m 2 and albuminuria > 30 mg/day. This study proposes to identify and monitor individuals with and without reduced GFR and high albuminuria in isolated populations of African descendants in Brazil. As there are currently no specific recommendations for detecting CKD in African descendants, four equations for estimating the GFR based on serum creatinine and cystatin C were used and will be retrospectively compared. The present report describes the characteristics of the target population, selection of individuals, and detection of a population at risk, along with the imaging, clinical, and laboratory methodologies used. The first and second stages have been concluded and the results will be published in the near future. The subsequent (third) stage is the long-term, continuous monitoring of individuals diagnosed with renal abnormalities or with CKD risk factors. The entire study population will be re-evaluated five years after the study initiation. The expectation is to obtain information about CKD evolution among this population, including the progression rate, complication development, and cardiovascular events.

  19. Survival in pediatric medulloblastoma: a population-based observational study to improve prognostication.

    PubMed

    Weil, Alexander G; Wang, Anthony C; Westwick, Harrison J; Ibrahim, George M; Ariani, Rojine T; Crevier, Louis; Perreault, Sebastien; Davidson, Tom; Tseng, Chi-Hong; Fallah, Aria

    2017-03-01

    Medulloblastoma is the most common form of brain malignancy of childhood. The mainstay of epidemiological data regarding childhood medulloblastoma is derived from case series, hence population-based studies are warranted to improve the accuracy of survival estimates. To utilize a big-data approach to update survival estimates in a contemporary cohort of children with medulloblastoma. We performed a population-based retrospective observational cohort study utilizing the Surveillance, Epidemiology, and End Results Program database that captures all children, less than 20 years of age, between 1973 and 2012 in 18 geographical regions representing 28% of the US population. We included all participants with a presumed or histologically diagnosis of medulloblastoma. The main outcome of interest is survivors at 1, 5 and 10 years following diagnosis. A cohort of 1735 children with a median (interquartile range) age at diagnosis of 7 (4-11) years, with a diagnosis of medulloblastoma were identified. The incidence and prevalence of pediatric medulloblastoma has remained stable over the past 4 decades. There is a critical time point at 1990 when the overall survival has drastically improved. In the contemporary cohort (1990 onwards), the percentage of participants alive was 86, 70 and 63% at 1, 5 and 10 years, respectively. Multivariate Cox-Regression model demonstrated Radiation (HR 0.37; 95% CI 0.30-0.46, p < 0.001) and Surgery (HR 0.42; 95% CI 0.30-0.58, p < 0.001) independently predict survival. The probability of mortality from a neurological cause is <5% in patients who are alive 8 years following diagnosis. The SEER cohort analysis demonstrates significant improvements in pediatric medulloblastoma survival. In contrast to previous reports, the majority of patients survive in the modern era, and those alive 8 years following initial diagnosis are likely a long-term survivor. The importance of minimizing treatment-related toxicity is increasingly apparent given the likelihood of long-term survival.

  20. Prevalence, Employment Rate, and Cost of Schizophrenia in a High-Income Welfare Society: A Population-Based Study Using Comprehensive Health and Welfare Registers

    PubMed Central

    Evensen, Stig; Wisløff, Torbjørn; Lystad, June Ullevoldsæter; Bull, Helen; Ueland, Torill; Falkum, Erik

    2016-01-01

    Schizophrenia is associated with recurrent hospitalizations, need for long-term community support, poor social functioning, and low employment rates. Despite the wide- ranging financial and social burdens associated with the illness, there is great uncertainty regarding prevalence, employment rates, and the societal costs of schizophrenia. The current study investigates 12-month prevalence of patients treated for schizophrenia, employment rates, and cost of schizophrenia using a population-based top-down approach. Data were obtained from comprehensive and mandatory health and welfare registers in Norway. We identified a 12-month prevalence of 0.17% for the entire population. The employment rate among working-age individuals was 10.24%. The societal costs for the 12-month period were USD 890 million. The average cost per individual with schizophrenia was USD 106 thousand. Inpatient care and lost productivity due to high unemployment represented 33% and 29%, respectively, of the total costs. The use of mandatory health and welfare registers enabled a unique and informative analysis on true population-based datasets. PMID:26433216

  1. Long-term care in international perspective.

    PubMed

    Doty, P

    1988-12-01

    The findings of a study of long-term care policies in 18 countries are reported in this article. Initial data were collected by a questionnaire survey under the auspices of the International Social Security Association. These data were supplemented by published documents and government statistics obtained while researching long-term care for the International Social Security Association and, subsequently, for the Organization for Economic Cooperation and Development. The principal focus is a cross-national comparison of institutionalization rates for the elderly. Differences in use rates for medically oriented facilities are less than those for nonmedical residential long-term care facilities. Only a small amount of variation is related to demographic differences, such as older or more female elderly populations in those countries with higher institutionalization rates. Included also is a description of the modes of financing long-term care.

  2. Aiding pest control management of long-tailed macaques (Macaca fascicularis fascicularis) in Malaysia by using molecular markers of mitochondrial DNA

    NASA Astrophysics Data System (ADS)

    Abdul-Latiff, M. A. B.; Abdul-Patah, P.; Yaakop, S.; Md-Zain, B. M.

    2017-10-01

    The long-tailed macaques (Macaca fascicularis fascicularis) has been the center of human wildlife conflict in Malaysia since 1970s. This well-adapted and opportunistic primates have been dominating wide range of habitat in Malaysia such as primary and secondary forest, mangrove, as well as human settlements. The conventional practices of translocation by the authorities are threatening the uniqueness of gene pool for this species and ironically contradicting with the ultimate purpose of genetic conservation of this species. The objectives of this study is to determine the level of genetic separation between populations of long-tailed macaques, primarily focusing on populations distributed in northern Peninsular Malaysia. A total of 954 base pairs of control regions mtDNA was sequenced and analyzed from 27 samples of M. fascicularis. The results exhibited a highly homogenous state of populations for long-tailed macaques genetically and this ultimately indicate unsuitable management and planning in terms of pest control management of the species. Authorities are suggested to translocate the species at least within the state boundaries to avoid homogeneity of gene pools for the particular species.

  3. Association of Long-Term Adherence to the MIND Diet with Cognitive Function and Cognitive Decline in American Women.

    PubMed

    Berendsen, A M; Kang, J H; Feskens, E J M; de Groot, C P G M; Grodstein, F; van de Rest, O

    2018-01-01

    There is increasing attention for dietary patterns as a potential strategy to prevent cognitive decline. We examined the association between adherence to a recently developed Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet with cognitive function and cognitive decline, taking into account the interaction between the apolipoprotein E ε4 genotype and the MIND diet. Population-based prospective cohort study. A total of 16,058 older women aged 70 and over from the Nurses' Health Study. Dietary intake was assessed five times between 1984 and 1998 with a 116-item Food Frequency Questionnaire. The MIND score includes ten brain-healthy foods and five unhealthy foods. Cognition was assessed four times by telephone from 1995 to 2001 (baseline) with the Telephone Interview for Cognitive Status (TICS) and by calculating composite scores of verbal memory and global cognition. Linear regression modelling and linear mixed modelling were used to examine the associations of adherence to the MIND diet with average cognitive function and cognitive change over six years, respectively. Greater long-term adherence to the MIND diet was associated with a better verbal memory score (multivariable-adjusted mean differences between extreme MIND quintiles=0.04 (95%CI 0.01-0.07), p-trend=0.006), but not with cognitive decline over 6 years in global cognition, verbal memory or TICS. Long-term adherence to the MIND diet was moderately associated with better verbal memory in later life. Future studies should address this association within populations at greater risk of cognitive decline.

  4. Spatiotemporal air pollution exposure assessment for a Canadian population-based lung cancer case-control study

    PubMed Central

    2012-01-01

    Background Few epidemiological studies of air pollution have used residential histories to develop long-term retrospective exposure estimates for multiple ambient air pollutants and vehicle and industrial emissions. We present such an exposure assessment for a Canadian population-based lung cancer case-control study of 8353 individuals using self-reported residential histories from 1975 to 1994. We also examine the implications of disregarding and/or improperly accounting for residential mobility in long-term exposure assessments. Methods National spatial surfaces of ambient air pollution were compiled from recent satellite-based estimates (for PM2.5 and NO2) and a chemical transport model (for O3). The surfaces were adjusted with historical annual air pollution monitoring data, using either spatiotemporal interpolation or linear regression. Model evaluation was conducted using an independent ten percent subset of monitoring data per year. Proximity to major roads, incorporating a temporal weighting factor based on Canadian mobile-source emission estimates, was used to estimate exposure to vehicle emissions. A comprehensive inventory of geocoded industries was used to estimate proximity to major and minor industrial emissions. Results Calibration of the national PM2.5 surface using annual spatiotemporal interpolation predicted historical PM2.5 measurement data best (R2 = 0.51), while linear regression incorporating the national surfaces, a time-trend and population density best predicted historical concentrations of NO2 (R2 = 0.38) and O3 (R2 = 0.56). Applying the models to study participants residential histories between 1975 and 1994 resulted in mean PM2.5, NO2 and O3 exposures of 11.3 μg/m3 (SD = 2.6), 17.7 ppb (4.1), and 26.4 ppb (3.4) respectively. On average, individuals lived within 300 m of a highway for 2.9 years (15% of exposure-years) and within 3 km of a major industrial emitter for 6.4 years (32% of exposure-years). Approximately 50% of individuals were classified into a different PM2.5, NO2 and O3 exposure quintile when using study entry postal codes and spatial pollution surfaces, in comparison to exposures derived from residential histories and spatiotemporal air pollution models. Recall bias was also present for self-reported residential histories prior to 1975, with cases recalling older residences more often than controls. Conclusions We demonstrate a flexible exposure assessment approach for estimating historical air pollution concentrations over large geographical areas and time-periods. In addition, we highlight the importance of including residential histories in long-term exposure assessments. For submission to: Environmental Health PMID:22475580

  5. All-Cause and Cause-Specific Mortality Associated with Bariatric Surgery: A Review.

    PubMed

    Adams, Ted D; Mehta, Tapan S; Davidson, Lance E; Hunt, Steven C

    2015-12-01

    The question of whether or not nonsurgical intentional or voluntary weight loss results in reduced mortality has been equivocal, with long-term mortality following weight loss being reported as increased, decreased, and not changed. In part, inconsistent results have been attributed to the uncertainty of whether the intentionality of weight loss is accurately reported in large population studies and also that achieving significant and sustained voluntary weight loss in large intervention trials is extremely difficult. Bariatric surgery has generally been free of these conflicts. Patients voluntarily undergo surgery and the resulting weight is typically significant and sustained. These elements, combined with possible non-weight loss-related mechanisms, have resulted in improved comorbidities, which likely contribute to a reduction in long-term mortality. This paper reviews the association between bariatric surgery and long-term mortality. From these studies, the general consensus is that bariatric surgical patients have: 1) significantly reduced long-term all-cause mortality when compared to severely obese non-bariatric surgical control groups; 2) greater mortality when compared to the general population, with the exception of one study; 3) reduced cardiovascular-, stroke-, and cancer-caused mortality when compared to severely obese non-operated controls; and 4) increased risk for externally caused death such as suicide.

  6. Long-term survival after childhood acute lymphoblastic leukaemia: population-based trends in cure and relapse by clinical characteristics.

    PubMed

    Smith, Lesley; Glaser, Adam W; Kinsey, Sally E; Greenwood, Darren C; Chilton, Lucy; Moorman, Anthony V; Feltbower, Richard G

    2018-05-29

    'Cure models' offer additional information to traditional epidemiological approaches to assess survival for cancer patients by simultaneously estimating the proportion cured and the survival of those 'uncured'. The proportion cured is a summary of long-term survival while the median survival time of the uncured provides important information on those who are not long-term survivors. Population-based trends in the cure proportion and survival of the uncured for childhood acute lymphoblastic leukaemia (ALL) by clinical prognostic risk factors were estimated using flexible parametric cure models, based on overall survival and event-free survival. Children aged 1-17 years diagnosed between 1990 and 2011 in Yorkshire, UK, were included (n = 492). The percentage cured increased from 77% (95% confidence interval 70-84%) in 1990-1997 to 89% (84-93%) in 2003-2011, while the median survival time of the uncured decreased from 3·2 years (2·2-4·1 years) to 0·7 years (0-1·5 years). Models based on event-free survival showed a similar trend. The 5-year cumulative incidence of relapse substantially decreased from 35% in 1990-97 to 9% in 2003-2011. These results show selective improvement in survival between 1990 and 2011 with a significant reduction in the risk of relapse alongside a reduced absolute duration of survival for those destined to be uncured. © 2018 John Wiley & Sons Ltd.

  7. Marketing in the long-term care continuum.

    PubMed

    Laurence, J Nathan; Kash, Bita A

    2010-04-01

    Today, long-term care facilities are composed of independent, assisted living, and skilled nursing facilities along with many variations of those themes in between. The clientele for these various types of facilities differ because of the level of care the facility provides as well as the amenities long-term care consumers are looking for. However, there many similarities and common approaches to how reaching the target audience through effective marketing activities. Knowing who the target audience is, how to reach them, and how to communicate with them will serve any facility well in this competitive market. Developing marketing strategies for long-term care settings is as important as understanding what elements of care can be marketed individually as a niche market. Determining the market base for a facility is equally crucial since the target populations differ among the three types of facilities. By reviewing current marketing articles and applying marketing practices, we have crafted some general principles for which each facility type can learn from. Finally, we will discuss the types of marketing and how they related to the spectrum of long-term care facilities.

  8. Short- and long-term eating habit modification predict weight change in overweight, post-menopausal women: results from the WOMAN Study

    PubMed Central

    Gibbs, Bethany Barone; Kinzel, Laura S.; Gabriel, Kelley Pettee; Chang, Yue-fang; Kuller, Lewis H.

    2012-01-01

    Background Standard behavioral obesity treatment produces poor long-term results. Focusing on healthy eating behaviors, rather than caloric intake, may be an alternative strategy. Furthermore, important behaviors might differ for short- vs. long-term weight control. Objective To describe and compare associations between changes in eating behaviors and weight after 6 and 48 months Design Secondary analysis of data collected during a randomized weight loss intervention trial with 48-month follow-up Participants 465 overweight and obese postmenopausal women enrolled in the Women on the Move through Activity and Nutrition (WOMAN) Study Main outcome measures Changes in weight from baseline to 6 and 48 months. Statistical analyses performed Linear regression models examined the associations between 6- and 48-month changes in eating habits assessed by the Conner Diet Habit Survey and changes in weight. Analyses were conducted in the combined study population and stratified by randomization group. Results At 6 months in the combined population, weight loss was independently associated with decreased desserts (p<0.001), restaurant eating (p=0.042), sugar-sweetened beverages (p=0.009), and fried foods (p<0.001), and increased fish consumption (p=0.003). Results were similar in intervention participants; only reduced desserts and fried foods associated with weight loss in controls. At 48 months in the combined population, weight loss was again associated with decreased desserts (p=0.003) and sugar-sweetened beverages (p=0.011), but also decreased meats/cheeses (p=0.024) and increased fruits/vegetables (p<0.001). Decreased meats/cheeses predicted weight loss in intervention participants; desserts, sugar-sweetened beverages, and fruits/vegetables were independently associated in controls. Conclusions Changes in eating behaviors were associated with weight change, though important behaviors differed for short- and long-term weight change and by randomization group. Future studies should determine whether interventions targeting these behaviors could improve long-term obesity treatment outcomes. PMID:22939439

  9. Living with mentally ill parents during adolescence: a risk factor for future welfare dependence? A longitudinal, population-based study.

    PubMed

    Homlong, Lisbeth; Rosvold, Elin Olaug; Sagatun, Åse; Wentzel-Larsen, Tore; Haavet, Ole Rikard

    2015-04-22

    Living with parents suffering from mental illness can influence adolescents' health and well-being, and adverse effects may persist into adulthood. The aim of this study was to investigate the relationship between parents' mental health problems reported by their 15-16-year-old adolescents, the potential protective effect of social support and long-term dependence on public welfare assistance in young adulthood. The study linked data from a youth health survey conducted during 1999-2004 among approximately 14 000 15-16-year-olds to data from high-quality, compulsory Norwegian registries that followed each participant through February 2010. Cox regression was used to compute hazard ratios for long-term welfare dependence in young adulthood based on several risk factors in 15-16-year-olds, including their parents' mental health problems. Of the total study population, 10% (1397) reported having parents who suffered from some level of mental health problems during the 12 months prior to the baseline survey; 3% (420) reported that their parents had frequent mental health problems. Adolescent report of their parents' mental health problems was associated with the adolescents' long-term welfare dependence during follow-up, with hazard ratios (HRs) of 1.49 (CI 1.29-1.71), 1.82 (1.44-2.31) and 2.13 (CI 1.59-2.85) for some trouble, moderate trouble and frequent trouble, respectively, compared with report of no trouble with mental health problems. The associations remained significant after adjusting for socio-demographic factors, although additionally correcting for the adolescents' own health status accounted for most of the effect. Perceived support from family, friends, classmates and teachers was analysed separately and each was associated with a lower risk of later welfare dependence. Family and classmate support remained a protective factor for welfare dependence after correcting for all study covariates (HR 0.84, CI 0.78-0.90 and 0.80, 0.75-0.85). We did not find evidence supporting a hypothesized buffering effect of social support. Exposure to a parent's mental health problem during adolescence may represent a risk for future welfare dependence in young adulthood. Perceived social support, from family and classmates in particular, may be a protective factor against future long-term welfare dependence.

  10. Low Indeterminate Rates Associated With Use of the QuantiFERON-TB Gold In-Tube Test in Children With Inflammatory Bowel Disease on Long-term Infliximab.

    PubMed

    Vortia, Eugene; Uko, Victor E; Yen-Lieberman, Belinda; Frawley, Jill; Worley, Sarah E; Danziger-Isakov, Lara; Kaplan, Barbara; Mahajan, Lori

    2018-03-19

    Tumor necrosis factor alpha (TNF-α) inhibitors are linked with increased risk of reactivation of active tuberculosis. The QuantiFERON-TB Gold In-Tube test is approved for screening latent tuberculosis infection in children and adults. There are limited data on the test performance in children on long-term treatment with TNF-α inhibitors. The objective of this study was to assess the proportion of indeterminate results for the QuantiFERON-TB Gold In-Tube in children with inflammatory bowel disease (IBD) on long-term infliximab treatment and to evaluate the range of interferon-γ responses to mitogen. A single-center prospective study of children 5 to 19 years of age with IBD on long-term infliximab treatment (>3 months). Each child was assessed for tuberculosis exposure risk and had blood drawn for the QuantiFERON-TB Gold In-Tube. Data on the range of interferon-γ responses and final QuantiFERON-TB Gold In-Tube test results were collected. Ninety-three children were included, with a median age of 16 years. The median total duration of infliximab therapy was 34 months (range, 3-119 months). The QuantiFERON-TB Gold In-Tube was indeterminate in 1 patient (1.1%), positive in 2 patients, and negative in 90 patients. The maximum interferon-γ response to mitogen (10 IU/mL) was observed in 82 patients (88%), with only 1 patient having an inadequate response. The proportion of indeterminate results was significantly lower than the prospectively hypothesized rate of 8%, based on prior studies in nonimmunosuppressed patients (P = 0.004). Pediatric patients with IBD on long-term treatment with infliximab had an adequate interferon-γ response to mitogen and a low indeterminate rate when assessed with the QuantiFERON-TB Gold In-Tube test. This study demonstrates a robust interferon gamma response to phytohemagglutinin stimulation in a pediatric population on long-term therapy with infliximab. The QuantiFERON-TB Gold In-Tube test may therefore be useful as a periodic screening tactic for latent TB in children on long-term infliximab therapy.

  11. Long-Term Protection against Diphtheria in the Netherlands after 50 Years of Vaccination: Results from a Seroepidemiological Study

    PubMed Central

    Swart, E. M.; van Gageldonk, P. G. M.; de Melker, H. E.; van der Klis, F. R.; Berbers, G. A. M.; Mollema, L.

    2016-01-01

    Background and Aims To evaluate the National Immunisation Programme (NIP) a population-based cross-sectional seroepidemiological study was performed in the Netherlands. We assessed diphtheria antitoxin levels in the general Dutch population and in low vaccination coverage (LVC) areas where a relatively high proportion of orthodox Protestants live who decline vaccination based on religious grounds. Results were compared with a nationwide seroepidemiological study performed 11 years earlier. Methods In 2006/2007 a national serum bank was established. Blood samples were tested for diphtheria antitoxin IgG concentrations using a multiplex immunoassay for 6383 participants from the national sample (NS) and 1518 participants from LVC municipalities. A cut-off above 0.01 international units per ml (IU/ml) was used as minimum protective level. Results In the NS 91% of the population had antibody levels above 0.01 IU/ml compared to 88% in the 1995/1996 serosurvey (p<0.05). On average, 82% (vs. 78% in the 1995/1996 serosurvey, p<0.05) of individuals from the NS born before introduction of diphtheria vaccination in the NIP and 46% (vs. 37% in the 1995/1996 serosurvey, p = 0.11) of orthodox Protestants living in LVC areas had antibody levels above 0.01 IU/ml. Linear regression analysis among fully immunized individuals (six vaccinations) without evidence of revaccination indicated a continuous decline in antibodies in both serosurveys, but geometric mean antibodies remained well above 0.01 IU/ml in all age groups. Conclusions The NIP provides long-term protection against diphtheria, although antibody levels decline after vaccination. As a result of natural waning immunity, a substantial proportion of individuals born before introduction of diphtheria vaccination in the NIP lack adequate levels of diphtheria antibodies. Susceptibility due to lack of vaccination is highest among strictly orthodox Protestants. The potential risk of spread of diphtheria within the geographically clustered orthodox Protestant community after introduction in the Netherlands has not disappeared, despite national long-term high vaccination coverage. PMID:26863307

  12. Health promotion interventions for community-dwelling older people with mild or pre-frailty: a systematic review and meta-analysis.

    PubMed

    Frost, Rachael; Belk, Celia; Jovicic, Ana; Ricciardi, Federico; Kharicha, Kalpa; Gardner, Benjamin; Iliffe, Steve; Goodman, Claire; Manthorpe, Jill; Drennan, Vari M; Walters, Kate

    2017-07-20

    Mild or pre-frailty is common and associated with increased risks of hospitalisation, functional decline, moves to long-term care, and death. Little is known about the effectiveness of health promotion in reducing these risks. This systematic review aimed to synthesise randomised controlled trials (RCTs) evaluating home and community-based health promotion interventions for older people with mild/pre-frailty. We searched 20 bibliographic databases and 3 trials registers (January 1990 - May 2016) using mild/pre-frailty and associated terms. We included randomised controlled and crossover trials of health promotion interventions for community-dwelling older people (65+ years) with mild/pre-frailty and excluded studies focussing on populations in hospital, long term care facilities or with a specific condition. Risk of bias was assessed by two reviewers using the Cochrane Risk of Bias tool. We pooled study results using standardised mean differences (SMD) where possible and used narrative synthesis where insufficient outcome data were available. We included 10 articles reporting on seven trials (total n = 506 participants) and included five trials in a meta-analysis. Studies were predominantly small, of limited quality and six studies tested group exercise alone. One study additionally investigated a nutrition and exercise intervention and one evaluated telemonitoring. Interventions of exercise in groups showed mixed effects on functioning (no effects on self-reported functioning SMD 0.19 (95% CI -0.57 to 0.95) n = 3 studies; positive effects on performance-based functioning SMD 0.37 (95% CI 0.07 to 0.68) n = 3 studies). No studies assessed moves to long-term care or hospitalisations. Currently the evidence base is of insufficient size, quality and breadth to recommend specific health promotion interventions for older people with mild or pre- frailty. High quality studies of rigorously developed interventions are needed. CRD42014010370 (Review 2).

  13. Risk of death from cardiovascular disease associated with low-level arsenic exposure among long-term smokers in a US population-based study

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

    Farzan, Shohreh F.; Departments of Population Health and Environmental Medicine, New York University School of Medicine, New York, NY; Chen, Yu

    High levels of arsenic exposure have been associated with increases in cardiovascular disease risk. However, studies of arsenic's effects at lower exposure levels are limited and few prospective studies exist in the United States using long-term arsenic exposure biomarkers. We conducted a prospective analysis of the association between toenail arsenic and cardiovascular disease mortality using longitudinal data collected on 3939 participants in the New Hampshire Skin Cancer Study. Using Cox proportional hazard models adjusted for potential confounders, we estimated hazard ratios and 95% confidence intervals associated with the risk of death from any cardiovascular disease, ischemic heart disease, and stroke,more » in relation to natural-log transformed toenail arsenic concentrations. In this US population, although we observed no overall association, arsenic exposure measured from toenail clipping samples was related to an increased risk of ischemic heart disease mortality among long-term smokers (as reported at baseline), with increased hazard ratios among individuals with ≥ 31 total smoking years (HR: 1.52, 95% CI: 1.02, 2.27), ≥ 30 pack-years (HR: 1.66, 95% CI: 1.12, 2.45), and among current smokers (HR: 1.69, 95% CI: 1.04, 2.75). These results are consistent with evidence from more highly exposed populations suggesting a synergistic relationship between arsenic exposure and smoking on health outcomes and support a role for lower-level arsenic exposure in ischemic heart disease mortality. - Highlights: • Arsenic (As) has been associated with increased cardiovascular disease (CVD) risk. • Little is known about CVD effects at lower levels of As exposure common in the US. • Few have investigated the joint effects of As and smoking on CVD in US adults. • We examine chronic low-level As exposure and smoking in relation to CVD mortality. • Arsenic exposure may increase ischemic heart disease mortality among smokers in US.« less

  14. Population Change as Related to Long-Term Cycles in Residential Construction in the United States.

    DTIC Science & Technology

    1981-03-01

    Research Paper Long-Term Cycles FPL 392 March 1 in Residential Construction in the United States , mllmill - -N ABSTRACT Major demographic changes have...ferent from what they are now. This paper analyzes the potential impact of changing population growth rates and the age structure of the population...United StatesPuiChangeDepartment of AgriculturePo ua inCng Forest Service Forest Lrouato as Related toP ductsLaboratory, Research Paper LongnTerm Cycles

  15. Diagnosis and duration of sickness absence as predictors for disability pension: results from a three-year, multi-register based* and prospective study.

    PubMed

    Gjesdal, Sturla; Bratberg, Espen

    2003-01-01

    A study was undertaken to identify predictors for the transition from long-term sickness absence into disability pension with special emphasis on routinely collected medical information (e.g. diagnoses on sickness certificates) and the duration of sickness-absence spells. The study used a 10% random sample of the Norwegian population of working age (the KIRUT database). Individuals below 60 years of age, with spells of long-term sickness absence starting in 1990-91, where the medical diagnoses on the sickness certificates were known, were identified. This group (4,432 men and 5,645 women) was followed up for three years after the end of sickness absence with regard to disability pension and working status. In logistic regression the following predictors significantly increased the risk of obtaining disability pension during the first three years after the long-term sickness spell: age, part-time employment, and duration of absence > 197 days. Higher education and having children < 11 years significantly decreased the risk. Having the medical diagnoses "mental problems" and diseases in the nervous system, respiratory system, and circulatory systems indicated high risk (compared with musculoskeletal disease). The diagnostic groups "pregnancy-related disease" and "injuries" implied low risk for disability pension. In separate regressions for both genders the "protective effect" of having small children remained only for women. High risk for sickness absence caused by "mental problems" reached significance only for men. Several risk factors for transition from long-term sickness absence into disability pension were identified. The finding that spells of sickness absence with duration up to seven months did not imply increased risk of disability during the first three years may have implications for interventions aimed at long-term sickness absentees.

  16. Physical and psychological long-term outcome after traumatic brain injury in children and adult patients

    PubMed Central

    2014-01-01

    Background Several studies have indicated that younger age is associated with worse recovery after pediatric traumatic brain injury (TBI) compared to elder children. In order to verify this association between long-term outcome after moderate to severe TBI and patient’s age, direct comparison between different pediatric age groups as well as an adult population was performed. Methods This investigation represents a retrospective cohort study at a level I trauma center including patients with moderate to severe, isolated TBI with a minimum follow-up of 10 years. According to their age at time of injury, patients were divided in pre-school (0–7 years), school (8–17 years) and adult (18–65 years) patients. Physical examination and standardized questionnaire on physical and psychological aspects (Glasgow Outcome Scale, Barthel Index, Impact of Event Scale, Hospital Anxiety and Depression Scale, short form 12) were performed. Results 135 traumatized patients were included. Physical and psychological long-term outcome was associated with injury severity but not with patients’ age at time of injury. Outcome recovery measured by Glasgow Outcome Scale was demonstrated with best results for pre-school aged children (p = 0.009). According to the Hospital Anxiety and Depression Scale an increased incidence of anxiety (p = 0.010) and depression (p = 0.026) was evaluated in older patients. Conclusion Long-term outcome perceptions after moderate to severe TBI presented in this study question current views of deteriorated recovery for the immature brain. The sustained TBI impact seemed not to reduce the child’s ability to overcome the suffered impairment measured by questionnaire based psychological, physical and health related outcome scores. These results distinguish the relevance of rehabilitation and family support in the long term. PMID:24571742

  17. Long-term trends in fire behavior and changes in population at risk

    EPA Science Inventory

    Long-term trends in fire behavior and changes in population at risk Rappold AG, Peterson GC, US EPA Matt Jolly, USFS Air pollution regulations and technological advances have successfully reduced emissions of air pollutants from many anthropogenic sources in recent decades. Duri...

  18. Le Conte's sparrows breeding in Conservation Reserve Program fields: precipitation and patterns of population change

    USGS Publications Warehouse

    Igl, Lawrence D.; Johnson, Douglas H.

    1999-01-01

    The climate of the North American Great Plains is highly dynamic, with great year-to-year variability in precipitation and periodic, often extreme, wet and dry cycles (Bragg 1995). Drought is a major force of ecological disturbance on the Great Plains and has played a key role in directing the evolution of the grassland biota of this region (Knopf and Samson 1997). Although grassland birds may differ in their responses to enviromenental variations (Rotenberry and Wiens 1991), climatic variability and concomitant unpredictability of resources strongly influence populations of grassland birds across space and time (Wiens 1974, 1986; Cody 1985). Not surprisingly, breeding bird populations on the Great Plains are highly dynamic, exhibiting considerable annual variation in composition, abundance, and distribution (Johnson and Grier 1988, George et al. 1992, Zimmerman 1992, Igl and Johnson 1997). Recently, interest in grassland birds has increased with the recognition that many species are declining both continentally (Droege and Sauer 1994) and globally (Goriup 1988). Identification of the specific factors associated with grassland bird declines in North America, however, remains largely enigmatic (Herkert 1997), and it is complicated by the considerable annual fluctuations in grassland bird distribution and abundance (Igl and Johnson 1997). Although there is evidence that land-use changes on the breeding grounds may have contributed to grassland bird declines (e.g., Igl and Johnson 1997), there also is an indication that long-term drought conditions may have influenced recent population changes of some breeding birds on the Great Plains (Droege and Sauer 1989, Peterjohn and Sauer 1993, Bethke and Nudds 1995, Igl and Johnson 1997). Le Conte's Sparrow (Ammodramus leconteii) is a secretive grassland bird that breeds in central and southern Canada and the northcentral United States (Murray 1969). It winters primarily in the southern United States (Peterson 1980, 1990). Like populations of many grassland breeding birds in North America (Fretwell 1986, Igl and Johnson 1997), Le Conte's Sparrow populations exhibit numerical highs and lows depending on local moisture conditions (Peabody 1901, Stewart 1975, Knapton 1979, Zimmer 1979, Madden 1996). This observation, however, is based largely on anecdotal evidence or short-term observations. Long-term studies of Le Conte's Sparrow populations are limited. Le Conte's Sparrow is poorly represented on the North American Breeding Bird Survey (BBS) because of small sample sizes, poor coverage in the northern portion of its breeding range, and the species' furtive behavior (Sauer et al. 1995). Moreover, dramatic fluctuations in Le Conte's Sparrow abundance tend to obscure the species' long-term population trends on the BBS (Sauer et al. 1995). In this paper we examine long-term population changes of Le Conte's Sparrows breeding in perennial grassland fields enrolled in the Conservation Reserve Program (CRP) on the northern Great Plains. We discuss patterns of population change of Le Conte's Sparrows associated with changes in precipitation and moisture conditions.

  19. Medical Underwriting In Long-Term Care Insurance: Market Conditions Limit Options For Higher-Risk Consumers.

    PubMed

    Cornell, Portia Y; Grabowski, David C; Cohen, Marc; Shi, Xiaomei; Stevenson, David G

    2016-08-01

    A key feature of private long-term care insurance is that medical underwriters screen out would-be buyers who have health conditions that portend near-term physical or cognitive disability. We applied common underwriting criteria based on data from two long-term care insurers to a nationally representative sample of individuals in the target age range (50-71 years) for long-term care insurance. The screening criteria put upper bounds on the current proportion of Americans who could gain coverage in the individual market without changes to medical underwriting practice. Specifically, our simulations show that in the target age range, approximately 30 percent of those whose wealth meets minimum industry standards for suitability for long-term care insurance would have their application for such insurance rejected at the underwriting stage. Among the general population-without considering financial suitability-we estimated that 40 percent would have their applications rejected. The predicted rejection rates are substantially higher than the rejection rates of about 20-25 percent of applicants in the actual market. In evaluating reforms for long-term care financing and their potential to increase private insurance rates, as well as to reduce financial pressure on public safety-net programs, policy makers need to consider the role of underwriting in the market for long-term care insurance. Project HOPE—The People-to-People Health Foundation, Inc.

  20. Assessment of thyroid function in children, adults and pregnant and lactating women after long-term salt iodisation measurements.

    PubMed

    Su, Xiaohui; Li, Mu; Liu, Lixiang; Shen, Hongmei; Kelly, Patrick J; Wang, Yanling; Chen, Zhihui; Wang, Jinbiao; Li, Weidong; Chen, Huixin; Xiao, Bangzhong; Han, Yunfeng; Liu, Shoujun; Liu, Peng

    2018-06-01

    Universal salt iodisation (USI) has been successfully implemented in China for more than 15 years. Recent evidence suggests that the definition of 'adequate iodine' (100-199 µg/l) be revised to 'sufficient iodine' (100-299 µg/l) based on the median urinary iodine concentration (MUI) in school-age children. The objective of this study was to determine the prevalence of thyroid dysfunction in populations after long-term salt iodisation and examine whether the definition of adequate iodine can be broadened to sufficient iodine based on the thyroid function in four population groups. A cross-sectional survey was conducted in six provinces in the northern, central and southern regions of China. Four population groups consisting of 657 children, 755 adults, 347 pregnant women and 348 lactating women were recruited. Three spot urinary samples were collected over a 10-d period and blood samples were collected on the 1st day. In the study, among the adults, pregnant women and lactating women, the prevalence rates of elevated thyroglobulin antibody and thyroid microsomal antibody levels were 12·4, 8·5 and 7·8 %, and 12·1, 9·1 and 9·1 %, respectively. Abnormally high thyroid dysfunction prevalence was not observed after more than 15 years of USI in China because the thyroid dysfunction rates were all <5 %. The recommended range should be cautiously broadened from adequate iodine to sufficient iodine according to the MUI of school-age children considering the high levels of hormones and antibodies in the other populations. Adults, particularly pregnant women positive for thyroid antibodies, should be closely monitored.

  1. Contemporary Trends of the Epidemiology, Clinical Characteristics, and Resource Utilization of Necrotizing Fasciitis in Texas: A Population-Based Cohort Study

    PubMed Central

    Oud, Lavi; Watkins, Phillip

    2015-01-01

    Introduction. There are limited population-level reports on the contemporary trends of the epidemiology, clinical features, resource utilization, and outcomes of necrotizing fasciitis (NF). Methods. We conducted a cohort study of Texas inpatient population, identifying hospitalizations with a diagnosis of NF during the years 2001–2010. The incidence, clinical features, resource utilization, and outcomes of NF hospitalizations were examined. Results. There were 12,172 NF hospitalizations during study period, with ICU admission in 50.3%. The incidence of NF rose 2.7%/year (P = 0.0001). Key changes between 2001-2002 and 2009-2010 included rising incidence of NF (5.9 versus 7.6 per 100,000 [P < 0.0001]), chronic comorbidities (69.4% versus 76.7% [P < 0.0001]), and development of ≥1 organ failure (28.5% versus 51.7% [P < 0.0001]). Inflation-adjusted hospital charges rose 37% (P < 0.0001). Hospital mortality (9.3%) remained unchanged during study period. Discharges to long-term care facilities rose from 12.2 to 30% (P < 0.0001). Conclusions. The present cohort of NF is the largest reported to date. There has been increasing incidence, chronic illness, and severity of illness of NF over the past decade, with half of NF hospitalizations admitted to ICU. Hospital mortality remained unchanged, while need for long-term care rose nearly 2.5-fold among survivors, suggesting increasing residual morbidity. The sources of the observed findings require further study. PMID:25893115

  2. The demography of a small population of yellow columbines in the Organ Mountains

    Treesearch

    Chris J. Stubben; Brook G. Milligan

    2001-01-01

    Yellow-flowered columbines (Aquilegia chrysantha Gray) are usually found in small, isolated populations near streams and pools in mountain ranges throughout the southwestern United States. To study the long-term dynamics of these populations, which are vulnerable to extinction, we have monitored the demography of a population in Fillmore Canyon in the Organ Mountains...

  3. The importance of within-year repeated counts and the influence of scale on long-term monitoring of sage-grouse

    USGS Publications Warehouse

    Fedy, B.C.; Aldridge, Cameron L.

    2011-01-01

    Long-term population monitoring is the cornerstone of animal conservation and management. The accuracy and precision of models developed using monitoring data can be influenced by the protocols guiding data collection. The greater sage-grouse (Centrocercus urophasianus) is a species of concern that has been monitored over decades, primarily, by counting the number of males that attend lek (breeding) sites. These lek count data have been used to assess long-term population trends and for multiple mechanistic studies. However, some studies have questioned the efficacy of lek counts to accurately identify population trends. In response, monitoring protocols were changed to have a goal of counting lek sites multiple times within a season. We assessed the influence of this change in monitoring protocols on model accuracy and precision applying generalized additive models to describe trends over time. We found that at large spatial scales including >50 leks, the absence of repeated counts within a year did not significantly alter population trend estimates or interpretation. Increasing sample size decreased the model confidence intervals. We developed a population trend model for Wyoming greater sage-grouse from 1965 to 2008, identifying significant changes in the population indices and capturing the cyclic nature of this species. Most sage-grouse declines in Wyoming occurred between 1965 and the 1990s and lek count numbers generally increased from the mid-1990s to 2008. Our results validate the combination of monitoring data collected under different protocols in past and future studies-provided those studies are addressing large-scale questions. We suggest that a larger sample of individual leks is preferable to multiple counts of a smaller sample of leks. ?? 2011 The Wildlife Society.

  4. Evidence-based Review, Grade of Recommendation, and Suggested Treatment Recommendations for Melasma

    PubMed Central

    Sarma, Nilendu; Chakraborty, Sayantani; Poojary, Shital A.; Rathi, Sanjay; Kumaran, Sendhil; Nirmal, Balakrishnan; Felicita, Joan; Sarkar, Rashmi; Jaiswal, Prashansa; D’Souza, Paschal; Donthula, Nagaraju; Sethi, Sumit; Ailawadi, Pallavi; Joseph, Bebisha

    2017-01-01

    Treatment of melasma is known to be less satisfactory, often incomplete, and relapse is frequent. Although many treatment options are available, they are either known to be unsafe on long-term use or their long-term safety profile is unknown. Patients often use various drugs, even topical steroid-based preparation without any medical supervision for long period of time, making the skin unsuitable for many of the drugs available. Thus, there has been gross disparity among the treating physician about what drugs and what regimen are best suitable for various categories of melasma patients and in different situations. With this background, numerous newer drugs, mostly combinations of some proprietary molecules or even unknown plant extracts, have flooded the market for the management of melasma. Information on efficacy or safety of these products are almost unknown. Studies on Asian people, especially Indian population, are far less commonly available. Therapeutic guideline for use on Indian patients with melasma is almost missing. Extrapolation of data from Caucasian people for use on Asian people may not be scientifically justifiable because Caucasian and Asian people are known to have inherent difference in their response as well as tolerance to the drugs used for melasma. With this background, we have extensively evaluated, following a strict, scientifically designed protocol, all the available studies on melasma management till May 2016 and prepared this document on level of evidence, grade of recommendation and suggested therapeutic guideline for melasma as per the method proposed by Oxford Centre of Evidence-Based Medicine. Various ethical, social, logical, regional, and economic issues in the context of Indian and similar populations were given due importance while preparing the suggested therapeutic recommendation. PMID:29204385

  5. Longterm follow-up in European respiratory health studies – patterns and implications

    PubMed Central

    2014-01-01

    Background Selection bias is a systematic error in epidemiologic studies that may seriously distort true measures of associations between exposure and disease. Observational studies are highly susceptible to selection bias, and researchers should therefore always examine to what extent selection bias may be present in their material and what characterizes the bias in their material. In the present study we examined long-term participation and consequences of loss to follow-up in the studies Respiratory Health in Northern Europe (RHINE), Italian centers of European Community Respiratory Health Survey (I-ECRHS), and the Italian Study on Asthma in Young Adults (ISAYA). Methods Logistic regression identified predictors for follow-up participation. Baseline prevalence of 9 respiratory symptoms (asthma attack, asthma medication, combined variable with asthma attack and/or asthma medication, wheeze, rhinitis, wheeze with dyspnea, wheeze without cold, waking with chest tightness, waking with dyspnea) and 9 exposure-outcome associations (predictors sex, age and smoking; outcomes wheeze, asthma and rhinitis) were compared between all baseline participants and long-term participants. Bias was measured as ratios of relative frequencies and ratios of odds ratios (ROR). Results Follow-up response rates after 10 years were 75% in RHINE, 64% in I-ECRHS and 53% in ISAYA. After 20 years of follow-up, response was 53% in RHINE and 49% in I-ECRHS. Female sex predicted long-term participation (in RHINE OR (95% CI) 1.30(1.22, 1.38); in I-ECRHS 1.29 (1.11, 1.50); and in ISAYA 1.42 (1.25, 1.61)), as did increasing age. Baseline prevalence of respiratory symptoms were lower among long-term participants (relative deviations compared to total baseline population 0-15% (RHINE), 0-48% (I-ECRHS), 3-20% (ISAYA)), except rhinitis which had a slightly higher prevalence. Most exposure-outcome associations did not differ between long-term participants and all baseline participants, except lower OR for rhinitis among ISAYA long-term participating smokers (relative deviation 17% (smokers) and 44% (10–20 pack years)). Conclusions We found comparable patterns of long-term participation and loss to follow-up in RHINE, I-ECRHS and ISAYA. Baseline prevalence estimates for long-term participants were slightly lower than for the total baseline population, while exposure-outcome associations were mainly unchanged by loss to follow-up. PMID:24739530

  6. Modeling the Complex Impacts of Timber Harvests to Find Optimal Management Regimes for Amazon Tidal Floodplain Forests

    PubMed Central

    Fortini, Lucas B.; Cropper, Wendell P.; Zarin, Daniel J.

    2015-01-01

    At the Amazon estuary, the oldest logging frontier in the Amazon, no studies have comprehensively explored the potential long-term population and yield consequences of multiple timber harvests over time. Matrix population modeling is one way to simulate long-term impacts of tree harvests, but this approach has often ignored common impacts of tree harvests including incidental damage, changes in post-harvest demography, shifts in the distribution of merchantable trees, and shifts in stand composition. We designed a matrix-based forest management model that incorporates these harvest-related impacts so resulting simulations reflect forest stand dynamics under repeated timber harvests as well as the realities of local smallholder timber management systems. Using a wide range of values for management criteria (e.g., length of cutting cycle, minimum cut diameter), we projected the long-term population dynamics and yields of hundreds of timber management regimes in the Amazon estuary, where small-scale, unmechanized logging is an important economic activity. These results were then compared to find optimal stand-level and species-specific sustainable timber management (STM) regimes using a set of timber yield and population growth indicators. Prospects for STM in Amazonian tidal floodplain forests are better than for many other tropical forests. However, generally high stock recovery rates between harvests are due to the comparatively high projected mean annualized yields from fast-growing species that effectively counterbalance the projected yield declines from other species. For Amazonian tidal floodplain forests, national management guidelines provide neither the highest yields nor the highest sustained population growth for species under management. Our research shows that management guidelines specific to a region’s ecological settings can be further refined to consider differences in species demographic responses to repeated harvests. In principle, such fine-tuned management guidelines could make management more attractive, thus bridging the currently prevalent gap between tropical timber management practice and regulation. PMID:26322896

  7. Modeling the complex impacts of timber harvests to find optimal management regimes for Amazon tidal floodplain forests

    USGS Publications Warehouse

    Fortini, Lucas B.; Cropper, Wendell P.; Zarin, Daniel J.

    2015-01-01

    At the Amazon estuary, the oldest logging frontier in the Amazon, no studies have comprehensively explored the potential long-term population and yield consequences of multiple timber harvests over time. Matrix population modeling is one way to simulate long-term impacts of tree harvests, but this approach has often ignored common impacts of tree harvests including incidental damage, changes in post-harvest demography, shifts in the distribution of merchantable trees, and shifts in stand composition. We designed a matrix-based forest management model that incorporates these harvest-related impacts so resulting simulations reflect forest stand dynamics under repeated timber harvests as well as the realities of local smallholder timber management systems. Using a wide range of values for management criteria (e.g., length of cutting cycle, minimum cut diameter), we projected the long-term population dynamics and yields of hundreds of timber management regimes in the Amazon estuary, where small-scale, unmechanized logging is an important economic activity. These results were then compared to find optimal stand-level and species-specific sustainable timber management (STM) regimes using a set of timber yield and population growth indicators. Prospects for STM in Amazonian tidal floodplain forests are better than for many other tropical forests. However, generally high stock recovery rates between harvests are due to the comparatively high projected mean annualized yields from fast-growing species that effectively counterbalance the projected yield declines from other species. For Amazonian tidal floodplain forests, national management guidelines provide neither the highest yields nor the highest sustained population growth for species under management. Our research shows that management guidelines specific to a region’s ecological settings can be further refined to consider differences in species demographic responses to repeated harvests. In principle, such fine-tuned management guidelines could make management more attractive, thus bridging the currently prevalent gap between tropical timber management practice and regulation.

  8. Long-Term Unemployment and Suicide: A Systematic Review and Meta-Analysis

    PubMed Central

    Milner, Allison; Page, Andrew; LaMontagne, Anthony D.

    2013-01-01

    Purpose There have been a number of reviews on the association+ between unemployment and suicide, but none have investigated how this relationship is influenced by duration of unemployment. Method A systematic review and meta-analysis was conducted of those studies that assessed duration of unemployment as a risk factor for suicide. Studies considered as eligible for inclusion were population-based cohort or case-control designs; population-based ecological designs, or hospital based clinical cohort or case-control designs published in the year 1980 or later. Results The review identified 16 eligible studies, out of a possible 10,358 articles resulting from a search of four databases: PubMed, Web of Knowledge, Scopus and Proquest. While all 16 studies measured unemployment duration in different ways, a common finding was that longer duration of unemployment was related to greater risk of suicide and suicide attempt. A random effects meta-analysis on a subsample of six cohort studies indicated that the pooled relative risk of suicide in relation to average follow-up time after unemployment was 1.70 (95% CI 1.22 to 2.18). However, results also suggested a possible habituation effect to unemployment over time, with the greatest risk of suicide occurring within five years of unemployment compared to the employed population (RR = 2.50, 95% CI 1.83 to 3.17). Relative risk appeared to decline in studies of those unemployed between 12 and 16 years compared to those currently employed (RR = 1.21, 95% CI 1.10 to 1.33). Conclusion Findings suggest that long-term unemployment is associated with greater incidence of suicide. Results of the meta-analysis suggest that risk is greatest in the first five years, and persists at a lower but elevated level up to 16 years after unemployment. These findings are limited by the paucity of data on this topic. PMID:23341881

  9. Individualised prediction model of seizure recurrence and long-term outcomes after withdrawal of antiepileptic drugs in seizure-free patients: a systematic review and individual participant data meta-analysis.

    PubMed

    Lamberink, Herm J; Otte, Willem M; Geerts, Ada T; Pavlovic, Milen; Ramos-Lizana, Julio; Marson, Anthony G; Overweg, Jan; Sauma, Letícia; Specchio, Luigi M; Tennison, Michael; Cardoso, Tania M O; Shinnar, Shlomo; Schmidt, Dieter; Geleijns, Karin; Braun, Kees P J

    2017-07-01

    People with epilepsy who became seizure-free while taking antiepileptic drugs might consider discontinuing their medication, with the possibility of increased quality of life because of the elimination of adverse events. The risk with this action, however, is seizure recurrence. The objectives of our study were to identify predictors of seizure recurrence and long-term seizure outcomes and to produce nomograms for estimation of individualised outcomes. We did a systematic review and meta-analysis, and identified eligible articles and candidate predictors, using PubMed and Embase databases with a last update on Nov 6, 2014. Eligible articles had to report on cohorts of patients with epilepsy who were seizure-free and had started withdrawal of antiepileptic drugs; articles also had to contain information regarding seizure recurrences during and after withdrawal. We excluded surgical cohorts, reports with fewer than 30 patients, and reports on acute symptomatic seizures because these topics were beyond the scope of our objective. Risk of bias was assessed using the Quality in Prognosis Studies system. Data analysis was based on individual participant data. Survival curves and proportional hazards were computed. The strongest predictors were selected with backward selection. Models were converted to nomograms and a web-based tool to determine individual risks. We identified 45 studies with 7082 patients; ten studies (22%) with 1769 patients (25%) were included in the meta-analysis. Median follow-up was 5·3 years (IQR 3·0-10·0, maximum 23 years). Prospective and retrospective studies and randomised controlled trials were included, covering non-selected and selected populations of both children and adults. Relapse occurred in 812 (46%) of 1769 patients; 136 (9%) of 1455 for whom data were available had seizures in their last year of follow-up, suggesting enduring seizure control was not regained by this timepoint. Independent predictors of seizure recurrence were epilepsy duration before remission, seizure-free interval before antiepileptic drug withdrawal, age at onset of epilepsy, history of febrile seizures, number of seizures before remission, absence of a self-limiting epilepsy syndrome, developmental delay, and epileptiform abnormality on electroencephalogram (EEG) before withdrawal. Independent predictors of seizures in the last year of follow-up were epilepsy duration before remission, seizure-free interval before antiepileptic drug withdrawal, number of antiepileptic drugs before withdrawal, female sex, family history of epilepsy, number of seizures before remission, focal seizures, and epileptiform abnormality on EEG before withdrawal. Adjusted concordance statistics were 0·65 (95% CI 0·65-0·66) for predicting seizure recurrence and 0·71 (0·70-0·71) for predicting long-term seizure freedom. Validation was stable across the individual study populations. We present evidence-based nomograms with robust performance across populations of children and adults. The nomograms facilitate prediction of outcomes following drug withdrawal for the individual patient, including both the risk of relapse and the chance of long-term freedom from seizures. The main limitations were the absence of a control group continuing antiepileptic drug treatment and a consistent definition of long-term seizure freedom. Epilepsiefonds. Copyright © 2017 Elsevier Ltd. All rights reserved.

  10. Linking demographic processes and foraging ecology in wandering albatross-Conservation implications.

    PubMed

    Weimerskirch, Henri

    2018-07-01

    Population dynamics and foraging ecology are two fields of the population ecology that are generally studied separately. Yet, foraging determines allocation processes and therefore demography. Studies on wandering albatrosses Diomedea exulans over the past 50 years have contributed to better understand the links between population dynamics and foraging ecology. This article reviews how these two facets of population ecology have been combined to better understand ecological processes, but also have contributed fundamentally for the conservation of this long-lived threatened species. Wandering albatross research has combined a 50-year long-term study of marked individuals with two decades of tracking studies that have been initiated on this species, favoured by its large size and tameness. At all stages of their life history, the body mass of individuals plays a central role in allocation processes, in particular in influencing adult and juvenile survival, decisions to recruit into the population or to invest into provisioning the offspring or into maintenance. Strong age-related variations in demographic parameters are observed and are linked to age-related differences in foraging distribution and efficiency. Marked sex-specific differences in foraging distribution, foraging efficiency and changes in mass over lifetime are directly related to the strong sex-specific investment in breeding and survival trajectories of the two sexes, with body mass playing a pivotal role especially in males. Long-term study has allowed determining the sex-specific and age-specific demographic causes of population decline, and the tracking studies have been able to derive where and how these impacts occur, in particular the role of long-line fisheries. © 2018 The Author. Journal of Animal Ecology published by John Wiley & Sons Ltd on behalf of British Ecological Society.

  11. The influence of personality disorder on the future mental health and social adjustment of young adults: a population-based, longitudinal cohort study.

    PubMed

    Moran, Paul; Romaniuk, Helena; Coffey, Carolyn; Chanen, Andrew; Degenhardt, Louisa; Borschmann, Rohan; Patton, George C

    2016-07-01

    Existing knowledge about the consequences of personality disorders is substantially derived from the study of clinical populations. To gain a fuller understanding of the disease burden associated with personality disorders, we report their long-term mental health and social consequences in a large population-based sample of young adults. We used data from a population-based, ten-wave cohort study of a stratified random sample of non-treatment-seeking young adults recruited from Victoria, Australia, between Aug 20, 1992, and March 3, 2014. The population sample was originally recruited in adolescence: here we report the analysis of data collected from wave 8 (participants aged 24-25 years) and wave 10 (participants aged 34-35 years). Presence and severity of personality disorder were assessed at age 24 years with a semi-structured, informant-based interview (the Standardised Assessment of Personality). At age 35 years, participants were assessed on the occurrence of the following outcomes: major depressive disorder, anxiety disorder, smoking and alcohol consumption, illicit substance use, ever having separated from a long-term partner or been divorced, not currently in a relationship, not currently in paid employment, and in receipt of government welfare. We used multiple imputation to address potentially biased estimates resulting from the reduction of the analysis sample to participants who had completed both survey waves. The imputation dataset contained 1635 individuals. For the 1520 participants in wave 8, 1145 (75%) informant interviews for personality disorder in these participants took place. At age 24 years, 305 (27%) of the observed sample had either personality difficulties or personality disorder. At age 24 years, in the imputed analysis sample, the severity of personality disorder was associated with the absence of a degree or vocational qualification (adjusted odds ratio [aOR] for the effect of complex and severe personality disorder vs no personality disorder 1·76, 95% CI 1·11-2·76), receipt of welfare (2·52, 1·33-4·78), the presence of common mental disorders (1·77, 1·08-2·90), and cigarette smoking (2·01, 1·29-3·14). At age 35 years, severity of personality disorder was independently associated with not being in a relationship (aOR for the effect of complex and severe personality disorder vs no personality disorder or personality difficulty 2·05, 95% CI 1·21-3·45), increased odds of an anxiety disorder (2·27, 1·2-4·28), and major depression (2·23, 1·24-4·01). The presence of personality disorder predicts the occurrence of later anxiety and depression, as well as the absence of long-term relationships, effects that are not attributable to pre-existing mental health, substance use or social problems. Our study provides strong support for including personality disorder in global studies of the burden of mental disorders to improve the understanding of population mental health. Australia's National Health and Medical Research Council (NHMRC) and Victoria's Operational Infrastructure Support Program. Copyright © 2016 Elsevier Ltd. All rights reserved.

  12. Short- and long-term changes in perceived work ability after interdisciplinary rehabilitation of chronic musculoskeletal disorders: prospective cohort study among 854 rehabilitants.

    PubMed

    Saltychev, Mikhail; Laimi, Katri; Pentti, Jaana; Kivimäki, Mika; Vahtera, Jussi

    2014-06-01

    To investigate the changes in rehabilitants' perceived work ability after rehabilitation for chronic musculoskeletal disorders with respect to the baseline characteristics. Prospective cohort study based on register and repeated survey data. Public sector employees in ten towns and five hospital districts. A total of 854 employees who participated in the rehabilitation programme owing to common chronic musculoskeletal disorders between 1997 and 2009. Interdisciplinary, biopsychosocial, inpatient rehabilitation programme targeting people of working age with common chronic musculoskeletal disorders. The programme was executed in different rehabilitation centres across the country and funded by the Social Insurance Institution of Finland. Differences in perceived work ability level before and after rehabilitation. Data were derived from repeated surveys on average 2.1 years before rehabilitation, and 1.5 years (short-term follow-up) and 6.0 years (long-term follow-up) after rehabilitation. Before the rehabilitation, perceived work ability was 7.13 (SD 1.84) among the rehabilitants and 7.27 (SD 1.72) in the matched reference population. Among rehabilitants, this figure decreased by 0.82 (95% confidence interval -0.98 to -0.67) in the short-term and by 1.26 (95% confidence interval -1.45 to -1.07) in the long-term follow-up. Only slight differences in steepness of this deterioration were observed between subgroups, created based on the participants' baseline characteristics. Perceived work ability of participants, in an interdisciplinary biopsychosocial rehabilitation programme for common musculoskeletal disorders, deteriorated regardless of any studied pretreatment characteristics. The improvement of work ability may be an unrealistic goal for participants in this type of rehabilitation. © The Author(s) 2014.

  13. Prognostic significance of functional somatic symptoms in adolescence: a 15-year community-based follow-up study of adolescents with depression compared with healthy peers

    PubMed Central

    2012-01-01

    Background There is a lack of population-based long-term longitudinal research on mental health status and functional physical/somatic symptoms. Little is known about the long-term mental health outcomes associated with somatic symptoms or the temporal relationship between depression and such symptoms. This 15-year study followed up adolescents with depression and matched controls, screened from a population-based sample, who reported different numbers of somatic symptoms. Methods The total population of 16–17-year-olds in Uppsala, Sweden, was screened for depression in 1991–1993. Adolescents who screened positive and an equal number of healthy controls took part in a semi-structured diagnostic interview. In addition, 21 different self-rated somatic symptoms were assessed. Sixty-four percent of those adolescents participated in a follow-up structured interview 15 years later. Results Somatic symptoms in adolescence predicted depression and other adult mental disorders regardless of the presence of adolescent depression. In adolescents with depression, the number of functional somatic symptoms predicted, in a dose response relationship, suicidal behavior, bipolar episodes, and psychotic episodes as well as chronic and recurrent depression. Contrary to expectations, the somatic symptoms of abdominal pain and perspiration without exertion better predicted depression than all DSM-IV depressive symptoms. Abdominal pain persisted as an independent strong predictor of depression and anxiety, even after controlling for other important confounders. Conclusions Somatic symptoms in adolescence can predict severe adult mental health disorders. The number of somatic symptoms concurrent with adolescent depression is, in a stepwise manner, linked to suicidal attempts, bipolar disorders, psychotic disorders, and recurrent and chronic depression. These findings can be useful in developing treatment guidelines for patients with somatic symptoms. PMID:22839681

  14. Long-term effect of lime-fly ash treated soils.

    DOT National Transportation Integrated Search

    2003-12-01

    In October of 2000 MDOT initiated State Study No. 147, entitled "Long-Term Effect of Lime-Fly Ash Treated Soils." The purpose of this study : was to evaluate the long-term performance of LFA stabilized soil as a base course material. Part of the impe...

  15. Relative Importance of Hip and Sacral Pain Among Long-Term Gynecological Cancer Survivors Treated With Pelvic Radiotherapy and Their Relationships to Mean Absorbed Doses

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

    Waldenstroem, Ann-Charlotte, E-mail: ann-charlotte.waldenstrom@oncology.gu.se; Department of Oncology, Sahlgrenska University Hospital, Gothenburg; Olsson, Caroline

    Purpose: To investigate the relative importance of patient-reported hip and sacral pain after pelvic radiotherapy (RT) for gynecological cancer and its relationship to the absorbed doses in these organs. Methods and Materials: We used data from a population-based study that included 650 long-term gynecological cancer survivors treated with pelvic RT in the Gothenburg and Stockholm areas in Sweden with a median follow-up of 6 years (range, 2-15) and 344 population controls. Symptoms were assessed through a study-specific postal questionnaire. We also analyzed the hip and sacral dose-volume histogram data for 358 of the survivors. Results: Of the survivors, one inmore » three reported having or having had hip pain after completing RT. Daily pain when walking was four times as common among the survivors compared to controls. Symptoms increased in frequency with a mean absorbed dose >37.5 Gy. Also, two in five survivors reported pain in the sacrum. Sacral pain also affected their walking ability and tended to increase with a mean absorbed dose >42.5 Gy. Conclusions: Long-term survivors of gynecological cancer treated with pelvic RT experience hip and sacral pain when walking. The mean absorbed dose was significantly related to hip pain and was borderline significantly related to sacral pain. Keeping the total mean absorbed hip dose below 37.5 Gy during treatment might lower the occurrence of long-lasting pain. In relation to the controls, the survivors had a lower occurrence of pain and pain-related symptoms from the hips and sacrum compared with what has previously been reported for the pubic bone.« less

  16. Reversible and long-term immobilization in a hydrogel-microbead matrix for high-resolution imaging of Caenorhabditis elegans and other small organisms

    PubMed Central

    Cornaglia, Matteo; Krishnamani, Gopalan; Zhang, Jingwei; Mouchiroud, Laurent; Lehnert, Thomas; Auwerx, Johan; Gijs, Martin A. M.

    2018-01-01

    The nematode Caenorhabditis elegans is an important model organism for biomedical research and genetic studies relevant to human biology and disease. Such studies are often based on high-resolution imaging of dynamic biological processes in the worm body tissues, requiring well-immobilized and physiologically active animals in order to avoid movement-related artifacts and to obtain meaningful biological information. However, existing immobilization methods employ the application of either anesthetics or servere physical constraints, by using glue or specific microfluidic on-chip mechanical structures, which in some cases may strongly affect physiological processes of the animals. Here, we immobilize C. elegans nematodes by taking advantage of a biocompatible and temperature-responsive hydrogel-microbead matrix. Our gel-based immobilization technique does not require a specific chip design and enables fast and reversible immobilization, thereby allowing successive imaging of the same single worm or of small worm populations at all development stages for several days. We successfully demonstrated the applicability of this method in challenging worm imaging contexts, in particular by applying it for high-resolution confocal imaging of the mitochondrial morphology in worm body wall muscle cells and for the long-term quantification of number and size of specific protein aggregates in different C. elegans neurodegenerative disease models. Our approach was also suitable for immobilizing other small organisms, such as the larvae of the fruit fly Drosophila melanogaster and the unicellular parasite Trypanosoma brucei. We anticipate that this versatile technique will significantly simplify biological assay-based longitudinal studies and long-term observation of small model organisms. PMID:29509812

  17. Mental illness and suicide after self-harm among young adults: long-term follow-up of self-harm patients, admitted to hospital care, in a national cohort.

    PubMed

    Beckman, K; Mittendorfer-Rutz, E; Lichtenstein, P; Larsson, H; Almqvist, C; Runeson, B; Dahlin, M

    2016-12-01

    Self-harm among young adults is a common and increasing phenomenon in many parts of the world. The long-term prognosis after self-harm at young age is inadequately known. We aimed to estimate the risk of mental illness and suicide in adult life after self-harm in young adulthood and to identify prognostic factors for adverse outcome. We conducted a national population-based matched case-cohort study. Patients aged 18-24 years (n = 13 731) hospitalized after self-harm between 1990 and 2003 and unexposed individuals of the same age (n = 137 310 ) were followed until December 2009. Outcomes were suicide, psychiatric hospitalization and psychotropic medication in short-term (1-5 years) and long-term (>5 years) follow-up. Self-harm implied an increased relative risk of suicide during follow-up [hazard ratio (HR) 16.4, 95% confidence interval (CI) 12.9-20.9). At long-term follow-up, 20.3% had psychiatric hospitalizations and 51.1% psychotropic medications, most commonly antidepressants and anxiolytics. There was a six-fold risk of psychiatric hospitalization (HR 6.3, 95% CI 5.8-6.8) and almost three-fold risk of psychotropic medication (HR 2.8, 95% CI 2.7-3.0) in long-term follow-up. Mental disorder at baseline, especially a psychotic disorder, and a family history of suicide were associated with adverse outcome among self-harm patients. We found highly increased risks of future mental illness and suicide among young adults after self-harm. A history of a mental disorder was an important indicator of long-term adverse outcome. Clinicians should consider the substantially increased risk of suicide among self-harm patients with psychotic disorders.

  18. Seroprevalence of Mumps in The Netherlands: Dynamics over a Decade with High Vaccination Coverage and Recent Outbreaks

    PubMed Central

    Smits, Gaby; Mollema, Liesbeth; Hahné, Susan; de Melker, Hester; Tcherniaeva, Irina; Waaijenborg, Sandra; van Binnendijk, Rob; van der Klis, Fiona; Berbers, Guy

    2013-01-01

    Here we present mumps virus specific antibody levels in a large cross-sectional population-based serosurveillance study performed in the Netherlands in 2006/2007 (n = 7900). Results were compared with a similar study (1995/1996) and discussed in the light of recent outbreaks. Mumps antibodies were tested using a fluorescent bead-based multiplex immunoassay. Overall seroprevalence was 90.9% with higher levels in the naturally infected cohorts compared with vaccinated cohorts. Mumps virus vaccinations at 14 months and 9 years resulted in an increased seroprevalence and antibody concentration. The second vaccination seemed to be important in acquiring stable mumps antibody levels in the long term. In conclusion, the Dutch population is well protected against mumps virus infection. However, we identified specific age- and population groups at increased risk of mumps infection. Indeed, in 2007/2008 an outbreak has occurred in the low vaccination coverage groups emphasizing the predictive value of serosurveillance studies. PMID:23520497

  19. Building an Evidence Base to Inform Interventions for Pregnant and Parenting Adolescents: A Call for Rigorous Evaluation

    PubMed Central

    Burrus, Barri B.; Scott, Alicia Richmond

    2012-01-01

    Adolescent parents and their children are at increased risk for adverse short- and long-term health and social outcomes. Effective interventions are needed to support these young families. We studied the evidence base and found a dearth of rigorously evaluated programs. Strategies from successful interventions are needed to inform both intervention design and policies affecting these adolescents. The lack of rigorous evaluations may be attributable to inadequate emphasis on and sufficient funding for evaluation, as well as to challenges encountered by program evaluators working with this population. More rigorous program evaluations are urgently needed to provide scientifically sound guidance for programming and policy decisions. Evaluation lessons learned have implications for other vulnerable populations. PMID:22897541

  20. Long-term persistence of protective antibodies in Dutch adolescents following a meningococcal serogroup C tetanus booster vaccination.

    PubMed

    van Ravenhorst, Mariëtte B; Marinovic, Axel Bonacic; van der Klis, Fiona R M; van Rooijen, Debbie M; van Maurik, Marjan; Stoof, Susanne P; Sanders, Elisabeth A M; Berbers, Guy A M

    2016-12-07

    Due to waning immunity, infant vaccination with meningococcal serogroup C conjugated (MenCC) vaccines is insufficient to maintain long-term individual protection. Adolescent booster vaccination is thought to offer direct protection against invasive meningococcal disease (IMD) but also to reduce meningococcal carriage and transmission and in this way establish herd protection in the population. Previously, we studied antibody levels after adolescent MenCC booster vaccination. In the present study, the adolescent vaccinees were revisited after three years to determine antibody persistence and to predict long-term protection. Meningococcal serogroup C tetanus toxoid conjugated (MenC-TT) vaccine was administered to 10-, 12- and 15-year old participants who had been primed nine years earlier with a single dose of MenC-TT vaccine. Blood samples were collected before, 1month, 1year and 3years after the adolescent booster vaccination. Functional antibody levels were measured with serum bactericidal assay using rabbit complement (rSBA). Meningococcal serogroup C polysaccharide and tetanus toxoid specific antibody levels were measured using fluorescent-bead-based multiplex immunoassay. Long-term protection was estimated using longitudinal multilevel antibody decay modeling. Of the original 268 participants, 201 (75%) were revisited after 3years. All participants still had an rSBA titer above the protective threshold of ⩾8 and 98% ⩾128. The 15-year-olds showed the highest antibody titers. Using a bi-exponential decay model, the median time to fall below the protection threshold (rSBA titer <8) was 16.3years, 45.9years and around 270years following the booster for the 10-, 12- and 15-year-olds, respectively. After a first steep decline in antibody levels in the first year after the booster, antibody levels slowly declined between one and three years post-booster. A routine MenC-TT booster vaccination for adolescents in the Netherlands will likely provide long-term individual protection and potentially reduce the risk of resurgence of MenC disease in the general population. Copyright © 2016 Elsevier Ltd. All rights reserved.

  1. Excess costs of dementia disorders and the role of age and gender - an analysis of German health and long-term care insurance claims data

    PubMed Central

    2012-01-01

    Background Demographic ageing is associated with an increasing number of dementia patients, who reportedly incur higher costs of care than individuals without dementia. Regarding Germany, evidence on these excess costs is scarce. Adopting a payer perspective, our study aimed to quantify the additional yearly expenditures per dementia patient for various health and long-term care services. Additionally, we sought to identify gender-specific cost patterns and to describe age-dependent cost profiles. Methods The analyses used 2006 claims data from the AOK Bavaria Statutory Health Insurance fund of 9,147 dementia patients and 29,741 age- and gender-matched control subjects. Cost predictions based on two-part regression models adjusted for age and gender and excess costs of dementia care refer to the difference in model-estimated means between both groups. Corresponding analyses were performed stratified for gender. Finally, a potentially non-linear association between age and costs was investigated within a generalized additive model. Results Yearly spending within the social security system was circa €12,300 per dementia patient and circa €4,000 per non-demented control subject. About two-thirds of the additional expenditure for dementia patients occurred in the long-term care sector. Within our study sample, male and female dementia patients incurred comparable total costs. However, women accounted for significantly lower health and significantly higher long-term care expenditures. Long-term care spending increased in older age, whereupon health care spending decreased. Thus, at more advanced ages, women incurred greater costs than men of the same age. Conclusions Dementia poses a substantial additional burden to the German social security system, with the long-term care sector being more seriously challenged than the health care sector. Our results suggest that female dementia patients need to be seen as a key target group for health services research in an ageing society. It seems clear that strategies enabling community-based care for this vulnerable population might contribute to lowering the financial burden caused by dementia. This would allow for the sustaining of comprehensive dementia care within the social security system. PMID:22713212

  2. Self-Reported Physical Quality of Life Before Thoracic Operations Is Associated With Long-Term Survival.

    PubMed

    Al-Ameri, Mamdoh; Bergman, Per; Franco-Cereceda, Anders; Sartipy, Ulrik

    2017-02-01

    The aim was to analyze the association between baseline self-reported health-related quality of life and long-term survival after thoracic operations. In a prospective population-based cohort study, we included patients scheduled for thoracic operations and obtained information about preoperative health-related quality of life using the validated quality-of-life instrument Short Form-36. Patients were categorized according to higher or lower physical and mental component scores, compared with an age- and sex-matched reference population. The primary outcome measure was all-cause mortality and was ascertained from Swedish national registers. We used Cox regression for estimation of hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between preoperative physical/mental quality of life and long-term survival while adjusting for differences in baseline characteristics, cancer stage, histopathologic process, and other factors. We included 249 patients between 2006 and 2008. During a median follow-up time of 8.0 years, 119 patients (48%) died. Having a physical component summary score less than reference was significantly associated with mortality (multivariable adjusted HR 2.02, 95% CI: 1.34 to 3.06, p = 0.001). A mental component summary score less than reference was not associated with mortality (adjusted HR 1.32, 95% CI: 0.84 to 3.06, p = 0.233). In patients who underwent thoracic operations, a self-reported physical quality of life lower than reference value was associated with significantly worse survival independent of histopathologic process, cancer stage, extent of operations, and other patient-related factors. The preoperative mental component of quality of life was not associated with long-term survival. Copyright © 2017 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  3. Air quality and urban form in U.S. urban areas: evidence from regulatory monitors.

    PubMed

    Clark, Lara P; Millet, Dylan B; Marshall, Julian D

    2011-08-15

    The layout of an urban area can impact air pollution via changes in emissions and their spatial distribution. Here, we explore relationships between air quality and urban form based on cross-sectional observations for 111 U.S. urban areas. We employ stepwise linear regression to quantify how long-term population-weighted outdoor concentrations of ozone, fine particulate matter (PM(2.5)), and other criteria pollutants measured by the U.S. Environmental Protection Agency depend on urban form, climate, transportation, city size, income, and region. Aspects of urban form evaluated here include city shape, road density, jobs-housing imbalance, population density, and population centrality. We find that population density is associated with higher population-weighted PM(2.5) concentrations (p < 0.01); population centrality is associated with lower population-weighted ozone and PM(2.5) concentrations (p < 0.01); and transit supply is associated with lower population-weighted PM(2.5) concentrations (p < 0.1). Among pollutants, interquartile range changes in urban form variables are associated with 4%-12% changes in population-weighted concentrations-amounts comparable, for example, to changes in climatic factors. Our empirical findings are consistent with prior modeling research and suggest that urban form could potentially play a modest but important role in achieving (or not achieving) long-term air quality goals.

  4. Sensitivity Analysis for Studying Impacts of Aging on Population Toxicokinetics and Toxicodynamics

    EPA Science Inventory

    Assessing the impacts of toxicant exposures upon susceptible populations such as the elderly requires adequate characterization of prior long-term exposures, reductions in various organ functions, and potential intake of multiple drugs. Additionally, significant uncertainties and...

  5. Population cycles are highly correlated over long time series and large spatial scales in two unrelated species: Greater sage-grouse and cottontail rabbits

    USGS Publications Warehouse

    Fedy, B.C.; Doherty, K.E.

    2011-01-01

    Animal species across multiple taxa demonstrate multi-annual population cycles, which have long been of interest to ecologists. Correlated population cycles between species that do not share a predator-prey relationship are particularly intriguing and challenging to explain. We investigated annual population trends of greater sage-grouse (Centrocercus urophasianus) and cottontail rabbits (Sylvilagus sp.) across Wyoming to explore the possibility of correlations between unrelated species, over multiple cycles, very large spatial areas, and relatively southern latitudes in terms of cycling species. We analyzed sage-grouse lek counts and annual hunter harvest indices from 1982 to 2007. We show that greater sage-grouse, currently listed as warranted but precluded under the US Endangered Species Act, and cottontails have highly correlated cycles (r = 0. 77). We explore possible mechanistic hypotheses to explain the synchronous population cycles. Our research highlights the importance of control populations in both adaptive management and impact studies. Furthermore, we demonstrate the functional value of these indices (lek counts and hunter harvest) for tracking broad-scale fluctuations in the species. This level of highly correlated long-term cycling has not previously been documented between two non-related species, over a long time-series, very large spatial scale, and within more southern latitudes. ?? 2010 US Government.

  6. A prospective population-based study of health complaints in adolescence and use of social welfare benefits in young adulthood.

    PubMed

    Homlong, Lisbeth; Rosvold, Elin O; Bruusgaard, Dag; Lien, Lars; Sagatun, Åse; Haavet, Ole R

    2015-08-01

    There is a lack of knowledge on how health problems in adolescence are connected to work marginalization in adulthood. The aim of this study was to study work marginalization in young adulthood, measured by use of long-term social welfare benefits, and its associations with self-reported health complaints, total symptom burden and self-rated general health at ages 15-16. We linked data from a youth health survey conducted during 1999-2004 to data from Norwegian registries that followed each participant through February 2010. Cox regression analysis was used to compute hazard ratios (HRs) for the use of long-term social welfare benefits in young adulthood, based on health measures in 15-16 year-olds. During the follow-up, 17% of the study population received some sort of long-term social welfare benefit. In the baseline survey, 95% of the adolescents reported one or more health complaints. The mean number of health complaints was 4.8. Girls reported a significantly higher mean number of complaints (5.7) than did boys (3.8) (p < 0.001). Several individual health complaints were associated with an increased use of long-term social welfare benefits. We found an increasing relative hazard of social welfare usage, depending on the number of complaints reported at baseline. Ill self-perceived general health was found to be strongly associated with the use of benefits during the follow-up: In girls, we found HRs of 1.41 (CI 1.21-1.65), 2.76 (2.29-3.31) and 2.77 (1.51-5.07) for those with good, not so good and bad health, respectively; compared to very good health. The corresponding numbers in boys were 1.41 (1.25-1.59), 1.93 (1.60-2.32) and 1.31 (0.72-2.38), respectively. Several health measures in adolescents were found to be associated with future work marginalization in young adulthood. The associations remained significant, even after correcting for such strong predictors as the parents' education and family economy. Total symptom burden and self-perceived general health can add additional knowledge onto how adolescent health is related to work marginalization, in a longitudinal perspective. © 2015 the Nordic Societies of Public Health.

  7. Toxicities Associated with Cisplatin-Based Chemotherapy and Radiotherapy in Long-Term Testicular Cancer Survivors

    PubMed Central

    Dinh, Paul; Ardeshir-Rouhani-Fard, Shirin; Fossa, Sophie D.; Travis, Lois B.

    2018-01-01

    Testicular cancer has become the paradigm of adult-onset cancer survivorship, due to the young age at diagnosis and 10-year relative survival of 95%. This clinical review presents the current status of various treatment-related complications experienced by long-term testicular cancer survivors (TCS) free of disease for 5 or more years after primary treatment. Cardiovascular disease and second malignant neoplasms represent the most common potentially life-threatening late effects. Other long-term adverse outcomes include neuro- and ototoxicity, pulmonary complications, nephrotoxicity, hypogonadism, infertility, and avascular necrosis. Future research efforts should focus on delineation of the genetic underpinning of these long-term toxicities to understand their biologic basis and etiopathogenetic pathways, with the goal of developing targeted prevention and intervention strategies to optimize risk-based care and minimize chronic morbidities. In the interim, health care providers should advise TCS to adhere to national guidelines for the management of cardiovascular disease risk factors, as well as to adopt behaviors consistent with a healthy lifestyle, including smoking cessation, a balanced diet, and a moderate to vigorous intensity exercise program. TCS should also follow national guidelines for cancer screening as currently applied to the general population. PMID:29670654

  8. Mate competition and evolutionary outcomes in genetically modified zebrafish (Danio rerio).

    PubMed

    Howard, Richard D; Rohrer, Karl; Liu, Yiyang; Muir, William M

    2015-05-01

    Demonstrating relationships between sexual selection mechanisms and trait evolution is central to testing evolutionary theory. Using zebrafish, we found that wild-type males possessed a significant advantage in mate competition over transgenic RFP Glofish® males. In mating trials, wild-type males were aggressively superior to transgenic males in male-male chases and male-female chases; as a result, wild-type males sired 2.5× as many young as did transgenic males. In contrast, an earlier study demonstrated that female zebrafish preferred transgenic males as mates when mate competition was excluded experimentally. We tested the evolutionary consequence of this conflict between sexual selection mechanisms in a long-term study. The predicted loss of the transgenic phenotype was confirmed. More than 18,500 adults collected from 18 populations across 15 generations revealed that the frequency of the transgenic phenotype declined rapidly and was eliminated entirely in all but one population. Fitness component data for both sexes indicated that only male mating success differed between wild-type and transgenic individuals. Our predictive demographic model based on fitness components closely matched the rate of transgenic phenotype loss observed in the long-term study, thereby supporting its utility for studies assessing evolutionary outcomes of escaped or released genetically modified animals. © 2015 The Author(s).

  9. Measuring short-term and long-term physiological stress effects by cortisol reactivity in saliva and hair.

    PubMed

    van Holland, Berry J; Frings-Dresen, Monique H W; Sluiter, Judith K

    2012-11-01

    The aims of this study were to investigate (1) the concurrent relationship between short-term and long-term stress reactivity measured by cortisol excretion and (2) the relationship of these physiological stress effects with self-reported stress and need for recovery after work (NFR). Participants were production workers in the meat-processing industry. Short-term cortisol excretion was calculated by summing 18 saliva samples, sampled over a 3-day period. Samples were delivered by 37 participants. Twenty-nine of them also supplied one hair sample of at least 3 cm in length for an analysis of long-term (3 months) cortisol excretion. All of them filled in a short questionnaire on self-reported stress and NFR. Self-reported stress was assessed by a three-item stress screener; NFR was assessed by an 11-item scale. Short-term and long-term cortisol excretion are significantly, but moderately, associated (r = 0.41, P = 0.03). Short-term and long-term cortisol excretion correlated weakly to self-reported stress and NFR (correlations varied from -0.04 to 0.21). Short-term and long-term physiological stress excretion levels are moderately associated. Physiological stress effects assessed from saliva and hair cannot be used interchangeably with self-reported stress because they only correlate weakly. To better predict long-term cortisol excretion in workers, the predictive value of short-term cortisol excretion must be evaluated in a prognostic longitudinal study in a working population.

  10. Quantifying landscape linkages among giant panda subpopulations in regional scale conservation.

    PubMed

    Qi, Dunwu; Hu, Yibo; Gu, Xiaodong; Yang, Xuyi; Yang, Guang; Wei, Fuwen

    2012-06-01

    Understanding habitat requirements and identifying landscape linkages are essential for the survival of isolated populations of endangered species. Currently, some of the giant panda populations are isolated, which threatens their long-term survival, particularly in the Xiaoxiangling mountains. In the present study, we quantified niche requirements and then identified potential linkages of giant panda subpopulations in the most isolated region, using ecological niche factor analysis and a least-cost path model. Giant pandas preferred habitat with conifer forest and gentle slopes (>20 to ≤30°). Based on spatial distribution of suitable habitat, linkages were identified for the Yele subpopulation to 4 other subpopulations (Liziping, Matou, Xinmin and Wanba). Their lengths ranged from 15 to 54 km. The accumulated cost ranged from 693 to 3166 and conifer forest covered over 31%. However, a variety of features (e.g. major roads, human settlements and large unforested areas) might act as barriers along the linkages for giant panda dispersal. Our analysis quantified giant panda subpopulation connectivity to ensure long-term survival. © 2012 ISZS, Blackwell Publishing and IOZ/CAS.

  11. Assessing anthropogenic impact on boreal lakes with historical fish species distribution data and hydrogeochemical modeling.

    PubMed

    Valinia, Salar; Englund, Göran; Moldan, Filip; Futter, Martyn N; Köhler, Stephan J; Bishop, Kevin; Fölster, Jens

    2014-09-01

    Quantifying the effects of human activity on the natural environment is dependent on credible estimates of reference conditions to define the state of the environment before the onset of adverse human impacts. In Europe, emission controls that aimed at restoring ecological status were based on hindcasts from process-based models or paleolimnological reconstructions. For instance, 1860 is used in Europe as the target for restoration from acidification concerning biological and chemical parameters. A more practical problem is that the historical states of ecosystems and their function cannot be observed directly. Therefore, we (i) compare estimates of acidification based on long-term observations of roach (Rutilus rutilus) populations with hindcast pH from the hydrogeochemical model MAGIC; (ii) discuss policy implications and possible scope for use of long-term archival data for assessing human impacts on the natural environment and (iii) present a novel conceptual model for interpreting the importance of physico-chemical and ecological deviations from reference conditions. Of the 85 lakes studied, 78 were coherently classified by both methods. In 1980, 28 lakes were classified as acidified with the MAGIC model, however, roach was present in 14 of these. In 2010, MAGIC predicted chemical recovery in 50% of the lakes, however roach only recolonized in five lakes after 1990, showing a lag between chemical and biological recovery. Our study is the first study of its kind to use long-term archival biological data in concert with hydrogeochemical modeling for regional assessments of anthropogenic acidification. Based on our results, we show how the conceptual model can be used to understand and prioritize management of physico-chemical and ecological effects of anthropogenic stressors on surface water quality. © 2014 The Authors Global Change Biology Published by John Wiley & Sons Ltd.

  12. Assessing anthropogenic impact on boreal lakes with historical fish species distribution data and hydrogeochemical modeling

    PubMed Central

    Valinia, Salar; Englund, Göran; Moldan, Filip; Futter, Martyn N; Köhler, Stephan J; Bishop, Kevin; Fölster, Jens

    2014-01-01

    Quantifying the effects of human activity on the natural environment is dependent on credible estimates of reference conditions to define the state of the environment before the onset of adverse human impacts. In Europe, emission controls that aimed at restoring ecological status were based on hindcasts from process-based models or paleolimnological reconstructions. For instance, 1860 is used in Europe as the target for restoration from acidification concerning biological and chemical parameters. A more practical problem is that the historical states of ecosystems and their function cannot be observed directly. Therefore, we (i) compare estimates of acidification based on long-term observations of roach (Rutilus rutilus) populations with hindcast pH from the hydrogeochemical model MAGIC; (ii) discuss policy implications and possible scope for use of long-term archival data for assessing human impacts on the natural environment and (iii) present a novel conceptual model for interpreting the importance of physico-chemical and ecological deviations from reference conditions. Of the 85 lakes studied, 78 were coherently classified by both methods. In 1980, 28 lakes were classified as acidified with the MAGIC model, however, roach was present in 14 of these. In 2010, MAGIC predicted chemical recovery in 50% of the lakes, however roach only recolonized in five lakes after 1990, showing a lag between chemical and biological recovery. Our study is the first study of its kind to use long-term archival biological data in concert with hydrogeochemical modeling for regional assessments of anthropogenic acidification. Based on our results, we show how the conceptual model can be used to understand and prioritize management of physico-chemical and ecological effects of anthropogenic stressors on surface water quality. PMID:24535943

  13. Aspects of mental health dysfunction among survivors of childhood cancer.

    PubMed

    Fidler, Miranda M; Ziff, Oliver J; Wang, Sarra; Cave, Joshua; Janardhanan, Pradeep; Winter, David L; Kelly, Julie; Mehta, Susan; Jenkinson, Helen; Frobisher, Clare; Reulen, Raoul C; Hawkins, Michael M

    2015-09-29

    Some previous studies have reported that survivors of childhood cancer are at an increased risk of developing long-term mental health morbidity, whilst others have reported that this is not the case. Therefore, we analysed 5-year survivors of childhood cancer using the British Childhood Cancer Survivor Study (BCCSS) to determine the risks of aspects of long-term mental health dysfunction. Within the BCCSS, 10 488 survivors completed a questionnaire that ascertained mental health-related information via 10 questions from the Short Form-36 survey. Internal analyses were conducted using multivariable logistic regression to determine risk factors for mental health dysfunction. External analyses were undertaken using direct standardisation to compare mental health dysfunction in survivors with UK norms. This study has shown that overall, childhood cancer survivors had a significantly higher prevalence of mental health dysfunction for 6/10 questions analysed compared to UK norms. Central nervous system (CNS) and bone sarcoma survivors reported the greatest dysfunction, compared to expected, with significant excess dysfunction in 10 and 6 questions, respectively; the excess ranged from 4.4-22.3% in CNS survivors and 6.9-15.9% in bone sarcoma survivors. Compared to expected, excess mental health dysfunction increased with attained age; this increase was greatest for reporting 'limitations in social activities due to health', where the excess rose from 4.5% to 12.8% in those aged 16-24 and 45+, respectively. Within the internal analyses, higher levels of educational attainment and socio-economic classification were protective against mental health dysfunction. Based upon the findings of this large population-based study, childhood cancer survivors report significantly higher levels of mental health dysfunction than those in the general population, where deficits were observed particularly among CNS and bone sarcoma survivors. Limitations were also observed to increase with age, and thus it is important to emphasise the need for mental health evaluation and services across the entire lifespan. There is evidence that low educational attainment and being unemployed or having never worked adversely impacts long-term mental health. These findings provide an evidence base for risk stratification and planning interventions.

  14. Long-term mobile phone use and acoustic neuroma risk.

    PubMed

    Pettersson, David; Mathiesen, Tiit; Prochazka, Michaela; Bergenheim, Tommy; Florentzson, Rut; Harder, Henrik; Nyberg, Gunnar; Siesjö, Peter; Feychting, Maria

    2014-03-01

    There is concern about potential effects of radiofrequency fields generated by mobile phones on cancer risk. Most previous studies have found no association between mobile phone use and acoustic neuroma, although information about long-term use is limited. We conducted a population-based, nation-wide, case-control study of acoustic neuroma in Sweden. Eligible cases were persons aged 20 to 69 years, who were diagnosed between 2002 and 2007. Controls were randomly selected from the population registry, matched on age, sex, and residential area. Postal questionnaires were completed by 451 cases (83%) and 710 controls (65%). Ever having used mobile phones regularly (defined as weekly use for at least 6 months) was associated with an odds ratio (OR) of 1.18 (95% confidence interval = 0.88 to 1.59). The association was weaker for the longest induction time (≥10 years) (1.11 [0.76 to 1.61]) and for regular use on the tumor side (0.98 [0.68 to 1.43]). The OR for the highest quartile of cumulative calling time (≥680 hours) was 1.46 (0.98 to 2.17). Restricting analyses to histologically confirmed cases reduced all ORs; the OR for ≥680 hours was 1.14 (0.63 to 2.07). A similar pattern was seen for cordless land-line phones, although with slightly higher ORs. Analyses of the complete history of laterality of mobile phone revealed considerable bias in laterality analyses. The findings do not support the hypothesis that long-term mobile phone use increases the risk of acoustic neuroma. The study suggests that phone use might increase the likelihood that an acoustic neuroma case is detected and that there could be bias in the laterality analyses performed in previous studies.

  15. Impact of home and community-based services on hospitalisation and institutionalisation among individuals eligible for long-term care insurance in Japan.

    PubMed

    Tomita, Naoki; Yoshimura, Kimio; Ikegami, Naoki

    2010-12-22

    This population-based retrospective cohort study aimed to clarify the impact of home and community-based services on the hospitalisation and institutionalisation of individuals certified as eligible for long-term care insurance (LTCI) benefits. Health insurance data and LTCI data were combined into a database of 1,020 individuals in two farming communities in Hokkaido who were enrolled in Citizen's Health Insurance. They had not received long-term care services prior to April 1, 2000 and were newly certified as eligible for Long-Term Care Insurance benefits between April 1, 2000 and February 29, 2008. The analysis covered 565 subjects who had not been hospitalised or institutionalised at the time of first certification of LTCI benefits. The adjusted hazard ratios (HRs) of hospitalisation or institutionalisation or death after the initial certification were calculated using the Cox proportional hazard model. The predictors were age, sex, eligibility level, area of residence, income, year of initial certification and average monthly outpatient medical expenditures, in addition to average monthly total home and community-based services expenditures (analysis 1), the use or no use of each type of service (analysis 2), and average monthly expenditures for home-visit and day-care types of services, the use or no use of respite care, and the use or no use of rental services for assistive devices (analysis 3). Users of home and community-based services were less likely than non-users to be hospitalised or institutionalised. Among the types of services, users of respite care (HR: 0.71, 95% confidence interval [CI]: 0.55-0.93) and rental services for assistive devices (HR: 0.70, 95% CI: 0.54-0.92) were less likely to be hospitalised or institutionalised than non-users. For those with relatively light needs, users of day care were also less likely to be hospitalised or institutionalized than non-users (HR: 0.77, 95% CI: 0.61-0.98). Respite care, rental services for assistive devices and day care are effective in preventing hospitalisation and institutionalisation. Our results suggest that home and community-based services contribute to the goal of the LTCI system of encouraging individuals certified as needing long-term care to live independently at home for as long as possible.

  16. Impact of home and community-based services on hospitalisation and institutionalisation among individuals eligible for long-term care insurance in Japan

    PubMed Central

    2010-01-01

    Background This population-based retrospective cohort study aimed to clarify the impact of home and community-based services on the hospitalisation and institutionalisation of individuals certified as eligible for long-term care insurance (LTCI) benefits. Methods Health insurance data and LTCI data were combined into a database of 1,020 individuals in two farming communities in Hokkaido who were enrolled in Citizen's Health Insurance. They had not received long-term care services prior to April 1, 2000 and were newly certified as eligible for Long-Term Care Insurance benefits between April 1, 2000 and February 29, 2008. The analysis covered 565 subjects who had not been hospitalised or institutionalised at the time of first certification of LTCI benefits. The adjusted hazard ratios (HRs) of hospitalisation or institutionalisation or death after the initial certification were calculated using the Cox proportional hazard model. The predictors were age, sex, eligibility level, area of residence, income, year of initial certification and average monthly outpatient medical expenditures, in addition to average monthly total home and community-based services expenditures (analysis 1), the use or no use of each type of service (analysis 2), and average monthly expenditures for home-visit and day-care types of services, the use or no use of respite care, and the use or no use of rental services for assistive devices (analysis 3). Results Users of home and community-based services were less likely than non-users to be hospitalised or institutionalised. Among the types of services, users of respite care (HR: 0.71, 95% confidence interval [CI]: 0.55-0.93) and rental services for assistive devices (HR: 0.70, 95% CI: 0.54-0.92) were less likely to be hospitalised or institutionalised than non-users. For those with relatively light needs, users of day care were also less likely to be hospitalised or institutionalized than non-users (HR: 0.77, 95% CI: 0.61-0.98). Conclusions Respite care, rental services for assistive devices and day care are effective in preventing hospitalisation and institutionalisation. Our results suggest that home and community-based services contribute to the goal of the LTCI system of encouraging individuals certified as needing long-term care to live independently at home for as long as possible. PMID:21176165

  17. Density-Dependent Recycling Promotes the Long-Term Survival of Bacterial Populations during Periods of Starvation.

    PubMed

    Takano, Sotaro; Pawlowska, Bogna J; Gudelj, Ivana; Yomo, Tetsuya; Tsuru, Saburo

    2017-02-07

    The amount of natural resources in the Earth's environment is in flux, which can trigger catastrophic collapses of ecosystems. How populations survive under nutrient-poor conditions is a central question in ecology. Curiously, some bacteria persist for a long time in nutrient-poor environments. Although this survival may be accomplished through cell death and the recycling of dead cells, the importance of these processes and the mechanisms underlying the survival of the populations have not been quantitated. Here, we use microbial laboratory experiments and mathematical models to demonstrate that death and recycling are essential activities for the maintenance of cell survival. We also show that the behavior of the survivors is governed by population density feedback, wherein growth is limited not only by the available resources but also by the population density. The numerical simulations suggest that population density-dependent recycling could be an advantageous behavior under starvation conditions. How organisms survive after exhaustion of resources is a central question in ecology. Starving Escherichia coli constitute a model system to understand survival mechanisms during long-term starvation. Although death and the recycling of dead cells might play a key role in the maintenance of long-term survival, their mechanisms and importance have not been quantitated. Here, we verified the significance of social recycling of dead cells for long-term survival. We also show that the survivors restrained their recycling and did not use all available nutrients released from dead cells, which may be advantageous under starvation conditions. These results indicate that not only the utilization of dead cells but also restrained recycling coordinate the effective utilization of limited resources for long-term survival under starvation. Copyright © 2017 Takano et al.

  18. Predictable Unpredictability: the Problem with Basing Medicare Policy on Long-Term Financial Forecasting.

    PubMed

    Glied, Sherry; Zaylor, Abigail

    2015-07-01

    The authors assess how Medicare financing and projections of future costs have changed since 2000. They also assess the impact of legislative reforms on the sources and levels of financing and compare cost forecasts made at different times. Although the aging U.S. population and rising health care costs are expected to increase the share of gross domestic product devoted to Medicare, changes made in the program over the past decade have helped stabilize Medicare's financial outlook--even as benefits have been expanded. Long-term forecasting uncertainty should make policymakers and beneficiaries wary of dramatic changes to the program in the near term that are intended to alter its long-term forecast: the range of error associated with cost forecasts rises as the forecast window lengthens. Instead, policymakers should focus on the immediate policy window, taking steps to reduce the current burden of Medicare costs by containing spending today.

  19. Spatial Assessment of the Association between Long-Term Exposure to Environmental Factors and the Occurrence of Amyotrophic Lateral Sclerosis in Catalonia, Spain: A Population-Based Nested Case-Control Study.

    PubMed

    Povedano, Mònica; Saez, Marc; Martínez-Matos, Juan-Antonio; Barceló, Maria Antònia

    2018-05-31

    It is believed that an interaction between genetic and non-genetic factors may be involved in the development of amyotrophic lateral sclerosis (ALS). With the exception of exposure to agricultural chemicals like pesticides, evidence of an association between environmental risk factors and ALS is inconsistent. Our objective here was to investigate the association between long-term exposure to environmental factors and the occurrence of ALS in Catalonia, Spain, and to provide evidence that spatial clusters of ALS related to these environmental factors exist. We carried out a nested case-control study constructed from a retrospective population-based cohort, covering the entire region. Environmental variables were the explanatory variables of interest. We controlled for both observed and unobserved confounders. We have found some spatial clusters of ALS. The results from the multivariate model suggest that these clusters could be related to some of the environmental variables, in particular agricultural chemicals. In addition, in high-risk clusters, besides corresponding to agricultural areas, key road infrastructures with a high density of traffic are also located. Our results indicate that some environmental factors, in particular those associated with exposure to pesticides and air pollutants as a result of urban traffic, could be associated with the occurrence of ALS. © 2018 S. Karger AG, Basel.

  20. A cohort study on full breastfeeding and child neuropsychological development: the role of maternal social, psychological, and nutritional factors.

    PubMed

    Julvez, Jordi; Guxens, Monica; Carsin, Anne-Elie; Forns, Joan; Mendez, Michelle; Turner, Michelle C; Sunyer, Jordi

    2014-02-01

    This study investigated whether duration of full breastfeeding is associated with child neuropsychological development and whether this association is explained by social, psychological, and nutritional factors within families. Participants in this study were a population-based birth cohort in the city of Sabadell (Catalonia, Spain). Females were recruited during the first trimester of pregnancy between July 2004 and July 2006. Information about parental characteristics and breastfeeding was obtained through questionnaires. Full breastfeeding was categorized as never, short term (≤4mo), long term (4-6mo), or very long term (>6mo). A trained psychologist assessed the neuropsychological development of children at 4 years of age (n=434) using the McCarthy Scales of Children's Abilities (MSCA). Full breastfeeding showed an independent association with child general MSCA scores after adjusting for a range of social, psychological, and nutritional factors (>6mo, coefficient=7.4 [95% confidence interval=2.8-12.0], p=0.011). Maternal social class, education level, and IQ were also associated with child neuropsychological scores, but did not explain breastfeeding associations. Omega-3 (n3) fatty acid levels were not associated with child neuropsychological scores. Very long-term full breastfeeding was independently associated with neuropsychological functions of children at 4 years of age. Maternal indicators of intelligence, psychopathology, and colostrum n3 fatty acids did not explain this association. © 2013 Mac Keith Press.

  1. Long-term safety of cilostazol in patients with peripheral artery disease: the CASTLE study (Cilostazol: A Study in Long-term Effects).

    PubMed

    Hiatt, William R; Money, Samuel R; Brass, Eric P

    2008-02-01

    Cilostazol, a phosphodiesterase III inhibitor, is indicated to treat the symptoms of intermittent claudication and increase walking distance in patients with peripheral arterial disease (PAD). At the time of approval, the United States Food and Drug Administration required an additional long-term safety study to evaluate the effect cilostazol on mortality. A total of 1899 subjects with a clinical diagnosis of PAD and symptoms of claudication were screened for participation in a randomized, double-blinded, placebo-controlled safety study of cilostazol. The intent-to-treat (ITT) population, which was the primary analysis (n = 1435), was defined as all randomized patients who received at least one dose of study medication and included patients who were followed up >30 days after discontinuation of study drug. A total of 717 patients received cilostazol and 718 received placebo. Cilostazol was administered at a primary dose of 100 mg twice daily. The dose could be reduced to 50 mg twice daily if patients experienced an adverse event that might have been drug related. Long-term adherence to study medication was poor, with >60% of participants discontinuing therapy by 36 months. The mortality analysis therefore focused on deaths during the period on-treatment, defined as the period during which the study drug was taken plus a 30-day follow-up period after dosing. Total patient-years of exposure were 1046 on-treatment for cilostazol and 1090 for placebo. On-treatment, there were 18 deaths on cilostazol and 19 deaths on placebo for a hazard ratio of 0.99 (95% confidence interval [CI], 0.52-1.88). Cardiovascular deaths on-treatment occurred in 14 patients on cilostazol and 14 on placebo. In the full ITT population at 36 months, there were 101 deaths, 49 on cilostazol and 52 on placebo, with hazard ratio of 0.94 (95% CI, 0.64-1.39). Thus, most deaths occurred >30 days after study drug discontinuation. Serious bleeding events affected 18 patients taking cilostazol in the on-treatment population and 22 taking placebo. The rates of bleeding events were similar in patients who used aspirin, aspirin plus clopidogrel, or anticoagulants at anytime during the course of the study This long-term study demonstrated no safety signal for cilostazol on all-cause or cardiovascular mortality. The study, however, was underpowered to detect a small adverse impact of cilostazol on mortality (hazard ratio upper bound of the 95% CI was 1.88 in the on-treatment population). Serious bleeding events appeared not to be increased by cilostazol.

  2. LONG-TERM INTAKE OF NUTS IN RELATION TO COGNITIVE FUNCTION IN OLDER WOMEN

    PubMed Central

    O’BRIEN, J.; OKEREKE, O.; DEVORE, E.; ROSNER, B.; BRETELER, M.; GRODSTEIN, F.

    2014-01-01

    Objective Nuts contain nutrients that may benefit brain health; thus, we examined long-term intake of nuts in relation to cognition in older women. Design Population-based prospective cohort study. Setting Academic research using data from the Nurses’ Health Study. Participants Nut intake was assessed in a food-frequency questionnaire beginning in1980, and approximately every four years thereafter. Between 1995–2001, 16,010 women age 70 or older (mean age = 74 years) without a history of stroke were administered 4 repeated telephone-based cognitive interviews over 6 years. Our final sample included 15,467 women who completed an initial cognitive interview and had complete information on nut intake. Main Outcome Measures The Telephone Interview for Cognitive Status (TICS), a global score averaging the results of all tests (TICS, immediate and delayed verbal recall, category fluency, and attention), and a verbal memory score averaging the results of tests of verbal recall. Results In multivariable-adjusted linear regression models, higher long-term total nut intake was associated with better average cognitive status for all cognitive outcomes. For the global composite score combining all tests, women consuming at least 5 servings of nuts/week had higher scores than non-consumers (mean difference=0.08 standard units, 95% confidence interval 0.00–0.15; p-trend=0.003). This mean difference of 0.08 is equivalent to the mean difference we find between women 2 years apart in age. Long-term intake of nuts was not associated with rates of cognitive decline. Conclusions Higher nut intake may be related to better overall cognition at older ages, and could be an easily-modifiable public health intervention. PMID:24886736

  3. Comparison of harvest scenarios for the cost-effective suppression of Lake Trout in Swan Lake, Montana

    USGS Publications Warehouse

    Syslo, John M.; Guy, Christopher S.; Cox, Benjamin S.

    2013-01-01

    Given the large amount of resources required for long-term control or eradication projects, it is important to assess strategies and associated costs and outcomes before a particular plan is implemented. We developed a population model to assess the cost-effectiveness of mechanical removal strategies for suppressing long-term abundance of nonnative Lake Trout Salvelinus namaycush in Swan Lake, Montana. We examined the efficacy of targeting life stages (i.e., juveniles or adults) using temporally pulsed fishing effort for reducing abundance and program cost. Exploitation rates were high (0.80 for juveniles and 0.68 for adults) compared with other lakes in the western USA with Lake Trout suppression programs. Harvesting juveniles every year caused the population to decline, whereas harvesting only adults caused the population to increase above carrying capacity. Simultaneous harvest of juveniles and adults was required to cause the population to collapse (i.e., 95% reduction relative to unharvested abundance) with 95% confidence. The population could collapse within 15 years for a total program cost of US$1,578,480 using the most aggressive scenario. Substantial variation in cost existed among harvest scenarios for a given reduction in abundance; however, total program cost was minimized when collapse was rapid. Our approach provides a useful case study for evaluating long-term mechanical removal options for fish populations that are not likely to be eradicated.

  4. Long-term results of percutaneous balloon valvuloplasty in pulmonary valve stenosis in the pediatric population.

    PubMed

    Merino-Ingelmo, Raquel; Santos-de Soto, José; Coserria-Sánchez, Félix; Descalzo-Señoran, Alfonso; Valverde-Pérez, Israel

    2014-05-01

    Percutaneous pulmonary valvuloplasty is the preferred interventional procedure for pulmonary valve stenosis. The aim of this study was to evaluate the effectiveness of this technique, assess the factors leading to its success, and determine the long-term results in the pediatric population. The study included 53 patients with pulmonary valve stenosis undergoing percutaneous balloon valvuloplasty between December 1985 and December 2000. Right ventricular size and functional echocardiographic parameters, such as pulmonary regurgitation and residual transvalvular gradient, were assessed during long-term follow-up. Peak-to-peak transvalvular gradient decreased from 74 mmHg [interquartile range, 65-100 mmHg] to 20 mmHg [interquartile range, 14-34 mmHg]. The procedure was unsuccessful in 2 patients (3.77%). The immediate success rate was 73.58%. Follow-up ranged from 10 years to 24 years (median, 15 years). During follow-up, all patients developed late pulmonary regurgitation which was assessed as grade II in 58.4% and grade III in 31.2%. There was only 1 case of long-term restenosis (2.1%). Severe right ventricular dilatation was observed in 27.1% of the patients. None of the patients developed significant right ventricular dysfunction. Pulmonary valve replacement was not required in any of the patients. Percutaneous balloon valvuloplasty is an effective technique in the treatment of pulmonary valve stenosis with good long-term results. Copyright © 2013 Sociedad Española de Cardiología. Published by Elsevier Espana. All rights reserved.

  5. Reliability of flipper-banded penguins as indicators of climate change.

    PubMed

    Saraux, Claire; Le Bohec, Céline; Durant, Joël M; Viblanc, Vincent A; Gauthier-Clerc, Michel; Beaune, David; Park, Young-Hyang; Yoccoz, Nigel G; Stenseth, Nils C; Le Maho, Yvon

    2011-01-13

    In 2007, the Intergovernmental Panel on Climate Change highlighted an urgent need to assess the responses of marine ecosystems to climate change. Because they lie in a high-latitude region, the Southern Ocean ecosystems are expected to be strongly affected by global warming. Using top predators of this highly productive ocean (such as penguins) as integrative indicators may help us assess the impacts of climate change on marine ecosystems. Yet most available information on penguin population dynamics is based on the controversial use of flipper banding. Although some reports have found the effects of flipper bands to be deleterious, some short-term (one-year) studies have concluded otherwise, resulting in the continuation of extensive banding schemes and the use of data sets thus collected to predict climate impact on natural populations. Here we show that banding of free-ranging king penguins (Aptenodytes patagonicus) impairs both survival and reproduction, ultimately affecting population growth rate. Over the course of a 10-year longitudinal study, banded birds produced 41% [corrected] fewer chicks and had a survival rate 16 percentage points [corrected] lower than non-banded birds, demonstrating a massive long-term impact of banding and thus refuting the assumption that birds will ultimately adapt to being banded. Indeed, banded birds still arrived later for breeding at the study site and had longer foraging trips even after 10 years. One of our major findings is that responses of flipper-banded penguins to climate variability (that is, changes in sea surface temperature and in the Southern Oscillation index) differ from those of non-banded birds. We show that only long-term investigations may allow an evaluation of the impact of flipper bands and that every major life-history trait can be affected, calling into question the banding schemes still going on. In addition, our understanding of the effects of climate change on marine ecosystems based on flipper-band data should be reconsidered.

  6. Evolutionary dynamics of social dilemmas in structured heterogeneous populations.

    PubMed

    Santos, F C; Pacheco, J M; Lenaerts, Tom

    2006-02-28

    Real populations have been shown to be heterogeneous, in which some individuals have many more contacts than others. This fact contrasts with the traditional homogeneous setting used in studies of evolutionary game dynamics. We incorporate heterogeneity in the population by studying games on graphs, in which the variability in connectivity ranges from single-scale graphs, for which heterogeneity is small and associated degree distributions exhibit a Gaussian tale, to scale-free graphs, for which heterogeneity is large with degree distributions exhibiting a power-law behavior. We study the evolution of cooperation, modeled in terms of the most popular dilemmas of cooperation. We show that, for all dilemmas, increasing heterogeneity favors the emergence of cooperation, such that long-term cooperative behavior easily resists short-term noncooperative behavior. Moreover, we show how cooperation depends on the intricate ties between individuals in scale-free populations.

  7. Chemical roots of biological evolution: the origins of life as a process of development of autonomous functional systems

    PubMed Central

    Ruiz-Mirazo, Kepa; Briones, Carlos

    2017-01-01

    In recent years, an extension of the Darwinian framework is being considered for the study of prebiotic chemical evolution, shifting the attention from homogeneous populations of naked molecular species to populations of heterogeneous, compartmentalized and functionally integrated assemblies of molecules. Several implications of this shift of perspective are analysed in this critical review, both in terms of the individual units, which require an adequate characterization as self-maintaining systems with an internal organization, and also in relation to their collective and long-term evolutionary dynamics, based on competition, collaboration and selection processes among those complex individuals. On these lines, a concrete proposal for the set of molecular control mechanisms that must be coupled to bring about autonomous functional systems, at the interface between chemistry and biology, is provided. PMID:28446711

  8. Chemical roots of biological evolution: the origins of life as a process of development of autonomous functional systems.

    PubMed

    Ruiz-Mirazo, Kepa; Briones, Carlos; de la Escosura, Andrés

    2017-04-01

    In recent years, an extension of the Darwinian framework is being considered for the study of prebiotic chemical evolution, shifting the attention from homogeneous populations of naked molecular species to populations of heterogeneous, compartmentalized and functionally integrated assemblies of molecules. Several implications of this shift of perspective are analysed in this critical review, both in terms of the individual units, which require an adequate characterization as self-maintaining systems with an internal organization, and also in relation to their collective and long-term evolutionary dynamics, based on competition, collaboration and selection processes among those complex individuals. On these lines, a concrete proposal for the set of molecular control mechanisms that must be coupled to bring about autonomous functional systems, at the interface between chemistry and biology, is provided. © 2017 The Authors.

  9. Selective impact of disease on short-term and long-term components of self-reported memory: a population-based HUNT study

    PubMed Central

    Almkvist, Ove; Bosnes, Ole; Bosnes, Ingunn; Stordal, Eystein

    2017-01-01

    Background Subjective memory is commonly considered to be a unidimensional measure. However, theories of performance-based memory suggest that subjective memory could be divided into more than one dimension. Objective To divide subjective memory into theoretically related components of memory and explore the relationship to disease. Methods In this study, various aspects of self-reported memory were studied with respect to demographics and diseases in the third wave of the HUNT epidemiological study in middle Norway. The study included all individuals 55 years of age or older, who responded to a nine-item questionnaire on subjective memory and questionnaires on health (n=18 633). Results A principle component analysis of the memory items resulted in two memory components; the criterion used was an eigenvalue above 1, which accounted for 54% of the total variance. The components were interpreted as long-term memory (LTM; the first component; 43% of the total variance) and short-term memory (STM; the second component; 11% of the total variance). Memory impairment was significantly related to all diseases (except Bechterew’s disease), most strongly to brain infarction, heart failure, diabetes, cancer, chronic obstructive pulmonary disease and whiplash. For most diseases, the STM component was more affected than the LTM component; however, in cancer, the opposite pattern was seen. Conclusions Subjective memory impairment as measured in HUNT contained two components, which were differentially associated with diseases. PMID:28490551

  10. Long-term follow-up study of radial forearm free flap reconstruction after hemiglossectomy.

    PubMed

    Akashi, Masaya; Hashikawa, Kazunobu; Sakakibara, Akiko; Komori, Takahide; Terashi, Hiroto

    2015-01-01

    Previous studies on postoperative long-term results in patients who underwent reconstructive free flap transfer following hemiglossectomy had some issues, including the heterogeneity of the patient population and the observation period. The present study aimed to evaluate changes of reconstructed tongues in patients who underwent radial forearm free flap (RFFF) after hemiglossectomy with long-term follow-up. We enrolled 23 patients who underwent RFFF after hemiglossectomy with a postoperative follow-up of 5 years or more. Postoperative status (eating, speech, sensation function) was assessed by concise medical inquiries. Morphological changes of flaps were evaluated by reviewing clinical photographs. Hemiglossectomy involving the base of the tongue was performed in 4 cases (17.4%) and was limited to the mobile tongue in 19 cases (82.6%). The mean follow-up was 85.4 months (range, 60-122 months). All patients experienced gradually improved postoperative status. The most significant improvement was found between 1 and 5 years after surgery (P = 0.007), but not between 1 and 3 years (P = 0.075) or between 3 and 5 years (P = 0.530). In almost all of the flaps, there were few morphological changes throughout the follow-up period. Postoperative status in patients who underwent reconstructive RFFF following hemiglossectomy improved sequentially.

  11. Nitrate in drinking water and colorectal cancer risk: A nationwide population-based cohort study.

    PubMed

    Schullehner, Jörg; Hansen, Birgitte; Thygesen, Malene; Pedersen, Carsten B; Sigsgaard, Torben

    2018-07-01

    Nitrate in drinking water may increase risk of colorectal cancer due to endogenous transformation into carcinogenic N-nitroso compounds. Epidemiological studies are few and often challenged by their limited ability of estimating long-term exposure on a detailed individual level. We exploited population-based health register data, linked in time and space with longitudinal drinking water quality data, on an individual level to study the association between long-term drinking water nitrate exposure and colorectal cancer (CRC) risk. Individual nitrate exposure was calculated for 2.7 million adults based on drinking water quality analyses at public waterworks and private wells between 1978 and 2011. For the main analyses, 1.7 million individuals with highest exposure assessment quality were included. Follow-up started at age 35. We identified 5,944 incident CRC cases during 23 million person-years at risk. We used Cox proportional hazards models to estimate hazard ratios (HRs) of nitrate exposure on the risk of CRC, colon and rectal cancer. Persons exposed to the highest level of drinking water nitrate had an HR of 1.16 (95% CI: 1.08-1.25) for CRC compared with persons exposed to the lowest level. We found statistically significant increased risks at drinking water levels above 3.87 mg/L, well below the current drinking water standard of 50 mg/L. Our results add to the existing evidence suggesting increased CRC risk at drinking water nitrate concentrations below the current drinking water standard. A discussion on the adequacy of the drinking water standard in regards to chronic effects is warranted. © 2018 UICC.

  12. Effect of short-term Zn/Pb or long-term multi-metal stress on physiological and morphological parameters of metallicolous and nonmetallicolous Echium vulgare L. populations.

    PubMed

    Dresler, Sławomir; Wójciak-Kosior, Magdalena; Sowa, Ireneusz; Stanisławski, Grzegorz; Bany, Izabela; Wójcik, Małgorzata

    2017-06-01

    The aim of the study was to determine the response of metallicolous and nonmetallicolous Echium vulgare L. populations to chronic multi-metal (Zn, Pb, Cd) and acute Zn (200, 400 μM) and Pb (30, 60 μM) stress. Three populations of E. vulgare, one from uncontaminated and two from metal-contaminated areas, were studied. Two types of experiments were performed - a short-term hydroponic experiment with acute Zn or Pb stress and a long-term manipulative soil experiment with the use of soils from the sites of origin of the three populations. Growth parameters, such as shoot and root fresh weight and leaf area, as well as organic acid accumulation were determined. Moreover, the concentration of selected secondary metabolites and antioxidant capacity in the three populations exposed to Pb or Zn excess were measured. Both metallicolous populations generally achieved higher biomass compared with the nonmetallicolous population cultivated under metal stress in hydroponics or on metalliferous substrates. Plants exposed to Pb or Zn excess or contaminated soil substrate exhibited higher malate and citrate concentrations compared with the reference (no metal stress) plants. It was observed that Zn or Pb stress increased accumulation of allantoin, chlorogenic and rosmarinic acids, total phenolics, and flavonoids. Moreover, it was shown that Pb sequestration in the roots or Zn translocation to the shoots may play a role in enhanced metal tolerance of metallicolous populations under acute Pb/Zn stress. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  13. VALIDATION OF A METHOD FOR ESTIMATING LONG-TERM EXPOSURES BASED ON SHORT-TERM MEASUREMENTS

    EPA Science Inventory

    A method for estimating long-term exposures from short-term measurements is validated using data from a recent EPA study of exposure to fine particles. The method was developed a decade ago but long-term exposure data to validate it did not exist until recently. In this paper, ...

  14. Factors affecting unintentional harvesting selectivity in a monomorphic species.

    PubMed

    Bunnefeld, Nils; Baines, David; Newborn, David; Milner-Gulland, E J

    2009-03-01

    1. Changes in the abundance of populations have always perplexed ecologists but long-term studies are revealing new insights into population dynamic processes. Long-term data are often derived from harvest records although many wild populations face high harvesting pressures leading to overharvesting and extinction. Additionally, harvest records used to describe population processes such as fluctuations in abundance and reproductive success often assume a random off-take. 2. Selective harvesting based on phenotypic characteristics occurs in many species (e.g. trophy hunting, fisheries) and has important implications for population dynamics, conservation and management. 3. In species with no marked morphological differences between the age and sex classes, such as the red grouse Lagopus lagopus scoticus during the shooting season, hunters cannot consciously select for a specific sex or age class during the shooting process but harvest records could still give a biased reflection of the population structure because of differences in behaviour between age and sex classes. 4. This study compared age and sex ratios in the bag with those in the population before shooting for red grouse at different points in the shooting season and different densities, which has rarely been tested before. 5. More young than old grouse were shot at large bag sizes and vice versa for small bag sizes than would be expected from the population composition before shooting. The susceptibility of old males to shooting compared to females increased with bag size and was high at the first time the area was shot but decreased with the number of times an area was harvested. 6. These findings stress that the assumption made in many studies that harvest records reflect the age and sex ratio of the population and therefore reflect productivity can be misleading. 7. In this paper, as in the literature, it is also shown that number of grouse shot reflects grouse density and therefore that hunting selectivity might influence population dynamics in a cyclic species. 8. The study is not only relevant for red grouse but applies to systems showing interactions between selective harvesting and wider ecological processes, such as age- and sex-related parasitism and territoriality, which may drive population fluctuations.

  15. Texting on mobile phones and musculoskeletal disorders in young adults: A five-year cohort study.

    PubMed

    Gustafsson, Ewa; Thomée, Sara; Grimby-Ekman, Anna; Hagberg, Mats

    2017-01-01

    The aim was to examine whether texting on a mobile phone is a risk factor for musculoskeletal disorders in the neck and upper extremities in a population of young adults. In a longitudinal population-based cohort study with Swedish young adults (aged 20-24 years) data were collected via a web-based questionnaire at baseline (n = 7092) and after one and five years. Cross-sectional associations were found between text messaging and reported ongoing symptoms in neck and upper extremities (odds ratios, ORs 1.3-2.0). Among symptom-free at baseline prospective associations were only found between text messaging and new cases of reported symptoms in the hand/fingers (OR 2.0) at one year follow up. Among those with symptoms at baseline prospective associations were found between text messaging and maintained pain in neck/upper back (OR 1.6). The results imply mostly short-term effects, and to a lesser extent, long-term effects on musculoskeletal disorders in neck and upper extremities. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  16. The roles of large top predators in coastal ecosystems: new insights from long term ecological research

    USGS Publications Warehouse

    Rosenblatt, Adam E.; Heithaus, Michael R.; Mather, Martha E.; Matich, Philip; Nifong, James C.; Ripple, William J.; Silliman, Brian R.

    2013-01-01

    During recent human history, human activities such as overhunting and habitat destruction have severely impacted many large top predator populations around the world. Studies from a variety of ecosystems show that loss or diminishment of top predator populations can have serious consequences for population and community dynamics and ecosystem stability. However, there are relatively few studies of the roles of large top predators in coastal ecosystems, so that we do not yet completely understand what could happen to coastal areas if large top predators are extirpated or significantly reduced in number. This lack of knowledge is surprising given that coastal areas around the globe are highly valued and densely populated by humans, and thus coastal large top predator populations frequently come into conflict with coastal human populations. This paper reviews what is known about the ecological roles of large top predators in coastal systems and presents a synthesis of recent work from three coastal eastern US Long Term Ecological Research (LTER) sites where long-term studies reveal what appear to be common themes relating to the roles of large top predators in coastal systems. We discuss three specific themes: (1) large top predators acting as mobile links between disparate habitats, (2) large top predators potentially affecting nutrient and biogeochemical dynamics through localized behaviors, and (3) individual specialization of large top predator behaviors. We also discuss how research within the LTER network has led to enhanced understanding of the ecological roles of coastal large top predators. Highlighting this work is intended to encourage further investigation of the roles of large top predators across diverse coastal aquatic habitats and to better inform researchers and ecosystem managers about the importance of large top predators for coastal ecosystem health and stability.

  17. State-space modeling of population sizes and trends in Nihoa Finch and Millerbird

    USGS Publications Warehouse

    Gorresen, P. Marcos; Brinck, Kevin W.; Camp, Richard J.; Farmer, Chris; Plentovich, Sheldon M.; Banko, Paul C.

    2016-01-01

    Both of the 2 passerines endemic to Nihoa Island, Hawai‘i, USA—the Nihoa Millerbird (Acrocephalus familiaris kingi) and Nihoa Finch (Telespiza ultima)—are listed as endangered by federal and state agencies. Their abundances have been estimated by irregularly implemented fixed-width strip-transect sampling from 1967 to 2012, from which area-based extrapolation of the raw counts produced highly variable abundance estimates for both species. To evaluate an alternative survey method and improve abundance estimates, we conducted variable-distance point-transect sampling between 2010 and 2014. We compared our results to those obtained from strip-transect samples. In addition, we applied state-space models to derive improved estimates of population size and trends from the legacy time series of strip-transect counts. Both species were fairly evenly distributed across Nihoa and occurred in all or nearly all available habitat. Population trends for Nihoa Millerbird were inconclusive because of high within-year variance. Trends for Nihoa Finch were positive, particularly since the early 1990s. Distance-based analysis of point-transect counts produced mean estimates of abundance similar to those from strip-transects but was generally more precise. However, both survey methods produced biologically unrealistic variability between years. State-space modeling of the long-term time series of abundances obtained from strip-transect counts effectively reduced uncertainty in both within- and between-year estimates of population size, and allowed short-term changes in abundance trajectories to be smoothed into a long-term trend.

  18. Age and Other Risk Factors Influencing Long-Term Mortality in Patients With Traumatic Cervical Spine Fracture.

    PubMed

    Bank, Matthew; Gibbs, Katie; Sison, Cristina; Kutub, Nawshin; Paptheodorou, Angelos; Lee, Samuel; Stein, Adam; Bloom, Ona

    2018-01-01

    To identify clinical or demographic variables that influence long-term mortality, as well as in-hospital mortality, with a particular focus on the effects of age. Cervical spine fractures with or without spinal cord injury (SCI) disproportionately impact the elderly who constitute an increasing percentage of the US population. We analyzed data collected for 10 years at a state-designated level I trauma center to identify variables that influenced in-hospital and long-term mortality among elderly patients with traumatic cervical spine fracture with or without SCI. Acute in-hospital mortality was determined from hospital records and long-term mortality within the study period (2003-2013) was determined from the National Death Index. Univariate and multivariate regression analyses were used to identify factors influencing survival. Data from patients (N = 632) with cervical spine fractures were analyzed, the majority (66%) of whom were geriatric (older than age 64). Most patients (62%) had a mild/moderate injury severity score (ISS; median, interquartile range: 6, 5). Patients with SCI had significantly longer lengths of stay (14.1 days), days on a ventilator (3.5 days), and higher ISS (14.9) than patients without SCI ( P < .0001 for all). Falls were the leading mechanism of injury for patients older than age 64. Univariate analysis identified that long-term survival decreased significantly for all patients older than age 65 (hazard ratio [HR]: 1.07; P < .0001). Multivariate analysis demonstrated age (HR: 1.08; P < .0001), gender (HR: 1.60; P < .0007), and SCI status (HR: 1.45, P < .02) significantly influenced survival during the study period. This study identified age, gender, and SCI status as significant variables for this study population influencing long-term survival among patients with cervical spine fractures. Our results support the growing notion that cervical spine injuries in geriatric patients with trauma may warrant additional research.

  19. Age and Other Risk Factors Influencing Long-Term Mortality in Patients With Traumatic Cervical Spine Fracture

    PubMed Central

    Bank, Matthew; Gibbs, Katie; Sison, Cristina; Kutub, Nawshin; Paptheodorou, Angelos; Lee, Samuel; Stein, Adam; Bloom, Ona

    2018-01-01

    Objective: To identify clinical or demographic variables that influence long-term mortality, as well as in-hospital mortality, with a particular focus on the effects of age. Summary and Background Data: Cervical spine fractures with or without spinal cord injury (SCI) disproportionately impact the elderly who constitute an increasing percentage of the US population. Methods: We analyzed data collected for 10 years at a state-designated level I trauma center to identify variables that influenced in-hospital and long-term mortality among elderly patients with traumatic cervical spine fracture with or without SCI. Acute in-hospital mortality was determined from hospital records and long-term mortality within the study period (2003-2013) was determined from the National Death Index. Univariate and multivariate regression analyses were used to identify factors influencing survival. Results: Data from patients (N = 632) with cervical spine fractures were analyzed, the majority (66%) of whom were geriatric (older than age 64). Most patients (62%) had a mild/moderate injury severity score (ISS; median, interquartile range: 6, 5). Patients with SCI had significantly longer lengths of stay (14.1 days), days on a ventilator (3.5 days), and higher ISS (14.9) than patients without SCI (P < .0001 for all). Falls were the leading mechanism of injury for patients older than age 64. Univariate analysis identified that long-term survival decreased significantly for all patients older than age 65 (hazard ratio [HR]: 1.07; P < .0001). Multivariate analysis demonstrated age (HR: 1.08; P < .0001), gender (HR: 1.60; P < .0007), and SCI status (HR: 1.45, P < .02) significantly influenced survival during the study period. Conclusion: This study identified age, gender, and SCI status as significant variables for this study population influencing long-term survival among patients with cervical spine fractures. Our results support the growing notion that cervical spine injuries in geriatric patients with trauma may warrant additional research. PMID:29760965

  20. Burden of cardiovascular risk factors and cardiovascular disease in childhood cancer survivors: data from the German CVSS-study.

    PubMed

    Faber, J; Wingerter, A; Neu, M A; Henninger, N; Eckerle, S; Münzel, T; Lackner, K J; Beutel, M E; Blettner, M; Rathmann, W; Peters, A; Meisinger, C; Linkohr, B; Neuhauser, H; Kaatsch, P; Spix, C; Schneider, A; Merzenich, H; Panova-Noeva, M; Prochaska, J H; Wild, P S

    2018-05-01

    The cardiac and vascular late sequelae in long-term survivors of childhood cancer (CVSS)-study aimed to quantify the prevalence of cardiovascular risk factors (CVRF) and cardiovascular disease (CVD) in German childhood cancer survivors (CCS). In the CVSS-study (NCT02181049), 1002 CCS (age range 23-48 years) diagnosed with neoplasia prior to 15 years of age between 1980 and 1990 prospectively underwent a systematic, standardized clinical and laboratory cardiovascular screening, identical to the population-based Gutenberg Health Study (GHS) cohort. For 951 individuals, prevalences of CVRF and CVD were primarily compared to the GHS sample and to two further German population-based cohorts. Using log-binomial regression models, an increased risk for occurrence of arterial hypertension [relative risk (RR) 1.38, 95% confidence interval (95% CI 1.21-1.57)] and dyslipidaemia [RR 1.26 (95% CI 1.12-1.42)] was found. This indicates a premature occurrence compared to the general population of approximately 6 and 8 years, respectively [rate advancement period estimator, RAPhypertension 5.75 (95% CI 3.5-8.0) and RAPdyslipidaemia 8.16 (95% CI 4.4-11.9)]. Overall, no differences were observed for obesity and diabetes. Overt CVD was present in 4.5% (95% CI 3.0-6.6%) of CCS [RR 1.89 (95% CI 1.34-2.66), RAPCVD 7.9 (95% CI 4.1-11.7)], of which the most frequent entities were congestive heart failure and venous thromboembolism. Prevalences of CVRF and CVD increased with age without reaching a plateau over time. This large CCS screening examination revealed consistently in comparison to three population samples a considerably increased risk for premature CVD. The findings in these young adult CCS indicate a high burden of cardiovascular morbidity and mortality in the long term. NCT02181049.

  1. Developing population models with data from marked individuals

    USGS Publications Warehouse

    Hae Yeong Ryu,; Kevin T. Shoemaker,; Eva Kneip,; Anna Pidgeon,; Patricia Heglund,; Brooke Bateman,; Thogmartin, Wayne E.; Reşit Akçakaya,

    2016-01-01

    Population viability analysis (PVA) is a powerful tool for biodiversity assessments, but its use has been limited because of the requirements for fully specified population models such as demographic structure, density-dependence, environmental stochasticity, and specification of uncertainties. Developing a fully specified population model from commonly available data sources – notably, mark–recapture studies – remains complicated due to lack of practical methods for estimating fecundity, true survival (as opposed to apparent survival), natural temporal variability in both survival and fecundity, density-dependence in the demographic parameters, and uncertainty in model parameters. We present a general method that estimates all the key parameters required to specify a stochastic, matrix-based population model, constructed using a long-term mark–recapture dataset. Unlike standard mark–recapture analyses, our approach provides estimates of true survival rates and fecundities, their respective natural temporal variabilities, and density-dependence functions, making it possible to construct a population model for long-term projection of population dynamics. Furthermore, our method includes a formal quantification of parameter uncertainty for global (multivariate) sensitivity analysis. We apply this approach to 9 bird species and demonstrate the feasibility of using data from the Monitoring Avian Productivity and Survivorship (MAPS) program. Bias-correction factors for raw estimates of survival and fecundity derived from mark–recapture data (apparent survival and juvenile:adult ratio, respectively) were non-negligible, and corrected parameters were generally more biologically reasonable than their uncorrected counterparts. Our method allows the development of fully specified stochastic population models using a single, widely available data source, substantially reducing the barriers that have until now limited the widespread application of PVA. This method is expected to greatly enhance our understanding of the processes underlying population dynamics and our ability to analyze viability and project trends for species of conservation concern.

  2. Considering long-term care insurance for middle-income countries: comparing South Korea with Japan and Germany.

    PubMed

    Rhee, Jong Chul; Done, Nicolae; Anderson, Gerard F

    2015-10-01

    Financing and provision of long-term care is an increasingly important concern for many middle-income countries experiencing rapid population aging. We examine three countries (South Korea, Japan, and Germany) that use social insurance to finance medical care and have developed long-term care insurance (LTCI) systems. These countries have adopted different approaches to LTCI design within the social insurance framework. We contrast their financing systems and draw lessons regarding revenue generation, benefits design, and eligibility. Based on this review, it seems important for middle-income countries to start developing LTCI schemes early, before aging becomes a significant problem and substantial revenues are needed. Early financing also ensures that the service delivery system has time to adapt because most middle-income countries lack the infrastructure for providing long-term care services. One approach is to start with a limited benefit package and strict eligibility rules and expanded the program as the country develops sufficient experience and more providers became available. All three countries use some form of cost-sharing to discourage service overuse, combined with subsidies for poor populations to maintain appropriate access. A major policy choice is between cash benefits or direct provision of services and the approach will have a large impact on the workforce participation of women. Copyright © 2015 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

  3. Burn leads to long-term elevated admissions to hospital for gastrointestinal disease in a West Australian population based study.

    PubMed

    Stevenson, Andrew W; Randall, Sean M; Boyd, James H; Wood, Fiona M; Fear, Mark W; Duke, Janine M

    2017-05-01

    While the most obvious impact of burn is on the skin, systemic responses also occur after burn, including intestinal inflammation. The objective of this study was to assess if burns are associated with increased long-term admissions for gastrointestinal diseases. A population-based longitudinal study using linked hospital morbidity and death data from Western Australia was undertaken of adults aged at least 15 years when hospitalized for a first burn (n=20,561) in 1980-2012. A frequency matched non-injury comparison cohort was randomly selected from Western Australia's birth registrations and electoral roll (n=80,960). Crude admission rates and summed days in hospital for digestive diseases were calculated. Negative binomial and Cox proportional hazards regression modeling were used to generate incidence rate ratios (IRR) and hazard ratios (HR), respectively. After adjustment for demographic factors and pre-existing health status, the burn cohort had 1.54 times (95% confidence interval (CI): 1.47-1.62) as many admissions and almost three times the number of days in hospital with a digestive system diagnosis (IRR, 95% CI: 2.90, 2.60-3.25) than the uninjured cohort. Significantly elevated adjusted post-burn incident rates were identified, with the risk decreasing with increasing time: in the first month (HR, 95% CI: 3.02, 1.89-4.82), from one month to five years (HR, 95% CI: 1.42, 1.31-1.54), and from five to twenty years after burn (HR, 95% CI: 1.13, 1.06-1.20). Findings of increased hospital admission rates and prolonged length of hospital stay for gastrointestinal diseases in the burn cohort provide evidence to support that burns have effects that persist long after the initial injury. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

  4. Population Size and Decadal Trends of Three Penguin Species Nesting at Signy Island, South Orkney Islands.

    PubMed

    Dunn, Michael J; Jackson, Jennifer A; Adlard, Stacey; Lynnes, Amanda S; Briggs, Dirk R; Fox, Derren; Waluda, Claire M

    2016-01-01

    We report long-term changes in population size of three species of sympatrically breeding pygoscelid penguins: Adélie (Pygoscelis adeliae), chinstrap (Pygoscelis antarctica) and gentoo (Pygoscelis papua ellsworthii) over a 38 year period at Signy Island, South Orkney Islands, based on annual counts from selected colonies and decadal all-island systematic counts of occupied nests. Comparing total numbers of breeding pairs over the whole island from 1978/79 to 2015/16 revealed varying fortunes: gentoo penguin pairs increased by 255%, (3.5% per annum), chinstrap penguins declined by 68% (-3.6% per annum) and Adélie penguins declined by 42% (-1.5% per annum). The chinstrap population has declined steadily over the last four decades. In contrast, Adélie and gentoo penguins have experienced phases of population increase and decline. Annual surveys of selected chinstrap and Adélie colonies produced similar trends from those revealed by island-wide surveys, allowing total island population trends to be inferred relatively well. However, while the annual colony counts of chinstrap and Adélie penguins showed a trend consistent in direction with the results from all-island surveys, the magnitude of estimated population change was markedly different between colony wide and all island counts. Annual population patterns suggest that pair numbers in the study areas partly reflect immigration and emigration of nesting birds between different parts of the island. Breeding success for all three species remained broadly stable over time in the annually monitored colonies. Breeding success rates in gentoo and chinstrap penguins were strongly correlated, despite the differing trends in population size. This study shows the importance of effective, standardised monitoring to accurately determine long-term population trajectories. Our results indicate significant declines in the Adélie and chinstrap penguin populations at Signy Island over the last five decades, and a gradual increase in gentoo breeding pairs.

  5. Population Size and Decadal Trends of Three Penguin Species Nesting at Signy Island, South Orkney Islands

    PubMed Central

    Dunn, Michael J.; Jackson, Jennifer A.; Adlard, Stacey; Lynnes, Amanda S.; Briggs, Dirk R.; Fox, Derren; Waluda, Claire M.

    2016-01-01

    We report long-term changes in population size of three species of sympatrically breeding pygoscelid penguins: Adélie (Pygoscelis adeliae), chinstrap (Pygoscelis antarctica) and gentoo (Pygoscelis papua ellsworthii) over a 38 year period at Signy Island, South Orkney Islands, based on annual counts from selected colonies and decadal all-island systematic counts of occupied nests. Comparing total numbers of breeding pairs over the whole island from 1978/79 to 2015/16 revealed varying fortunes: gentoo penguin pairs increased by 255%, (3.5% per annum), chinstrap penguins declined by 68% (-3.6% per annum) and Adélie penguins declined by 42% (-1.5% per annum). The chinstrap population has declined steadily over the last four decades. In contrast, Adélie and gentoo penguins have experienced phases of population increase and decline. Annual surveys of selected chinstrap and Adélie colonies produced similar trends from those revealed by island-wide surveys, allowing total island population trends to be inferred relatively well. However, while the annual colony counts of chinstrap and Adélie penguins showed a trend consistent in direction with the results from all-island surveys, the magnitude of estimated population change was markedly different between colony wide and all island counts. Annual population patterns suggest that pair numbers in the study areas partly reflect immigration and emigration of nesting birds between different parts of the island. Breeding success for all three species remained broadly stable over time in the annually monitored colonies. Breeding success rates in gentoo and chinstrap penguins were strongly correlated, despite the differing trends in population size. This study shows the importance of effective, standardised monitoring to accurately determine long-term population trajectories. Our results indicate significant declines in the Adélie and chinstrap penguin populations at Signy Island over the last five decades, and a gradual increase in gentoo breeding pairs. PMID:27783668

  6. Effect of in-home and community-based services on the functional status of elderly in the long-term care insurance system in Japan.

    PubMed

    Olivares-Tirado, Pedro; Tamiya, Nanako; Kashiwagi, Masayo

    2012-08-04

    Japan is setting the pace among aging societies of the world. In 2005, Japan became the country with the highest proportion of elderly persons in the world. To deal with the accelerated ageing population and with an increased demand for long-term care services, in April 2000 the Japanese government introduced a mandatory social Long-Term Care Insurance System (LTCI), making long-term care services a universal entitlement for elderly. Overseas literature suggests that the effectiveness of a home visiting program is uncertain in terms of preventing a decline in the functional status of elderly individuals. In Japan, many studies regarding factors associated with LTC service utilization have been conducted, however, limited evidence about the effect of LTC services on the progression of recipient disability is available. Data were obtained from databases of the LTC insurer of City A. To examine the effect of in-home and community-based services on disability status of recipients, a survival analysis in a cohort of moderately disabled elderly people, was conducted. The mean age of participants was 81 years old, and females represented 69% of the participants. A decline or an improvement in functional status, was observed in 43% and 27% of the sample, respectively. After controlling for other variables, women had a significantly greater probability of improving their functional status during all phases of the observation period. The use of "one service" and the amount of services utilized (days/month), were marginally (p = < 0.10) associated with a greater probability of improving their functional status at 12 months into the observation period. The observed effects of in-home and community-based services on disability transition status were considered fairly modest and weak, in terms of their ability to improve or to prevent a decline in functional status. We suggest two mechanisms to explain these findings. First, disability transition as a measure of disability progression may not be specific enough to assess changes in functional status of LTCI recipients. Secondly, in-home and community-based services provided in City A, may be inappropriate in terms of intensity, duration or quality of care.

  7. Heterosynaptic changes accompany long-term but not short-term potentiation of the perforant path in the anaesthetized rat.

    PubMed

    Abraham, W C; Bliss, T V; Goddard, G V

    1985-06-01

    Brief high-frequency trains of electrical stimulation delivered to the perforant path result in long-term potentiation (l.t.p.) of field potentials recorded extracellularly from granule cells of the dentate gyrus. L.t.p. of the population spike is often disproportionately greater than l.t.p. of the population excitatory post-synaptic potential (e.p.s.p.). We have investigated the basis of this effect in rats anaesthetized with sodium pentobarbitone. A series of graded stimuli were given before and after tetanization of the perforant path. From data obtained in this way, we plotted stimulus-response curves, and the relation (E-S curve) between the slope of the population e.p.s.p. (E) and the amplitude of the population spike (S). Curves relating spike onset latency to the slope of the e.p.s.p. were also constructed. Tetanization of the combined medial and lateral components of the perforant path led to long-term changes in the relation between the e.p.s.p. and the population spike. For a given e.p.s.p., the corresponding population spike was of greater amplitude and earlier onset. This E-S potentiation was marked by a shift to the left of the E-S amplitude curve and a downward displacement of the E-S latency curve. Tetanization of the lateral component of the perforant path had two long-term effects on responses evoked by test stimuli to the untetanized medial component: (1) long-term depression of the medial e.p.s.p. and (2) long-term E-S potentiation. The net result of these two heterosynaptically induced effects was to leave unaltered information transfer across medial perforant path-granule cell synapses; for a given test volley the e.p.s.p. was smaller, but because of E-S potentiation the population spike remained relatively unaffected. Short-term potentiation, which has a time course of only a few minutes and is presumed to be mediated by presynaptic mechanisms, was not accompanied by E-S potentiation or by corresponding changes in spike latency. Possible mechanisms of long-term heterosynaptic depression of the e.p.s.p. and of homo- and heterosynaptic E-S potentiation, are discussed. We conclude that although these effects probably reflect a generalized post-synaptic change, this change is unlikely to be a prolonged reduction in the membrane potential of granule cells.

  8. Thyroid cancer in a long-term nonprogressor HIV-1 infection

    PubMed Central

    Phatak, Uday A.; Chitale, P. V.; Jagdale, Rakhi V.

    2015-01-01

    Long-term non-progressor HIV infection (LTNP-HIV) is seen in <1 percent of HIV-afflicted population. There are definite criteria for the diagnosis of LTNP-HIV. Malignancies either solid tumors or haematological cancers have not been reported in such population. We report here a rare case of follicular thyroid carcinoma in LTNP-HIV infection. She never had any opportunistic infections. She did not receive anti-retroviral therapy in the entire course of illness and continued to have good quality of life. Treatment of follicular thyroid cancer was similar to other patients without HIV infection. This could be the first case study from India. PMID:26692617

  9. Corticosteroid Treatments in Males With Duchenne Muscular Dystrophy: Treatment Duration and Time to Loss of Ambulation.

    PubMed

    Kim, Sunkyung; Campbell, Kimberly A; Fox, Deborah J; Matthews, Dennis J; Valdez, Rodolfo

    2015-09-01

    This population-based study examines the association between corticosteroid treatment and time to loss of ambulation, stratifying by treatment duration (short: 0.25-3 years, long: >3 years), among 477 Duchenne muscular dystrophy cases identified by the Muscular Dystrophy Surveillance Tracking and Research Network (MDSTARnet). Those cases who received short-term corticosteroid treatment had a time to loss of ambulation that was 0.8 years shorter (t test) and an annual risk of losing ambulation 77% higher than the untreated (Cox regression). Conversely, cases who received long-term corticosteroid treatment had a time to loss of ambulation that was 2 years longer and an annual risk of losing ambulation 82% lower than the untreated, up to age 11 years; after which the risks were not statistically different. The relationship of corticosteroids and time to loss of ambulation is more complex than depicted by previous studies limited to treatment responders or subjects who lost ambulation during study follow-up. © The Author(s) 2014.

  10. Are older people more vulnerable to long-term impacts of disasters?

    PubMed

    Rafiey, Hassan; Momtaz, Yadollah Abolfathi; Alipour, Fardin; Khankeh, Hamidreza; Ahmadi, Shokoufeh; Sabzi Khoshnami, Mohammad; Haron, Sharifah Azizah

    2016-01-01

    Despite the growing interest in the study of disasters, there is limited research addressing the elderly population that lead to prejudiced beliefs that older adults are more vulnerable to disasters than younger adults. This study aimed to compare positive mental health between elderly and young earthquake survivors. Data for this study, consisting of 324 earthquake survivors, were obtained from a population-based cross-sectional survey conducted in Iran, 2015. The long-term effect of earthquake was assessed using the Mental Health Continuum-Short Form questionnaire. A one-way multivariate analysis of covariance (MANCOVA) using SPSS (version 22) was used in data analysis. Older adults scored significantly a higher level of overall positive mental health (mean [M]=34.31, standard deviation [SD]=10.52) than younger age group (M=27.48, SD=10.56, t =-4.41; P <0.001). Results of MANCOVA revealed a statistically significant difference between older and young adults on the combined positive mental health subscales ( F (3,317) =6.95; P <0.001), after controlling for marital status, sex, and employment status. The present findings showing a higher level of positive mental health among elderly earthquake survivors compared with their younger counterparts in the wake of natural disasters suggest that advancing age per se does not contribute to increasing vulnerability.

  11. Spatial Ecology of Blanding’s Turtles (Emydoidea blandingii) in Southcentral New Hampshire with Implications to Road Mortality

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

    Walston, Leroy J.; Najjar, Stephen J.; LaGory, Kirk E.

    Understanding the spatial ecology and habitat requirements of rare turtle species and the factors that threaten their populations is important for the success of long-term conservation programs. We present results on an eight-year field study in which we used radiotelemetry to monitor the activity and habitat use of 23 adult (male, n = 7; female, n = 16) Blanding’s turtles in southcentral New Hampshire. We found that females occupied home ranges (as defined by minimum convex polygons) that were approximately two times larger than the home ranges of males. Despite the sex difference in home range size, we found nomore » sex difference in core area size (defined as the 50% kernel density estimate). We found that activity patterns varied by season, with increased activity each month after hibernation, and peak activity coinciding with the late spring-early summer nesting season. We observed sex-based and seasonal differences in wetland use. Males appeared to prefer emergent and scrub-shrub wetlands in each season, whereas females preferred scrub-shrub wetlands in spring and ponds in summer and fall. We identified road mortality risk as a potentially important threat for this population because females crossed roads ten times more frequently than males (based on proportion of observations). The preservation of wetland networks, as well as the implementation of measures to minimize road mortality, are important considerations for the long-term persistence of this population.« less

  12. Skin Stem Cell Hypotheses and Long Term Clone Survival – Explored Using Agent-based Modelling

    PubMed Central

    Li, X.; Upadhyay, A. K.; Bullock, A. J.; Dicolandrea, T.; Xu, J.; Binder, R. L.; Robinson, M. K.; Finlay, D. R.; Mills, K. J.; Bascom, C. C.; Kelling, C. K.; Isfort, R. J.; Haycock, J. W.; MacNeil, S.; Smallwood, R. H.

    2013-01-01

    Epithelial renewal in skin is achieved by the constant turnover and differentiation of keratinocytes. Three popular hypotheses have been proposed to explain basal keratinocyte regeneration and epidermal homeostasis: 1) asymmetric division (stem-transit amplifying cell); 2) populational asymmetry (progenitor cell with stochastic fate); and 3) populational asymmetry with stem cells. In this study, we investigated lineage dynamics using these hypotheses with a 3D agent-based model of the epidermis. The model simulated the growth and maintenance of the epidermis over three years. The offspring of each proliferative cell was traced. While all lineages were preserved in asymmetric division, the vast majority were lost when assuming populational asymmetry. The third hypothesis provided the most reliable mechanism for self-renewal by preserving genetic heterogeneity in quiescent stem cells, and also inherent mechanisms for skin ageing and the accumulation of genetic mutation. PMID:23712735

  13. Skin stem cell hypotheses and long term clone survival--explored using agent-based modelling.

    PubMed

    Li, X; Upadhyay, A K; Bullock, A J; Dicolandrea, T; Xu, J; Binder, R L; Robinson, M K; Finlay, D R; Mills, K J; Bascom, C C; Kelling, C K; Isfort, R J; Haycock, J W; MacNeil, S; Smallwood, R H

    2013-01-01

    Epithelial renewal in skin is achieved by the constant turnover and differentiation of keratinocytes. Three popular hypotheses have been proposed to explain basal keratinocyte regeneration and epidermal homeostasis: 1) asymmetric division (stem-transit amplifying cell); 2) populational asymmetry (progenitor cell with stochastic fate); and 3) populational asymmetry with stem cells. In this study, we investigated lineage dynamics using these hypotheses with a 3D agent-based model of the epidermis. The model simulated the growth and maintenance of the epidermis over three years. The offspring of each proliferative cell was traced. While all lineages were preserved in asymmetric division, the vast majority were lost when assuming populational asymmetry. The third hypothesis provided the most reliable mechanism for self-renewal by preserving genetic heterogeneity in quiescent stem cells, and also inherent mechanisms for skin ageing and the accumulation of genetic mutation.

  14. Historical data as a baseline for conservation: reconstructing long-term faunal extinction dynamics in Late Imperial–modern China

    PubMed Central

    Turvey, Samuel T.; Crees, Jennifer J.; Di Fonzo, Martina M. I.

    2015-01-01

    Extinction events typically represent extended processes of decline that cannot be reconstructed using short-term studies. Long-term archives are necessary to determine past baselines and the extent of human-caused biodiversity change, but the capacity of historical datasets to provide predictive power for conservation must be assessed within a robust analytical framework. Local Chinese gazetteers represent a more than 400-year country-level dataset containing abundant information on past environmental conditions and include extensive records of gibbons, which have a restricted present-day distribution but formerly occurred across much of China. Gibbons show pre-twentieth century range contraction, with significant fragmentation by the mid-eighteenth century and population loss escalating in the late nineteenth century. Isolated gibbon populations persisted for about 40 years before local extinction. Populations persisted for longer at higher elevations, and disappeared earlier from northern and eastern regions, with the biogeography of population loss consistent with the contagion model of range collapse in response to human demographic expansion spreading directionally across China. The long-term Chinese historical record can track extinction events and human interactions with the environment across much longer timescales than are usually addressed in ecology, contributing novel baselines for conservation and an increased understanding of extinction dynamics and species vulnerability or resilience to human pressures. PMID:26246553

  15. Historical data as a baseline for conservation: reconstructing long-term faunal extinction dynamics in Late Imperial-modern China.

    PubMed

    Turvey, Samuel T; Crees, Jennifer J; Di Fonzo, Martina M I

    2015-08-22

    Extinction events typically represent extended processes of decline that cannot be reconstructed using short-term studies. Long-term archives are necessary to determine past baselines and the extent of human-caused biodiversity change, but the capacity of historical datasets to provide predictive power for conservation must be assessed within a robust analytical framework. Local Chinese gazetteers represent a more than 400-year country-level dataset containing abundant information on past environmental conditions and include extensive records of gibbons, which have a restricted present-day distribution but formerly occurred across much of China. Gibbons show pre-twentieth century range contraction, with significant fragmentation by the mid-eighteenth century and population loss escalating in the late nineteenth century. Isolated gibbon populations persisted for about 40 years before local extinction. Populations persisted for longer at higher elevations, and disappeared earlier from northern and eastern regions, with the biogeography of population loss consistent with the contagion model of range collapse in response to human demographic expansion spreading directionally across China. The long-term Chinese historical record can track extinction events and human interactions with the environment across much longer timescales than are usually addressed in ecology, contributing novel baselines for conservation and an increased understanding of extinction dynamics and species vulnerability or resilience to human pressures. © 2015 The Authors.

  16. Long-term pediatric skin eruption-related hospitalizations in offspring conceived via fertility treatment.

    PubMed

    Krieger, Yuval; Wainstock, Tamar; Sheiner, Eyal; Harlev, Avi; Landau, Daniella; Horev, Amir; Bogdanov-Berezovsky, Alexander; Walfisch, Asnat

    2018-03-01

    Although concerns have been raised regarding the long-term health risks of offspring conceived following fertility treatments, limited information is available regarding their health status beyond the neonatal period. We aimed to evaluate the risk of long-term eruptive dermatological morbidity among children born following fertility treatments as compared to those conceived spontaneously. A population-based cohort study was conducted, including all singleton deliveries occurring between the years 1991 and 2014 at a single tertiary medical center. Fetuses with congenital malformations and multiple gestations were excluded. Children delivered following fertility treatment pregnancies and spontaneous pregnancies were compared. Hospitalizations of the offspring up to the age of 18 years involving cutaneous eruptions were evaluated. A Kaplan-Meier survival curve was used to compare cumulative morbidity incidence and a Cox regression model to control for confounders. During the study period, 242,187 singleton deliveries met the inclusion criteria, 1.8% of which were following fertility treatments (n = 4324). Eruptive dermatological morbidity of the offspring up to the age of 18 years was significantly more common in the fertility treatment group (1.5%) as compared to spontaneous pregnancies (1.1%; P = 0.023). The Kaplan-Meier survival curve demonstrated a significantly higher cumulative incidence of eruptive dermatological morbidity following fertility treatments (log-rank P = 0.007). Using the Cox regression model, while controlling for multiple confounders, fertility treatment was noted as an independent risk factor for long-term pediatric eruptive dermatological morbidity (adjusted HR = 1.43, CI 1.12-1.83, P = 0.004). Singletons conceived via fertility treatments appear to be at an increased risk for long-term eruptive dermatological morbidity. © 2018 The International Society of Dermatology.

  17. Rapid evolution mitigates the ecological consequences of an invasive species (Bythotrephes longimanus) in lakes in Wisconsin.

    PubMed

    Gillis, Michael K; Walsh, Matthew R

    2017-07-12

    Invasive species have extensive negative consequences for biodiversity and ecosystem health. Novel species also drive contemporary evolution in many native populations, which could mitigate or amplify their impacts on ecosystems. The predatory zooplankton Bythotrephes longimanus invaded lakes in Wisconsin, USA, in 2009. This invasion caused precipitous declines in zooplankton prey ( Daphnia pulicaria ), with cascading impacts on ecosystem services (water clarity). Here, we tested the link between Bythotrephes invasion, evolution in Daphnia and post-invasion ecological dynamics using 15 years of long-term data in conjunction with comparative experiments. Invasion by Bythotrephes is associated with rapid increases in the body size of Daphnia Laboratory experiments revealed that such shifts have a genetic component; third-generation laboratory-reared Daphnia from 'invaded' lakes are significantly larger and exhibit greater reproductive effort than individuals from 'uninvaded' lakes. This trajectory of evolution should accelerate Daphnia population growth and enhance population persistence. We tested this prediction by comparing analyses of long-term data with laboratory-based simulations, and show that rapid evolution in Daphnia is associated with increased population growth in invaded lakes. © 2017 The Authors.

  18. Assessing the Deepwater Horizon oil spill impact on marine mammal population through acoustics: endangered sperm whales.

    PubMed

    Ackleh, Azmy S; Ioup, George E; Ioup, Juliette W; Ma, Baoling; Newcomb, Joal J; Pal, Nabendu; Sidorovskaia, Natalia A; Tiemann, Christopher

    2012-03-01

    Long-term monitoring of endangered species abundance based on acoustic recordings has not yet been pursued. This paper reports the first attempt to use multi-year passive acoustic data to study the impact of the Deepwater Horizon oil spill on the population of endangered sperm whales. Prior to the spill the Littoral Acoustic Demonstration Center (LADC) collected acoustic recordings near the spill site in 2007. These baseline data now provide a unique opportunity to better understand how the oil spill affected marine mammals in the Gulf of Mexico. In September 2010, LADC redeployed recording buoys at previously used locations 9, 25, and 50 miles away from the incident site. A statistical methodology that provides point and interval estimates of the abundance of the sperm whale population at the two nearest sites is presented. A comparison of the 2007 and the 2010 recordings shows a decrease in acoustic activity and abundance of sperm whales at the 9-mile site by a factor of 2, whereas acoustic activity and abundance at the 25-mile site has clearly increased. This indicates that some sperm whales may have relocated farther away from the spill. Follow-up experiments will be important for understanding long-term impact. © 2012 Acoustical Society of America

  19. Long-term risk of seizures in adult survivors of sepsis.

    PubMed

    Reznik, Michael E; Merkler, Alexander E; Mahta, Ali; Murthy, Santosh B; Claassen, Jan; Kamel, Hooman

    2017-10-03

    To examine the association between sepsis and the long-term risk of seizures. We conducted a retrospective population-based cohort study using administrative claims data from all emergency department visits and hospitalizations at nonfederal acute care hospitals in California, Florida, and New York from 2005 to 2013. Using previously validated diagnosis codes, we identified all adult patients hospitalized with sepsis. Our outcome was any emergency department visit or hospitalization for seizure. Poisson regression and demographic data were used to calculate age-, sex-, and race-standardized incidence rate ratios (IRR). To confirm our findings, we used a matched cohort of hospitalized patients without sepsis for comparison and additionally assessed claims data from a nationally representative 5% sample of Medicare beneficiaries. We identified 842,735 patients with sepsis. The annual incidence of seizure was 1.29% (95% confidence interval [CI] 1.27%-1.30%) in patients with sepsis vs 0.16% (95% CI 0.16%-0.16%) in the general population (IRR 4.98; 95% CI 4.92-5.04). A secondary analysis using matched hospitalized patients confirmed these findings (IRR 4.33; 95% CI 4.13-4.55), as did a separate analysis of Medicare beneficiaries, in whom we found a similar strength of association (IRR 2.72; 95% CI 2.60-2.83), as we did in patients ≥65 years of age in our primary statewide data (IRR 2.83; 95% CI 2.78-2.88). We found that survivors of sepsis faced a significantly higher long-term risk of seizures than both the general population and other hospitalized patients. Our findings suggest that sepsis is associated with pathways that lead to permanent neurologic sequelae. © 2017 American Academy of Neurology.

  20. Long-term survival and conditional survival of cancer patients in Japan using population-based cancer registry data

    PubMed Central

    Ito, Yuri; Miyashiro, Isao; Ito, Hidemi; Hosono, Satoyo; Chihara, Dai; Nakata-Yamada, Kayo; Nakayama, Masashi; Matsuzaka, Masashi; Hattori, Masakazu; Sugiyama, Hiromi; Oze, Isao; Tanaka, Rina; Nomura, Etsuko; Nishino, Yoshikazu; Matsuda, Tomohiro; Ioka, Akiko; Tsukuma, Hideaki; Nakayama, Tomio

    2014-01-01

    Although we usually report 5-year cancer survival using population-based cancer registry data, nowadays many cancer patients survive longer and need to be followed-up for more than 5 years. Long-term cancer survival figures are scarce in Japan. Here we report 10-year cancer survival and conditional survival using an established statistical approach. We received data on 1 387 489 cancer cases from six prefectural population-based cancer registries in Japan, diagnosed between 1993 and 2009 and followed-up for at least 5 years. We estimated the 10-year relative survival of patients who were followed-up between 2002 and 2006 using period analysis. Using this 10-year survival, we also calculated the conditional 5-year survival for cancer survivors who lived for some years after diagnosis. We reported 10-year survival and conditional survival of 23 types of cancer for 15–99-year-old patients and four types of cancer for children (0–14 years old) and adolescent and young adults (15–29 years old) patients by sex. Variation in 10-year cancer survival by site was wide, from 5% for pancreatic cancer to 95% for female thyroid cancer. Approximately 70–80% of children and adolescent and young adult cancer patients survived for more than 10 years. Conditional 5-year survival for most cancer sites increased according to years, whereas those for liver cancer and multiple myeloma did not increase. We reported 10-year cancer survival and conditional survival using population-based cancer registries in Japan. It is important for patients and clinicians to report these relevant figures using population-based data. PMID:25183551

  1. Short- and long-term eating habit modification predicts weight change in overweight, postmenopausal women: results from the WOMAN study.

    PubMed

    Barone Gibbs, Bethany; Kinzel, Laura S; Pettee Gabriel, Kelley; Chang, Yue-Fang; Kuller, Lewis H

    2012-09-01

    Standard behavioral obesity treatment produces poor long-term results. Focusing on healthy eating behaviors rather than energy intake may be an alternative strategy. In addition, important behaviors might differ for short- vs long-term weight control. Our aim was to describe and compare associations between changes in eating behaviors and weight after 6 and 48 months. We performed secondary analysis of data collected during a randomized weight-loss intervention trial with 48-month follow-up. We studied 481 overweight and obese postmenopausal women enrolled in the Women on the Move through Activity and Nutrition (WOMAN) Study. We measured changes in weight from baseline to 6 and 48 months. Linear regression models were used to examine the associations between 6- and 48-month changes in eating habits assessed by the Conner Diet Habit Survey and changes in weight. Analyses were conducted in the combined study population and stratified by randomization group. At 6 months in the combined population, weight loss was independently associated with decreased desserts (P<0.001), restaurant eating (P=0.042), sugar-sweetened beverages (P=0.009), and fried foods (P<0.001), and increased fish consumption (P=0.003). Results were similar in intervention participants; only reduced desserts and fried foods associated with weight loss in controls. At 48 months in the combined population, weight loss was again associated with decreased desserts (P=0.003) and sugar-sweetened beverages (P=0.011), but also decreased meats/cheeses (P=0.024) and increased fruits/vegetables (P<0.001). Decreased meats/cheeses predicted weight loss in intervention participants; desserts, sugar-sweetened beverages, and fruits/vegetables were independently associated in controls. Changes in eating behaviors were associated with weight change, although important behaviors differed for short- and long-term weight change and by randomization group. Future studies should determine whether interventions targeting these behaviors could improve long-term obesity treatment outcomes. Copyright © 2012 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

  2. Kelt Reconditioning: A Research Project to Enhance Iteroparity in Columbia Basin Steelhead (Oncorhynchus mykiss), 2003 Annual Report.

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

    Hatch, Douglas R.; Branstetter, Ryan; Blodgett, Joe

    Repeat spawning is a life history strategy that is expressed by some species from the family Salmonidae. Rates of repeat spawning for post-development Columbia River steelhead Oncorhynchus mykiss populations range from 1.6 to 17%. It is expected that currently observed iteroparity rates for wild steelhead in the Basin are severely depressed due to development and operation of the hydropower system and various additional anthropogenic factors. Increasing the natural expression of historical repeat spawning rates using fish culturing methods could be a viable technique to assist the recovery of depressed steelhead populations. Reconditioning is the process of culturing post-spawned fish (kelts)more » in a captive environment until they are able to reinitiate feeding, growth, and redevelop mature gonads. Kelt reconditioning techniques were initially developed for Atlantic salmon Salmo salar and sea-trout S. trutta. The recent Endangered Species Act listing of many Columbia Basin steelhead populations has prompted interest in developing reconditioning methods for wild steelhead populations within the Basin. To test kelt steelhead reconditioning as a potential recovery tool, we captured wild emigrating steelhead kelts from the Yakima River and evaluated reconditioning (short and long-term) success and diet formulations at Prosser Hatchery on the Yakima River. Steelhead kelts from the Yakima River were collected at the Chandler Juvenile Monitoring Facility (CJMF, located on the Yakima River at river kilometer 75.6) from 12 March to 28 May 2003. In total, 690 kelts were collected for reconditioning at Prosser Hatchery. Captive specimens represented 30.8% (690 of 2,235) of the entire 2002-2003 Yakima River wild steelhead population, based on fish ladder counts at Prosser Dam. All steelhead kelts were reconditioned in circular tanks, fed freeze-dried krill and received hw-wiegandt multi vit dietary supplement; long-term steelhead kelts also received Moore-Clark pellets. Oxytetracycline was administered to reconditioned fish to boost immune system response following the stress of initial capture. Formalin was also administered to prevent outbreaks of fungus and we also intubated the fish that were collected with Ivermectin{trademark} to control internal parasites (e.g., Salmincola spp.). Captured kelts were separated into two experimental groups: short-term and long-term reconditioning. Success indicators for the short-term experiment include the proportion of fish that survived the reconditioning process and the proportion of fish that initiated a feeding response. Short-term kelts were reconditioned for 3 to 7 weeks. Surviving specimens were released for natural spawning on June 4, 2003. Survival-to-release was very good for the short-term experiment, with a rate of 89.9%. Long-term steelhead kelts were held for 5-9 months then released on December 8, 2003. Long-term success indicators include the proportion of fish that survived the reconditioning process and the proportion of surviving fish that successfully remature. Survival and rematuration for long-term kelts increased as well with 62.4% surviving to release and 91.7% rematuring. A total of 47 reconditioned kelts were radio tagged to assess their spawning migration behavior and success following release from Prosser Hatchery and to evaluate in-season homing fidelity. As in previous years, the kelts reconditioned during this project will substantially bolster the number of repeat spawners in the Yakima River. Valuable knowledge regarding kelt husbandry, condition, and rearing environments were obtained during this research endeavor. The authors were very pleased with the high survival rates. Information collected during this feasibility study has been significantly incorporated into the experimental design for upcoming years of research, and is expected to continue to increase survival of long-term reconditioned fish and successful expression of iteroparity.« less

  3. Life histories and conservation of long-lived reptiles, an illustration with the American crocodile (Crocodylus acutus)

    USGS Publications Warehouse

    Briggs-Gonzalez, Venetia; Bonefant, Christophe; Basille, Mathieu; Cherkiss, Michael S.; Beauchamp, Jeff; Mazzotti, Frank J.

    2017-01-01

    Successful species conservation is dependent on adequate estimates of population dynamics, but age-specific demographics are generally lacking for many long-lived iteroparous species such as large reptiles. Accurate demographic information allows estimation of population growth rate, as well as projection of future population sizes and quantitative analyses of fitness trade-offs involved in the evolution of life-history strategies.Here, a long-term capture–recapture study was conducted from 1978 to 2014 on the American crocodile (Crocodylus acutus) in southern Florida. Over the study period, 7,427 hatchlings were marked and 380 individuals were recaptured for as many as 25 years. We estimated survival to be strongly age dependent with hatchlings having the lowest survival rates (16%) but increasing to nearly 90% at adulthood based on mark–recapture models. More than 5% of the female population were predicted to be reproductive by age 8 years; the age-specific proportion of reproductive females steadily increased until age 18 when more than 95% of females were predicted to be reproductive. Population growth rate, estimated from a Leslie–Lefkovitch stage-class model, showed a positive annual growth rate of 4% over the study period.Using a prospective sensitivity analysis, we revealed that the adult stage, as expected, was the most critical stage for population growth rate; however, the survival of younger crocodiles before they became reproductive also had a surprisingly high elasticity. We found that variation in age-specific fecundity has very limited impact on population growth rate in American crocodiles.We used a comparative approach to show that the original life-history strategy of American crocodiles is actually shared by other large, long-lived reptiles: while adult survival rates always have a large impact on population growth, this decreases with declining increasing growth rates, in favour of a higher elasticity of the juvenile stage.Crocodiles, as a long-lived and highly fecund species, deviate from the usual association of life histories of “slow” species. Current management practices are focused on nests and hatchling survival; however, protection efforts that extend to juvenile crocodiles would be most effective for conservation of the species, especially in an ever-developing landscape.

  4. Removal targets' classification: How time considerations modify the definition of the index

    NASA Astrophysics Data System (ADS)

    Zemoura, Mélissa; Hanada, Toshiya; Kawamoto, Satomi

    2017-09-01

    The growth of the near-Earth debris population since the beginning of human space activities is now a fact commonly admitted by space agencies worldwide. Numerous entities have warned about the danger that debris may have over time. Presently mitigation methods such as imposing post-mission disposal time after launch will no longer be sufficient; remediation processes seem necessary to limit the increase. In particular, this phenomenon is attributed to the generation of fragments due to more and more on-orbit collisions. Therefore, investigations on indexes to select potential removal targets were recently conducted, considering solely objects implicated in a collision course. This study also looks at the multiple fragmentation factors, including time through the altitude at time of impact (due to the behaviour of debris re-entering with time). The focal point is here to compare different criteria to select removal targets that enable scenarios in best adequacy with the future in question (long term, mid term or short term). Aware of the uncertainty of evolutionary models, this study also incorporates the simulation method as an impactful factor and tries to overcome the potential randomness of the results. Therefore, this paper presents a way to establish a selection criterion the most adequate for the time period focused on. In order to solve this issue, a ;double-check; method is proposed. First, an analytical evolutionary model simulates the environment over 100 years, through 100 Monte-Carlo runs. Then, among the initial population of year 2009, the objects supposed to be at the origin of the debris detected at a given time are tracked back in time into the simulations, using a collision-detecting program. The ;given period; above mentioned for the presence of debris is based on a future as such that 2029 be considered a short-term scenario, 2059 a midterm scenario and 2109 a long-term scenario. This step produces three lists of targets for removal (one for each future), and simulations are run once again, through different scenarios involving the removal of particular listed targets in order to verify the appropriateness of the proposed scenarios. The analysis of the results is based both on the mean of the simulations and on the recurrence considering each run. Three studies were conducted one for each term, and a fourth one completed the work by establishing comparison between short, mid and long-term periods. As a result, three main criteria could be established: the altitude of the objects, the number of targets necessary to remove, and the phenomenon of chain collisions. According to the future that was investigated, the most adequate criterion appeared to be different, consisting in the number of objects in the long-term analysis or the ranking position at short term (linked to the close-time consideration). As a main conclusion and further perspectives, it should be more efficient to consider the collision-probability and mass product together with the time-depending generation of fragments. This would help increasing the precision in the prediction of collision impacts. Rather than pinpointing specified targets to be removed, the aim of this study is simply to understand the mechanisms at the origin of the population increase around the Earth. Also to demonstrate that a careful definition of selection criteria would enable to adopt a suitable removal process in the period of action or for the goal to be reached.

  5. Impacts of Informal Caregiver Availability on Long-term Care Expenditures in OECD Countries

    PubMed Central

    Yoo, Byung-Kwang; Bhattacharya, Jay; McDonald, Kathryn M; Garber, Alan M

    2004-01-01

    Objective To quantify the effects of informal caregiver availability and public funding on formal long-term care (LTC) expenditures in developed countries. Data Source/Study Setting Secondary data were acquired for 15 Organization for Economic Cooperation and Development (OECD) countries from 1970 to 2000. Study Design Secondary data analysis, applying fixed- and random-effects models to time-series cross-sectional data. Outcome variables are inpatient or home heath LTC expenditures. Key explanatory variables are measures of the availability of informal caregivers, generosity in public funding for formal LTC, and the proportion of the elderly population in the total population. Data Collection/Extraction Method Aggregated macro data were obtained from OECD Health Data, United Nations Demographic Yearbooks, and U.S. Census Bureau International Data Base. Principal Findings Most of the 15 OECD countries experienced growth in LTC expenditures over the study period. The availability of a spouse caregiver, measured by male-to-female ratio among the elderly, is associated with a $28,840 (1995 U.S. dollars) annual reduction in formal LTC expenditure per additional elderly male. Availability of an adult child caregiver, measured by female labor force participation and full-time/part-time status shift, is associated with a reduction of $310 to $3,830 in LTC expenditures. These impacts on LTC expenditure vary across countries and across time within a country. Conclusions The availability of an informal caregiver, particularly a spouse caregiver, is among the most important factors explaining variation in LTC expenditure growth. Long-term care policies should take into account behavioral responses: decreased public funding in LTC may lead working women to leave the labor force to provide more informal care. PMID:15544640

  6. Effect of long-term hydroxychloroquine on vascular events in patients with systemic lupus erythematosus: a database prospective cohort study.

    PubMed

    Hsu, Chung-Yuan; Lin, Yu-Sheng; Su, Yu-Jih; Lin, Hsing-Fen; Lin, Ming-Shyan; Syu, Ya-Jhu; Cheng, Tien-Tsai; Yu, Shan-Fu; Chen, Jia-Feng; Chen, Tien-Hsing

    2017-12-01

    The incidence of thromboembolism in patients with SLE is higher than that in the general population. HCQ, widely used to treat lupus, may have vascular protective effects. The aim of this study was to determine whether long-term HCQ exposure is associated with decreased thromboembolism risk in SLE. We designed a prospective cohort study within an SLE population based on the National Health Insurance Research Database in Taiwan. We divided participants into HCQ and control groups according to HCQ prescription during the first year. These groups were defined by medication possession ratio (MPR) ⩾80% and MPR = 0%, respectively. Patients with an MPR between 0 and 80% were excluded. The primary outcome was a composite vascular event, including acute coronary syndrome, ischaemic stroke, pulmonary embolism, deep vein thrombosis and peripheral arterial disease 1 year after inclusion. We excluded patients from the cohort if they had outcomes within the first year. A total of 8397 patients were eligible for analysis. After propensity-score matching, we included 1946 patients in each group. During a mean follow-up of 7.4 years, the number of events was 139 in the HCQ group (7.1%) and 149 in the control group (7.7%). The risk of vascular events in the HCQ group was similar to that in the control group (hazard ratio = 0.91; 95% CI: 0.72, 1.15). Further subgroup analyses confirmed no statistically significant differences between the groups. Long-term HCQ appears to have no vascular protective effect in patients with SLE. © The Author 2017. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com

  7. Effects of an invasive plant on population dynamics in toads.

    PubMed

    Greenberg, Daniel A; Green, David M

    2013-10-01

    When populations decline in response to unfavorable environmental change, the dynamics of their population growth shift. In populations that normally exhibit high levels of variation in recruitment and abundance, as do many amphibians, declines may be difficult to identify from natural fluctuations in abundance. However, the onset of declines may be evident from changes in population growth rate in sufficiently long time series of population data. With data from 23 years of study of a population of Fowler's toad (Anaxyrus [ = Bufo] fowleri) at Long Point, Ontario (1989-2011), we sought to identify such a shift in dynamics. We tested for trends in abundance to detect a change point in population dynamics and then tested among competing population models to identify associated intrinsic and extrinsic factors. The most informative models of population growth included terms for toad abundance and the extent of an invasive marsh plant, the common reed (Phragmites australis), throughout the toads' marshland breeding areas. Our results showed density-dependent growth in the toad population from 1989 through 2002. After 2002, however, we found progressive population decline in the toads associated with the spread of common reeds and consequent loss of toad breeding habitat. This resulted in reduced recruitment and population growth despite the lack of significant loss of adult habitat. Our results underscore the value of using long-term time series to identify shifts in population dynamics coincident with the advent of population decline. © 2013 Society for Conservation Biology.

  8. Kelt Reconditioning: A Research Project to Enhance Iteroparity in Columbia Basin Steelhead (Oncorhynchus mykiss), 2004 Annual Report.

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

    Hatch, Douglas R.; Branstetter, Ryan; Whiteaker, John

    Iteroparity, the ability to repeat spawn, is a life history strategy that is expressed by some species from the family Salmonidae. Rates of repeat spawning for post-development Columbia River steelhead Oncorhynchus mykiss populations range from 1.6 to 17%. It is expected that currently observed iteroparity rates for wild steelhead in the Basin are severely depressed due to development and operation of the hydropower system and various additional anthropogenic factors. Increasing the expression of historical repeat spawning rates using fish culturing methods could be a viable technique to assist the recovery of depressed steelhead populations, and could help reestablish this naturallymore » occurring life history trait. Reconditioning is the process of culturing post-spawned fish (kelts) in a captive environment until they are able to reinitiate feeding, growth, and redevelop mature gonads. Kelt reconditioning techniques were initially developed for Atlantic salmon Salmo salar and sea-trout S. trutta. The recent Endangered Species Act listing of many Columbia River Basin steelhead populations has prompted interest in developing reconditioning methods for wild steelhead populations within the Basin. To test kelt steelhead reconditioning as a potential recovery tool, wild emigrating steelhead kelts were placed into one of three study groups (direct capture and transport, short-term reconditioning, or long-term reconditioning). Steelhead kelts from the Yakima River were collected at the Chandler Juvenile Monitoring Facility (CJMF, located on the Yakima River at river kilometer 75.6) from 15 March to 21 June 2004. In total, 842 kelts were collected for reconditioning at Prosser Hatchery. Captive specimens represented 30.5% (842 of 2,755) of the entire 2003-2004 Yakima River wild steelhead population, based on fish ladder counts at Prosser Dam. All steelhead kelts were reconditioned in 20-foot circular tanks, and fed freeze-dried krill initially or for the duration of the experiment. All steelhead kelts received hw-wiegandt multi vit dietary supplement as a means to improve initial nutrition. Long-term steelhead kelts received Moore-Clark pellets to provide essential minerals and nutrients necessary for gonadal redevelopment. Oxytetracycline was administered to all reconditioned fish to boost immune system response following the stress of initial capture. To control parasitic infestations two methods were used, first, after initial capture an intubation of Ivermectin{trademark} was administered to control internal parasites (e.g., Salmincola spp.). Next, a Formalin drip was used for the duration of reconditioning to prevent fungal outbreaks. Captured kelts were separated into three experimental groups: short-term reconditioning, long-term reconditioning, and direct transport and release. Success indicators for the short-term experiment include the proportion of fish that survived the reconditioning process and the proportion of fish that initiated a feeding response. Short-term kelts were reconditioned for 3 to 5 weeks. Surviving specimens were released for natural spawning on May 11, 2004. Survival-to-release was good for the short-term experiment, with a rate of 79.0%. Long-term steelhead kelts are currently being held for a 6-9 month period with a scheduled release in December 2004. Long-term success indicators include the proportion of fish that survived the reconditioning process and the proportion of surviving fish that successfully remature. Survival and rematuration for long-term kelts has not been determined and will be presented in the 2005 annual report. Direct transport and release kelts and short-term reconditioned kelts were radio or acoustic tagged to assess their travel time and migratory behaviors below Bonneville Dam. A total of 29 direct-transport and release kelts and 29 short-term reconditioned kelts received surgically implanted radio tags, and a total of 28 direct-transport/release and 26 short-term reconditioned fish received surgically implanted hydro acoustic tags. These tags will allow us to determine outmigration timing for adults as well as determine if reconditioning has any deleterious effects on migration behavior. Long-term reconditioned fish will have radio tags inserted gastrically to monitor migration to spawning grounds. As in previous years, the kelts reconditioned during this project should substantially bolster the number of repeat spawners in the Yakima River. Valuable knowledge regarding kelt husbandry, condition, and rearing environments were obtained during this research endeavor. The authors were very pleased with the high survival rates. Information collected during this feasibility study will be incorporated into the experimental design for next year's research, and is expected to continue to increase survival of long-term reconditioned fish and the successful expression of iteroparity.« less

  9. Risk of erectile dysfunction in transfusion-naive thalassemia men: a nationwide population-based retrospective cohort study.

    PubMed

    Chen, Yu-Guang; Lin, Te-Yu; Lin, Cheng-Li; Dai, Ming-Shen; Ho, Ching-Liang; Kao, Chia-Hung

    2015-04-01

    Based on the mechanism of pathophysiology, thalassemia major or transfusion-dependent thalassemia patients may have an increased risk of developing organic erectile dysfunction resulting from hypogonadism. However, there have been few studies investigating the association between erectile dysfunction and transfusion-naive thalassemia populations. We constructed a population-based cohort study to elucidate the association between transfusion-naive thalassemia populations and organic erectile dysfunction. This nationwide population-based cohort study involved analyzing data from 1998 to 2010 obtained from the Taiwanese National Health Insurance Research Database, with a follow-up period extending to the end of 2011. We identified men with transfusion-naive thalassemia and selected a comparison cohort that was frequency-matched with these according to age, and year of diagnosis thalassemia at a ratio of 1 thalassemia man to 4 control men. We analyzed the risks for transfusion-naive thalassemia men and organic erectile dysfunction by using Cox proportional hazards regression models. In this study, 588 transfusion-naive thalassemia men and 2337 controls were included. Total 12 patients were identified within the thalassaemia group and 10 within the control group. The overall risks for developing organic erectile dysfunction were 4.56-fold in patients with transfusion-naive thalassemia men compared with the comparison cohort after we adjusted for age and comorbidities. Our long-term cohort study results showed that in transfusion-naive thalassemia men, there was a higher risk for the development of organic erectile dysfunction, particularly in those patients with comorbidities.

  10. A long-term evaluation of biopsy darts and DNA to estimate cougar density

    USGS Publications Warehouse

    Beausoleil, Richard A.; Clark, Joseph D.; Maletzke, Benjamin T.

    2016-01-01

    Accurately estimating cougar (Puma concolor) density is usually based on long-term research consisting of intensive capture and Global Positioning System collaring efforts and may cost hundreds of thousands of dollars annually. Because wildlife agency budgets rarely accommodate this approach, most infer cougar density from published literature, rely on short-term studies, or use hunter harvest data as a surrogate in their jurisdictions; all of which may limit accuracy and increase risk of management actions. In an effort to develop a more cost-effective long-term strategy, we evaluated a research approach using citizen scientists with trained hounds to tree cougars and collect tissue samples with biopsy darts. We then used the DNA to individually identify cougars and employed spatially explicit capture–recapture models to estimate cougar densities. Overall, 240 tissue samples were collected in northeastern Washington, USA, producing 166 genotypes (including recaptures and excluding dependent kittens) of 133 different cougars (8-25/yr) from 2003 to 2011. Mark–recapture analyses revealed a mean density of 2.2 cougars/100 km2 (95% CI=1.1-4.3) and stable to decreasing population trends (β=-0.048, 95% CI=-0.106–0.011) over the 9 years of study, with an average annual harvest rate of 14% (range=7-21%). The average annual cost per year for field sampling and genotyping was US$11,265 ($422.24/sample or $610.73/successfully genotyped sample). Our results demonstrated that long-term biopsy sampling using citizen scientists can increase capture success and provide reliable cougar-density information at a reasonable cost.

  11. Standing genetic variation as a major contributor to adaptation in the Virginia chicken lines selection experiment.

    PubMed

    Sheng, Zheya; Pettersson, Mats E; Honaker, Christa F; Siegel, Paul B; Carlborg, Örjan

    2015-10-01

    Artificial selection provides a powerful approach to study the genetics of adaptation. Using selective-sweep mapping, it is possible to identify genomic regions where allele-frequencies have diverged during selection. To avoid false positive signatures of selection, it is necessary to show that a sweep affects a selected trait before it can be considered adaptive. Here, we confirm candidate, genome-wide distributed selective sweeps originating from the standing genetic variation in a long-term selection experiment on high and low body weight of chickens. Using an intercross between the two divergent chicken lines, 16 adaptive selective sweeps were confirmed based on their association with the body weight at 56 days of age. Although individual additive effects were small, the fixation for alternative alleles across the loci contributed at least 40 % of the phenotypic difference for the selected trait between these lines. The sweeps contributed about half of the additive genetic variance present within and between the lines after 40 generations of selection, corresponding to a considerable portion of the additive genetic variance of the base population. Long-term, single-trait, bi-directional selection in the Virginia chicken lines has resulted in a gradual response to selection for extreme phenotypes without a drastic reduction in the genetic variation. We find that fixation of several standing genetic variants across a highly polygenic genetic architecture made a considerable contribution to long-term selection response. This provides new fundamental insights into the dynamics of standing genetic variation during long-term selection and adaptation.

  12. Long-term Diet and Biomarker Changes after a Short-term Intervention among Hispanic Breast Cancer Survivors: The ¡Cocinar Para Su Salud! Randomized Controlled Trial.

    PubMed

    Greenlee, Heather; Ogden Gaffney, Ann; Aycinena, A Corina; Koch, Pam; Contento, Isobel; Karmally, Wahida; Richardson, John M; Shi, Zaixing; Lim, Emerson; Tsai, Wei-Yann; Santella, Regina M; Blaner, William S; Clugston, Robin D; Cremers, Serge; Pollak, Susan; Sirosh, Iryna; Crew, Katherine D; Maurer, Matthew; Kalinsky, Kevin; Hershman, Dawn L

    2016-11-01

    Among Hispanic breast cancer survivors, we examined the long-term effects of a short-term culturally based dietary intervention on increasing fruits/vegetables (F/V), decreasing fat, and changing biomarkers associated with breast cancer recurrence risk. Spanish-speaking women (n = 70) with a history of stage 0-III breast cancer who completed treatment were randomized to ¡Cocinar Para Su Salud! (n = 34), a culturally based 9-session program (24 hours over 12 weeks, including nutrition education, cooking classes, and food-shopping field trips), or a control group (n = 36, written dietary recommendations for breast cancer survivors). Diet recalls, fasting blood, and anthropometric measures were collected at baseline, 6, and 12 months. We report changes between groups at 12 months in dietary intake and biomarkers using 2-sample Wilcoxon t tests and generalized estimating equation (GEE) models. At 12 months, the intervention group compared with the control group reported higher increases in mean daily F/V servings (total: +2.0 vs. -0.4; P < 0.01), and nonsignificant decreases in the percentage of calories from fat (-2.2% vs. -1.1%; P = 0.69) and weight (-2.6 kg vs. -1.5 kg; P = 0.56). Compared with controls, participants in the intervention group had higher increases in plasma lutein (+20.4% vs. -11.5%; P < 0.01), and borderline significant increases in global DNA methylation (+0.8% vs. -0.5%; P = 0.06). The short-term ¡Cocinar Para Su Salud! program was effective at increasing long-term F/V intake in Hispanic breast cancer survivors and changed biomarkers associated with breast cancer recurrence risk. It is possible for short-term behavioral interventions to have long-term effects on behaviors and biomarkers in minority cancer patient populations. Results can inform future study designs. Cancer Epidemiol Biomarkers Prev; 25(11); 1491-502. ©2016 AACR. ©2016 American Association for Cancer Research.

  13. Long-term diet and biomarker changes after a short-term intervention among Hispanic breast cancer survivors: The ¡Cocinar Para Su Salud! randomized controlled trial

    PubMed Central

    Greenlee, Heather; Gaffney, Ann Ogden; Aycinena, A. Corina; Koch, Pam; Contento, Isobel; Karmally, Wahida; Richardson, John M.; Shi, Zaixing; Lim, Emerson; Tsai, Wei-Yann; Santella, Regina M.; Blaner, William S.; Clugston, Robin D.; Cremers, Serge; Pollak, Susan; Sirosh, Iryna; Crew, Katherine D.; Maurer, Matthew; Kalinsky, Kevin; Hershman, Dawn L.

    2017-01-01

    Background Among Hispanic breast cancer (BC) survivors, we examined the long-term effects of a short-term culturally-based dietary intervention on increasing fruits/vegetables (F/V), decreasing fat and changing biomarkers associated with BC recurrence risk. Methods Spanish-speaking women (n=70) with a history of stage 0-III BC who completed treatment were randomized to ¡Cocinar Para Su Salud! (n=34), a culturally-based 9-session program (24 hours over 12 weeks, including nutrition education, cooking classes, and food-shopping field trips), or a control group (n=36, written dietary recommendations for BC survivors). Diet recalls, fasting blood, and anthropometric measures were collected at baseline, 6, and 12 months. We report changes between groups at 12 months in dietary intake and biomarkers using 2-sample Wilcoxon t-tests and Generalized Estimating Equation (GEE) models. Results At 12 months, the intervention group compared to the control group reported higher increases in mean daily F/V servings (total: +2.0 vs. −0.4; P=0.006), and non-significant decreases in percent calories from fat (−2.2% vs. −1.1%; P=0.69) and weight (−2.6 kg vs. −1.5 kg; P=0.56). Compared to controls, participants in the intervention group had higher increases in plasma lutein (+20.4% vs. −11.5%; P=0.002), and borderline significant increases in global DNA methylation (+0.8% vs. −0.5%; P=0.06). Conclusions The short-term ¡Cocinar Para Su Salud! program was effective at increasing long-term F/V intake in Hispanic BC survivors and changed biomarkers associated with BC recurrence risk. Impact It is possible for short-term behavioral interventions to have long-term effects on behaviors and biomarkers in minority cancer patient populations. Results can inform future study designs. PMID:27461049

  14. Effectiveness and implementation aspects of interventions for preventing falls in elderly people in long-term care facilities: a systematic review of RCTs.

    PubMed

    Neyens, Jacques C; van Haastregt, Jolanda C; Dijcks, Béatrice P; Martens, Mark; van den Heuvel, Wim J; de Witte, Luc P; Schols, Jos M

    2011-07-01

    There is extensive literature on interventions to prevent or reduce falls in elderly people. These findings, however, were based mainly on studies of community-living persons. The primary aim of the present study was to report the effectiveness and implementation aspects of interventions aimed at reducing falls in elderly residents in long-term care facilities: a systematic review of randomized controlled trials (RCTs). MEDLINE, EMBASE, CINAHL, and hand searching of reference lists of included RCTs. RCTs that assessed fall incidents (falls, fallers, recurrent fallers, fall-related injuries) among elderly residents in long-term care facilities were included in this narrative review. Two independent reviewers abstracted data: general program characteristics (setting, population, intervention program) and outcomes, detailed program characteristics (assessment, intervention content, individually tailored, multidisciplinary), and implementation aspects (feasibility, implications for practice). The CONSORT Statement 2001 Checklist was used regarding the quality of reporting RCTs. Twenty trials met the inclusion criteria. Seven trials, 4 multifactorial and 3 monofactorial, showed a significant reduction in the fall rate, the percentage of recurrent fallers, or both the fall rate and the percentage of persons sustaining femoral fractures. The positive effective programs were as follows: a comprehensive structured individual assessment with specific safety recommendations; a multidisciplinary program including general strategies tailored to the setting and strategies tailored specifically to residents; a multifaceted intervention including education, environmental adaptation, balance, resistance training, and hip protector; calcium plus vitamin D supplementation; vitamin D supplementation; a clinical medication review; and a multifactorial intervention (fall risk evaluation, specific and general interventions). In general, because of the limited number of included trials, the evidence is inconclusive for multifaceted and single interventions in long-term care facilities. Most of the reviewed studies did not find a significant positive effect on fall incidents. However, our data support the conclusions of Gillespie et al. that multifactorial interventions in long-term care populations seem more likely to be beneficial. However, single interventions (eg, targeting vitamin D insufficiency) can be effective. Furthermore, a careful approach is needed as programs to prevent falls in these settings may be ineffective or even may have adverse effects. This may occur especially when a program is not feasible for the setting in which it is implemented. Copyright © 2011 American Medical Directors Association. Published by Elsevier Inc. All rights reserved.

  15. Post-release monitoring of Antillean manatees: an assessment of the Brazilian rehabilitation and release programme

    USGS Publications Warehouse

    Normande, Iran C.; Malhado, Ana C. M.; Reid, James P.; Viana Junior, P.C.; Savaget, P. V. S.; Correia, R. A.; Luna, F. O.; R. J. Ladle,

    2016-01-01

    Mammalian reintroduction programmes frequently aim to reconnect isolated sub-populations and restore population viability. However, these long-term objectives are rarely evaluated due to the inadequacy of post-release monitoring. Here, we report the results of a unique long term telemetry-based monitoring programme for rehabilitated Antillean manatees (Trichechus manatus manatus) reintroduced into selected sites in northeast Brazil with the aim of reconnecting isolated relict populations. Twenty-one satellite-tagged rehabilitated manatees, 13 males and 8 females, were released into the wild from two sites between November 2008 and June 2013. Individual accumulation curves were plotted and home ranges were calculated through the fixed kernel method using 95% of the utilization distribution. The number and size of the Centres of Activity (COAs) were calculated using 50% of the utilization distribution. Manatees displayed a dichotomous pattern of movement, with individuals either characterized by sedentary habits or by much more extensive movements. Moreover, home range size was not significantly influenced by gender, age at release or release site. COAs were strongly associated with sheltered conditions within reefs and estuaries, and also by the presence of freshwater and feeding sites. Our data confirm that manatee reintroductions in Brazil have the potential to reconnect distant sub-populations. However, pre-release identification of potential long-distance migrants is currently unfeasible, and further analysis would be required to confirm genetic mixing of distant sub-populations.

  16. Development and Application of Genomic Resources in an Endangered Palaeoendemic Tree, Parrotia subaequalis (Hamamelidaceae) From Eastern China

    PubMed Central

    Zhang, Yun-Yan; Shi, En; Yang, Zhao-Ping; Geng, Qi-Fang; Qiu, Ying-Xiong; Wang, Zhong-Sheng

    2018-01-01

    Parrotia subaequalis is an endangered palaeoendemic tree from disjunct montane sites in eastern China. Due to the lack of effective genomic resources, the genetic diversity and population structure of this endangered species are not clearly understood. In this study, we conducted paired-end shotgun sequencing (2 × 125 bp) of genomic DNA for two individuals of P. subaequalis on the Illumina HiSeq platform. Based on the resulting sequences, we have successfully assembled the complete chloroplast genome of P. subaequalis, as well as identified the polymorphic chloroplast microsatellites (cpSSRs), nuclear microsatellites (nSSRs) and mutational hotspots of chloroplast. Ten polymorphic cpSSR loci and 12 polymorphic nSSR loci were used to genotype 96 individuals of P. subaequalis from six populations to estimate genetic diversity and population structure. Our results revealed that P. subaequalis exhibited abundant genetic diversity (e.g., cpSSRs: Hcp = 0.862; nSSRs: HT = 0.559) and high genetic differentiation (e.g., cpSSRs: RST = 0.652; nSSRs: RST = 0.331), and characterized by a low pollen-to-seed migration ratio (r ≈ 1.78). These genetic patterns are attributable to its long evolutionary histories and low levels of contemporary inter-population gene flow by pollen and seed. In addition, lack of isolation-by-distance pattern and strong population genetic structuring in both marker systems, suggests that long-term isolation and/or habitat fragmentation as well as genetic drift may have also contributed to the geographic differentiation of P. subaequalis. Therefore, long-term habitat protection is the most important methods to prevent further loss of genetic variation and a decrease in effective population size. Furthermore, both cpSSRs and nSSRs revealed that P. subaequalis populations consisted of three genetic clusters, which should be considered as separated conservation units. PMID:29545814

  17. Electromagnetic fields and the public: EMF standards and estimation of risk

    NASA Astrophysics Data System (ADS)

    Grigoriev, Yury

    2010-04-01

    Mobile communications are a relatively new and additional source of electromagnetic exposure for the population. Standard daily mobile-phone use is known to increase RF-EMF (radiofrequency electromagnetic field) exposure to the brains of users of all ages, whilst mobile-phone base stations, and base station units for cordless phones, can regularly increase the exposures of large numbers of the population to RF-EMF radiation in everyday life. The need to determine appropriate standards stipulating the maximum acceptable short-term and long-term RF-EMF levels encountered by the public, and set such levels as general guidelines, is of great importance in order to help preserve the general public's health and that of the next generation of humanity.

  18. Long-term effects of traumatic experience: Comparison study in the adolescent IDPs in Serbia.

    PubMed

    Matsunaga, Chieko; Ristic, Dragana; Niregi, Mitsuki

    2006-12-01

    The purpose of this study is to examine the long term psychological effects of war stress regarded as traumatic experience. The subjects are Serbian internally displaced people (IDP) of adolescent population from Kosovo. It is a very big concern whether the adolescents would overcome the social and psychological difficulties caused by the war stress in order to reconstruct the better society. The result came out that the long-term effects still exist in PTSD, depression and hopelessness, which affects self-esteem and the attitude in purpose in life that are important factors for personality development. This paper also examines the difference between IDPs with war stress and the adolescent sufferers of the big earthquake in Japan.

  19. Longitudinal Effects of Air Pollution on Exhaled Nitric Oxide: The Children’s Health Study

    PubMed Central

    Berhane, Kiros; Zhang, Yue; Salam, Muhammad T.; Eckel, Sandrah P.; Linn, William S.; Rappaport, Edward B.; Bastain, Theresa M; Lurmann, Fred; Gilliland, Frank D.

    2015-01-01

    OBJECTIVES To assess the effects of long-term variations in ambient air pollutants on longitudinal changes in exhaled nitric oxide (FeNO), a potentially useful biomarker of eosinophilic airway inflammation, based on data from the southern California Children’s Health Study. METHODS Based on a cohort of 1,211 schoolchildren from 8 Southern California communities with FeNO measurements in 2006/07 and 2007/08, regression models adjusted for short-term effects of air pollution were fitted to assess the association between changes in annual long-term exposures and changes in FeNO. RESULTS Increases in annual average concentrations of 24-hr average NO2 and PM2.5 (scaled to the interquartile range (IQR) of 1.8 ppb and 2.4 μg/m3, respectively) were associated with a 2.29 ppb (CI=[0.36,4.21]; p =0.02) and a 4.94 ppb (CI=[1.44,8.47]; p = 0.005) increase in FeNO, respectively, after adjustments for short term effects of the respective pollutants. In contrast, changes in annual averages of PM10 and O3 were not significantly associated with changes in FeNO. These findings did not differ significantly by asthma status. CONCLUSIONS Changes in annual average exposure to current levels of ambient air pollutants are significantly associated with changes in FeNO levels in children, independent of short-term exposures and asthma status. Use of this biomarker in population-based epidemiologic research has great potential for assessing the impact of changing real world mixtures of ambient air pollutants on children’s respiratory health. PMID:24696513

  20. Long-term performance of passive materials for removal of ozone from indoor air.

    PubMed

    Cros, C J; Morrison, G C; Siegel, J A; Corsi, R L

    2012-02-01

    The health effects associated with exposure to ozone range from respiratory irritation to increased mortality. In this paper, we explore the use of three green building materials and an activated carbon (AC) mat that remove ozone from indoor air. We studied the effects of long-term exposure of these materials to real environments on ozone removal capability and pre- and post-ozonation emissions. A field study was completed over a 6-month period, and laboratory testing was intermittently conducted on material samples retrieved from the field. The results show sustained ozone removal for all materials except recycled carpet, with greatest ozone deposition velocity for AC mat (2.5-3.8 m/h) and perlite-based ceiling tile (2.2-3.2 m/h). Carbonyl emission rates were low for AC across all field sites. Painted gypsum wallboard and perlite-based ceiling tile had similar overall emission rates over the 6-month period, while carpet had large initial emission rates of undesirable by-products that decayed rapidly but remained high compared with other materials. This study confirms that AC mats and perlite-based ceiling tile are viable surfaces for inclusion in buildings to remove ozone without generating undesirable by-products. PRACTICAL IMPLICATIONS The use of passive removal materials for ozone control could decrease the need for, or even render unnecessary, active but energy consuming control solutions. In buildings where ozone should be controlled (high outdoor ozone concentrations, sensitive populations), materials specifically designed or selected for removing ozone could be implemented, as long as ozone removal is not associated with large emissions of harmful by-products. We find that activated carbon mats and perlite-based ceiling tiles can provide substantial, long-lasting, ozone control. © 2011 John Wiley & Sons A/S.

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