WorldWideScience

Sample records for billion years older

  1. $17 billion needed by year 2000.

    Science.gov (United States)

    Finger, W R

    1995-09-01

    The United Nations Population Fund (UNFPA) estimates that US$17 billion will be needed to fund reproductive health care in developing countries by the year 2000. About US$10 billion of would go for family planning: currently, the amount spent on family planning is about US$5 billion. Donors are focusing on fewer countries because of limited resources. The United States Agency for International Development (USAID) is planning to phase out support for family planning in Jamaica and Brazil because the programs there have advanced sufficiently. Resources will be shifted to countries with more pressing needs. Dr. Richard Osborn, senior technical officer for UNFPA, states that UNFPA works with national program managers in allocating resources at the macro level (commodities, training). Currently, two-thirds of family planning funds spent worldwide come from developing country governments (mainly China, India, Indonesia, Mexico, South Africa, Turkey, and Bangladesh). Sustaining programs, much less adding new services, will be difficult. User fees and public-private partnerships are being considered; worldwide, consumers provide, currently, about 14% of family planning funds (The portion is higher in most Latin American countries.). In a few countries, insurance, social security, and other public-private arrangements contribute. Social marketing programs are being considered that would remove constraints on prescriptions and prices and improve the quality of services so that clients would be more willing to pay for contraceptives. Although governments are attempting to fit family planning into their health care budgets, estimates at the national level are difficult to make. Standards are needed to make expenditure estimates quickly and at low cost, according to Dr. Barbara Janowitz of FHI, which is developing guidelines. Studies in Bangladesh, Ecuador, Ghana, Mexico, and the Philippines are being conducted, with the assistance of The Evaluation Project at the Population

  2. Origins fourteen billion years of cosmic evolution

    CERN Document Server

    Tyson, Neil deGrasse

    2004-01-01

    Origins explores cosmic science's stunning new insights into the formation and evolution of our universe--of the cosmos, of galaxies and galaxy clusters, of stars within galaxies, of planets that orbit those stars, and of different forms of life that take us back to the first three seconds and forward through three billion years of life on Earth to today's search for life on other planets. Drawing on the current cross-pollination of geology, biology and astrophysics, Origins explains the thrilling daily breakthroughs in our knowledge of the universe from dark energy to life on Mars to the mysteries of space and time. Distilling complex science in clear and lively prose, co-authors Neil deGrasse Tyson and Donald Goldsmith conduct a galvanising tour of the cosmos revealing what the universe has been up to while turning part of itself into us.

  3. Cosmic rays and the biosphere over 4 billion years

    DEFF Research Database (Denmark)

    Svensmark, Henrik

    2006-01-01

    Variations in the flux of cosmic rays (CR) at Earth during the last 4.6 billion years are constructed from information about the star formation rate in the Milky Way and the evolution of the solar activity. The constructed CR signal is compared with variations in the Earths biological productivit...... as recorded in the isotope delta C-13, which spans more than 3 billion years. CR and fluctuations in biological productivity show a remarkable correlation and indicate that the evolution of climate and the biosphere on the Earth is closely linked to the evolution of the Milky Way....

  4. A two-billion-year history for the lunar dynamo.

    Science.gov (United States)

    Tikoo, Sonia M; Weiss, Benjamin P; Shuster, David L; Suavet, Clément; Wang, Huapei; Grove, Timothy L

    2017-08-01

    Magnetic studies of lunar rocks indicate that the Moon generated a core dynamo with surface field intensities of ~20 to 110 μT between at least 4.25 and 3.56 billion years ago (Ga). The field subsequently declined to lunar dynamo by at least 1 billion years. Such a protracted history requires an extraordinarily long-lived power source like core crystallization or precession. No single dynamo mechanism proposed thus far can explain the strong fields inferred for the period before 3.56 Ga while also allowing the dynamo to persist in such a weakened state beyond ~2.5 Ga. Therefore, our results suggest that the dynamo was powered by at least two distinct mechanisms operating during early and late lunar history.

  5. A SWIRE Picture is Worth Billions of Years

    Science.gov (United States)

    2005-01-01

    [figure removed for brevity, see original site] Figure 1: SWIRE View of Distant Galaxies [figure removed for brevity, see original site] [figure removed for brevity, see original site] [figure removed for brevity, see original site] Figure 2Figure 3 Figure 4 These spectacular images, taken by the Spitzer Wide-area Infrared Extragalactic (SWIRE) Legacy project, encapsulate one of the primary objectives of the Spitzer mission: to connect the evolution of galaxies from the distant, or early, universe to the nearby, or present day, universe. The Tadpole galaxy (main image) is the result of a recent galactic interaction in the local universe. Although these galactic mergers are rare in the universe's recent history, astronomers believe that they were much more common in the early universe. Thus, SWIRE team members will use this detailed image of the Tadpole galaxy to help understand the nature of the 'faint red-orange specks' of the early universe. The larger picture (figure 2) depicts one-sixteenth of the SWIRE survey field called ELAIS-N1. In this image, the bright blue sources are hot stars in our own Milky Way, which range anywhere from 3 to 60 times the mass of our Sun. The fainter green spots are cooler stars and galaxies beyond the Milky Way whose light is dominated by older stellar populations. The red dots are dusty galaxies that are undergoing intense star formation. The faintest specks of red-orange are galaxies billions of light-years away in the distant universe. Figure 3 features an unusual ring-like galaxy called CGCG 275-022. The red spiral arms indicate that this galaxy is very dusty and perhaps undergoing intense star formation. The star-forming activity could have been initiated by a near head-on collision with another galaxy. The most distant galaxies that SWIRE is able to detect are revealed in a zoom of deep space (figure 4). The colors in this feature represent the same objects as those in the larger field image of ELAIS-N1. The observed SWIRE

  6. Orbital forcing of climate 1.4 billion years ago

    DEFF Research Database (Denmark)

    Zhang, Shuichang; Wang, Xiaomei; Hammarlund, Emma U

    2015-01-01

    Fluctuating climate is a hallmark of Earth. As one transcends deep into Earth time, however, both the evidence for and the causes of climate change become difficult to establish. We report geochemical and sedimentological evidence for repeated, short-term climate fluctuations from the exceptionally...... well-preserved ∼1.4-billion-year-old Xiamaling Formation of the North China Craton. We observe two patterns of climate fluctuations: On long time scales, over what amounts to tens of millions of years, sediments of the Xiamaling Formation record changes in geochemistry consistent with long-term changes...... reflect what appear to be orbitally forced changes in wind patterns and ocean circulation as they influenced rates of organic carbon flux, trace metal accumulation, and the source of detrital particles to the sediment....

  7. Galaxies in the First Billion Years After the Big Bang

    Science.gov (United States)

    Stark, Daniel P.

    2016-09-01

    In the past five years, deep imaging campaigns conducted with the Hubble Space Telescope (HST) and ground-based observatories have delivered large samples of galaxies at 6.5space density of luminous galaxies has been shown to decrease by 15-20× over 4Space Telescope demonstrates that z>6 UV-selected galaxies are relatively compact with blue UV continuum slopes, low stellar masses, and large specific star formation rates. In the last year, ALMA (the Atacama Large Millimeter Array) and ground-based infrared spectrographs have begun to complement this picture, revealing minimal dust obscuration and hard radiation fields, and providing evidence for metal-poor ionized gas. Weak low-ionization absorption lines suggest a patchy distribution of neutral gas surrounds O and B stars, possibly aiding in the escape of ionizing radiation. Gamma ray burst afterglows and Lyman-α surveys have provided evidence that the intergalactic medium (IGM) evolves from mostly ionized at z≃6-6.5 ([Formula: see text]) to considerably neutral at z≃7-8 ([Formula: see text]). The reionization history that emerges from considering the UV output of galaxies over 6

  8. Spatial variability in oceanic redox structure 1.8 billion years ago

    DEFF Research Database (Denmark)

    Poulton, Simon W.; Fralick, Philip W.; Canfield, Donald Eugene

    2010-01-01

    to reconstruct oceanic redox conditions from the 1.88- to 1.83-billion-year-old Animikie group from the Superior region, North America. We find that surface waters were oxygenated, whereas at mid-depths, anoxic and sulphidic (euxinic) conditions extended over 100 km from the palaeoshoreline. The spatial extent...

  9. Galaxy growth in a massive halo in the first billion years of cosmic history

    Science.gov (United States)

    Marrone, D. P.; Spilker, J. S.; Hayward, C. C.; Vieira, J. D.; Aravena, M.; Ashby, M. L. N.; Bayliss, M. B.; Béthermin, M.; Brodwin, M.; Bothwell, M. S.; Carlstrom, J. E.; Chapman, S. C.; Chen, Chian-Chou; Crawford, T. M.; Cunningham, D. J. M.; De Breuck, C.; Fassnacht, C. D.; Gonzalez, A. H.; Greve, T. R.; Hezaveh, Y. D.; Lacaille, K.; Litke, K. C.; Lower, S.; Ma, J.; Malkan, M.; Miller, T. B.; Morningstar, W. R.; Murphy, E. J.; Narayanan, D.; Phadke, K. A.; Rotermund, K. M.; Sreevani, J.; Stalder, B.; Stark, A. A.; Strandet, M. L.; Tang, M.; Weiß, A.

    2018-01-01

    According to the current understanding of cosmic structure formation, the precursors of the most massive structures in the Universe began to form shortly after the Big Bang, in regions corresponding to the largest fluctuations in the cosmic density field. Observing these structures during their period of active growth and assembly—the first few hundred million years of the Universe—is challenging because it requires surveys that are sensitive enough to detect the distant galaxies that act as signposts for these structures and wide enough to capture the rarest objects. As a result, very few such objects have been detected so far. Here we report observations of a far-infrared-luminous object at redshift 6.900 (less than 800 million years after the Big Bang) that was discovered in a wide-field survey. High-resolution imaging shows it to be a pair of extremely massive star-forming galaxies. The larger is forming stars at a rate of 2,900 solar masses per year, contains 270 billion solar masses of gas and 2.5 billion solar masses of dust, and is more massive than any other known object at a redshift of more than 6. Its rapid star formation is probably triggered by its companion galaxy at a projected separation of 8 kiloparsecs. This merging companion hosts 35 billion solar masses of stars and has a star-formation rate of 540 solar masses per year, but has an order of magnitude less gas and dust than its neighbour and physical conditions akin to those observed in lower-metallicity galaxies in the nearby Universe. These objects suggest the presence of a dark-matter halo with a mass of more than 100 billion solar masses, making it among the rarest dark-matter haloes that should exist in the Universe at this epoch.

  10. A field like today's? The strength of the geomagnetic field 1.1 billion years ago

    Science.gov (United States)

    Sprain, Courtney J.; Swanson-Hysell, Nicholas L.; Fairchild, Luke M.; Gaastra, Kevin

    2018-06-01

    Palaeomagnetic data from ancient rocks are one of the few types of observational data that can be brought to bear on the long-term evolution of Earth's core. A recent compilation of palaeointensity estimates from throughout Earth history has been interpreted to indicate that Earth's magnetic field strength increased in the Mesoproterozoic (between 1.5 and 1.0 billion years ago), with this increase taken to mark the onset of inner core nucleation. However, much of the data within the Precambrian palaeointensity database are from Thellier-style experiments with non-ideal behaviour that manifests in results such as double-slope Arai plots. Choices made when interpreting these data may significantly change conclusions about long-term trends in the intensity of Earth's geomagnetic field. In this study, we present new palaeointensity results from volcanics of the ˜1.1-billion-year-old North American Midcontinent Rift. While most of the results exhibit non-ideal double-slope or sagging behaviour in Arai plots, some flows have more ideal single-slope behaviour leading to palaeointensity estimates that may be some of the best constraints on the strength of Earth's field for this time. Taken together, new and previously published palaeointensity data from the Midcontinent Rift yield a median field strength estimate of 56.0 ZAm2—very similar to the median for the past 300 Myr. These field strength estimates are distinctly higher than those for the preceding billion years (Ga) after excluding ca. 1.3 Ga data that may be biased by non-ideal behaviour—consistent with an increase in field strength in the late Mesoproterozoic. However, given that ˜90 per cent of palaeointensity estimates from 1.1 to 0.5 Ga come from the Midcontinent Rift, it is difficult to evaluate whether these high values relative to those estimated for the preceding billion years are the result of a stepwise, sustained increase in dipole moment. Regardless, palaeointensity estimates from the Midcontinent

  11. Plate tectonic influences on Earth's baseline climate: a 2 billion-year record

    Science.gov (United States)

    McKenzie, R.; Evans, D. A.; Eglington, B. M.; Planavsky, N.

    2017-12-01

    Plate tectonic processes present strong influences on the long-term carbon cycle, and thus global climate. Here we utilize multiple aspects of the geologic record to assess the role plate tectonics has played in driving major icehouse­-greenhouse transitions for the past 2 billion years. Refined paleogeographic reconstructions allow us to quantitatively assess the area of continents in various latitudinal belts throughout this interval. From these data we are able to test the hypothesis that concentrating continental masses in low-latitudes will drive cooler climates due to increased silicate weathering. We further superimpose records of events that are believed to increase the `weatherability' of the crust, such as large igneous province emplacement, island-arc accretion, and continental collisional belts. Climatic records are then compared with global detrital zircon U-Pb age data as a proxy for continental magmatism. Our results show a consistent relationship between zircon-generating magmatism and icehouse-greenhouse transitions for > 2 billion years, whereas paleogeographic records show no clear consistent relationship between continental configurations and prominent climate transitions. Volcanic outgassing appears to exert a first-order control on major baseline climatic shifts; however, paleogeography likely plays an important role in the magnitude of this change. Notably, climatic extremes, such as the Cryogenian icehouse, occur during a combination of reduce volcanism and end-member concentrations of low-latitudinal continents.

  12. Mars’ First Billion Years: Key Findings, Key Unsolved Paradoxes, and Future Exploration

    Science.gov (United States)

    Ehlmann, Bethany

    2017-10-01

    In the evolution of terrestrial planets, the first billion years are the period most shrouded in mystery: How vigorous is early atmospheric loss? How do planetary climates respond to a brightening sun? When and how are plate tectonic recycling processes initiated? How do voluminous volcanism and heavy impact bombardment influence the composition of the atmosphere? Under what conditions might life arise? Looking outward to terrestrial planets around other stars, the record from Venus, Earth and Mars in this solar system is crucial for developing models of physical can chemical processes. Of these three worlds, Mars provides the longest record of planetary evolution from the first billion years, comprising >50% of exposed geologic units, which are only lightly overprinted by later processes.Orbital observations of the last decade have revealed abundant evidence for surface waters in the form of lakes, valley networks, and evidence of chemically open-system near-surface weathering. Groundwaters at temperatures ranging from just above freezing to hydrothermal have also left a rich record of process in the mineralogical record. A rsuite of environments - similar in diversity to Earth’s - has been discovered on Mars with water pH, temperature, redox, and chemistries varying in space and time.Here, I will focus on the consequences of the aqueous alteration of the Martian crust on the composition of the atmosphere based on recent work studying aspects of the volatile budget (Usui et al., 2015; Edwards & Ehlmann, 2015; Hu et al., 2015; Jakosky et al., 2017, Wordsworth et al., 2017, and Ehlmann, in prep.). The solid crust and mantle of Mars act as volatile reservoirs and volatile sources through volcanism, mineral precipitation, and release of gases. We examine the extent to which the budget is understood or ill-understood for hydrogen and carbon, and associated phases H2O, CO2, and CH4. Additionally, I identify some key stratigraphies where a combination of focused in

  13. IRON AND {alpha}-ELEMENT PRODUCTION IN THE FIRST ONE BILLION YEARS AFTER THE BIG BANG

    Energy Technology Data Exchange (ETDEWEB)

    Becker, George D.; Carswell, Robert F. [Kavli Institute for Cosmology and Institute of Astronomy, Madingley Road, Cambridge, CB3 0HA (United Kingdom); Sargent, Wallace L. W. [Palomar Observatory, California Institute of Technology, Pasadena, CA 91125 (United States); Rauch, Michael, E-mail: gdb@ast.cam.ac.uk, E-mail: acalver@ast.cam.ac.uk, E-mail: wws@astro.caltech.edu, E-mail: mr@obs.carnegiescience.edu [Carnegie Observatories, 813 Santa Barbara Street, Pasadena, CA 91101 (United States)

    2012-01-10

    We present measurements of carbon, oxygen, silicon, and iron in quasar absorption systems existing when the universe was roughly one billion years old. We measure column densities in nine low-ionization systems at 4.7 < z < 6.3 using Keck, Magellan, and Very Large Telescope optical and near-infrared spectra with moderate to high resolution. The column density ratios among C II, O I, Si II, and Fe II are nearly identical to sub-damped Ly{alpha} systems (sub-DLAs) and metal-poor ([M/H] {<=} -1) DLAs at lower redshifts, with no significant evolution over 2 {approx}< z {approx}< 6. The estimated intrinsic scatter in the ratio of any two elements is also small, with a typical rms deviation of {approx}< 0.1 dex. These facts suggest that dust depletion and ionization effects are minimal in our z > 4.7 systems, as in the lower-redshift DLAs, and that the column density ratios are close to the intrinsic relative element abundances. The abundances in our z > 4.7 systems are therefore likely to represent the typical integrated yields from stellar populations within the first gigayear of cosmic history. Due to the time limit imposed by the age of the universe at these redshifts, our measurements thus place direct constraints on the metal production of massive stars, including iron yields of prompt supernovae. The lack of redshift evolution further suggests that the metal inventories of most metal-poor absorption systems at z {approx}> 2 are also dominated by massive stars, with minimal contributions from delayed Type Ia supernovae or winds from asymptotic giant branch stars. The relative abundances in our systems broadly agree with those in very metal-poor, non-carbon-enhanced Galactic halo stars. This is consistent with the picture in which present-day metal-poor stars were potentially formed as early as one billion years after the big bang.

  14. Searching for Organics Preserved in 4.5 Billion Year Old Salt

    Science.gov (United States)

    Zolensky, Michael E.; Fries, M.; Steele, A.; Bodnar, R.

    2012-01-01

    Our understanding of early solar system fluids took a dramatic turn a decade ago with the discovery of fluid inclusion-bearing halite (NaCl) crystals in the matrix of two freshly fallen brecciated H chondrite falls, Monahans and Zag. Both meteorites are regolith breccias, and contain xenolithic halite (and minor admixed sylvite -- KCl, crystals in their regolith lithologies. The halites are purple to dark blue, due to the presence of color centers (electrons in anion vacancies) which slowly accumulated as 40K (in sylvite) decayed over billions of years. The halites were dated by K-Ar, Rb-Sr and I-Xe systematics to be 4.5 billion years old. The "blue" halites were a fantastic discovery for the following reasons: (1) Halite+sylvite can be dated (K is in sylvite and will substitute for Na in halite, Rb substitutes in halite for Na, and I substitutes for Cl). (2) The blue color is lost if the halite dissolves on Earth and reprecipitates (because the newly-formed halite has no color centers), so the color serves as a "freshness" or pristinity indicator. (3) Halite frequently contains aqueous fluid inclusions. (4) Halite contains no structural oxygen, carbon or hydrogen, making them ideal materials to measure these isotopic systems in any fluid inclusions. (5) It is possible to directly measure fluid inclusion formation temperatures, and thus directly measure the temperature of the mineralizing aqueous fluid. In addition to these two ordinary chondrites halite grains have been reliably reported in several ureilites, an additional ordinary chondrite (Jilin), and in the carbonaceous chondrite (Murchison), although these reports were unfortunately not taken seriously. We have lately found additional fluid inclusions in carbonates in several additional carbonaceous chondrites. Meteoritic aqueous fluid inclusions are apparently relatively widespread in meteorites, though very small and thus difficult to analyze.

  15. Prodigious degassing of a billion years of accumulated radiogenic helium at Yellowstone

    Science.gov (United States)

    Lowenstern, Jacob B.; Evans, William C.; Bergfeld, D.; Hunt, Andrew G.

    2014-01-01

    Helium is used as a critical tracer throughout the Earth sciences, where its relatively simple isotopic systematics is used to trace degassing from the mantle, to date groundwater and to time the rise of continents1. The hydrothermal system at Yellowstone National Park is famous for its high helium-3/helium-4 isotope ratio, commonly cited as evidence for a deep mantle source for the Yellowstone hotspot2. However, much of the helium emitted from this region is actually radiogenic helium-4 produced within the crust by α-decay of uranium and thorium. Here we show, by combining gas emission rates with chemistry and isotopic analyses, that crustal helium-4 emission rates from Yellowstone exceed (by orders of magnitude) any conceivable rate of generation within the crust. It seems that helium has accumulated for (at least) many hundreds of millions of years in Archaean (more than 2.5 billion years old) cratonic rocks beneath Yellowstone, only to be liberated over the past two million years by intense crustal metamorphism induced by the Yellowstone hotspot. Our results demonstrate the extremes in variability of crustal helium efflux on geologic timescales and imply crustal-scale open-system behaviour of helium in tectonically and magmatically active regions.

  16. One billion year-old Mid-continent Rift leaves virtually no clues in the mantle

    Science.gov (United States)

    Bollmann, T. A.; Frederiksen, A. W.; van der Lee, S.; Wolin, E.; Revenaugh, J.; Wiens, D.; Darbyshire, F. A.; Aleqabi, G. I.; Wysession, M. E.; Stein, S.; Jurdy, D. M.

    2017-12-01

    We measured the relative arrival times of more than forty-six thousand teleseismic P waves recorded by seismic stations of Earthscope's Superior Province Rifting Earthscope Experiment (SPREE) and combined them with a similar amount of such measurements from other seismic stations in the larger region. SPREE recorded seismic waves for two and a half years around the prominent, one billion year-old Mid-continent Rift structure. The curvilinear Mid-continent Rift (MR) is distinguished by voluminous one billion year-old lava flows, which produce a prominent gravity high along the MR. As for other seismic waves, these lava flows along with their underplated counterpart, slightly slow down the measured teleseismic P waves, on average, compared to P waves that did not traverse structures beneath the Mid-continent Rift. However, the variance in the P wave arrival times in these two groups is nearly ten times higher than their average difference. In a seismic-tomographic inversion, we mapped all measured arrival times into structures deep beneath the crust, in the Earth's mantle. Beneath the crust we generally find relatively high P velocities, indicating relatively cool and undeformable mantle structures. However, the uppermost mantle beneath the MR shows several patches of slightly decreased P velocities. These patches are coincident with where the gravity anomalies peak, in Iowa and along the northern Minnesota/Wisconsin border. We will report on the likelihood that these anomalies are indeed a remaining mantle-lithospheric signature of the MR or whether these patches indirectly reflect the presence of the lava flows and their underplated counterparts at the crust-mantle interface. Other structures of interest and of varying depth extent in our tomographic image locate at 1) the intersection of the Superior Craton with the Penokean Province and the Marshfield Terrane west of the MR in southern Minnesota, 2) the intersection of the Penokean, Yavapai, and Mazatzal Terranes

  17. Evidence for oxygenic photosynthesis half a billion years before the Great Oxidation Event

    Science.gov (United States)

    Planavsky, Noah J.; Asael, Dan; Hofmann, Axel; Reinhard, Christopher T.; Lalonde, Stefan V.; Knudsen, Andrew; Wang, Xiangli; Ossa Ossa, Frantz; Pecoits, Ernesto; Smith, Albertus J. B.; Beukes, Nicolas J.; Bekker, Andrey; Johnson, Thomas M.; Konhauser, Kurt O.; Lyons, Timothy W.; Rouxel, Olivier J.

    2014-04-01

    The early Earth was characterized by the absence of oxygen in the ocean-atmosphere system, in contrast to the well-oxygenated conditions that prevail today. Atmospheric concentrations first rose to appreciable levels during the Great Oxidation Event, roughly 2.5-2.3 Gyr ago. The evolution of oxygenic photosynthesis is generally accepted to have been the ultimate cause of this rise, but it has proved difficult to constrain the timing of this evolutionary innovation. The oxidation of manganese in the water column requires substantial free oxygen concentrations, and thus any indication that Mn oxides were present in ancient environments would imply that oxygenic photosynthesis was ongoing. Mn oxides are not commonly preserved in ancient rocks, but there is a large fractionation of molybdenum isotopes associated with the sorption of Mo onto the Mn oxides that would be retained. Here we report Mo isotopes from rocks of the Sinqeni Formation, Pongola Supergroup, South Africa. These rocks formed no less than 2.95 Gyr ago in a nearshore setting. The Mo isotopic signature is consistent with interaction with Mn oxides. We therefore infer that oxygen produced through oxygenic photosynthesis began to accumulate in shallow marine settings at least half a billion years before the accumulation of significant levels of atmospheric oxygen.

  18. A large neutral fraction of cosmic hydrogen a billion years after the Big Bang.

    Science.gov (United States)

    Wyithe, J Stuart B; Loeb, Abraham

    2004-02-26

    The fraction of ionized hydrogen left over from the Big Bang provides evidence for the time of formation of the first stars and quasar black holes in the early Universe; such objects provide the high-energy photons necessary to ionize hydrogen. Spectra of the two most distant known quasars show nearly complete absorption of photons with wavelengths shorter than the Lyman alpha transition of neutral hydrogen, indicating that hydrogen in the intergalactic medium (IGM) had not been completely ionized at a redshift of z approximately 6.3, about one billion years after the Big Bang. Here we show that the IGM surrounding these quasars had a neutral hydrogen fraction of tens of per cent before the quasar activity started, much higher than the previous lower limits of approximately 0.1 per cent. Our results, when combined with the recent inference of a large cumulative optical depth to electron scattering after cosmological recombination therefore suggest the presence of a second peak in the mean ionization history of the Universe.

  19. A Massive Galaxy in Its Core Formation Phase Three Billion Years After the Big Bang

    Science.gov (United States)

    Nelson, Erica; van Dokkum, Pieter; Franx, Marijn; Brammer, Gabriel; Momcheva, Ivelina; Schreiber, Natascha M. Forster; da Cunha, Elisabete; Tacconi, Linda; Bezanson, Rachel; Kirkpatrick, Allison; hide

    2014-01-01

    Most massive galaxies are thought to have formed their dense stellar cores at early cosmic epochs. However, cores in their formation phase have not yet been observed. Previous studies have found galaxies with high gas velocity dispersions or small apparent sizes but so far no objects have been identified with both the stellar structure and the gas dynamics of a forming core. Here we present a candidate core in formation 11 billion years ago, at z = 2.3. GOODS-N-774 has a stellar mass of 1.0 × 10 (exp 11) solar mass, a half-light radius of 1.0 kpc, and a star formation rate of 90 (sup +45 / sub -20) solar mass/yr. The star forming gas has a velocity dispersion 317 plus or minus 30 km/s, amongst the highest ever measured. It is similar to the stellar velocity dispersions of the putative descendants of GOODS-N-774, compact quiescent galaxies at z is approximately equal to 2 (exp 8-11) and giant elliptical galaxies in the nearby Universe. Galaxies such as GOODS-N-774 appear to be rare; however, from the star formation rate and size of the galaxy we infer that many star forming cores may be heavily obscured, and could be missed in optical and near-infrared surveys.

  20. Galaxy evolution. Evidence for mature bulges and an inside-out quenching phase 3 billion years after the Big Bang.

    Science.gov (United States)

    Tacchella, S; Carollo, C M; Renzini, A; Förster Schreiber, N M; Lang, P; Wuyts, S; Cresci, G; Dekel, A; Genzel, R; Lilly, S J; Mancini, C; Newman, S; Onodera, M; Shapley, A; Tacconi, L; Woo, J; Zamorani, G

    2015-04-17

    Most present-day galaxies with stellar masses ≥10(11) solar masses show no ongoing star formation and are dense spheroids. Ten billion years ago, similarly massive galaxies were typically forming stars at rates of hundreds solar masses per year. It is debated how star formation ceased, on which time scales, and how this "quenching" relates to the emergence of dense spheroids. We measured stellar mass and star-formation rate surface density distributions in star-forming galaxies at redshift 2.2 with ~1-kiloparsec resolution. We find that, in the most massive galaxies, star formation is quenched from the inside out, on time scales less than 1 billion years in the inner regions, up to a few billion years in the outer disks. These galaxies sustain high star-formation activity at large radii, while hosting fully grown and already quenched bulges in their cores. Copyright © 2015, American Association for the Advancement of Science.

  1. Four billion years of ophiolites reveal secular trends in oceanic crust formation

    Directory of Open Access Journals (Sweden)

    Harald Furnes

    2014-07-01

    Full Text Available We combine a geological, geochemical and tectonic dataset from 118 ophiolite complexes of the major global Phanerozoic orogenic belts with similar datasets of ophiolites from 111 Precambrian greenstone belts to construct an overview of oceanic crust generation over 4 billion years. Geochemical discrimination systematics built on immobile trace elements reveal that the basaltic units of the Phanerozoic ophiolites are dominantly subduction-related (75%, linked to backarc processes and characterized by a strong MORB component, similar to ophiolites in Precambrian greenstone sequences (85%. The remaining 25% Phanerozoic subduction-unrelated ophiolites are mainly (74% of Mid-Ocean-Ridge type (MORB type, in contrast to the equal proportion of Rift/Continental Margin, Plume, and MORB type ophiolites in the Precambrian greenstone belts. Throughout the Phanerozoic there are large geochemical variations in major and trace elements, but for average element values calculated in 5 bins of 100 million year intervals there are no obvious secular trends. By contrast, basaltic units in the ophiolites of the Precambrian greenstones (calculated in 12 bins of 250 million years intervals, starting in late Paleo- to early Mesoproterozoic (ca. 2.0–1.8 Ga, exhibit an apparent decrease in the average values of incompatible elements such as Ti, P, Zr, Y and Nb, and an increase in the compatible elements Ni and Cr with deeper time to the end of the Archean and into the Hadean. These changes can be attributed to decreasing degrees of partial melting of the upper mantle from Hadean/Archean to Present. The onset of geochemical changes coincide with the timing of detectible changes in the structural architecture of the ophiolites such as greater volumes of gabbro and more common sheeted dyke complexes, and lesser occurrences of ocelli (varioles in the pillow lavas in ophiolites younger than 2 Ga. The global data from the Precambrian ophiolites, representative of nearly 50

  2. Strongly baryon-dominated disk galaxies at the peak of galaxy formation ten billion years ago.

    Science.gov (United States)

    Genzel, R; Schreiber, N M Förster; Übler, H; Lang, P; Naab, T; Bender, R; Tacconi, L J; Wisnioski, E; Wuyts, S; Alexander, T; Beifiori, A; Belli, S; Brammer, G; Burkert, A; Carollo, C M; Chan, J; Davies, R; Fossati, M; Galametz, A; Genel, S; Gerhard, O; Lutz, D; Mendel, J T; Momcheva, I; Nelson, E J; Renzini, A; Saglia, R; Sternberg, A; Tacchella, S; Tadaki, K; Wilman, D

    2017-03-15

    In the cold dark matter cosmology, the baryonic components of galaxies-stars and gas-are thought to be mixed with and embedded in non-baryonic and non-relativistic dark matter, which dominates the total mass of the galaxy and its dark-matter halo. In the local (low-redshift) Universe, the mass of dark matter within a galactic disk increases with disk radius, becoming appreciable and then dominant in the outer, baryonic regions of the disks of star-forming galaxies. This results in rotation velocities of the visible matter within the disk that are constant or increasing with disk radius-a hallmark of the dark-matter model. Comparisons between the dynamical mass, inferred from these velocities in rotational equilibrium, and the sum of the stellar and cold-gas mass at the peak epoch of galaxy formation ten billion years ago, inferred from ancillary data, suggest high baryon fractions in the inner, star-forming regions of the disks. Although this implied baryon fraction may be larger than in the local Universe, the systematic uncertainties (owing to the chosen stellar initial-mass function and the calibration of gas masses) render such comparisons inconclusive in terms of the mass of dark matter. Here we report rotation curves (showing rotation velocity as a function of disk radius) for the outer disks of six massive star-forming galaxies, and find that the rotation velocities are not constant, but decrease with radius. We propose that this trend arises because of a combination of two main factors: first, a large fraction of the massive high-redshift galaxy population was strongly baryon-dominated, with dark matter playing a smaller part than in the local Universe; and second, the large velocity dispersion in high-redshift disks introduces a substantial pressure term that leads to a decrease in rotation velocity with increasing radius. The effect of both factors appears to increase with redshift. Qualitatively, the observations suggest that baryons in the early (high

  3. THE SOUTHERN FRAGMENT OF THE SIBERIAN CRATON: “LANDSCAPE” HISTORY OVER TWO BILLION YEARS

    Directory of Open Access Journals (Sweden)

    Arkady M. Stanevich

    2010-01-01

    background of sub-continental sedimentation. In the Late Paleozoic, the geologic development was marked by major transformation of the pattern of tectonic structures, that was most likely related to inside-plate extension and thinning of the continental crust. In the Mid and Late Carbon (Fig. 4A, the integrated Tungusskiy sedimentation basin was formed as a result of continuous and uniform bending. In the Early Permian (see Fig. 4Б, positive tectonic movements led to significant dewatering of the Paleozoic basins, so that they turned into a washed-out area. Overall raising of the Siberian Platform preconditioned climate changes, such as aridization and climate cooling. In the Mesozoic, landscapes were presented by a combination of flat uplands, wide river valleys with swampy plains and lakes wherein carbonous sediments were accumulated. Basic volcanism with shield eruptions and sub-volcanic rocks was typical then. In the Jurassic (see Fig. 4B, elements observed in the recent topography of the Siberian Platform were formed. In that period, major structural transformation occurred in association with the largest diastrophic cycles in the territory of the Eastern Asia, including formation of the Baikal rift and its branches.From the analyses of the available data which are briefly presented above, it is obvious that the period of two billion years in the Earth history includes numerous epochs of diastrophic processes of tremendous destructive capacity. Unconformities of formations differing in ages by millions and even hundreds of million years, as those dating back to the Pre-Cambrian, suggest quite realistic yet astounding visions. At the background of scenarios of floods, rock up-thrusts, volcanic explosions and earthquakes evidenced from the very remote past, the current geological and climatic phenomena may seem quite trivial.

  4. Constraint on a Varying Proton-Electron Mass Ratio 1.5 Billion Years after the Big Bang

    NARCIS (Netherlands)

    Bagdonaite, J.; Ubachs, W.M.G.; Murphy, M.T.; Withmore, J.B.

    2015-01-01

    A molecular hydrogen absorber at a lookback time of 12.4 billion years, corresponding to 10% of the age of the Universe today, is analyzed to put a constraint on a varying proton-electron mass ratio, μ. A high resolution spectrum of the J1443+2724 quasar, which was observed with the Very Large

  5. Rapid emergence of subaerial landmasses and onset of a modern hydrologic cycle 2.5 billion years ago.

    Science.gov (United States)

    Bindeman, I N; Zakharov, D O; Palandri, J; Greber, N D; Dauphas, N; Retallack, G J; Hofmann, A; Lackey, J S; Bekker, A

    2018-05-01

    The history of the growth of continental crust is uncertain, and several different models that involve a gradual, decelerating, or stepwise process have been proposed 1-4 . Even more uncertain is the timing and the secular trend of the emergence of most landmasses above the sea (subaerial landmasses), with estimates ranging from about one billion to three billion years ago 5-7 . The area of emerged crust influences global climate feedbacks and the supply of nutrients to the oceans 8 , and therefore connects Earth's crustal evolution to surface environmental conditions 9-11 . Here we use the triple-oxygen-isotope composition of shales from all continents, spanning 3.7 billion years, to provide constraints on the emergence of continents over time. Our measurements show a stepwise total decrease of 0.08 per mille in the average triple-oxygen-isotope value of shales across the Archaean-Proterozoic boundary. We suggest that our data are best explained by a shift in the nature of water-rock interactions, from near-coastal in the Archaean era to predominantly continental in the Proterozoic, accompanied by a decrease in average surface temperatures. We propose that this shift may have coincided with the onset of a modern hydrological cycle owing to the rapid emergence of continental crust with near-modern average elevation and aerial extent roughly 2.5 billion years ago.

  6. $17 billion needed for population programme to year 2000: Dr. Nafis Sadik launches State of World Population Report.

    Science.gov (United States)

    1995-01-01

    Dr. Nafis Sadik, Executive Director of the United Nations Population Fund (UNFPA), in her address on July 11 to the Foreign Press Association in London on the occasion of the release of the "1995 State of the World Population Report," stated that governments needed to invest in people, and that the estimated amount needed to reduce population numbers in developing countries was $17 billion for the year 2000. Two-thirds of the cost would be supplied by the developing countries. She said that coordinating population policies globally through such documents as the Programme of Action from the Cairo Conference would aid in slowing population growth. World population, currently 5.7 billion, is projected to reach 7.1-7.83 billion in 2015 and 7.9-11.9 billion in 2050. She also noted that certain conditions faced by women bear upon unsustainable population growth. The cycle of poverty continues in developing countries because very young mothers, who face higher risks in pregnancy and childbirth than those who delay childbearing until after the age of 20, are less likely to continue their education, more likely to have lower-paying jobs, and have a higher rate of separation and divorce. The isolation of women from widespread political participation and the marginalization of women's concerns from mainstream topics has resulted in ineffective family planning programs, including prevention of illness or impairment related to pregnancy or childbirth. Women, in most societies, cannot fully participate in economic and public life, have limited access to positions of influence and power, have narrower occupational choices and lower earnings than men, and must struggle to reconcile activities outside the home with their traditional roles. Sustainable development can only be achieved when social development expands opportunities for individuals (men and women), and their families, empowering them in the attainment of their social, economic, political, and cultural aspirations.

  7. A Record Year at the Federal Trough: Colleges Feast on $1.67-Billion in Earmarks.

    Science.gov (United States)

    Brainard, Jeffrey; Southwick, Ron

    2001-01-01

    Discusses how for fiscal year 2001, Congress earmarked more money for federal projects for specific colleges than ever before. It provided a 60 percent increase over the previous year, although such earmarks have drawn criticism as wasteful and harmful to merit-based competition for funds. Includes a list of top recipients of "pork." (EV)

  8. Backlog at December 31, 2007: euro 39,8 billion, up by 55% from year-end 2006. 2007 sales revenue: euro 11.9 billion, up by 9.8% (+10.4% like-for-like)

    International Nuclear Information System (INIS)

    2008-01-01

    The AREVA group's backlog reached a record level of euro 39.834 billion as of December 31, 2007, up by 55% from that of year-end 2006. In Nuclear, the backlog was euro 34.927 billion at year-end 2007 (+58%), due in particular to the signature of a contract in a record amount with the Chinese utility CGNPC. The series of agreements concluded provide among other things for the construction of two new-generation EPR nuclear islands and the supply of all of the materials and services needed for their operation through 2027. CGNPC also bought 35% of the production of UraMin, the mining company acquired by AREVA in August 2007. Industrial cooperation in the Back End of the cycle was launched with the signature of an agreement between China and France. In addition, the group signed several long-term contracts in significant amounts, particularly with KHNP of South Korea, EDF and Japanese utilities. The Transmission and Distribution division won several major contracts in Libya and Qatar at the end of the year approaching a total of euro 750 million. For the entire year, new orders grew by 34% to euro 5.816 billion. The backlog, meanwhile, grew by 40% to euro 4.906 billion at year-end. The group cleared sales revenue of euro 11.923 billion in 2007, up by 9.8% (+10.4% like-for-like) in relation to 2006 sales of euro 10.863 billion. Sales revenue for the 4. quarter of 2007 rose to euro 3.858 billion, for growth of 16.7% (+18.8% like-for-like) over one year. Sales revenue for the year was marked by: - Growth of 7.6% (+10.6% like-for-like) in Front End sales revenue, which rose to euro 3.140 billion. The division's Enrichment operations posted strong growth. - Sales were up by 17.5% (+15.2% like-for-like) to euro 2.717 billion in the Reactors and Services division. Sales revenue was driven in particular by the growth of Services operations, after weak demand in 2006, by progress on OL3 construction, and by the start of Flamanville 3, the second EPR. For the Back End division

  9. Constraint on a varying proton-electron mass ratio 1.5 billion years after the big bang.

    Science.gov (United States)

    Bagdonaite, J; Ubachs, W; Murphy, M T; Whitmore, J B

    2015-02-20

    A molecular hydrogen absorber at a lookback time of 12.4 billion years, corresponding to 10% of the age of the Universe today, is analyzed to put a constraint on a varying proton-electron mass ratio, μ. A high resolution spectrum of the J1443+2724 quasar, which was observed with the Very Large Telescope, is used to create an accurate model of 89 Lyman and Werner band transitions whose relative frequencies are sensitive to μ, yielding a limit on the relative deviation from the current laboratory value of Δμ/μ=(-9.5 ± 5.4(stat)± 5.3(syst))×10(-6).

  10. Two billion year old natural analogs for nuclear waste disposal: the natural nuclear fission reactors in Gabon (Africa)

    International Nuclear Information System (INIS)

    Gauthier-Lafaye, F.

    2002-01-01

    Two billion years ago, the increase of oxygen in atmosphere and the high 235 U/ 238 U uranium ratio (> 3%) made possible the occurrence of natural nuclear reactors on Earth. These reactors are considered to be a good natural analogue for nuclear waste disposal. Their preservation during such a long period of time is mainly due to the geological stability of the site, the occurrence of clays surrounding the reactors and acting as an impermeable shield, and the occurrence of organic matter that maintained the environment in reducing conditions, favourable for the stability of uraninite. Hydrogeochemical studies and modelling have shown the complexity of the geochemical system at Oklo and Bangombe (Gabon) and the lack of precise data about uranium and fission products retention and migration mechanisms in geological environments. (author)

  11. Taking out one billion tones of carbon: the magic of China's 11thFive-Year Plan

    Energy Technology Data Exchange (ETDEWEB)

    Lin, Jiang; Zhou, Nan; Levine, Mark D.; Fridley, David

    2007-05-01

    China's 11th Five-Year Plan (FYP) sets an ambitious targetfor energy-efficiency improvement: energy intensity of the country sgross domestic product (GDP) should be reduced by 20 percent from 2005 to2010 (NDRC, 2006). This is the first time that a quantitative and bindingtarget has been set for energy efficiency, and signals a major shift inChina's strategic thinking about its long-term economic and energydevelopment. The 20 percent energy intensity target also translates intoan annual reduction of over one billion tons of CO2 by 2010, making theChinese effort one of most significant carbon mitigation effort in theworld today. While it is still too early to tell whether China willachieve this target, this paper attempts to understand the trend inenergy intensity in China and to explore a variety of options towardmeeting the 20 percent target using a detailed endues energymodel.

  12. Taking out 1 billion tons of CO2: The magic of China's 11th Five-Year Plan?

    International Nuclear Information System (INIS)

    Lin Jiang; Zhou Nan; Levine, Mark; Fridley, David

    2008-01-01

    China's 11th Five-Year Plan (FYP) sets an ambitious target for energy-efficiency improvement: energy intensity of the country's gross domestic product (GDP) should be reduced by 20% from 2005 to 2010 [National Development and Reform Commission (NDRC), 2006. Overview of the 11th Five Year Plan for National Economic and Social Development. NDRC, Beijing]. This is the first time that a quantitative and binding target has been set for energy efficiency, and signals a major shift in China's strategic thinking about its long-term economic and energy development. The 20% energy-intensity target also translates into an annual reduction of over 1.5 billion tons of CO 2 by 2010, making the Chinese effort one of the most significant carbon mitigation efforts in the world today. While it is still too early to tell whether China will achieve this target, this paper attempts to understand the trend in energy intensity in China and to explore a variety of options toward meeting the 20% target using a detailed end-use energy model

  13. ALMA Shows that Gas Reservoirs of Star-forming Disks over the Past 3 Billion Years Are Not Predominantly Molecular

    Energy Technology Data Exchange (ETDEWEB)

    Cortese, Luca; Catinella, Barbara; Janowiecki, Steven, E-mail: luca.cortese@uwa.edu.au [International Centre for Radio Astronomy Research, The University of Western Australia, 35 Stirling Highway, Crawley, WA 6009 (Australia)

    2017-10-10

    Cold hydrogen gas is the raw fuel for star formation in galaxies, and its partition into atomic and molecular phases is a key quantity for galaxy evolution. In this Letter, we combine Atacama Large Millimeter/submillimeter Array and Arecibo single-dish observations to estimate the molecular-to-atomic hydrogen mass ratio for massive star-forming galaxies at z ∼ 0.2 extracted from the HIGHz survey, i.e., some of the most massive gas-rich systems currently known. We show that the balance between atomic and molecular hydrogen in these galaxies is similar to that of local main-sequence disks, implying that atomic hydrogen has been dominating the cold gas mass budget of star-forming galaxies for at least the past three billion years. In addition, despite harboring gas reservoirs that are more typical of objects at the cosmic noon, HIGHz galaxies host regular rotating disks with low gas velocity dispersions suggesting that high total gas fractions do not necessarily drive high turbulence in the interstellar medium.

  14. Taking out 1 billion tons of CO2: The magic of China's 11th Five-Year Plan?

    Energy Technology Data Exchange (ETDEWEB)

    Zhou, Nan; Lin, Jiang; Zhou, Nan; Levine, Mark; Fridley, David

    2007-07-01

    China's 11th Five-Year Plan (FYP) sets an ambitious target for energy-efficiency improvement: energy intensity of the country's gross domestic product (GDP) should be reduced by 20% from 2005 to 2010 (NDRC, 2006). This is the first time that a quantitative and binding target has been set for energy efficiency, and signals a major shift in China's strategic thinking about its long-term economic and energy development. The 20% energy intensity target also translates into an annual reduction of over 1.5 billion tons of CO2 by 2010, making the Chinese effort one of most significant carbon mitigation effort in the world today. While it is still too early to tell whether China will achieve this target, this paper attempts to understand the trend in energy intensity in China and to explore a variety of options toward meeting the 20% target using a detailed end-use energy model.

  15. The First Billion Years project: constraining the dust attenuation law of star-forming galaxies at z ≃ 5

    Science.gov (United States)

    Cullen, F.; McLure, R. J.; Khochfar, S.; Dunlop, J. S.; Dalla Vecchia, C.

    2017-09-01

    We present the results of a study investigating the dust attenuation law at z ≃ 5, based on synthetic spectral energy distributions (SEDs) calculated for a sample of N = 498 galaxies drawn from the First Billion Years (FiBY) simulation project. The simulated galaxies at z ≃ 5, which have M1500 ≤ -18.0 and 7.5 ≤ log(M/M}_{⊙}) ≤ 10.2, display a mass-dependent α-enhancement, with a median value of [α /{Fe}]_{z=5} ˜eq 4 × [α /{Fe}]_{Z_{⊙}}. The median Fe/H ratio of the simulated galaxies is 0.14 ± 0.05 which produces steep intrinsic ultraviolet (UV) continuum slopes; 〈βI〉 = -2.4 ± 0.05. Using a set of simple dust attenuation models, in which the wavelength-dependent attenuation is assumed to be of the form A(λ) ∝ λn, we explore the parameter values which best reproduce the observed z = 5 luminosity function (LF) and colour-magnitude relation (CMR). We find that a simple model in which the absolute UV attenuation is a linearly increasing function of log stellar mass (A1500 = 0.5 × log(M/M⊙) - 3.3), and the dust attenuation slope (n) is within the range -0.7 ≤ n ≤ -0.3, can successfully reproduce the LF and CMR over a wide range of stellar population synthesis model assumptions, including the effects of massive binaries. This range of attenuation curves is consistent with a power-law fit to the Calzetti attenuation law in the UV (n = -0.55). In contrast, curves as steep as the Small Magellanic Cloud extinction curve (n = -1.24) are formally ruled out. Finally, we show that our models are consistent with recent 1.3 mm Atacama Large Millimeter Array observations of the Hubble Ultra Deep Field, and predict the form of the z ≃ 5 infrared excess (IRX)-β relation.

  16. A 2-3 billion year old major merger paradigm for the Andromeda galaxy and its outskirts

    Science.gov (United States)

    Hammer, F.; Yang, Y. B.; Wang, J. L.; Ibata, R.; Flores, H.; Puech, M.

    2018-04-01

    Recent observations of our neighbouring galaxy M31 have revealed that its disc was shaped by widespread events. The evidence for this includes the high dispersion (V/σ ≤ 3) of stars older than 2 Gyr, and a global star formation episode, 2-4 Gyr ago. Using the modern hydrodynamical code, GIZMO, we have performed 300 high-resolution simulations to explore the extent to which these observed properties can be explained by a single merger. We find that the observed M31 disc resembles models having experienced a 4:1 merger, in which the nuclei coalesced 1.8-3 Gyr ago, and where the first passage took place 7-10 Gyr ago at a large pericentre distance (32 kpc). We also show that within a family of orbital parameters, the Giant Stream (GS) can be formed with various merger mass ratios, from 2:1 to 300:1. A recent major merger may be the only way to create the very unusual age-dispersion relation in the disc. It reproduces and explains the long-lived 10 kpc ring, the widespread and recent star formation event, the absence of a remnant of the GS progenitor, the apparent complexity of the 3D spatial distribution of the GS, the NE and G Clumps and their formation process, and the observed slope of the halo profile. These modelling successes lead us to propose that the bulk of the substructure in the M31 halo, as well as the complexity of the inner galaxy, may be attributable to a single major interaction with a galaxy that has now fully coalesced with Andromeda.

  17. Evidence for 3.3-billion-year-old oceanic crust in the Barberton greenstone belt, South Africa

    Czech Academy of Sciences Publication Activity Database

    Grosch, E. G.; Sláma, Jiří

    2017-01-01

    Roč. 45, č. 8 (2017), 695-698 ISSN 0091-7613 Institutional support: RVO:67985831 Keywords : volcanic rocks * subduction zone * mountain land * evolution * geochemistry * constraints * komatiites * Kaapvaal * mantle * craton Subject RIV: DB - Geology ; Mineralogy OBOR OECD: Geology Impact factor: 4.635, year: 2016

  18. Association of dietary patterns and weight change in rural older adults 75 years and older

    Science.gov (United States)

    Little is known about the relationship between weight change and dietary patterns (DP) in older adults, especially in those of advanced age (_75 years). We examined the association of DP with obesity and five-year weight change in community-dwelling older adults (n=270; mean±SD age: 78.6±3.9 years)....

  19. Connecting the last billion

    OpenAIRE

    Ben David, Yahel

    2015-01-01

    The last billion people to join the online world, are likely to face at least one of two obstacles:Part I: Rural Internet AccessRural, sparsely populated, areas make conventional infrastructure investments unfeasible: Bigcorporations attempt to address this challenge via the launch of Low-Earth-Orbiting (LEO) satelliteconstellations, fleets of high-altitude balloons, and giant solar-powered drones; although thesegrandiose initiatives hold potential, they are costly and risky. At the same time...

  20. Chlorine isotopic compositions of apatite in Apollo 14 rocks: Evidence for widespread vapor-phase metasomatism on the lunar nearside ∼4 billion years ago

    Science.gov (United States)

    Potts, Nicola J.; Barnes, Jessica J.; Tartèse, Romain; Franchi, Ian A.; Anand, Mahesh

    2018-06-01

    Compared to most other planetary materials in the Solar System, some lunar rocks display high δ37Cl signatures. Loss of Cl in a H ≪ Cl environment has been invoked to explain the heavy signatures observed in lunar samples, either during volcanic eruptions onto the lunar surface or during large scale degassing of the lunar magma ocean. To explore the conditions under which Cl isotope fractionation occurred in lunar basaltic melts, five Apollo 14 crystalline samples were selected (14053,19, 14072,13, 14073,9, 14310,171 along with basaltic clast 14321,1482) for in situ analysis of Cl isotopes using secondary ion mass spectrometry. Cl isotopes were measured within the mineral apatite, with δ37Cl values ranging from +14.6 ± 1.6‰ to +40.0 ± 2.9‰. These values expand the range previously reported for apatite in lunar rocks, and include some of the heaviest Cl isotope compositions measured in lunar samples to date. The data here do not display a trend between increasing rare earth elements contents and δ37Cl values, reported in previous studies. Other processes that can explain the wide inter- and intra-sample variability of δ37Cl values are explored. Magmatic degassing is suggested to have potentially played a role in fractionating Cl isotope in these samples. Degassing alone, however, could not create the wide variability in isotopic signatures. Our favored hypothesis, to explain small scale heterogeneity, is late-stage interaction with a volatile-rich gas phase, originating from devolatilization of lunar surface regolith rocks ∼4 billion years ago. This period coincides with vapor-induced metasomastism recorded in other lunar samples collected at the Apollo 16 and 17 landing sites, pointing to the possibility of widespread volatile-induced metasomatism on the lunar nearside at that time, potentially attributed to the Imbrium formation event.

  1. 16 Years, 16 Cruises, 1.6 Billion Soundings: a Compilation of High-Resolution Multibeam Bathymetry of the Active Plate Boundary Along the Chilean Continental Margin

    Science.gov (United States)

    Weinrebe, W.; Flueh, E. R.; Hasert, M.; Behrmann, J. H.; Voelker, D.; Geersen, J.; Ranero, C. R.; Diaz-Naveas, J. L.

    2011-12-01

    Chile, a country stranding the active plate boundary between the South-American and the Nazca Plate is afflicted by recurrent earthquakes and hazardous volcanic eruptions. The strongest earthquake ever recorded occurred here, and volcanic hazards are frequent. Consequently, this area has been studied by geoscientists for many years to improve the understanding of subduction zone processes. Swath bathymetry mapping of the ocean floor has proven to bear a large potential for the interpretation of subduction-related processes, such as tectonic deformation of the marine forearc, release and migration of fluids as well as earthquake-triggered mass wasting. Multibeam bathymetry data of 16 major cruises of German, British, and Chilean research vessels recorded between 1995 and December 2010, in total more than 10,000 data files comprising about 1.6 billion soundings, have now been carefully reprocessed, compiled and merged into a unifying set of high-resolution bathymetric maps of the Chilean continental margin from latitude 40°S to 20°S. The imprint of subsurface processes on the surface morphology is well displayed in the case of the Chilean continental margin. The 3,500 km long Chilean convergent margin is not uniform, as various segments with different tectonic characteristics can be distinguished. Major factors that control margin morphology and thus the style of subduction are (1) relief and structure of the incoming oceanic plate, (2) supply of trench sediment, (3) turbidite transport within the trench, and (4) the input of terrigeneous sediments down the continental slope. A major segment boundary occurs at latitude 32°-33° S where the hotspot-related volcanic chain of Juan Fernandez is presently subducting. South of the area of ridge subduction the trench is filled with turbidites, and accretionary ridges develop across the base of the slope along most of the segment, whereas north of this boundary the turbiditic infill is reduced and subduction erosion is

  2. Stable Isotope Geochemistry of Extremely Well-Preserved 2.45-Billion-Year-Old Hydrothermal Systems in the Vetreny Belt, Baltic Shield: Insights into Paleohydrosphere

    Science.gov (United States)

    Zakharov, D. O.; Bindeman, I. N.

    2015-12-01

    The early Paleoproterozoic was an eventful period in the Earth's history. The first portions of free oxygen emerged in the atmosphere, Snowball Earth glaciations happened several times and the first supercontinent broke up due to extensive rifting. These events should have affected the stable isotopic composition of the hydrosphere. In this study, we use rocks that were altered in underwater hydrothermal systems to investigate the stable isotopic composition of the hydrosphere 2.39-2.45 billion years ago (hereinafter, Ga). Extremely low-δ18O (down to -27.5‰ SMOW) rocks from 2.39 Ga metamorphosed subglacial hydrothermal systems of the Belomorian belt, Baltic Shield formed at near-equatorial latitudes suggesting a Snowball (or Slushball) Earth glaciation. These results motivated us to look at temporally and geographically close hydrothermal systems from the unmetamorhposed 2.45 Ga Vetreny Belt rift. The length of the rift is 250 km and it is composed of high-Mg basalts, mafic-ultramafic intrusions and sedimentary successions. We examined several localities of high-Mg basalt flows that include astonishingly fresh pillow lavas, often with preserved volcanic glass, eruptive breccias, and hydrothermal alteration zones. Collected samples serve a great textural evidence of water-rock interaction that occurred in situ while basalts were cooling. The preliminary results from coexisting quartz and epidote (T, D18O=311°C), and from coexisting calcite and quartz (T, D18O=190°C) yield values of δ18O of involved water between -1.6 and -0.9 ‰. The values of δ13C in calcites vary between -4.0 and -2.3 ‰. It is likely that hydrothermal fluids operated in the Vetreny Belt rift were derived from seawater that is no different from modern oceanic water in terms of δ18O. Apparently, the rift was a Paleoproterozoic analog of the modern Red Sea, filled with oceanic water. The result is important because the Vetreny Belt rift predates the onset of Snowball Earth glaciation at 2

  3. Fluid-chemical evidence for one billion years of fluid flow through Mesoproterozoic deep-water carbonate mounds (Nanisivik zinc district, Nunavut)

    Science.gov (United States)

    Hahn, K. E.; Turner, E. C.; Kontak, D. J.; Fayek, M.

    2018-02-01

    -filling mineral phases spans over 1 billion years, and was decipherable only because of the in situ protocol used. The multiple-method in situ analytical protocol employed in this study substantially augments the knowledge of an area's geological history, parts of which cannot be discerned by means other than meticulous study of diagenetic phases, and should become routine in similar studies.

  4. Molecular Gas in a Submillimeter Galaxy at z = 4.5: Evidence for a Major Merger at 1 Billion Years after the Big Bang

    Science.gov (United States)

    Schinnerer, E.; Carilli, C. L.; Capak, P.; Martinez-Sansigre, A.; Scoville, N. Z.; Smolčić, V.; Taniguchi, Y.; Yun, M. S.; Bertoldi, F.; Le Fevre, O.; de Ravel, L.

    2008-12-01

    We report the detection of CO molecular line emission in the z = 4.5 millimeter-detected galaxy COSMOS J100054+023436 (hereafter J1000+0234) using the IRAM Plateau de Bure interferometer (PdBI) and NRAO's Very Large Array (VLA). The 12CO(4-3) line as observed with PdBI has a full line width of ~1000 km s-1, an integrated line flux of 0.66 Jy km s-1, and a CO luminosity of 3.2 × 1010 L⊙. Comparison to the 3.3 σ detection of the CO(2-1) line emission with the VLA suggests that the molecular gas is likely thermalized to the J = 4-3 transition level. The corresponding molecular gas mass is 2.6 × 1010 M⊙ assuming an ULIRG-like conversion factor. From the spatial offset of the red- and blueshifted line peaks and the line width a dynamical mass of 1.1 × 1011 M⊙ is estimated assuming a merging scenario. The molecular gas distribution coincides with the rest-frame optical and radio position of the object while being offset by 0.5'' from the previously detected Lyα emission. J1000+0234 exhibits very typical properties for lower redshift (z ~ 2) submillimeter galaxies (SMGs) and thus is very likely one of the long sought after high-redshift (z > 4) objects of this population. The large CO(4-3) line width taken together with its highly disturbed rest-frame UV geometry suggest an ongoing major merger about a billion years after the big bang. Given its large star formation rate (SFR) of >1000 M⊙ yr-1 and molecular gas content this object could be the precursor of a "red and dead" elliptical observed at a redshift of z = 2. Based on observations carried out with the IRAM Plateau de Bure Interferometer. IRAM is supported by INSU/CNRS (France), MPG (Germany), and IGN (Spain).

  5. Outcome of children older than one year with neuroblastoma.

    Science.gov (United States)

    Fayea, Najwa Y; Atra, Ayad A; Khattab, Taha; Elimam, Najla A; Felimban, Sami; Yousef, Abdelmoutaleb; Basheer, Ahmed; Zayed, Abdullah; Baothman, Abdullah; Al-Sheikh, Nada; Hussen, Wafa

    2008-01-01

    To assess the outcome of children older than one year with neuroblastoma treated at King Abdul-Aziz Medical City, Jeddah, Kingdom of Saudi Arabia. We retrospectively reviewed the files of 52 children older than one year with neuroblastoma (NBL) treated at our center between September 1987 and May 2003. Treatment consisted of OPEC chemotherapy regimen (vincristine, cisplatin, etoposide, and cyclophosphamide) or alternating OPEC/OJEC (carboplatin in place of cisplatin), surgical resection +/- radiotherapy (RT). No patient received high dose therapy (HDT). Thirty-four patients (65%) were stage 4, 12 (23%) stage 3, and 6 (11%) stage 2. Three stage 2 patients were treated with surgery only, all are alive in complete remission (CR). All stage 3 and 4 patients were treated with chemotherapy and surgery +/- RT. After induction chemotherapy, CR was achieved in 17 patients (32%) and partial remission in 10 (19%). Complete surgical resection was possible in 11 patients (22%). Disease recurrence or progression occurred in 27 patients (51%). With a median follow-up of 24 months (range 4-120), the 2-year event free survival was 10%, 82%, and 87% and the overall survival was 12%, 83%, and 100% for stage 4, 3, and 2. Children older than one year with localized NBL have good prognosis compared to those with stage 4. The use of HDT may improve the outcome in the latter group. Toxicity was significant, and adoption of risk-stratified treatment may help to reduce treatment complications.

  6. Naturalistic speeding data: Drivers aged 75 years and older

    Directory of Open Access Journals (Sweden)

    Anna Chevalier

    2016-09-01

    Full Text Available The data presented in this article are related to the research article entitled “A longitudinal investigation of the predictors of older drivers׳ speeding behavior” (Chevalier et al., 2016 [1], wherein these speed events were used to investigate older drivers speeding behavior and the influence of cognition, vision, functional decline, and self-reported citations and crashes on speeding behavior over a year of driving. Naturalistic speeding behavior data were collected for up to 52 weeks from volunteer drivers aged 75–94 years (median 80 years, 52% male living in the suburban outskirts of Sydney. Driving data were collected using an in-vehicle monitoring device. Global Positioning System (GPS data were recorded at each second and determined driving speed through triangulation of satellite collected location data. Driving speed data were linked with mapped speed zone data based on a service-provider database. To measure speeding behavior, speed events were defined as driving 1 km/h or more, with a 3% tolerance, above a single speed limit, averaged over 30 s. The data contains a row per 124,374 speed events. This article contains information about data processing and quality control. Keywords: Older drivers, Speed, Road safety, Naturalistic, In-vehicle monitoring, Device

  7. Screening mammography in women 65 years old and older

    International Nuclear Information System (INIS)

    Rubin, E.; Mulligan, S.A.; Han, S.Y.; Bernreuter, W.K.; Stanley, R.J.

    1990-01-01

    This paper compares the results of mammographic screening in women aged 65 years and older to those of women aged 50--64 years, to define risk factors and prior use of mammography in these women, and to determine whether mammographic abnormalities are managed differently in the two age groups. Historical data, mammographic findings, and biopsy results were analyzed for all women over 50 years of age screened during 1988 (2,862 patients) at a university hospital-based outpatient center and mobile van, excluding those referred by oncologists. The following factors were determined for patients screened at the outpatient center and the mobile van, with both groups divided according to patient age (50--64 vs ≥ 65 years): presence of risk factors, previous biopsy, exogenous hormones, percentage of black patients, previous mammography, biopsy rate, cancer detection rate, positive nodes, and presence of tumors smaller than 1 cm or ductal carcinoma in-situ

  8. Transplantation With Livers From Deceased Donors Older Than 75 Years

    DEFF Research Database (Denmark)

    Thorsen, Trygve; Aandahl, Einar Martin; Bennet, William

    2015-01-01

    BACKGROUND: The availability of donor organs limits the number of patients in need who are offered liver transplantation. Measures to expand the donor pool are crucial to prevent on-list mortality. The aim of this study was to evaluate the use of livers from deceased donors who were older than 75...... years. METHODS: Fifty-four patients who received a first liver transplant (D75 group) from 2001 to 2011 were included. Donor and recipient data were collected from the Nordic Liver Transplant Registry and medical records. The outcome was compared with a control group of 54 patients who received a liver...... graft from donors aged 20 to 49 years (D20-49 group). Median donor age was 77 years (range, 75-86 years) in the D75 group and 41 years (range, 20-49 years) in the D20-49 group. Median recipient age was 59 years (range, 31-73 years) in the D75 group and 58 years (range, 31-74 years) in the D20-49 group...

  9. 100 billion suns

    International Nuclear Information System (INIS)

    Kippenhahn, R.

    1983-01-01

    A work on the world of astrophysics primarily for lay readers. The author writes only about the discoveries he ''experienced'' during the past 25 years (before 1979). Illustrated somewhat in color plus a set of superb colar plates. Contents, abridged: The long life of stars. The life story of the sun. The life story of massive stars. The end of stars. How stars are born. Planets and their inhabitants

  10. Personality Predicts Cognitive Function Over Seven Years in Older Persons

    Science.gov (United States)

    Chapman, Benjamin; Duberstein, Paul; Tindle, Hilary A; Sink, Kaycee M; Robbins, John; Tancredi, Daniel J.; Franks, Peter

    2011-01-01

    Objectives To determine whether Neuroticism, as well as the less-studied dimensions the Five Factor Model of personality (Extraversion, Openness to Experience, Agreeableness, and Conscientiousness) were associated with 7-year trajectories of cognitive functioning in older persons. Design Primary analysis of existing clinical trial data. Participants 602 persons of average age 79 at baseline. Measurements The NEO-Five Factor Inventory of personality, completed at baseline, and the modified Mini Mental Status Exam (3MSE) measured every 6 months for 7 years. Results Controlling for demographics, baseline morbidities including depression, health behaviors, Apolipoprotein E4 genotype, and self-rated health, higher Neuroticism was associated with worse average cognitive functioning and a steeper rate of decline over follow-up. Higher Extraversion and lower Openness were both associated with worse average cognitive functioning prospectively, while persons higher in Conscientiousness showed a slower rate of cognitive decline. Conclusions In addition to Neuroticism, other dispositional tendencies appear prognostically relevant for cognitive functioning in older persons. More work is needed to understand the mechanisms by which traits operate, as well as whether mitigation of certain dispositional tendencies can facilitate a better course of cognitive function. PMID:22735597

  11. Naturalistic rapid deceleration data: Drivers aged 75 years and older

    Directory of Open Access Journals (Sweden)

    Anna Chevalier

    2016-12-01

    Full Text Available The data presented in this article are related to the research manuscript “Predictors of older drivers’ involvement in rapid deceleration events”, which investigates potential predictors of older drivers’ involvement in rapid deceleration events including measures of vision, cognitive function and driving confidence (A. Chevalier et al., 2016 [1]. In naturalistic driving studies such as this, when sample size is not large enough to allow crashes to be used to investigate driver safety, rapid deceleration events may be used as a surrogate safety measure. Naturalistic driving data were collected for up to 52 weeks from 182 volunteer drivers aged 75–94 years (median 80 years, 52% male living in the suburban outskirts of Sydney. Driving data were collected using an in-vehicle monitoring device. Accelerometer data were recorded 32 times per second and Global Positioning System (GPS data each second. To measure rapid deceleration behavior, rapid deceleration events (RDEs were defined as having at least one data point at or above the deceleration threshold of 750 milli-g (7.35 m/s2. All events were constrained to a maximum 5 s duration. The dataset provided with this article contains 473 events, with a row per RDE. This article also contains information about data processing, treatment and quality control. The methods and data presented here may assist with planning and analysis of future studies into rapid deceleration behaviour using in-vehicle monitoring.

  12. Nuclear business worth billions begins

    International Nuclear Information System (INIS)

    Beer, G.; Marcan, P.; Slovak, K.

    2005-01-01

    The first V1 unit of Bohunice nuclear power station is to be shutdown by the end of next year. However, its decommissioning can only start in 2011 as before the decommissioning can start the second unit must be shutdown and the nuclear fuel to be stored in a basin must cool down. But in spite of these limitations, the decommissioning process has already started. Various analyses and projects have been put out to tender, work on the technical division of the decommissioned V1 units from the V2 units, which will remain in service, has also began. The state owned company, GovCo, a.s., will be in charge of the decommissioning of the V1 units. The method to be applied to the decommissioning of the V1 units has not yet been selected. The project management unit of Slovak Electric favours immediate decommissioning. 'Not only will decommissioning start immediately following the removal of the nuclear fuel, but it will also be done continuously,'explained unit director, Peter Hlbocky. Using this procedure, decommissioned could be complete by 2026. The question as to whether the power plant will be completely decommissioned to create a green field site will, according to P. Hlbocky, depend on Slovakia's future plans regarding nuclear energy generation at Jaslovske Bohunice, which could be a suitable location for building a new nuclear power station. In such a case, a part of the infrastructure would remain in place. 'Should Slovakia decide to continue its nuclear program, it would be a waste not to take advantage of the existing infrastructure,' said P. Hlbocky. The cabinet is to decide on the method to be used for decommissioning of the V1 reactor and the time frame for the process by the end of next year. The cabinet will decide mainly on the basis of cost estimates to be prepared together with decommissioning concept that is currently under preparation. The decommissioning concept financed by the Bohunice International Decommissioning Support Fund should provide more

  13. FY97 nuclear-related budgets total 493 billion yen (4.4 billion dollars)

    International Nuclear Information System (INIS)

    Anon.

    1996-01-01

    On September 13, the Atomic Energy Commission of Japan announced the estimated nuclear-related budget requests for FY1997 (April, 1997 - Mach, 1998), giving the breakdowns for eight ministries and agencies. The total amount requested by the government bodies was 493.3 billion yen, 0.8% increase as compared with FY96. this figure includes the budget requests of the Science and Technology Agency (STA), the Ministry of International Trade and Industry (MITI), the Ministry of Foreign Affairs, the Ministry of Transport, the Ministry of Agriculture, Forestry and Fisheries, the Okinawa Development Agency, and the Ministry of Home Affairs, but excludes the budget request made by the Ministry of Education. The budget requests of STA and MITI are 360 billion yen and 126 billion yen, respectively. On August 29, STA released its estimated FY97 budget request. The nuclear-related 360.4 billion yen is 0.9% more than that in year before. Of this sum, 199.9 billion yen is in the general account, and 160.6 billion yen is in the special account for power source development. The details of the nuclear-related amounts are explained. On August 26, MITI released its estimated budget request for FY97, and of the nuclear-related 125.7 billion yen (0.1% increase from FY96), 200 million yen is in the general account, and 98.9 billion yen and 26.6 billion yen are in the special accounts for power resource development and power source diversification, respectively. (K.I.)

  14. A billion-dollar bonanza

    International Nuclear Information System (INIS)

    Isaacs, J.

    1993-01-01

    In late May -- only weeks after Congress had rejected the president's economic stimulus package because it would add to the federal deficit -- the House of Representatives generously allocated an extra $1.2 billion to the Pentagon. This article discusses some of the rationalizations House members gave for the gift and describes the attempts of a bipartisan group to defeat this request for funds propounded by Pennsylvania Democrat John Murtha. This gist of the arguments for and against the $1.2 billion and the results of votes on the bill are presented

  15. Three-dimensional preservation of cellular and subcellular structures suggests 1.6 billion-year-old crown-group red algae

    DEFF Research Database (Denmark)

    Bengtson, Stefan; Sallstedt, Therese; Belivanova, Veneta

    2017-01-01

    The ~1.6 Ga Tirohan Dolomite of the Lower Vindhyan in central India contains phosphatized stromatolitic microbialites. We report from there uniquely well-preserved fossils interpreted as probable crown-group rhodophytes (red algae). The filamentous form Rafatazmia chitrakootensis n. gen, n. sp. has....... The wider affinities of Denaricion are uncertain. Ramathallus lobatus n. gen., n. sp. is a lobate sessile alga with pseudoparenchymatous thallus, “cell fountains,” and apical growth, suggesting florideophycean affinity. If these inferences are correct, Rafatazmia and Ramathallus represent crown......-group multicellular rhodophytes, antedating the oldest previously accepted red alga in the fossil record by about 400 million years....

  16. [Dissertations 25 year after date 41. Older people's adaptability].

    Science.gov (United States)

    de Baat, C; Gerritsen, A E; van der Putten, G J; van der Maarel-Wierink, C D

    2015-09-01

    In 1990, the thesis 'Removable complete dentures in older people, an issue dealing with adaptability?' was published. Among other things, this thesis aimed at finding a method of measuring older people's adaptability to removable complete dentures. Its conclusion was that a subscale of the "Beoordelingsschaal voor Oudere Patiënten" (Rating scale for older patients) had predictive value. Subsequently, only a few research projects on this topic have been carried out. They dealt with demonstrated adaptation achieved after treatment, the realised adaptation. The results were disappointing. Ever since the availability of endosseous oral implants, research into adaptability to conventional removable complete dentures seems less relevant. During the last decades, inquiries into a method of measuring treatment effectiveness has focused on older people's quality of life and general health condition. However, to assess with respect to oral health care an older person's general health condition and load-taking capacity adequately, some experience is indispensable.

  17. Probing the Big Bang at the Relativistic Heavy Ion Collider (RHIC) (or Probing the Big Bang 13.7 billion years later)

    International Nuclear Information System (INIS)

    Lee, David M

    2010-01-01

    The Relativistic Heavy Ion Collider (RHIC) at the Brookhaven National Laboratory in the USA is a variable energy proton-proton and ion-ion collider that is the first accelerator capable of colliding heavy ions. RHIC was designed to do experiments that provide important information about the Standard Model of particle physics, Quantum Chromodynamics (QCD). QCD predicts that in the early part of the Universe just after the Big Bang the world consisted of a Quark Gluon Plasma, a weakly interacting collection of quarks and gluons. At RHIC we can recreate the conditions of the early Universe by colliding heavy ions at 200 GeV. This paper will give a general overview of the physics motivation for studying the QGP, how our experiments are designed to study the QGP, what we have learned over the last 9 years, and what the future holds.

  18. 12 billion DM for Germany

    International Nuclear Information System (INIS)

    Anon.

    1975-01-01

    The German atomic industry has achieved the break-through to the world market: Brazil orders eight nuclear electricity generating plants from Siemens-AEG daughter Kraftwerk-Union. US concerns attacked the twelve billion DM deal, the biggest export order in the history of German industry. Without avail - the contract is to be signed in Bonn this week. (orig./LH) [de

  19. Three-dimensional preservation of cellular and subcellular structures suggests 1.6 billion-year-old crown-group red algae.

    Science.gov (United States)

    Bengtson, Stefan; Sallstedt, Therese; Belivanova, Veneta; Whitehouse, Martin

    2017-03-01

    The ~1.6 Ga Tirohan Dolomite of the Lower Vindhyan in central India contains phosphatized stromatolitic microbialites. We report from there uniquely well-preserved fossils interpreted as probable crown-group rhodophytes (red algae). The filamentous form Rafatazmia chitrakootensis n. gen, n. sp. has uniserial rows of large cells and grows through diffusely distributed septation. Each cell has a centrally suspended, conspicuous rhomboidal disk interpreted as a pyrenoid. The septa between the cells have central structures that may represent pit connections and pit plugs. Another filamentous form, Denaricion mendax n. gen., n. sp., has coin-like cells reminiscent of those in large sulfur-oxidizing bacteria but much more recalcitrant than the liquid-vacuole-filled cells of the latter. There are also resemblances with oscillatoriacean cyanobacteria, although cell volumes in the latter are much smaller. The wider affinities of Denaricion are uncertain. Ramathallus lobatus n. gen., n. sp. is a lobate sessile alga with pseudoparenchymatous thallus, "cell fountains," and apical growth, suggesting florideophycean affinity. If these inferences are correct, Rafatazmia and Ramathallus represent crown-group multicellular rhodophytes, antedating the oldest previously accepted red alga in the fossil record by about 400 million years.

  20. Bone mineral density in Brazilian men 50 years and older

    Directory of Open Access Journals (Sweden)

    C.A.F. Zerbini

    2000-12-01

    Full Text Available Bone mineral density (BMD in the lumbar spine (LSBMD, femoral neck (FNBMD and whole body (WBBMD and whole body tissue composition were evaluated in 288 Brazilian men 50 years and older, 80% white and 20% Mulattoes. Age was inversely correlated with WBBMD (r = -0.20 and FNBMD (r = -0.21 but not with LSBMD (r = 0.03. Body mass index and weight showed a strong positive correlation with WBBMD (r = 0.48 and 0.54, LSBMD (r = 0.37 and 0.45 and FNBMD (r = 0.42 and 0.48. Correlation with height was positive but weaker. No significant bone loss at the lumbar spine level was observed as the population aged. FNBMD and WBBMD decreased significantly only in the last decade (age 70-79 studied. BMD was higher for Brazilian men as compared to Brazilian women at all sites. No significant differences were observed between Brazilian and the US/European male population for BMD in the femoral neck. BMD measured by dual-energy X-ray absorptiometry in South American men is reported here for the first time. A decrease in FNBMD was detected only later in life, with a pattern similar to that described for the US/European male population.

  1. Ten years of integrated care for the older in France

    Directory of Open Access Journals (Sweden)

    Dominique Somme

    2011-12-01

    Full Text Available Background: This paper analyzes progress made toward the integration of the French health care system for the older and chronically ill population. Policies: Over the last ten years, the French health care system has been principally influenced by two competing linkage models that failed to integrate social and health care services: local information and coordination centers, governed by the social field, and the gerontological health networks governed by the health field. In response to this fragmentation, Homes for the Integration and Autonomy for Alzheimer patients (MAIAs is currently being implemented at experimental sites in the French national Alzheimer plan, using an evidence-based model of integrated care. In addition, the state's reforms recently created regional health agencies (ARSs by merging seven strategic institutions to manage the overall delivery of care. Conclusion: The French health care system is moving from a linkage-based model to a more integrated care system. We draw some early lessons from these changes, including the importance of national leadership and governance and a change management strategy that uses both top-down and bottom-up approaches to implement these reforms.

  2. Four billion people facing severe water scarcity.

    Science.gov (United States)

    Mekonnen, Mesfin M; Hoekstra, Arjen Y

    2016-02-01

    Freshwater scarcity is increasingly perceived as a global systemic risk. Previous global water scarcity assessments, measuring water scarcity annually, have underestimated experienced water scarcity by failing to capture the seasonal fluctuations in water consumption and availability. We assess blue water scarcity globally at a high spatial resolution on a monthly basis. We find that two-thirds of the global population (4.0 billion people) live under conditions of severe water scarcity at least 1 month of the year. Nearly half of those people live in India and China. Half a billion people in the world face severe water scarcity all year round. Putting caps to water consumption by river basin, increasing water-use efficiencies, and better sharing of the limited freshwater resources will be key in reducing the threat posed by water scarcity on biodiversity and human welfare.

  3. Oxygen - A Four Billion Year History

    DEFF Research Database (Denmark)

    Canfield, Donald Eugene

    of fields, including geology, paleontology, geochemistry, biochemistry, animal physiology, and microbiology, to explain why our oxygenated Earth became the ideal place for life. Describing which processes, both biological and geological, act to control oxygen levels in the atmosphere, Canfield traces...... guides readers through the various lines of scientific evidence, considers some of the wrong turns and dead ends along the way, and highlights the scientists and researchers who have made key discoveries in the field. Showing how Earth's atmosphere developed over time, Oxygen takes readers...

  4. Oxygen - A Four Billion Year History

    DEFF Research Database (Denmark)

    Canfield, Donald Eugene

    The air we breathe is twenty-one percent oxygen, an amount higher than on any other known world. While we may take our air for granted, Earth was not always an oxygenated planet. How did it become this way? Oxygen is the most current account of the history of atmospheric oxygen on Earth. Donald...... Canfield--one of the world's leading authorities on geochemistry, earth history, and the early oceans--covers this vast history, emphasizing its relationship to the evolution of life and the evolving chemistry of the Earth. With an accessible and colorful first-person narrative, he draws from a variety...... of fields, including geology, paleontology, geochemistry, biochemistry, animal physiology, and microbiology, to explain why our oxygenated Earth became the ideal place for life. Describing which processes, both biological and geological, act to control oxygen levels in the atmosphere, Canfield traces...

  5. Oklo 2 Billion Years Before Fermi

    International Nuclear Information System (INIS)

    Barre, B.

    2005-02-01

    The author aims to present the little-known story of the Oklo natural reactors. He recalls the historical aspects of the Oklo reactors discovery by the CEA in 1972, he explains the scientific phenomenon and the interest, notably as a ''natural analogue'' for the geological disposal of high level radioactive wastes. (A.L.B.)

  6. What You Should Know and Do This Flu Season If You Are 65 Years and Older

    Science.gov (United States)

    ... Pandemic Other What You Should Know and Do this Flu Season If You Are 65 Years and Older Language: English (US) Español Recommend on ... for people 65 and older. Actions To Take This Flu Season: Get Your ... get a seasonal flu vaccine each year by the end of October if possible. However, ...

  7. Escalating energy costs threaten health care for critically ill and homebound seniors: home care nurses, aides and therapists drive 4.8 billion miles per year to reach shut-in patients.

    Science.gov (United States)

    2008-08-01

    The rapidly rising cost of fuel has had a profound impact on the home care and hospice industry. In an effort to quantify the increased burden, the National Association for Home Care & Hospice's (NAHC) Foundation for Hospice and Home Care conducted a study showing that home care and hospice providers drive over 5 billion miles per year to deliver services --about two-and-a-half times the number driven by United Parcel Service, the international delivery service. The findings garnered significant interest by the media and elected officials. Reprinted in this issue of CARING Magazine are the press release that NAHC issued regarding the study, as well as a graphic representation of the study's findings that was circulated to the National Conference of State Legislatures at its most recent meeting in July. Also represented on these pages is a reprint from the Congressional Record of July 11, 2008, in which Senator Debbie Stabenow (D-MI), one of the highest ranking Democrats in the US. Senate, entered into the record an article from the front page of the New York Times of July 5, 2008, that covered the mileage study.

  8. To reactivate or not to reactivate: nature and varied behavior of structural inheritance in the Proterozoic basement of the Eastern Colorado mineral belt over 1.7 billion years of earth history

    Science.gov (United States)

    Caine, Jonathan S.; Ridley, John; Wessel, Zachary R.

    2010-01-01

    The eastern central Front Range of the Rocky Mountains in Colorado has long been a region of geologic interest because of Laramide-age hydrothermal polymetallic vein-related ores. The region is characterized by a well-exposed array of geologic structures associated with ductile and brittle deformation, which record crustal strain over 1.7 billion years of continental growth and evolution. The mineralized areas lie along a broad linear zone termed the Colorado Mineral Belt. This lineament has commonly been interpreted as following a fundamental boundary, such as a suture zone, in the North American Proterozoic crust that acted as a persistent zone of weakness localizing the emplacement of magmas and associated hydrothermal fluid flow. However, the details on the controls of the location, orientation, kinematics, density, permeability, and relative strength of various geological structures and their specific relationships to mineral deposit formation are not related to Proterozoic ancestry in a simple manner. The objectives of this field trip are to show key localities typical of the various types of structures present, show recently compiled and new data, offer alternative conceptual models, and foster dialogue. Topics to be discussed include: (1) structural history of the eastern Front Range; (2) characteristics, kinematics, orientations, and age of ductile and brittle structures and how they may or may not relate to one another and mineral deposit permeability; and (3) characteristics, localization, and evolution of the metal and non–metal-bearing hydrothermal systems in the eastern Colorado Mineral Belt.

  9. Age-Adjusted Percentage of Adults Aged 18 Years or Older with Diagnosed Diabetes Performing Daily Self-Monitoring of ...

    Science.gov (United States)

    ... Years or Older with Diagnosed Diabetes Performing Daily Self-Monitoring of Blood Glucose, United States, 1994–2010 From ... years or older with diagnosed diabetes performing daily self-monitoring of blood glucose increased by 27.9 points, ...

  10. Impact of Social Capital on 8-year Mortality Among Older People in 34 Danish Municipalities

    DEFF Research Database (Denmark)

    Poulsen, Tine; Siersma, Volkert Dirk; Christensen, Ulla

    2012-01-01

    To analyze the impact of social capital measures (bonding, bridging, and linking) on all-cause mortality at 8-year follow-up among older people aged 75 and 80 at baseline.......To analyze the impact of social capital measures (bonding, bridging, and linking) on all-cause mortality at 8-year follow-up among older people aged 75 and 80 at baseline....

  11. Obesity, sarcopenia, sarcopenic obesity and reduced mobility in Brazilian older people aged 80 years and over.

    Science.gov (United States)

    Santos, Vanessa Ribeiro Dos; Gomes, Igor Conterato; Bueno, Denise Rodrigues; Christofaro, Diego Giulliano Destro; Freitas, Ismael Forte; Gobbo, Luis Alberto

    2017-01-01

    To analyze which abnormalities in body composition (obesity, sarcopenia or sarcopenic obesity) are related to reduced mobility in older people aged 80 years and older. The sample included 116 subjects aged 80 years and older. The body composition was measured using dual-energy X-ray absorptiometry (DXA) and mobility was assessed by motor tests. The χ2 test was used to analyze the proportion of older people with sarcopenia, obesity and sarcopenic obesity based on sex as well as to indicate an association between obesity, sarcopenia, sarcopenic obesity and mobility. Binary logistic regression, adjusted for the variables (sex and osteoarticular diseases), was used to express the magnitude of these associations. One-way analysis of variance was used to compare the mobility of four groups (Normal, Obesity, Sarcopenia and Sarcopenic Obesity). The Sarcopenia Group had lower performance in the lower limbs strength test and in sum of two tests compared with Obesity and Normal Groups. Older people with sarcopenia had higher chance of reduced mobility (OR: 3.44; 95%CI: 1.12-10.52). Older people aged 80 years and older with sarcopenia have more chance for reduction in mobility.

  12. Older adults' alcohol consumption and late-life drinking problems: a 20-year perspective.

    Science.gov (United States)

    Moos, Rudolf H; Schutte, Kathleen K; Brennan, Penny L; Moos, Bernice S

    2009-08-01

    The aim of this study was to identify changes in patterns of alcohol consumption over a 20-year interval among older women and men, and to examine the associations between guideline-defined excessive drinking and late-life drinking problems. DESIGN, PARTICIPANTS AND MEASURES: A community sample of 719 adults between 55 and 65 years of age who consumed alcohol at or prior to baseline participated in a survey of alcohol consumption and drinking problems and was followed 10 years and 20 years later. The likelihood of excessive drinking declined over the 20-year interval as adults matured into their 70s and 80s. However, at ages 75-85, 27.1% of women and 48.6% of men consumed more than two drinks per day or seven drinks per week. At comparable guideline levels of alcohol consumption, older men were more likely to have drinking problems than were older women. Consumption of more than two drinks per day or seven drinks per week was identified as a potential conservative guideline for identifying excessive drinking associated with an elevated likelihood of drinking problems. A substantial percentage of older adults who consume alcohol engage in guideline-defined excessive drinking and incur drinking problems. The finding that older men may be more likely than older women to experience problems when they drink beyond guideline levels suggests that alcohol guidelines for men should not be set higher than those for women.

  13. Older Adults’ Alcohol Consumption and Late-Life Drinking Problems: A 20-Year Perspective

    Science.gov (United States)

    Moos, Rudolf H.; Schutte, Kathleen K.; Brennan, Penny L.; Moos, Bernice S.

    2009-01-01

    Aims The aim was to identify changes in patterns of alcohol consumption over a 20-year interval among older women and men, and to examine the associations between guideline-defined excessive drinking and late-life drinking problems. Design, Participants, and Measures A community sample of 719 adults between 55 and 65 years of age who consumed alcohol at or prior to baseline participated in a survey of alcohol consumption and drinking problems and was followed 10 years and 20 years later. Findings The likelihood of excessive drinking declined over the 20-year interval as adults matured into their 70s and 80s. However, at ages 75–85, 27% of women and 49% of men consumed more than 2 drinks per day or 7 drinks per week. At comparable guideline levels of alcohol consumption, older men were more likely to have drinking problems than were older women. Consumption of more than 2 drinks per day or 7 drinks per week was identified as a potential conservative guideline for identifying excessive drinking associated with an elevated likelihood of drinking problems. Conclusions A substantial percentage of older adults who consume alcohol engage in guideline-defined excessive drinking and incur drinking problems. The finding that older men may be more likely than older women to experience problems when they drink beyond guideline levels suggests that alcohol guidelines for men should not be set higher than those for women. PMID:19438836

  14. McBride's operation for hallux valgus can be used in patients older than 30 years

    DEFF Research Database (Denmark)

    Gebuhr, Peter Henrik; Soelberg, M; Larsen, T

    1992-01-01

    . In patients older than 30 years there were significant reductions. In patients younger than 30 years, the reduction was not significant. The rate of problems with daily footwear was reduced from 36 of 46 feet to 13 of 38 feet. The authors noted few problems and a high rate of satisfied patients, despite...

  15. DYNAPENIA AND METABOLIC HEALTH IN OBESE AND NON-OBESE OLDER ADULTS AGED 70 YEARS AND OLDER: THE LIFE STUDY

    Science.gov (United States)

    Anton, S; Beavers, DP; Manini, TM; Fielding, R; Newman, A; Church, T; Kritchevsky, SB; Conroy, D; McDermott, MM; Botoseneanu, A; Hauser, ME; Pahor, M

    2016-01-01

    Objective The purpose of this study was to examine the relationship between dynapenia and metabolic risk factors in obese and non-obese older adults. Methods A total of 1453 men and women (age ≥ 70 years) from the Lifestyle Interventions and Independence for Elders (LIFE) Study were categorized as (1) non-dynapenic/non-obese (NDYN-NO), (2) dynapenic/non-obese (DYN-NO), (3) non-dynapenic/obese (NDYN-O), or (4) dynapenic/obese (DYN-O), based on muscle strength (FNIH criteria) and body mass index. Dependent variables were blood lipids, fasting glucose, blood pressure, presence of at least three metabolic syndrome (MetS) criteria and other chronic conditions. Results A significantly higher likelihood of having abdominal obesity criteria in NDYN-NO compared to DYN-NO groups (55.6 vs 45.1%, p ≤ 0.01) was observed. Waist circumference was also significantly higher in obese groups (DYN-O=114.0±12.9 and NDYN-O=111.2±13.1) than in non-obese (NDYN-NO=93.1±10.7 and DYN-NO=92.2±11.2, p ≤ 0.01); and higher in NDYN-O compared to DYN-O (p = 0.008). Additionally, NDYN-O demonstrated higher diastolic blood pressure compared to DYN-O (70.9±10.1 vs 67.7±9.7, p ≤ 0.001). No significant differences were found across dynapenia and obesity status for all other metabolic components (p>0.05). The odds of having metabolic syndrome or its individual components were similar in obese and non-obese, combined or not with dynapenia (non-significant OR [95%CI]). Conclusion Non-obese dynapenic older adults had fewer metabolic disease risk factors than non-obese and non-dynapenic older adults. Moreover, among obese older adults, dynapenia was associated with lower risk of meeting metabolic syndrome criteria for waist circumference and diastolic blood pressure. Additionally, the presence of dynapenia did not increase cardiometabolic disease risk in either obese or non-obese older adults. PMID:27914851

  16. Interaction, at Ambient Temperature and 80 °C, between Minerals and Artificial Seawaters Resembling the Present Ocean Composition and that of 4.0 Billion Years Ago.

    Science.gov (United States)

    Carneiro, Cristine E A; Stabile, Antonio C; Gomes, Frederico P; da Costa, Antonio C S; Zaia, Cássia T B V; Zaia, Dimas A M

    2017-09-01

    Probably one of the most important roles played by minerals in the origin of life on Earth was to pre-concentrate biomolecules from the prebiotic seas. There are other ways to pre concentrate biomolecules such as wetting/drying cycles and freezing/sublimation. However, adsorption is most important. If the pre-concentration did not occur-because of degradation of the minerals-other roles played by them such as protection against degradation, formation of polymers, or even as primitive cell walls would be seriously compromised. We studied the interaction of two artificial seawaters with kaolinite, bentonite, montmorillonite, goethite, ferrihydrite and quartz. One seawater has a major cation and anion composition similar to that of the oceans of the Earth 4.0 billion years ago (ASW 4.0 Ga). In the other, the major cations and anions are an average of the compositions of the seawaters of today (ASWT). When ASWT, which is rich in Na + and Cl - , interacted with bentonite and montmorrilonite structural collapse occurred on the 001 plane. However, ASW 4.0 Ga, which is rich in Mg 2+ and SO 4 2- , did not induce this behavior. When ASW 4.0 Ga was reacted with the minerals for 24 h at room temperature and 80 °C, the release of Si and Al to the fluid was below 1 % of the amount in the minerals-meaning that dissolution of the minerals did not occur. In general, minerals adsorbed Mg 2+ and K + from the ASW 4.0 Ga and these cations could be used for the formation of polymers. Also, when the minerals were mixed with ASW 4.0 Ga at 80 °C and ASWT at room temperature or 80 °C it caused the precipitation of CaSO 4 ∙2H 2 O and halite, respectively. Finally, further experiments (adsorption, formation of polymers, protection of molecules against degradation, primitive cell wall formation) performed under the conditions described in this paper will probably be more representative of what happened on the prebiotic Earth.

  17. Countdown to Six Billion Teaching Kit.

    Science.gov (United States)

    Zero Population Growth, Inc., Washington, DC.

    This teaching kit features six activities focused on helping students understand the significance of the world population reaching six billion for our society and our environment. Featured activities include: (1) History of the World: Part Six Billion; (2) A Woman's Place; (3) Baby-O-Matic; (4) Earth: The Apple of Our Eye; (5) Needs vs. Wants; and…

  18. Assessment of surgical treatment and postoperative nutrition in gastric cancer patients older than 80 years.

    Science.gov (United States)

    Nakanoko, Tomonori; Kakeji, Yoshihiro; Ando, Koji; Nakashima, Yuichiro; Ohgaki, Kippei; Kimura, Yasue; Saeki, Hiroshi; Oki, Eiji; Morita, Masaru; Maehara, Yoshihiko

    2015-01-01

    A gastrectomy for gastric cancer is sometimes required in patients older than 80 years due to the continuously increasing age of society. However, if a gastrectomy worsens the postoperative quality of life and daily activity in elderly patients because of poor nutrition, the procedure may not always be a useful treatment strategy. Clinicopathological data of patients with gastric cancer who underwent a gastrectomy at our Department between 1998 and 2008 (N=471) were collected and analyzed. The results of treatment for patients older than 80 years (N=41) were analyzed and compared against those of patients younger than 80 years (N=430). Patients older than 80 years had a higher frequency of preoperative co-morbidities than patients younger than 80 years. However, there was no statistical difference in postoperative complications regarding nutrition between the two groups. Older age is not a determinant of poor nutrition following gastrectomy. Gastrectomy for gastric cancer is, therefore, a useful treatment strategy, regardless of ageing. Copyright© 2015 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

  19. Geriatric Conditions in Acutely Hospitalized Older Patients: Prevalence and One-Year Survival and Functional Decline

    Science.gov (United States)

    Buurman, Bianca M.; Hoogerduijn, Jita G.; de Haan, Rob J.; Abu-Hanna, Ameen; Lagaay, A. Margot; Verhaar, Harald J.; Schuurmans, Marieke J.; Levi, Marcel; de Rooij, Sophia E.

    2011-01-01

    Background To study the prevalence of eighteen geriatric conditions in older patients at admission, their reporting rate in discharge summaries and the impact of these conditions on mortality and functional decline one year after admission. Method A prospective multicenter cohort study conducted between 2006 and 2008 in two tertiary university teaching hospitals and one regional teaching hospital in the Netherlands. Patients of 65 years and older, acutely admitted and hospitalized for at least 48 hours, were invited to participate. Eighteen geriatric conditions were assessed at hospital admission, and outcomes (mortality, functional decline) were assessed one year after admission. Results 639 patients were included, with a mean age of 78 years. IADL impairment (83%), polypharmacy (61%), mobility difficulty (59%), high levels of primary caregiver burden (53%), and malnutrition (52%) were most prevalent. Except for polypharmacy and cognitive impairment, the reporting rate of the geriatric conditions in discharge summaries was less than 50%. One year after admission, 35% had died and 33% suffered from functional decline. A high Charlson comorbidity index score, presence of malnutrition, high fall risk, presence of delirium and premorbid IADL impairment were associated with mortality and overall poor outcome (mortality or functional decline). Obesity lowered the risk for mortality. Conclusion Geriatric conditions were highly prevalent and associated with poor health outcomes after admission. Early recognition of these conditions in acutely hospitalized older patients and improving the handover to the general practitioner could lead to better health outcomes and reduce the burden of hospital admission for older patients. PMID:22110598

  20. Quality of life among older stroke patients in Taiwan during the first year after discharge.

    Science.gov (United States)

    Shyu, Yea-Ing L; Maa, Suh-Hwa; Chen, Sien-Tsong; Chen, Min-Chi

    2009-08-01

    To explore the one-year poststroke trajectories in health-related quality of life and physical function in a sample of older stroke patients in Taiwan. Health-related quality of life has repeatedly been reported as decreased in poststroke patients. The vast majority of information on the health-related quality of life of older patients after stroke is based on data collected in Western developed countries. In contrast, little is known about older stroke patients in Asian countries. A descriptive, prospective and correlational design was used. Older stroke survivors (n = 98) were assessed at the end of one, three, six and 12 months after hospital discharge for health-related quality of life (measured by the Medical Outcomes Study Short Form 36) and physical functioning (measured by the Chinese Barthel Index and Instrumental Activities of Daily Living Scale). The subjects, who were 65-88 years old, performed considerably worse at 12 months after hospital discharge in social and physical functioning (means = 61.1, 54.8, respectively) than the age-matched community-dwelling norm (means = 78.7, 69.7, respectively). During the first year after discharge, subjects improved significantly on the Medical Outcomes Study Short Form 36 physical component summary scale and role limitations due to physical problems; during the first three months after discharge, they improved significantly on performance of activities of daily living and instrumental activities of daily living; and from the third to sixth month after discharge, they improved significantly in physical functioning. The first year, especially the first three months after hospital discharge, is critical for improvements in health-related quality of life and physical functioning for older stroke survivors in Taiwan. Older Taiwanese/Chinese people who suffer a stroke will likely benefit from interventions during the first 12 months after discharge and the most effective interventions may be earlier, during the first

  1. Meniscus suture repair: minimum 10-year outcomes in patients younger than 40 years compared with patients 40 and older.

    Science.gov (United States)

    Steadman, J Richard; Matheny, Lauren M; Singleton, Steven B; Johnson, Nicholas S; Rodkey, William G; Crespo, Bernardo; Briggs, Karen K

    2015-09-01

    Few studies have compared outcomes after meniscus suture repair in patients younger than 40 years versus patients 40 years and older. To document failure rates and long-term outcomes after meniscus suture repair by a single surgeon, using the inside-out technique, at a minimum 10-year follow-up in patients younger than 40 years versus those 40 years and older. Cohort study; Level of evidence, 3. This study included all patients 18 years or older who underwent meniscus suture repair with the inside-out technique by a single surgeon between January 1992 and December 2003. Patients were divided into 2 cohorts according to age: meniscus as repaired in the index surgery. Patients completed a subjective questionnaire at minimum of 10 years after arthroscopy. Outcomes measures included Lysholm, Tegner, and patient satisfaction with outcome. All data were collected prospectively. The surgeon performed 339 meniscus repairs between 1992 and 2003. The study included 181 knees in 178 patients, who had a mean age of 33 years (range, 18-70 years). Cohort 1 contained 136 knees; 16 patients (12%) were lost to follow-up and 47 (35%) underwent a subsequent knee arthroscopy. Cohort 2 contained 45 knees; 2 patients (4.4%) were lost to follow-up, 3 patients had a total knee arthroplasty, and 12 patients (28%) underwent a subsequent knee arthroscopy. In cohort 1, the meniscus repair failure rate was 5.5% (6/110), and in cohort 2 it was 5.3% (2/38) (P = .927). There was no significant difference in failure rate based on which meniscus was repaired (P = .257), concomitant anterior cruciate ligament (ACL) reconstruction (P = .092), or microfracture (P = .674). Average follow-up time for cohort 1 was 16.1 years (range, 10.0-21.9 years), with 82% follow-up (n = 73/89); average follow-up time for cohort 2 was 16.2 years (range, 10.1-21.0 years), with 93% follow-up (n = 28/30). There were no significant differences in outcomes scores after meniscus suture repair based on age cohort or meniscus

  2. Subjective physical and cognitive age among community-dwelling older people aged 75 years and older: differences with chronological age and its associated factors.

    Science.gov (United States)

    Ihira, Hikaru; Furuna, Taketo; Mizumoto, Atsushi; Makino, Keitaro; Saitoh, Shigeyuki; Ohnishi, Hirofumi; Shimada, Hiroyuki; Makizako, Hyuma

    2015-01-01

    The aim of this cross-sectional study was to determine the associations between self-reported subjective physical and cognitive age, and actual physical and cognitive functions among community-dwelling older people aged 75 years and older. The sample comprised 275 older adults aged 75-91 years. Two questions were asked regarding subjective age: 'How old do you feel physically?' and 'How old do you feel cognitively?' To assess physical functions, we measured handgrip strength, knee extension strength, standing balance and walking speed. Tests of attention, executive function, processing speed and memory were performed to assess actual cognitive function. Subjective physical and cognitive age was associated with performance on all of the physical and cognitive tests, respectively (p older adults who reported themselves as feeling older than their chronological age had a slower walking speed and lower scores for word-list memory recall than those who did not report themselves as feeling older than their actual age. These findings suggest that promoting a fast walking speed and good memory function may help to maintain a younger subjective physical and cognitive age in older adults aged 75 years and older.

  3. Backlog at December 31, 2007: euro 39,8 billion, up by 55% from year-end 2006. 2007 sales revenue: euro 11.9 billion, up by 9.8% (+10.4% like-for-like); Carnet de commandes au 31 decembre 2007: 39,8 milliards d'euros, en progression de 55% par rapport a fin 2006. Chiffre d'affaires de l'exercice 2007: 11,9 milliards d'euros, en progression de 9,8% (+10,4% en donnees comparables)

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2008-01-15

    The AREVA group's backlog reached a record level of euro 39.834 billion as of December 31, 2007, up by 55% from that of year-end 2006. In Nuclear, the backlog was euro 34.927 billion at year-end 2007 (+58%), due in particular to the signature of a contract in a record amount with the Chinese utility CGNPC. The series of agreements concluded provide among other things for the construction of two new-generation EPR nuclear islands and the supply of all of the materials and services needed for their operation through 2027. CGNPC also bought 35% of the production of UraMin, the mining company acquired by AREVA in August 2007. Industrial cooperation in the Back End of the cycle was launched with the signature of an agreement between China and France. In addition, the group signed several long-term contracts in significant amounts, particularly with KHNP of South Korea, EDF and Japanese utilities. The Transmission and Distribution division won several major contracts in Libya and Qatar at the end of the year approaching a total of euro 750 million. For the entire year, new orders grew by 34% to euro 5.816 billion. The backlog, meanwhile, grew by 40% to euro 4.906 billion at year-end. The group cleared sales revenue of euro 11.923 billion in 2007, up by 9.8% (+10.4% like-for-like) in relation to 2006 sales of euro 10.863 billion. Sales revenue for the 4. quarter of 2007 rose to euro 3.858 billion, for growth of 16.7% (+18.8% like-for-like) over one year. Sales revenue for the year was marked by: - Growth of 7.6% (+10.6% like-for-like) in Front End sales revenue, which rose to euro 3.140 billion. The division's Enrichment operations posted strong growth. - Sales were up by 17.5% (+15.2% like-for-like) to euro 2.717 billion in the Reactors and Services division. Sales revenue was driven in particular by the growth of Services operations, after weak demand in 2006, by progress on OL3 construction, and by the start of Flamanville 3, the second EPR. For the Back End

  4. Changes in Leisure Styles and Satisfaction of Older People: A Five Years Follow-Up

    Science.gov (United States)

    Gagliardi, Cristina; Spazzafumo, Liana; Papa, Roberta; Marcellini, Fiorella

    2012-01-01

    The present study examines the leisure style and leisure satisfaction of a sample of older people at baseline and after a period of 5 years. Three groups were identified by factorial and cluster analyses and labelled under the headings of: Organised Style, Surrounding Style and Indoor Style. Each group represented a different typology of leisure,…

  5. [Risk factors of endometriosis associated ovarian carcinoma in women aged 45 years and older].

    Science.gov (United States)

    He, Z X; Wang, S; Li, Z F; Zhu, L; Leng, J H; Lang, J H

    2017-05-25

    Obiective: To explore the risk factors of endometriosis-associated ovarian cancer (EAOC) in women with ovarian endometriosis aged 45 years and older in China. Methods: The medical records of total 1 038 women aged 45 years and older with a surgicopathological diagnosis of ovarian endometriosis treated at Peking Union Medical College Hospital from December 1994 to December 2014 were reviewed. Histology evaluation determined ovarian endometriosis with ( n =30) or without ( n =1 008) ovarian cancer. Results: (1) There were 30 (2.9%, 30/1 018) cases confirmed as having EAOC. Clear cell carcinoma (63.3%, 17/30) and endometrioid adenocarcinoma (23.3%, 7/30) were commonly observed subtypes and 70.0% of EAOC patients were at stage Ⅰ. (2) Compared women with ovarian endometriosis in the same age group, patients with EAOC were older (50.8 vs 48.5 years, P =0.002). There were more in postmenopausal status at diagnosis of EAOC ( P 0.05). Conclusions: For women with ovarian endometriosis aged 45 years and older, the subgroup of patients characterized by postmenopausal status and ovarian endometrioma (≥8 cm) have a higher risk of EAOC. Active intervention or intensive follow-up should be considered for this population group, especially for those concurrent with endometrial disorders.

  6. Somatic chronic diseases and 6-year change in cognitive functioning among older persons

    NARCIS (Netherlands)

    Comijs, H.; Kriegsman, D.M.W.; Dik, M.G.; Deeg, D.J.H.; Jonker, C.; Stalman, W.A.B.

    2009-01-01

    The influence of seven highly prevalent somatic chronic diseases on changes in cognitive functioning is investigated in older persons in a prospective design covering a 6-year follow-up period. The data were collected as part of the Longitudinal Aging Study Amsterdam (LASA). The associations between

  7. Oral nutritional support of older (65 years+) medical and surgical patients after discharge from hospital

    DEFF Research Database (Denmark)

    Beck, Anne Marie; Holst, Mette; Rasmussen, Henrik Højgaard

    2013-01-01

    To estimate the effectiveness of oral nutritional support compared to placebo or usual care in improving clinical outcome in older (65 years+) medical and surgical patients after discharge from hospital. Outcome goals were: re-admissions, survival, nutritional and functional status, quality of life...

  8. Development of health over four years among middle-aged and older Europeans

    DEFF Research Database (Denmark)

    Vestergaard, Sonja; Eriksen, Mette Lindholm; Andersen-Ranberg, Karen

    2013-01-01

    Older adults in Eastern and Central European countries have a higher risk of developing poor self-rated health over four years. The same geographical pattern is seen for a higher risk of developing hypertension and diabetes. Low educational level significantly increases the risk of developing poor...... self-perceived health....

  9. Risk of Bleeding and Thrombosis in Patients 70 Years or Older Using Vitamin K Antagonists

    NARCIS (Netherlands)

    Kooistra, Hilde A. M.; Calf, Agneta H.; Piersma - Wichers, Grietje; Kluin-Nelemans, Hanneke C.; Izaks, Gerbrand J.; Veeger, Nic J. G. M.; Meijer, Karina

    IMPORTANCE Previous studies have shown that, despite the higher risk of bleeding, the elderly still benefit from taking anticoagulants if they have a stringent indication. However, owing to the relatively low number of patients older than 90 years in these studies, it is unknown whether this benefit

  10. Sociodemographic, behavioural and health factors associated with changes in older adults' TV viewing over 2 years.

    Science.gov (United States)

    Gardner, Benjamin; Iliffe, Steve; Fox, Kenneth R; Jefferis, Barbara J; Hamer, Mark

    2014-08-15

    Of all age groups, older adults spend the most time watching TV, which is one of the most common sedentary behaviours. Such sedentary activity in older adulthood is thought to risk deterioration of physical and mental functioning, health and wellbeing. Identifying the characteristics of older adults whose TV viewing increases over time may help to target sedentary behaviour reduction interventions to those in most urgent need. Yet, studies of the factors associated with TV viewing have predominantly been cross-sectional. This study used a prospective design to describe changes in TV viewing over a two-year follow-up period, and to model socio-demographic, behavioural and health factors associated with observed changes in viewing time. A two-year follow-up of 6,090 male and female older adults (mean age 64.9 ± 8.9 years) was conducted in the English Longitudinal Study of Ageing, a cohort of community dwelling older adults. TV viewing time was self-reported at baseline and at follow-up. The sample was categorised according to baseline TV viewing duration (TV viewing time between baseline and follow-up. Mean self-reported TV viewing time increased from 5.32 ± 4.08 hrs/d at baseline to 5.53 ± 4.19 hrs/d at follow-up (p TV viewing (23% of all participants by 60 minutes or more), 41% decreased their viewing, and 10% reported no change in viewing duration. Increases in TV viewing at follow-up were associated with lower socioeconomic status, presence of depressive symptoms, higher BMI, physical inactivity, and being a smoker at baseline. Findings call for the development of effective behaviour change interventions to counter increases in inactive TV viewing among older adults, and point to subgroups who may need to be prioritised for such interventions.

  11. Hydroelectric dams need billions for rehab

    International Nuclear Information System (INIS)

    Carr, F.H.; Soast, A.

    1993-01-01

    Many of the Corps of Engineers older hydroelectric dams will require major rehabilitation over the next ten years. Preventive maintenance, repair work, and major rehabilitation of the Corp's hydro dams in inadequate because the revenue generated by sales of electricity, by law, is returned to the Treasury. Most multimillion dollar rehabilitation projects require specific approval for funding by Congress and securing it is a long and difficult process. It is hoped the funding problem will soon be addressed by the Clinton administration. Already, nearly one-sixth of the 2,154 Mw of hydro is unavailable because with hydro units are either out of service or operating at less than full capacity

  12. Etiology of Overt or Subclinical Hyperthyroidism and Iodine Status in Older Than Sixty Years

    Directory of Open Access Journals (Sweden)

    Oguzhan Aksu

    2016-04-01

    Full Text Available Aim: Thyroid dysfunction is common among older people associated with morbidity and mortality. Overall, the most common cause of hyperthyroidism is Grave%u2019s Disease (GD. In the older population however, Toxic Multinodular Goitre (TMG is more common. Iodine is an essential molecule for thyroid hormone synthesis. This may be due to the presence of autonomic areas with a higher sensitivity to iodine in the thyroid gland. The aim of this study was to detect the etiology of hyperthyroidism among cases older than 60 years.Material and Method: The study included 100 patients %u226560 years or older with hyperthyroidism. Demographic and clinical features of the patients were recorded. All patients were tested for anti-thyroid autoantibodies and underwent thyroid ultrasonographic (USG and scintigraphic examination. Iodine exposure was detected in 24-hour urine specimens. Results: Eighty-one patients (81% had overt and the remaining 19 (19% had subclinical hyperthyroidism and the mean age was 70.48 ± 6.16 (range 60-88. Thirteen patients had recent exposure to iodine and 11 had Jod Basedow Phenomenon (JBP. The most common disease was TMNG (29.2% and 8 patients had no definitive diagnosis; they were designated nondiagnostic (ND. Discussion: This is the first study that investigates the causes of thyrotoxicosis amoung older people in our country. The results indicated that TMNG was the most common cause. JBP cases had a history of exposure to iodine. For this reason, radiocontrast use in older people should be carefully evaluated with this respect.

  13. When Contact Is Not Enough: Affecting First Year Medical Students' Image towards Older Persons.

    Directory of Open Access Journals (Sweden)

    Sasmita Kusumastuti

    Full Text Available Many medical schools have initiated care internships to familiarize their students with older persons and to instil a professional attitude.To examine the impact of care internships on the image that first-year medical students have of older persons and to explore the underlying concepts that may play a role in shaping this image.Survey before and after a two-week compulsory care internship using the Aging Semantic Differential (ASD; 32 adjectives and the Attitudes toward Old People (AOP; 34 positions questionnaires.Before and after a care internship involving interpersonal contact, 252 and 244 first-year medical students at the Leiden University Medical Centre (LUMC in the academic year 2012-2013 participated.Descriptive statistics, analyses of variance, and principal component analysis were used; clusters of adjectives and positions were reduced into concepts to examine dominant patterns of views. Changes in image were investigated as mean differences of the total and concept scores.Both the ASD and the AOP questionnaires showed a poor general image of older persons that significantly worsened after the care internship (p < 0.01. The percentage of students considering over 75 years as being old increased from 17.2% to 31.2% (p < 0.01 and those who thought they would find as much satisfaction in care for older as for younger patients decreased from 78.5% to 62.1% (p < 0.001. Exploratory principal component analysis showed particularly low scores on 'comportment' and 'pleasurable interaction' whereas the scores on 'personality traits' and 'habitual behaviour' significantly deteriorated (both p < 0.001. These patterns were irrespective of the student's gender and previous contact experience.Medical schools should carefully consider care internships to ensure that students do not worsen their views on older patients, which may occur due to inadequate contact depth and quality within a rather unsupportive context.

  14. One billion cubic meters of gas produced in Kikinda area

    Energy Technology Data Exchange (ETDEWEB)

    Vicicevic, M; Duric, N

    1969-10-01

    The Kikinda gas reservoir has just passed a milestone in producing one billion cubic meters of natural gas. The reservoir was discovered in 1962, and its present production amounts to 26 million cu m. One of the biggest problems was formation of hydrates, which has successfully been solved by using methanol. Four tables show production statistics by years and productive formations.

  15. Congress OKs $2 Billion Boost for the NIH.

    Science.gov (United States)

    2017-07-01

    President Donald Trump last week signed a $1.1 trillion spending bill for fiscal year 2017, including a welcome $2 billion boost for the NIH that will support former Vice President Joe Biden's Cancer Moonshot initiative, among other priorities. However, researchers who rely heavily on NIH grant funding remain concerned about proposed cuts for 2018. ©2017 American Association for Cancer Research.

  16. Food and nutrient consumption trends in older Australians: a 10-year cohort study.

    Science.gov (United States)

    Flood, V M; Burlutsky, G; Webb, K L; Wang, J J; Smith, W T; Mitchell, P

    2010-06-01

    Few longitudinal population-based cohort studies of older people have described dietary intakes over time. The objective of this study was to assess changes in the food and nutrient intake in a cohort of older Australians, using longitudinal data collected over 10 years. Population-based cohort of people aged 49 years and over at baseline (82% of those eligible) living in two postcode areas, west of Sydney. In 1992-1994, 3654 people were examined; 2334 were reexamined after 5 years and 1952 after 10 years (75% survivors at both examinations). A 145-item food frequency questionnaire was used to assess food and nutrient intake on each occasion, and 1166 participants provided usable dietary data at all three examinations. Energy and sugar intake significantly increased among women over the 10-year period (P-value for trend bread consumption decreased in both men and women (P-value for trend choices. This information could be used to inform nutrition policy and programs targeted to older persons. These data highlight the need to identify barriers to better food choices.

  17. One-year mortality after hip fracture in older individuals: the effects of delirium and dementia.

    Science.gov (United States)

    Mitchell, Rebecca; Harvey, Lara; Brodaty, Henry; Draper, Brian; Close, Jacqueline

    2017-09-01

    Delirium is common in older hip fracture patients, yet its association with mortality after hip fracture remains uncertain. This study aimed to determine whether delirium was associated with all-cause one-year mortality after hip fracture in older patients and whether the effect of delirium was independent of dementia status. A retrospective analysis of linked hospitalisation and mortality data for patients aged ≥65 years with a hip fracture during 1 January 2010 to 30 June 2014 in New South Wales, Australia. The association between delirium and mortality after a hip fracture was assessed using Cox proportional hazard regression. There were 4,065 (14.6%) of 27,888 hip fracture hospitalisations identified with delirium during hospitalisation. Individuals with delirium had a higher age-adjusted rate of all-cause one-year mortality after hip fracture compared to individuals without delirium (35.3% versus 23.9%). After adjusting for covariates, the risk of all-cause mortality was increased at one-year post-admission for older individuals compared to those aged 65-69 years, for individuals with multiple comorbidities, dementia (Hazard Ratio (HR): 1.14; 95%CI:1.08-1.20), delirium (HR: 1.19; 95%CI:1.12-1.26), and who had an Intensive Care Unit admission (HR: 1.44; 95%CI:1.31-1.59). Comorbid delirium did not add additional mortality risk for individuals with a hip fracture who have dementia. Delirium identified in hospital was associated with all-cause one-year mortality after hip fracture in older Australians without dementia. As delirium is potentially preventable, better systematic assessment and documentation of a hip fracture patient's cognitive state is warranted to select the most effective strategies to prevent and manage delirium. Copyright © 2017 Elsevier B.V. All rights reserved.

  18. Consumer Decision-Making of Older People: A 45-Year Review.

    Science.gov (United States)

    Hettich, Dominik; Hattula, Stefan; Bornemann, Torsten

    2017-03-15

    Aging is one of the key future challenges for global life. Of particular interest is the consumption-related decision-making of older people, as its better understanding would enable the effective influence of behavior, which would help to secure the economic well-being and ensure a better quality of life for this population. This article explores the respective literature and identifies gaps for future research. We conducted a holistic review of peer-reviewed literature that examined the decision-making of older consumers. Using a structured approach based on the consumer decision process model, we present the findings of 45 years of research (a total of 42 articles) and identify further research areas. The review reveals that the literature on older consumers' decision-making is fragmented, and that the findings are mixed. In particular, results on the role of emotions are controversial. While emotions have been shown to be better controlled by older individuals, emotions are also found to be highly influential in commercial advertisements. Similarly, the literature contains a lively debate on the relevance of price, service and store quality, and provider choice. These results call for a more holistic view of the decision-making of older consumers, and the review highlights numerous opportunities for future research. For instance, little is known about how older consumers deal with need recognition and the reasons they search for particular information. Moreover, understanding is lacking with respect to online purchase and feedback behavior. © The Author 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  19. Five-year trajectories of social networks and social support in older adults with major depression.

    Science.gov (United States)

    Voils, Corrine I; Allaire, Jason C; Olsen, Maren K; Steffens, David C; Hoyle, Rick H; Bosworth, Hayden B

    2007-12-01

    Research with nondepressed adults suggests that social networks and social support are stable over the life course until very late age. This may not hold true for older adults with depression. We examined baseline status and trajectories of social networks and social support at the group and individual levels over five years. The sample consisted of 339 initially depressed adults aged 59 or older (M = 69 years) enrolled in a naturalistic study of depression. Measures of social ties, including social network size, frequency of interaction, instrumental support, and subjective support, were administered at baseline and yearly for five years. Latent growth curve models were estimated for each aspect of social ties. On average, social network size and frequency of interaction were low at baseline and remained stable over time, whereas subjective and instrumental support were high at baseline yet increased over time. There was significant variation in the direction and rate of change over time, which was not predicted by demographic or clinical factors. Because increasing social networks may be ineffective and may not be possible for a portion of people who already receive maximal support, interventions to increase social support may only work for a portion of older depressed adults.

  20. Older adults' health and late-life drinking patterns: a 20-year perspective.

    Science.gov (United States)

    Moos, Rudolf H; Brennan, Penny L; Schutte, Kathleen K; Moos, Bernice S

    2010-01-01

    This study focused on the associations between older adults' health-related problems and their late-life alcohol consumption and drinking problems. A sample of 719 late-middle-aged community residents (55-65 years old at baseline) participated in a survey of health and alcohol consumption and this survey was followed 10 years and 20 years later. Health-related problems increased and alcohol consumption and drinking problems declined over the 20-year interval. Medical conditions, depressive symptoms, medication use, and acute health events were associated with a higher likelihood of abstinence; acute health events were also associated with less alcohol consumption. In contrast, reliance on alcohol to reduce pain was linked to more alcohol consumption. Moreover, an individual's overall health burden and reliance on alcohol to reduce pain were associated with more drinking problems. Reliance on alcohol to reduce pain potentiated the association between health burden, alcohol consumption and drinking problems. Older adults who have more health problems and rely on alcohol to manage pain are at elevated risk for drinking problems. Health care providers should target high-risk older adults, such as those who drink to reduce pain, for screening and brief interventions to help them identify new ways to cope with pain and curtail their drinking.

  1. Personality and medication non-adherence among older adults enrolled in a six-year trial

    Science.gov (United States)

    Jerant, Anthony; Chapman, Benjamin; Duberstein, Paul; Robbins, John; Franks, Peter

    2011-01-01

    Objectives Personality factors parsimoniously capture the variation in dispositional characteristics that affect behaviours, but their value in predicting medication non-adherence is unclear. We investigated the relationship between five-factor model personality factors (Conscientiousness, Neuroticism, Agreeableness, Extraversion, and Openness) and medication non-adherence among older participants during a six-year randomized placebo-controlled trial (RCT). Design Observational cohort data from 771 subjects aged ≥72 years enrolled in the Ginkgo Evaluation of Memory study, a RCT of Ginkgo biloba for prevention of dementia. Methods Random effects logistic regression analyses examined effects of NEO Five-Factor Inventory scores on medication non-adherence, determined via pill counts every 6 months (median follow-up 6.1 years) and defined as taking personality factor associated with non-adherence: a 1 SD increase was associated with a 3.8% increase in the probability of non-adherence (95% CI [0.4, 7.2]). Lower cognitive function was also associated with non-adherence: a 1 SD decrease in mental status exam score was associated with a 3.0% increase in the probability of non-adherence (95% CI [0.2, 5.9]). Conclusions Neuroticism was associated with medication non-adherence over 6 years of follow-up in a large sample of older RCT participants. Personality measurement in clinical and research settings might help to identify and guide interventions for older adults at risk for medication non-adherence. PMID:21226789

  2. Early and mid-term results of lung transplantation with donors 60 years and older.

    Science.gov (United States)

    López, Iker; Zapata, Ricardo; Solé, Juan; Jaúregui, Alberto; Deu, María; Romero, Laura; Pérez, Javier; Bello, Irene; Wong, Manuel; Ribas, Montse; Masnou, Nuria; Rello, Jordi; Roman, Antonio; Canela, Mercedes

    2015-01-01

    There are doubts about the age limit for lung donors and the ideal donor has traditionally been considered to be one younger than 55 years. The objective of this study was to compare the outcomes in lung transplantation between organs from donors older and younger than 60 years. We performed a retrospective observational study comparing the group of patients receiving organs from donors 60 years or older (Group A) or younger than 60 years (Group B) between January 2007 and December 2011. Postoperative evolution and mortality rates, short-term and mid-term postoperative complications, and global survival rate were evaluated. We analysed a total of 230 lung transplants, of which 53 (23%) involved lungs from donors 60 years of age or older (Group A), and 177 (77%) were from donors younger than 60 years (Group B). Three (5.7%) patients from Group A and 14 patients (7.9%) from Group B died within 30 days (P = 0.58). The percentage of patients free from chronic lung allograft dysfunction at 1-3 years was 95.5, 74.3 and 69.3% for Group A, and 94.5, 84.8 and 73.3% for Group B, respectively (P = 0.47). There were no statistically significant differences between Groups A and B in terms of survival at 3 years, (69.4 vs 68.8%; P = 0.28). Our results support the idea that lungs from donors aged 60-70 years can be used safely for lung transplantation with comparable results to lungs from younger donors in terms of postoperative mortality and mid-term survival. © The Author 2014. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  3. Does life satisfaction predict five-year mortality in community-living older adults?

    Science.gov (United States)

    St John, Philip D; Mackenzie, Corey; Menec, Verena

    2015-01-01

    Depression and depressive symptoms predict death, but it is less clear if more general measures of life satisfaction (LS) predict death. Our objectives were to determine: (1) if LS predicts mortality over a five-year period in community-living older adults; and (2) which aspects of LS predict death. 1751 adults over the age of 65 who were living in the community were sampled from a representative population sampling frame in 1991/1992 and followed five years later. Age, gender, and education were self-reported. An index of multimorbidity and the Older American Resource Survey measured health and functional status, and the Terrible-Delightful Scale assessed overall LS as well as satisfaction with: health, finances, family, friends, housing, recreation, self-esteem, religion, and transportation. Cox proportional hazards models examined the influence of LS on time to death. 417 participants died during the five-year study period. Overall LS and all aspects of LS except finances, religion, and self-esteem predicted death in unadjusted analyses. In fully adjusted analyses, LS with health, housing, and recreation predicted death. Other aspects of LS did not predict death after accounting for functional status and multimorbidity. LS predicted death, but certain aspects of LS are more strongly associated with death. The effect of LS is complex and may be mediated or confounded by health and functional status. It is important to consider different domains of LS when considering the impact of this important emotional indicator on mortality among older adults.

  4. Milk consumption during teenage years and risk of hip fractures in older adults.

    Science.gov (United States)

    Feskanich, Diane; Bischoff-Ferrari, Heike A; Frazier, A Lindsay; Willett, Walter C

    2014-01-01

    Milk consumption during adolescence is recommended to promote peak bone mass and thereby reduce fracture risk in later life. However, its role in hip fracture prevention is not established and high consumption may adversely influence risk by increasing height. To determine whether milk consumption during teenage years influences risk of hip fracture in older adults and to investigate the role of attained height in this association. Prospective cohort study over 22 years of follow-up in more than 96,000 white postmenopausal women from the Nurses' Health Study and men aged 50 years and older from the Health Professionals Follow-up Study in the United States. Frequency of consumption of milk and other foods during ages 13 to 18 years and attained height were reported at baseline. Current diet, weight, smoking, physical activity, medication use, and other risk factors for hip fractures were reported on biennial questionnaires. Cox proportional hazards models were used to calculate relative risks (RRs) of first incidence of hip fracture from low-trauma events per glass (8 fl oz or 240 mL) of milk consumed per day during teenage years. During follow-up, 1226 hip fractures were identified in women and 490 in men. After controlling for known risk factors and current milk consumption, each additional glass of milk per day during teenage years was associated with a significant 9% higher risk of hip fracture in men (RR = 1.09; 95% CI, 1.01-1.17). The association was attenuated when height was added to the model (RR = 1.06; 95% CI, 0.98-1.14). Teenage milk consumption was not associated with hip fractures in women (RR = 1.00 per glass per day; 95% CI, 0.95-1.05). Greater milk consumption during teenage years was not associated with a lower risk of hip fracture in older adults. The positive association observed in men was partially mediated through attained height.

  5. Trajectories of Leisure Activity and Disability in Older Adults Over 11 Years in Taiwan.

    Science.gov (United States)

    Yu, Hsiao-Wei; Chiang, Tung-Liang; Chen, Duan-Rung; Tu, Yu-Kang; Chen, Ya-Mei

    2018-06-01

    We aimed to identify leisure activity (LA) trajectories and examined the association among baseline characteristics, LA trajectories, and the later disability among older Taiwanese adults. Data were from the Taiwan Longitudinal Study on Aging Survey for the years 1996-2007 ( N = 3,186). LA trajectories were identified by using latent class growth curve modeling. Regression analyses were applied to predict the relationships among baseline characteristics, LA trajectories, and disability. Four LA trajectories-consistent high, consistent low, increasing, and decreasing-were identified. Lower depressive symptom was related to consistently active in LAs. Younger age and fewer comorbidities were related to develop an increasing LA trajectory. Participants in the consistent-high or increasing LA trajectories were more likely to be functionally independent, but those in the decreasing LA subgroup were more at risk of developing disability. The findings suggested that long-term changes in LA over time have benefits on physical health in older population.

  6. Seven Billion People: Fostering Productive Struggle

    Science.gov (United States)

    Murawska, Jaclyn M.

    2018-01-01

    How can a cognitively demanding real-world task such as the Seven Billion People problem promote productive struggle "and" help shape students' mathematical dispositions? Driving home from school one evening, Jaclyn Murawska heard a commentator on the radio announce three statements: (1) experts had determined that the world population…

  7. Chronic vulvovaginitis in women older than 50 years: analysis of a prospective database.

    Science.gov (United States)

    Nyirjesy, Paul; Leigh, Randi D; Mathew, Leny; Lev-Sagie, Ahinoam; Culhane, Jennifer F

    2012-01-01

    This study aimed to examine differences in symptoms and diagnoses between women 50 years and younger and women older than 50 years who have chronic vulvovaginal complaints. New patients of the Drexel University Vaginitis Center with chronic vulvovaginal complaints were eligible. Participants underwent a standardized medical evaluation and completed detailed questionnaires. Data were analyzed using the t test, χ test, and the Fisher exact test. Subjects were 469 women aged 18 to 79 years. Subjects 50 years and younger (group A) were more likely to complain of vaginal itching and were less likely to complain of burning, irritation, or soreness (p ≤ .05 for all). Subjects older than 50 years (group B) were more likely to be diagnosed with atrophic vaginitis (p = .000), desquamative inflammatory vaginitis (DIV; p = .001), lichen planus (LP; p = .000), and lichen sclerosus (p = .000). Diagnosis of LS, LP, or DIV was associated with increased likelihood of multiparity and decreased likelihood of a history of systemic estrogen use. Postmenopausal women are more likely than premenopausal women to be diagnosed with DIV, LP, or LS. Both childbirth and estrogen nonuse were associated with the occurrence of these latter 3 conditions.

  8. Total elbow arthroplasty in distal humerus fracture in patients older than 65 years.

    Directory of Open Access Journals (Sweden)

    Gerardo Gallucci

    2016-05-01

    Full Text Available Objective To report the clinical-functional results of the treatment of humeral distal fractures with a total elbow prosthesis in patients older than 65 years old. Material and methods This retrospective paper was performed in two surgical centers. Criteria inclusion were: patients with humeral distal fractures, > 65 years, operated on with Coonrad-Morrey prostheses, and with a follow-up of  >1 year. Twenty-one patients were included. Twenty were women with an average age of 79 years old. According to AO classification, 13 fractures were type C3, 7 C2 and 1 A2. All patientes were operated on without desinsertion of the extensor mechanism. Average follow-up was 40 months. Results Flexo-extension was 123-17°, with a total arc of mobility of 106° (80 % of the contralateral side. Pain according to AVE was 1. The MEPI was 83 points: 8 patients had excellent results, 11 good, 1 regular and 1 bad. Average DASH score was 24 points. Conclusion Treatment of humeral distal fractures with total elbow arthoplasty in patients older than 65 years old, may lead to a good option of treatment, but indications must be limited to patients with complex fractures, bad bone quality, with osteoporosis and low functional demands.

  9. Effects of integrated dental care on oral treatment needs in residents of nursing homes older than 70 years

    NARCIS (Netherlands)

    Gerritsen, Paul; Cune, Marco; van der Bilt, Andries; Abbink, Jan; de Putter, Cornelis

    2015-01-01

    Aim: To determine effects of integrated dental care in older nursing home residents. Methods: In three nursing homes offering integrated dental care, we studied the oral treatment need of 355 residents older than 70 years. To determine effects of integrated care, we discriminated between short-stay

  10. 'Suddenly the First Fifty Years of My Life Made Sense': Experiences of Older People with Autism

    Science.gov (United States)

    Hickey, Aoife; Crabtree, Jason; Stott, Joshua

    2018-01-01

    Research on the experience of growing older with autism is very limited. In this study, 13 people with autism aged over 50 years participated in semi-structured interviews about their experiences of diagnosis, social support and getting older. Interviews were analysed using thematic analysis. Three overarching themes were generated: difference,…

  11. Control beliefs and risk for 4-year mortality in older adults: a prospective cohort study.

    Science.gov (United States)

    Duan-Porter, Wei; Hastings, Susan Nicole; Neelon, Brian; Van Houtven, Courtney Harold

    2017-01-11

    Control beliefs are important psychological factors that likely contribute to heterogeneity in health outcomes for older adults. We evaluated whether control beliefs are associated with risk for 4-year mortality, after accounting for established "classic" biomedical risk factors. We also determined if an enhanced risk model with control beliefs improved identification of individuals with low vs. high mortality risk. We used nationally representative data from the Health and Retirement Study (2006-2012) for adults 50 years or older in 2006 (n = 7313) or 2008 (n = 6301). We assessed baseline perceived global control (measured as 2 dimensions-"constraints" and "mastery"), and health-specific control. We also obtained baseline data for 12 established biomedical risk factors of 4-year mortality: age, sex, 4 medical conditions (diabetes mellitus, cancer, lung disease and heart failure), body mass index less than 25 kg/m 2 , smoking, and 4 functional difficulties (with bathing, managing finances, walking several blocks and pushing or pulling heavy objects). Deaths within 4 years of follow-up were determined through interviews with respondents' family and the National Death Index. After accounting for classic biomedical risk factors, perceived constraints were significantly associated with higher mortality risk (third quartile scores odds ratio [OR] 1.37, 95% CI 1.03-1.81; fourth quartile scores OR 1.45, 95% CI, 1.09-1.92), while health-specific control was significantly associated with lower risk (OR 0.69-0.78 for scores above first quartile). Higher perceived mastery scores were not consistently associated with decreased risk. The enhanced model with control beliefs found an additional 3.5% of participants (n = 222) with low predicted risk of 4-year mortality (i.e., 4% or less); observed mortality for these individuals was 1.8% during follow-up. Compared with participants predicted to have low mortality risk only by the classic biomedical model

  12. Effects of Organized Physical Activity on Selected Health Indices among Women Older than 55 Years

    Directory of Open Access Journals (Sweden)

    Piotr Zmijewski

    2015-01-01

    Full Text Available The main aim of this study was to determine health benefits among women older than 55 years who participated in organized, group-based physical activity (OPA. Thirty-five women aged 65.0 ± 7.3 years volunteered for this study. The classical and nonclassical cardiovascular (CVD risk factors were measured before and after a 2-week OPA camp in a remote location and 3 months of OPA. Self-guided physical activity was analyzed 18 months after OPA. Two-week effects included significant decreases in body mass index, waist and hip circumferences, resting systolic and diastolic blood pressure (BP and resting heart rate, improved exercise capacity (EC, improved low-density lipoprotein and high-density lipoprotein (HDL-C, cholesterol, and other atherogenic lipid indices (ALI, and a reduction in 10-year estimated risk of death from CVD. Three-month effects included a further decrease in systolic BP, improvements in EC and HDL-C, and maintenance of lower levels of ALI, as well as lower CVD risk. The implementation of the OPA programme had a positive impact on somatic features, exercise capacity, biochemical indices, and risk for death from CVD. The presented programme can be regarded as an effective element of primary prevention of cardiovascular diseases among women older than 55 years.

  13. A review of therapeutic results in oral cancer patients 70 years or older

    International Nuclear Information System (INIS)

    Shimizutani, Kiminari; Kikuchi, Yuko; Koseki, Yonoshin

    1992-01-01

    Sixty-four patients aged 70 years or older were treated for squamous cell carcinoma of the oral cavity between 1980 and 1990 at the Department of Radiology, Osaka University Hospital. Twenty-six patients received primary external irradiation with relatively low dose (30 Gy) combined with peplomycin. According to the T category, the 5-year survival rate was 49% for T1 and T2 and 35% for T3 and T4. Based on the treatment modality, the 5-year survival rate was 59% for radiotherapy with or without chemotherapy plus surgical treatment, 43% for radiotherapy plus chemotherapy, and 38% for radiotherapy alone. The combined use of peplomycin with external irradiation (30 Gy) was found very effective as an initial trial for patients aged 70 years or older in view of survival time. Therefore, a small dose (30 Gy) of external irradiation combined with peplomycin would also be significantly useful for patients who refuse surgery or have inoperable carcinoma. (J.P.N.)

  14. Diet quality and osteosarcopenic obesity in community-dwelling adults 50 years and older.

    Science.gov (United States)

    Kim, Jinhee; Lee, Yunhwan; Kye, Seunghee; Chung, Yoon-Sok; Kim, Jae-Hyun; Chon, Doukyoung; Lee, Kyung Eun

    2017-10-01

    To examine the association between diet quality and osteosarcopenic obesity (OSO), low bone and muscle mass with concurrent high fat mass, in middle-aged and older adults. Data were from a cross-sectional study of 2579 men and 3550 women aged 50 years and older who completed the Korea National Health and Nutritional Examination Survey from 2008 to 2010. Data were collected using 24-h dietary recall, and diet quality was determined by the Diet Quality Index-International (DQI-I), on which higher scores denote better quality. Body composition was evaluated by dual-energy x-ray absorptiometry. The association between dietary quality and the number of body composition abnormalities (including OSO) was analyzed by multinomial logistic regression, adjusting for covariates. In women, after controlling for covariates, higher scores on the DQI-I were associated with a significantly lower number of phenotypes associated with adverse body composition. Those in the highest tertile group of DQI-I were less likely to have OSO compared with those in the lowest tertile (odds ratio=0.54, 95% confidence interval: 0.32-0.92). In men, DQI-I scores were not associated with the number of body composition abnormalities. Middle-aged and older women who eat a healthier diet, as determined by a high DQI-I score, are less likely to have multiple body composition abnormalities. Copyright © 2017 Elsevier B.V. All rights reserved.

  15. Adiposity predicts cognitive decline in older persons with diabetes: a 2-year follow-up.

    Directory of Open Access Journals (Sweden)

    Angela Marie Abbatecola

    Full Text Available BACKGROUND: The mechanisms related to cognitive impairment in older persons with Type 2 diabetes (DM remains unclear. We tested if adiposity parameters and body fat distribution could predict cognitive decline in older persons with DM vs. normal glucose tolerance (NGT. METHODOLOGY: 693 older persons with no dementia were enrolled: 253 with DM in good metabolic control; 440 with NGT (age range:65-85 years. Longitudinal study comparing DM and NGT individuals according to the association of baseline adiposity parameters (body mass index (BMI, waist-hip-ratio (WHR, waist circumference (WC and total body fat mass to cognitive change (Mini Mental State Examination (MMSE, a composite score of executive and attention functioning (CCS over time. FINDINGS: At baseline, in DM participants, MMSE correlated with WHR (beta = -0.240; p = 0.043, WC (beta = -0.264; p = 0.041 while CCS correlated with WHR (beta = -0.238; p = 0.041, WC (beta = -0.326; p = 0.013 after adjusting for confounders. In NGT subjects, no significant correlations were found among any adiposity parameters and MMSE, while CCS was associated with WHR (beta = -0.194; p = 0.036 and WC (beta = -0.210; p = 0.024. Participants with DM in the 3(rd tertile of total fat mass showed the greatest decline in cognitive performance compared to those in 1(st tertile (tests for trend: MMSE(p = 0.007, CCS(p = 0.003. Logistic regression models showed that 3(rd vs. 1(st tertile of total fat mass, WHR, and WC predicted an almost two-fold decline in cognitive function in DM subjects at 2(nd yr (OR 1.68, 95%IC 1.08-3.52. CONCLUSIONS: Total fat mass and central adiposity predict an increased risk for cognitive decline in older person with DM.

  16. Oncology pharma costs to exceed $150 billion by 2020.

    Science.gov (United States)

    2016-10-01

    Worldwide costs of oncology drugs will rise above $150 billion by 2020, according to a report by the IMS Institute for Healthcare Informatics. Many factors are in play, according to IMS, including the new wave of expensive immunotherapies. Pembrolizumab (Keytruda), priced at $150,000 per year per patient, and nivolumab (Opdivo), priced at $165,000, may be harbingers of the market for cancer immunotherapies.

  17. Ubiquitous Supercritical Wing Design Cuts Billions in Fuel Costs

    Science.gov (United States)

    2015-01-01

    A Langley Research Center engineer’s work in the 1960s and ’70s to develop a wing with better performance near the speed of sound resulted in a significant increase in subsonic efficiency. The design was shared with industry. Today, Renton, Washington-based Boeing Commercial Airplanes, as well as most other plane manufacturers, apply it to all their aircraft, saving the airline industry billions of dollars in fuel every year.

  18. Risk factors for falls and fall-related injuries in adults 85 years of age and older.

    Science.gov (United States)

    Grundstrom, Anna C; Guse, Clare E; Layde, Peter M

    2012-01-01

    Falls are a leading cause of morbidity and mortality in older adults. No previous studies on risk factors for falls have focused on adults 85 years and older, the most rapidly growing segment of adults. We examined demographic, health, and behavioral risk factors for falls and fall-related injuries in adults 65 years and older, with a particular focus on adults 85 years and older. We analyzed self-reported information from the Behavioral Risk Factor Surveillance System (BRFSS) for 2008. Data was available for 120,923 people aged 65 or older and 12,684 people aged 85 or older. Of those aged 85 or older, 21.3% reported at least one fall in the past 3 months and 7.2% reported at least one fall related injury requiring medical care or limiting activity for a day or longer. Below average general health, male sex, perceived insufficient sleep, health problems requiring assistive devices, alcohol consumption, increasing body mass index and history of stroke were all independently associated with a greater risk of falls or fall related injuries. The greater risk of falling in those 85 years and older appeared to be due to the deterioration of overall health status with age; among those with excellent overall health status, there was no greater risk of falling in adults 85 years and older compared to those 65-84 years of age. Our results suggest that those with risk factors for falls and fall-related injuries may be appropriate targets for evidence-based fall prevention programs. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  19. Early Hospital Readmission is a Predictor of One-Year Mortality in Community-Dwelling Older Medicare Beneficiaries

    NARCIS (Netherlands)

    Lum, H.D.; Studenski, S.A.; Degenholtz, H.B.; Hardy, S.E.

    2012-01-01

    BACKGROUND: Hospital readmission within thirty days is common among Medicare beneficiaries, but the relationship between rehospitalization and subsequent mortality in older adults is not known. OBJECTIVE: To compare one-year mortality rates among community-dwelling elderly hospitalized Medicare

  20. Utility of urine cytology in evaluating hematuria with sonographically suspected bladder lesion in patients older than 50 years

    Directory of Open Access Journals (Sweden)

    Hussam Eldin Helmy Mady

    2014-01-01

    Conclusion: Hematuria in patients older than 50 years with sonographically suspected bladder lesion mandates cystoscopy and biopsy. UC does not add more significant information in this group of patients.

  1. Balance Screening of Vestibular Function in Subjects Aged 4 Years and Older: A Living Laboratory Experience

    Directory of Open Access Journals (Sweden)

    María Carolina Bermúdez Rey

    2017-11-01

    Full Text Available To better understand the various individual factors that contribute to balance and the relation to fall risk, we performed the modified Romberg Test of Standing Balance on Firm and Compliant Support, with 1,174 participants between 4 and 83 years of age. This research was conducted in the Living Laboratory® at the Museum of Science, Boston. We specifically focus on balance test condition 4, in which individuals stand on memory foam with eyes closed, and must rely on their vestibular system; therefore, performance in this balance test condition provides a proxy for vestibular function. We looked for balance variations associated with sex, race/ethnicity, health factors, and age. We found that balance test performance was stable between 10 and 39 years of age, with a slight increase in the failure rate for participants 4–9 years of age, suggesting a period of balance development in younger children. For participants 40 years and older, the balance test failure rate increased progressively with age. Diabetes and obesity are the two main health factors we found associated with poor balance, with test condition 4 failure rates of 57 and 19%, respectively. An increase in the odds of having fallen in the last year was associated with a decrease in the time to failure; once individuals dropped below a time to failure of 10 s, there was a significant 5.5-fold increase in the odds of having fallen in the last 12 months. These data alert us to screen for poor vestibular function in individuals 40 years and older or suffering from diabetes, in order to undertake the necessary diagnostic and rehabilitation measures, with a focus on reducing the morbidity and mortality of falls.

  2. Global cognition and 8-year survival among Japanese community-dwelling older adults.

    Science.gov (United States)

    Iwasa, Hajime; Kai, Ichiro; Yoshida, Yuko; Suzuki, Takao; Kim, Hunkyung; Yoshida, Hideyo

    2013-08-01

    We sought to examine the longitudinal relationship between cognitive function and all-cause mortality among Japanese community-dwelling older adults, using an 8-year prospective cohort study design with mortality surveillance. A total of 454 men and 386 women, aged 70 years and older, participated in the study. The Mini Mental State Examination (MMSE) was administered to assess global cognition. The total MMSE score and subscale scores were used as independent variables, and age, gender, education level, chronic disease, sensory deficit, depressive symptoms, and instrumental activities of daily living were used as covariates. During the follow-up period, 191 subjects (139 men and 52 women) died, and 64 subjects (31 men and 33 women) moved to a different region of Japan and were lost to follow-up. Use of the multivariate Cox proportional hazards model, adjusted for potential confounders, showed that global cognition was significantly and independently associated with mortality (hazard ratio [HR] = 1.59, 95% confidence interval [CI]: 1.14-2.23 and HR = 2.81, 95% CI: 1.77-4.36 for the middle [24-27 points] and lowest [0-23 points] categories, respectively). Among the MMSE subscales, place orientation (HR = 1.57, 95% CI: 1.09-2.25), calculation (HR = 1.67, 95% CI: 1.18-2.35), and delayed recall (HR = 1.42, 95% CI: 1.03-1.96), were also significantly and independently associated with mortality. Our study suggests that among older individuals, those with lower levels of cognitive function are more likely to have a shorter lifespan compared with those with higher cognitive functioning. Copyright © 2012 John Wiley & Sons, Ltd.

  3. Optic Neuritis in the Older Chinese Population: A 5-Year Follow-Up Study

    Directory of Open Access Journals (Sweden)

    Junqing Wang

    2017-01-01

    Full Text Available Objective. This study aims to describe the clinical manifestations and outcomes in a cohort of older Chinese patients. Method. A retrospective study of patients aged ≥ 45 years who had a first episode of optic neuritis (ON between May 2008 and November 2012. Clinical features at onset and last follow-up were analyzed within subgroups (age 45–65 years and age ≥ 65 years. Results. 76 patients (99 eyes were included, of which 58% were females. The mean age at presentation was 55.53 ± 8.29 years (range: 45–83 years. Vision loss was severe at presentation, with initial best corrected vision activity (BCVA < 20/200 in 93% and final BCVA < 20/200 in 53% of patients at 5-year follow-up. Final BCVA significantly correlated with the initial BCVA and peripapillary retinal nerve fiber layer. At last follow-up, 14.5% were diagnosed with neuromyelitis optica spectrum disorder (NMOSD, 1.3% were diagnosed with multiple sclerosis (MS, 5.2% with chronic relapsing inflammatory optic neuropathy, 1.3% with infectious ON, and 19.7% with autoimmune ON. None of the elderly group (≥65 years developed NMOSD or MS. Conclusion. Chinese patients in the age group ≥ 65 years with ON are less likely to develop NMOSD or MS. Notwithstanding, they had more severe visual loss at onset and poor recovery.

  4. Profile and outcome of neuroblastoma with convertional chemotherapy in children older than one year: a 15-years experience.

    Science.gov (United States)

    Bansal, Deepak; Marwaha, R K; Trehan, Amita; Rao, K L N; Gupta, Vishal

    2008-02-01

    The clinical profile and outcome of neuroblastoma in 103 children, older than one-year is presented. 74 had Stage IV, 27 Stage III and one patient each had Stage I or II disease. Treatment included chemotherapy followed by surgical resection/debulking. Radiotherapy was administered to those with residual tumor. Chemotherapy consisted of OPEC (vincristine, cyclophosphamide, cisplatin and etoposide). The caretakers of 54 (52.4%) children either did not opt for or defaulted therapy, whilst 3 patients died before chemotherapy could be initiated. Of the remaining 46 patients, the tumor progressed during therapy in 19 (41.3%). Relapse of disease was documented in 22 (47.8%) cases. Merely 4 (8.7%) children are disease free for a period of 16.5+/-6.7 months. Majority of children presented with advanced disease and the outcome was dismal with conventional non-myloablative chemotherapy.

  5. A model for partnering first-year student pharmacists with community-based older adults.

    Science.gov (United States)

    Martin, Beth A; Porter, Andrea L; Shawl, Lauren; Motl Moroney, Susannah E

    2012-06-18

    To design, integrate, and assess the effectiveness of an introductory pharmacy practice experience intended to redefine first-year student pharmacists' views on aging and medication use through their work with a healthy, community-based older-adult population. All students (N = 273) completed live skills training in an 8-hour boot camp provided during orientation week. Teams were assigned an independently living senior partner, completed 10 visits and reflections, and documented health-related information using an electronic portfolio (e-portfolio). As determined by pre- and post-experience survey instruments, students gained significant confidence in 7 skill areas related to communication, medication interviews, involving the partner in health care, and applying patient-care skills. Student reflections, in-class presentations, and e-portfolios documented that personal attitudes toward seniors changed over time. Senior partners enjoyed mentoring and interacting with students and many experienced health improvements as a result of the interaction. The model for partnering first-year student pharmacists with community-based older adults improved students' skills and fostered their connections to pharmacist roles and growth as person-centered providers.

  6. Balance Training with Wii Fit Plus for Community-Dwelling Persons 60 Years and Older.

    Science.gov (United States)

    Roopchand-Martin, Sharmella; McLean, Roshé; Gordon, Carron; Nelson, Gail

    2015-06-01

    This study sought to determine the effect of 6 weeks of training, using activities from the Nintendo(®) (Kyoto, Japan) "Wii™ Fit Plus" disc, on balance in community-dwelling Jamaicans 60 years and older. A single group pretest/posttest design was used. Thirty-three subjects enrolled and 28 completed the study. Participants completed 30-minute training sessions on the Nintendo "Wii Fit" twice per week for 6 weeks. Activities used included "Obstacle Course," "Penguin Slide," "Soccer Heading," "River Bubble," "Snow Board," "Tilt Table," "Skate Board," and "Yoga Single Tree Pose." Balance was assessed with the Berg Balance Scale, the Multi Directional Reach Test, the Star Excursion Balance Test and the Modified Clinical Test for Sensory Integration in Balance. There was significant improvement in the mean Berg Balance Scale score (P=0.004), Star Excursion Balance Test score (SEBT) (PBalance. Balance games on the Nintendo "Wii Fit Plus" disc can be used as a tool for balance training in community-dwelling persons 60 years of age and older.

  7. Feelings of uselessness and 3-year mortality in an Italian community older people: the role of the functional status.

    Science.gov (United States)

    Curzio, Olivia; Bernacca, Emilia; Bianchi, Bruno; Rossi, Giuseppe

    2017-09-01

    Sense of self-worth influences the health status of the elderly and may be associated with mortality. The aim of the study was to investigate whether the association between subjective feelings of uselessness and mortality was confounded or modified by functional limitation in non-institutionalized older people. Participants were community-dwelling older people, aged 70 years and older, who lived in neighbourhoods of Massa and Carrara municipalities in northern Tuscany, Italy. At baseline, 2335 non-institutionalized older people were assessed with a short self-administered questionnaire; the analysis included 2132 older persons for whom vital statistical data were available after a 3-year follow-up. The feeling of uselessness was associated with an increased mortality at the 3-year follow-up, but only in older people who reported disability problems (adjusted hazard ratio = 1.97, 95% confidence interval = 1.48-2.63, P feeling of uselessness may be vulnerable to an increased risk for poor health outcomes in later life. This study outlined the importance of enquiring about feelings of uselessness, which is a relational variable that is linked to both psychological and physical health status, especially in older people who need help in daily activities. © 2017 Japanese Psychogeriatric Society.

  8. 6-minute walk distance in healthy North Africans older than 40 years: influence of parity.

    Science.gov (United States)

    Ben Saad, Helmi; Prefaut, Christian; Tabka, Zouhair; Mtir, Abdelaziz Hadj; Chemit, Mohamed; Hassaoune, Rym; Ben Abid, Tarek; Zara, Khelifa; Mercier, Grégoire; Zbidi, Abdelkrim; Hayot, Maurice

    2009-01-01

    The need for a 6-min walk distance (6-MWD) reference equation for healthy North African adults older than 40 years was assessed in a prospective cross-sectional study. Anthropometric data and 6-MWD were measured in 229 healthy Tunisian adults (125 women) over 40 years old. Two subgroups of 38 women were identified according to the parity (lowor=6). The published reference equations did not reliably predict measured 6-MWD. The 6-MWD was significantly correlated with gender, age, weight and height (pgender (0: men; 1: women) - 5.14 x age (yr) - 2.23 x weight (kg)+2.72 x height (cm)+720.50. Parity accelerated the 6-MWD decline (r=-0.39, pparity (or=6) showed different 6-MWD (589+/-60 m vs. 555+/-57 m, pparity.

  9. ALMA imaging of gas and dust in a galaxy protocluster at redshift 5.3: [C II] emission in 'typical' galaxies and dusty starbursts ≈1 billion years after the big bang

    Energy Technology Data Exchange (ETDEWEB)

    Riechers, Dominik A. [Department of Astronomy, Cornell University, 220 Space Sciences Building, Ithaca, NY 14853 (United States); Carilli, Christopher L. [National Radio Astronomy Observatory, PO Box O, Socorro, NM 87801 (United States); Capak, Peter L.; Yan, Lin [Spitzer Science Center, California Institute of Technology, MC 220-6, 1200 East California Boulevard, Pasadena, CA 91125 (United States); Scoville, Nicholas Z. [Astronomy Department, California Institute of Technology, MC 249-17, 1200 East California Boulevard, Pasadena, CA 91125 (United States); Smolčić, Vernesa [University of Zagreb, Physics Department, Bijenička cesta 32, 10002 Zagreb (Croatia); Schinnerer, Eva [Max-Planck-Institut für Astronomie, Königstuhl 17, D-69117 Heidelberg (Germany); Yun, Min [Department of Astronomy, University of Massachusetts, Amherst, MA 01003 (United States); Cox, Pierre [ALMA Santiago Central Office, Alonso de Cordova 3107, Vitacura, Santiago (Chile); Bertoldi, Frank; Karim, Alexander, E-mail: dr@astro.cornell.edu [Argelander-Institut für Astronomie, Universität Bonn, Auf dem Hügel 71, Bonn, D-53121 (Germany)

    2014-12-01

    We report interferometric imaging of [C II]({sup 2} P {sub 3/2}→{sup 2} P {sub 1/2}) and OH({sup 2}Π{sub 1/2} J = 3/2→1/2) emission toward the center of the galaxy protocluster associated with the z = 5.3 submillimeter galaxy (SMG) AzTEC-3, using the Atacama Large (sub)Millimeter Array (ALMA). We detect strong [C II], OH, and rest-frame 157.7 μm continuum emission toward the SMG. The [C II]({sup 2} P {sub 3/2}→{sup 2} P {sub 1/2}) emission is distributed over a scale of 3.9 kpc, implying a dynamical mass of 9.7 × 10{sup 10} M {sub ☉}, and a star formation rate (SFR) surface density of Σ{sub SFR} = 530 M {sub ☉} yr{sup –1} kpc{sup –2}. This suggests that AzTEC-3 forms stars at Σ{sub SFR} approaching the Eddington limit for radiation pressure supported disks. We find that the OH emission is slightly blueshifted relative to the [C II] line, which may indicate a molecular outflow associated with the peak phase of the starburst. We also detect and dynamically resolve [C II]({sup 2} P {sub 3/2}→{sup 2} P {sub 1/2}) emission over a scale of 7.5 kpc toward a triplet of Lyman-break galaxies with moderate UV-based SFRs in the protocluster at ∼95 kpc projected distance from the SMG. These galaxies are not detected in the continuum, suggesting far-infrared SFRs of <18-54 M {sub ☉} yr{sup –1}, consistent with a UV-based estimate of 22 M {sub ☉} yr{sup –1}. The spectral energy distribution of these galaxies is inconsistent with nearby spiral and starburst galaxies, but resembles those of dwarf galaxies. This is consistent with expectations for young starbursts without significant older stellar populations. This suggests that these galaxies are significantly metal-enriched, but not heavily dust-obscured, 'normal' star-forming galaxies at z > 5, showing that ALMA can detect the interstellar medium in 'typical' galaxies in the very early universe.

  10. Five-year follow-up of cognitive impairment in older adults with bipolar disorder.

    Science.gov (United States)

    Schouws, Sigfried N T M; Comijs, Hannie C; Dols, Annemieke; Beekman, Aartjan T F; Stek, Max L

    2016-03-01

    To date, cognitive impairment has been thought to be an integral part of bipolar disorder. In clinical staging models, cognitive impairment is one of the hallmarks to define the clinical stage and it plays an important role in identifying the risk factors for progression to later stages of the illness. It is important to examine neurocognitive performance over longer periods to test the hypothesis of neuroprogression of bipolar disorder. A comprehensive neuropsychological test battery was applied at baseline and five years later to 56 euthymic older outpatients with bipolar disorder (mean age = 68.35 years, range: 60-90 years) and to a demographically matched sample of 44 healthy subjects. A group-by-time repeated measures multivariate analysis of variance was performed to measure changes over time for the two groups. The impact of baseline illness characteristics on the intra-individual change in neurocognitive performance within the bipolar disorder group was studied by using logistic regression analysis. At baseline and at follow-up, patients with bipolar disorder performed worse on all neurocognitive measures compared to the matched healthy subjects. However, there was no significant group-by-time interaction between the patients with bipolar disorder and the comparison group. Although older patients with bipolar disorder had worse cognitive function than healthy subjects, they did not have greater cognitive decline over a five-year period. The change in acquired cognitive impairment of patients with bipolar disorder might parallel the cognitive development as seen in normal aging. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  11. Outcomes and Tolerability of Chemoradiation Therapy for Pancreatic Cancer Patients Aged 75 Years or Older

    International Nuclear Information System (INIS)

    Miyamoto, David T.; Mamon, Harvey J.; Ryan, David P.

    2010-01-01

    Purpose: To review the outcomes and tolerability of full-dose chemoradiation in elderly patients aged 75 years or older with localized pancreatic cancer. Methods and Materials: We retrospectively reviewed patients aged 75 years or older with nonmetastatic pancreatic cancer treated with chemoradiation therapy at two institutions from 2002 to 2007. Patients were analyzed for treatment toxicity, local recurrences, distant metastases, and survival. Results: A total of 42 patients with a median age of 78 years (range, 75-90 years) who received chemoradiation therapy for pancreatic cancer were identified. Of the patients, 24 had locally advanced disease treated with definitive chemoradiation, and 18 had disease treated with surgery and chemoradiation. Before chemoradiotherapy, the mean Eastern Cooperative Oncology Group performance status was 1.0 ± 0.8, and the mean 6-month weight loss was 5.3 ± 3.8 kg. The mean radiation dose delivered was 48.1 ± 9.2 Gy. All patients received fluoropyrimidine-based chemotherapy concurrently with radiotherapy. In all, 8 patients (19%) were hospitalized, 7 (17%) had an emergency room visit, 15 (36%) required a radiation treatment break, 3 (7%) required a chemotherapy break, 9 (21%) did not complete therapy, and 22 (49%) had at least one of these adverse events. The most common toxicities were nausea, pain, and failure to thrive. Median overall survival was 8.6 months (95% confidence interval, 7.2-13.1) in patients who received definitive chemoradiation therapy and 20.6 months (95% confidence interval, 9.5-∞) in patients who underwent resection and chemoradiation therapy. Conclusions: In this dataset of very elderly patients with pancreatic cancer and good Eastern Cooperative Oncology Group performance status, outcomes after chemoradiotherapy were similar to those among historic controls for patients with locally advanced and resected pancreatic cancer, although many patients experienced substantial treatment-related toxicity.

  12. Emergency department recidivism in adults older than 65 years treated for fractures.

    Science.gov (United States)

    Southerland, Lauren T; Richardson, Daniel S; Caterino, Jeffrey M; Essenmacher, Alex C; Swor, Robert A

    2014-09-01

    Fractures in older adults are a commonly diagnosed injury in the emergency department (ED). We performed a retrospective medical record review to determine the rate of return to the same ED within 72 hours (returns) and the risk factors associated with returning. A retrospective medical record review of patients at least 65 years old discharged from a large, academic ED with a new diagnosis of upper extremity, lower extremity, or rib fractures was performed. Risk factors analyzed included demographic data, type of fracture, analgesic prescriptions, assistive devices provided, other concurrent injuries, and comorbidities (Charlson Comorbidity Index). Our primary outcome was return to the ED within 72 hours. Three hundred fifteen patients qualified. Most fractures were in the upper extremity (64% [95% confidence interval {CI}, 58%-69%]). Twenty patients (6.3% [95% CI, 3.9%-9.6%]) returned within 72 hours. Most returns (15/20, 75%) were for reasons associated with the fracture itself, such as cast problems and inadequate pain control. Only 3 (fractures had higher return rates (10.7% vs 4.5%, P = .03), and most commonly returned for cast or splint problems. Age, sex, other injuries, assistive devices, and Charlson Comorbidity Index score (median, 1 [interquartile range, 1-2] for both groups) did not predict 72-hour returns. Older adults with distal forearm fractures may have more unscheduled health care usage in the first 3 days after fracture diagnosis than older adults with other fracture types. Overall, revisits for cardiac reasons or repeat falls were rare (<1%). Copyright © 2014 Elsevier Inc. All rights reserved.

  13. Impact of Sarcopenia on One-Year Mortality among Older Hospitalized Patients with Impaired Mobility.

    Science.gov (United States)

    Pourhassan, M; Norman, K; Müller, M J; Dziewas, R; Wirth, R

    2018-01-01

    However, the information regarding the impact of sarcopenia on mortality in older individuals is rising, there is a lack of knowledge concerning this issue among geriatric hospitalized patients. Therefore, aim of the present study was to investigate the associations between sarcopenia and 1-year mortality in a prospectively recruited sample of geriatric inpatients with different mobility and dependency status. Sarcopenia was diagnosed using the criteria of the European Working Group on Sarcopenia in Older People (EWGSOP). Hand grip strength and skeletal muscle mass were measured using Jamar dynamometer and bioelectrical impedance analysis, respectively. Physical function was assessed with the Short Physical Performance Battery. Dependency status was defined by Barthel-Index (BI). Mobility limitation was defined according to walking ability as described in BI. The survival status was ascertained by telephone interview. The recruited population comprised 198 patients from a geriatric acute ward with a mean age of 82.8 ± 5.9 (70.2% females). 50 (25.3%) patients had sarcopenia, while 148 (74.7%) had no sarcopenia. 14 (28%) patients died among sarcopenic subjects compared with 28 (19%) non-sarcopenic subjects (P=0.229). After adjustment for potential confounders, sarcopenia was associated with increased mortality among patients with limited mobility prior to admission (n=138, hazard ratio, HR: 2.52, 95% CI: 1.17-5.44) and at time of discharge (n=162, HR: 1.93, 95% CI: 0.67-3.22). In a sub-group of patients with pre-admission BIsarcopenia and mortality across the different scores of BI during admission and at time of discharge. Sarcopenia is significantly associated with higher risk of mortality among sub-groups of older patients with limited mobility and impaired functional status, independently of age and other clinical variables.

  14. Transitions in Relationships With Older Parents: From Middle to Later Years

    Science.gov (United States)

    Silverstein, Merril D.

    2015-01-01

    Objective. Although intergenerational relationships have been extensively examined, studies applying dynamic multidimensional treatments are rare. Employing the life course framework and the intergenerational solidarity and ambivalence paradigms, a typology of intergenerational relationships was derived and propositions about dynamics of intergenerational relationships were tested. Method. Using latent transition analysis, we modeled 4 waves of panel data spanning 18 years from the Longitudinal Study of Generations to examine how older parent–child relationships (N = 938) transitioned in and out of complex relational configurations. Results. We derived 5 relationship types roughly corresponding to those found in earlier research. Transitions in relationship type occurred mostly when both generations were relatively young, and along the lines of what attachment, ambivalence, and latent kinship theories would predict. When change did occur, it was primarily structured by factors affecting the availability of adult children, as well as circumstances that elevated the dependency of older parents and promoted both positive and negative reactivity in their adult children. Discussion. This study has demonstrated how typological analysis captures both the complexities and dynamics of intergenerational relationships in mature families. By including behavioral, emotional, and normative aspects of later life intergenerational relationships, we told a story that was more about continuity than change. PMID:24958693

  15. The Transfer of Cognitive Speed of Processing Training to Older Adults' Driving Mobility Across 5 Years.

    Science.gov (United States)

    Ross, Lesley A; Edwards, Jerri D; O'Connor, Melissa L; Ball, Karlene K; Wadley, Virginia G; Vance, David E

    2016-01-01

    Multilevel models assessed the effects of cognitive speed of processing training (SPT) on older adults' self-reported driving using intention-to-treat (ITT, randomization to training or control conditions) and dosage (treatment-received via number of training sessions) analyses across 5 years. Participants randomized to SPT (n = 598) were compared with those randomized to either the no-contact control (n = 598) or memory training, which served as an active control (n = 610). Driving mobility (frequency, exposure, and space) was assessed over time. No significant effects were found within the ITT analyses. However, number of SPT sessions did affect driving mobility outcomes. In the full sample (N = 1,806), higher SPT doses were associated with maintained driving frequency as compared with both control groups, but no effects were found for driving exposure or space. Subsample analyses (n = 315) revealed that persons at-risk for mobility declines (i.e., poor initial processing speed) who received additional booster SPT sessions reported greater maintenance of both driving frequency and exposure over time as compared with the no-contact and active control groups. These results and prior research indicate that cognitive SPT transfers to prolonged driving mobility among older adults. Future research should investigate the mechanisms behind transfer effects to real-world activities, such as driving. © The Author 2015. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  16. The Transfer of Cognitive Speed of Processing Training to Older Adults’ Driving Mobility Across 5 Years

    Science.gov (United States)

    Edwards, Jerri D.; O’Connor, Melissa L.; Ball, Karlene K.; Wadley, Virginia G.; Vance, David E.

    2016-01-01

    Objectives. Multilevel models assessed the effects of cognitive speed of processing training (SPT) on older adults’ self-reported driving using intention-to-treat (ITT, randomization to training or control conditions) and dosage (treatment-received via number of training sessions) analyses across 5 years. Method. Participants randomized to SPT (n = 598) were compared with those randomized to either the no-contact control (n = 598) or memory training, which served as an active control (n = 610). Driving mobility (frequency, exposure, and space) was assessed over time. Results. No significant effects were found within the ITT analyses. However, number of SPT sessions did affect driving mobility outcomes. In the full sample (N = 1,806), higher SPT doses were associated with maintained driving frequency as compared with both control groups, but no effects were found for driving exposure or space. Subsample analyses (n = 315) revealed that persons at-risk for mobility declines (i.e., poor initial processing speed) who received additional booster SPT sessions reported greater maintenance of both driving frequency and exposure over time as compared with the no-contact and active control groups. Discussion. These results and prior research indicate that cognitive SPT transfers to prolonged driving mobility among older adults. Future research should investigate the mechanisms behind transfer effects to real-world activities, such as driving. PMID:25878053

  17. Cardiovascular risk factors in adults 80 years of age or older

    Directory of Open Access Journals (Sweden)

    Enrique Ruiz Mori

    2015-09-01

    Full Text Available In Peru, the 80 years‘ population and older is increasing and cardiovascular diseases are the leading cause of death. The aim of the study is to analyze the cardiovascular risk factors in octogenarians. Material and methods: It is a descriptive, observational cross prevalence research, conducted in March 2015 in Lima. A questionnaire on cardiovascular risk factors was used; blood pressure, weight, height and body mass index, in people 80 years of age or older was recorded. Results: Were evaluated 969 subjects, of whom 562 (58% were women and 407 (42% were male; with an average age of 84.2 years; predominant age group of 80-84 years 60.5%. 427 cases were hypertensive (44.1%, and was more common in women (62.2%. 9% of the study population (87 cases were smokers; being more common in men (64% (p = 0.000009. They were recorded at 220 subjects (22.7% with hypercholesterolemia, being more common in women (139 patients: 63.2%, without statistical significance. Diabetes was reported in 11.5% of the studied sample (111 patients, it was the most frequently in women (68.5% (p = 0.018. According to BMI values, 537 subjects (55.4% had a BMI <25, while 33.8% of the population (328 were overweight and 10.7% were enrolled with obesity, more prevalent in women (70, 2% (p = 0.028. In the hypertensive population was 87% in drug treatment, of which 65% were controlled. 26.5% (257 cases of the studied population had two risk factors and 13.1% (127 three or more risk factors. Conclusions: The most frequent factor of cardiovascular risk has been Hypertension, predominantly women. 40% of the evaluated subjects had two or more risk factors. 87% of hypertensive patients received drug treatment and 65% of them were controlled.

  18. Prevalence of waterpipe tobacco smoking among population aged 15 years or older, Vietnam, 2010.

    Science.gov (United States)

    Xuan, Le Thi Thanh; Van Minh, Hoang; Giang, Kim Bao; Nga, Pham Thi Quynh; Hai, Phan Thi; Minh, Nguyen Thac; Hsia, Jason

    2013-04-18

    The prevalence of waterpipe tobacco smoking is increasing globally and is associated with adverse outcomes requiring tobacco control interventions. We estimated the prevalence of waterpipe tobacco use among adult populations in Vietnam in 2010 and examined its association with sociodemographic factors. We used data from the Global Adult Tobacco Survey (GATS) conducted in Vietnam in 2010. GATS surveyed a national representative sample of adults aged 15 years or older from 11,142 households by using a 2-phase sampling design analogous to a 3-stage stratified cluster sampling. Descriptive statistical analyses and multivariate logistic regression modeling were conducted. A total of 6.4% of Vietnamese aged 15 years or older (representing about 4.1 million adult waterpipe smokers) reported current waterpipe tobacco smoking. The prevalence of waterpipe tobacco smoking was significantly higher among men than women (13% vs 0.1%). Area of residence (rural or urban), age group, asset-based wealth quintile, and geographic region of residence were significantly associated with waterpipe tobacco smoking among men. The significant correlates of current waterpipe tobacco smoking among men were lower education levels, being middle-aged (45-54 years), lower asset-based wealth levels, living in rural areas, not living in the South East and the Mekong River Delta geographic regions, and the belief that smoking does not causes diseases. Rural dwellers who are poor should be targeted in tobacco control programs. Further studies are needed that examine perceptions of the adverse health effects and the cultural factors of waterpipe tobacco smoking.

  19. Radiotherapy for patients with malignant diseases aged 85 years or older

    International Nuclear Information System (INIS)

    Asakura, Hirofumi; Mizumoto, Masashi; Zenda, Sadamoto

    2007-01-01

    The purpose of this study was to assess the efficacy and problems of radiotherapy for patients aged 85 or older. Forty-five patients were assessed (oldest old group): They were 85 years of age or older and had received radiotherapy between September 2002 and September 2005. Sixty-nine patients, 75 years of age at the start of radiotherapy, were also assessed (old group). In the oldest old group, there were 21 men and 24 women, and median age was 87 years (range; 85-99). The sites of disease were: 10 in head and neck, 5 in lung, 5 in malignant lymphoma, 4 in skin, 4 in esophagus, 2 in breast, 2 in uterine cervix, 2 in rectum, 2 in soft tissue, 2 in metastatic bone tumor, 7 in others. The treatment was deemed curative in 49%, palliative in 40%, and others in 11%. Treatment fields were limited due to performance status (PS) or age in 13 patients. The rate of treatment completion was 91% (41/45). Eleven of 26 inpatients were admitted because of difficulty in hospital visit. Seventeen of 19 outpatients needed familial escort. Of patients completed radiotherapy, 47% of the patients achieved complete response (CR), 37% achieved partial response (PR), and 16% achieved no change (NC) in the group of curative radiotherapy, and 88% of the patients achieved effective response, and only 2 cases resulted in ineffective response in the group of palliative radiotherapy. While only one patient received grade 3 dermatitis and mucositis, other patients received grade 2 and below adverse events. Three patients resulted in deterioration of PS, and 2 patients deteriorated dementia. Although higher rates in female patients, worse PS, and limitation of treatment field were seen in the oldest old group, there were no significant difference in terms of the rate of treatment completion, effectiveness, and adverse events between the two groups. Our study showed radiotherapy is effective and well tolerated in patients aged 85 or older. Considering the oldest old requiring radiotherapy

  20. Lean body mass change over 6 years is associated with dietary leucine intake in an older Danish population

    DEFF Research Database (Denmark)

    McDonald, Cameron Keith; Ankarfeldt, Mikkel Z.; Capra, Sandra

    2016-01-01

    Higher protein intake, and particularly higher leucine intake, is associated with attenuated loss of lean body mass (LBM) over time in older individuals. Dietary leucine is thought to be a key mediator of anabolism. This study aimed to assess this relationship over 6 years among younger and older...... corroborates findings from laboratory investigations in relation to protein and leucine intakes and LBM change. A more diverse and larger sample is needed for confirmation of these results....

  1. Fatal traumatic brain injury in older adults in Austria 1980-2012: an analysis of 33 years.

    Science.gov (United States)

    Brazinova, Alexandra; Mauritz, Walter; Majdan, Marek; Rehorcikova, Veronika; Leitgeb, Johannes

    2015-05-01

    traumatic brain injury (TBI) is a significant public health problem. Developed countries report a significant increase of TBI in older adults in the past decades. The objective of this study was to investigate the changes in TBI-related mortality in older Austrians (65 years or older) between 1980 and 2012 (33 years) and to identify possible causes for these changes. data from Statistics Austria on mortality in Austria between 1980 and 2012 were screened and data on TBI-related mortality in adults aged 65 and older were extracted and analysed, based on the diagnostic codes of the International Classification of Diseases, 10th and 9th revision. Mortality rates were calculated for 5-year age groups; standardized mortality rates were calculated for the total. Mechanism of injury was analysed for all events, both sexes and individual age groups. between 1980 and 2012, 16,204 people aged 65 or older died from TBI in Austria; 61% of these were male. Fatal TBI cases and mortality rates increased in the oldest age groups (80 years or older). Half of the fatal TBI cases were caused by falls, 22% by traffic accidents and 17% by suicides. Rate of fall-related fatal TBI increased and rate of traffic accident-related fatal TBI decreased with age. preventive measures introduced in the past decades in the developed countries have contributed to a decrease in traffic injuries. However, falls in the older population are on the rise, mainly due to ageing of the population, throughout the reported period. It is important to take preventive measures to stop the epidemics of fall-related TBIs and fatalities in older adults. © The Author 2014. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  2. Structural knee joint pathology in patients aged 40 years or older with meniscal tears

    DEFF Research Database (Denmark)

    Pihl, Kenneth; Englund, Martin; Lohmander, L S

    2017-01-01

    Purpose: Recent studies have challenged the tenet that mechanical symptoms of the knee (i.e. the sensation of catching or locking) are caused by degenerative meniscal tears per se and relieved by surgery. We explored the potential associations between meniscal and other knee joint pathologies...... identified at meniscal surgery with the presence of patient-reported mechanical symptoms. Methods: This study included patients aged 40 years or older undergoing surgery for a meniscal tear from the Knee Arthroscopy Cohort Southern Denmark (KACS). Patients were consecutively recruited from February 2013...... score (KOOS), together with information on previous meniscal surgery. At arthroscopy, the operating surgeon recorded information about specific meniscal pathology (tear location, depth, type, length, meniscal tissue quality and circumferential and radial location) and other structural knee pathologies...

  3. Preimplantation genetic diagnosis for aneuploidy testing in women older than 44 years: a multicenter experience.

    Science.gov (United States)

    Ubaldi, Filippo Maria; Cimadomo, Danilo; Capalbo, Antonio; Vaiarelli, Alberto; Buffo, Laura; Trabucco, Elisabetta; Ferrero, Susanna; Albani, Elena; Rienzi, Laura; Levi Setti, Paolo E

    2017-05-01

    To report laboratory and clinical outcomes in preimplantation genetic diagnosis for aneuploidies (PGD-A) cycles for women 44 to 47 years old. Multicenter, longitudinal, observational study. In vitro fertilization (IVF) centers. One hundred and thirty-seven women aged 44.7 ± 0.7 years (range: 44.0-46.7) undergoing 150 PGD-A cycles during April 2013 to January 2016. Quantitative polymerase chain reaction-based PGD-A on trophectoderm biopsies and cryopreserved euploid single-embryo transfer (SET). Primary outcome measure: delivery rate per cycle; secondary outcome measures: miscarriage rate, and the rate and reasons for cycle cancelation with subanalyses for female age and number of metaphase 2 oocytes retrieved. In 102 (68.0%) of 150 cycles blastocyst development was obtained, but only 21 (14.0%) were euploid blastocysts. The overall euploidy rate was 11.8% (22 of 187). Twenty-one SET procedures were performed, resulting in 13 clinical pregnancies, of which 1 miscarried and 12 delivered. The delivery rate was 57.1% per transfer, 8.0% per cycle, and 8.8% per patient. The logistic regression analysis found that only female age (odds ratio 0.78) and number of metaphase 2 oocytes retrieved (odds ratio 1.25) statistically significantly correlated with the likelihood of delivery. The delivery rate per cycle was 10.6% (11 of 104) in patients aged 44.0 to 44.9 years and 2.6% in patients aged 45.0 to 45.9 years (n = 1 of 38). No euploid blastocysts were found for patients older than 45.0 years. Extensive counseling based on biological and clinical data should be provided to women older than 43 years who are requesting IVF because of their very low odds of success and high risk for embryonic aneuploidies. Nevertheless, the low miscarriage and good delivery rates reported in this study in women with good ovarian reserve aged 44 should encourage the use of PGD-A in this population. Copyright © 2017 American Society for Reproductive Medicine. Published by Elsevier Inc

  4. [Immunogenicity and safety of the influenza vaccine, in a population older than 55-years in Mexico].

    Science.gov (United States)

    Ayala-Montiel, Octavio; Mascareñas, César; García-Hernández, Delfino; Rendón-Muñiz, Jorge; López, Irma; Felipe Montaño, Luis; Zenteno, I; Franco-Paredes, C

    2005-01-01

    To confirm the immunogenicity and tolerance of the inactivated, fractionated, and purified influenza vaccine, in a Mexican adult population aged 55 and older, medically served at a Petróleos Mexicanos Hospital (Pemex, Mexican Oil Company). The study was conducted between November and December, 2000, among ninety adult subjects aged 55 years and older who were seen at the Hospital Central Sur Pemex. The primary endpoints regarding immunogenicity were the percentage of individuals with protective antibodies targeting hemagglutinins higher than or equal to 1:40, and the percentage of subjects who seroconverted as measured by a four-fold increase in protective antibody production. Secondary endpoints included the frequency of local and systemic reactions to the vaccine. An additional criterion that was evaluated included antigen-antibody affinity assays to measure the polyclonal antibody response to the vaccine and the specific generation of high-affinity antibodies to viral proteins, before and after vaccination. The antibody protection rate was 95.6% against the HINI strain, 98.9% against the H3N2 strain, and a 100% against the B/Yamanashi strain. Seroconversion to the HINI strain was elicited in 74.4% of subjects, to the H3N2 strain in 88.9%, and to the B/Yamanashi strain in 82.2%. Eighteen (20%) subjects developed local reactions; 17 (18.8%) developed a systemic reaction post vaccination at day 5 and nine subjects (10%) at day 28. Local reactions consisted of pain in 10 (11.1%) subjects, redness in 8 (8.8%), and induration in 6 (6.6%). General malaise, headache, and fever were identified in 10, 8.8, and 0% of subjects, respectively, at day 5, and in 4.4, 6.6, and 0%, respectively, at day 28. Influenza vaccine was highly immunogenic in a healthy Mexican adult population aged 55 years and older. The generation of high-affinity antibodies to the virus after vaccination was also demonstrated. Local and systemic adverse reactions to the vaccine identified in our study

  5. Cognitive abilities predict death during the next 15 years in older Japanese adults.

    Science.gov (United States)

    Nishita, Yukiko; Tange, Chikako; Tomida, Makiko; Otsuka, Rei; Ando, Fujiko; Shimokata, Hiroshi

    2017-10-01

    The longitudinal relationship between cognitive abilities and subsequent death was investigated among community-dwelling older Japanese adults. Participants (n = 1060; age range 60-79 years) comprised the first-wave participants of the National Institute for Longevity Sciences-Longitudinal Study of Aging. Participants' cognitive abilities were measured at baseline using the Japanese Wechsler Adult Intelligence Scale-Revised Short Form, which includes the following tests: Information (general knowledge), Similarities (logical abstract thinking), Picture Completion (visual perception and long-term visual memory) and Digit Symbol (information processing speed). By each cognitive test score, participants were classified into three groups: the high-level group (≥ the mean + 1SD), the low-level group (≤ the mean - 1SD) and the middle-level group. Data on death and moving during the subsequent 15 years were collected and analyzed using the multiple Cox proportional hazard model adjusted for physical and psychosocial covariates. During the follow-up period, 308 participants (29.06%) had died and 93 participants (8.77%) had moved. In the Similarities test, adjusted hazard ratios (HR) of the low-level group to the high-level group were significant (HR 1.49, 95% CI 1.02-2.17, P = 0.038). Furthermore, in the Digit symbol test, the adjusted HR of the low-level group to the high-level group was significant (HR 1.62, 95% CI 1.03-2.58, P = 0.038). Significant adjusted HR were not observed for the Information or Picture Completion tests. It is suggested that a lower level of logical abstract thinking and slower information processing speed are associated with shorter survival among older Japanese adults. Geriatr Gerontol Int 2017; 17: 1654-1660. © 2016 Japan Geriatrics Society.

  6. The association between depressive disorder and cardiac autonomic control in adults 60 years and older.

    Science.gov (United States)

    Licht, Carmilla M M; Naarding, Paul; Penninx, Brenda W J H; van der Mast, Roos C; de Geus, Eco J C; Comijs, Hannie

    2015-04-01

    Altered cardiac autonomic control has often been reported in depressed persons and might play an important role in the increased risk for cardiovascular disease (CVD). A negative association between cardiac autonomic control and depression might become specifically clinically relevant in persons 60 years or older as CVD risk increases with age. This study included data of 321 persons with a depressive disorder and 115 controls participating in the Netherlands Study of Depression in Older Persons (mean age = 70.3 years, 65.7% female). Respiratory sinus arrhythmia (RSA), heart rate (HR), and preejection period (PEP) were measured and compared between depressed persons and controls. In addition, the role of antidepressants and clinical characteristics (e.g., age of depression onset and comorbid anxiety) was examined. Compared with controls, depressed persons had lower RSA (mean [standard error of the mean] = 23.5 [1.2] milliseconds versus 18.6 [0.7] milliseconds, p = .001, d = 0.373) and marginally higher HR (73.1 [1.1] beats/min versus 75.6 [0.6] beats/min, p = .065, d = 0.212), but comparable PEP (113.9 [2.1] milliseconds versus 112.0 [1.2] milliseconds, p = .45, d = 0.087), fully adjusted. Antidepressants strongly attenuated the associations between depression and HR and RSA. Antidepressant-naïve depressed persons had similar HR and RSA to controls, whereas users of antidepressants showed significantly lower RSA. In addition, tricyclic antidepressant users had higher HR (p 768) and shorter PEP (p = .014, d = 0.395) than did controls. Depression was not associated with cardiac autonomic control, but antidepressants were in this sample. All antidepressants were associated with low cardiac parasympathetic control and specifically tricyclic antidepressants with high cardiac sympathetic control.

  7. Radiation therapy for malignant tumors in patients 80 years of age or older

    International Nuclear Information System (INIS)

    Mitsuhashi, Norio; Niibe, Hideo; Hayakawa, Kazushige; Takahashi, Mitsuhiro; Nozaki, Miwako; Yamakawa, Michitaka

    1992-01-01

    We report here, results of investigation of changes in the condition of elderly patients, 80 years of age or older (EP-80), treated with radiation, and analysis of the results of radiotherapy to assess the value of radiotherapy in treating the elderly. Between 1970 and 1989, 294 EP-80 with various malignant tumors received radiation therapy at the Department of Radiology, Gunma University Hospital. The number of EP-80 treated has increased recently to about thirty per year, and their incidence among newly registered patients has also increased to over 5%. The 5-year cause specific survival rates for male and female were 14% and 32%, respectively. There was a significant difference between the survival rates for male and female (x 2 =11.89, p=0.00056) because of inclusion of a significant proportion of female patients with gynecological malignancies. The 5-year survival rate for patients in the curative radiotherapy group (CRG) was 30%, whereas no patient of the palliative radiotherapy group (PRG) has survived for 5 years (x 2 =90.23, p=0.00000). In the CRG, the survival rate for females was significantly higher than that for males (x 2 =11.48, p=0.00070). Thirty-one patients survived for 5 year. Head and neck cancer and uterine lervix cancer were the most common tumors in 5 year survivors. Age was not a significant prognostic factor in the elderly patients treated with radiation. It is considered that radiation therapy is as valuable in elderly patients as in the younger patient population. (author)

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

    Science.gov (United States)

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

    2012-01-01

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

  9. Tolerability of Combined Modality Therapy for Rectal Cancer in Elderly Patients Aged 75 Years and Older

    International Nuclear Information System (INIS)

    Margalit, Danielle N.; Mamon, Harvey J.; Ancukiewicz, Marek; Kobayashi, Wendy; Ryan, David P.; Blaszkowsky, Lawrence S.; Clark, Jeffrey; Willett, Christopher G.; Hong, Theodore S.

    2011-01-01

    Purpose: To determine the rate of treatment deviations during combined modality therapy for rectal cancer in elderly patients aged 75 years and older. Methods and Materials: We reviewed the records of consecutively treated patients with rectal cancer aged 75 years and older treated with combined modality therapy at Massachusetts General Hospital and Brigham and Women’s Hospital from 2002 to 2007. The primary endpoint was the rate of treatment deviation, defined as a treatment break, dose reduction, early discontinuation of therapy, or hospitalization during combined modality therapy. Patient comorbidity was rated using the validated Adult Comorbidity Evaluation 27 Test (ACE-27) comorbidity index. Fisher’s exact test and the Mantel–Haenszel trend test were used to identify predictors of treatment tolerability. Results: Thirty-six eligible patients had a median age of 79.0 years (range, 75–87 years); 53% (19/36) had no or mild comorbidity and 47% (17/36) had moderate or severe comorbidity. In all, 58% of patients (21/36) were treated with preoperative chemoradiotherapy (CRT) and 33% (12/36) with postoperative CRT. Although 92% patients (33/36) completed the planned radiotherapy (RT) dose, 25% (9/36) required an RT-treatment break, 11% (4/36) were hospitalized, and 33% (12/36) had a dose reduction, break, or discontinuation of concurrent chemotherapy. In all, 39% of patients (14/36) completed ≥4 months of adjuvant chemotherapy, and 17% (6/36) completed therapy without a treatment deviation. More patients with no to mild comorbidity completed treatment than did patients with moderate to severe comorbidity (21% vs. 12%, p = 0.66). The rate of deviation did not differ between patients who had preoperative or postoperative CRT (19% vs. 17%, p = 1.0). Conclusions: The majority of elderly patients with rectal cancer in this series required early termination of treatment, treatment interruptions, or dose reductions. These data suggest that further intensification

  10. Nuclear budget for FY1991 up 3.6% to 409.7 billion yen

    International Nuclear Information System (INIS)

    Anon.

    1991-01-01

    A total of yen409.7 billion was approved for the Governmental nuclear energy draft budget for fiscal 1991 on December 28, as the Cabinet gave its approval. The total, the highest ever, was divided into yen182.6 billion for the general account and yen227.1 billion for the special account for power resources development, representing a 3.6% increase over the ongoing fiscal year's level of yen395.5 billion. The draft budget will be examined for approval of the Diet session by the end of March. The nuclear energy budget devoted to research and development projects governed by the Science and Technology Agency amounts yen306.4 billion, up 3.5% exceeding yen300 billion for the first time. The nuclear budget for the Ministry of International Trade and Industry is yen98.1 billion, up 3.5%. For the other ministries, including the Ministry of Foreign Affairs, yen5.1 billion was allotted to nuclear energy-related projects. The Government had decided to raise the unit cost of the power plant siting promotion subsidies in the special account for power resources development by 25% --- from yen600/kw to yen750/kw --- in order to support the siting of plants. Consequently, the power resources siting account of the special accounts for both STA and MITI showed high levels of growth rates: 6.3% and 7.5%, respectively. (N.K.)

  11. Background characteristics, resources and volunteering among older adults (aged ≥70 years) in the community: A longitudinal study.

    Science.gov (United States)

    Cramm, Jane M; Nieboer, Anna P

    2015-08-01

    The aim of the present study was to describe (in)formal volunteering among older adults (aged ≥70 years) in the community, and the longitudinal relationships between background characteristics, resources (social, cognitive and physical functioning, social capital) and volunteering. At baseline, a total of 945 (out of 1440) independently living Dutch older adults (aged ≥70 years) completed the questionnaire (66% response). Two years later, these respondents were asked to complete a questionnaire again, of which 588 (62%) responded. Of 945 respondents (43% male; mean age 77.5 ± 5.8 years, range 70-101 years), 34.7% were married and 83.3% were born in the Netherlands. Social capital, social functioning and physical functioning were significantly higher among volunteering older adults. Being born in the Netherlands, higher educational level, social capital and social functioning were related to formal volunteering activities at baseline, and also predicted these activities 2 years later. Regarding informal volunteering activities, we found a significant association with age, being born in the Netherlands, marital status, educational level, social capital and social functioning at baseline. Examining their predictive nature, we found that younger age, being born in the Netherlands, social capital and physical functioning were associated with engagement in informal volunteering activities 2 years later. The present study shows that older adults remain engaged in volunteering activities, and that background characteristics (e.g. ethnic background, education) and resources (social functioning, social capital) contribute to this engagement. © 2014 Japan Geriatrics Society.

  12. Adding life to your years: Transformative learning for older people at the Irish Museum of Modern Art.

    OpenAIRE

    Fleming, Dr Ted

    2000-01-01

    Life expectancy has increased by 30 years during the past century. By 2150 the percentage of the world’s population over 65 will be 30%, up from 7% at present. A high percentage of older people are actively involved in adult education (Lamdin and Fugate, 1997, p. 85). During the United Nations International Year of Older Persons (1999) the Irish Museum of Modern Art (IMMA), with EU SOCRATES funding, undertook a study of its education work with members of St. Michael's Parish Active ...

  13. US Adults Drink 17 Billion Binge Drinks a Year

    Science.gov (United States)

    ... result in dangerous driving, risky sexual behavior, and violent behavior. Over time, binge drinking also increases the ... Am J Prev Med 2018; 54(4). Features Media Sign up for Features Get Email Updates To ...

  14. Galaxy Evolution Over the Past Eleven Billion Years

    DEFF Research Database (Denmark)

    Man, Wing Shan

    mechanism in evolving the sizes and stellar masses of quiescent galaxies? Are quiescent galaxies truly passive, or are their stellar populations in fact not old but reddened by dust? The goal of this thesis is to address these two outstanding questions, in order to verify the existence of such an extreme...

  15. Uranium in Canada: Billion-dollar industry

    International Nuclear Information System (INIS)

    Whillans, R.T.

    1989-01-01

    In 1988, Canada maintained its position as the world's leading producer and exporter of uranium; five primary uranium producers reported concentrate output containing 12,400 MT of uranium, or about one-third of Western production. Uranium shipments made by these producers in 1988 exceeded 13,200 MT, worth Canadian $1.1 billion. Because domestic requirements represent only 15% of current Canadian output, most of Canada's uranium production is available for export. Despite continued market uncertainty in 1988, Canada's uranium producers signed new sales contracts for some 14,000 MT, twice the 1987 level. About 90% of this new volume is with the US, now Canada's major uranium customer. The recent implementation of the Canada/US Free Trade agreement brings benefits to both countries; the uranium industries in each can now develop in an orderly, free market. Canada's uranium industry was restructured and consolidated in 1988 through merger and acquisition; three new uranium projects advanced significantly. Canada's new policy on nonresident ownership in the uranium mining sector, designed to encourage both Canadian and foreign investment, should greatly improve efforts to finance the development of recent Canadian uranium discoveries

  16. Empowering billions with food safety and food security

    International Nuclear Information System (INIS)

    Pillai, Suresh D.

    2009-01-01

    Full text: There are virtually millions of people -who die needlessly every year due to contaminated water and food. There are virtually many millions more who are starving due to an inadequate supply of food. Billions of pounds of food are unnecessarily wasted due to insect and other damage. Deaths and illness due to contaminated food or inadequate food are at catastrophic levels in many regions of the world. A majority of the food and water borne illnesses and deaths are preventable. It can be prevented by improved food production methods, improved food processing technologies, improved food distribution systems and improved personal hygiene. Food irradiation technology is over 100 years old. Yet, this technology is poorly understood by governments and corporate decision makers all around the world. Many consumers also are unfortunately misinformed of this technology. There is an urgent need for nations and people around the world to empower themselves with the knowledge and the expertise to harness this powerful technology. Widespread and sensible adoption of this technology can empower billions around the world with clean and abundant food supplies. It is unconscionable in the 21st century for governments to allow people to die or go hungry when the technology to prevent them is readily available

  17. Lean body mass change over 6 years is associated with dietary leucine intake in an older Danish population.

    Science.gov (United States)

    McDonald, Cameron Keith; Ankarfeldt, Mikkel Z; Capra, Sandra; Bauer, Judy; Raymond, Kyle; Heitmann, Berit Lilienthal

    2016-05-01

    Higher protein intake, and particularly higher leucine intake, is associated with attenuated loss of lean body mass (LBM) over time in older individuals. Dietary leucine is thought to be a key mediator of anabolism. This study aimed to assess this relationship over 6 years among younger and older adult Danes. Dietary leucine intake was assessed at baseline and after 6 years in men and women, aged 35-65 years, participating in the Danish cohort of the WHO-MONICA (Multinational MONItoring of trends and determinants in CArdiovascular disease) study (n 368). Changes in LBM over the 6 years were measured by bioelectrical impedance using equations developed for this Danish population. The association between leucine and LBM changes was examined using multivariate linear regression and ANCOVA analyses adjusted for potential confounders. After adjustment for baseline LBM, sex, age, energy intake and physical activity, leucine intake was associated with LBM change in those older than 65 years (n 79), with no effect seen in those younger than 65 years. Older participants in the highest quartile of leucine intake (7·1 g/d) experienced LBM maintenance, whereas lower intakes were associated with LBM loss over 6 years (for trend: β=0·434, P=0·03). Sensitivity analysis indicated no effect modification of sex or the presence of CVD. Greater leucine intake in conjunction with adequate total protein intake was associated with long-term LBM retention in a healthy older Danish population. This study corroborates findings from laboratory investigations in relation to protein and leucine intakes and LBM change. A more diverse and larger sample is needed for confirmation of these results.

  18. Association of Warfarin Use With Lower Overall Cancer Incidence Among Patients Older Than 50 Years.

    Science.gov (United States)

    Haaland, Gry S; Falk, Ragnhild S; Straume, Oddbjørn; Lorens, James B

    2017-12-01

    In cancer models, warfarin inhibits AXL receptor tyrosine kinase-dependent tumorigenesis and enhances antitumor immune responses at doses not reaching anticoagulation levels. This study investigates the association between warfarin use and cancer incidence in a large, unselected population-based cohort. To examine the association between warfarin use and cancer incidence. This population-based cohort study with subgroup analysis used the Norwegian National Registry coupled with the Norwegian Prescription Database and the Cancer Registry of Norway. The cohort comprised all persons (N = 1 256 725) born between January 1, 1924, and December 31, 1954, who were residing in Norway from January 1, 2006, through December 31, 2012. The cohort was divided into 2 groups-warfarin users and nonusers; persons taking warfarin for atrial fibrillation or atrial flutter were the subgroup. Data were collected from January 1, 2004, to December 31, 2012. Data analysis was conducted from October 15, 2016, to January 31, 2017. Warfarin use was defined as taking at least 6 months of a prescription and at least 2 years from first prescription to any cancer diagnosis. If warfarin treatment started after January 1, 2006, each person contributed person-time in the nonuser group until the warfarin user criteria were fulfilled. Cancer diagnosis of any type during the 7-year observation period (January 1, 2006, through December 31, 2012). Of the 1 256 725 persons in the cohort, 607 350 (48.3%) were male, 649 375 (51.7%) were female, 132 687 (10.6%) had cancer, 92 942 (7.4%) were classified as warfarin users, and 1 163 783 (92.6%) were classified as nonusers. Warfarin users were older, with a mean (SD) age of 70.2 (8.2) years, and were predominantly men (57 370 [61.7%]) as compared with nonusers, who had a mean (SD) age of 63.9 (8.6) years and were mostly women (613 803 [52.7%]). Among warfarin users and compared with nonusers, there was a significantly lower age- and sex

  19. Trajectories of older adults' hearing difficulties: examining the influence of health behaviors and social activity over 10 years.

    Science.gov (United States)

    Heine, Chyrisse; Browning, Colette; Cowlishaw, Sean; Kendig, Hal

    2013-10-01

    The aims of the present study were to describe the trajectories of self-reported hearing difficulties over time, and evaluate the impacts of age, sex, lifestyle factors and social activity, in explaining individual differences in patterns of change over time. As part of the Melbourne Longitudinal Studies on Healthy Aging (MELSHA) Program, the hearing status of 947 adults aged 65 years and older, across five measurement periods (over 10 years), were analyzed using Latent Growth Curve Modeling analysis. A multidimensional survey was also administered, which included questions relating to sociodemographic variables, self-reported hearing difficulties, nutrition, smoking habits and level of social activity. Although there was a general increase in hearing difficulties over time, older age, poor nutrition, a lifetime of smoking and increased social activity predicted more rapid increases in hearing difficulty over time. Findings support the importance of lifestyle factors in reducing the rate of perceived hearing difficulties in older people, and provide further evidence of the links between lifestyle and sensory loss in older people. Poor nutrition and smoking are areas that both clinicians and public health professionals should address in their work with older people. © 2013 Japan Geriatrics Society.

  20. Effect of physical activity counseling on disability in older people: a 2-year randomized controlled trial.

    Science.gov (United States)

    von Bonsdorff, Mikaela B; Leinonen, Raija; Kujala, Urho M; Heikkinen, Eino; Törmäkangas, Timo; Hirvensalo, Mirja; Rasinaho, Minna; Karhula, Sirkka; Mänty, Minna; Rantanen, Taina

    2008-12-01

    To study the effect of a physical activity counseling intervention on instrumental activity of daily living (IADL) disability. Primary care-based, single-blind, randomized controlled trial. City of Jyväskylä, central Finland. Six hundred thirty-two people aged 75 to 81 who were able to walk 500 meters without assistance, were at most moderately physically active, had a Mini-Mental State Examination score greater than 21, had no medical contraindications for physical activity, and gave informed consent for participation. A single individualized physical activity counseling session with supportive phone calls from a physiotherapist every 4 months for 2 years and annual lectures on physical activity. Control group received no intervention. The outcome was IADL disability defined as having difficulties in or inability to perform IADL tasks. Analyses were carried out according to baseline IADL disability, mobility limitation, and cognitive status. At the end of the follow-up, IADL disability had increased in both groups (Pphysical activity counseling intervention had no effect on older sedentary community-dwelling persons with a wide range of IADL disability, although it prevented incident IADL disability. The results warrant further investigation to explore the benefits of a primary care-based physical activity counseling program on decreasing and postponing IADL disability.

  1. Selective fine needle aspiration of parotid masses. FNA should be performed in all patients older than 60 years.

    LENUS (Irish Health Repository)

    Kieran, S M

    2012-02-01

    OBJECTIVES: The exact role of fine needle aspiration in the pre-operative assessment of patients presenting with parotid masses is controversial. Some surgeons propose that fine needle aspiration be performed only selectively in those patients with likely malignant disease, whilst others recommend it for all patients presenting with such a mass. Intuitively, one would expect older patients to be more likely to suffer from primary malignant parotid tumours and secondary deposits of malignant skin tumours. Therefore, we hypothesised that older patients with a parotid mass should undergo fine needle aspiration regardless of their medical history. DESIGN: We retrospectively reviewed 197 consecutive parotidectomies to test this hypothesis. RESULTS: One hundred and twenty-one patients (61.4 per cent) were diagnosed with benign disease, whilst 76 (38.6 per cent) were diagnosed with malignant disease. Eighty-three per cent of patients aged 60 years or younger had benign disease, as opposed to 35.6 per cent of patients aged more than 60 years. Malignant disease occurred more commonly in patients older than 60 years (odds ratio 8.962, 95 per cent confidence interval 4.607-17.434). CONCLUSION: In patients with a parotid mass, fine needle aspiration should be performed on all those aged 60 years or older.

  2. Influenza vaccine effectiveness in adults 65 years and older, Denmark, 2015/16 - a rapid epidemiological and virological assessment

    DEFF Research Database (Denmark)

    Emborg, Hanne Dorthe; Krause, Tyra Grove; Nielsen, Lene

    2016-01-01

    In Denmark, both influenza A(H1N1)pdm09 and influenza B co-circulated in the 2015/16 season. We estimated the vaccine effectiveness (VE) of the trivalent influenza vaccine in patients 65 years and older using the test-negative case-control design. The adjusted VE against influenza A(H1N1)pdm09 wa...

  3. Dynapenia and metabolic health in obese and nonobese adults aged 70 years and older: The LIFE Study

    Science.gov (United States)

    OBJECTIVE: The purpose of this study was to examine the relationship between dynapenia and metabolic risk factors in obese and nonobese older adults. METHODS: A total of 1453 men and women (age >/= 70 years) from the Lifestyle Interventions and Independence for Elders (LIFE) Study were categorized a...

  4. Body Image, self-esteem, and clothing of men and women aged 55 years and older

    OpenAIRE

    Hwang, Jinsook

    1993-01-01

    Although there are many studies regarding body image of younger people, there have been few studies on that of older people. Since today's culture considers the young, thin body image ideal, it is important to investigate body image of older people and the relationships between their body image, self esteem, and clothing behavior. The purpose of this study was to determine the relationships between 1) body-cathexis and self-esteem, 2) body-cathexis and clothing behavio...

  5. Multi-morbidity, disability and adaptation strategies among community-dwelling adults aged 75 years and older.

    Science.gov (United States)

    Yuen, Hon K; Vogtle, Laura K

    2016-10-01

    The impact of multi-morbidity and disability on the use of adaptation strategies in older adults has not been well researched. This study investigated categories of adaptation strategies that community-dwelling older adults use to complete their daily activities, identified factors that are associated with the use of behavioral adaptations, and examined the relationship among multi-morbidity, disability and adaptation strategies in this population. A mixed methods research design was used. 105 community-dwelling older adults with ages ranging from 75 to 94 years completed a questionnaire and semi-structured interview on types of chronic illnesses (multi-morbidity), amount of difficulty in completing daily activities (degree of disability), and types of behavioral efforts made to complete daily activities that are challenging (adaptation strategies). The model of selective optimization with compensation (SOC) was used to categorize these strategies. The findings revealed that older adults use a wide range of adaptations with compensation and selection the most (40.4%) and least (16.5%) frequently reported respectively. Degree of disability was uniquely associated with the frequency of using SOC strategies while controlling for other factors. Furthermore, degree of disability was a mediator for multi-morbidity in predicting frequency of using SOC strategies. The findings support that older adults using behavioral adaptations to cope with functional decline is prevalent. Knowing the types of adaptation that older adults employed and the indirect relationship between multi-morbidity and frequency of using SOC strategies, with degree of disability as the mediator will be helpful in planning interventions and prevention programs for educating older adults. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Kicking Back Cognitive Ageing: Leg Power Predicts Cognitive Ageing after Ten Years in Older Female Twins.

    Science.gov (United States)

    Steves, Claire J; Mehta, Mitul M; Jackson, Stephen H D; Spector, Tim D

    2016-01-01

    Many observational studies have shown a protective effect of physical activity on cognitive ageing, but interventional studies have been less convincing. This may be due to short time scales of interventions, suboptimal interventional regimes or lack of lasting effect. Confounding through common genetic and developmental causes is also possible. We aimed to test whether muscle fitness (measured by leg power) could predict cognitive change in a healthy older population over a 10-year time interval, how this performed alongside other predictors of cognitive ageing, and whether this effect was confounded by factors shared by twins. In addition, we investigated whether differences in leg power were predictive of differences in brain structure and function after 12 years of follow-up in identical twin pairs. A total of 324 healthy female twins (average age at baseline 55, range 43-73) performed the Cambridge Neuropsychological Test Automated Battery (CANTAB) at two time points 10 years apart. Linear regression modelling was used to assess the relationships between baseline leg power, physical activity and subsequent cognitive change, adjusting comprehensively for baseline covariates (including heart disease, diabetes, blood pressure, fasting blood glucose, lipids, diet, body habitus, smoking and alcohol habits, reading IQ, socioeconomic status and birthweight). A discordant twin approach was used to adjust for factors shared by twins. A subset of monozygotic pairs then underwent magnetic resonance imaging. The relationship between muscle fitness and brain structure and function was assessed using linear regression modelling and paired t tests. A striking protective relationship was found between muscle fitness (leg power) and both 10-year cognitive change [fully adjusted model standardised β-coefficient (Stdβ) = 0.174, p = 0.002] and subsequent total grey matter (Stdβ = 0.362, p = 0.005). These effects were robust in discordant twin analyses, where within

  7. Prevalence and Determinants of Glaucoma in Citizens of Qatar Aged 40 Years or Older: A Community-Based Survey

    Science.gov (United States)

    Al-Mansouri, Fatma A.; Kanaan, Aida; Gamra, Hamad; Khandekar, Rajiv; Hashim, Shakeel P.; Al Qahtani, Omar; Ahmed, Mohd. Farouk

    2011-01-01

    Background: We present the prevalence and determinants of glaucoma among subjects 40 years of age and older in Qatar. Materials and Methods: This community-based survey was held in 2009 at 49 randomly selected clusters. Demographic details and history of glaucoma was collected by the nurses. Ophthalmologists evaluated the optic disc and retina using a digital camera housed in a mobile van. Visual field was tested with an automated perimeter, the intraocular pressure with an applanation tonometer and the angle of the anterior chamber by gonioscopy. A panel of glaucoma experts diagnosed subjects with glaucoma. Results: This survey enrolled 3,149 (97.3%) participants. The age- and sex-adjusted prevalence of glaucoma in the population aged 40 years and older was 1.73% (95% confidence intervals [CI] 1.69-1.77). Accordingly, 5,641 individuals in this age group in Qatar would have glaucoma. Chronological age of 60 years and older (Odds ratio [OR] 11.1) and the presence of myopia (OR 1.78) were predictors of glaucoma. Open-angle glaucoma was diagnosed in 44 (65.7%) individuals with glaucoma. In nine (13.4%) and 15 (20.9%) subjects, angle closure glaucoma and other (post-traumatic, pseudoexfoliation) glaucoma were present. Bilateral blindness (vision glaucoma, respectively. Glaucoma was treated in 36 (54%) subjects. Conclusions: The prevalence of glaucoma among citizens of Qatar aged 40 years and older was 1.71%. Glaucoma was associated with the age of 60 years and older and the presence of myopia. PMID:21731325

  8. Regional and Gender Differences in Years with and without Mobility Limitation in the Older Population of Thailand.

    Directory of Open Access Journals (Sweden)

    Benjawan Apinonkul

    Full Text Available To examine gender and regional differences in health expectancies based on the measure of mobility.Health expectancies by gender and region were computed by Sullivan's method from the fourth Thai National Health Examination Survey (2009. A total of 9,210 older persons aged 60 years and older were included. Mobility limitation was defined as self-reporting of ability to perform only with assistances/aids at least one of: walking at least 400 metres; or going up or down a flight of 10 stairs. Severe limitation was defined as complete inability to do at least one of these two functions, even with assistances or aids.At age 60, females compared to males, spent significantly fewer years without mobility limitation (male-female = 3.2 years and more years with any limitation (female-male = 6.7 years and with severe limitation (female-male = 3.2 years. For both genders, years lived with severe limitation were remarkably constant across age. Significant regional inequalities in years lived without and with limitation were evident, with a consistent pattern by gender in years free of mobility limitation (Central ranked the best and the North East ranked the worst. Finally, both males and females in the South had the longest life expectancy and the most years of life with severe mobility limitation.This study identifies inequalities in years without and with mobility limitations with important policy implication.

  9. Better Survival of Total Knee Replacement in Patients Older Than 70 Years: A Prospective Study with 8 To 12 Years Follow-Up

    Directory of Open Access Journals (Sweden)

    Ricardo Fernandez-Fernandez

    2015-01-01

    Full Text Available  Background: Modern knee designs have popularized its use in younger patients due to its better performance. There remains uncertainty whether higher demands of these patients can affect implant survivorship.    Purpose: To assess whether modern knee designs have provided similar results in patients younger than 70 years versus older patients. Methods: We included 203 consecutive patients (236 knees who underwent knee replacement for osteoarthritis with a mean follow-up of 11.4 years (range: 8.8 to 12. The mean age was 70 years (range: 31 to 85. Knee replacements were stratified into two groups: 109 were younger than 70 years and 127 were older than 70 years (70 years of age is the mandatory retirement age. Results: There were no significant pre-operative differences between groups with regards to knee alignment, alpha or beta angles, knee score or function score. Fourteen implants were radiographically loose at last follow up visit. Groups were matched in terms of demographic data. We found that patients older than 70 years had significantly better mean survivorship at 12 years. (97% vs. 88%; P=0.010. Patients under 70 years presented with a higher rate of polyethylene wear which was further associated with radiolucent lines in the femur and tibia as well as the presence of osteolysis. There was also an association between migration and presence of osteolysis. Conclusions: Patients over 70 years old undergoing cemented total knee replacement for osteoarthritis showed better implant survivorship versus patients under 70 years old.

  10. Sneak Peek to the 2016 Billion-Ton Report

    Energy Technology Data Exchange (ETDEWEB)

    None

    2016-06-01

    The 2005 Billion-Ton Study became a landmark resource for bioenergy stakeholders, detailing for the first time the potential to produce at least one billion dry tons of biomass annually in a sustainable manner from U.S. agriculture and forest resources. The 2011 U.S. Billion-Ton Update expanded and updated the analysis, and in 2016, the U.S. Department of Energy’s Bioenergy Technologies Office plans to release the 2016 Billion-Ton Report: Advancing Domestic Resources for a Thriving Bioeconomy.

  11. Sarcopenia as a Risk Factor for Cognitive Deterioration in Community-Dwelling Older Adults: A 1-Year Prospective Study.

    Science.gov (United States)

    Nishiguchi, Shu; Yamada, Minoru; Shirooka, Hidehiko; Nozaki, Yuma; Fukutani, Naoto; Tashiro, Yuto; Hirata, Hinako; Yamaguchi, Moe; Tasaka, Seishiro; Matsushita, Tomofumi; Matsubara, Keisuke; Tsuboyama, Tadao; Aoyama, Tomoki

    2016-04-01

    The purpose of this 1-year prospective study was to determine whether sarcopenia is an independent risk factor of cognitive deterioration in community-dwelling older adults. One-year prospective study. Japanese community. A total of 131 community-dwelling older adults aged 65 years and older participated in this study. We defined sarcopenia using the diagnostic algorithm recommended by the Asian Working Group for Sarcopenia, and the participants were classified into the sarcopenia and normal groups according to this definition. The participants' cognitive functions were assessed using the Mini-Mental State Examination (MMSE) during pre- and postdata collection (after 1 year). The rate of change in pre- and post-MMSE scores during the follow-up term was significantly different between the 2 groups (normal group, -0.32 ± 8.39%; sarcopenia group, -5.86 ± 5.16%; P = .002). The analysis of covariance, adjusted for demographic data and the pre-MMSE scores, showed a significant change in the MMSE scores between the normal and sarcopenia group (F = 9.30, P = .003). Furthermore, in the multivariate logistic regression analysis, the cognitive function was significantly more likely to deteriorate (defined as a loss of at least 2 points of MMSE) in the sarcopenia group during the follow-up term (odds ratio: 7.86, 95% confidence interval: 1.53-40.5). Sarcopenia was identified as an independent risk factor of cognitive deterioration in community-dwelling older adults during the 1-year study period. Copyright © 2016 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

  12. Onset of loneliness in older adults: results of a 28 year prospective study

    NARCIS (Netherlands)

    Aartsen, M.J.; Jylhä, M

    2011-01-01

    The goal of this research is to test whether often observed correlates of loneliness in older age are related to onset of loneliness longitudinally. Despite the increasing number of longitudinal studies, the investigation of factors that are related to onset of loneliness is still limited. Analyses

  13. Follow-up for osteoporosis in older patients three years after a fracture

    NARCIS (Netherlands)

    Schurink, M.; Hegeman, J. H.; Kreeftenberg, H. G.; ten Duis, H. J.

    Background: Recently a Fracture and Osteoporosis outpatient clinic (FO clinic) was set up at the University Medical Centre Groningen (UMCG) with the aim to optimise case-finding of osteoporosis in older patients with a low-energy fracture. To provide a diagnostic setting before the start of our FO

  14. Life styles related to coronary artery disease in Saudi Males older than 12 years of age

    International Nuclear Information System (INIS)

    Al-Turki, Yousef Abdullah

    2007-01-01

    The present study highlighted life styles related to coronary artery disease risk factors among patients attending a primary care clinic at King Khalid University Hospital, in Riyadh, Saudi Arabia. We conducted a cross-sectional study at a primary care clinic at King Khalid University Hospital, Riyadh, Saudi Arabia, during the period from 18/4/2006 to 13/6/2006. All adult male patients older than 12 years of age who attended one consultant primary care clinic were included in the study. All patients were interviewed by one consultant in family medicine during the study period. The patients were asked about dietary habits, physical activity and type of exercise, and smoking habits. Weight and height was taken for all patients by the nurse in the clinic and body mass index (BMI) were calculated for all patients. The total number of participants was 246 patients. The data were analyzed using the Statistical Package of Social Science (SPSS) version 11.5. A p value of less than 0.05 was considered statistically significant. Of the 246 male adult patients, 45.4% always consumed vegetables and fruits in their diet, 21.5% exercised on a daily basis, 51.2% exercised sometimes and 26% did not exercise at all. The type of exercise practiced by active participants was walking (76.5%) and sports (22.9%). Sports included football, basketball, swimming and other sports club activity. Only 20.7% of the participants had an ideal body weight (BMI =30). 8.9% of the participants were current smokers. Overweight and obesity is a common health problem among male adult patients attending a primary care setting. Improved dietary habits (consumption of vegetables and fruits and minimization of fat and suits) encouraging exercise and walking and helping current smokers to quit smoking are essential steps towards improving life styles in the community. It is an important health plan priority to concentrate on improving life styles in the Saudi community, to prevent cardiovascular risk

  15. Magnetic resonance arthrography and the prevalence of acetabular labral tears in patients 50 years of age and older

    International Nuclear Information System (INIS)

    Jayakar, Rohit; Merz, Alexa; Wang, Dean; Hame, Sharon L.; Plotkin, Benjamin; Seeger, Leanne

    2016-01-01

    Arthroscopy for acetabular labral tears has minimal impact on pain and function in older patients, especially in the setting of concomitant osteoarthritis. Still, many physicians seek this diagnosis with MR arthrography. Our purpose is to assess the frequency of acetabular labral tears in older patients with hip pain and correlate likelihood of labral pathology with severity of osteoarthritis as visualized on conventional radiograph. From 2004 to 2013, 208 hip MRI arthrograms and corresponding radiographs on patients aged 50 years and older were identified. Age, gender, grade and location of labral tear, alpha angle, Toennis grade, and joint space width were documented. Labral tears and alpha angle were identified and measured on MR arthrogram. Toennis grade and joint space width were measured on radiographs. On MR arthrography, true labral tearing was identified in 73 % of patients. There was some degree of labral pathology in 93.3 % of patients, and this increased to 100 % in patients with moderate to severe osteoarthritis, as defined by Toennis grade 2-3 or joint space width ≤ 2 mm. There were no statistically significant correlations between labral tear grade and Toennis grade or joint space width. Given the high frequency of labral pathology and the questionable efficacy of arthroscopic surgical intervention in older patients, MR arthrography should be primarily for those with minimal arthritis on radiograph and potential to benefit from surgery. If further imaging beyond radiographs is necessary in these patients, standard MRI may be a more appropriate imaging tool. (orig.)

  16. Outcomes of hip arthroscopy in patients aged 50 years or older compared with a matched-pair control of patients aged 30 years or younger.

    Science.gov (United States)

    Domb, Benjamin G; Linder, Dror; Finley, Zachary; Botser, Itamar B; Chen, Austin; Williamson, Joseph; Gupta, Asheesh

    2015-02-01

    Age has been suggested as a negative prognostic factor for hip arthroscopy. The purpose of this study was to compare patient characteristics and outcomes after hip arthroscopy in patients aged 50 years or older with a matched control group of patients aged 30 years or younger at a minimum postoperative follow-up of 2 years. Between September 2008 and March 2010, data were prospectively collected on all patients aged 50 years or older undergoing primary hip arthroscopy. Fifty-two patients met our inclusion and matching criteria, of whom all 52 (100%) were available for follow-up at a minimum of 2 years. This cohort was compared with a matched-pair control group of patients aged 30 years or younger who underwent similar procedures. The mean age of the study group was 54.8 years (range, 50 to 69 years), and that of the control group was 20.3 years (range, 13 to 30 years). The groups were matched at a 1:1 ratio, including 18 male patients (34.6%) and 34 female patients (65.4%) in each group, with a mean follow-up period of 32 months (range, 24 to 54 months). In the younger control group, the score improvement from preoperatively to 2 years' follow-up was 62.9 to 84.2 for the modified Harris Hip Score, 60.5 to 84.2 for the Non-Arthritic Hip Score, 63.1 to 86.5 for the Hip Outcome Score-Activities of Daily Living, and 42.2 to 72.7 for the Hip Outcome Score-Sport-Specific Subscale. In the older study group, the score improvement from preoperatively to 2 years' follow-up was 61.2 to 82.2 for the modified Harris Hip Score, 59.9 to 80.4 for the Non-Arthritic Hip Score, 63.9 to 83 for the Hip Outcome Score-Activities of Daily Living, and 41.2 to 64.6 for the Hip Outcome Score-Sport-Specific Subscale. All improvements in both groups were statistically significant at the 2-year postoperative follow-up (P arthroscopy should be considered a valid treatment option when treating hip pain in patients aged 50 years or older with a Tönnis arthritic grade of 0 or 1. Older patients

  17. Proton collider breaks the six-billion-dollar barrier

    CERN Multimedia

    Vaughan, C

    1990-01-01

    The SSC will cost at least 1 billion more than its estimated final price of 5.9 billion dollars. Critics in congress believe the final bill could be double that figure. The director of the SSC blames most of the increase in cost on technical problems with developing the superconducting magnets for the SSC (1/2 page).

  18. National indicators for quality of drug therapy in older persons: the Swedish experience from the first 10 years.

    Science.gov (United States)

    Fastbom, Johan; Johnell, Kristina

    2015-03-01

    Inappropriate drug use is an important health problem in elderly persons. Beginning with the Beers' criteria in the early 1990s, explicit criteria have been extensively used to measure and improve quality of drug use in older people. This article describes the Swedish indicators for quality of drug therapy in the elderly, introduced in 2004 and updated in 2010. These indicators were designed to be applied to people aged 75 years and over, regardless of residence and other characteristics. The indicators are divided into drug specific, covering choice, indication and dosage of drugs, polypharmacy, drug-drug interactions (DDIs), drug use in decreased renal function and in some symptoms; and diagnosis specific, covering the rational, irrational and hazardous drug use in common disorders in elderly people. During the 10 years since introduction, the Swedish indicators have several applications. They form the basis for recommendations for drug therapy in older people, are implemented in prescribing supports and drug utilisation reviews, are used in national benchmarking of the quality of Swedish healthcare and have contributed to initiatives from pensioner organisations. The indicators have also been used in several pharmacoepidemiological studies. Since 2005, there have been signs of improvement of the quality of drug prescribing to elderly persons in Sweden. For example, the prescribing of drugs that should be avoided in older persons decreased by 36 % between 2006 and 2012 in persons aged 80 years and older. Similarly, drug combinations that may cause DDIs decreased by 26 % and antipsychotics by 41 %. The indicators have likely contributed to this.

  19. Mining survival in parts per billion

    International Nuclear Information System (INIS)

    Christensen, J.C.

    1992-01-01

    The paper discusses the economic situation in the coal industry of Utah. Coal prices are down for the tenth year in a row, Utah is isolated from major markets and freight rates are high, and the state legislature has not dropped the issue of a coal severance tax. The author believes the only potential for increased use of Utah coal is the Pacific Rim countries. Environmental issues are also discussed

  20. Areva excellent business volume: backlog as of december 31, 2008: + 21.1% to 48.2 billion euros. 2008 revenue: + 10.4% to 13.2 billion euros

    International Nuclear Information System (INIS)

    2009-01-01

    AREVA's backlog stood at 48.2 billion euros as of December 31, 2008, for 21.1% growth year-on-year, including 21.8% growth in Nuclear and 16.5% growth in Transmission and Distribution. The Nuclear backlog came to 42.5 billion euros at December 31, 2008. The Transmission and Distribution backlog came to 5.7 billion euros at year-end. The group recognized revenue of 13.2 billion euros in 2008, for year-on-year growth of 10.4% (+9.8% like-for-like). Revenue outside France was up 10.5% to 9.5 billion euros, representing 72% of total revenue. Revenue was up 6.5% in the Nuclear businesses (up 6.3% LFL), with strong performance in the Reactors and Services division (+10.9% LFL) and the Front End division (+7.2% LFL). The Transmission and Distribution division recorded growth of 17% (+15.8% LFL). Revenue for the fourth quarter of 2008 rose to 4.1 billion euros, up 5.2% (+1.6% LFL) from that of the fourth quarter of 2007. Revenue for the Front End division rose to 3.363 billion euros in 2008, up 7.1% over 2007 (+7.2% LFL). Foreign exchange (currency translations) had a negative impact of 53 million euros. Revenue for the Reactors and Services division rose to 3.037 billion euros, up 11.8% over 2007 (+10.9% LFL). Foreign exchange (currency translations) had a negative impact of 47 million euros. Revenue for the Back End division came to 1.692 billion euros, a drop of 2.7% (-2.5% LFL). Foreign exchange (currency translations) had a negative impact of 3.5 million euros. Revenue for the Transmission and Distribution division rose to 5.065 billion euros in 2008, up 17.0% (+15.8% LFL)

  1. Admissions to inpatient care facilities in the last year of life of community-dwelling older people in Europe.

    Science.gov (United States)

    Overbeek, Anouk; Van den Block, Lieve; Korfage, Ida J; Penders, Yolanda W H; van der Heide, Agnes; Rietjens, Judith A C

    2017-10-01

    In the last year of life, many older people rather avoid admissions to inpatient care facilities. We describe and compare such admissions in the last year of life of 5092 community-dwelling older people in 15 European countries (+Israel). Proxy-respondents of the older people, who participated in the longitudinal SHARE study, reported on admissions to inpatient care facilities (hospital, nursing home or hospice) during the last year of their life. Multivariable regression analyses assessed associations between hospitalizations and personal/contextual characteristics. The proportion of people who had been admitted at least once to an inpatient care facility in the last year of life ranged from 54% (France) to 76% (Austria, Israel, Slovenia). Admissions mostly concerned hospitalizations. Multivariable analyses showed that especially Austrians, Israelis and Poles had higher chances of being hospitalized. Further, hospitalizations were more likely for those being ill for 6 months or more (OR:1.67, CI:1.39-2.01), and less likely for persons aged 80+ (OR:0.54, CI:0.39-0.74; compared with 48-65 years), females (OR:0.74, CI:0.63-0.89) and those dying of cardiovascular diseases (OR:0.66, CI:0.51-0.86; compared with those dying of cancer). Although healthcare policies increasingly stress the importance that people reside at home as long as possible, admissions to inpatient care facilities in the last year of life are relatively common across all countries. Furthermore, we found a striking variation concerning the proportion of admissions across countries which cannot only be explained by patient needs. It suggests that such admissions are at least partly driven by system-level or cultural factors. © The Author 2017. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

  2. Time trends in 20 years of medication use in older adults: Findings from three elderly cohorts in Stockholm, Sweden.

    Science.gov (United States)

    Craftman, Åsa Gransjön; Johnell, Kristina; Fastbom, Johan; Westerbotn, Margareta; von Strauss, Eva

    2016-01-01

    New drugs and expanded drug indications are constantly being introduced. Welfare states strive to provide equity in drug treatment for all of its citizens and todaýs healthcare systems spend financial resources on drugs for the elderly in a higher rate than for any other age group. Drug utilization in elderly persons has an impact in health and wellbeing in older people. It was to describe the changes in medication use including people aged 78 years and over regardless of residence and other characteristics over 20 years. The study population consisted of 4304 participants in three population-based cross-sectional surveys conducted in the Kungsholmen area of central Stockholm, Sweden. The participant's current drug utilization was reviewed by physicians following standardized protocols. Data were statistical analyzed. Logistic regression models was used to estimate odds ratios and 95% confidence intervals for use of analgesics and psychotropic drugs in the cohorts of 2001 and 2007, controlling for age, gender, education and cognition. Results shows that the prevalence of medication use and polypharmacy in older adults has increased dramatically the late 1980s to the 2000s in central Stockholm, Sweden. In particular, the use of analgesics increased significantly, while some drug groups decreased, i.e., antipsychotics. Women used more medication than men in all three cohorts. Older adults living in service buildings used the largest amount of drugs in 1987, whereas those living in institutions were the most frequent users in 2001 and 2007. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  3. Readability of the web: a study on 1 billion web pages

    NARCIS (Netherlands)

    de Heus, Marije; Hiemstra, Djoerd

    We have performed a readability study on more than 1 billion web pages. The Automated Readability Index was used to determine the average grade level required to easily comprehend a website. Some of the results are that a 16-year-old can easily understand 50% of the web and an 18-year old can easily

  4. Fiscal 1988 draft budget for nuclear energy up 1.9% to yen 369 billion

    International Nuclear Information System (INIS)

    Anon.

    1988-01-01

    AT the cabinet meeting held on December 28, the government approved the fiscal 1988 draft budget, with a general account of yen 56.6 trillion. The nuclear energy related budget is yen 181.124 billion from the general account and yen 186.098 billion from the special account for power sources development, totalling yen 367.222 billion, up 1.9% on the previous year. The largest appropriation goes to the Science and Technology Agency (STA) totaling yen 271 billion. The STA is promoting safety studies and R and D for extensive nuclear energy utilization but the budget shows a 0.7% decrease from the previous year, reflecting completion of the construction of JT-60, which is one of the Agency's major projects. MITI, with its budget of yen 91 billion will carry on policies related to the promotion of commercial nuclear power program as well as support for the industrialization program of the nuclear fuel cycle. Nuclear related budget of Ministry of Foreign Affairs is yen 2.8 billion, consisting mainly of IAEA subscriptions and contributions and OECD/NEA subscriptions. Besides these three government agencies, a large sum of yen 1.2 billion is allocated to the Okinawa Development Agency for the prevention and elimination of melon-flies in Kume Island and islands around Okinawa main island. The draft government budget will be submitted to the ordinary session of the Diet when it resumes towards the end of January. After deliberation in the Budget Committees of the House of Representatives and the House of Councilors, the draft budget will be put to the vote in the plenary session. Assuming that all proceeds smoothly, the budget is expected to be approved by the end of March without any major revision. (author)

  5. Regional Feedstock Partnership Summary Report: Enabling the Billion-Ton Vision

    Energy Technology Data Exchange (ETDEWEB)

    Owens, Vance N. [South Dakota State Univ., Brookings, SD (United States). North Central Sun Grant Center; Karlen, Douglas L. [Dept. of Agriculture Agricultural Research Service, Ames, IA (United States). National Lab. for Agriculture and the Environment; Lacey, Jeffrey A. [Idaho National Lab. (INL), Idaho Falls, ID (United States). Process Science and Technology Division

    2016-07-12

    The U.S. Department of Energy (DOE) and the Sun Grant Initiative established the Regional Feedstock Partnership (referred to as the Partnership) to address information gaps associated with enabling the vision of a sustainable, reliable, billion-ton U.S. bioenergy industry by the year 2030 (i.e., the Billion-Ton Vision). Over the past 7 years (2008–2014), the Partnership has been successful at advancing the biomass feedstock production industry in the United States, with notable accomplishments. The Billion-Ton Study identifies the technical potential to expand domestic biomass production to offset up to 30% of U.S. petroleum consumption, while continuing to meet demands for food, feed, fiber, and export. This study verifies for the biofuels and chemical industries that a real and substantial resource base could justify the significant investment needed to develop robust conversion technologies and commercial-scale facilities. DOE and the Sun Grant Initiative established the Partnership to demonstrate and validate the underlying assumptions underpinning the Billion-Ton Vision to supply a sustainable and reliable source of lignocellulosic feedstock to a large-scale bioenergy industry. This report discusses the accomplishments of the Partnership, with references to accompanying scientific publications. These accomplishments include advances in sustainable feedstock production, feedstock yield, yield stability and stand persistence, energy crop commercialization readiness, information transfer, assessment of the economic impacts of achieving the Billion-Ton Vision, and the impact of feedstock species and environment conditions on feedstock quality characteristics.

  6. Concurrent chemoradiotherapy for limited-disease small cell lung cancer in elderly patients aged 75 years or older

    International Nuclear Information System (INIS)

    Shimizu, Toshio; Sekine, Ikuo; Sumi, Minako

    2007-01-01

    The optimal treatment for limited-disease small cell lung cancer (LD-SCLC) in patients aged 75 years or older remains unknown. Elderly patients with LD-SCLC who were treated with chemoradiotherapy were retrospectively reviewed to evaluate their demographic characteristics and the treatment delivery, drug toxicities and antitumor efficacy. Of the 94 LD-SCLC patients treated with chemotherapy and thoracic radiotherapy at the National Cancer Center Hospital between 1998 and 2003, seven (7.4%) were 75 years of age or older. All of the seven patients were in good general condition, with a performance status of 0 or 1. Five and two patients were treated with early and late concurrent chemoradiotherapy, respectively. While the four cycles of chemotherapy could be completed in only four patients, the full dose of radiotherapy was completed in all of the patients. Grade 4 neutropenia and thrombocytopenia were noted in seven and three patients, respectively. Granulocyte-colony stimulating factor support was used in five patients, red blood cell transfusion was administered in two patients and platelet transfusion was administered in one patient. Grade 3 or more severe esophagitis, pneumonitis and neutropenic fever developed in one, two and three patients, respectively, and one patient died of radiation pneumonitis. Complete response was achieved in six patients and partial response in one patient. The median survival time was 24.7 months, with three disease-free survivors for more than 5 years. Concurrent chemoradiotherapy promises to provide long-term benefit with acceptable toxicity for selected patients of LD-SCLC aged 75 years or older. (author)

  7. Albumin, Hemoglobin, and the Trajectory of Cognitive Function in Community-Dwelling Older Japanese: A 13-Year Longitudinal Study.

    Science.gov (United States)

    Murayama, H; Shinkai, S; Nishi, M; Taniguchi, Y; Amano, H; Seino, S; Yokoyama, Y; Yoshida, H; Fujiwara, Y; Ito, H

    2017-01-01

    Cognitive function can substantially decline over a long period, and understanding the trajectory of cognitive function is important. However, little is known about the linkage between nutritional biomarkers and long-term cognitive change. We analyzed 13-year longitudinal data for older Japanese to examine the associations of serum albumin and hemoglobin levels with the trajectory of cognitive function. Longitudinal study. Community-based. A total of 1,744 community-dwelling adults aged 65 years or older who participated in annual health examinations in Kusatsu town, Gunma Prefecture, Japan, from 2002-2014. Cognitive function was assessed annually by the Mini-Mental State Examination (MMSE). Albumin and hemoglobin levels at baseline (the year when a respondent first participated in the health examination) were divided into quartiles. Hierarchical linear modeling was used to analyze intrapersonal and interpersonal differences in cognitive function. Participants' MMSE scores decreased at an accelerated rate over the 13-year period. Participants with the lowest baseline albumin level (below the first quartile line) showed a greater accelerated decline in MMSE scores over time, compared with those with the highest level (above the third quartile line). Moreover, MMSE scores in participants with a lower hemoglobin level and lower MMSE score at baseline tended to decline faster over time at an accelerated rate. These findings yield new insights about the complex and diverse roles of these nutritional biomarkers on the trajectory of cognitive function in old age.

  8. Social Environment of Older People during the First Year in Senior Housing and Its Association with Physical Performance.

    Science.gov (United States)

    Lotvonen, Sinikka; Kyngäs, Helvi; Koistinen, Pentti; Bloigu, Risto; Elo, Satu

    2017-08-25

    Increasing numbers of older people relocate into senior housing when their physical performance declines. The change in social environment is known to affect their wellbeing, providing both challenges and opportunities, but more information on the relations between social and physical parameters is required. Thus, we elicited perceptions of the social environment of 81 older people (aged 59-93 years, living in northern Finland) and changes in it 3 and 12 months after relocation to senior housing. We also measured their physical performance, then analysed associations between the social and physical variables. Participants reported that they had freedom to do whatever they liked and generally had enough contact with close people (which have recognized importance for older people's wellbeing), but changes in their physical condition limited their social activity. Moreover, their usual walking speed, dominant hand's grip strength and instrumental activities of daily living (IADL) significantly decreased. The pleasantness of the residential community, peer support, constraints on social activity imposed by changes in physical condition, meaningful activity at home and meeting close people all affected these physical performance parameters. Clearly, in addition to assessing physical performance and encouraging regular exercise, the complex interactions among social factors, physical performance and wellbeing should be considered when addressing individuals' needs.

  9. Social Environment of Older People during the First Year in Senior Housing and Its Association with Physical Performance

    Science.gov (United States)

    Kyngäs, Helvi; Koistinen, Pentti; Bloigu, Risto; Elo, Satu

    2017-01-01

    Increasing numbers of older people relocate into senior housing when their physical performance declines. The change in social environment is known to affect their wellbeing, providing both challenges and opportunities, but more information on the relations between social and physical parameters is required. Thus, we elicited perceptions of the social environment of 81 older people (aged 59–93 years, living in northern Finland) and changes in it 3 and 12 months after relocation to senior housing. We also measured their physical performance, then analysed associations between the social and physical variables. Participants reported that they had freedom to do whatever they liked and generally had enough contact with close people (which have recognized importance for older people’s wellbeing), but changes in their physical condition limited their social activity. Moreover, their usual walking speed, dominant hand’s grip strength and instrumental activities of daily living (IADL) significantly decreased. The pleasantness of the residential community, peer support, constraints on social activity imposed by changes in physical condition, meaningful activity at home and meeting close people all affected these physical performance parameters. Clearly, in addition to assessing physical performance and encouraging regular exercise, the complex interactions among social factors, physical performance and wellbeing should be considered when addressing individuals’ needs. PMID:28841198

  10. Diet quality of urban older adults age 60 to 99 years: the Cardiovascular Health of Seniors and Built Environment Study.

    Science.gov (United States)

    Deierlein, Andrea L; Morland, Kimberly B; Scanlin, Kathleen; Wong, Sally; Spark, Arlene

    2014-02-01

    There are few studies that evaluate dietary intakes and predictors of diet quality in older adults. The objectives of this study were to describe nutrient intakes and examine associations between demographic, economic, behavioral, social environment, and health status factors and diet quality. Cross-sectional data were from black, white, and Hispanic adults, age 60 to 99 years, living independently in New York City and participating in the Cardiovascular Health of Seniors and the Built Environment Study, 2009-2011 (n=1,306). Multivariable log-linear regression estimated associations between selected factors and good diet quality, defined as a Healthy Eating Index score more than 80 (based on the 2005 Dietary Guidelines for Americans [HEI-2005]). Dietary intakes were similar for men and women; intakes of energy, fiber, and the majority of micronutrients were less than recommendations, whereas intakes of fats, added sugar, and sodium were within the upper range or exceeded recommendations. Hispanic ethnicity (relative risk [RR]=1.37; 95% CI 1.07 to 1.75), energy intake older adults, such as blacks or those who live alone, who may benefit from dietary interventions, as well as specific modifiable behaviors among older adults, such as eating restaurant meals or shopping at supermarkets, which may be targeted through interventions. Copyright © 2014 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

  11. Motivational characteristics and resistance training in older adults: a randomized controlled trial and 1-year follow-up.

    Science.gov (United States)

    Kekäläinen, Tiia; Kokko, Katja; Tammelin, Tuija; Sipilä, Sarianna; Walker, Simon

    2018-06-07

    The aim of this study was to investigate the effects of a nine-month supervised resistance training intervention on motivational and volitional characteristics related to exercise, and whether the absolute level and/or intervention-induced change in these characteristics predict self-directed continuation of resistance training one year after the intervention. Community-dwelling older adults aged 65-75, who did not fulfill physical activity recommendations, were randomized into resistance training intervention groups: training once- (n=26), twice- (n=27), three-times-a-week (n=28) or non-training control group (n=25). Training groups participated in supervised resistance training for nine months: during months 1-3 all groups trained twice-a-week and then with allocated frequencies during months 4-9. Exercise-related motivation, self-efficacy and planning were measured with questionnaires at baseline, month-3 and month-9. The continuance of resistance training was determined by interviews six and twelve months after the end of the intervention. The intervention improved action and coping planning as well as intrinsic motivation (group×time p<.05). During one-year follow-up, 54% of participants did not continue self-directed regular resistance training, 22% continued regular resistance training once-a-week and 24% twice-a-week. Increases in exercise self-efficacy and intrinsic motivation related to training during the intervention predicted continuation of resistance training twice-a-week. Resistance training improved exercise-related motivational and volitional characteristics in older adults. These improvements were linked to continuing resistance training one year after the supervised intervention. The role of these characteristics should be taken into account when promoting long-term resistance training participation among older adults. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  12. Cut-off scores of a brief neuropsychological battery (NBACE for Spanish individual adults older than 44 years old.

    Directory of Open Access Journals (Sweden)

    Montserrat Alegret

    Full Text Available The neuropsychological battery used in Fundació ACE (NBACE is a relatively brief, and easy to administer, test battery that was designed to detect cognitive impairment in the adulthood. The NBACE includes measures of cognitive information processing speed, orientation, attention, verbal learning and memory, language, visuoperception, praxis and executive functions. The aim of the present study was to establish the cut-off scores for impairment for different levels of age and education that could be useful in the cognitive assessment of Spanish subjects who are at risk for cognitive impairment, especially dementia. Data from 1018 patients with a mild dementia syndrome, and 512 cognitively healthy subjects, older than 44 years, from the Memory Clinic of Fundació ACE (Barcelona, Spain were analyzed. In the whole sample, cut-off scores and sensitivity/specificity values were calculated for six conditions after combining 3 age ranges (44 to 64; 65 to 74; and older than 74 years old by 2 educational levels (until Elementary school; and more than Elementary school. Moreover, general cut-offs are reported for Catalan and Spanish speakers. The results showed that most of NBACE tests reached good sensitivity and specificity values, except for Ideomotor praxis, Repetition and Verbal Comprehension tests, which had a ceiling effect. Word List Learning from the Wechsler Memory Scale-III and Semantic Verbal Fluency were the most useful tests to discriminate between cognitively healthy and demented subjects. The NBACE has been shown to be a useful tool able to detect cognitive impairment, especially dementia, in older than 44 years Spanish persons.

  13. Three-Year Changes in Physical Activity and Decline in Physical Performance Over 9 Years of Follow-Up in Older Adults: The Invecchiare in Chianti Study.

    Science.gov (United States)

    Martinez-Gomez, David; Bandinelli, Stefania; Del-Panta, Vieri; Patel, Kushang V; Guralnik, Jack M; Ferrucci, Luigi

    2017-06-01

    To examine the associations between cumulative physical activity (PA) and its changes over 3 years and changes over 9 years of follow-up in physical performance in older adults. Longitudinal. Community-based. Men and women aged 65 and older from the Invecchiare in Chianti study (N = 782). Physical performance was assessed at baseline and at 3-, 6-, and 9-year follow-up using the Short Physical Performance Battery (SPPB). PA was assessed through an interviewer-administered questionnaire at baseline and 3-year follow-up. Analyses were adjusted for education, body mass index, smoking, alcohol intake, coronary heart disease, stroke, peripheral arterial disease, cancer, lung disease, lower extremity osteoarthritis, depression, and Mini-Mental State Examination. Over 3 years of follow-up, 27.8% of participants were inactive, 52.2% were minimally active, and 20.0% were active, and the PA of 37.2% decreased, there was no change in PA of 50.1% and the PA of 12.7% increased. After adjustment for potential covariates, being mostly active (-1.08, 95% confidence interval (CI) = -1.43 to -0.73) and minimally active (-1.33, 95% CI = -1.53 to -1.12) over 3 years of follow-up was associated with less decline in SPPB score than being mostly inactive (-2.60, 95% CI = -2.92 to -2.27). When analyzing changes, increasing PA (-0.57, 95% CI = -1.01 to -0.12) was associated with less decline in SPPB score over 9 years than decreasing PA (-2.16, 95% CI = -2.42 to -1.89). Maintaining or increasing PA levels may attenuate age-associated physical performance decline. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

  14. Subjective life expectancy and actual mortality: results of a 10-year panel study among older workers.

    Science.gov (United States)

    van Solinge, Hanna; Henkens, Kène

    2018-06-01

    This research examined the judgemental process underlying subjective life expectancy (SLE) and the predictive value of SLE on actual mortality in older adults in the Netherlands. We integrated theoretical insights from life satisfaction research with existing models of SLE. Our model differentiates between bottom-up (objective data of any type) and top-down factors (psychological variables). The study used data from the first wave of the Netherlands Interdisciplinary Demographic Institute Work and Retirement Panel. This is a prospective cohort study among Dutch older workers. The analytical sample included 2278 individuals, assessed at age 50-64 in 2001, with vital statistics tracked through 2011. We used a linear regression model to estimate the impact of bottom-up and top-down factors on SLE. Cox proportional hazard regression was used to determine the impact of SLE on the timing of mortality, crude and adjusted for actuarial correlates of general life expectancy, family history, health and trait-like dispositions. Results reveal that psychological variables play a role in the formation of SLE. Further, the results indicate that SLE predicts actual mortality, crude and adjusted for socio-demographic, biomedical and psychological confounders. Education has an additional effect on mortality. Those with higher educational attainment were less likely to die within the follow-up period. This SES gradient in mortality was not captured in SLE. The findings indicate that SLE is an independent predictor of mortality in a pre-retirement cohort in the Netherlands. SLE does not fully capture educational differences in mortality. Particularly, higher-educated individuals underestimate their life expectancy.

  15. Temporal Patterns of Cervical Cancer Screening Among Danish Women 55 Years and Older Diagnosed With Cervical Cancer

    DEFF Research Database (Denmark)

    Hammer, Anne; Hee, Lene; Blaakær, Jan

    2018-01-01

    OBJECTIVE: The aim of the study was to describe the screening history in postmenopausal women diagnosed with cervical cancer during 1990-2013 by age and screening period. MATERIALS AND METHODS: This hospital-based cohort study included women 55 years and older diagnosed with cervical cancer...... at Aarhus University Hospital, Denmark, during 1990-2013. Information on their previous history of cervical cancer screening was obtained from the Danish Pathology Databank. RESULTS: Overall, 47.0% (95% CI = 42.6-51.4) had no record of screening before their cervical cancer diagnosis. This proportion...

  16. Summary and Comparison of the 2016 Billion-Ton Report with the 2011 U.S. Billion-Ton Update

    Energy Technology Data Exchange (ETDEWEB)

    None

    2016-06-01

    In terms of the magnitude of the resource potential, the results of the 2016 Billion-Ton Report (BT16) are consistent with the original 2005 Billion-Ton Study (BTS) and the 2011 report, U.S. Billion-Ton Update: Biomass Supply for a Bioenergy and Bioproducts Industry (BT2. An effort was made to reevaluate the potential forestland, agricultural, and waste resources at the roadside, then extend the analysis by adding transportation costs to a biorefinery under specified logistics assumptions to major resource fractions.

  17. Effects of extremely hot days on people older than 65 years in Seville (Spain) from 1986 to 1997

    Science.gov (United States)

    Díaz, J.; García, R.; Velázquez de Castro, F.; Hernández, E.; López, C.; Otero, A.

    2002-04-01

    The effects of heat waves on the population have been described by different authors and a consistent relationship between mortality and temperature has been found, especially in elderly subjects. The present paper studies this effect in Seville, a city in the south of Spain, known for its climate of mild winters and hot summers, when the temperature frequently exceeds 40 °C. This study focuses on the summer months (June to September) for the years from 1986 to 1997. The relationships between total daily mortality and different specific causes for persons older than 65 and 75 years, of each gender, were analysed. Maximum daily temperature and relative humidity at 7.00 a.m. were introduced as environmental variables. The possible confounding effect of different atmospheric pollutants, particularly ozone, were considered. The methodology employed was time series analysis using Box-Jenkins models with exogenous variables. On the basis of dispersion diagrams, we defined extremely hot days as those when the maximum daily temperature surpassed 41 °C. The ARIMA model clearly shows the relationship between temperature and mortality. Mortality for all causes increased up to 51% above the average in the group over 75 years for each degree Celsius beyond 41 °C. The effect is more noticeable for cardiovascular than for respiratory diseases, and more in women than in men. Among the atmospheric pollutants, a relation was found between mortality and concentrations of ozone, especially for men older than 75.

  18. The heritability of level and rate-of-change in cognitive functioning in Danish twins aged 70 years and older

    DEFF Research Database (Denmark)

    McGue, Matt; Christensen, Kaare

    2002-01-01

    To investigate heritable influences on overall level and rate-of-change in cognitive ability, biometric growth models were fit to cognitive data from nearly 1000 Danish twins age 70 years and older. Twins are participants in the ongoing Longitudinal Study of Aging Danish Twins, a cohort-sequentia......To investigate heritable influences on overall level and rate-of-change in cognitive ability, biometric growth models were fit to cognitive data from nearly 1000 Danish twins age 70 years and older. Twins are participants in the ongoing Longitudinal Study of Aging Danish Twins, a cohort......-sequential study of twins assessed every 2 years for up to four waves. Cognitive ability was assessed by five brief cognitive tasks: a fluency measure, forward and backward digit span, and immediate and delayed list recall. Model-fitting results indicated that although the overall level of cognitive functioning...... was highly heritable (h(2) = .76, 95% confidence interval of .68 to .82), the rate of linear change was not (h(2) = .06, 95% confidence interval of .00 to .57). These findings suggest that the search for specific genes might reasonably focus on average level of cognitive performance, whereas specific...

  19. 1.6 billion euros for nuclear research through the 'Horizon 2020' program

    International Nuclear Information System (INIS)

    Anon.

    2014-01-01

    The European Union Council has approved the budget for the future European program for research and innovation called 'Horizon 2020'. A global funding of 77 billion euros has been allocated to 'Horizon 2020' for the 2014 to 2020 years. The share for nuclear sciences will reach 1.6 billion euros and will break down as follows: 316 million euros for fundamental research on fission, 728 million euros for fundamental research on fusion (ITER not included) and 560 million euros for the research projects of the European Joint Research Center (JRC). (A.C.)

  20. Dynapenia and Metabolic Health in Obese and Nonobese Adults Aged 70 Years and Older: The LIFE Study.

    Science.gov (United States)

    Aubertin-Leheudre, Mylène; Anton, Stephen; Beavers, Daniel P; Manini, Todd M; Fielding, Roger; Newman, Ann; Church, Tim; Kritchevsky, Stephen B; Conroy, David; McDermott, Mary M; Botoseneanu, Anda; Hauser, Michelle E; Pahor, Marco

    2017-04-01

    The purpose of this study was to examine the relationship between dynapenia and metabolic risk factors in obese and nonobese older adults. A total of 1453 men and women (age ≥70 years) from the Lifestyle Interventions and Independence for Elders (LIFE) Study were categorized as (1) nondynapenic/nonobese (NDYN-NO), (2) dynapenic/nonobese (DYN-NO), (3) nondynapenic/obese (NDYN-O), or (4) dynapenic/obese (DYN-O), based on muscle strength (Foundation for the National Institute of Health criteria) and body mass index. Dependent variables were blood lipids, fasting glucose, blood pressure, presence of at least 3 metabolic syndrome (MetS) criteria, and other chronic conditions. A significantly higher likelihood of having abdominal obesity criteria in NDYN-NO compared with DYN-NO groups (55.6 vs 45.1%, P ≤ .01) was observed. Waist circumference also was significantly higher in obese groups (DYN-O = 114.0 ± 12.9 and NDYN-O = 111.2 ± 13.1) than in nonobese (NDYN-NO = 93.1 ± 10.7 and DYN-NO = 92.2 ± 11.2, P ≤ .01); and higher in NDYN-O compared with DYN-O (P = .008). Additionally, NDYN-O demonstrated higher diastolic blood pressure compared with DYN-O (70.9 ± 10.1 vs 67.7 ± 9.7, P ≤ .001). No significant differences were found across dynapenia and obesity status for all other metabolic components (P > .05). The odds of having MetS or its individual components were similar in obese and nonobese, combined or not with dynapenia (nonsignificant odds ratio [95% confidence interval]). Nonobese dynapenic older adults had fewer metabolic disease risk factors than nonobese and nondynapenic older adults. Moreover, among obese older adults, dynapenia was associated with lower risk of meeting MetS criteria for waist circumference and diastolic blood pressure. Additionally, the presence of dynapenia did not increase cardiometabolic disease risk in either obese or nonobese older adults. Copyright © 2016 AMDA – The Society for Post-Acute and

  1. Decrease in incidence of colorectal cancer among individuals 50 years or older following recommendations for population-based screening

    Science.gov (United States)

    Murphy, Caitlin C.; Sandler, Robert S.; Sanoff, Hanna K.; Yang, Y. Claire; Lund, Jennifer L.; Baron, John A.

    2016-01-01

    Background & Aims The incidence of colorectal cancer (CRC) in the U.S. is increasing among adults younger than age 50 years, but incidence has decreased among older populations after population-based screening was recommended in the late 1980s. Blacks have higher incidence than whites. These patterns have prompted suggestions to lower the screening age for average-risk populations or in blacks. At the same time, there has been controversy over whether reductions in CRC incidence can be attributed to screening. We examined age- and race-related differences in CRC incidence over a 40-year time period. Methods We determined the age-standardized incidence of CRC, from 1975 through 2013, using the population-based Surveillance, Epidemiology, and End Results (SEER) program of cancer registries. We calculated incidence for 5-year age categories (20—24 years through 80—84 years and 85 years or older) for different time periods (1975—1979, 1980—1984, 1985—1989, 1990—1994, 1995—1999, 2000—2004, 2005—2009, and 2010—2013), tumor subsite (proximal colon, descending colon, and rectum), and stages at diagnosis (localized, regional, and distant). Analyses were stratified by race (white vs. black). Results There were 450,682 incident cases of CRC reported to the SEER registries over the entire period (1975—2013). Overall incidence was 75.5/100,000 white persons and 83.6/100,000 black persons. CRC incidence peaked during 1980 through 1989 and began to decrease in 1990. In whites and blacks, the decreases in incidence between the time periods of 1980—1984 and 2010—2013 were limited to the screening-age population (ages 50 years or older). Between these time periods, there was a 40% decrease in incidence among whites compared with a 26% decrease in incidence among blacks. Decreases in incidence were greater for cancers of the distal colon and rectum, and reductions in these cancers were greater among whites than blacks. CRC incidence among persons younger

  2. The association between exposure to psychosocial work factors and mental health in older employees: A 3-year follow-up study

    OpenAIRE

    Havermans, B.M.; Boot, C.R.L.; Hoekstra, T.; Houtman, I.L.D.; Brouwers, E.P.M.; Anema, J.R.; Van Der Beek, A.J.

    2018-01-01

    Purpose Unfavourable exposure to psychosocial work factors threatens older employees’ mental health, and their sustained employment. This study assesses whether an improved compared to stable unfavourable and stable favourable exposure to psychosocial work factors is associated with a change in mental health in older employees at 3-year follow-up. Methods The current study used data from the Study on Transitions in Employment, Ability and Motivation (STREAM), in workers aged 45–65 years (n = ...

  3. Price of next big thing in physics: $6.7 billion

    CERN Multimedia

    Overbye, Dennis

    2007-01-01

    The price of exploring inner space went up Thursday. The machine discusses in a news conference in Beijing, will be 20 miles long and would cost about $6.7 billion and 13'000 person-years of labor to be built. (1,5 page)

  4. Universities Report $1.8-Billion in Earnings on Inventions in 2011

    Science.gov (United States)

    Blumenstyk, Goldie

    2012-01-01

    Universities and their inventors earned more than $1.8-billion from commercializing their academic research in the 2011 fiscal year, collecting royalties from new breeds of wheat, from a new drug for the treatment of HIV, and from longstanding arrangements over enduring products like Gatorade. Northwestern University earned the most of any…

  5. U of M seeking $1.1 billion in projects for Soudan Mine lab.

    CERN Multimedia

    2003-01-01

    The University of Minnesota is hoping that groundbreaking research underway at its labs at the Soudan Underground Mine near Tower will help secure up to $1.1 billion in the next 5 to 20 years to expand its work into particle physics (1 page).

  6. The Geriatric ICF Core Set reflecting health-related problems in community-living older adults aged 75 years and older without dementia: development and validation.

    Science.gov (United States)

    Spoorenberg, Sophie L W; Reijneveld, Sijmen A; Middel, Berrie; Uittenbroek, Ronald J; Kremer, Hubertus P H; Wynia, Klaske

    2015-01-01

    The aim of the present study was to develop a valid Geriatric ICF Core Set reflecting relevant health-related problems of community-living older adults without dementia. A Delphi study was performed in order to reach consensus (≥70% agreement) on second-level categories from the International Classification of Functioning, Disability and Health (ICF). The Delphi panel comprised 41 older adults, medical and non-medical experts. Content validity of the set was tested in a cross-sectional study including 267 older adults identified as frail or having complex care needs. Consensus was reached for 30 ICF categories in the Delphi study (fourteen Body functions, ten Activities and Participation and six Environmental Factors categories). Content validity of the set was high: the prevalence of all the problems was >10%, except for d530 Toileting. The most frequently reported problems were b710 Mobility of joint functions (70%), b152 Emotional functions (65%) and b455 Exercise tolerance functions (62%). No categories had missing values. The final Geriatric ICF Core Set is a comprehensive and valid set of 29 ICF categories, reflecting the most relevant health-related problems among community-living older adults without dementia. This Core Set may contribute to optimal care provision and support of the older population. Implications for Rehabilitation The Geriatric ICF Core Set may provide a practical tool for gaining an understanding of the relevant health-related problems of community-living older adults without dementia. The Geriatric ICF Core Set may be used in primary care practice as an assessment tool in order to tailor care and support to the needs of older adults. The Geriatric ICF Core Set may be suitable for use in multidisciplinary teams in integrated care settings, since it is based on a broad range of problems in functioning. Professionals should pay special attention to health problems related to mobility and emotional functioning since these are the most

  7. Sociodemographic and clinical differences between suicide ideators and attempters: a study of mood disordered patients 50 years and older.

    Science.gov (United States)

    Pompili, Maurizio; Innamorati, Marco; Di Vittorio, Cristina; Sher, Leo; Girardi, Paolo; Amore, Mario

    2014-02-01

    Our study sought to characterize mood disordered suicide ideators and attempters 50 years and older admitted to a psychiatric ward either for a recent suicide attempt or for ongoing suicidal ideation. We enrolled 50 patients with suicide ideation consecutively admitted to an inpatient department and 50 patients admitted for a suicide attempt made in the last 48 hours. Suicide attempters more frequently had low social support and an age of onset of mood disorder of 46 years and older, and less frequently had a history of suicidal behaviors in the family members and pharmacological treatment, despite the fact that the groups did not differ with regard to antidepressants prescribed. The groups were not distinguishable based on several variables assumed to be risk factors for suicide behavior, such as proximal life events and stressors or alcohol use disorders. In both samples, comorbidity with organic diseases, the presence of stressful life events in the past 12 months, and a diagnosis of major depression were frequently reported. In conclusion, the presence of low social support and the absence of a pharmacotherapy may increase suicidal behaviors in patients at risk. © 2013 The American Association of Suicidology.

  8. Individual, Psychosocial, and environmental correlates of 4-year declines in walking among middle-to-older aged adults.

    Science.gov (United States)

    Shimura, Hiroko; Winkler, Elisabeth; Owen, Neville

    2014-08-01

    We examined associations of individual, psychosocial and environmental characteristics with 4-year changes in walking among middle-to-older aged adults; few such studies have employed prospective designs. Walking for transport and walking for recreation were assessed during 2003-2004 (baseline) and 2007-2008 (follow-up) among 445 adults aged 50-65 years residing in Adelaide, Australia. Logistic regression analyses examined predictors of being in the highest quintile of decline in walking (21.4 minutes/day or more reduction in walking for transport; 18.6 minutes/day or more reduction in walking for recreation). Declines in walking for transport were related to higher level of walking at baseline, low perceived benefits of activity, low family social support, a medium level of social interaction, low sense of community, and higher neighborhood walkability. Declines in walking for recreation were related to higher level of walking at baseline, low self-efficacy for activity, low family social support, and a medium level of available walking facilities. Declines in middle-to-older aged adults' walking for transport and walking for recreation have differing personal, psychosocial and built-environment correlates, for which particular preventive strategies may be developed. Targeted campaigns, community-based programs, and environmental and policy initiatives can be informed by these findings.

  9. Nutritional advice in older patients at risk of malnutrition during treatment for chemotherapy: a two-year randomized controlled trial.

    Science.gov (United States)

    Bourdel-Marchasson, Isabelle; Blanc-Bisson, Christelle; Doussau, Adélaïde; Germain, Christine; Blanc, Jean-Frédéric; Dauba, Jérôme; Lahmar, Cyril; Terrebonne, Eric; Lecaille, Cédric; Ceccaldi, Joël; Cany, Laurent; Lavau-Denes, Sandrine; Houede, Nadine; Chomy, François; Durrieu, Jessica; Soubeyran, Pierre; Senesse, Pierre; Chene, Geneviève; Fonck, Mariane

    2014-01-01

    We tested the effect of dietary advice dedicated to increase intake in older patients at risk for malnutrition during chemotherapy, versus usual care, on one-year mortality. We conducted a multicentre, open-label interventional, stratified (centre), parallel randomised controlled trial, with a 1∶1 ratio, with two-year follow-up. Patients were aged 70 years or older treated with chemotherapy for solid tumour and at risk of malnutrition (MNA, Mini Nutritional Assessment 17-23.5). Intervention consisted of diet counselling with the aim of achieving an energy intake of 30 kCal/kg body weight/d and 1.2 g protein/kg/d, by face-to-face discussion targeting the main nutritional symptoms, compared to usual care. Interviews were performed 6 times during the chemotherapy sessions for 3 to 6 months. The primary endpoint was 1-year mortality and secondary endpoints were 2-year mortality, toxicities and chemotherapy outcomes. Between April 2007 and March 2010 we randomised 341 patients and 336 were analysed: mean (standard deviation) age of 78.0 y (4·9), 51.2% male, mean MNA 20.2 (2.1). Distribution of cancer types was similar in the two groups; the most frequent were colon (22.4%), lymphoma (14.9%), lung (10.4%), and pancreas (17.0%). Both groups increased their dietary intake, but to a larger extent with intervention (pnutritional status changes was found. Response to chemotherapy was also similar between the groups. Early dietary counselling was efficient in increasing intake but had no beneficial effect on mortality or secondary outcomes. Cancer cachexia antianabolism may explain this lack of effect. ClinicalTrials.gov NCT00459589.

  10. Reproductive history, socioeconomic status and disability in the women aged 65 years or older in Turkey.

    Science.gov (United States)

    Akin, Belgin; Ege, Emel; Koçoğlu, Deniz; Arslan, Selda Y; Bilgili, Naile

    2010-01-01

    Pregnancy and childbirth are an important physiological and emotional phenomenon in their lives for most women and studies have shown that this process may have a significant impact on their health at later ages. The objective of the study is to examine the relationship between functional disabilities in women over the age of 65 and their reproductive history and socioeconomic status. This is a cross-sectional study. The study group consisted of 543 women aged 65 or over. A general questionnaire and the Brief Disability Questionnaire (BDQ) were used to collect data with face-to-face interview in home visits. Of the women 79.2% have disability. First childbirth was experienced at the average age of 19.6+/-3.3 and the average age at which the women experienced their last delivery was 32.5+/-6.3. Parity was 4.1+/-1.7. Advanced age, being widowed and illiterate, less income, being outside of the middle class and having more than four children are important determinants for later life disability. The study highlights the importance of focusing not just on the short-term effects of childbearing and socioeconomic factors, but also of taking into account the possibility of long-term effects on disability in older women.

  11. Personality and Risk for Alzheimer’s Disease in Adults 72 Years of Age and Older: A Six-Year Follow-Up

    Science.gov (United States)

    Duberstein, Paul R.; Chapman, Benjamin P.; Tindle, Hilary A.; Sink, Kaycee M.; Bamonti, Patricia; Robbins, John; Jerant, Anthony F.; Franks, Peter

    2010-01-01

    We conducted secondary analyses to determine the relationship between longstanding personality traits and risk for Alzheimer’s disease (AD) among 767 participants 72 years of age or older who were followed for more than 6 years. Personality was assessed with the NEO-FFI. We hypothesized that elevated Neuroticism, lower Openness, and lower Conscientiousness would be independently associated with risk of AD. Hypotheses were supported. The finding that AD risk is associated with elevated Neuroticism and lower Conscientiousness can be added to the accumulating literature documenting the pathogenic effects of these two traits. The link between lower Openness and AD risk is consistent with recent findings on cognitive activity and AD risk. Findings have implications for prevention research and for the conceptualization of the etiology of Alzheimer’s Disease. PMID:20973606

  12. The Association of APOE Genotype with Cognitive Function in Persons Aged 35 Years or Older

    NARCIS (Netherlands)

    Izaks, Gerbrand J.; Gansevoort, Ron T.; van der Knaap, Aafke M.; Navis, Gerjan; Dullaart, Robin P. F.; Slaets, Joris P. J.

    2011-01-01

    APOE genotype is associated with the risk of Alzheimer's disease. In the present study, we investigated whether APOE genotype was associated with cognitive function in predominantly middle-aged persons. In a population-based cohort of 4,135 persons aged 35 to 82 years (mean age (SD), 55 (12) years),

  13. Effectiveness of the 23-valent polysaccharide pneumococcal vaccine against invasive pneumococcal disease in people 60 years or older

    Directory of Open Access Journals (Sweden)

    Salsench Elisabet

    2010-03-01

    Full Text Available Abstract Background The 23-valent polysaccharide pneumococcal vaccine (PPV is currently recommended in elderly and high-risk adults. However, its efficacy in preventing pneumococcal infections remains controversial. This study assessed the clinical effectiveness of vaccination against invasive pneumococcal disease (IPD among people over 60 years. Methods Population-based case-control study that included 88 case patients over 60 years-old with a laboratory-confirmed IPD (bacteraemic pneumonia, meningitis or sepsis and 176 outpatient control subjects who were matched by primary care centre, age, sex and risk stratum. Adjusted odds ratios (ORs for vaccination were calculated using conditional logistic regression, controlling for underlying conditions. Vaccine effectiveness was estimated as (1 - OR ×100. Results Pneumococcal vaccination rate was significantly lower in cases than in control subjects (38.6% vs 59.1%; p = 0.002. The adjusted vaccine effectiveness was 72% (OR: 0.28; 95% CI: 0.15-0.54 against all IPD and 77% (OR: 0.23; 95% CI: 0.08-0.60 against vaccine-type IPD. Vaccination was significantly effective against all IPD in both age groups: 60-79 years-old (OR 0.32; 95% CI: 0.14-0.74 and people 80 years or older (OR: 0.29; 95% CI: 0.09-0.91. Vaccination appears significantly effective as for high-risk immunocompetent subjects (OR: 0.29; 95% CI: 0.11-0.79 as well as for immunocompromised subjects (OR: 0.12; 95% CI: 0.03-0.53. Conclusion These findings confirm the effectiveness of the 23-valent PPV against IPD, and they also support the benefit of vaccination in preventing invasive infections among high-risk and older people.

  14. Combined resistance and balance-jumping exercise reduces older women's injurious falls and fractures: 5-year follow-up study.

    Science.gov (United States)

    Karinkanta, Saija; Kannus, Pekka; Uusi-Rasi, Kirsti; Heinonen, Ari; Sievänen, Harri

    2015-09-01

    previously, a randomised controlled exercise intervention study (RCT) showed that combined resistance and balance-jumping training (COMB) improved physical functioning and bone strength. The purpose of this follow-up study was to assess whether this exercise intervention had long-lasting effects in reducing injurious falls and fractures. five-year health-care register-based follow-up study after a 1-year, four-arm RCT. community-dwelling older women in Finland. one hundred and forty-five of the original 149 RCT participants; women aged 70-78 years at the beginning. participants' health-care visits were collected from computerised patient register. An injurious fall was defined as an event in which the subject contacted the health-care professionals or was taken to a hospital, due to a fall. The rate of injured fallers was assessed by Cox proportional hazards model (hazard ratio, HR), and the rate of injurious falls and fractures by Poisson regression (risk ratio, RR). eighty-one injurious falls including 26 fractures occurred during the follow-up. The rate of injured fallers was 62% lower in COMB group compared with the controls (HR 0.38, 95% CI 0.17 to 0.85). In addition, COMB group had 51% less injurious falls (RR 0.49, 95% CI 0.25 to 0.98) and 74% less fractures (RR 0.26, 95% CI 0.07 to 0.97). home-dwelling older women who participated in a 12-month intensive multi-component exercise training showed a reduced incidence for injurious falls during 5-year post-intervention period. Reduction in fractures was also evident. These long-term effects need to be confirmed in future studies. © The Author 2015. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  15. [Prevalence of cardiovascular diseases and cardiovascular risk factors in older than 65 years persons in an urban area: DERIVA study].

    Science.gov (United States)

    Rodríguez-Sánchez, Emiliano; García-Ortiz, Luis; Gómez-Marcos, Manuel A; Recio-Rodríguez, José I; Mora-Simón, Sara; Pérez-Arechaederra, Diana; Agudo-Conde, Cristina; Escribano-Hernández, Alfonso; Patino-Alonso, María C

    2013-01-01

    To estimate the prevalence of cardiovascular diseases, cardiovascular risk factors, and the psychosocial characteristics associated with them in an urban population aged 65 years and older. Descriptive cross-sectional study of the population. City of Salamanca (Spain). A total of 480 participants aged 65 and older were selected using a stratified randomized sampling method. A health questionnaire was completed in the participants' homes. Weight, height, waist circumference, arterial pressure, blood glucose and cholesterol, were measured, and the standardized prevalence for a European population was estimated. A total of 327 participants were interviewed (68.10% of those selected), mean age of participants was 76 (SD: 7.33). Of the total, 64.5% were women and 20.2% (15.8-24.5) had some cardiovascular disease. In males, the most prevalent cardiovascular disease was ischemic heart disease (12.1% [6.1-18]), while in females it was heart failure (10.4% [6.3-14.6]). Hypertension was the most frequent cardiovascular risk factor for males (63.8% [53.2-70.9]) and females (69.7%.[63.5-75.9]), followed by diabetes in males (36.2% [27.5-45]), and sedentary lifestyle in females (36.0% [29.5-42.5]). Those with cardiovascular diseases were more dependent and had a worse prognosis (Charlson's Comorbility Index). Ischemic heart disease is the most prevalent heart disease in males, while heart failure is the most prevalent disease for females. Almost 80% of the population aged 65 and older did not suffer any of the three cardiovascular diseases that are the main causes of mortality in this group of age. Participants who had a CVD were more dependent for activities of daily living. Copyright © 2012 Elsevier España, S.L. All rights reserved.

  16. 3-year changes in physical activity and physical performance decline over 9 years of follow-up in older adults: The InCHIANTI study

    Science.gov (United States)

    Martinez-Gomez, David; Bandinelli, Stefania; Del-Panta, Vieri; Patel, Kushang V; Guralnik, Jack M; Ferrucci, Luigi

    2016-01-01

    OBJECTIVES To examine the associations of cumulative physical activity (PA) and its changes over 3-year with changes over 9 years of follow-up in physical performance in older adults. DESIGN Longitudinal. SETTING Community-based. PARTICIPANTS Men and women, aged 65 years and older, from the InCHIANTI study (N=782). MEASUREMENTS Physical performance was assessed at baseline and at 3-, 6- and 9-year follow-up with the Short Physical Performance Battery (SPPB). PA was assessed through an interviewer-administered questionnaire at baseline and at 3-year follow-up. Analyses were adjusted for education, body mass index, smoking, alcohol intake, coronary heart disease, stroke, peripheral arterial disease, cancer, lung disease, lower extremity osteoarthritis, depression, and Mini-mental state examination. RESULTS Over 3-year of follow-up, the prevalence of participants inactive, minimally active and active was 27.8%, 52.2% and 20.0%, respectively. The prevalence of participants who decreased, no change or increased PA over 3-year of follow-up was 37.2%, 50.1% and 12.7%, respectively. Compared with participants who spent most of the time inactive and after adjustment for potential covariates (−2.60 score, 95%CI: −2.92, −2.27), being mostly active (−1.08 score, 95%CI: −1.43, −0.73) and even minimally active (−1.33 score, 95%CI: −1.53, −1.12) over 3 years of follow-up was associated with lower declines in the SPPB score. When analyzing changes, increasing PA (−0.57 score, 95%CI: −1.01, −0.12) was associated with lower declines in the SPPB score over 9 years as compared with those who decreased PA (−2.16 score, 95%CI: −2.42, −1.89). CONCLUSION Maintaining or increasing PA levels may attenuate age-associated physical performance decline. PMID:28248412

  17. Survival and Toxicity in Patients With Disseminated Germ CellCancer Aged 40 Years and Older

    DEFF Research Database (Denmark)

    Thomsen, Frederik B; Bandak, Mikkel; Thomsen, Maria F

    2014-01-01

    , etoposide and cisplatin (BEP). A control-group of 135 patients aged 18-35 years was randomly selected matched on year of BEP treatment. Cumulated doses of BEP as well as bone marrow toxicity, renal- and lung functions were recorded before, during and after termination of treatment. All patients were...... followed until death or October 1, 2011. RESULTS: The cumulated doses of BEP were comparable between the two groups, however, more patients aged ≥40 years were reduced in bleomycin doses based on a decrease in carbon monoxide diffusion capacity corrected for haemoglobin (P = 0.03). No differences between...

  18. Winglets Save Billions of Dollars in Fuel Costs

    Science.gov (United States)

    2010-01-01

    The upturned ends now featured on many airplane wings are saving airlines billions of dollars in fuel costs. Called winglets, the drag-reducing technology was advanced through the research of Langley Research Center engineer Richard Whitcomb and through flight tests conducted at Dryden Flight Research Center. Seattle-based Aviation Partners Boeing -- a partnership between Aviation Partners Inc., of Seattle, and The Boeing Company, of Chicago -- manufactures Blended Winglets, a unique design featured on Boeing aircraft around the world. These winglets have saved more than 2 billion gallons of jet fuel to date, representing a cost savings of more than $4 billion and a reduction of almost 21.5 million tons in carbon dioxide emissions.

  19. Conventional external beam radiation therapy and high dose rate afterloading brachytherapy as a boost for patients older than 70 years

    International Nuclear Information System (INIS)

    Pellizzon, Antonio Cassio Assis; Salvajoli, Joao Vitor; Fogaroli, Ricardo Cesar; Novaes, Paulo Eduardo R.S.; Maia, Maria Aparecida Conte; Ferrigno, Robson

    2005-01-01

    The treatment options for patients with non metastatic prostate cancer range from observation, radical prostatectomy, radiation therapy, hormonal therapy to various combination of some to all of them. Objective: we evaluated the impact on biochemical control of disease (bNED), acute and late intestinal (GI) and urological (GU) morbidity for a group of patients older than 70 years presenting initial or locally advanced prostate cancer treated with fractionated high dose rate brachytherapy (HDRB) as a boost to conventional external beam radiation therapy (RT) at the Department of Radiation Oncology from Hospital do Cancer A. C. Camargo, Sao Paulo, Brazil. Methods: a total of 56 patients older than 70 were treated from March, 1997 to June, 2002. All patients had prior to HDRB a course of RT to a median dose of 45 Gy. HDRB doses ranged from 16 Gy to 20 Gy, given in 4 fractions. Results: the median age of the patients was 74.4 years (range 70-83) and the median follow-up 33 months (range 24 to 60). The 5-year actuarial bNED rate was 77%. Acute GU and GI morbidity G1-2 were seen in 17.8% and 7.1% of patients, respectively. Late G1 or G2 GU morbidity was seen in 10.7% of the patients, while late G3 morbidity was observed in 7.1% of the patients, represented by urethral strictures. Conclusion: this group of patients had similar bNED rates when compared to literature, with acceptable morbidity rates. (author)

  20. Repeatability of stance phase kinematics from a multi-segment foot model in people aged 50 years and older.

    Science.gov (United States)

    Arnold, John B; Mackintosh, Shylie; Jones, Sara; Thewlis, Dominic

    2013-06-01

    Confidence in 3D multi-segment foot models has been limited by a lack of repeatability data, particularly in older populations that may display unique functional foot characteristics. This study aimed to determine the intra and inter-observer repeatability of stance phase kinematic data from a multi-segment foot model described by Leardini et al. [2] in people aged 50 years or older. Twenty healthy adults participated (mean age 65.4 years SD 8.4). A repeated measures study design was used with data collected from four testing sessions on two days from two observers. Intra (within-day and between-day) and inter-observer coefficient of multiple correlations revealed moderate to excellent similarity of stance phase joint range of motion (0.621-0.975). Relative to the joint range of motion (ROM), mean differences (MD) between sessions were highest for the within-day comparison for all planar ROM at the metatarsus-midfoot articulation (sagittal plane ROM 5.2° vs. 3.9°, MD 3.1°; coronal plane ROM 3.9 vs. 3.1°, MD 2.3°; transverse plane ROM 6.8° vs. 5.16°, MD 3.5°). Consequently, data from the metatarsus-midfoot articulation in the Istituto Ortopedico Rizzoli (IOR) foot model in adults aged over 50 years needs to be considered with respect to the findings of this study. Crown Copyright © 2012. Published by Elsevier B.V. All rights reserved.

  1. Study of Duchenne muscular dystrophy long-term survivors aged 40 years and older living in specialized institutions in Japan.

    Science.gov (United States)

    Saito, Toshio; Kawai, Mitsuru; Kimura, En; Ogata, Katsuhisa; Takahashi, Toshiaki; Kobayashi, Michio; Takada, Hiroto; Kuru, Satoshi; Mikata, Takashi; Matsumura, Tsuyoshi; Yonemoto, Naohiro; Fujimura, Harutoshi; Sakoda, Saburo

    2017-02-01

    The national muscular dystrophy wards database of Japan lists 118 long-term Duchenne muscular dystrophy (DMD) patients who were at least 40 years old as of October 1, 2013. To elucidate the clinical features of DMD patients aged 40 years and older, we obtained gene analysis and muscle biopsy findings, as well as medical condition information. Ninety-four of the registered patients consented to participate, of whom 55 meeting genetic or biochemical criteria confirming DMD were analyzed. The mean age at the time of the study was 43.6 ± 3.0 years, while at the time of independent ambulation loss it was 10.6 ± 1.5 years and at mechanical ventilation introduction it was 24.1 ± 5.5 years. All were receiving continuous ventilation support, 27 with non-invasive positive pressure ventilation and 28 with tracheal intermittent positive pressure ventilation. Thirty-eight were receiving β-blockers or a renin-angiotensin system inhibitor, while 9 were free from those agents. Forty had maintained oral nutrition. The 55 analyzed patients had survived into their 40s by receiving multidisciplinary intervention. Our findings emphasize the need of future studies to investigate disease modifiers and the mechanism of long-term survival. In addition, establishment of a worldwide care standard with focus on quality of life for adult males with DMD is important. Copyright © 2016 Elsevier B.V. All rights reserved.

  2. Colorectal cancer: screening double-contrast barium enema examination in average-risk adults older than 50 years.

    Science.gov (United States)

    Kung, Justin W; Levine, Marc S; Glick, Seth N; Lakhani, Paras; Rubesin, Stephen E; Laufer, Igor

    2006-09-01

    To retrospectively determine the diagnostic yield of double-contrast barium enema examinations performed for colorectal cancer screening of neoplasms 1 cm or larger or advanced neoplastic lesions of any size in average-risk adults older than 50 years. The Institutional Review Board at the affiliated Veterans Affairs Medical Center approved this HIPAA-compliant study protocol and did not require informed consent from patients. Computerized databases revealed 276 double-contrast barium enema examinations performed for colorectal cancer screening in average-risk adults older than 50 years. Radiographic and pathologic reports were reviewed to determine the number of patients who had polypoid lesions 1 cm or larger, polyps smaller than 1 cm, or advanced neoplastic lesions of any size. Forty-five (16.3%) of the 276 patients underwent follow-up sigmoidoscopy or colonoscopy. Medical, endoscopic, and pathologic records were reviewed and compared with radiographic findings. The results of double-contrast barium enema examination revealed 74 (26.8%) of 276 patients with 104 polypoid lesions in the colon, including 32 patients (11.6%) with 41 polypoid lesions 1 cm or larger, 15 patients (5.4%) with 19 polyps 6-9 mm, and 27 patients (9.8%) with 44 polyps 5 mm or smaller. Endoscopy was performed in 24 (75%) of 32 patients, the results of which confirmed 23 (72%) of 32 radiographically diagnosed lesions 1 cm or larger in 16 (67%) of 24 patients. In two of these individuals, the polyps were hyperplastic. The remaining 14 patients had a total of 21 neoplastic lesions 1 cm or larger, including 11 tubular adenomas, seven tubulovillous adenomas, one villous adenoma with marked dysplasia, and two cancers. The diagnostic yield of screening double-contrast barium enema examination was 5.1% (14 of 276 patients) for neoplastic lesions 1 cm or larger and 6.2% (17 of 276 patients) for advanced neoplastic lesions of any size. Double-contrast barium enema examinations performed in average

  3. Increasing primary health-care services are associated with acute short-term hospitalization of Danes aged 70 years and older

    DEFF Research Database (Denmark)

    Vestergaard Fournaise, Anders; Espensen, Niels; Jakobsen, Søren

    2017-01-01

    Background: Ageing is accompanied by increased risk of morbidity and subsequent risk of acute hospitalisation. With ageing populations, health-care providers focus on prevention of acute admissions of older adults by timely identification and treatment in the community. However, identifying...... an emerging acute disease can be difficult in older adults due to atypical and vague symptoms, but may be expressed by increased contact to health-care providers. Method: During a 12-month period, all 70+-year-old people short-term (.... Monitoring health-care use may timely identify older adults at risk of acute hospitalisation....

  4. How do you interpret a billion primary care records?

    Directory of Open Access Journals (Sweden)

    Martin Heaven

    2017-04-01

    To establish this we explored just over 1 billion unique Read coded records generated in the time period 1999 to 2015 by GP practices participating in the provision of anonymised records to SAIL, aligning, filtering and summarising the data in a series of observational exercises to generate hypotheses related to the capture and recording of the data. Results A fascinating journey through 1 billion GP practice generated pieces of information, embarked upon to aid interpretation of our Supporting People results, and providing insights into the patterns of recording within GP data.

  5. Cholesteryl Ester Transfer Protein (CETP) genotype and cognitive function in persons aged 35 years or older

    NARCIS (Netherlands)

    Izaks, Gerbrand J.; van der Knaap, Aafke M.; Gansevoort, Ron T.; Navis, Gerjan; Slaets, Joris P. J.; Dullaart, Robin P. F.

    Common polymorphisms of the Cholestryl Ester Transfer Protein (CETP) gene may predict lower risk of cognitive decline. We investigated the association of cognitive function with CETP genotype in a population-based cohort of 4135 persons aged 35-82 years. Cognitive function was measured with the Ruff

  6. Nutritional advice in older patients at risk of malnutrition during treatment for chemotherapy: a two-year randomized controlled trial.

    Directory of Open Access Journals (Sweden)

    Isabelle Bourdel-Marchasson

    Full Text Available We tested the effect of dietary advice dedicated to increase intake in older patients at risk for malnutrition during chemotherapy, versus usual care, on one-year mortality.We conducted a multicentre, open-label interventional, stratified (centre, parallel randomised controlled trial, with a 1∶1 ratio, with two-year follow-up. Patients were aged 70 years or older treated with chemotherapy for solid tumour and at risk of malnutrition (MNA, Mini Nutritional Assessment 17-23.5. Intervention consisted of diet counselling with the aim of achieving an energy intake of 30 kCal/kg body weight/d and 1.2 g protein/kg/d, by face-to-face discussion targeting the main nutritional symptoms, compared to usual care. Interviews were performed 6 times during the chemotherapy sessions for 3 to 6 months. The primary endpoint was 1-year mortality and secondary endpoints were 2-year mortality, toxicities and chemotherapy outcomes.Between April 2007 and March 2010 we randomised 341 patients and 336 were analysed: mean (standard deviation age of 78.0 y (4·9, 51.2% male, mean MNA 20.2 (2.1. Distribution of cancer types was similar in the two groups; the most frequent were colon (22.4%, lymphoma (14.9%, lung (10.4%, and pancreas (17.0%. Both groups increased their dietary intake, but to a larger extent with intervention (p<0.01. At the second visit, the energy target was achieved in 57 (40.4% patients and the protein target in 66 (46.8% with the intervention compared respectively to 13 (13.5% and 20 (20.8% in the controls. Death occurred during the first year in 143 patients (42.56%, without difference according to the intervention (p = 0.79. No difference in nutritional status changes was found. Response to chemotherapy was also similar between the groups.Early dietary counselling was efficient in increasing intake but had no beneficial effect on mortality or secondary outcomes. Cancer cachexia antianabolism may explain this lack of effect.ClinicalTrials.gov NCT

  7. Nutritional Advice in Older Patients at Risk of Malnutrition during Treatment for Chemotherapy: A Two-Year Randomized Controlled Trial

    Science.gov (United States)

    Bourdel-Marchasson, Isabelle; Blanc-Bisson, Christelle; Doussau, Adélaïde; Germain, Christine; Blanc, Jean-Frédéric; Dauba, Jérôme; Lahmar, Cyril; Terrebonne, Eric; Lecaille, Cédric; Ceccaldi, Joël; Cany, Laurent; Lavau-Denes, Sandrine; Houede, Nadine; Chomy, François; Durrieu, Jessica; Soubeyran, Pierre; Senesse, Pierre; Chene, Geneviève; Fonck, Mariane

    2014-01-01

    Objective We tested the effect of dietary advice dedicated to increase intake in older patients at risk for malnutrition during chemotherapy, versus usual care, on one-year mortality. Method We conducted a multicentre, open-label interventional, stratified (centre), parallel randomised controlled trial, with a 1∶1 ratio, with two-year follow-up. Patients were aged 70 years or older treated with chemotherapy for solid tumour and at risk of malnutrition (MNA, Mini Nutritional Assessment 17–23.5). Intervention consisted of diet counselling with the aim of achieving an energy intake of 30 kCal/kg body weight/d and 1.2 g protein/kg/d, by face-to-face discussion targeting the main nutritional symptoms, compared to usual care. Interviews were performed 6 times during the chemotherapy sessions for 3 to 6 months. The primary endpoint was 1-year mortality and secondary endpoints were 2-year mortality, toxicities and chemotherapy outcomes. Results Between April 2007 and March 2010 we randomised 341 patients and 336 were analysed: mean (standard deviation) age of 78.0 y (4·9), 51.2% male, mean MNA 20.2 (2.1). Distribution of cancer types was similar in the two groups; the most frequent were colon (22.4%), lymphoma (14.9%), lung (10.4%), and pancreas (17.0%). Both groups increased their dietary intake, but to a larger extent with intervention (p<0.01). At the second visit, the energy target was achieved in 57 (40.4%) patients and the protein target in 66 (46.8%) with the intervention compared respectively to 13 (13.5%) and 20 (20.8%) in the controls. Death occurred during the first year in 143 patients (42.56%), without difference according to the intervention (p = 0.79). No difference in nutritional status changes was found. Response to chemotherapy was also similar between the groups. Conclusion Early dietary counselling was efficient in increasing intake but had no beneficial effect on mortality or secondary outcomes. Cancer cachexia antianabolism may explain this

  8. Estimated Glomerular Filtration Rate, Cardiovascular Events and Mortality Across Age Groups Among Individuals Older Than 60 Years in Southern Europe.

    Science.gov (United States)

    Salvador-González, Betlem; Gil-Terrón, Neus; Cerain-Herrero, M Jesús; Subirana, Isaac; Güell-Miró, Roser; Rodríguez-Latre, Luisa M; Cunillera-Puértolas, Oriol; Elosua, Roberto; Grau, Maria; Vila, Joan; Pascual-Benito, Luisa; Mestre-Ferrer, Jordi; Ramos, Rafel; Baena-Díez, José Miguel; Soler-Vila, Maria; Alonso-Bes, Eva; Ruipérez-Guijarro, Laura; Álvarez-Funes, Virtudes; Freixes-Villaró, Esther; Rodríguez-Pascual, Mercedes; Martínez-Castelao, Alberto

    2018-06-01

    Individuals with a decreased estimated glomerular filtration rate (eGFR) are at increased risk of all-cause (ACM) and cardiovascular mortality; there is ongoing debate about whether older individuals with eGFR 45 to 59mL/min/1.73 m 2 are also at increased risk. We evaluated the association between eGFR and ACM and cardiovascular events (CVE) in people aged 60 to 74 and ≥ 75 years in a population with a low coronary disease incidence. We conducted a retrospective cohort study by using primary care and hospital electronic records. We included 130 233 individuals aged ≥ 60 years with creatinine measurement between January 1, 2010 and December 31, 2011; eGFR was estimated by using the Chronic Kidney Disease Epidemiology Collaboration creatinine equation. The independent association between eGFR and the risk of ACM and hospital admission due to CVE were determined with Cox and Fine-Gray regressions, respectively. The median was age 70 years, and 56.1% were women; 13.5% had eGFR < 60 (69.7% eGFR 45-59). During a median follow-up of 38.2 months, 6474 participants died and 3746 had a CVE. For ACM and CVE, the HR in older individuals became significant at eGFR < 60. Fully adjusted HR for ACM in the eGFR 45 to 59 category were 1.61; 95%CI, 1.37-1.89 and 1.19; 95%CI, 1.10-1.28 in 60- to 74-year-olds and ≥ 75-year-olds, respectively; for CVE HR were 1.28; 95%CI, 1.08-1.51 and 1.12; 95%CI, 0.99-1.26. In a region with low coronary disease incidence, the risk of death and CVE increased with decreasing eGFR. In ≥ 75-year-olds, the eGFR 45 to 59 category, which had borderline risk for CVE, included many individuals without significant additional risk. Copyright © 2017 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

  9. The Geriatric ICF Core Set reflecting health-related problems in community-living older adults aged 75 years and older without dementia : development and validation

    NARCIS (Netherlands)

    Spoorenberg, Sophie L. W.; Reijneveld, Sijmen A.; Middel, Berrie; Uittenbroek, Ronald J.; Kremer, Hubertus P. H.; Wynia, Klaske

    2015-01-01

    Purpose: The aim of the present study was to develop a valid Geriatric ICF Core Set reflecting relevant health-related problems of community-living older adults without dementia. Methods: A Delphi study was performed in order to reach consensus (70% agreement) on second-level categories from the

  10. The Prevalence and Correlates of Falling Down in the Older Adults Over 55 Years in Shiraz

    Directory of Open Access Journals (Sweden)

    Ali Ghanbary

    2013-04-01

    Full Text Available Objectives: Falling down is one of the most common problems that involve old people. It may affect the physical, emotional and social aspects of individual’s health and may cause economical and social problems for individuals and society. Methods & Materials: In a cross sectional study, 750 old people with ages of 55 or more, living in the city of Shiraz (409 female, 341 male, mean ages 67.32 year with a convenience sampling method took part in this study. A questionnaire was designed to gather the information about the history of falling down on past year, its complications and the possible associated factors. Chi square and Mann_ Witeny test and logistic regression method was used to analyze the study data. Results: the prevalence of falling down was 33.6%. 20.4% of people had single falling down and 13.2% of them had recurrent falling down. There were significant correlations between falling down and age (P=0.016, sex (P<0.001, diabetes (P=0.008, vertigo (P<0.0001. However no significant correlation was found between falling down with arthritis, heart disease, nervous system disease, rheumatologic disease, hypertension and use of cane and glass. There were significant correlation between recurrent falling down and sex (P=0.021, vertigo (P<0.0001 and osteoporosis (P=0.024. Also, use of cane (P=0.023 and arthritis (P=0.048 were associated with falling down with injury. Conclusion: According to results of this study, one third of old people over 55 year living in the community experienced falling down within one year. Diabetes and vertigo increased the risk of falling down in elderly population. Planning for controlling these risk factors can reduce the rate of falling down and its associated problems and complications.

  11. Daily home gardening improved survival for older people with mobility limitations: an 11-year follow-up study in Taiwan.

    Science.gov (United States)

    Lêng, Chhian Hūi; Wang, Jung-Der

    2016-01-01

    To test the hypothesis that gardening is beneficial for survival after taking time-dependent comorbidities, mobility, and depression into account in a longitudinal middle-aged (50-64 years) and older (≥65 years) cohort in Taiwan. The cohort contained 5,058 nationally sampled adults ≥50 years old from the Taiwan Longitudinal Study on Aging (1996-2007). Gardening was defined as growing flowers, gardening, or cultivating potted plants for pleasure with five different frequencies. We calculated hazard ratios for the mortality risks of gardening and adjusted the analysis for socioeconomic status, health behaviors and conditions, depression, mobility limitations, and comorbidities. Survival models also examined time-dependent effects and risks in each stratum contingent upon baseline mobility and depression. Sensitivity analyses used imputation methods for missing values. Daily home gardening was associated with a high survival rate (hazard ratio: 0.82; 95% confidence interval: 0.71-0.94). The benefits were robust for those with mobility limitations, but without depression at baseline (hazard ratio: 0.64, 95% confidence interval: 0.48-0.87) when adjusted for time-dependent comorbidities, mobility limitations, and depression. Chronic or relapsed depression weakened the protection of gardening. For those without mobility limitations and not depressed at baseline, gardening had no effect. Sensitivity analyses using different imputation methods yielded similar results and corroborated the hypothesis. Daily gardening for pleasure was associated with reduced mortality for Taiwanese >50 years old with mobility limitations but without depression.

  12. Sexual activity in Brazilian women aged 50 years or older within the framework of a population-based study.

    Science.gov (United States)

    Valadares, Ana Lúcia Ribeiro; Santos Machado, Vanessa S; da Costa-Paiva, Lúcia S; de Souza, Maria Helena; Osis, Maria José; Pinto-Neto, Aarão M

    2014-03-01

    This study aims to evaluate the prevalence of sexual activity, factors associated with being sexually active, and sexual self-perception in women 50 years or older living in a Brazilian city. This population-based study applied a questionnaire to a random sample of 622 Brazilian women 50 years or older, representative of a population of 131,800 women, to obtain data on sexual activity and women's perception of their sexual life as part of a broader study that dealt with women's health. Associations between sexual activity, women's perception of their sexual life, and demographic, behavioral, and medical characteristics were determined. Overall, 36.7% of the participants reported being sexually active. Of these, 53.5% classified their sexual life as very good or good. Multiple regression analysis showed that the main factors associated with the absence of sexual activity were not having a partner (prevalence ratio [PR], 0.16; 95% CI, 0.12-0.23; P aging (PR, 0.95; 95% CI, 0.94-0.96; P sexually active was associated with the practice of physical activity (PR, 1.20; 95% CI, 1.02-1.41; P = 0.032). A woman's classification of her sexual life as very poor, poor, or fair was associated with current or past use of natural remedies to treat menopausal symptoms (PR, 1.38; 95% CI, 1.06-1.81; P = 0.020). The main factors associated with the absence of sexual activity are not having a sexual partner, aging, and smoking, whereas weekly physical activity is associated with being sexually active. A poorer classification of a woman's sexual life is associated with her having used natural remedies to treat menopausal symptoms.

  13. Perceived effects of health status on sexual activity in women and men older than 50 years.

    Science.gov (United States)

    Rohde, Gudrun; Berg, Kari Hansen; Haugeberg, Glenn

    2014-03-27

    Sexual activity and enjoyment are considered to be important components of quality of life (QOL) for adults of all ages. However, limited data are available on the effects of health status on sexual activity in women and men older than 50 years. Thus, our aim was to explore the perceived effects of health status on sexual activity in women and men older than 50 years. For this purpose we used data from an age and gender matched control study initially designed to study QOL in patients with low-energy wrist fracture. We investigated patients with wrist fractures older than 50 years (n = 181), as well as age- and gender-matched controls (n = 226), who participated in the QOL study. There were minimal differences between patients and controls, thus the groups were pooled (mean age 67 years (8 SD)). Health-related quality of life (HRQOL) was assessed using SF-36 and 15D, and the global quality of life using the Quality of Life Scale (QOLS). To assess perceived effects of health status on sexual activity we used the question on sexuality from the 15D questionnaires. Group comparisons and logistic regression analyses were conducted. The 15D question on sexuality was not answered by 25% of the participants. Health status having a large negative effect on sexual activity was reported by only 13% of the participants. In the multivariate analyses a large negative effect of health status on sexual activity was associated with higher age (60-69 years: OR = 5.7, 95% CI = 1.62-29.2; 70-79 years: OR = 3.60, 95% CI = 0.94-13.9; ≥80 years: OR = 9.04, 95% CI = 1.29-63.4), male gender (OR = 10.8, 95% CI = 3.01-38.9), weight (OR = 1.03, 95% CI = 1.00-1.07), low SF-36 PCS score (OR = 0.88, 95% CI = 0.37-0.93) and a low SF-36 MCS score (OR = 0.92, 95% CI = 0.88-0.96). Only a small proportion of the participants reported their health status to have a large negative effect on sexual activity. Furthermore, health

  14. International collaboration in SSC (or any $4 billion scientific project)

    International Nuclear Information System (INIS)

    Lederman, L.M.

    1988-01-01

    In this paper, the author discusses the superconducting supercollider. This is a project that costs U.S. $4.4 billion. The author spends a short time giving the motivation (which is a scientific motivation) and also giving the idea of how it is possible, with U.S. deficits

  15. Working Paper 5: Beyond Collier's Bottom Billion | IDRC ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    2010-12-16

    Dec 16, 2010 ... The heart of the narrative presented in the book is that a group of almost 60 countries, with a population of about a billion people, are caught in four main traps. Their prospects for escaping the traps are poor, and they need a set of actions from the international community to achieve the rapid rates of growth ...

  16. Cataract surgical coverage rate among adults aged 40 years and older

    Directory of Open Access Journals (Sweden)

    Lusianawaty Tana

    2016-02-01

    Full Text Available Cataract is a leading cause of curable blindness. Hence, in its global declaration of ‘Vision 2020 Right to Sight’, the World Health Organization (WHO encouraged its member countries to address the problem of incident cataract. Many factors are related to the cataract surgical coverage rate, such as gender and diabetes mellitus. The objective of this study was to determine the cataract surgical coverage rate and investigate the determinants factors of cataract surgical coverage rate among adults 40 years old and above with cataract. A cross sectional study was conducted using National Basic Health Research (Riskesdas 2007 data. Cataract surgery was defined as surgery conducted within the last 12 months before the survey was performed. There were 6939 subjects (3105 male, 3834 female who fulfilled the study criteria. The cataract surgical coverage rate was 19.3%. The cataract surgical coverage rate was lower in subjects with low education, in the group of farmers/fishermen/laborers, in the 40-49 years age group, in rural areas, and in subjects of low socioeconomic status (p0.05. Determinants that were related to cataract surgical coverage rate were age, type of area of residence, socioeconomic status, and region of residence (p<0.001. The implementation of educational programs and reforms to local ophthalmic health services may improve the cataract surgical coverage rate.

  17. Compensation claims for occupational noise induced hearing loss between 1998 and 2008: yearly incidence rates and trends in older workers.

    Science.gov (United States)

    Radi, Samia; Benke, Geza; Schaafsma, Frederieke; Sim, Malcolm

    2016-04-01

    To estimate yearly incidence rates for occupational noise induced hearing loss (ONIHL) claims and to describe occupational factors in relation to age for incident cases in Victoria, Australia, between 1998 and 2008. All compensation claims lodged for deafness between 1 July 1998 and 30 June 2008 in the working population covered by the Victorian compensation scheme were analysed. Denominators were provided from 1999-2000 and incidence rates were expressed per 100,000 workers for each financial year. Overall, 81.2% of the 4,518 claims lodged were accepted. Successful claimants were predominantly males (96.5%) and claimants aged 56 to 65 years formed half the overall claims. The number of accepted claims was almost five times higher in 2007-08 than 1998-99. The highest rise was in claimants aged 56 years and above, particularly in those after retirement age. The number of claims and yearly incidence rates (IR) more than doubled over the period (240 claims and IR of 15.1 per 100,000 workers in 1999-2000 versus 669 claims and IR of 34.2 in 2007-08) with a sharp increase from 2004-05 to almost double within one single year and remained at high levels afterwards. The dramatic increase in eligible claims may reflect an increase in awareness of entitlements among workers eligible to make a successful claim. This awareness may be the result of increased opportunities for screening coinciding with changes in regulations. Older workers who worked in smaller workplaces may also be targeted by services providers as they combine occupational noise induced hearing loss (ONIHL) and presbycusis (hearing loss due to age), but this hypothesis needs further evaluation. © 2015 Public Health Association of Australia.

  18. Tolerability and outcomes of radiotherapy or chemoradiotherapy for rectal cancer in elderly patients aged 70 years and older

    International Nuclear Information System (INIS)

    Cai, Xin; Wu, Hongbin; Peng, Junjie; Zhu, Ji; Cai, Sanjun; Cai, Gang; Zhang, Zhen

    2013-01-01

    To assess the safety and outcomes of radiotherapy (RT) or chemoradiotherapy (CRT) in elderly patients (≥70) with rectal cancer. Elderly patients aged 70 and older with rectal cancer, who were treated with RT or CRT at a single institution, were retrospectively analyzed. Performance status (KPS and ECOG score) and comorbidity (Charlson comorbidity index) were calculated, and their correlation with treatment toxicity and overall survival were studied. Risk factors for overall survival were investigated using univariate and multivariate survival analysis. A total of 126 patients with locally advanced disease, local recurrence or synchronous metastasis were included, with a 3-year OS rate of 48.1%. Scheduled dosage of radiation was delivered to 69% of patients. Grade 3 toxicities occurred more often in patients treated with CRT versus RT. The occurrence of grade 3 toxicities was not related to KPS score, ECOG score, number of comorbidities, and Charlson score. Multivariate analysis found that only age and Charlson score were independent prognostic factors for predicting patients’ 3-year OS. The 3-year OS rate was significantly higher in patients with Charlson score <4 vs Charlson score ≥4 (71.1% vs. 26.4%, P=0.0003). Although toxicities may be significant, elderly patients with rectal cancer of varied stages can be safely treated with RT or CRT with careful monitoring and frequent modification of treatment. Except for patients’ age, Charlson comorbidity index may be helpful in assessing patients’ outcomes in elderly patients with rectal cancer

  19. [Reliability of the PRISCUS-PAQ. Questionnaire to assess physical activity of persons aged 70 years and older].

    Science.gov (United States)

    Trampisch, U; Platen, P; Burghaus, I; Moschny, A; Wilm, S; Thiem, U; Hinrichs, T

    2010-12-01

    A questionnaire (Q) to measure physical activity (PA) of persons ≥70 years for epidemiological research is lacking. The aim was to develop the PRISCUS-PAQ and test the reliability in community-dwelling people (≥70 years). Validated PA questionnaires were translated and adapted to design the PRISCUS-PAQ. Its test-retest reliability for 91 randomly selected people (36% men) aged 70-98 (76±5) years ranged from 0.47 (walking) to 0.82 (riding a bicycle). The overall activity score was 0.59 as determined by the intraclass correlation coefficient (ICC). Recording of general activities, e.g., housework (ICC=0.59), was in general less reliable than athletic activities, e.g., gymnastics (ICC=0.76). The PRISCUS-PAQ, which is a short instrument with acceptable reliability to collect the physical activity of the elderly in a telephone interview, will be used to collect data in a large cohort of older people in the German research consortium PRISCUS.

  20. Prognosis after surgical treatment for pancreatic cancer in patients aged 80 years or older: a multicenter study.

    Science.gov (United States)

    Sho, Masayuki; Murakami, Yoshiaki; Kawai, Manabu; Motoi, Fuyuhiko; Satoi, Sohei; Matsumoto, Ippei; Honda, Goro; Uemura, Kenichiro; Yanagimoto, Hiroaki; Kurata, Masanao; Akahori, Takahiro; Kinoshita, Shoichi; Nagai, Minako; Nishiwada, Satoshi; Fukumoto, Takumi; Unno, Michiaki; Yamaue, Hiroki; Nakajima, Yoshiyuki

    2016-03-01

    The optimal therapeutic strategy for very elderly pancreatic cancer patients remains to be determined. The aim of this study was to clarify the role of pancreatic resection in patients 80 years of age or older. A retrospective multicenter analysis of 1401 patients who had undergone pancreatic resection for pancreatic cancer was performed. The patients aged ≥ 80 years (n = 99) were compared with a control group <80 years of age (n = 1302). There were no significant differences in the postoperative complications and mortality between the two groups. However, the prognosis of octogenarians was poorer than that of younger patients for both resectable and borderline resectable tumors. Importantly, there were few long-term survivors in the elderly group, especially among those with borderline resectable pancreatic cancer. A multivariate analysis of the prognostic factors in the very elderly patients indicated that the completion of adjuvant chemotherapy was the only significant factor. In addition, preoperative albumin level was the only independent risk factor for a failure to complete adjuvant chemotherapy. This study demonstrates that the postoperative prognosis in octogenarian patients was not good as that in younger patients possibly due to less frequent completion of adjuvant chemotherapy. © 2016 Japanese Society of Hepato-Biliary-Pancreatic Surgery.

  1. Various distinctive cytogenetic abnormalities in patients with acute myeloid leukaemia aged 60 years and older express adverse prognostic value : results from a prospective clinical trial

    NARCIS (Netherlands)

    van der Holt, Bronno; Breems, Dimitri A.; Beverloo, H. Berna; van den Berg, Eva; Burnett, Alan K.; Sonneveld, Pieter; Lowenberg, Bob

    Diagnostic cytogenetic abnormalities are considered important prognostic factors in patients with acute myeloid leukaemia (AML). However, the prognostic assessments have mainly been derived from patients with AML aged <60 years. Two recent studies of AML patients of 60 years and older proposed

  2. Updated recommendations for use of tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccine in adults aged 65 years and older - Advisory Committee on Immunization Practices (ACIP), 2012.

    Science.gov (United States)

    2012-06-29

    Since 2005, the Advisory Committee on Immunization Practices (ACIP) has recommended a tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccine booster dose for all adolescents aged 11 through 18 years (preferred at 11 through 12 years) and for those adults aged 19 through 64 years who have not yet received a dose. In October 2010, despite the lack of an approved Tdap vaccine for adults aged 65 years and older, ACIP recommended that unvaccinated adults aged 65 years and older be vaccinated with Tdap if in close contact with an infant, and that other adults aged 65 years and older may receive Tdap. In July 2011, the Food and Drug Administration (FDA) approved expanding the age indication for Boostrix (GlaxoSmithKline Biologicals, Rixensart, Belgium) to aged 65 years and older. In February 2012, ACIP recommended Tdap for all adults aged 65 years and older. This recommendation supersedes previous Tdap recommendations regarding adults aged 65 years and older.

  3. Depression, frailty, and all-cause mortality: a cohort study of men older than 75 years.

    Science.gov (United States)

    Almeida, Osvaldo P; Hankey, Graeme J; Yeap, Bu B; Golledge, Jonathan; Norman, Paul E; Flicker, Leon

    2015-04-01

    Depression is associated with increased mortality, but it is unclear if this relationship is truly causal. To determine the relative mortality associated with past and current depression, taking into account the effect of frailty. Prospective longitudinal cohort study of 2565 men aged 75 years or over living in metropolitan Perth, Western Australia, who completed the third wave of assessments of the Health In Men Study throughout 2008. All-cause mortality data were derived from Australian death records up to June 17, 2013. History of past depression and age of onset of symptoms were obtained from direct questioning and from electronic health record linkage. Diagnosis of current major depressive symptoms followed Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision guidelines. We considered that participants were frail if they showed evidence of impairment in 3 or more of the 5 domains on the fatigue, resistance, ambulation, illnesses, and loss of weight (FRAIL) scale. Other measured factors included age, education, living arrangements, smoking and alcohol history, and physical activity. 558 participants died during mean period of follow-up of 4.2 ± 1.1 years. The annual death rate per thousand was 50 for men without depression, 52 for men with past depression, and 201 for men with major depressive symptoms at baseline. The crude mortality hazard was 4.26 (95% confidence interval = 2.98, 6.09) for men with depression at baseline compared with never depressed men, and 1.79 (95% confidence interval = 1.21, 2.62) after adjustment for frailty. Further decline in mortality hazard was observed after adjustment for other measured factors. Current, but not past, depression is associated with increased mortality, and this excess mortality is strongly associated with frailty. Interventions designed to decrease depression-related mortality in later life may need to focus on ameliorating frailty in addition to treating depression. Copyright © 2015

  4. [Use of health services by a population of 60-year olds and older in Mexico].

    Science.gov (United States)

    Borges-Yáñez, S A; Gómez-Dantés, H

    1998-01-01

    To describe the sociodemographic characteristics and determinants of health services utilization by the Mexican population of 60 years of age or more. Information obtained from the National Health Survey II (ENSA-II) allowed analysis of 4,628 elderly people. Prevalence of chronic diseases was analyzed and the determinants of individuals who had used the health services in the two weeks prior to the interview. The chronic diseases most frequently reported were: hypertension, diabetes and heart disease. The utilization and hospitalization rates of that age group were 11.4 and 5.5%, respectively. The services most frequently used were: the private physician, social security (IMSS, ISSSTE) welfare services (Ministry of Health--SSA- and IMSS-Solidaridad). Interestingly, 25 to 45% of social security insurance holders did not use the services, instead they consulted a private physician. The most important explanatory variables for health services utilization were: the perceived illness, not having worked for the previous week and being a social security insurance holder. Gender, area of residence and level of education were not significant in the explanation of health services utilization. This study demonstrates the need to strengthen preventive and support programs for the elderly population, since they only demand health services when they feel sick.

  5. Prognostic value of handgrip strength in people aged 60 years and older: A systematic review and meta-analysis.

    Science.gov (United States)

    Rijk, Joke M; Roos, Paul Rkm; Deckx, Laura; van den Akker, Marjan; Buntinx, Frank

    2016-01-01

    The aim of the present study was to systematically review the literature on the predictive value of handgrip strength as a marker for vulnerability. Furthermore, we aimed to update a recent systematic review on the association between handgrip strength and mortality. Literature searches using Cochrane, PubMed and Embase databases, and searching reference lists of included studies. Eligible studies were observational longitudinal studies presenting handgrip strength at baseline as an independent variable and its association with cognition, depression, mobility, functional status, hospitalization or mortality at follow up in a general population aged 60 years and older. With respect to mortality, we updated a recent systematic review. We included 34 articles. Most of them involved the association between handgrip strength and cognition (n = 9), functional status (n = 12), mobility (n = 6) or mortality (n = 22), and mainly found a positive relationship, meaning that higher handgrip strength at baseline is protective for declines in these outcome measures. Statistical pooling was carried out for functional status and mortality, with a pooled ratio for functional status of 1.78 (95% CI 1.28-2.48) for categorical variables (high vs low handgrip strength) and 0.95 (95% CI 0.92-0.99) for handgrip strength as a continuous variable. The pooled hazard ratio for mortality was 1.79 (95% CI 1.26-2.55) for categorical variables and 0.96 (95% CI 0.93-0.98) for continuous variables. Handgrip strength has a predictive validity for decline in cognition, mobility, functional status and mortality in older community-dwelling populations. © 2015 Japan Geriatrics Society.

  6. Body image and weight control in South Africans 15 years or older: SANHANES-1.

    Science.gov (United States)

    Mchiza, Zandile J; Parker, Whadi-Ah; Makoae, Mokhantso; Sewpaul, Ronel; Kupamupindi, Takura; Labadarios, Demetre

    2015-09-30

    South African studies have suggested that differences in obesity prevalence between groups may be partly related to differences in body image and body size dissatisfaction. However, there has never been a national study that measured body image and its relationship to weight control in the country. Hence, the main aim of the study was to examine body image in relation to body mass index and weight control in South Africa. A cross-sectional survey and a secondary analyses of data were undertaken for 6 411 South Africans (15+ years) participating in the first South African National Health and Nutrition Examination Survey. Body image was investigated in relation to weight status and attempts to lose or gain weight. Data were analysed using STATA version 11.0. Descriptive statistics are presented as counts (numbers), percentages, means, standard error of means, and 95 % confidence intervals. Any differences in values were considered to be significantly different if the confidence intervals did not overlap. Overall, 84.5 % participants had a largely distorted body image and 45.3 % were highly dissatisfied about their body size. Overweight and obese participants under estimated their body size and desired to be thinner. On the other hand, normal- and under-weight participants over estimated their body size and desired to be fatter. Only 12.1 and 10.1 % of participants attempted to lose or gain weight, respectively, mainly by adjusting dietary intake and physical activity. Body mass index appears to influence body image and weight adjustment in South Africa. South Africans at the extreme ends of the body mass index range have a largely distorted body image and are highly dissatisfied by it. This suggests a need for health education and beneficial weight control strategies to halt the obesity epidemic in the country.

  7. The impact of obesity on foot morphology in women aged 48 years or older

    Directory of Open Access Journals (Sweden)

    Kristína Tománková

    2015-06-01

    Full Text Available Background: Obesity is major risk factor for many diseases within society and represents extensive loads for the feet which lead to various foot disorders and deformities. Objective: The aim of this study was to evaluate the impact of obesity as represented by percent body fat (PBF on foot morphology. Methods: The study sample included 139 Czech women aged 48-69 years. The women were divided into two groups by PBF: non-obese women (NOW (n = 66; PBF < 35% and obese women (OW (n = 73; PBF > 35%. Measurements included % PBF and width, length and angle dimensions of foot. The Chippaux-Smirak index (CSI was calculated for each foot. Results: We found significant differences between OW and NOW in these parameters: direct forefoot width (sin. p = .02, rpb = .20, direct heel width (sin. p = .01, rpb = .22; dex. p < .01, rpb = .22, hallux angle (sin. p = .01, rpb = .25 and CSI (sin. p < .01, rpb = .26; dex. p < .01, rpb = .27. The results showed that the mean values of the heel width and CSI were significantly higher in OW on both feet, the mean values of forefoot width only on the left foot. Conclusions: Results proved that obesity impacts all parts of the foot (heel, longitudinal foot arch, forefoot. Despite significant differences of the CSI between NOW and OW, the number of subjects with flat feet was in both groups negligible.

  8. Assessment of the cardiovascular effects of electroconvulsive therapy in individuals older than 50 years

    Directory of Open Access Journals (Sweden)

    Takada J.Y.

    2005-01-01

    Full Text Available To evaluate the impact of electroconvulsive therapy on arterial blood pressure, heart rate, heart rate variability, and the occurrence of ischemia or arrhythmias, 38 (18 men depressive patients free from systemic diseases, 50 to 83 years old (mean: 64.7 ± 8.6 underwent electroconvulsive therapy. All patients were studied with simultaneous 24-h ambulatory blood pressure and Holter monitoring, starting 18 h before and continuing for 3 h after electroconvulsive therapy. Blood pressure, heart rate, heart rate variability, arrhythmias, and ischemic episodes were recorded. Before each session of electroconvulsive therapy, blood pressure and heart rate were in the normal range; supraventricular ectopic beats occurred in all patients and ventricular ectopic beats in 27/38; 2 patients had non-sustained ventricular tachycardia. After shock, systolic, mean and diastolic blood pressure increased 29, 25, and 24% (P < 0.001, respectively, and returned to baseline values within 1 h. Maximum, mean and minimum heart rate increased 56, 52, and 49% (P < 0.001, respectively, followed by a significant decrease within 5 min; heart rate gradually increased again thereafter and remained elevated for 1 h. Analysis of heart rate variability showed increased sympathetic activity during shock with a decrease in both sympathetic and parasympathetic drive afterwards. No serious adverse effects occurred; electroconvulsive therapy did not trigger any malignant arrhythmias or ischemia. In middle-aged and elderly people free from systemic diseases, electroconvulsive therapy caused transitory increases in blood pressure and heart rate and a decrease in heart rate variability but these changes were not associated with serious adverse clinical events.

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

    Science.gov (United States)

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

    2017-08-01

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

  10. [Effects of prophylactic chemotherapy on outcomes and prognosis of patients older than 40 years with invasive mole].

    Science.gov (United States)

    Jiang, S Y; Li, L; Zhao, J; Xiang, Y; Wan, X R; Feng, F Z; Ren, T; Yang, J J

    2017-06-25

    Objective: To discuss the effects of prophylactic chemotherapy on the outcomes and prognosis of invasive mole patients. Methods: One hundred and fifteen invasive mole (IM) patients older than 40 years were registered in Peking Union Medical Collage Hospital.Eleven of them were treated with prophylactic chemotherapy before diagnosed as IM prophylactic chemotherapy group, while the other 104 cases received therapeutic chemotherapy after diagnosed as IM (non-prophylactic chemotherapy group). The general clinical data (including age, clinical stage, risk factor score), treatment, outcomes and relapse of patients were retrospectively compared between two groups. Results: (1) The age of prophylactic chemotherapy group and non-prophylactic chemotherapy group were (47±5) versus (46±4) years old. Ratio of clinical stageⅠ-Ⅱ were 3/11 versus 29.8% (31/104), clinical stage Ⅲ-Ⅳ were 8/11 versus 70.2% (73/104). Ratio of risk factor score 0-6 were 11/11 versus 84.6% (88/104), risk factor score >6 were 0 versus 15.4% (16/104). There were no significant statistical differences between two groups in age, clinical stage or risk factor score (all P> 0.05). (2) Treatment: the total chemotherapy courses between prophylactic chemotherapy group and non-prophylactic chemotherapy group (median 7 versus 5) were significantly different ( Z= 3.071, P= 0.002). There were no significant statistical differences between two groups in the chemotherapy courses until negative conversion of β-hCG, consolidation chemotherapy courses, total therapeutic chemotherapy courses or ratio of hysterectomy (all P> 0.05). (3) Outcomes and relapse: between the prophylactic chemotherapy group and the non-prophylactic chemotherapy group, the complete remission rate were 11/11 versus 98.1%(102/104), the relapse rate were 0 versus 1.0%(1/102). There were no significant difference between the two groups in outcomes or relapse rate ( P> 0.05). Conclusions: Prophylactic chemotherapy does not substantially

  11. [Old and offline? : Findings on the use of the Internet by people aged 65 years and older in Switzerland].

    Science.gov (United States)

    Seifert, Alexander; Schelling, Hans Rudolf

    2016-10-01

    The supply of information and communication is becoming continuously more focused on the Internet. While the age groups up to 64 years have shown a vast increase in the use of the Internet since 1997, intensive use of the Internet by age groups above 64 years lags behind and this is not only the case in Switzerland. Against this background and an interest in finding out more about Internet (non)use of older people, two representative surveys were conducted in Switzerland, one in 2009 and another one in 2014. The data used were acquired throughout Switzerland via a standardized telephone survey. The random sample (2014) consisted of 1037 people aged between 65 and 100 years old. Although the digital divide between the age groups has lessened over the past years, only 55.7 % of the elderly people interviewed were using the Internet in the autumn of 2014. Internet usage differs greatly between age groups. Resources such as education, income and health positively impact actual use of the Internet. Additionally, recommendations from a person's social environment, as well as an affinity for technology and a personal benefit assessment have a positive impact on Internet usage. In particular, security concerns and difficulties of use were mentioned as predominant reasons for the non-use of the Internet. Some of the people questioned felt excluded from society because they did not use the Internet. Internet usage among elderly people depends on individual and social resources, as well as on general attitude towards technology and personal benefit expectations. The exclusion of today's elderly "offliners" should be avoided, even if the digital divide will decrease in the future.

  12. Radiation therapy for stage I-II non-small cell lung cancer in patients aged 75 years and older

    International Nuclear Information System (INIS)

    Furuta, Masaya; Hayakawa, Kazushige; Katano, Susumu

    1996-01-01

    Between 1976 and 1992, 32 patients aged 75 and older with stage I-II non-small cell lung cancer (NSCLC) were given definitive radiation therapy. These patients did not undergo surgery because of old age, poor cardiac/pulmonary condition, or refusal to give consent. The mean age was 79 years, and 11 patients were over 80 years old. The histologic type was squamous cell carcinoma in 25 patients and adenocarcinoma in 7. The clinical T and N stage was T1N0 in 4 patients, T2N0 in 9, and T2N0 in 19. The total dose of radiation therapy given to each patient exceeded 60 Gy using 10-MV X-rays. The treatment was completed in all 32 patients without treatment-related complications. The 2- and 5-year overall actuarial survival rates were 40% and 16%, respectively. Eleven intercurrent deaths occurred, including 7 patients who died of heart disease. The 2- and 5-year cause-specific survival rates were 57% and 36%, respectively. None of the patients developed severe pneumonitis requiring hospitalization. All but three patients received radiation therapy on an inpatient basis. The mean duration of the hospital stay for initial treatment was 56 days, and mean ratio to total survival period (mean 739 days) was 8%. Although many elderly patients have concurrent medical complications such as heart disease and chronic pulmonary disease, the present study showed that elderly patients with clinical stage I-II NSCLC can expert a realistic probability of long-term survival with definitive radiation therapy. (author)

  13. Part-time occlusion therapy for anisometropic amblyopia detected in children eight years of age and older.

    Science.gov (United States)

    Lee, Young Rok; Lee, Ju Youn

    2006-09-01

    To determine the outcome of part-time occlusion therapy in children with anisometropic amblyopia detected after they were 8 years of age. We analyzed 29 eyes with anisometropic amblyopia in children 8 years of age and older. The mean age was 8.79 +/- 0.98 (range 8-12) years old. The subjects whose best-corrected visual acuity (BCVA) did not improve by two lines or better within 2 weeks of wearing glasses full-time were prescribed occlusion therapy for 6 hours a day outside of school hours, along with the instruction to wear glasses full-time. Subjects who complied with occlusion for more than 3 hours a day were considered to comply well. The major component of the anisometropia was hyperopia in 51.7% of the subjects, and hyperopia plus astigmatism was found in 24.1%. The mean pretreatment BCVA score was 0.51 0.23 (LogMAR). Compliance was 89.66%. The mean posttreatment BCVA was 0.03 +/- 0.01 (LogMAR), and the success rate, based on a posttreatment BCVA of 0.1 (LogMAR) and better, was 96.43%. It took an average of 4.79 +/- 3.35 months to reach the desired posttreatment BCVA. The mean posttreatment stereopsis was 79.78 +/- 37.61 seconds of arc. The recurrence rate was 8%. The visual improvement was related to the degree of compliance (p = 0.000). The time taken to reach the posttreatment BCVA was shorter in subjects with a better pretreatment BCVA (p = 0.019), but it did not relate to the compliance (p = 0.366). The most common component of anisometropia detected after 8 years of age was hyperopia. The part-time occlusion therapy, which had been carried out after school hours, was successful in most cases.

  14. Areva - First quarter 2009 revenue climbs 8.5% to 3.003 billion euros

    International Nuclear Information System (INIS)

    2009-04-01

    First quarter 2009 revenue was up 8.5% compared with the same period last year, to 3.003 billion euros. At constant exchange rates and consolidation scope, growth came to 3.9%. Currency translation had a positive impact of 57 million euros over the quarter. Changes in the consolidation scope had an impact of 66 million euros, primarily due to the consolidation of acquisitions made in 2008 in Transmission and Distribution and in Renewable Energies. The growth engines for first quarter revenue were the Reactors and Services division and the Transmission and Distribution division, with growth of 9.2% and 16.1% respectively. Outside France, revenue rose to 2.032 billion euros, compared with 1.857 billion euros in the first quarter of 2008, and represents 68% of total revenue. Orders were steady in the first quarter, particularly in the Front End, which posted several significant contracts with US and Asian utilities, and in Transmission and Distribution, with orders up sharply in Asia and South America. As of March 31, 2009, the group's backlog reached 49.5 billion euros, for 28.3% growth year-on-year, including 31.3% growth in Nuclear and 10.2% in Transmission and Distribution. For the year as a whole, the group confirms its outlook for backlog and revenue growth as well as rising operating income It should be noted that revenue may vary significantly from one quarter to the next in nuclear operations. Accordingly, quarterly data cannot be viewed as a reliable indicator of annual trends

  15. 2016 Billion-Ton Report: Environmental Sustainability Effects of Select Scenarios from Volume 1 (Volume 2)

    Energy Technology Data Exchange (ETDEWEB)

    Efroymson, R. A. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Langholtz, M. H. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Johnson, K. E. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Stokes, B. J. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)

    2017-01-13

    On behalf of all the authors and contributors, it is a great privilege to present the 2016 Billion-Ton Report (BT16), volume 2: Environmental Sustainability Effects of Select Scenarios from volume 1. This report represents the culmination of several years of collaborative effort among national laboratories, government agencies, academic institutions, and industry. BT16 was developed to support the U.S. Department of Energy’s efforts towards national goals of energy security and associated quality of life.

  16. 8-year trends in physical activity, nutrition, TV viewing time, smoking, alcohol and BMI: A comparison of younger and older Queensland adults

    Science.gov (United States)

    Duncan, Mitch J.; Schoeppe, Stephanie; Rebar, Amanda L.; Vandelanotte, Corneel

    2017-01-01

    Lifestyle behaviours significantly contribute to high levels of chronic disease in older adults. The aims of the study were to compare the prevalence and the prevalence trends of health behaviours (physical activity, fruit and vegetable consumption, fast food consumption, TV viewing, smoking and alcohol consumption), BMI and a summary health behaviour indicator score in older (65+ years) versus younger adults (18–65 years). The self-report outcomes were assessed through the Queensland Social Survey annually between 2007–2014 (n = 12,552). Regression analyses were conducted to compare the proportion of older versus younger adults engaging in health behaviours and of healthy weight in all years combined and examine trends in the proportion of younger and older adults engaging in health behaviours and of healthy weight over time. Older adults were more likely to meet recommended intakes of fruit and vegetable (OR = 1.43, 95%CI = 1.23–1.67), not consume fast food (OR = 2.54, 95%CI = 2.25–2.86) and be non-smokers (OR = 3.02, 95%CI = 2.53–3.60) in comparison to younger adults. Conversely, older adults were less likely to meet the physical activity recommendations (OR = 0.86, 95%CI = 0.78–0.95) and watch less than 14 hours of TV per week (OR = 0.65, 95%CI = 0.58–0.74). Overall, older adults were more likely to report engaging in 3, or at least 4 out of 5 healthy behaviours. The proportion of both older and younger adults meeting the physical activity recommendations (OR = 0.97, 95%CI = 0.95–0.98 and OR = 0.94, 95%CI = 0.91–0.97 respectively), watching less than 14 hours of TV per week (OR = 0.96, 95%CI = 0.94–0.99 and OR = 0.94, 95%CI = 0.90–0.99 respectively) and who were a healthy weight (OR = 0.95, 95%CI = 0.92–0.99 and OR = 0.96, 95%CI = 0.94–0.98 respectively) decreased over time. The proportion of older adults meeting the fruit and vegetable recommendations (OR = 0.90, 95%CI = 0.84–0.96) and not consuming fast food (OR = 0.94, 95%CI = 0

  17. Gaia: Science with 1 billion objects in three dimensions

    Science.gov (United States)

    Prusti, Timo

    2018-02-01

    Gaia is an operational satellite in the ESA science programme. It is gathering data for more than a billion objects. Gaia measures positions and motions of stars in our Milky Way Galaxy, but captures many asteroids and extragalactic sources as well. The first data release has already been made and exploitation by the world-wide scientific community is underway. Further data releases will be made with further increasing accuracy. Gaia is well underway to provide its promised set of fundamental astronomical data.

  18. Document de travail 5: Beyond Collier's Bottom Billion | CRDI ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    16 déc. 2010 ... L'ouvrage de Paul Collier, The Bottom Billion, suscite un grand intérêt dans le domaine du développement. Il repose sur la thèse selon laquelle un groupe de près de 60 pays, dont la population totale avoisine un milliard de personnes, sont pris dans quatre pièges principaux.

  19. Cost of solving mysteries of universe: $6.7 billion

    CERN Multimedia

    Overbye, Dennis

    2007-01-01

    "An international consortium of physicists on Thursday released the first detailed design of what they believe will be the next big thing in physics. The machine, 20 miles long, will slam together electrons and their opposites, positrons, to produce fireballs of energy re-creating conditions when the universe was only a trillionth of a second old. It would cost about $6.7 billion." (1 page)

  20. The Mindful Eating Behavior Scale: Development and Psychometric Properties in a Sample of Dutch Adults Aged 55 Years and Older.

    Science.gov (United States)

    Winkens, Laura H H; van Strien, Tatjana; Barrada, Juan Ramón; Brouwer, Ingeborg A; Penninx, Brenda W J H; Visser, Marjolein

    2018-04-11

    Earlier scales on mindful eating do not measure mindful eating independent from emotional or external eating, or mindful eating in common situations. The objective was to develop a new instrument to measure the attention element of mindful eating, the Mindful Eating Behavior Scale (MEBS), and to compute the internal structure, reliabilities, and convergent validity of this scale. A cross-sectional ancillary study within the Longitudinal Aging Study Amsterdam was conducted between fall 2014 and spring 2015. Participants were 1,227 Dutch adults aged 55 years and older from the Longitudinal Aging Study Amsterdam. A selection of 20 items from existing instruments was used to design an initial version of the MEBS. The internal structure of the MEBS was evaluated using an exploratory structural equation modeling approach on half of the sample and confirmatory factor analysis on the whole sample to develop the final version of the scale. The measurement invariance of the scores was tested with respect to sex, age, and body mass index. Reliabilities of subscales were determined with Cronbach's α. To test convergent validity, the scores of the new scale were correlated with theoretically relevant variables. Two items were deleted because of low item loadings and one item because of high correlated uniqueness. The final confirmatory factor analysis model with 17 items and four domains (Focused Eating, Hunger and Satiety Cues, Eating with Awareness, and Eating without Distraction) showed good fit (comparative fit index=0.97, Tucker-Lewis index=0.96, and root mean square error of approximation=0.04). Measurement invariance was found for sex, age, and body mass index. Cronbach's α values were medium to high (.70 to .89). Most correlations were in the expected directions, which indicated good preliminary convergent validity. The MEBS was successfully developed consisting of 17 items and four domains. Because of low interfactor correlations, a total score combining the four

  1. Risk of Injury in Basketball, Football, and Soccer Players, Ages 15 Years and Older, 2003–2007

    Science.gov (United States)

    Carter, Elizabeth A.; Westerman, Beverly J.; Hunting, Katherine L.

    2011-01-01

    Context: A major challenge in the field of sports injury epidemiology is identifying the appropriate denominators for injury rates. Objective: To characterize risk of injury from participation in basketball, football, and soccer in the United States, using hours of participation as the measure of exposure, and to compare these rates with those derived using population estimates in the denominator. Design: Descriptive epidemiology study. Setting: United States, 2003–2007. Participants: People ages 15 years and older who experienced an emergency department–treated injury while playing basketball, football, or soccer. Main Outcome Measure(s): Rates of emergency department–treated injuries resulting from participation in basketball, football, or soccer. Injury rates were calculated for people ages 15 and older for the years 2003–2007 using the U.S. population and hours of participation as the denominators. The risk of injury associated with each of these sports was compared for all participants and by sex. Results: From 2003 through 2007, annual injury rates per 1000 U.S. population were as follows: 1.49 (95% confidence interval [CI] = 1.30, 1.67) in basketball, 0.93 (95% CI = 0.82, 1.04) in football, and 0.43 (95% CI = 0.33, 0.53) in soccer. When the denominator was hours of participation, the injury rate in football (5.08 [95% CI = 4.46, 5.69]/10 000 hours) was almost twice as high as that for basketball (2.69 [95% CI = 2.35, 3.02]/10 000 hours) and soccer (2.69 [95% CI = 2.07, 3.30]/10 000 hours). Conclusions: Depending on the choice of denominator, interpretation of the risk of an emergency department–treated injury in basketball, football, or soccer varies greatly. Using the U.S. population as the denominator produced rates that were highest in basketball and lowest in soccer. However, using hours of participation as a more accurate measure of exposure demonstrated that football had a higher rate of injury than basketball or soccer for both males and

  2. Risk of injury in basketball, football, and soccer players, ages 15 years and older, 2003-2007.

    Science.gov (United States)

    Carter, Elizabeth A; Westerman, Beverly J; Hunting, Katherine L

    2011-01-01

    A major challenge in the field of sports injury epidemiology is identifying the appropriate denominators for injury rates. To characterize risk of injury from participation in basketball, football, and soccer in the United States, using hours of participation as the measure of exposure, and to compare these rates with those derived using population estimates in the denominator. Descriptive epidemiology study. United States, 2003-2007. People ages 15 years and older who experienced an emergency department-treated injury while playing basketball, football, or soccer. Rates of emergency department-treated injuries resulting from participation in basketball, football, or soccer. Injury rates were calculated for people ages 15 and older for the years 2003-2007 using the U.S. population and hours of participation as the denominators. The risk of injury associated with each of these sports was compared for all participants and by sex. From 2003 through 2007, annual injury rates per 1000 U.S. population were as follows: 1.49 (95% confidence interval [CI] = 1.30, 1.67) in basketball, 0.93 (95% CI = 0.82, 1.04) in football, and 0.43 (95% CI = 0.33, 0.53) in soccer. When the denominator was hours of participation, the injury rate in football (5.08 [95% CI = 4.46, 5.69]/10 000 hours) was almost twice as high as that for basketball (2.69 [95% CI = 2.35, 3.02]/10 000 hours) and soccer (2.69 [95% CI = 2.07, 3.30]/10 000 hours). Depending on the choice of denominator, interpretation of the risk of an emergency department-treated injury in basketball, football, or soccer varies greatly. Using the U.S. population as the denominator produced rates that were highest in basketball and lowest in soccer. However, using hours of participation as a more accurate measure of exposure demonstrated that football had a higher rate of injury than basketball or soccer for both males and females.

  3. $35 billion habit: will nuclear cost overruns bankrupt the utilities

    International Nuclear Information System (INIS)

    Morgan, R.E.

    1980-01-01

    The Nuclear Regulatory Commission (NRC) has proposed some 150 modifications in the design and operation of nuclear power plants as a result of the accident at Three Mile Island. The Atomic Industrial Forum estimates the total cost of the NRC's proposed rule changes at $35.5 billion ($3.5 billion in capital costs for the entire industry, and $32 billion in outage and construction-delay costs to the utilities) for existing facilities and for those with construction well underway. The changes range from improved training for reactor workers to a major overhaul of the reactor-containment design. The nuclear industry is asking the NRC to modify the proposals citing excessive costs (like the $100 million changes needed for a plant that cost $17 million to build) and safety (some of the complex regulations may interfere with safety). Financing the changes has become a major problem for the utilities. If the regulators allow all the costs to be passed along to the consumer, the author feels electricity will be too expensive for the consumer

  4. Gender-specific hip fracture risk in community-dwelling and institutionalized seniors age 65 years and older.

    Science.gov (United States)

    Finsterwald, M; Sidelnikov, E; Orav, E J; Dawson-Hughes, B; Theiler, R; Egli, A; Platz, A; Simmen, H P; Meier, C; Grob, D; Beck, S; Stähelin, H B; Bischoff-Ferrari, H A

    2014-01-01

    In this study of acute hip fracture patients, we show that hip fracture rates differ by gender between community-dwelling seniors and seniors residing in nursing homes. While women have a significantly higher rate of hip fracture among the community-dwelling seniors, men have a significantly higher rate among nursing home residents. Differences in gender-specific hip fracture risk between community-dwelling and institutionalized seniors have not been well established, and seasonality of hip fracture risk has been controversial. We analyzed detailed data from 1,084 hip fracture patients age 65 years and older admitted to one large hospital center in Zurich, Switzerland. In a sensitivity analysis, we extend to de-personalized data from 1,265 hip fracture patients from the other two large hospital centers in Zurich within the same time frame (total n = 2,349). The denominators were person-times accumulated by the Zurich population in the corresponding age/gender/type of dwelling stratum in each calendar season for the period of the study. In the primary analysis of 1,084 hip fracture patients (mean age 85.1 years; 78% women): Among community-dwelling seniors, the risk of hip fracture was twofold higher among women compared with men (RR = 2.16; 95% CI, 1.74-2.69) independent of age, season, number of comorbidities, and cognitive function; among institutionalized seniors, the risk of hip fracture was 26% lower among women compared with men (RR = 0.77; 95% CI: 0.63-0.95) adjusting for the same confounders. In the sensitivity analysis of 2,349 hip fracture patients (mean age 85.0 years, 76% women), this pattern remained largely unchanged. There is no seasonal swing in hip fracture incidence. We confirm for seniors living in the community that women have a higher risk of hip fracture than men. However, among institutionalized seniors, men are at higher risk for hip fracture.

  5. Do Arterial Hemodynamic Parameters Predict Cognitive Decline Over a Period of 2 Years in Individuals Older Than 80 Years Living in Nursing Homes? The PARTAGE Study.

    Science.gov (United States)

    Watfa, Ghassan; Benetos, Athanase; Kearney-Schwartz, Anna; Labat, Carlos; Gautier, Sylvie; Hanon, Olivier; Salvi, Paolo; Joly, Laure

    2015-07-01

    Several studies have highlighted a link between vascular alterations and cognitive decline. The PARTAGE study showed that arterial stiffness as evaluated by carotid-femoral pulse wave velocity (cfPWV) was associated with a more pronounced cognitive decline over a 1-year period in very old frail institutionalized individuals. The aim of the present analysis was to assess the role of hemodynamic parameters, such as blood pressure (BP), heart rate (HR), cfPWV, and central/peripheral pulse pressure amplification (PPA) on cognitive decline over 2 years in very old frail individuals. A total of 682 individuals from the PARTAGE study cohort, aged older than 80 years (mean age at inclusion: 87.5 ± 5.0 years) and living in French and Italian nursing homes, were analyzed. Mini-Mental State Examination (MMSE) score was assessed at baseline (BL) and at the end of the first and second year of follow-up (2y-FU). Those with a decrease in MMSE of 3 or more points between BL and 2y-FU were considered as "decliners." The cfPWV and PPA at baseline were assessed with an arterial tonometer. After adjustment for baseline MMSE, HR, body mass index, age, education level, and activities of daily living (ADLs), cfPWV was higher and PPA lower in "decliners" compared with "nondecliners," whereas BP did not differ between the 2 groups. Logistic multivariate analysis also revealed that high cfPWV, low PPA, high HR, and low ADLs were all determinants of MMSE decline. This 2-year longitudinal study in very old institutionalized individuals shows that arterial stiffness and high HR enabled us to identify subjects at higher risk of cognitive decline, whereas BP alone did not appear to have a significant predictive value. These findings highlight the contribution of vascular determinants in cognitive decline even in this very old population. Copyright © 2015 AMDA - The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

  6. Blood pressure and falls in community-dwelling people aged 60 years and older in the VHM&PP cohort.

    Science.gov (United States)

    Klein, Diana; Nagel, Gabriele; Kleiner, Andrea; Ulmer, Hanno; Rehberger, Barbara; Concin, Hans; Rapp, Kilian

    2013-05-21

    Falls are one of the major health problems in old people. Different risk factors were identified but only few epidemiological studies analysed the influence of conventionally measured blood pressure on falls. The objective of our study was to investigate the relationship between systolic and diastolic blood pressure and falls. In 3,544 community-dwelling Austrian women and men aged 60 years and older, data on falls within the previous three months were collected by questionnaire. Blood pressure was measured by general practitioners within the Vorarlberg Health Monitoring and Prevention Programme (VHM&PP) 90 to 1095 days before the fall assessment. A multiple logistic regression analysis was conducted. The models were stratified by gender and adjusted by age, number of medical conditions and subjective feeling of illness. In total, 257 falls in 3,544 persons were reported. In women, high systolic and diastolic blood pressure was associated with a decreased risk of falls. An increase of systolic blood pressure by 10 mmHg and of diastolic blood pressure by 5 mmHg reduced the risk of falling by 9% (OR 0.91, 95% Cl 0.84-0.98) and 8% (OR 0.92, 95% Cl 0.85-0.99), respectively. In men, an increased risk of falls was observed in participants with low systolic or low diastolic blood pressure. Blood pressure was associated with the risk of falls. Hypertensive values decreased the risk in women and low blood pressure increased the risk in men.

  7. Advisory Committee on Immunization Practices Recommended Immunization Schedule for Adults Aged 19 Years or Older - United States, 2018.

    Science.gov (United States)

    Kim, David K; Riley, Laura E; Hunter, Paul

    2018-02-09

    In October 2017, the Advisory Committee on Immunization Practices (ACIP) voted to approve the Recommended Immunization Schedule for Adults Aged 19 Years or Older, United States, 2018. The 2018 adult immunization schedule summarizes ACIP recommendations in two figures and a table of contraindications and precautions for vaccines recommended for adults, and is intended is to assist health care providers in implementing the current ACIP recommendations for vaccinating adults. The schedule can be found at https://www.cdc.gov/vaccines/schedules.* The full ACIP recommendations for each vaccine are available at https://www.cdc.gov/vaccines/hcp/acip-recs/index.html. The 2018 adult immunization schedule has also been approved by the American College of Physicians (https://www.acponline.org), the American Academy of Family Physicians (https://www.aafp.org), the American College of Obstetricians and Gynecologists (https://www.acog.org), and the American College of Nurse-Midwives (http://www.midwife.org). The ACIP-recommended use of each vaccine is developed after an in-depth review of vaccine-related data, including data on disease epidemiology, vaccine efficacy and effectiveness, vaccine safety, feasibility of program implementation, and economic aspects of immunization policy (1).

  8. Minimally Invasive Treatment of Displaced Proximal Humeral Fractures in Patients Older Than 70 Years Using the Humerusblock

    Directory of Open Access Journals (Sweden)

    Robert Bogner

    2016-01-01

    Full Text Available Background. Surgical treatment of proximal humeral fractures (PHF in osteoporotic bone of elderly patients is challenging. The aim of this retrospective study was to evaluate the clinical and radiological outcome after percutaneous reduction and internal fixation of osteoporotic PHF in geriatric patients using the semirigid Humerusblock device. Methods. In the study period from 2005 to 2010, 129 patients older than 70 years were enrolled in the study. After a mean follow-up of 23 months, a physical examination, using the Constant-Murley score and the VAS pain scale, was performed. Furthermore radiographs were taken to detect signs of malunion, nonunion, and avascular necrosis. Results. The recorded Constant-Murley score was 67.7 points (87.7% of the noninjured arm for two-part fractures, 67.9 points (90.8% for three-part fractures, and 43.0 points (56.7% for four-part fractures. In ten shoulders (7.8% loss of reduction and in four shoulders (3.1% nonunion were the reason for revision surgery. Avascular humeral head necrosis developed in eight patients (6.2%. Conclusions. In two- and three-part fractures postoperative results are promising. Sufficient ability for the activities of daily living was achieved. In four-part fractures the functional results were less satisfying regarding function and pain with a high postoperative complication rate. In those patients other treatment strategies should be considered. Study design. Therapeutic retrospective case series (evidence-based medicine (EBM level IV.

  9. Multidimensional construct of life satisfaction in older adults in Korea: a six-year follow-up study.

    Science.gov (United States)

    Lim, Hyun Ja; Min, Dae Kee; Thorpe, Lilian; Lee, Chel Hee

    2016-11-28

    Aging raises wide-ranging issues within social, economic, welfare, and health care systems. Life satisfaction (LS) is regarded as an indicator of quality of life which, in turn, is associated with mortality and morbidity in older adults. The objective of this study was to identify the relevant predictors of life satisfaction and to investigate changes in a multidimensional construct of LS over time. This analysis utilized data from the large-scale, nationally representative Korean Retirement and Income Study (KReIS), a longitudinal survey conducted biennially from 2005 to 2011. Outcome measures were degree of satisfaction with health, economic status, housing, neighbor relationships, and family relationships. GEE models were used to investigate changes in satisfaction within each of the five domains. Of a total 3531 individuals aged 65 or older, 2083 (59%) were women, and the mean age was 72 (s.d = ±6) years. The majority had a spouse (60.8%) and lived in a rural area (58%). Analysis showed that physical and mental health were consistently and significantly associated with satisfaction in each of the domains after adjusting for potential confounders. Living in a rural area and living with a spouse were related to satisfaction with economic, housing, family relationships, and neighbor relationships compared to living in urban areas and living without a spouse; the only outcome that did not show relationship to these predictors was health satisfaction. Female and rural residents reported greater economic satisfaction compared to male and urban residents. Living in an apartment was associated with 1.32 times greater odds of economic satisfaction compared to living in a detached house (95% CI: 1.14-1.53; p satisfaction was also 1.62 times more likely among individuals living with a spouse compared to single households (95% CI: 1.35-1.96; p satisfaction with family relationships. Our study indicates that a single domain of LS or overall LS will miss many

  10. LLNL's Big Science Capabilities Help Spur Over $796 Billion in U.S. Economic Activity Sequencing the Human Genome

    Energy Technology Data Exchange (ETDEWEB)

    Stewart, Jeffrey S. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States)

    2015-07-28

    LLNL’s successful history of taking on big science projects spans beyond national security and has helped create billions of dollars per year in new economic activity. One example is LLNL’s role in helping sequence the human genome. Over $796 billion in new economic activity in over half a dozen fields has been documented since LLNL successfully completed this Grand Challenge.

  11. Effects of a one year physical activity program on serum C Terminal Agrin Fragment (CAF) concentrations among mobility limited older adults

    Science.gov (United States)

    OBJECTIVES: C terminal Agrin Fragment (CAF) has been proposed as a potential circulating biomarker for predicting changes in physical function among older adults. To determine the effect of a one year PA intervention on changes in CAF concentrations and to evaluate baseline and longitudinal associat...

  12. Cognitive performance in depressed older persons : the impact of vascular burden and remission. A two-year follow-up study

    NARCIS (Netherlands)

    Zuidersma, Marij; Comijs, Hannie C.; Naarding, Paul; Oude Voshaar, Richard C.

    Objectives: Depression is associated with an increased risk of cognitive decline. The present study compared two-year change in cognitive performance between depressed older persons and a non-depressed control group, between remitted and non-remitted patients, and evaluated whether vascular burden

  13. Attempted suicide in the elderly: characteristics of suicide attempters 70 years and older and a general population comparison group.

    Science.gov (United States)

    Wiktorsson, Stefan; Runeson, Bo; Skoog, Ingmar; Ostling, Svante; Waern, Margda

    2010-01-01

    To identify factors associated with attempted suicide in the elderly. Social, psychological, and psychiatric characteristics were compared in suicide attempters (70 years and older) and a representative population sample. Emergency departments at five hospitals in western Sweden and a representative sample of the elderly population. Persons with Mini Mental State Examination (MMSE) score age 80 years). Comparison subjects matched for gender and age group (N = 408) were randomly selected among participants in our general population studies. Symptoms were rated with identical instruments in cases and comparison subjects. The examination included the MMSE and tests of short- and long-term memory, abstract thinking, aphasia, apraxia, and agnosia. Depressive symptomatology was measured using the Montgomery-Asberg Depression Rating Scale, and major and minor depressions were diagnosed according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, using symptom algorithms. Factors associated with attempted suicide included being unmarried, living alone, low education level, history of psychiatric treatment, and previous suicide attempt. There was no association with dementia. Odds ratios were increased for both major (odds ratio [OR]: 47.4, 95% confidence interval [CI]: 19.1-117.7) and minor (OR: 2.6, 95% CI: 1.5-4.7) depressions. An association was observed between perceived loneliness and attempted suicide; this relationship was independent of depression (OR: 2.8, 95% CI: 1.3-6.1). Observed associations mirrored those previously shown for completed suicide. Results may help to inform clinical decisions regarding suicide risk evaluation in this vulnerable and growing age group.

  14. Diabetes and diabetic retinopathy in people aged 50 years and older in the Republic of Suriname.

    Science.gov (United States)

    Minderhoud, Janna; Pawiroredjo, Jerrel C; Bueno de Mesquita-Voigt, Anne-Marie T; Themen, Herman Ci; Siban, Michael R; Forster-Pawiroredjo, Cindy M; Limburg, Hans; van Nispen, Ruth Ma; Mans, Dennis Ra; Moll, Annette C

    2016-06-01

    Population-based surveys on diabetes and diabetic retinopathy (DR) are necessary to increase awareness and develop screening and therapeutic programmes. The aim was to estimate the prevalence of DR in older adults of different ethnic backgrounds in Suriname. Fifty clusters of 60 people aged ≥50 years were randomly selected with a probability proportional to the size of the population unit. Eligible people were randomly selected through compact segment sampling and examined using the Rapid Assessment of Avoidable Blindness plus Diabetic Retinopathy (RAAB + DR) protocol. Participants were classified as having diabetes if they: were previously diagnosed with diabetes; were receiving treatment for glucose control; had a random blood glucose level >200 mg/dL. These participants were dilated for funduscopy, assessed for DR following the Scottish DR grading protocol and evaluated for ethnicity and DR ophthalmic screening frequencies. A total of 2806 individuals was examined (response 93.6%). The prevalence of diabetes was 24.6%. In these patients any type of DR and/or maculopathy occurred in 21.6% and sight-threatening DR in 8.0%. Of the known diabetics, 34.2% never had an eye examination for DR and in 13.0% the last examination was >24 months ago. The prevalence of diabetes was significantly higher in Hindustani people compared with other major ethnic groups. The prevalence of diabetes and diabetics without regular DR control in people aged ≥50 years in Suriname was higher than expected. The uptake for special services for DR has to be expanded to decrease patient delay and DR-induced blindness. 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/

  15. Risk of venous thromboembolism following influenza vaccination in adults aged 50years and older in the Vaccine Safety Datalink.

    Science.gov (United States)

    Vickers, Elizabeth R; McClure, David L; Naleway, Allison L; Jacobsen, Steven J; Klein, Nicola P; Glanz, Jason M; Weintraub, Eric S; Belongia, Edward A

    2017-10-13

    Influenza-like illness and inflammation are known risk factors for venous thromboembolism (VTE), which includes deep vein thrombosis (DVT) and pulmonary embolism (PE). However, few studies have characterized the risk of VTE following influenza vaccination. We examined VTE risk after vaccination in adults 50years old and older within the Vaccine Safety Datalink (VSD). We used the self-controlled case series method to determine the risk of VTE among age-eligible adults who received influenza vaccine (with or without pandemic H1N1) and experienced a VTE during the months of September through December in 2007 through 2012. Presumptive VTE cases were identified among VSD participants using diagnostic codes, diagnostic tests, and oral anticoagulant prescription. Potential cases were validated by medical record review. The VTE incidence rate ratio was calculated among confirmed cases for the risk window 1 to 10days after vaccination relative to all other person-time from September through December. Of the 1,488 presumptive cases identified, 508 were reviewed, of which 492 (97%) were confirmed cases of VTE. The analysis included 396 incident, confirmed cases. Overall, there was no increased risk of VTE in the 1 to 10days after influenza vaccination (IRR=0.89, 95% CI 0.69-1.17) compared to the control period. Results were similar when all person-time was censored before vaccination. A post hoc analysis showed an increased risk among current tobacco smokers (IRR=2.57, 95% CI 1.06-6.23). No clustering of VTE was observed in the 1-42days after vaccination. Overall, there was no evidence that inactivated influenza vaccine was associated with VTE in adults ≥50years old. An increased risk was found among current smokers in a post hoc analysis. These findings are consistent with previous research and support the safety of annual vaccination in this population. Copyright © 2017 Elsevier Ltd. All rights reserved.

  16. Association between sarcopenia with lifestyle and family function among community-dwelling Chinese aged 60 years and older.

    Science.gov (United States)

    Hai, Shan; Wang, Hui; Cao, Li; Liu, Ping; Zhou, Jianghua; Yang, Ying; Dong, Birong

    2017-08-18

    Sarcopenia is defined as the age-related decline in skeletal muscle mass and function. The risk factors and causes of sarcopenia must be identified to develop prevention and treatment strategies for this syndrome. Our aim was to examine the association between sarcopenia with lifestyle and family function among community-dwelling Chinese people aged 60 years and older. We conducted this study to evaluate sarcopenia among 834 community-dwelling Chinese individuals aged ≥60 years using the Asian Working Group for Sarcopenia (AWGS) criteria. The sociodemographic characteristics, food consumption patterns, habits of smoking, and alcohol consumption of the participants were collected using a general questionnaire, whereas physical activity was assessed using the International Physical Activity Questionnaire (IPAQ; long-form version). Family function was assessed using the Family APGAR scale. In addition, the association of sarcopenia with lifestyle and family function was examined using univariate and multivariate analyses. The total prevalence rate of sarcopenia was 10.6%. Female participants with sarcopenia had a lower frequency per week of nut consumption than those without sarcopenia (p sarcopenia versus those without sarcopenia were not significant. Among the participants, the mean Family APGAR score was 8 (standard deviation [SD] = 0.92). For both sexes, participants with sarcopenia had lower family function scores than those without sarcopenia. In the multivariate model, after adjustment for all covariates, frequency per week of nut consumption (adjusted OR 0.724, 95% CI 0.532-0.985, P sarcopenia. The relationship between other lifestyle habits and sarcopenia was not significant. There was significant association between sarcopenia with intake of nuts and family function. Further studies should evaluate if adequate intake of nuts and a well-functioning family may be effective in lowering the risk of sarcopenia.

  17. Secondhand smoke exposure at home among one billion children in 21 countries: findings from the Global Adult Tobacco Survey (GATS).

    Science.gov (United States)

    Mbulo, Lazarous; Palipudi, Krishna Mohan; Andes, Linda; Morton, Jeremy; Bashir, Rizwan; Fouad, Heba; Ramanandraibe, Nivo; Caixeta, Roberta; Dias, Rula Cavaco; Wijnhoven, Trudy M A; Kashiwabara, Mina; Sinha, Dhirendra N; Tursan d'Espaignet, Edouard

    2016-12-01

    Children are vulnerable to secondhand smoke (SHS) exposure because of limited control over their indoor environment. Homes remain the major place where children may be exposed to SHS. Our study examines the magnitude, patterns and determinants of SHS exposure in the home among children in 21 countries (19 low-income and middle-income countries and 2 high-income countries). Global Adult Tobacco Survey (GATS) data, a household survey of people 15 years of age or older. Data collected during 2009-2013 were analysed to estimate the proportion of children exposed to SHS in the home. GATS estimates and 2012 United Nations population projections for 2015 were also used to estimate the number of children exposed to SHS in the home. The proportion of children younger than 15 years of age exposed to SHS in the home ranged from 4.5% (Panama) to 79.0% (Indonesia). Of the approximately one billion children younger than 15 years of age living in the 21 countries under study, an estimated 507.74 million were exposed to SHS in the home. China, India, Bangladesh, Indonesia and the Philippines accounted for almost 84.6% of the children exposed to SHS. The prevalence of SHS exposure was higher in countries with higher adult smoking rates and was also higher in rural areas than in urban areas, in most countries. A large number of children were exposed to SHS in the home. Encouraging of voluntary smoke-free rules in homes and cessation in adults has the potential to reduce SHS exposure among children and prevent SHS-related diseases and deaths. 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. Beliefs concerning death, dying, and hastening death among older, functionally impaired Dutch adults : A one-year longitudinal study

    NARCIS (Netherlands)

    Sullivan, M.; Ormel, J.; Kempen, G.I J M; Tymstra, T.

    1998-01-01

    OBJECTIVES: Population surveys have documented increasing public support for euthanasia and assisted suicide but have not focused on the population of chronically ill older persons, obtained detailed sociocultural or health status information, or performed repeat assessments. This study seeks to

  19. Changes in white matter as determinant of global functional decline in older independent outpatients: three year follow-up of LADIS (leukoaraiosis and disability) study cohort

    DEFF Research Database (Denmark)

    Inzitari, Domenico; Pracucci, Giovanni; Poggesi, Anna

    2009-01-01

    OBJECTIVE: To assess the impairment in daily living activities in older people with age related changes in white matter according to the severity of these changes. DESIGN: Observational data collection and follow-up of a cohort of older people undergoing brain magnetic resonance imaging after non-disabling...... complaints. SETTING: 11 European centres. PARTICIPANTS: 639 non-disabled older patients (mean age 74.1 (SD 5.0), 45.1% men) in whom brain magnetic resonance imaging showed mild, moderate, or severe age related changes in white matter (Fazekas scale). Magnetic resonance imaging assessment also included...... cerebral infarcts and atrophy. MAIN OUTCOME MEASURE: Transition from no disability (defined as a score of 0 or 1 on the instrumental activities of daily living scale) to disability (score >/=2) or death over three year follow-up. Secondary outcomes were incident dementia and stroke. RESULTS: Over a mean...

  20. Older siblings, pets and early life infections: impact on gut microbiota and allergy prevalence during the first three years of life

    DEFF Research Database (Denmark)

    Laursen, Martin Frederik; Zachariassen, Gitte; Bahl, Martin Iain

    Background: Early life infections and presence of older siblings or pets in the household are factors known to affect the risk of developing allergic diseases, and this effect is suggested to be mediated by interactions between microbes and the immune system. However, very limited research has been...... done on the effect of these factors on the developing gut microbiota in infants. Thus, we aimed to elucidate associations between older siblings, pets and early life infections, the microbial gut communities at 9 and 18 months of age and the prevalence of allergies in three year old children. Methods...... of respiratory allergy, eczema and presence of older siblings, pets and early life infections, previously collected through interviews with parents, were compared to the obtained data on bacterial taxonomy. Results: Early life infections were positively associated with the risk of developing respiratory allergy...

  1. Knee pain and future self-reliance in older adults: evidence from a community-based 3-year cohort study in Japan.

    Science.gov (United States)

    Nishiwaki, Yuji; Michikawa, Takehiro; Yamada, Mutsuko; Eto, Norihito; Takebayashi, Toru

    2011-01-01

    Although knee pain is common in older persons and can cause ambulatory limitation, its impact on self-reliance has rarely been examined in Japan, particularly in a community setting. The aim of this 3-year cohort study was to investigate the association of knee pain with dependence in activities of daily living (ADL) and mortality in community-dwelling older Japanese adults. In 2005, presence of knee pain was assessed by a home visit survey of 1391 older adults aged 65 years or older (participation proportion = 97.3%). A total of 1265 participants who were ADL-independent at baseline were followed for 3 years, and information on outcomes, namely death and dependence in ADL, was collected. Participants who always had knee pain were more likely to become dependent in ADL than those who reported no knee pain (multivariate-adjusted OR, 1.98; 95% CI, 1.03-3.83); however, always having knee pain was not associated with mortality or a composite outcome of ADL dependence and death. Further analyses of each component of ADL dependence revealed that knee pain was associated with a need for assistance at home (long-term care eligibility, bathing, dressing, and transferring), but not with institutionalization. The participants were highly representative of the target population and the rate of follow-up was almost perfect (99.4%). The results suggest that knee pain is associated with future dependence in ADL, particularly a need for assistance at home.

  2. Car seat inspection among children older than 3 years: Using data to drive practice in child passenger safety.

    Science.gov (United States)

    Kroeker, Amber M; Teddy, Amy J; Macy, Michelle L

    2015-09-01

    Motor vehicle crashes are the leading cause of unintentional death and disability among children 4 years to 12 years of age in the United States. Despite the high risk of injury from motor vehicle crashes in this age group, parental awareness and child passenger safety programs in particular may lack focus on this age group. This is a retrospective cross-sectional analysis of child passenger safety seat checklist forms from two Safe Kids coalitions in Michigan (2013) to identify restraint type upon arrival to car seat inspections. Other variables were included if the coalition provided a new child safety seat and if the child had a sibling who underwent a car seat inspection. χ statistics were used to compare change in restraint use on arrival and at departure, the proportion of children attending a car seat inspection event by age, the age category of children by site, the proportion of children with siblings also undergoing a car seat inspection by age, and the distribution of a new child safety seat by age. Data were available from 1,316 Safe Kids Huron Valley and 3,215 Safe Kids Greater Grand Rapids car seat inspections. Just 10.8% of the total seats inspected were booster seats. Child safety seats for infant and young children were more commonly inspected (rear-facing carrier [40.3%], rear-facing convertible [10.2%], and forward-facing [19.3%] car seats). Few children at inspections used a seat belt only (5.4%) or had no restraint (13.8%). Children 4 years and older were found to be in a suboptimal restraint at least 30% of the time. Low proportions of parents use car seat inspections for children in the booster seat age group. The proportion of children departing the inspection in a more protective restraint increased with increasing age. This highlights an area of weakness in child passenger safety programs and signals an opportunity to strengthen efforts on The Booster Age Child. Epidemiologic/prognostic study, level III.

  3. A 17-billion-solar-mass black hole in a group galaxy with a diffuse core.

    Science.gov (United States)

    Thomas, Jens; Ma, Chung-Pei; McConnell, Nicholas J; Greene, Jenny E; Blakeslee, John P; Janish, Ryan

    2016-04-21

    Quasars are associated with and powered by the accretion of material onto massive black holes; the detection of highly luminous quasars with redshifts greater than z = 6 suggests that black holes of up to ten billion solar masses already existed 13 billion years ago. Two possible present-day 'dormant' descendants of this population of 'active' black holes have been found in the galaxies NGC 3842 and NGC 4889 at the centres of the Leo and Coma galaxy clusters, which together form the central region of the Great Wall--the largest local structure of galaxies. The most luminous quasars, however, are not confined to such high-density regions of the early Universe; yet dormant black holes of this high mass have not yet been found outside of modern-day rich clusters. Here we report observations of the stellar velocity distribution in the galaxy NGC 1600--a relatively isolated elliptical galaxy near the centre of a galaxy group at a distance of 64 megaparsecs from Earth. We use orbit superposition models to determine that the black hole at the centre of NGC 1600 has a mass of 17 billion solar masses. The spatial distribution of stars near the centre of NGC 1600 is rather diffuse. We find that the region of depleted stellar density in the cores of massive elliptical galaxies extends over the same radius as the gravitational sphere of influence of the central black holes, and interpret this as the dynamical imprint of the black holes.

  4. Does Playing Sports Video Games Predict Increased Involvement in Real-Life Sports Over Several Years Among Older Adolescents and Emerging Adults?

    Science.gov (United States)

    Adachi, Paul J C; Willoughby, Teena

    2016-02-01

    Given the extreme popularity of video games among older adolescents and emerging adults, the investigation of positive outcomes of video game play during these developmental periods is crucial. An important direction for research in this area is the investigation of a link between sports video game play and involvement in real-life sports among youth. Yet, this association has not been examined in the long-term among older adolescents and emerging adults, and thus represents an exciting new area for discovery. The primary goal of the current study, therefore, was to examine the long-term association between sports video game play and involvement in real-life sports clubs among older adolescents and emerging adults. In addition, we examined whether self-esteem was an underlying mechanism of this longitudinal association. We surveyed older adolescents and emerging adults (N = 1132; 70.6 % female; M age = 19.06 years, range of 17-25 years at the first assessment) annually over 3 years about their video game play, self-esteem, and involvement in real-life sports. We found a long-term predictive effect of sports video game play on increased involvement in real-life sports over the 3 years. Furthermore, we demonstrated that self-esteem was an underlying mechanism of this long-term association. Our findings make an important contribution to an emerging body of literature on the positive outcomes of video game play, as they suggest that sports video game play may be an effective tool to promote real-life sports participation and physical activity among older adolescents and emerging adults.

  5. Associations of dietary protein intake on subsequent decline in muscle mass and physical functions over four years in ambulant older Chinese people.

    Science.gov (United States)

    Chan, R; Leung, J; Woo, J; Kwok, T

    2014-01-01

    To examine the association of dietary protein intake with 4-year change in physical performance measures and muscle mass in Chinese community-dwelling older people aged 65 and older in Hong Kong. Prospective cohort study design. Hong Kong, People's of Republic of China. There were 2,726 (1411 male, 1315 female) community-dwelling older people aged 65 and older. Baseline total, animal and vegetable protein intakes were collected using a validated food frequency questionnaire. Relative protein intake expressed as g/kg body weight was calculated and divided into quartiles for data analysis. Baseline and 4-year physical performance measures (normal and narrow 6-meters walking speed and step length in a 6-meters walk) were measured and 4-year change in appendicular skeletal muscle mass (ASM) from baseline was assessed by dual-energy X-ray absorptiometry. Univariate analysis identified age and sex as significant factors associated with change in physical performance measures or ASM, thus adjustments for these factors were made for subsequent analysis of covariance. Median relative total protein intake was 1.3 g/kg body weight in men and 1.1 g/kg body weight in women. After adjustment for age and sex, relative total protein intake and animal protein intake were not associated with change in physical performance measures and ASM. In contrast, participants in the highest quartile (>0.72 g/kg body weight) of relative vegetable protein intake lost significantly less ASM over 4-year than those in the lowest quartile of relative vegetable protein intake (physical performance measures. Higher protein intake from vegetable source was associated with reduced muscle loss in Chinese community-dwelling older people in Hong Kong whereas no association between total and animal protein intake and subsequent decline in muscle mass or physical performance measures was observed in this sample.

  6. The Boring Billion, a slingshot for Complex Life on Earth.

    Science.gov (United States)

    Mukherjee, Indrani; Large, Ross R; Corkrey, Ross; Danyushevsky, Leonid V

    2018-03-13

    The period 1800 to 800 Ma ("Boring Billion") is believed to mark a delay in the evolution of complex life, primarily due to low levels of oxygen in the atmosphere. Earlier studies highlight the remarkably flat C, Cr isotopes and low trace element trends during the so-called stasis, caused by prolonged nutrient, climatic, atmospheric and tectonic stability. In contrast, we suggest a first-order variability of bio-essential trace element availability in the oceans by combining systematic sampling of the Proterozoic rock record with sensitive geochemical analyses of marine pyrite by LA-ICP-MS technique. We also recall that several critical biological evolutionary events, such as the appearance of eukaryotes, origin of multicellularity & sexual reproduction, and the first major diversification of eukaryotes (crown group) occurred during this period. Therefore, it appears possible that the period of low nutrient trace elements (1800-1400 Ma) caused evolutionary pressures which became an essential trigger for promoting biological innovations in the eukaryotic domain. Later periods of stress-free conditions, with relatively high nutrient trace element concentration, facilitated diversification. We propose that the "Boring Billion" was a period of sequential stepwise evolution and diversification of complex eukaryotes, triggering evolutionary pathways that made possible the later rise of micro-metazoans and their macroscopic counterparts.

  7. The intention of Dutch general practitioners to offer vaccination against pneumococcal disease, herpes zoster and pertussis to people aged 60 years and older.

    Science.gov (United States)

    Lehmann, Birthe A; Eilers, Renske; Mollema, Liesbeth; Ferreira, José; de Melker, Hester E

    2017-06-07

    Increasing life expectancy results in a larger proportion of older people susceptible to vaccine preventable diseases (VPDs). In the Netherlands, influenza vaccination is routinely offered to people aged 60 years and older. Vaccination against pneumococcal disease, herpes zoster and pertussis is rarely used. These vaccines will be evaluated by the Dutch Health Council and might be routinely offered to older people in the near future. Possible expansion of the program depends partly on the willingness of general practitioners (GPs) to endorse additional vaccinations. In this study, we assessed predictors of GPs' attitude and intention to vaccinate people aged 60 years and older. GPs (N = 12.194) were invited to fill in an online questionnaire consisting of questions about social cognitive factors that can influence the willingness of GPs to vaccinate people aged 60 years and older, including underlying beliefs, practical considerations of adding more vaccines to the national program, demographics, and GPs' patient population characteristics. The questionnaire was filled in by 732 GPs. GPs were positive both about vaccination as a preventive tool and the influenza vaccination program, but somewhat less positive about expanding the current program. Prediction analysis showed that the intention of GPs to offer additional vaccination was predicted by their attitude towards offering additional vaccination, towards vaccination as a preventive tool, towards offering vaccination during an outbreak and on GPs opinion regarding suitability to offer additional vaccination (R 2  = 0.60). The attitude of GPs towards offering additional vaccination was predicted by the perceived severity of herpes zoster and pneumonia, as well as the perceived incidence of herpes zoster. Severity of diseases was ranked as important argument to recommend vaccination, followed by effectiveness and health benefits of vaccines. Providing GPs with evidence-based information about the severity

  8. Physical functions, health-related outcomes, nutritional status, and blood markers in community-dwelling cancer survivors aged 75 years and older.

    Science.gov (United States)

    Ihira, Hikaru; Mizumoto, Atsushi; Makino, Keitarou; Yasuda, Keisuke; Yoko, Yoko; Saitoh, Shigeyuki; Ohnishi, Hirofumi; Furuna, Taketo

    2014-01-01

    A cancer survivor is defined as anyone who has been diagnosed with cancer, from the time of diagnosis through the rest of their life. The purpose of this study was to examine whether physical functions, health-related outcomes, nutritional status and blood markers in community-dwelling cancer survivors aged 75 years and older are different from those who do not have cancer Two hundred seventy-five participants were asked by physicians, nurses, and physical therapists, questions regarding cancer history in a face-to-face interview. Data were collected for demographic information, physical functions, such as handgrip strength, knee extension power, abdominal muscle strength, static standing balance, walking speed and the timed-up-and-go test, health-related outcomes, nutritional status, and blood markers. The measured parameters of survivor diagnosed with cancer were compared with those without a history of cancer. Thirty-seven older adults were previously diagnosed with cancer. Female cancer survivors had lower knee extension power (pcancer. In men, none of the measured parameters were significantly different between cancer survivors and older men with no history of cancer. The present study shows that partial physical function of women cancer survivors aged 75 years and older differs from that in women with no history of cancer.

  9. Physical activity (PA) and the disablement process: a 14-year follow-up study of older non-disabled women and men.

    Science.gov (United States)

    Schultz-Larsen, Kirsten; Rahmanfard, Naghmeh; Holst, Claus

    2012-01-01

    Few studies have explored the associations of reported PA (RPA) with the processes underlying the development of disability. The present study was performed to explore RPA among older persons and its association with onset of functional dependence and mortality. Among a probability sample of 1782 community-living persons, aged 75-83 years, we evaluated the 1021 who reported no disability in basic activities of daily living. Participants were followed for a median of 8.34 years in public registers to determine onset of disability and mortality. RPA predicted mortality in older women (HR=1.77, 95%CI=1.42-2.19) and men (HR=1.65, 95%CI=1.27-2.14) over long time intervals. The effect of RPA persisted among permanently disabled older women, after adjusting for age, baseline vulnerability and grade of disability. Low RPA was independently associated with risk of incident disability (HR=1.56, 95%CI=1.10-2.23) in men. Among older women, the association between RPA and incidence of disability was attenuated in analyses that controlled for baseline mobility function. Thus, the association between physical activity and mortality reflected processes different from those underlying a simple relation between physical activity, disability and mortality. Physical activity was an ubiquitous predictor of longevity, but only for women. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  10. Life styles related to coronary artery disease in Saudi males older than 12 years of age life styles related to coronary artery disease in Saudi males older than 12 years of age

    International Nuclear Information System (INIS)

    AlTurki, Yousef Abdullah

    2007-01-01

    The present study highlighted life styles related to coronary artery disease risk factors among patients attending a primary care clinic at King Khalid University Hospital, in Riyadh, Saudi Arabia Methods: We conducted a cross-sectional study at a primary care clinic at King Khalid University Hospital, Riyadh, Saudi Arabia, during the period from 18/4/2006 to 13/6/2006. All adult male patients older than 12 years of age who attended one consultant primary care clinic were included in the study. All patients were interviewed by one consultant in family medicine during the study period. The patients were asked about dietary habits, physical activity and type of exercise, and smoking habits. Weight and height was taken for all patients by the nurse in the clinic and body mass index (BMI) was calculated for all patients. The total numbers of participants were 246 patients. The data were analyzed using the Statistical Package of Social Science (SPSS) version 11.5. A p value of less than 0.05 was considered statistically significant. Results: Of the 246 male adult patients, 45.4% always consumed vegetables and fruits in their diet, 21.5% exercised on a daily bases, 51.2% exercised sometimes, and 26% did not exercise at all. The type of exercise practiced by active participants was walking (76.5%) and sports (22.9%). Sports included football, basketball, swimming, and other sport club activity. Only 20.7% of the participants had an ideal body weight (BMI<25), 37.4% were overweight (BMI 25 to <30), while 37.7% of the participants were obese (BMI ? 30). 8.9% of the participants were current smokers. Conclusion and recommendation: Overweight and obesity is a common health problem among male adult patients attending a primary care setting. Improved dietary habits (consumption of vegetables and fruits, and minimization of fat and sweets), encouraging exercise and walking, and helping current smokers to quit smoking are essential steps towards improving life styles in the

  11. Ultrarelativistic heavy ion collisions: the first billion seconds

    Energy Technology Data Exchange (ETDEWEB)

    Baym, Gordon

    2016-12-15

    I first review the early history of the ultrarelativistic heavy ion program, starting with the 1974 Bear Mountain Workshop, and the 1983 Aurora meeting of the U.S. Nuclear Science Committtee, just one billion seconds ago, which laid out the initial science goals of an ultrarelativistic collider. The primary goal, to discover the properties of nuclear matter at the highest energy densities, included finding new states of matter – the quark-gluon plasma primarily – and to use collisions to open a new window on related problems of matter in cosmology, neutron stars, supernovae, and elsewhere. To bring out how the study of heavy ions and hot, dense matter in QCD has been fulfilling these goals, I concentrate on a few topics, the phase diagram of matter in QCD, and connections of heavy ion physics to cold atoms, cosmology, and neutron stars.

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

    Science.gov (United States)

    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.

  13. Dietary quality and lifestyle factors in relation to 10-year mortality in older Europeans - The SENECA study

    NARCIS (Netherlands)

    Haveman-Nies, A.; Groot, de C.P.G.M.; Burema, J.; Amorim Cruz, J.A.; Osler, M.; Staveren, van W.A.

    2002-01-01

    The single and combined effects of three healthy lifestyle behaviors—nonsmoking, being physically active, and having a high-quality diet—on survival were investigated among older people in the SENECA Study. This European longitudinal study started with baseline measurements in 1988–1989 and lasted

  14. When the "Golden Years" Turn Blue: Using the Healthy Aging Literature to Elucidate Anxious and Depressive Disorders in Older Adulthood

    Science.gov (United States)

    Green, Jennifer S.; Magee, Joshua C.; Steiner, Amanda R. W.; Teachman, Bethany A.

    2017-01-01

    Current treatments for disorders of emotion, such as pathological anxiety, are often less effective in older adults than in younger adults and have poorly understood mechanisms, pointing to the need for psychopathology models that better account for age-related changes in normative emotional functioning and the expression of disordered emotion.…

  15. Vitamin D status in relation to one-year risk of recurrent falling in older men and woman

    NARCIS (Netherlands)

    Snijder, M.B.; van Schoor, N.M.; Pluijm, S.M.F.; van Dam, R.M.; Visser, M.; Lips, P.T.A.M.

    2006-01-01

    Background: Falls frequently occur in the elderly and are a major cause of morbidity and mortality. Objective: The objective of the study was to prospectively investigate the association between serum 25-hydroxyvitamin D [25(OH)D] levels and risk of recurrent falling in older men and women. Design:

  16. Vitamin D status in relation to one-year risk of recurrent falling in older men and women

    NARCIS (Netherlands)

    M.B. Snijder (Marieke); N.M. van Schoor (Natasja); S. Pluijm (Saskia); R.M. van Dam (Rob); M. Visser (Marjolein); P. Lips (Paul)

    2006-01-01

    textabstractBackground: Falls frequently occur in the elderly and are a major cause of morbidity and mortality. Objective: The objective of the study was to prospectively investigate the association between serum 25-hydroxyvitamin D [25(OH)D] levels and risk of recurrent falling in older men and

  17. Comorbidity and favorable neurologic outcome after out-of-hospital cardiac arrest in patients of 70 years and older

    NARCIS (Netherlands)

    Beesems, Stefanie G.; Blom, Marieke T.; van der Pas, Martine H. A.; Hulleman, Michiel; van de Glind, Esther M. M.; van Munster, Barbara C.; Tijssen, Jan G. P.; Tan, Hanno L.; van Delden, Johannes J. M.; Koster, Rudolph W.

    2015-01-01

    Advanced age is reported to be associated with lower survival after out-of-hospital cardiac arrest (OHCA). We aimed to establish survival rate and neurological outcome at hospital discharge after OHCA in older patients and evaluated whether pre-OHCA comorbidity was associated with favorable

  18. Comorbidity and favorable neurologic outcome after out-of-hospital cardiac arrest in patients of 70 years and older

    NARCIS (Netherlands)

    Beesems, Stefanie G.; Blom, Marieke T.; van der Pas, Martine H. A.; Hulleman, Michiel; van de Glind, Esther M. M.; van Munster, Barbara C.; Tijssen, Jan G. P.; Tan, Hanno L.; van Delden, Johannes J. M.; Koster, Rudolph W.

    Introduction: Advanced age is reported to be associated with lower survival after out-of-hospital cardiac arrest (OHCA). We aimed to establish survival rate and neurological outcome at hospital discharge after OHCA in older patients and evaluated whether pre-OHCA comorbidity was associated with

  19. Daily-life gait quality as predictor of falls in older people: A 1-year prospect cohort study

    NARCIS (Netherlands)

    Schooten, van K.S.; Pijnappels, M.A.G.M.; Rispens, S.M.; Elders, P.J.M.; Lips, P.; Daffertshofer, A.; Beek, P.J.; Dieen, van J.H.

    2016-01-01

    Falls can have devastating consequences for older people. We determined the relationship between the likelihood of fall incidents and daily-life behavior. We used wearable sensors to assess habitual physical activity and daily-life gait quality (in terms of e.g. stability, variability, smoothness

  20. Subjective life expectancy and actual mortality: results of a 10‑year panel study among older workers

    NARCIS (Netherlands)

    van Solinge, H.; Henkens, K.

    2017-01-01

    This research examined the judgemental process underlying subjective life expectancy (SLE) and the predictive value of SLE on actual mortality in older adults in the Netherlands. We integrated theoretical insights from life satisfaction research with existing models of SLE. Our model differentiates

  1. A randomized trial to evaluate the effectiveness of an individual, education-based safe transport program for drivers aged 75 years and older

    Directory of Open Access Journals (Sweden)

    Keay Lisa

    2013-02-01

    Full Text Available Abstract Background There are concerns over safety of older drivers due to increased crash involvement and vulnerability to injury. However, loss of driving privileges can dramatically reduce independence and quality of life for older members of the community. The aim of this trial is to examine the effectiveness of a safe transport program for drivers aged 75 years and older at reducing driving exposure but maintaining mobility. Methods and design A randomised trial will be conducted, involving 380 drivers aged 75 years and older, resident in urban and semi-rural areas of North-West Sydney. The intervention is an education program based on the Knowledge Enhances Your Safety (KEYS program, adapted for the Australian context. Driving experience will be measured objectively using an in-vehicle monitoring device which includes a global positioning system (GPS to assess driving exposure and an accelerometer to detect rapid deceleration events. Participation will be assessed using the Keele Assessment of Participation (KAP. Data will be analysed on an intention-to-treat basis; the primary outcomes include driving exposure, rapid deceleration events and scores for KAP. Secondary outcomes include self-reported measures of driving, socialisation, uptake of alternative forms of transport, depressive symptoms and mood. A detailed process evaluation will be conducted, including examination of the delivery of the program and uptake of alternative forms of transport. A subgroup analysis is planned for drivers with reduced function as characterized by established cut-off scores on the Drivesafe assessment tool. Discussion This randomised trial is powered to provide an objective assessment of the efficacy of an individually tailored education and alternative transportation program to promote safety of older drivers but maintain mobility. Trial registration: Australian New Zealand Clinical Trials Registry ACTRN12612000543886.

  2. Energy tax price tag for CPI: $1.2 billion, jobs, and production

    International Nuclear Information System (INIS)

    Begley, R.

    1993-01-01

    If President Clinton's proposed energy tax had been fully in place last year, it would have cost the US chemical industry an additional $1.2 billion and 9,900 jobs, according to Chemical Manufacturers Association (CMA; Washington) estimates. It also would have driven output down 3% and prices up 5%, CMA says. Allen Lenz, CMA director/trade and economics, says the increase in production costs that would accompany the tax will not be shared by foreign competitors, cannot be neutralized with higher border taxes because of existing trade agreements, and provides another reason to move production offshore. Worse, the US chemical industry's generally impressive trade surplus declined by $2.5 billion last year, and a further drop is projected for this year. The margin of error gets thinner all the time as competition increases, Lenz says. We're not concerned only with the chemical industry, but the rest of US-based manufacturing because they taken half our output, he adds. One problem is the energy intensiveness of the chemical process industries-a CMA report says that 55% of the cost of producing ethylene glycol is energy related. And double taxation of such things as coproducts returned for credit to oil refineries could add up to $115 million/year, the report says

  3. Tendances Carbone no. 75 'The CDM: let's not discard a tool that raised over US$ 200 billion'

    International Nuclear Information System (INIS)

    Shishlov, Igor

    2012-01-01

    Among the publications of CDC Climat Research, 'Tendances Carbone' bulletin specifically studies the developments of the European market for CO 2 allowances. This issue addresses the following points: Everyone wonders which miraculous instrument will enable the Green Climate Fund to mobilize the pledged US$100 billion per year in climate finance by 2020. Developing countries are now asking for interim targets to quench their mounting skepticism that this level of commitment can be reached. In the meantime paradoxically, the Clean Development Mechanism (CDM) - a tool that managed to leverage over US$200 billion of mostly private investment for climate change mitigation - is left dying without much regret

  4. Pre-pregnancy body mass index, weight gain and birth weight of children born to mothers aged 35 years or older

    Directory of Open Access Journals (Sweden)

    Conceição Aparecida de Mattos Segre

    2007-09-01

    Full Text Available Objective: To assess if pregnant women aged 35 years or older aredifferent from younger women, aged from 21 to 34 years, regardingweight gain during pregnancy, body mass index and birth weight ofthe newborn. Methods: Medical records of pregnant women aged35 years or older, seen at the Hospital do Servidor Público Estadualde São Paulo, were studied. The consecutive records of pregnantwomen aged from 21 to 34 years were used to form the control group.Statistics: Descriptive statistical tests and Student’s t test were used.To compare the means between the groups, the ANOVA test wasused, and a value of p < 0.05 was considered significant. Results:Comparing the two age groups, a significant difference was observedbetween the means of initial weight, final weight, and mean weeklygain in the third trimester. No significant differences were found amongthe pregnant women of the various pre-pregnancy body mass indexor weight gain ranges regarding the number of cesarean sections orthe mean birth weight of the newborns. Among the older pregnantwomen there was a significant, although weak, correlation betweenthe mean weekly weight gain in the third trimester and the newborn’sbirth weight, and between the mean weekly weight gain in the secondand third trimesters and the weight gain during the whole pregnancy.Conclusion: The high educational level and the average income of thisgroup were able to guarantee an appropriate nutrition. The older meanage of these pregnant women was consistent with their schooling andcould explain their good compliance with prenatal directions. Theseresults allow reassuring women who become pregnant in this period oflife that they can have a good perinatal outcome, provided they followthe prenatal care directions.

  5. Outcome of older persons admitted to intensive care unit, mortality, prognosis factors, dependency scores and ability trajectory within 1 year: a prospective cohort study.

    Science.gov (United States)

    Level, Claude; Tellier, Eric; Dezou, Patrick; Chaoui, Karim; Kherchache, Aissa; Sejourné, Philippe; Rullion-Pac Soo, Anne Marie

    2017-12-06

    The outcome and functional trajectory of older persons admitted to intensive care (ICU) unit remain a true question for critical care physicians and geriatricians, due to the heterogeneity of geriatric population, heterogeneity of practices and absence of guidelines. To describe the 1-year outcome, prognosis factors and functional trajectory for older people admitted to ICU. In a prospective 1-year cohort study, all patients aged 75 years and over admitted to our ICU were included according to a global comprehensive geriatric assessment. Follow-up was conducted for 1 year survivors, in particular, ability scores and living conditions. Of 188 patients included [aged 82.3 ± 4.7 years, 46% of admissions, median SAPS II 53.5 (43-74), ADL of Katz's score 4.2 ± 1.6, median Barthel's index 71 (55-90), AGGIR scale 4.5 ± 1.5], the ICU, hospital and 1-year mortality were, respectively, 34, 42.5 and 65.5%. Prognosis factors were: SAPS 2, mechanical ventilation, comorbidity (Lee's and Mc Cabe's scores), disability scores (ADL of Katz's score, Barthel's index and AGGIR scale), admission creatinin, hypoalbuminemia, malignant haemopathy, cognitive impairment. One-year survivors lived in their own home for 83%, with a preserved physical ability, without significant variation of the three ability assessed scores compared to prior ICU admission. The mortality of older people admitted to ICU is high, with a significant impact of disabilty scores, and preserved 1-year survivor independency. Other studies, including a better comprehensive geriatric assessment, seem necessary to determine a predictive "phenotype" of survival with a "satisfactory" level of autonomy.

  6. Achados oculares em pacientes com mais de 99 anos Ocular findings in patients older than 99 years

    Directory of Open Access Journals (Sweden)

    Marcela Colussi Cypel

    2006-10-01

    desenvolvimento de política específica de saúde ocular. Esse estudo demonstrou idosos com maioria do sexo feminino (83,3%, boa saúde geral (35%, hipertensos (40%, com dificuldade para leitura (55% e com baixa visual em decorrência de degeneração macular relacionada à idade.PURPOSE: To determine vision conditions and ocular findings in patients older than 99 years. METHODS: Patients were recruited by media advertisement and examined at the Vision Institute of UNIFESP. The following examinations were performed: visual acuity, ectoscopy, refraction, biomicroscopy, tear film break-up time, Schirmer basal test, tonometry, direct and indirect ophthalmoscopy. Complementary examinations such as optical coherence tomography were performed when indicated. RESULTS: Thirty patients older than 99 years were identified. Mean age of 101.5±1.8, 25 females and 5 males. Most common systemic disease, according to history, was arterial hypertension. In 11 patients (55%, the best corrected far visual acuity was 20/100 or better. The best corrected near visual acuity was J4 or better also in 55% (11 patients and 63.0% (7 patients of these were the ones that had not been submitted to cataract surgery. The most frequent visual complaint was low vision for reading (55% and other 8 patients (40% reported no disturbance (satisfied with their vision. Lens opacity was present in 9 patients (60% and 8 patients (40% had previous cataract surgery (5 aphakic eyes, 9 pseudophakic eyes. Cataract was identified as important for impairment of vision in 5 patients but only 2 of them wanted to be submitted to surgery. The main cause of visual impairment was age-related macular degeneration, present in all patients, 95% with no exudative form. Vision improved with new refractive prescription in 4 patients. CONCLUSION: Once we understand the needs we can plan specific diagnostic and treatment strategies. This sample showed that most were female (83.3%, with good general health (35%, most with systemic arterial

  7. Role of physical activity, physical fitness, and chronic health conditions on the physical independence of community-dwelling older adults over a 5-year period.

    Science.gov (United States)

    Pereira, Catarina; Baptista, Fátima; Cruz-Ferreira, Ana

    2016-01-01

    The variability in the individual characteristics and habits could help determine how older adults maintain independence. The impact of the variability in physical activity, physical fitness, body composition, and chronic health conditions (co-morbidities) on the independence of older adults, especially over time, is seldom examined. This study aims to analyze quantitatively the impact of baseline values and changes in physical activity, physical fitness, body composition, and co-morbidities on the physical independence of community-dwelling, older adults over a 5-year period. Data from 106 and 85 community-dwelling adults (≥60 years) were collected at baseline and after five years, respectively. Linear regression selected the main predictors of changes in physical independence as follows: the baseline physical independence (β=0.032, R(2)=9.9%) and co-morbidities (β=-0.191, R(2)=6.3%) and the changes in co-morbidities (β=-0.244, R(2)=10.8%), agility (β=-0.288, R(2)=6.7%), aerobic endurance (β=0.007, R(2)=3.2%), and walking expenditure (β=0.001, R(2)=5.1%) (page and gender. Gains of up to 8.3% in physical independence were associated with improvements in these variables, which corresponds to regaining independence for performing one or two activities of daily living. Copyright © 2016. Published by Elsevier Ireland Ltd.

  8. In patients older than 55 years with AML in first CR, should we search for a matched unrelated donor when an old sibling donor is available?

    DEFF Research Database (Denmark)

    Peffault de Latour, R; Labopin, M; Cornelissen, J

    2015-01-01

    Allogeneic hematopoietic transplantation is increasingly used in patients aged 55 years or more with AML. The question of whether outcomes can be improved with an allele-level 8/8 HLA-matched unrelated donor (MUD) rather than an older HLA-matched sibling (MSD, more than 55 years) is still...... unanswered. We thus analyzed outcomes in 714 patients aged 55 years and older with AML in first CR (CR1) who received PBSCs after a reduced-intensity conditioning hematopoietic cell transplant from a MUD (n=310) or a MSD (n=404) in a recent period (2005-2010). The 3-year cumulative incidences (CIs) of non......-relapse mortality were 17% and 23% with MSD and MUD, respectively (P=0.17). The 3-year CIs of relapse were 37% and 30%, respectively (P=0.12), resulting in a 3-year CI of leukemia-free survival of 46% and 47%, respectively (P=0.51). The 3-year overall survival was 49% with both MSD and MUD. In conclusion, HLA...

  9. Increase in breast cancer incidence among older women in Mumbai: 30-year trends and predictions to 2025.

    Science.gov (United States)

    Dikshit, Rajesh P; Yeole, B B; Nagrani, Rajini; Dhillon, P; Badwe, R; Bray, Freddie

    2012-08-01

    Increasing trends in the incidence of breast cancer have been observed in India, including Mumbai. These have likely stemmed from an increasing adoption of lifestyle factors more akin to those commonly observed in westernized countries. Analyses of breast cancer trends and corresponding estimation of the future burden are necessary to better plan rationale cancer control programmes within the country. We used data from the population-based Mumbai Cancer Registry to study time trends in breast cancer incidence rates 1976-2005 and stratified them according to younger (25-49) and older age group (50-74). Age-period-cohort models were fitted and the net drift used as a measure of the estimated annual percentage change (EAPC). Age-period-cohort models and population projections were used to predict the age-adjusted rates and number of breast cancer cases circa 2025. Breast cancer incidence increased significantly among older women over three decades (EAPC = 1.6%; 95% CI 1.1-2.0), while lesser but significant 1% increase in incidence among younger women was observed (EAPC = 1.0; 95% CI 0.2-1.8). Non-linear period and cohort effects were observed; a trends-based model predicted a close-to-doubling of incident cases by 2025 from 1300 mean cases per annum in 2001-2005 to over 2500 cases in 2021-2025. The incidence of breast cancer has increased in Mumbai during last two to three decades, with increases greater among older women. The number of breast cancer cases is predicted to double to over 2500 cases, the vast majority affecting older women. Copyright © 2012 Elsevier Ltd. All rights reserved.

  10. Prevalence of rheumatoid arthritis in persons 60 years of age and older in the United States: effect of different methods of case classification.

    Science.gov (United States)

    Rasch, Elizabeth K; Hirsch, Rosemarie; Paulose-Ram, Ryne; Hochberg, Marc C

    2003-04-01

    To determine prevalence estimates for rheumatoid arthritis (RA) in noninstitutionalized older adults in the US. Prevalence estimates were compared using 3 different classification methods based on current classification criteria for RA. Data from the Third National Health and Nutrition Examination Survey (NHANES-III) were used to generate prevalence estimates by 3 classification methods in persons 60 years of age and older (n = 5,302). Method 1 applied the "n of k" rule, such that subjects who met 3 of 6 of the American College of Rheumatology (ACR) 1987 criteria were classified as having RA (data from hand radiographs were not available). In method 2, the ACR classification tree algorithm was applied. For method 3, medication data were used to augment case identification via method 2. Population prevalence estimates and 95% confidence intervals (95% CIs) were determined using the 3 methods on data stratified by sex, race/ethnicity, age, and education. Overall prevalence estimates using the 3 classification methods were 2.03% (95% CI 1.30-2.76), 2.15% (95% CI 1.43-2.87), and 2.34% (95% CI 1.66-3.02), respectively. The prevalence of RA was generally greater in the following groups: women, Mexican Americans, respondents with less education, and respondents who were 70 years of age and older. The prevalence of RA in persons 60 years of age and older is approximately 2%, representing the proportion of the US elderly population who will most likely require medical intervention because of disease activity. Different classification methods yielded similar prevalence estimates, although detection of RA was enhanced by incorporation of data on use of prescription medications, an important consideration in large population surveys.

  11. Increasing and Decreasing Alcohol Use Trajectories Among Older Women in the U.S. Across a 10-Year Interval

    Directory of Open Access Journals (Sweden)

    Janet Kay Bobo

    2011-08-01

    Full Text Available Older women who routinely drink alcohol may experience health benefits, but they are also at risk for adverse effects. Despite the importance of their drinking patterns, few studies have analyzed longitudinal data on changes in drinking among community-based samples of women ages 50 and older. Reported here are findings from a semi-parametric group-based model that used data from 4,439 randomly sampled U.S. women who enrolled in the Health and Retirement Study (HRS and completed ≥3 biannual alcohol assessments during 1998–2008. The best-fitting model based on the drinks per day data had four trajectories labeled as “Increasing Drinkers” (5.3% of sample, “Decreasing Drinkers” (5.9%, “Stable Drinkers” (24.2%, and “Non/Infrequent Drinkers” (64.6%. Using group assignments generated by the trajectory model, one adjusted logistic regression analysis contrasted the groups with low alcohol intake in 1998 (Increasing Drinkers and Non/Infrequent Drinkers. In this model, baseline education, physical activity, cigarette smoking, and binge drinking were significant factors. Another analysis compared the groups with higher intake in 1998 (Decreasing Drinkers versus Stable Drinkers. In this comparison, baseline depression, cigarette smoking, binge drinking, and retirement status were significant. Findings underscore the need to periodically counsel all older women on the risks and benefits of alcohol use.

  12. Is there an association between food patterns and life satisfaction among Norway's inhabitants ages 65 years and older?

    Science.gov (United States)

    André, Beate; Canhão, Helena; Espnes, Geir A; Ferreira Rodrigues, Ana Maria; Gregorio, Maria João; Nguyen, Camilla; Sousa, Rute; Grønning, Kjersti

    2017-03-01

    The lack of information regarding older adults' health and lifestyles makes it difficult to design suitable interventions for people at risk of developing unhealth lifestyles. Therefore, there is a need to increase knowledge about older adults' food patterns and quality of life. Our aim was to determine associations among food patterns, anxiety, depression, and life satisfaction in Norwegian inhabitants ages 65+. The Nord-Trøndelag Health Study (The HUNT Study) is a large, population-based cohort study that includes data for 125 000 Norwegian participants. The cohort used for this study is wave three of the study, consisting of 11 619 participants age 65 and over. Cluster analysis was used to categorize the participants based on similarities in food consumption; two clusters were identified based on similarities regarding food consumption among participants. Significant differences between the clusters were found, as participants in the healthy food-patterns cluster had higher life satisfaction and lower anxiety and depression than those in the unhealthy food-patterns cluster. The associations among food patterns, anxiety, depression, and life satisfaction among older adults show the need for increased focus on interactions among food patterns, food consumption, and life satisfaction among the elderly in order to explore how society can influence these patterns. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  13. Dynapenic Abdominal Obesity Increases Mortality Risk among English and Brazilian Older Adults: A 10-Year Follow-Up of the ELSA and SABE Studies.

    Science.gov (United States)

    da Silva Alexandre, T; Scholes, S; Ferreira Santos, J L; de Oliveira Duarte, Y A; de Oliveira, C

    2018-01-01

    There is little epidemiological evidence demonstrating that dynapenic abdominal obesity has higher mortality risk than dynapenia and abdominal obesity alone. Our main aim was to investigate whether dynapenia combined with abdominal obesity increases mortality risk among English and Brazilian older adults over ten-year follow-up. Cohort study. United Kingdom and Brazil. Data came from 4,683 individuals from the English Longitudinal Study of Ageing (ELSA) and 1,490 from the Brazilian Health, Well-being and Aging study (SABE), hence the final sample of this study was 6,173 older adults. The study population was categorized into the following groups: non-dynapenic/non-abdominal obese, abdominal obese, dynapenic, and dynapenic abdominal obese according to their handgrip strength ( 102 cm for men and > 88 cm for women). The outcome was all-cause mortality over a ten-year follow-up. Adjusted hazard ratios by sociodemographic, behavioural and clinical characteristics were estimated using Cox proportional hazards models. The fully adjusted model showed that dynapenic abdominal obesity has a higher mortality risk among the groups. The hazard ratios (HR) were 1.37 for dynapenic abdominal obesity (95% CI = 1.12 - 1.68), 1.15 for abdominal obesity (95% CI = 0.98 - 1.35), and 1.23 for dynapenia (95% CI = 1.04 - 1.45). Dynapenia is an important risk factor for mortality but dynapenic abdominal obesity has the highest mortality risk among English and Brazilian older adults.

  14. Fuel efficient stoves for the poorest two billion

    Science.gov (United States)

    Gadgil, Ashok

    2012-03-01

    About 2 billion people cook their daily meals on generally inefficient, polluting, biomass cookstoves. The fuels include twigs and leaves, agricultural waste, animal dung, firewood, and charcoal. Exposure to resulting smoke leads to acute respiratory illness, and cancers, particularly among women cooks, and their infant children near them. Resulting annual mortality estimate is almost 2 million deaths, higher than that from malaria or tuberculosis. There is a large diversity of cooking methods (baking, boiling, long simmers, brazing and roasting), and a diversity of pot shapes and sizes in which the cooking is undertaken. Fuel-efficiency and emissions depend on the tending of the fire (and thermal power), type of fuel, stove characteristics, and fit of the pot to the stove. Thus, no one perfect fuel-efficient low-emitting stove can suit all users. Affordability imposes a further severe constraint on the stove design. For various economic strata within the users, a variety of stove designs may be appropriate and affordable. In some regions, biomass is harvested non-renewably for cooking fuel. There is also increasing evidence that black carbon emitted from stoves is a significant contributor to atmospheric forcing. Thus improved biomass stoves can also help mitigate global climate change. The speaker will describe specific work undertaken to design, develop, test, and disseminate affordable fuel-efficient stoves for internally displaced persons (IDPs) of Darfur, Sudan, where the IDPs face hardship, humiliation, hunger, and risk of sexual assault owing to their dependence on local biomass for cooking their meals.

  15. The frequency of atheromas in panoramic radiographs of patients with periodontal disease, 40 year and older attending the University Dental Clinic

    International Nuclear Information System (INIS)

    Quinonez Bartra, Patricia; Calderon Ubaqui, Victor; Quintana del Solar, Martin

    2006-01-01

    The aim of the present study was to determine the frequency of atheromas in panoramic radiographic in patients 40 years and older with periodontal diseases attending the Dental School 'Roberto Beltran Neira' in the Universidad Peruana Cayetano Heredia, during the period 2000 and 2004. The sample consisted of 217 random panoramic radiographic with no systematically selected subjects. Variables were analyzed using frequency tables and the chi-square test. Results showed the frequency of atheromas was of 17.1% and the highest number of atheromas appeared between the ages of 40 and 59 years, mostly of feminine sex. (author)

  16. Diagnostic value of self-reported mechanical symptoms for diagnosing large meniscal tears in patients aged 40 years or older with meniscal tears

    DEFF Research Database (Denmark)

    Pihl, Kenneth; Englund, Martin; Lohmander, Stefan

    2017-01-01

    Purpose: Meniscal tears, which are longitudinal-vertical tears (e.g. bucket-handle tears) and/or involve all three meniscal sub regions (anterior horn, body and posterior horn), are typically large and assumed to cause patient perceived mechanical knee symptoms (knee grinding or clicking and knee...... catching or locking). However, whether the presence of such mechanical symptoms is useful for diagnosing these forms of meniscus tears is unknown. Therefore, we investigated the diagnostic values of having mechanical symptoms in diagnosing a bucket-handle tear and/or a tear involving all three meniscal sub...... regions in middle-aged and older patients undergoing arthroscopic meniscal surgery. Methods: This study is a secondary analysis of Pihl et al. OARSI 2017. The study included patients aged 40 years or older undergoing surgery for a meniscal tear from Knee Arthroscopy Cohort Southern Denmark (KACS...

  17. Effective interventions for unintentional injuries: a systematic review and mortality impact assessment among the poorest billion.

    Science.gov (United States)

    Vecino-Ortiz, Andres I; Jafri, Aisha; Hyder, Adnan A

    2018-05-01

    Between 1990 and 2015, the global injury mortality declined, but in countries where the poorest billion live, injuries are becoming an increasingly prevalent cause of death. The vulnerability of this population requires immediate attention from policy makers to implement effective interventions that lessen the burden of injuries in these countries. Our aim was two-fold; first, to review all the evidence on effective interventions for the five main types of unintentional injury; and second, to estimate the potential number of lives saved by effective injury interventions among the poorest billion. For our systematic review we used references in the Disability Control Priorities third edition, and searched PubMed and the Cochrane database for papers published until Sept 10, 2016, using a comprehensive search strategy to find interventions for the five major causes of unintentional injuries: road traffic crashes, falls, drowning, burns, and poisoning. Studies were included if they presented evidence with significant effects sizes for any outcome; no inclusions or exclusions made on the basis of where the study was carried out (ie, low-income, middle-income, or high-income country). Then we used data from the Global Burden of Disease 2015 study and a Monte Carlo simulation technique to estimate the potential annual attributable number of lives saved among the poorest billion by these evidence-based injury interventions. We estimated results for 84 countries where the poorest billion live. From the 513 papers identified, 47 were eligible for inclusion. We identified 11 interventions that had an effect on injury mortality. For road traffic deaths, the most successful interventions in preventing deaths are speed enforcement (>80 000 lives saved per year) and drink-driving enforcement (>60 000 lives saved per year). Interventions potentially most effective in preventing deaths from drowning are formal swimming lessons for children younger than 14 years (>25 000 lives

  18. Effective interventions for unintentional injuries: a systematic review and mortality impact assessment among the poorest billion

    Directory of Open Access Journals (Sweden)

    Andres I Vecino-Ortiz, PhD

    2018-05-01

    Full Text Available Summary: Background: Between 1990 and 2015, the global injury mortality declined, but in countries where the poorest billion live, injuries are becoming an increasingly prevalent cause of death. The vulnerability of this population requires immediate attention from policy makers to implement effective interventions that lessen the burden of injuries in these countries. Our aim was two-fold; first, to review all the evidence on effective interventions for the five main types of unintentional injury; and second, to estimate the potential number of lives saved by effective injury interventions among the poorest billion. Methods: For our systematic review we used references in the Disability Control Priorities third edition, and searched PubMed and the Cochrane database for papers published until Sept 10, 2016, using a comprehensive search strategy to find interventions for the five major causes of unintentional injuries: road traffic crashes, falls, drowning, burns, and poisoning. Studies were included if they presented evidence with significant effects sizes for any outcome; no inclusions or exclusions made on the basis of where the study was carried out (ie, low-income, middle-income, or high-income country. Then we used data from the Global Burden of Disease 2015 study and a Monte Carlo simulation technique to estimate the potential annual attributable number of lives saved among the poorest billion by these evidence-based injury interventions. We estimated results for 84 countries where the poorest billion live. Findings: From the 513 papers identified, 47 were eligible for inclusion. We identified 11 interventions that had an effect on injury mortality. For road traffic deaths, the most successful interventions in preventing deaths are speed enforcement (>80 000 lives saved per year and drink-driving enforcement (>60 000 lives saved per year. Interventions potentially most effective in preventing deaths from drowning are formal swimming

  19. Higher Protein Intake Is Not Associated with Decreased Kidney Function in Pre-Diabetic Older Adults Following a One-Year Intervention—A Preview Sub-Study

    Directory of Open Access Journals (Sweden)

    Grith Møller

    2018-01-01

    Full Text Available Concerns about detrimental renal effects of a high-protein intake have been raised due to an induced glomerular hyperfiltration, since this may accelerate the progression of kidney disease. The aim of this sub-study was to assess the effect of a higher intake of protein on kidney function in pre-diabetic men and women, aged 55 years and older. Analyses were based on baseline and one-year data in a sub-group of 310 participants included in the PREVIEW project (PREVention of diabetes through lifestyle Intervention and population studies in Europe and around the World. Protein intake was estimated from four-day dietary records and 24-hour urinary urea excretion. We used linear regression to assess the association between protein intake after one year of intervention and kidney function markers: creatinine clearance, estimated glomerular filtration rate (eGFR, urinary albumin/creatinine ratio (ACR, urinary urea/creatinine ratio (UCR, serum creatinine, and serum urea before and after adjustments for potential confounders. A higher protein intake was associated with a significant increase in UCR (p = 0.03 and serum urea (p = 0.05 after one year. There were no associations between increased protein intake and creatinine clearance, eGFR, ACR, or serum creatinine. We found no indication of impaired kidney function after one year with a higher protein intake in pre-diabetic older adults.

  20. Single-Fraction Carbon-Ion Radiation Therapy for Patients 80 Years of Age and Older With Stage I Non-Small Cell Lung Cancer

    International Nuclear Information System (INIS)

    Karube, Masataka; Yamamoto, Naoyoshi; Nakajima, Mio; Yamashita, Hideomi; Nakagawa, Keiichi; Miyamoto, Tadaaki; Tsuji, Hiroshi; Fujisawa, Takehiko; Kamada, Tadashi

    2016-01-01

    Purpose: In an aging society, many senior citizens want less invasive treatment because of potential medical complications. The National Institute of Radiological Sciences has started to treat stage I lung cancer with single-fraction carbon-ion radiation therapy (CIRT) as a dose escalation prospective phase 1/2 trial. We evaluated the efficacy and safety of CIRT for patients 80 years of age and older, undergoing single-fraction CIRT. Methods and Materials: Peripheral non-small cell lung cancer patients who were treated with single-fraction CIRT were prospectively followed. We analyzed the data from among these patients 80 years of age and older. Results: There were 70 patients. Median age was 83 years (range: 80-89) and median follow-up period was 42.7 months (range: 12-128 months). Three-year local control, cause-specific survival, and overall survival rates were 88.0%, 81.6%, and 72.4%, respectively. Five-year local control, cause-specific survival, and overall survival rates were 85.8%, 64.9%, and 39.7%, respectively. There were no adverse effects higher than grade 2 either in the acute or late phase in terms of skin and lung. Analgesic agents were necessary for only 5 patients (7.1%), to relieve muscular or rib fracture pain caused by irradiation. Conclusions: Single-fraction CIRT was low-risk and effective, even for the elderly.

  1. Single-Fraction Carbon-Ion Radiation Therapy for Patients 80 Years of Age and Older With Stage I Non-Small Cell Lung Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Karube, Masataka, E-mail: mstk117@gmail.com [Research Center Hospital for Charged Particle Therapy, National Institute of Radiological Sciences, Chiba (Japan); Department of Radiology, The University of Tokyo Hospital, Tokyo (Japan); Yamamoto, Naoyoshi; Nakajima, Mio [Research Center Hospital for Charged Particle Therapy, National Institute of Radiological Sciences, Chiba (Japan); Yamashita, Hideomi; Nakagawa, Keiichi [Department of Radiology, The University of Tokyo Hospital, Tokyo (Japan); Miyamoto, Tadaaki; Tsuji, Hiroshi [Research Center Hospital for Charged Particle Therapy, National Institute of Radiological Sciences, Chiba (Japan); Fujisawa, Takehiko [Chiba Foundation for Health Promotion and Disease Prevention, Chiba (Japan); Kamada, Tadashi [Research Center Hospital for Charged Particle Therapy, National Institute of Radiological Sciences, Chiba (Japan)

    2016-05-01

    Purpose: In an aging society, many senior citizens want less invasive treatment because of potential medical complications. The National Institute of Radiological Sciences has started to treat stage I lung cancer with single-fraction carbon-ion radiation therapy (CIRT) as a dose escalation prospective phase 1/2 trial. We evaluated the efficacy and safety of CIRT for patients 80 years of age and older, undergoing single-fraction CIRT. Methods and Materials: Peripheral non-small cell lung cancer patients who were treated with single-fraction CIRT were prospectively followed. We analyzed the data from among these patients 80 years of age and older. Results: There were 70 patients. Median age was 83 years (range: 80-89) and median follow-up period was 42.7 months (range: 12-128 months). Three-year local control, cause-specific survival, and overall survival rates were 88.0%, 81.6%, and 72.4%, respectively. Five-year local control, cause-specific survival, and overall survival rates were 85.8%, 64.9%, and 39.7%, respectively. There were no adverse effects higher than grade 2 either in the acute or late phase in terms of skin and lung. Analgesic agents were necessary for only 5 patients (7.1%), to relieve muscular or rib fracture pain caused by irradiation. Conclusions: Single-fraction CIRT was low-risk and effective, even for the elderly.

  2. Identifying characteristics and outcomes that are associated with fall-related fatalities: multi-year retrospective summary of fall deaths in older adults from 2005-2012.

    Science.gov (United States)

    Deprey, Sara M; Biedrzycki, Lynda; Klenz, Kristine

    2017-12-01

    Fall-related deaths continue to be the leading cause of accidental deaths in the older adult (65+ year) population. However, many fall-related fatalities are unspecified and little is known about the fall characteristics and personal demographics at the time of the fall. Therefore, this report describes the characteristics, circumstances and injuries of falls that resulted in older adult deaths in one U.S. County and explores the variables associated with fatal injuries from falls. This is a continued retrospective analysis of 841older adults whose underlying cause of death was due to a fall over an 8-year period (2005-2012). Demographics and logistic regression of fall characteristics and injuries were analyzed. Falls that led to death most often occurred when walking in one's own home. Most of the residents in this study were community-dwellers who had previous comorbidities taking an average of six medications prior to their fall. Survival after a fall was on average 31 days. The two most common injuries after a fatal fall were hip fractures (54%), and head injuries (21%). A logistic regression identified two variables associated with hip fracture, advancing age (OR = 1.05, 95% confidence interval [CI] = 1.02-1.08) and diagnosis of a prior neurological condition (OR = 2.1, 95% CI = 1.4-3.1). Variables associated with head injuries included younger age (OR = .91, 95% CI = .89-.94), male gender (OR = 2.5, 95% CI = 1.7-3.8), prescribed anticoagulants (OR = 2.4, 95% CI = 1.5-3.9) and negative musculoskeletal comorbidity (OR = 1.9. 95% CI = 1.1-3.0). Hip fractures and head injuries were the most common injury after a fall that led to death in older adults greater than 65 years. There are opposing risk factors for older adults who incur a hip fracture compared to a head injury. Thus, health professionals will need to individualize prevention efforts to reduce fall fatalities.

  3. Rib fracture fixation in the 65 years and older population: A paradigm shift in management strategy at a Level I trauma center.

    Science.gov (United States)

    Fitzgerald, Michael T; Ashley, Dennis W; Abukhdeir, Hesham; Christie, D Benjamin

    2017-03-01

    Rib fractures after chest wall trauma are a common injury; however, they carry a significant morbidity and mortality risk. The impact of rib fractures in the 65-year and older patient population has been well documented as have the mortality and pneumonia rates. We hypothesize that patients 65 years and older receiving rib plating (RP) have decreased mortality, complication rates, and an accelerated return to normal functional states when compared with controls. With institutional review board approval, a retrospective review analyzed patients 65 years and older with rib fractures admitted from 2009 to 2015 receiving RP (RP group) (n = 23) compared to nonoperative, injury-matched controls admitted from 2003 to 2008 (NO group) (n = 50). Patients were followed prospectively with regard to lifestyle and functional satisfaction. Independent variables analyzed included Injury Severity Score (ISS), number of rib fractures, mortalities, hospital days, intensive care unit days, pneumonia development, respiratory complications, readmission rates, need for and length of rehabilitation stay time. Comparisons were by χ tests/Fisher's exact tests, Student's t tests and Wilcoxon rank sum tests. From 2003 to 2008, 50 NO patients were admitted with ages ranging 65 to 97 years, average ISS of 18.47 (14.28-22.66) versus ages ranging from 63 to 89 years, average ISS of 20.71 (15.7-25.73) for the RP group (n = 23). Average hospital days were 16.76 (10.35-23.18) and 18.36 (13.61-23.11) in the NO and RP groups, respectively. Average intensive care unit days were 11.65 (6.45-16.85) and 8.29 (5.31-11.26) days in the NO and RP groups, respectively. Four respiratory readmissions, two deaths, seven pneumonias, seven pleural-effusions, and 19 recurrent pneumothoraces were encountered in the NO group versus 0 in the RP group (p < 0.001). An equal percentage of patients in both groups entered rehabilitation facilities with average stay time of 18.5 and 28.53 days for the RP and NO groups

  4. Vizualization Challenges of a Subduction Simulation Using One Billion Markers

    Science.gov (United States)

    Rudolph, M. L.; Gerya, T. V.; Yuen, D. A.

    2004-12-01

    Recent advances in supercomputing technology have permitted us to study the multiscale, multicomponent fluid dynamics of subduction zones at unprecedented resolutions down to about the length of a football field. We have performed numerical simulations using one billion tracers over a grid of about 80 thousand points in two dimensions. These runs have been performed using a thermal-chemical simulation that accounts for hydration and partial melting in the thermal, mechanical, petrological, and rheological domains. From these runs, we have observed several geophysically interesting phenomena including the development of plumes with unmixed mantle composition as well as plumes with mixed mantle/crust components. Unmixed plumes form at depths greater than 100km (5-10 km above the upper interface of subducting slab) and consist of partially molten wet peridotite. Mixed plumes form at lesser depth directly from the subducting slab and contain partially molten hydrated oceanic crust and sediments. These high resolution simulations have also spurred the development of new visualization methods. We have created a new web-based interface to data from our subduction simulation and other high-resolution 2D data that uses an hierarchical data format to achieve response times of less than one second when accessing data files on the order of 3GB. This interface, WEB-IS4, uses a Javascript and HTML frontend coupled with a C and PHP backend and allows the user to perform region of interest zooming, real-time colormap selection, and can return relevant statistics relating to the data in the region of interest.

  5. The association between exposure to psychosocial work factors and mental health in older employees, a 3-year follow-up study.

    Science.gov (United States)

    Havermans, Bo M; Boot, Cécile R L; Hoekstra, Trynke; Houtman, Irene L D; Brouwers, Evelien P M; Anema, Johannes R; van der Beek, Allard J

    2018-01-01

    Unfavourable exposure to psychosocial work factors threatens older employees' mental health, and their sustained employment. This study assesses whether an improved compared to stable unfavourable and stable favourable exposure to psychosocial work factors is associated with a change in mental health in older employees at 3-year follow-up. The current study used data from the Study on Transitions in Employment, Ability and Motivation (STREAM), in workers aged 45-65 years (n = 5249). Two-year (2010-2012) exposure was assessed for psychological demands, autonomy, support, mental load, and distributive justice. Linear regression analyses were performed to compare improved exposure to unfavourable psychosocial work factors with stable unfavourable and stable favourable exposure and mental health at follow-up (2013), corrected for confounders. Analyses were stratified for age groups (45-54 and 55-65 years) and gender. In certain subgroups, stable unfavourable exposure to psychological demands, autonomy, support, and distributive justice was associated with a significantly lower mental health score than improved exposure. Stable favourable exposure to support was associated with a higher mental health score than improved support, whereas stable favourable exposure to autonomy was associated with a lower mental health score compared to improved exposure. There is a longitudinal association between changes in exposure to psychosocial work factors and mental health. Improvement in unfavourable exposure to psychosocial work factors was associated with improved mental health. This is important information for organisations that consider deploying measures to improve the psychosocial work environment of older workers.

  6. Do Additional Cardiac Surgical Procedures Increase the Surgical Risk in Patients 80 Years of age or Older Undergoing Coronary Bypass Gragting

    Directory of Open Access Journals (Sweden)

    Korhan Erkanlı

    2014-03-01

    Full Text Available Aim: In association with increasing life expectancy, the number of elderly individuals undergoing coronary bypass grafting (CABG and additional cardiac surgical procedures are increasing. In this study, we evaluated the effects of additional cardiac procedures and preoperative risk factors for postoperative mortality and morbidity in patients 80 years of age and older. Methods: The records of 29 patients aged 80 years and older (82.86±2.91 who had undergone coronary bypass surgery in the department of cardiac surgery between September 2009 and June 2012, were retrospectively reviewed. The subjects were divided into two groups: group 1 included the patients who had undergone CABG, group 2 consisted of those who had undergone CABG and additional cardiac procedures. Results: The mean age of the patients [14 male (48.3% 15 female (51.7%] was 82.86±2.91 years. The left internal thoracic artery was harvested for all patients. The mean number of graft per patient was 3.07±0.95. Carotid endarterectomy was performed in 3 patients before CABG. CABG and aortic valve replacement were performed in 1 patient. CABG, mitral valve replacement ant tricuspid plasty were performed in another patient. Furthermore, in one patient, abdominal aortic graft replacement due to ruptured abdominal aortic aneurysm and CABG was performed at the same session. The mean EuroSCORE was 5.06±5.16. Postoperative 30 days mortality was 6.8%, and the mean length of stay in hospital was 10.45±8.18 days. Conclusion: Coronary bypass surgery is an acceptable treatment method in patients 80 years of age and older. Although additional cardiac procedures may increase sugical risks, they can be successfully performed. (The Me­di­cal Bul­le­tin of Ha­se­ki 2014; 52: 14-8

  7. Health-related quality of life among adults 65 years and older in the United States, 2011-2012: a multilevel small area estimation approach.

    Science.gov (United States)

    Lin, Yu-Hsiu; McLain, Alexander C; Probst, Janice C; Bennett, Kevin J; Qureshi, Zaina P; Eberth, Jan M

    2017-01-01

    The purpose of this study was to develop county-level estimates of poor health-related quality of life (HRQOL) among aged 65 years and older U.S. adults and to identify spatial clusters of poor HRQOL using a multilevel, poststratification approach. Multilevel, random-intercept models were fit to HRQOL data (two domains: physical health and mental health) from the 2011-2012 Behavioral Risk Factor Surveillance System. Using a poststratification, small area estimation approach, we generated county-level probabilities of having poor HRQOL for each domain in U.S. adults aged 65 and older, and validated our model-based estimates against state and county direct estimates. County-level estimates of poor HRQOL in the United States ranged from 18.07% to 44.81% for physical health and 14.77% to 37.86% for mental health. Correlations between model-based and direct estimates were higher for physical than mental HRQOL. Counties located in the Arkansas, Kentucky, and Mississippi exhibited the worst physical HRQOL scores, but this pattern did not hold for mental HRQOL, which had the highest probability of mentally unhealthy days in Illinois, Indiana, and Vermont. Substantial geographic variation in physical and mental HRQOL scores exists among older U.S. adults. State and local policy makers should consider these local conditions in targeting interventions and policies to counties with high levels of poor HRQOL scores. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. Relationship Between the Remaining Years of Healthy Life Expectancy in Older Age and National Income Level, Educational Attainment, and Improved Water Quality.

    Science.gov (United States)

    Kim, Jong In; Kim, Gukbin

    2016-10-01

    The remaining years of healthy life expectancy (RYH) at age 65 years can be calculated as RYH (65) = healthy life expectancy-aged 65 years. This study confirms the associations between socioeconomic indicators and the RYH (65) in 148 countries. The RYH data were obtained from the World Health Organization. Significant positive correlations between RYH (65) in men and women and the socioeconomic indicators national income, education level, and improved drinking water were found. Finally, the predictors of RYH (65) in men and women were used to build a model of the RYH using higher socioeconomic indicators (R(2 )= 0.744, p educational attainment, national income level, and improved water quality influenced the RYH at 65 years. Therefore, policymaking to improve these country-level socioeconomic factors is expected to have latent effects on RYH in older age. © The Author(s) 2016.

  9. Older drivers : a review.

    NARCIS (Netherlands)

    Hakamies-Blomqvist, L. Sirén, A. & Davidse, R.J.

    2004-01-01

    The proportion of senior citizens (aged 65+) will grow from about 15 per cent in the year 2000 to about 30 per cent in the year 2050. The share of older drivers in the driver population will grow even faster because of increasing licensing rates among the ageing population. Older drivers do not have

  10. Disability transitions and health expectancies among adults 45 years and older in Malawi: a cohort-based model.

    Directory of Open Access Journals (Sweden)

    Collin F Payne

    Full Text Available Falling fertility and increasing life expectancy contribute to a growing elderly population in sub-Saharan Africa (SSA; by 2060, persons aged 45 y and older are projected to be 25% of SSA's population, up from 10% in 2010. Aging in SSA is associated with unique challenges because of poverty and inadequate social supports. However, despite its importance for understanding the consequences of population aging, the evidence about the prevalence of disabilities and functional limitations due to poor physical health among older adults in SSA continues to be very limited.Participants came from 2006, 2008, and 2010 waves of the Malawi Longitudinal Survey of Families and Health, a study of the rural population in Malawi. We investigate how poor physical health results in functional limitations that limit the day-to-day activities of individuals in domains relevant to this subsistence-agriculture context. These disabilities were parameterized based on questions from the SF-12 questionnaire about limitations in daily living activities. We estimated age-specific patterns of functional limitations and the transitions over time between different disability states using a discrete-time hazard model. The estimated transition rates were then used to calculate the first (to our knowledge microdata-based health expectancies calculated for SSA. The risks of experiencing functional limitations due to poor physical health are high in this population, and the onset of disabilities happens early in life. Our analyses show that 45-y-old women can expect to spend 58% (95% CI, 55%-64% of their remaining 28 y of life (95% CI, 25.7-33.5 with functional limitations; 45-y-old men can expect to live 41% (95% CI, 35%-46% of their remaining 25.4 y (95% CI, 23.3-28.8 with such limitations. Disabilities related to functional limitations are shown to have a substantial negative effect on individuals' labor activities, and are negatively related to subjective well

  11. Disability transitions and health expectancies among adults 45 years and older in Malawi: a cohort-based model.

    Science.gov (United States)

    Payne, Collin F; Mkandawire, James; Kohler, Hans-Peter

    2013-01-01

    Falling fertility and increasing life expectancy contribute to a growing elderly population in sub-Saharan Africa (SSA); by 2060, persons aged 45 y and older are projected to be 25% of SSA's population, up from 10% in 2010. Aging in SSA is associated with unique challenges because of poverty and inadequate social supports. However, despite its importance for understanding the consequences of population aging, the evidence about the prevalence of disabilities and functional limitations due to poor physical health among older adults in SSA continues to be very limited. Participants came from 2006, 2008, and 2010 waves of the Malawi Longitudinal Survey of Families and Health, a study of the rural population in Malawi. We investigate how poor physical health results in functional limitations that limit the day-to-day activities of individuals in domains relevant to this subsistence-agriculture context. These disabilities were parameterized based on questions from the SF-12 questionnaire about limitations in daily living activities. We estimated age-specific patterns of functional limitations and the transitions over time between different disability states using a discrete-time hazard model. The estimated transition rates were then used to calculate the first (to our knowledge) microdata-based health expectancies calculated for SSA. The risks of experiencing functional limitations due to poor physical health are high in this population, and the onset of disabilities happens early in life. Our analyses show that 45-y-old women can expect to spend 58% (95% CI, 55%-64%) of their remaining 28 y of life (95% CI, 25.7-33.5) with functional limitations; 45-y-old men can expect to live 41% (95% CI, 35%-46%) of their remaining 25.4 y (95% CI, 23.3-28.8) with such limitations. Disabilities related to functional limitations are shown to have a substantial negative effect on individuals' labor activities, and are negatively related to subjective well-being. Individuals in this

  12. Conservative care as a treatment option for patients aged 75 years and older with CKD stage V: a National survey in the Netherlands.

    Science.gov (United States)

    Susanto, Christopher; Kooman, J; Courtens, A M; Konings, C J A M

    2018-01-01

    Conservative care for patients aged 75 years and older with CKD stage 5 as a treatment option besides dialysis was proposed officially in the Netherlands in October 2016. This national survey showed the current implementation of this option in Netherlands nephrology departments. A web-based survey was sent to medical managers of 60 nephrology departments in the Netherlands in August 2016. Twenty-one medical managers (35%) completed the survey. The term "conservative care" is frequently used and well known. The estimated number of patients in whom the decision for maximal conservative care was made in 2015 was 310 of 2249 patients with CKD stage 5 age 75 years and older (range 5-50 patients per department). 164 patients became symptomatic and received no dialysis. There is no official registration for this treatment option and patient category. The practice patterns vary widely. Only one of 21 respondents reported a conservative care outpatient clinic. Formal training or education regarding conservative care is not available in most of departments. 95% of respondents discussed this treatment option with their patients. General practitioners are always being informed about their patient's decision. Their main role is providing or organizing palliative care support at the end of life and discussing advance care planning. Most respondents (86%) considered to include their patients in a prospective multicentre observational study, conservative care versus dialysis. Conservative care as a treatment option for patients with CKD stage 5 aged 75 years and older is well established. The practice patterns are varied in the Netherlands. Follow-up studies are needed to see whether the new multidisciplinary guideline facilitates harmonization of practice pattern. Funding is needed to optimize the implementation of conservative care.

  13. Association between Cognition and Serum Insulin-Like Growth Factor-1 in Middle-Aged & Older Men: An 8 Year Follow-Up Study.

    Directory of Open Access Journals (Sweden)

    Shankar Tumati

    Full Text Available Low levels of insulin-like growth factor-1 (IGF-1, an essential neurotrophic factor, have been associated with worse cognitive function in older adults. However, few studies have assessed the prospective association of serum IGF-1 with cognitive function. We aimed to determine the association between serum IGF-1 on concurrent and prospective cognitive function in a population sample of men aged 40-80 years. Blood samples were assessed for IGF-1 levels at baseline and neuropsychological assessments were performed at baseline (n = 400 and at follow-up after a mean duration of 8.3 years (n = 286. Linear regression analyses were carried out to determine the associations between quintiles of IGF-1 and cognitive function at the baseline and follow-up visits. Results showed that those in the top quintile of IGF-1 had lower processing capacity and global cognition scores at follow-up after controlling for cognitive function at baseline and other confounding factors. Additional analyses exploring associations with IGF-1 separately in middle-aged and older participants, and with quartiles of IGF-1 produced similar results. In those older than 60 years, high IGF-1 levels were also associated with lower baseline processing capacity. These results suggest that high IGF-1 levels are associated with worse long-term cognition in men. Together with past studies, we suggest that both, high and low levels of IGF-1 may be associated with poor cognitive function and that optimum levels of IGF-1 (quintile 2 and 3 in current study may be associated with better cognitive function.

  14. Associations of exercise, sedentary time and insomnia with metabolic syndrome in Taiwanese older adults: A 1-year follow-up study.

    Science.gov (United States)

    Chen, Li-Jung; Lai, Yun-Ju; Sun, Wen-Jung; Fox, Kenneth R; Chu, Dachen; Ku, Po-Wen

    2015-01-01

    Understanding the risk factors of metabolic syndrome (MetS) is important to public health, since individuals with MetS have an increased risk of health problems. This study examined the associations of exercise, sedentary time and insomnia with incident MetS among older adults 1 year later. A total of 1,359 older adults receiving hospital health examinations in 2012 were studied, and 779 subjects had a follow-up after 1 year. The components of MetS (waist, blood pressure, high-density lipoprotein cholesterol, fasting glucose and triglyceride) were defined by the Program's Adult Treatment Panel III report. Exercise, sedentary time and insomnia data were obtained through self-report questionnaires. Physical fitness (body fatness, balance and hand grip strength) was measured. Two logistic regressions were computed to examine the associations of exercise/physical fitness, sedentary time and insomnia at baseline with incident MetS 1 year later. The first regression included age, sex, smoking and alcohol as covariates. The second regression was further adjusted with the components of MetS. Sex, exercise/balance, sedentary time and insomnia were significant predictors of MetS. The risk of MetS incidence was 3.36 (95% CI 1.96-5.77) for women, 1.92 (95% CI 1.01-3.63) for those who did not exercise, 2.52 (95% CI 1.37-4.63) for those who sat more than 5 h/day, and 2.17 (95% CI 1.13-4.15) for those with insomnia. Poor balance was significantly associated with greater risk of MetS (AOR = 1.07, 95% CI 1.02-1.12). Sex, sedentary time, insomnia and balance remained significant after adjusting with the components of MetS. Cultivating exercise habits, reducing sedentary time and improving sleep quality may be important strategies for MetS prevention among older adults.

  15. Executive function and falls in older adults: new findings from a five-year prospective study link fall risk to cognition.

    Science.gov (United States)

    Mirelman, Anat; Herman, Talia; Brozgol, Marina; Dorfman, Moran; Sprecher, Elliot; Schweiger, Avraham; Giladi, Nir; Hausdorff, Jeffrey M

    2012-01-01

    Recent findings suggest that executive function (EF) plays a critical role in the regulation of gait in older adults, especially under complex and challenging conditions, and that EF deficits may, therefore, contribute to fall risk. The objective of this study was to evaluate if reduced EF is a risk factor for future falls over the course of 5 years of follow-up. Secondary objectives were to assess whether single and dual task walking abilities, an alternative window into EF, were associated with fall risk. We longitudinally followed 256 community-living older adults (age: 76.4±4.5 yrs; 61% women) who were dementia free and had good mobility upon entrance into the study. At baseline, a computerized cognitive battery generated an index of EF, attention, a closely related construct, and other cognitive domains. Gait was assessed during single and dual task conditions. Falls data were collected prospectively using monthly calendars. Negative binomial regression quantified risk ratios (RR). After adjusting for age, gender and the number of falls in the year prior to the study, only the EF index (RR: .85; CI: .74-.98, p = .021), the attention index (RR: .84; CI: .75-.94, p = .002) and dual tasking gait variability (RR: 1.11; CI: 1.01-1.23; p = .027) were associated with future fall risk. Other cognitive function measures were not related to falls. Survival analyses indicated that subjects with the lowest EF scores were more likely to fall sooner and more likely to experience multiple falls during the 66 months of follow-up (pfalls was predicted by performance on EF and attention tests conducted 5 years earlier. The present results link falls among older adults to cognition, indicating that screening EF will likely enhance fall risk assessment, and that treatment of EF may reduce fall risk.

  16. Health and Physiological Adaptations of Small-Sided Ball Games in Untrained Older Adults Aged 65-93 Years

    DEFF Research Database (Denmark)

    Vorup Petersen, Jacob

    Introduction. Aging is associated with a physiological decline that contributes to loss of physical function and increased risk of adverse cardiovascular events and development of type 2 diabetes. The vast majority of research has focused on traditional exercise activities such as brisk walking......, cycling or resistance training in the prevention of this physiological decline with age. However, untrained elderly may be reluctant to participate in multiple training sessions a week, and may also be unwilling to take part in intense exercise due to motivational reasons. Thus, efficient and motivating...... elderly: 1) The effect of other small-sided ball games, e.g. floorball training and cone ball, on physiological adaptations important for health as well as the effect of combined protein intake, 2) the effect of regular small-sided ball games in older adults with a more advanced age and low physical...

  17. Health and Physiological Adaptations of Small-Sided Ball Games in Untrained Older Adults Aged 65-93 Years

    DEFF Research Database (Denmark)

    Vorup Petersen, Jacob

    function, and 3) the feasibility, motivation and injury rate of regular small-sided ball games in untrained elderly. Purpose. The overall aims of the present thesis were to examine physiological adaptations important for health after a period of small-sided ball game training and protein ingestion...... adults, 16 weeks of small-sided soccer was shown to improve physical function and exercise capacity, whereas muscle mass was unaffected by the training despite a high intake of daily protein. However, a number of questions still need to be answered regarding small-sided ball game training in untrained...... elderly: 1) The effect of other small-sided ball games, e.g. floorball training and cone ball, on physiological adaptations important for health as well as the effect of combined protein intake, 2) the effect of regular small-sided ball games in older adults with a more advanced age and low physical...

  18. Mortality from Unspecified Unintentional Injury among Individuals Aged 65 Years and Older by U.S. State, 1999–2013

    Directory of Open Access Journals (Sweden)

    Xunjie Cheng

    2016-07-01

    Full Text Available Introduction: Recent changes in unspecified unintentional injury mortality for the elderly by U.S. state remain unreported. This study aims to examine U.S. state variations in mortality from unspecified unintentional injury among Americans aged 65+, 1999–2013; Methods: Using mortality rates from the U.S. CDC’s Web-based Injury Statistics Query and Reporting System (WISQARS™, we examined unspecified unintentional injury mortality for older adults aged 65+ from 1999 to 2013 by state. Specifically, the proportion of unintentional injury deaths with unspecified external cause in the data was considered. Linear regression examined the statistical significance of changes in proportion of unspecified unintentional injury from 1999 to 2013; Results: Of the 36 U.S. states with stable mortality rates, over 8-fold differences were observed for both the mortality rates and the proportions of unspecified unintentional injury for Americans aged 65+ during 1999–2013. Twenty-nine of the 36 states showed reductions in the proportion of unspecified unintentional injury cause, with Oklahoma (−89%, Massachusetts (−86% and Oregon (−81% displaying the largest changes. As unspecified unintentional injury mortality decreased, mortality from falls in 28 states and poisoning in 3 states increased significantly. Mortality from suffocation in 15 states, motor vehicle traffic crashes in 12 states, and fire/burn in 8 states also decreased; Conclusions: The proportion of unintentional injuries among older adults with unspecified cause decreased significantly for many states in the United States from 1999 to 2013. The reduced proportion of unspecified injury has implications for research and practice. It should be considered in state-level trend analysis during 1999–2013. It also suggests comparisons between states for specific injury mortality should be conducted with caution, as large differences in unspecified injury mortality across states and over time

  19. Daily-Life Gait Quality as Predictor of Falls in Older People: A 1-Year Prospective Cohort Study.

    Directory of Open Access Journals (Sweden)

    Kimberley S van Schooten

    Full Text Available Falls can have devastating consequences for older people. We determined the relationship between the likelihood of fall incidents and daily-life behavior. We used wearable sensors to assess habitual physical activity and daily-life gait quality (in terms of e.g. stability, variability, smoothness and symmetry, and determined their predictive ability for time-to-first-and-second-falls. 319 older people wore a trunk accelerometer (Dynaport MoveMonitor, McRoberts during one week. Participants further completed questionnaires and performed grip strength and trail making tests to identify risk factors for falls. Their prospective fall incidence was followed up for six to twelve months. We determined interrelations between commonly used gait characteristics to gain insight in their interpretation and determined their association with time-to-falls. For all data -including questionnaires and tests- we determined the corresponding principal components and studied their predictive ability for falls. We showed that gait characteristics of walking speed, stride length, stride frequency, intensity, variability, smoothness, symmetry and complexity were often moderately to highly correlated (r > 0.4. We further showed that these characteristics were predictive of falls. Principal components dominated by history of falls, alcohol consumption, gait quality and muscle strength proved predictive for time-to-fall. The cross-validated prediction models had adequate to high accuracy (time dependent AUC of 0.66-0.72 for time-to-first-fall and 0.69-0.76 for -second-fall. Daily-life gait quality obtained from a single accelerometer on the trunk is predictive for falls. These findings confirm that ambulant measurements of daily behavior contribute substantially to the identification of elderly at (high risk of falling.

  20. Higher protein intake is not associated with decreased kidney function in pre-diabetic older adults following a one-year intervention

    DEFF Research Database (Denmark)

    Møller, Grith; Andersen, Jens Rikardt; Ritz, Christian

    2018-01-01

    Concerns about detrimental renal effects of a high-protein intake have been raised due to an induced glomerular hyperfiltration, since this may accelerate the progression of kidney disease. The aim of this sub-study was to assess the effect of a higher intake of protein on kidney function in pre-diabetic...... intake and creatinine clearance, eGFR, ACR, or serum creatinine. We found no indication of impaired kidney function after one year with a higher protein intake in pre-diabetic older adults....

  1. Synergistic effects of cognitive impairment on physical disability in all-cause mortality among men aged 80 years and over: Results from longitudinal older veterans study.

    Directory of Open Access Journals (Sweden)

    Wan-Chen Yu

    Full Text Available We evaluated effects of the interrelationship between physical disability and cognitive impairment on long-term mortality of men aged 80 years and older living in a retirement community in Taiwan.This prospective cohort study enrolled older men aged 80 and older living in a Veterans Care Home. Those with confirmed diagnosis of dementia were excluded. All participants received comprehensive geriatric assessment, including sociodemographic data, Charlson's Comorbidity Index (CCI, geriatric syndromes, activities of daily living (ADL using the Barthel index and cognitive function using the Mini-Mental State Examination (MMSE. Subjects were categorized into normal cognitive function, mild cognitive deterioration, and moderate-to-severe cognitive impairment and were further stratified by physical disability status. Kaplan-Meier log-rank test was used for survival analysis. After adjusting for sociodemographic characteristics and geriatric syndromes, Cox proportional hazards model was constructed to examine associations between cognitive function, disability and increased mortality risk.Among 305 male subjects aged 85.1 ± 4.1 years, 89 subjects died during follow-up (mean follow-up: 1.87 ± 0.90 years. Kaplan-Meier unadjusted analysis showed reduced survival probability associated with moderate-to-severe cognitive status and physical disability. Mortality risk increased significantly only for physically disabled subjects with simultaneous mild cognitive deterioration (adjusted HR 1.951, 95% CI 1.036-3.673, p = 0.038 or moderate-to-severe cognitive impairment (aHR 2.722, 95% CI 1.430-5.181, p = 0.002 after adjusting for age, BMI, education levels, smoking status, polypharmacy, visual and hearing impairment, urinary incontinence, fall history, depressive symptoms and CCI. Mortality risk was not increased among physically independent subjects with or without cognitive impairment, and physically disabled subjects with intact cognition.Physical disability

  2. Synergistic effects of cognitive impairment on physical disability in all-cause mortality among men aged 80 years and over: Results from longitudinal older veterans study.

    Science.gov (United States)

    Yu, Wan-Chen; Chou, Ming-Yueh; Peng, Li-Ning; Lin, Yu-Te; Liang, Chih-Kuang; Chen, Liang-Kung

    2017-01-01

    We evaluated effects of the interrelationship between physical disability and cognitive impairment on long-term mortality of men aged 80 years and older living in a retirement community in Taiwan. This prospective cohort study enrolled older men aged 80 and older living in a Veterans Care Home. Those with confirmed diagnosis of dementia were excluded. All participants received comprehensive geriatric assessment, including sociodemographic data, Charlson's Comorbidity Index (CCI), geriatric syndromes, activities of daily living (ADL) using the Barthel index and cognitive function using the Mini-Mental State Examination (MMSE). Subjects were categorized into normal cognitive function, mild cognitive deterioration, and moderate-to-severe cognitive impairment and were further stratified by physical disability status. Kaplan-Meier log-rank test was used for survival analysis. After adjusting for sociodemographic characteristics and geriatric syndromes, Cox proportional hazards model was constructed to examine associations between cognitive function, disability and increased mortality risk. Among 305 male subjects aged 85.1 ± 4.1 years, 89 subjects died during follow-up (mean follow-up: 1.87 ± 0.90 years). Kaplan-Meier unadjusted analysis showed reduced survival probability associated with moderate-to-severe cognitive status and physical disability. Mortality risk increased significantly only for physically disabled subjects with simultaneous mild cognitive deterioration (adjusted HR 1.951, 95% CI 1.036-3.673, p = 0.038) or moderate-to-severe cognitive impairment (aHR 2.722, 95% CI 1.430-5.181, p = 0.002) after adjusting for age, BMI, education levels, smoking status, polypharmacy, visual and hearing impairment, urinary incontinence, fall history, depressive symptoms and CCI. Mortality risk was not increased among physically independent subjects with or without cognitive impairment, and physically disabled subjects with intact cognition. Physical disability is a major

  3. Predictors of mortality and short-term physical and cognitive dependence in critically ill persons 75 years and older: a prospective cohort study.

    Science.gov (United States)

    Daubin, Cédric; Chevalier, Stéphanie; Séguin, Amélie; Gaillard, Cathy; Valette, Xavier; Prévost, Fabrice; Terzi, Nicolas; Ramakers, Michel; Parienti, Jean-Jacques; du Cheyron, Damien; Charbonneau, Pierre

    2011-05-16

    The purpose of this study was to identify predictors of 3-month mortality in critically ill older persons under medical care and to assess the clinical impact of an ICU stay on physical and cognitive dependence and subjective health status in survivors. We conducted a prospective observational cohort study including all older persons 75 years and older consecutively admitted into ICU during a one-year period, except those admitted after cardiac arrest, All patients were followed for 3 months or until death. Comorbidities were assessed using the Charlson index and physical dependence was evaluated using the Katz index of Activity of Daily Living (ADL). Cognitive dependence was determined by a score based on the individual components of the Lawton index of Daily Living and subjective health status was evaluated using the Nottingham Health Profile (NHP) score. One hundred patients were included in the analysis. The mean age was 79.3 ± 3.4 years. The median Charlson index was 6 [IQR, 4 to 7] and the mean ADL and cognitive scores were 5.4 ± 1.1 and 1.2 ± 1.4, respectively, corresponding to a population with a high level of comorbidities but low physical and cognitive dependence. Mortality was 61/100 (61%) at 3 months. In multivariate analysis only comorbidities assessed by the Charlson index [Adjusted Odds Ratio, 1.6; 95% CI, 1.2-2.2; p physical (p = 0.04), and cognitive (p = 0.62) dependence in survivors had changed very little at 3 months. In addition, the mean NHP score was 213.1 ± 132.8 at 3 months, suggesting an acceptable perception of their quality of life. In a selected population of non surgical patients 75 years and older, admission into the ICU is associated with a 3-month survival rate of 38% with little impact on physical and cognitive dependence and subjective health status. Nevertheless, a high comorbidity level (ie, Charlson index), multi-organ failure, and the need for extra-renal support at the early phase of intensive care could be considered as

  4. B-Vitamin Intake and Biomarker Status in Relation to Cognitive Decline in Healthy Older Adults in a 4-Year Follow-Up Study.

    Science.gov (United States)

    Hughes, Catherine F; Ward, Mary; Tracey, Fergal; Hoey, Leane; Molloy, Anne M; Pentieva, Kristina; McNulty, Helene

    2017-01-10

    Advancing age can be associated with an increase in cognitive dysfunction, a spectrum of disability that ranges in severity from mild cognitive impairment to dementia. Folate and the other B-vitamins involved in one-carbon metabolism are associated with cognition in ageing but the evidence is not entirely clear. The hypothesis addressed in this study was that lower dietary intake or biomarker status of folate and/or the metabolically related B-vitamins would be associated with a greater than expected rate of cognitive decline over a 4-year follow-up period in healthy older adults. Participants (aged 60-88 years; n = 155) who had been previously screened for cognitive function were reassessed four years after initial investigation using the Mini-Mental State Examination (MMSE). At the 4-year follow-up assessment when participants were aged 73.4 ± 7.1 years, mean cognitive MMSE scores had declined from 29.1 ± 1.3 at baseline to 27.5 ± 2.4 ( p 0.56 points per year). Lower vitamin B6 status, as measured using pyridoxal-5-phosphate (PLP; vitamin B6 was also associated with a greater rate of cognitive decline (OR, 4.22; 95% CI, 1.28-13.90; p B-vitamins. In conclusion, lower dietary and biomarker status of vitamin B6 at baseline predicted a greater than expected rate of cognitive decline over a 4-year period in healthy older adults. Vitamin B6 may be an important protective factor in helping maintain cognitive health in ageing.

  5. Changes in gait performance over several years are associated with recurrent falls status in community-dwelling older women at high risk of fracture.

    Science.gov (United States)

    Scott, David; McLaughlin, Patrick; Nicholson, Geoff C; Ebeling, Peter R; Stuart, Amanda L; Kay, Deborah; Sanders, Kerrie M

    2015-03-01

    Gait analysis is a recommended geriatric assessment for falls risk and sarcopenia; however, previous research utilises measurements at a single time point only. It is presently unclear how changes in gait over several years influence risk of recurrent falls in older adults. We investigated 135 female volunteers (mean age±SD: 76.7±5.0 years; range: 70-92 years) at high risk of fracture. Gait parameters (speed, cadence, step length, step width, swing time and double support phase) were assessed using the GAITRite Electronic Walkway System at four annual clinics over ∼3.7±0.5 years. Participants reported incident falls monthly for 3.7±1.2 years. Increasing gait speed (odds ratio: 0.96; 95% confidence interval 0.93, 0.99) and step length (0.87; 0.77, 0.98) from baseline to final follow-up was associated with reduced likelihood of being a recurrent faller over the study period. No significant associations were observed for baseline gait parameters (all P≥0.05). At the second follow-up (2.8±0.6 years), an increase in swing time (0.65; 0.43, 0.98) was associated with reduced likelihood, while an increase in double support phase (1.31; 1.04, 1.66) was associated with increased likelihood, for being a recurrent faller in the subsequent 1.3 years following this time point. Changes in gait parameters over several years are significantly associated with the likelihood of being a recurrent faller among community-dwelling older women at high risk of fracture. Further research is required to develop gait monitoring guidelines and gait parameter decline cut points that may be utilised by clinicians to identify older adults at risk of incident falls and sarcopenia. © The Author 2014. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  6. Associations of work-related factors and work engagement with mental and physical health: a 1-year follow-up study among older workers.

    Science.gov (United States)

    Leijten, Fenna R M; van den Heuvel, Swenne G; van der Beek, Allard J; Ybema, Jan Fekke; Robroek, Suzan J W; Burdorf, Alex

    2015-03-01

    The goals of this study were to determine whether, among older employees, unfavourable physical and psychosocial work-related factors were associated with poorer mental and physical health and whether high work engagement buffered the associations between unfavourable work-related factors and poorer health. A 1-year longitudinal study with employed persons aged 45-64 was conducted within the Study on Transitions in Employment, Ability and Motivation (n = 8,837). Using an online questionnaire, work-related factors (physical: physical load; psychosocial: psychological job demands, autonomy, and support) and work engagement were measured at baseline and health at baseline and 1-year follow-up. General linear models were used to assess associations of work-related factors and work engagement with health. Tests of interaction terms assessed whether work engagement buffered the work-related factor-health associations. Unfavourable psychosocial work-related factors at baseline were associated with poorer mental health at follow-up. Higher physical load, higher psychological job demands, and lower autonomy at baseline were associated with poorer physical health at follow-up. Higher work engagement at baseline was related to better physical and especially better mental health during the 1-year follow-up. Work engagement had a small effect on the associations between work-related factors and health. Among older employees, especially the promotion of a high work engagement and, to a lesser extent, favourable work-related factors can be beneficial for mental health in particular.

  7. Financial impact of injury in older workers: use of a national retrospective e-cohort to compare income patterns over 3 years in a universal injury compensation scheme.

    Science.gov (United States)

    Davie, Gabrielle; Lilley, Rebbecca

    2018-04-27

    The study aims to quantify the impact of injury on the financial well-being of older workers. The hypothesis was that injured older workers have substantially reduced income from work following injury, but that New Zealand's (NZ) universal injury compensation scheme mitigates the difference for total income. An e-cohort of 617 722 workers aged 45-64 years old was created using de-identified linked administrative data in NZ's Integrated Data Infrastructure. Person-level data from numerous government agencies were used to compare 21 639 with an injury-related entitlement claim in 2009 with the remaining 596 133. Event date was the date of injury, or for the comparison group, a randomly selected date in 2009. Geometric mean ratios (GMRs) were used to compare income from work and total income from all taxable sources between those injured and the comparison group. Adjusted GMRs estimated income differences up to 36 months following the event date. Differences in total income increased over time. In the third year, those injured received 6.7% less (adjusted GMR 0.933 (95% CI 0.925 to 0.941)) than the comparison group, equivalent to an average loss of $NZ2628. Restricting to income from work, those injured received 29.2% less than the comparison group at 3 years (adjusted GMR 0.708 (95% CI 0.686 to 0.730)). For both men and women, those injured at 45-49 years consistently had the greatest relative income loss compared with those aged 50-54, 55-59 or 60-64 years. Although the substantial impacts of injury on income were mainly mitigated by public income transfers, relative losses in income in those aged 45-64 years increased in the 3 years following injury. Policies focused on adequate compensation and reducing the time away from employment could reduce these financial impacts in older workers. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise

  8. Marital status and living situation during a 5-year period are associated with a subsequent 10-year cognitive decline in older men: The FINE study

    NARCIS (Netherlands)

    Gelder, van B.M.; Tijhuis, M.; Kalmijn, S.; Giampaoli, S.; Nissinen, A.; Kromhout, D.

    2006-01-01

    We investigate the association between marital status and living situation (over 5 years) on 10-year subsequent cognitive decline. The study population consisted of 1,042 men aged 70-89 years in 1990, who participated in the longitudinal Finland, Italy, the Netherlands Elderly (known as FINE) Study.

  9. Executive function and falls in older adults: new findings from a five-year prospective study link fall risk to cognition.

    Directory of Open Access Journals (Sweden)

    Anat Mirelman

    Full Text Available Recent findings suggest that executive function (EF plays a critical role in the regulation of gait in older adults, especially under complex and challenging conditions, and that EF deficits may, therefore, contribute to fall risk. The objective of this study was to evaluate if reduced EF is a risk factor for future falls over the course of 5 years of follow-up. Secondary objectives were to assess whether single and dual task walking abilities, an alternative window into EF, were associated with fall risk.We longitudinally followed 256 community-living older adults (age: 76.4±4.5 yrs; 61% women who were dementia free and had good mobility upon entrance into the study. At baseline, a computerized cognitive battery generated an index of EF, attention, a closely related construct, and other cognitive domains. Gait was assessed during single and dual task conditions. Falls data were collected prospectively using monthly calendars. Negative binomial regression quantified risk ratios (RR. After adjusting for age, gender and the number of falls in the year prior to the study, only the EF index (RR: .85; CI: .74-.98, p = .021, the attention index (RR: .84; CI: .75-.94, p = .002 and dual tasking gait variability (RR: 1.11; CI: 1.01-1.23; p = .027 were associated with future fall risk. Other cognitive function measures were not related to falls. Survival analyses indicated that subjects with the lowest EF scores were more likely to fall sooner and more likely to experience multiple falls during the 66 months of follow-up (p<0.02.These findings demonstrate that among community-living older adults, the risk of future falls was predicted by performance on EF and attention tests conducted 5 years earlier. The present results link falls among older adults to cognition, indicating that screening EF will likely enhance fall risk assessment, and that treatment of EF may reduce fall risk.

  10. Late-career unemployment and all-cause mortality, functional disability and depression among the older adults in Taiwan: A 12-year population-based cohort study.

    Science.gov (United States)

    Chu, Wei-Min; Liao, Wen-Chun; Li, Chi-Rong; Lee, Shu-Hsin; Tang, Yih-Jing; Ho, Hsin-En; Lee, Meng-Chih

    2016-01-01

    To evaluate whether late-career unemployment is associated with increased all-cause mortality, functional disability, and depression among older adults in Taiwan. In this long-term prospective cohort study, data were retrieved from the Taiwan Longitudinal Study on Aging. This study was conducted from 1996 to 2007. The complete data from 716 men and 327 women aged 50-64 years were retrieved. Participants were categorized as normally employed or unemployed depending on their employment status in 1996. The cumulative number of unemployment after age 50 was also calculated. Logistic regression analysis was used to examine the effect of the association between late-career unemployment and cumulative number of late-career unemployment on all-cause mortality, functional disability, and depression in 2007. The average age of the participants in 1996 was 56.3 years [interquartile range (IQR)=7.0]. A total of 871 participants were in the normally employed group, and 172 participants were in the unemployed group. After adjustment of gender, age, level of education, income, self-rated health and major comorbidities, late-career unemployment was associated with increased all-cause mortality [Odds ratio (OR)=2.79; 95% confidence interval (CI)=1.74-4.47] and functional disability [OR=2.33; 95% CI=1.54-3.55]. The cumulative number of late-career unemployment was also associated with increased all-cause mortality [OR=1.91; 95% CI=1.35-2.70] and functional disability [OR=2.35; 95% CI=1.55-3.55]. Late-career unemployment and cumulative number of late-career unemployment are associated with increased all-cause mortality and functional disability. Older adults should be encouraged to maintain normal employment during the later stage of their career before retirement. Employers should routinely examine the fitness for work of older employees to prevent future unemployment. Copyright © 2016. Published by Elsevier Ireland Ltd.

  11. A Nine-Year Follow-up Study of Sleep Patterns and Mortality in Community-Dwelling Older Adults in Taiwan

    Science.gov (United States)

    Chen, Hsi-Chung; Su, Tung-Ping; Chou, Pesus

    2013-01-01

    Study Objectives: To simultaneously explore the associations between mortality and insomnia, sleep duration, and the use of hypnotics in older adults. Design: A fixed cohort study. Setting: A community in Shih-Pai area, Taipei, Taiwan. Participants: A total of 4,064 participants over the age of 65 completed the study. Intervention: N/A. Measurements and Results: Insomnia was classified using an exclusionary hierarchical algorithm, which categorized insomnia as “no insomnia,” “subjective poor sleep quality,” “Pittsburgh Sleep Quality Index > 5 insomnia,” “1-month insomnia disorder,” and “6-month insomnia disorder.” The main outcome variables were 9-year all-cause mortality rates. In the all-cause mortality analyses, when hypnotic use, depressive symptoms and total sleep time were excluded from a proportional hazards regression model, subjects with “Pittsburgh Sleep Quality Index > 5 insomnia” had a higher mortality risk (HR: 1.21, 95% CI: 1.01-1.45). In the full model, frequent hypnotic use and long sleep duration predicted higher mortality rates. However, the increased mortality risk for subjects with “Pittsburgh Sleep Quality Index > 5 insomnia” was not observed in the full model. On the contrary, individuals with a 6-month DSM-IV insomnia disorder had a lower risk for premature death (HR: 0.64, 95% CI: 0.43-0.96). Conclusions: Long sleep duration and frequent hypnotics use predicted an increased mortality risk within a community-dwelling sample of older adults. The association between insomnia and mortality was affected by insomnia definition and other parameters related to sleep patterns. Citation: Chen HC; Su TP; Chou P. A nine-year follow-up study of sleep patterns and mortality in community-dwelling older adults in Taiwan. SLEEP 2013;36(8):1187-1198. PMID:23904679

  12. Outcomes of basilar artery occlusion in patients aged 75 years or older in the Basilar Artery International Cooperation Study.

    Science.gov (United States)

    Vergouwen, Mervyn D I; Compter, Annette; Tanne, David; Engelter, Stefan T; Audebert, Heinrich; Thijs, Vincent; de Freitas, Gabriel; Algra, Ale; Jaap Kappelle, L; Schonewille, Wouter J

    2012-11-01

    Patients with an acute basilar artery occlusion (BAO) have a high risk of long-lasting disability and death. Only limited data are available on functional outcome in elderly patients with BAO. Using data from the Basilar Artery International Cooperation Study, we aimed to determine outcomes in patients ≥75 years. Primary outcome measure was poor functional outcome (modified Rankin scale score 4-6). Secondary outcomes were death, insufficient vessel recanalization (defined as thrombolysis in myocardial infarction score 0-1) and symptomatic intracranial hemorrhage (SICH). Patients were divided into four age-groups, based on quartiles: 18-54, 55-64, 65-74, and ≥75 years. Outcomes were compared between patients ≥75 years and patients aged 18-54 years. Risk ratios with corresponding 95 % confidence intervals (CI) were calculated and Poisson regression analyses were performed to calculate adjusted risk ratios (aRR). We included 619 patients [18-54 years n = 153 (25 %), 55-64 years n = 133 (21 %), 65-74 years n = 171 (28 %), and ≥75 years n = 162 (26 %)]. Compared with patients aged 18-54 years, patients ≥75 years were at increased risk of poor functional outcome [aRR 1.33 (1.14-1.55)] and death [aRR 2.47 (1.75-3.51)]. Nevertheless, 35/162 (22 %, 95 % CI 15-28 %) of patients ≥75 years had good functional outcome. No significant differences between age groups were observed for recanalization rate and incidence of SICH. Although patients ≥75 years with BAO have an increased risk of poor outcome compared with younger patients, a substantial group of patients ≥75 years survives with a good functional outcome.

  13. Factors associated with bone mineral density and risk of fall in Korean adults with type 2 diabetes mellitus aged 50 years and older.

    Science.gov (United States)

    Lee, Kyoung Min; Chung, Chin Youb; Kwon, Soon-Sun; Lee, Seung Yeol; Kim, Tae Gyun; Choi, Young; Park, Moon Seok

    2014-11-01

    Osteoporotic fractures in subjects with diabetes mellitus (DM) carry higher mortality and morbidity. Because bone strength and minor trauma, such as a falls, are considered to be significant factors contributing to osteoporotic fractures, it is important to elucidate the associated factors with these. This study was performed to investigate the factors associated with bone mineral density (BMD) and falls in noninstitutionalized subjects with DM aged 50 years or older. We used the database from the 2010 Fifth Korea National Health and Nutrition Examination Survey. Subjects with DM aged 50 years or older were selected and included in the data analyses. Associated factors with BMD of the femoral neck and lumbar spine and those with falls were analyzed using multiple linear regression and binary logistic regression analyses, respectively. Three hundred sixty-two subjects [209 males; 153 females; average age, 66.0 y (SD 8.2 y)] were included. Among the male subjects, the total body muscle mass (P factors with femoral neck BMD, whereas age (P risk of falls. Total body muscle mass was the most prominent factor predicting femoral neck BMD and risk of falls in community-dwelling elderly subjects with DM. Further investigation is required to determine their role in preventing osteoporotic fractures in diabetic subjects.

  14. Longitudinal Patterns of Stability and Change in Tenacious Goal Pursuit and Flexible Goal Adjustment among Older People over a 9-Year Period.

    Science.gov (United States)

    Martinent, Guillaume; Bailly, Nathalie; Ferrand, Claude; Gana, Kamel; Giraudeau, Caroline; Joulain, Michèle

    2017-01-01

    Using the dual-process model of assimilative-tenacity (TGP) and accommodative-flexibility (FGA), the study aims to identify trajectories of TGP and FGA over five time points within a 9-year period, explore the relationships between the trajectories of TGP and FGA, and explore if participants from distinct TGP and FGA trajectories differed in indicators of well-being and depression. Latent class growth analysis was used in a five-wave longitudinal design among an older population of 747 participants over 65 years. Results highlight (1) emergence of four trajectories for flexibility (low and increasing, moderate and increasing, moderately high and stable, and high and stable trajectories) and three trajectories for tenacity (low and stable, moderate and stable, and high and decreasing trajectories), (2) that older people belonging to particular trajectories of FGA are not more likely to belong to particular trajectories of TGP, and (3) that participants from the high and decreasing TGP and high or moderately high and stable FGA trajectories were characterized by high score of perceived health, satisfaction with life, and self-esteem and low score of depression moods. These results highlight that the heterogeneity in longitudinal TGP and FGA scores throughout the life span needs to be accounted for in future research.

  15. Longitudinal Patterns of Stability and Change in Tenacious Goal Pursuit and Flexible Goal Adjustment among Older People over a 9-Year Period

    Directory of Open Access Journals (Sweden)

    Guillaume Martinent

    2017-01-01

    Full Text Available Using the dual-process model of assimilative-tenacity (TGP and accommodative-flexibility (FGA, the study aims to identify trajectories of TGP and FGA over five time points within a 9-year period, explore the relationships between the trajectories of TGP and FGA, and explore if participants from distinct TGP and FGA trajectories differed in indicators of well-being and depression. Latent class growth analysis was used in a five-wave longitudinal design among an older population of 747 participants over 65 years. Results highlight (1 emergence of four trajectories for flexibility (low and increasing, moderate and increasing, moderately high and stable, and high and stable trajectories and three trajectories for tenacity (low and stable, moderate and stable, and high and decreasing trajectories, (2 that older people belonging to particular trajectories of FGA are not more likely to belong to particular trajectories of TGP, and (3 that participants from the high and decreasing TGP and high or moderately high and stable FGA trajectories were characterized by high score of perceived health, satisfaction with life, and self-esteem and low score of depression moods. These results highlight that the heterogeneity in longitudinal TGP and FGA scores throughout the life span needs to be accounted for in future research.

  16. Lifestyle factors and site-specific risk of hip fracture in community dwelling older women – a 13-year prospective population-based cohort study

    Directory of Open Access Journals (Sweden)

    Määttä Mikko

    2012-09-01

    Full Text Available Abstract Background Several risk factors are associated to hip fractures. It seems that different hip fracture types have different etiologies. In this study, we evaluated the lifestyle-related risk factors for cervical and trochanteric hip fractures in older women over a 13-year follow-up period. Methods The study design was a prospective, population-based study consisting of 1681 women (mean age 72 years. Seventy-three percent (n = 1222 participated in the baseline measurements, including medical history, leisure-time physical activity, smoking, and nutrition, along with body anthropometrics and functional mobility. Cox regression was used to identify the independent predictors of cervical and trochanteric hip fractures. Results During the follow-up, 49 cervical and 31 trochanteric fractures were recorded. The women with hip fractures were older, taller, and thinner than the women with no fractures (p  Conclusions Impaired functional mobility, physical inactivity, and low body mass may increase the risk for hip fractures with different effects at the cervical and trochanteric levels.

  17. Falls in the community-dwelling older adult: A review for primary-care providers

    Science.gov (United States)

    Soriano, Theresa A; DeCherrie, Linda V; Thomas, David C

    2007-01-01

    Falls in the elderly are an important independent marker of frailty. Up to half of elderly people over 65 experience a fall every year. They are associated with high morbidity and mortality and are responsible for greater than 20 billion dollars a year in healthcare costs in the United States. This article presents a review and guide for the primary care provider of the predisposing and situational risk factors for falls; comprehensive assessment for screening and tailored intervention; and discussion of single and multicomponent measures for fall prevention and management in the older person living in the community. Interventions for the cognitively impaired and demented elderly will also be addressed. PMID:18225454

  18. Strategies to reduce the risk of falling: Cohort study analysis with 1-year follow-up in community dwelling older adults.

    Science.gov (United States)

    Morris, John N; Howard, Elizabeth P; Steel, Knight; Berg, Katherine; Tchalla, Achille; Munankarmi, Amy; David, Daniel

    2016-04-29

    According to the CDC, falls rank among the leading causes of accidental death in the United States, resulting in significant health care costs annually. In this paper we present information about everyday lifestyle decisions of the older adult that may help reduce the risk of falling. We pursued two lines of inquiry: first, we identify and then test known mutable fall risk factors and ask how the resolution of such problems correlates with changes in fall rates. Second, we identify a series of everyday lifestyle options that persons may follow and then ask, does such engagement (e.g., engagement in exercise programs) lessen the older adult's risk of falling and if it does, will the relationship hold as the count of risk factors increases? Using a secondary analysis of lifestyle choices and risk changes that may explain fall rates over one year, we drew on a data set of 13,623 community residing elders in independent housing sites from 24 US states. All older adults were assessed at baseline, and a subset assessed one year later (n = 4,563) using two interRAI tools: the interRAI Community Health Assessment and interRAI Wellness Assessment. For the vast majority of risk measures, problem resolution is followed by lower rate of falls. This is true for physical measures such as doing housework, meal preparation, unsteady gait, transferring, and dressing the lower body. Similarly, this pattern is observed for clinical measures such as depression, memory, vision, dizziness, and fatigue. Among the older adults who had a falls risk at the baseline assessment, about 20 % improve, that is, they had a decreased falls rate when the problem risk improved. This outcome suggests that improvement of physical or clinical states potentially may result in a decreased falls rate. Additionally, physical exercise and cognitive activities are associated with a lower rate of falls. The resolution of risk problems and physical and cognitive lifestyle choices are related to lower fall rates

  19. Efficacy and safety of enzalutamide in patients 75 years or older with chemotherapy-naive metastatic castration-resistant prostate cancer

    DEFF Research Database (Denmark)

    Graff, J N; Baciarello, G; Armstrong, A J

    2016-01-01

    BACKGROUND: Prostate cancer disproportionately affects older men. Because age affects treatment decisions, it is important to understand the efficacy and tolerability of therapies for advanced prostate cancer in elderly men. This analysis describes efficacy and safety outcomes in men aged ≥75 years......-resistant prostate cancer. Overall survival (OS) and radiographic progression-free survival (rPFS) were coprimary end points. Subgroup analysis of men aged ≥75 years (elderly) and men aged ... who received enzalutamide, an androgen receptor inhibitor, in the phase III PREVAIL trial. PATIENTS AND METHODS: PREVAIL was a randomised, double-blind, multinational study of oral enzalutamide 160 mg/day (N = 872) versus placebo (N = 845) in chemotherapy-naive men with metastatic castration...

  20. Small effect of genetic factors on neck pain in old age: a study of 2,108 Danish twins 70 years of age and older

    DEFF Research Database (Denmark)

    Hartvigsen, Jan; Petersen, Hans Christian; Frederiksen, Henrik

    2005-01-01

    STUDY DESIGN: Classic twin study. OBJECTIVES: To determine the heritability of neck pain in persons 70 years of age and older. SUMMARY OF BACKGROUND DATA: Previous studies have shown a moderate effect of genetic factors on back pain in the elderly. Genetic influence on neck pain in old age...... calculated and compared for monozygotic and dizygotic twins. Further, heritability estimates were calculated using bivariate probit estimation. RESULTS: A total of 2,108 twin individuals, including 1,054 complete twin pairs, answered the question related to neck pain at intake into the Longitudinal Study...... environmental risk factors (rheumatoid arthritis, osteoarthritis, disc prolapse, and coronary heart disease) showed no significant additive genetic, dominant genetic, or common environmental effects. CONCLUSION: Genetic factors do not play an important role in the liability to neck pain in persons 70 years...

  1. Stable or improved health status in the population 65 years and older in Stockholm, Sweden - an 8-year follow-up of self-reported health items.

    Science.gov (United States)

    Modig, Karin; Virtanen, Suvi; Ahlbom, Anders; Agahi, Neda

    2016-07-01

    Previous studies have reached different conclusions about whether health is improving in the ageing population. More studies with narrow age groups analyzed separately for men and women will contribute to the literature. To describe trends in self-reported indicators of health and health-related quality of life between 2002 and 2010, focusing on differences between gender and age groups. A population-based survey of individuals 65+ in the Stockholm County was used. Prevalence of health problems increased with age both among men and women. Men generally reported having no health problems to a larger extent than women, but the proportions reporting severe problems were similar. The larger picture is one of stability in health-related quality of life, even if several items developed for the better, especially among women. While the proportions reporting no health/functional problems increased for many items, the proportions reporting severe problems remained unchanged among men and improved only for two items among women. CONCLUSIONS OVERALL, IMPROVEMENTS WERE SEEN IN MANY OF THE HEALTH-RELATED QUALITY OF LIFE ITEMS AS WELL AS FOR SELF-RATED HEALTH AMONG WOMEN THE PROPORTIONS REPORTING LONG-TERM ILLNESS OR PERSISTENT HEALTH PROBLEMS INCREASED, BUT FEWER SEEM TO BE LIMITED IN THEIR DAILY ACTIVITIES BY THESE PROBLEMS THE STABLE PROPORTIONS OF POOR SELF-RATED HEALTH INDICATES THAT WHILE HEALTH AND FUNCTIONING SEEM TO BE IMPROVING FOR THE MAJORITY OF THE OLDER POPULATION, SOME GROUPS MAY BE LAGGING BEHIND FUTURE STUDIES SHOULD PAY ATTENTION TO CHANGES BOTH IN THE UPPER AND LOWER ENDS OF THE HEALTH SPECTRUM. © 2016 the Nordic Societies of Public Health.

  2. Sexual Behaviors, Healthcare Interactions, and HIV-Related Perceptions Among Adults Age 60 Years and Older: An Investigation by Race/Ethnicity.

    Science.gov (United States)

    Glaude-Hosch, Jonathan A; Smith, Matthew Lee; Heckman, Timothy G; Miles, Toni P; Olubajo, Babatunde A; Ory, Marcia G

    2015-01-01

    Older adults are remaining sexually active for longer periods of time, underscoring the need to assess sexual activity patterns in this group and identify differences by race/ethnicity, some of which may have implications for the development and implementation of sexual risk reduction interventions. Using data from the 2010 National Social Life, Health, and Aging Project, this study examined responses from 1,429 adults aged 60 years and older. Multinomial logistic regression compared sexual behaviors, health-related indicators, interactions with healthcare professionals, and HIV-related perceptions across participants' race/ethnicity. Approximately 81% of participants self-reported as non-Hispanic white, 10.59% as African American, and 8.05% as Hispanic. On average, participants were 69.9 years of age. In the previous year, 49.3% of participants engaged in sexual intercourse; only 3% used condoms. The majority of participants (83.1%) visited a physician at least twice in the previous year, 30.9% had discussed sex with a physician since turning 50, and 14.2% had been tested for HIV. Relative to non-Hispanic whites, African Americans were more likely to be divorced (OR=3.23, Psexually transmitted infection (STI) diagnoses (OR=1.67, P=0.030); and have paid for sex (OR=2.83, P=0.002). Although African Americans had greater perceived risk for HIV infection (OR=1.66, P=0.046), they were less likely to have discussed sex with a physician since turning 50 (OR=0.45, P=0.009). Contextualized interventions to improve patient-provider communication and proactive screening behaviors in sexually-active and aging African Americans are needed.

  3. Perceived environmental barriers to outdoor mobility and changes in sense of autonomy in participation outdoors among older people: a prospective two-year cohort study.

    Science.gov (United States)

    Rantakokko, Merja; Portegijs, Erja; Viljanen, Anne; Iwarsson, Susanne; Kauppinen, Markku; Rantanen, Taina

    2017-08-01

    The aim was to study whether perceived environmental barriers to outdoor mobility affect changes in sense of autonomy in participation outdoors among community-dwelling older people over a two-year period. Community-dwelling people aged 75-90 years (n = 848) in central Finland were interviewed on two occasions, face-to-face at baseline and over the telephone two years later. Perceived environmental barriers to outdoor mobility were assessed using a 15-item structured questionnaire, and the sum scores categorized into tertiles (0, 1 and 2 or more barriers). Autonomy in participation outdoors was assessed with the 'Impact on Participation and Autonomy' (IPA) questionnaire using the autonomy outdoors subscale (score range 0-20, higher scores indicating more restricted autonomy). Scores for autonomy in participation outdoors were available for 848 participants at baseline (mean 6.2, SD = 3.8) and for 748 participants at the two-year follow-up (mean 6.7, SD = 3.9). At baseline, those reporting multiple environmental barriers had the most restricted autonomy, while those reporting no environmental barriers had the least restricted autonomy (p autonomy in participation outdoors declined more among those reporting multiple environmental barriers compared to those reporting none (age- and sex-adjusted group*time β = .629, s.e. = .277, p = .023). Adjustment for cognitive functioning, education, number of chronic conditions and change in walking difficulty did not influence the association. Perceived environmental barriers to outdoor mobility accelerate the decline in autonomy in participation outdoors among older community-dwelling people. Understanding factors affecting autonomy can help in finding ways to support the sense of autonomy as people age.

  4. Association between Serum Uric Acid Level and Carotid Atherosclerosis in Chinese Individuals Aged 75 Years or Older: A Hospital-Based Case-Control Study.

    Science.gov (United States)

    Feng, L; Hua, C; Sun, H; Qin, L-Y; Niu, P-P; Guo, Z-N; Yang, Y

    2018-01-01

    To investigate the association between serum uric acid level and the presence and progression of carotid atherosclerosis in Chinese individuals aged 75 years or older. Case-control study. In a teaching hospital. Five hundred and sixty-four elderlies (75 years or above) who underwent general health screening in our hospital were enrolled. The detailed carotid ultrasound results, physical examination information, medical history, and laboratory test results including serum uric acid level were recorded, these data were used to analyze the relationship between serum uric acid level and carotid atherosclerosis. Then, subjects who underwent the second carotid ultrasound 1.5-2 years later were further identified to analyzed the relationship between serum uric acid and the progression of carotid atherosclerosis. A total of 564 subjects were included, carotid plaque was found in 482 (85.5%) individuals. Logistic regression showed that subjects with elevated serum uric acid (expressed per 1 standard deviation change) had significantly higher incidence of carotid plaque (odds ratio, 1.37; 95% confidence interval, 1.07-1.75; P= 0.012) after controlling for other factors. A total of 236 subjects underwent the follow-up carotid ultrasound. Linear regression showed that serum uric acid level (expressed per 1 standard deviation change; 1 standard deviation = 95.5 μmol/L) was significantly associated with percentage of change of plaque score (P = 0.008). Multivariable linear regression showed that 1 standard deviation increase in serum uric acid levels was expected to increase 0.448% of plaque score (P = 0.023). The elevated serum uric acid level may be independently and significantly associated with the presence and progression of carotid atherosclerosis in Chinese individuals aged 75 years or older.

  5. 180 billion pounds to fix transport or save New Labour?

    International Nuclear Information System (INIS)

    Anon.

    2000-01-01

    This article considers that the UK government's ten-year transport plan, launched in July 2000, is as much about boosting New Labour's popularity as it is about addressing the nation's transport problems

  6. A nine-year follow-up study of sleep patterns and mortality in community-dwelling older adults in Taiwan.

    Science.gov (United States)

    Chen, Hsi-Chung; Su, Tung-Ping; Chou, Pesus

    2013-08-01

    To simultaneously explore the associations between mortality and insomnia, sleep duration, and the use of hypnotics in older adults. A fixed cohort study. A community in Shih-Pai area, Taipei, Taiwan. A total of 4,064 participants over the age of 65 completed the study. N/A. Insomnia was classified using an exclusionary hierarchical algorithm, which categorized insomnia as "no insomnia," "subjective poor sleep quality," "Pittsburgh Sleep Quality Index > 5 insomnia," "1-month insomnia disorder," and "6-month insomnia disorder." The main outcome variables were 9-year all-cause mortality rates. In the all-cause mortality analyses, when hypnotic use, depressive symptoms and total sleep time were excluded from a proportional hazards regression model, subjects with "Pittsburgh Sleep Quality Index > 5 insomnia" had a higher mortality risk (HR: 1.21, 95% CI: 1.01-1.45). In the full model, frequent hypnotic use and long sleep duration predicted higher mortality rates. However, the increased mortality risk for subjects with "Pittsburgh Sleep Quality Index > 5 insomnia" was not observed in the full model. On the contrary, individuals with a 6-month DSM-IV insomnia disorder had a lower risk for premature death (HR: 0.64, 95% CI: 0.43-0.96). Long sleep duration and frequent hypnotics use predicted an increased mortality risk within a community-dwelling sample of older adults. The association between insomnia and mortality was affected by insomnia definition and other parameters related to sleep patterns.

  7. First Episode of Self-Harm in Older Age : A Report From the 10-Year Prospective Manchester Self-Harm Project

    NARCIS (Netherlands)

    Voshaar, Richard C. Oude; Cooper, Jayne; Murphy, Elizabeth; Steeg, Sarah; Kapur, Nay; Purandare, Nitin B.

    Objective: Self-harm is closely related to completed suicide, especially in older age. As empirical research of self-harm in older age is scarce, with no studies confined to first-ever episodes in older age, we examined the clinical characteristics and the risk of repetition in first-ever self-harm

  8. First episode of self-harm in older age: a report from the 10-year prospective Manchester Self-Harm project

    NARCIS (Netherlands)

    Oude Voshaar, R.C.; Cooper, J.; Murphy, E.; Steeg, S.; Kapur, N.; Purandare, N.B.

    2011-01-01

    OBJECTIVE: Self-harm is closely related to completed suicide, especially in older age. As empirical research of self-harm in older age is scarce, with no studies confined to first-ever episodes in older age, we examined the clinical characteristics and the risk of repetition in first-ever self-harm

  9. Missing billions. How the Australian government's climate policy is penalising farmers

    International Nuclear Information System (INIS)

    Riguet, T.

    2006-10-01

    The Climate Institute analysis suggests ratifying the Kyoto Protocol and implementing a national emissions trading scheme today could provide Australian farmers with an income of $1.8 billion over the period 2008-2012, due to the emissions saved by limiting land clearing. Separately, a report to the National Farmers Federation by the Allen Consulting Group earlier this year concluded that a carbon emission trading system which recognised Kyoto Protocol rules could create an additional income stream of $0.7-0.9 billion over a five year period from revenue to farmers from forestry sinks. These two studies suggest that ratification of the Kyoto Protocol and the introduction of a national emissions trading scheme could provide farmers an income stream in the order of $2.5 billion. A central tenet of the Federal Government's greenhouse policy for over a decade has been to not ratify Kyoto, but to meet its Kyoto target - a national emissions increase of 8% from 1990 levels, in the period 2008-2012. Australia's National Greenhouse Gas Accounts show that farmers, by reducing land clearing rates since 1990, have offset substantial increases in greenhouse gas emissions from other sectors, mainly energy. Official Federal Government projections show that without land clearing reductions, Australia's greenhouse emissions would be 30% above 1990 levels by 2010. Australia's farmers have been responsible for virtually the entire share of the nation's greenhouse gas emissions reductions, but their efforts, worth around $2 billion, have not been recognised or financially rewarded by the Government. By reducing land clearing, farmers have already reduced greenhouse gas emissions by about 75 million tonnes since 1990. By 2010, the savings are projected to be about 83 million tonnes. This level of emissions reductions is equivalent to eliminating the total annual emissions of New Zealand or Ireland. Over that same period, emissions from energy and transport have and continue to sky

  10. Mobility Modification Alleviates Environmental Influence on Incident Mobility Difficulty among Community-Dwelling Older People: A Two-Year Follow-Up Study

    Science.gov (United States)

    Portegijs, Erja; Viljanen, Anne; Iwarsson, Susanne; Rantanen, Taina

    2016-01-01

    Background Environmental barriers increase risk for mobility difficulties in old age. Mobility difficulty is preceded by a phase where people try to postpone a difficulty through mobility modification. We studied whether perceived environmental mobility barriers outdoors correlate with mobility modification and mobility difficulty, predict development of mobility difficulty over a two-year follow-up, and whether mobility modification alleviates the risk for difficulty. Methods At baseline, 848 people aged 75–90 were interviewed face-to-face. Telephone follow-up interviews were conducted one (n = 816) and two years (n = 761) later. Environmental barriers to mobility were self-reported using a15-item structured questionnaire at baseline, summed and divided into tertiles (0, 1 and 2 or more barriers). Mobility difficulty was assessed as self-reported ability to walk 2 km at all assessment points and categorized into ‘no difficulty’, ‘no difficulty but mobility modifications’ (reducing frequency, stopping walking, using an aid, slowing down or resting during the performance) and ‘difficulty’. Results At baseline, 212 participants reported mobility modifications and 356 mobility difficulties. Those reporting one or multiple environmental barriers had twice the odds for mobility modifications and up to five times the odds for mobility difficulty compared to those reporting no environmental barriers. After multiple adjustments for health and functioning, reporting multiple environmental barriers outdoors continued to predict the development of incident mobility difficulty over the two-year follow-up. Mobility modifications attenuated the association. Conclusion For older people who successfully modify their performance, environmental influence on incident mobility difficulty can be diminished. Older people use mobility modification to alleviate environmental press on mobility. PMID:27104750

  11. Does multicomponent physical exercise with simultaneous cognitive training boost cognitive performance in older adults? A 6-month randomized controlled trial with a 1-year follow-up.

    Science.gov (United States)

    Eggenberger, Patrick; Schumacher, Vera; Angst, Marius; Theill, Nathan; de Bruin, Eling D

    2015-01-01

    Cognitive impairment is a health problem that concerns almost every second elderly person. Physical and cognitive training have differential positive effects on cognition, but have been rarely applied in combination. This study evaluates synergistic effects of multicomponent physical exercise complemented with novel simultaneous cognitive training on cognition in older adults. We hypothesized that simultaneous cognitive-physical components would add training specific cognitive benefits compared to exclusively physical training. Seniors, older than 70 years, without cognitive impairment, were randomly assigned to either: 1) virtual reality video game dancing (DANCE), 2) treadmill walking with simultaneous verbal memory training (MEMORY), or 3) treadmill walking (PHYS). Each program was complemented with strength and balance exercises. Two 1-hour training sessions per week over 6 months were applied. Cognitive performance was assessed at baseline, after 3 and 6 months, and at 1-year follow-up. Multiple regression analyses with planned comparisons were calculated. Eighty-nine participants were randomized to the three groups initially, 71 completed the training, while 47 were available at 1-year follow-up. Advantages of the simultaneous cognitive-physical programs were found in two dimensions of executive function. "Shifting attention" showed a time×intervention interaction in favor of DANCE/MEMORY versus PHYS (F[2, 68] =1.95, trend P=0.075, r=0.17); and "working memory" showed a time×intervention interaction in favor of DANCE versus MEMORY (F[1, 136] =2.71, trend P=0.051, R (2)=0.006). Performance improvements in executive functions, long-term visual memory (episodic memory), and processing speed were maintained at follow-up in all groups. Particular executive functions benefit from simultaneous cognitive-physical training compared to exclusively physical multicomponent training. Cognitive-physical training programs may counteract widespread cognitive impairments in

  12. Self-reported vision impairment and incident prefrailty and frailty in English community-dwelling older adults: findings from a 4-year follow-up study.

    Science.gov (United States)

    Liljas, Ann E M; Carvalho, Livia A; Papachristou, Efstathios; De Oliveira, Cesar; Wannamethee, S Goya; Ramsay, Sheena E; Walters, Kate R

    2017-11-01

    Little is known about vision impairment and frailty in older age. We investigated the relationship of poor vision and incident prefrailty and frailty. Cross-sectional and longitudinal analyses with 4-year follow-up of 2836 English community-dwellers aged ≥60 years. Vision impairment was defined as poor self-reported vision. A score of 0 out of the 5 Fried phenotype components was defined as non-frail, 1-2 prefrail and ≥3 as frail. Participants non-frail at baseline were followed-up for incident prefrailty and frailty. Participants prefrail at baseline were followed-up for incident frailty. 49% of participants (n=1396) were non-frail, 42% (n=1178) prefrail and 9% (n=262) frail. At follow-up, there were 367 new cases of prefrailty and frailty among those non-frail at baseline, and 133 new cases of frailty among those prefrail at baseline. In cross-sectional analysis, vision impairment was associated with frailty (age-adjustedandsex-adjusted OR 2.53, 95% CI 1.95 to 3.30). The association remained after further adjustment for wealth, education, cardiovascular disease, diabetes, falls, cognition and depression. In longitudinal analysis, compared with non-frail participants with no vision impairment, non-frail participants with vision impairment had twofold increased risks of prefrailty or frailty at follow-up (OR 2.07, 95% CI 1.32 to 3.24). The association remained after further adjustment. Prefrail participants with vision impairment did not have greater risks of becoming frail at follow-up. Non-frail older adults who experience poor vision have increased risks of becoming prefrail and frail over 4 years. This is of public health importance as both vision impairment and frailty affect a large number of older adults. © 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.

  13. Community access networks: how to connect the next billion to the ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Community access networks: how to connect the next billion to the Internet. Despite recent progress with mobile technology diffusion, more than four billion people worldwide are unconnected and have limited access to global communication infrastructure. The cost of implementing connectivity infrastructure in underserved ...

  14. Interactive (statistical) visualisation and exploration of a billion objects with vaex

    NARCIS (Netherlands)

    Breddels, M. A.

    2016-01-01

    With new catalogues arriving such as the Gaia DR1, containing more than a billion objects, new methods of handling and visualizing these data volumes are needed. We show that by calculating statistics on a regular (N-dimensional) grid, visualizations of a billion objects can be done within a second

  15. B-Vitamin Intake and Biomarker Status in Relation to Cognitive Decline in Healthy Older Adults in a 4-Year Follow-Up Study

    Directory of Open Access Journals (Sweden)

    Catherine F. Hughes

    2017-01-01

    Full Text Available Advancing age can be associated with an increase in cognitive dysfunction, a spectrum of disability that ranges in severity from mild cognitive impairment to dementia. Folate and the other B-vitamins involved in one-carbon metabolism are associated with cognition in ageing but the evidence is not entirely clear. The hypothesis addressed in this study was that lower dietary intake or biomarker status of folate and/or the metabolically related B-vitamins would be associated with a greater than expected rate of cognitive decline over a 4-year follow-up period in healthy older adults. Participants (aged 60–88 years; n = 155 who had been previously screened for cognitive function were reassessed four years after initial investigation using the Mini-Mental State Examination (MMSE. At the 4-year follow-up assessment when participants were aged 73.4 ± 7.1 years, mean cognitive MMSE scores had declined from 29.1 ± 1.3 at baseline to 27.5 ± 2.4 (p < 0.001, but some 27% of participants showed a greater than expected rate of cognitive decline (i.e., decrease in MMSE > 0.56 points per year. Lower vitamin B6 status, as measured using pyridoxal-5-phosphate (PLP; <43 nmol/L was associated with a 3.5 times higher risk of accelerated cognitive decline, after adjustment for age and baseline MMSE score (OR, 3.48; 95% CI, 1.58 to 7.63; p < 0.05. Correspondingly, lower dietary intake (0.9–1.4 mg/day of vitamin B6 was also associated with a greater rate of cognitive decline (OR, 4.22; 95% CI, 1.28–13.90; p < 0.05. No significant relationships of dietary intake or biomarker status with cognitive decline were observed for the other B-vitamins. In conclusion, lower dietary and biomarker status of vitamin B6 at baseline predicted a greater than expected rate of cognitive decline over a 4-year period in healthy older adults. Vitamin B6 may be an important protective factor in helping maintain cognitive health in ageing.

  16. Boltzmann's dynamic on the primitive earth about 3.9 billion years ago

    International Nuclear Information System (INIS)

    Matsuno, Koichiro

    1995-01-01

    An evolutionary significant event that could have happened on the primitive earth would be a process of enhancing energy concentrations locally. Once the concentrated energy be released, it could drive various molecular association and dissociation. We have examined, both theoretically and experimentally, a possibility of forming such microscopic heat engines feeding upon the then available thermal environment. Theoretically, Boltzmann's dynamics of molecules that would lose their memory of pas collisions with others is found to uphold those molecules that could feed upon thermal energy if the thermal environment would fluctuate through, for instance, a diurnal cycle. Experimentally, thermal heterocomplex molecules from amino acids, that could have been ubiquitous on the primitive earth, are shown to carry with themselves a wide variety of quasi-stable states such that they could remain in excited states for a considerable period of time even if the temperature of the thermal environment is lowered. The stored energy in these excited states, once released, can be utilized as a factor for driving various molecular association and dissociation. (author). Abstract only

  17. Evidence for the effect of disease management: is $1 billion a year a good investment?

    Science.gov (United States)

    Mattke, Soeren; Seid, Michael; Ma, Sai

    2007-12-01

    To assess the evidence for the effect of disease management on quality of care, disease control, and cost, with a focus on population-based programs. Literature review. We conducted a literature search for and a structured review of studies on population-based disease management programs, as well as for reviews and meta-analyses of disease management interventions. We identified 3 evaluations of large-scale population-based programs, as well as 10 meta-analyses and 16 systematic reviews, covering 317 unique studies. We found consistent evidence that disease management improves processes of care and disease control but no conclusive support for its effect on health outcomes. Overall, disease management does not seem to affect utilization except for a reduction in hospitalization rates among patients with congestive heart failure and an increase in outpatient care and prescription drug use among patients with depression. When the costs of the intervention were appropriately accounted for and subtracted from any savings, there was no conclusive evidence that disease management leads to a net reduction of direct medical costs. Although disease management seems to improve quality of care, its effect on cost is uncertain. Most of the evidence to date addresses small-scale programs targeting high-risk individuals, while only 3 studies evaluate large population-based interventions, implying that little is known about their effect. Payers and policy makers should remain skeptical about vendor claims and should demand supporting evidence based on transparent and scientifically sound methods.

  18. A Powerful Toolkit for Synthetic Biology: Over 3.8 Billion Years of Evolution

    Science.gov (United States)

    Rothschild, Lynn J.

    2010-01-01

    The combination of evolutionary with engineering principles will enhance synthetic biology. Conversely, synthetic biology has the potential to enrich evolutionary biology by explaining why some adaptive space is empty, on Earth or elsewhere. Synthetic biology, the design and construction of artificial biological systems, substitutes bio-engineering for evolution, which is seen as an obstacle. But because evolution has produced the complexity and diversity of life, it provides a proven toolkit of genetic materials and principles available to synthetic biology. Evolution operates on the population level, with the populations composed of unique individuals that are historical entities. The source of genetic novelty includes mutation, gene regulation, sex, symbiosis, and interspecies gene transfer. At a phenotypic level, variation derives from regulatory control, replication and diversification of components, compartmentalization, sexual selection and speciation, among others. Variation is limited by physical constraints such as diffusion, and chemical constraints such as reaction rates and membrane fluidity. While some of these tools of evolution are currently in use in synthetic biology, all ought to be examined for utility. A hybrid approach of synthetic biology coupled with fine-tuning through evolution is suggested

  19. The rapid formation of a large rotating disk galaxy three billion years after the Big Bang.

    Science.gov (United States)

    Genzel, R; Tacconi, L J; Eisenhauer, F; Schreiber, N M Förster; Cimatti, A; Daddi, E; Bouché, N; Davies, R; Lehnert, M D; Lutz, D; Nesvadba, N; Verma, A; Abuter, R; Shapiro, K; Sternberg, A; Renzini, A; Kong, X; Arimoto, N; Mignoli, M

    2006-08-17

    Observations and theoretical simulations have established a framework for galaxy formation and evolution in the young Universe. Galaxies formed as baryonic gas cooled at the centres of collapsing dark-matter haloes; mergers of haloes and galaxies then led to the hierarchical build-up of galaxy mass. It remains unclear, however, over what timescales galaxies were assembled and when and how bulges and disks--the primary components of present-day galaxies--were formed. It is also puzzling that the most massive galaxies were more abundant and were forming stars more rapidly at early epochs than expected from models. Here we report high-angular-resolution observations of a representative luminous star-forming galaxy when the Universe was only 20% of its current age. A large and massive rotating protodisk is channelling gas towards a growing central stellar bulge hosting an accreting massive black hole. The high surface densities of gas, the high rate of star formation and the moderately young stellar ages suggest rapid assembly, fragmentation and conversion to stars of an initially very gas-rich protodisk, with no obvious evidence for a major merger.

  20. Detection of pristine gas two billion years after the Big Bang.

    Science.gov (United States)

    Fumagalli, Michele; O'Meara, John M; Prochaska, J Xavier

    2011-12-02

    In the current cosmological model, only the three lightest elements were created in the first few minutes after the Big Bang; all other elements were produced later in stars. To date, however, heavy elements have been observed in all astrophysical environments. We report the detection of two gas clouds with no discernible elements heavier than hydrogen. These systems exhibit the lowest heavy-element abundance in the early universe, and thus are potential fuel for the most metal-poor halo stars. The detection of deuterium in one system at the level predicted by primordial nucleosynthesis provides a direct confirmation of the standard cosmological model. The composition of these clouds further implies that the transport of heavy elements from galaxies to their surroundings is highly inhomogeneous.

  1. Changes in Prescribing Symptomatic and Preventive Medications in the Last Year of Life in Older Nursing Home Residents

    NARCIS (Netherlands)

    van der Meer, Helene G.; Taxis, Katja; Pont, Lisa G.

    2018-01-01

    Background At the end of life goals of care change from disease prevention to symptomatic control, however little is known about the patterns of medication prescribing at this stage. Objectives To explore changes in prescribing of symptomatic and preventive medication in the last year of life in

  2. Trends in screening mammograms for women 50 years of age and older - behavioral risk factor surveillance system, 1987

    International Nuclear Information System (INIS)

    Anon.

    1989-01-01

    To assess whether the media attention to breast cancer screening and the promotional efforts in 1987 were paralleled by increases in screening of women greater than or equal to 50 years of age, CDC analyzed data from 33 states that participated in the 1987 Behavioral Risk Factor Surveillance System (BRFSS)

  3. Potential effects of the next 100 billion hamburgers sold by McDonald's.

    Science.gov (United States)

    Spencer, Elsa H; Frank, Erica; McIntosh, Nichole F

    2005-05-01

    McDonald's has sold >100 billion beef-based hamburgers worldwide with a potentially considerable health impact. This paper explores whether there would be any advantages if the next 100 billion burgers were instead plant-based burgers. Nutrient composition of the beef hamburger patty and the McVeggie burger patty were obtained from the McDonald's website; sales data were obtained from the McDonald's customer service. Consuming 100 billion McDonald's beef burgers versus the same company's McVeggie burgers would provide, approximately, on average, an additional 550 million pounds of saturated fat and 1.2 billion total pounds of fat, as well as 1 billion fewer pounds of fiber, 660 million fewer pounds of protein, and no difference in calories. These data suggest that the McDonald's new McVeggie burger represents a less harmful fast-food choice than the beef burger.

  4. Uncharted territory - environment and population beyond six billion

    OpenAIRE

    Benedick, Richard Elliot

    2000-01-01

    "That human populations can exert strains upon their natural surrounding is nothing new. However, from the dawn of history until about thirty years ago, the impacts of human activities were primarily localized. Early regional civilizations – Mesopotamia in the Near East, Mohenjo Daro in Southwest Asia, the Mayans of Central America, possibly the Anasazi in the southwest of what is now the United States – collapsed due to a likely combination of overpopulation and scarcity or ...

  5. Outcome and survival of patients aged 75 years and older compared to younger patients after ruptured abdominal aortic aneurysm repair: do the results justify the effort?

    DEFF Research Database (Denmark)

    Shahidi, S; Schroeder, T Veith; Carstensen, M.

    2009-01-01

    We evaluated early mortality (preoperative variables that may be predictive of 30-day mortality in elderly patients compared to younger patients after emergency open repair of ruptured abdominal aortic aneurysm (RAAA). The survey is a retrospective analysis based...... patients compared to the younger group. Between the survivors of the two groups, there were no significant differences in the total length of stay (LOS) and the LOS in the intensive care unit. Advanced age (>or=75) and the combination of this advanced age and serum creatinine of >or=0.150 mmol/L were...... the only significant (p preoperative risk factors in our single-center study. However, we believe that treatment for RAAA can be justified in elderly patients. In our experience, surgical open repair has been life-saving in 33% of patients aged 75 years and older, at a relatively low price for each...

  6. Associations of sarcopenic obesity with the metabolic syndrome and insulin resistance over five years in older men: The Concord Health and Ageing in Men Project.

    Science.gov (United States)

    Scott, David; Cumming, Robert; Naganathan, Vasi; Blyth, Fiona; Le Couteur, David G; Handelsman, David J; Seibel, Markus; Waite, Louise M; Hirani, Vasant

    2018-04-09

    Previous cross-sectional studies investigating associations of sarcopenic obesity with metabolic syndrome (MetS) and insulin resistance have not utilised consensus definitions of sarcopenia. We aimed to determine associations of sarcopenic obesity with MetS and insulin resistance over five years in community-dwelling older men. 1231 men aged ≥70 years had appendicular lean mass (ALM) and body fat percentage assessed by dual-energy X-ray absorptiometry and hand grip strength and gait speed tests. Sarcopenia was defined as low ALM/height (m 2 ) and low hand grip strength or gait speed (European Working Group definition); obesity was defined as body fat percentage ≥30%. MetS was assessed at baseline and 5-years later. Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) was assessed at 5-years only. Men with sarcopenic obesity (odds ratio, 95% CI: 2.07, 1.21-3.55) and non-sarcopenic obesity (4.19, 3.16-5.57) had higher MetS likelihood than those with non-sarcopenic non-obesity at baseline. Higher gait speed predicted lower odds for prevalent MetS (0.45, 0.21-0.96 per m/s). Higher body fat predicted increased odds for prevalent and incident MetS (1.14, 1.11-1.17 and 1.11, 1.02-1.20 per kg, respectively) and deleterious 5-year changes in MetS fasting glucose, high-density lipoprotein cholesterol and triglycerides (all P < 0.05). Compared with non-sarcopenic non-obesity, estimated marginal means for HOMA-IR at 5-years were higher in non-sarcopenic obesity only (1.0, 0.8-1.1 vs 1.3, 1.2-1.5; P < 0.001). Similar results were observed when sarcopenic obesity was defined by waist circumference. Sarcopenic obesity does not appear to confer greater risk for incident MetS or insulin resistance than obesity alone in community-dwelling older men. Copyright © 2018 Elsevier Inc. All rights reserved.

  7. Is cholecystectomy necessary after endoscopic treatment of bile duct stones in patients older than 80 years of age?

    Science.gov (United States)

    Yasui, Takaharu; Takahata, Shunichi; Kono, Hiroshi; Nagayoshi, Yosuke; Mori, Yasuhisa; Tsutsumi, Kosuke; Sadakari, Yoshihiko; Ohtsuka, Takao; Nakamura, Masafumi; Tanaka, Masao

    2012-01-01

    Although patients with cholecystocholedocholithiasis are generally referred to cholecystectomy after endoscopic sphincterotomy (ES) and common bile duct clearance, we often have a conflict whether cholecystectomy is necessary in very elderly patients with comorbid diseases. The aim of this study is to assess whether cholecystectomy in very elderly patients is justified after ES. Patients with cholecystocholedocholithiasis who underwent ES and stone extraction and were followed-up for more than 10 years were retrospectively reviewed. We divided these patients into two groups: the elderly group (equal to or more than 80 years old) and young group (less than 80 years old) and compared late biliary complications and mortality. The 10-year cumulative incidence of overall biliary complications was significantly lower in cholecystectomized patients than in patients with gallbladder in situ in the young group (7.5 vs. 21.7%, p = 0.0037), but not different in the elderly group (8.3 vs. 7.4%, p = 0.92). When each complication was evaluated separately, the rate of recurrent common bile duct stones (CBDS) was not different, but that of acute cholecystitis was significantly lower in the elderly group than in the young group (4.1 vs. 22.6%, p = 0.011). In very elderly patients the incidence of acute cholecystitis is low even when the gallbladder is preserved after endoscopic treatment of CBDS, with a similar risk of CBDS recurrence. Thus, it may not be necessary to recommend cholecystectomy after ES for CBDS in very elderly patients.

  8. One year B-vitamins increases serum and whole blood folate forms and lowers plasma homocysteine in older Germans.

    Science.gov (United States)

    Kirsch, Susanne H; Herrmann, Wolfgang; Kruse, Vera; Eckert, Rudolf; Gräber, Stefan; Geisel, Jürgen; Obeid, Rima

    2015-02-01

    We aimed to study the effect of long-term supplementation of B-vitamins on folate forms in serum and whole blood (WB) in elderly German subjects. 59 participants (mean age 67 years) were randomized to daily receive either vitamin D3 (1200 IU), folic acid (500 μg), vitamin B12 (500 μg), vitamin B6 (50 mg), and calcium carbonate (456 mg) or vitamin D3 plus calcium carbonate. Serum and WB folate forms were measured before and after 6 and 12 months. B-vitamins supplementation for 6 months led to higher concentrations of 5-methyltetrahydrofolate (5-methylTHF) in serum (mean 49.1 vs. 19.6 nmol/L) and WB (1332 vs. 616 nmol/L). Also non-methyl-folate concentrations in serum and WB were higher after 6 months with B-vitamins supplementation. Unmetabolized folic acid (UFA) increased after supplementation. tHcy concentration was lowered after 1 year of B-vitamin supplementation (mean 13.1 vs. 9.6 μmol/L). A stronger reduction of tHcy after 1 year was found in participants who had baseline level >12.5 μmol/L (mean 17.0 vs. 11.9 μmol/L) compared to those with baseline tHcy lower than this limit (mean 9.1 vs. 7.4 μmol/L). In contrast, the increases in serum and WB 5-methylTHF were comparable between the two groups. One year B-vitamins supplementation increased the levels of 5-methylTHF and non-methyl-folate in serum and WB, normalized tHcy, but caused an increase in the number of cases with detectable UFA in serum. Lowering of tHcy was predicted by baseline tHcy, but not by baseline serum or WB 5-methylTHF.

  9. Opioids, antiepileptic and anticholinergic drugs and the risk of fractures in patients 65 years of age and older: a prospective population-based study.

    Science.gov (United States)

    Nurminen, Janne; Puustinen, Juha; Piirtola, Maarit; Vahlberg, Tero; Lyles, Alan; Kivelä, Sirkka-Liisa

    2013-05-01

    in men, the concomitant use of two or more benzodiazepines or two or more antipsychotics is associated with an increased risk of fracture(s). Potential associations between the concomitant use of drugs with central nervous system effects and fracture risk have not been studied. the purpose was to describe the gender-specific risk of fractures in a population aged 65 years or over associated with the use of an opioid, antiepileptic or anticholinergic drug individually; or, their concomitant use with each other; or the concomitant use of one of these with a psychotropic drug. this study was part of a prospective, population-based study performed in Lieto, Finland. Information about fractures in 1,177 subjects (482 men and 695 women) was confirmed with radiology reports. at 3 years of follow-up, the concomitant use of an opioid with an antipsychotic was associated with an increased risk of fractures in men. During the 6-year follow-up, the concomitant use of an opioid with a benzodiazepine was also related to the risk of fractures for males. No significant associations were found for females. the concomitant use of an opioid with an antipsychotic, or with a benzodiazepine may increase the risk of fractures in men aged 65 years and older.

  10. Dietary pattern transitions, and the associations with BMI, waist circumference, weight and hypertension in a 7-year follow-up among the older Chinese population: a longitudinal study

    Directory of Open Access Journals (Sweden)

    Xiaoyue Xu

    2016-08-01

    Full Text Available Abstract Background Few studies explored the effects of nutritional changes on body mass index (BMI, weight (Wt, waist circumference (WC and hypertension, especially for the older Chinese population. Methods By using China Health and Nutrition Survey 2004-2011 waves, a total of 6348 observations aged ≥ 60 were involved in the study. The number of participants dropped from 2197 in 2004, to 1763 in 2006, 1303 in 2009, and 1085 in 2011. Dietary information was obtained from participants using 24 hour-recall over three consecutive days. Height, Wt, WC, systolic and diastolic blood pressure were also measured in each survey year. The dietary pattern was derived by exploratory factor analysis using principal component analysis methods. Linear Mixed Models were used to investigate associations of dietary patterns with BMI, Wt and WC. Generalized Estimating Equation models were used to assess the associations between dietary patterns and hypertension. Results Over time, older people’s diets were shifting towards a modern dietary pattern (high intake of dairy, fruit, cakes and fast food. Traditional and modern dietary patterns had distinct associations with BMI, Wt and WC. Participants with a diet in the highest quartile for traditional composition had a β (difference in mean of −0.23 (95 % CI: −0.44; −0.02 for BMI decrease, β of −0.90 (95 % CI: −1.42; −0.37 for Wt decrease; and β of −1.57 (95 % CI: −2.32; −0.83 for WC decrease. However, participants with a diet in the highest quartile for modern diet had a β of 0.29 (95 % CI: 0.12; 0.47 for BMI increase; β of 1.02 (95 % CI: 0.58; 1.46 for Wt increase; and β of 1.44 (95 % CI: 0.78; 2.10 for Wt increase. No significant associations were found between dietary patterns and hypertension. Conclusions We elucidate the associations between dietary pattern and change in BMI, Wt, WC and hypertension in a 7-year follow-up study. The strong association between favourable body

  11. Dietary pattern transitions, and the associations with BMI, waist circumference, weight and hypertension in a 7-year follow-up among the older Chinese population: a longitudinal study.

    Science.gov (United States)

    Xu, Xiaoyue; Byles, Julie; Shi, Zumin; McElduff, Patrick; Hall, John

    2016-08-08

    Few studies explored the effects of nutritional changes on body mass index (BMI), weight (Wt), waist circumference (WC) and hypertension, especially for the older Chinese population. By using China Health and Nutrition Survey 2004-2011 waves, a total of 6348 observations aged ≥ 60 were involved in the study. The number of participants dropped from 2197 in 2004, to 1763 in 2006, 1303 in 2009, and 1085 in 2011. Dietary information was obtained from participants using 24 hour-recall over three consecutive days. Height, Wt, WC, systolic and diastolic blood pressure were also measured in each survey year. The dietary pattern was derived by exploratory factor analysis using principal component analysis methods. Linear Mixed Models were used to investigate associations of dietary patterns with BMI, Wt and WC. Generalized Estimating Equation models were used to assess the associations between dietary patterns and hypertension. Over time, older people's diets were shifting towards a modern dietary pattern (high intake of dairy, fruit, cakes and fast food). Traditional and modern dietary patterns had distinct associations with BMI, Wt and WC. Participants with a diet in the highest quartile for traditional composition had a β (difference in mean) of -0.23 (95 % CI: -0.44; -0.02) for BMI decrease, β of -0.90 (95 % CI: -1.42; -0.37) for Wt decrease; and β of -1.57 (95 % CI: -2.32; -0.83) for WC decrease. However, participants with a diet in the highest quartile for modern diet had a β of 0.29 (95 % CI: 0.12; 0.47) for BMI increase; β of 1.02 (95 % CI: 0.58; 1.46) for Wt increase; and β of 1.44 (95 % CI: 0.78; 2.10) for Wt increase. No significant associations were found between dietary patterns and hypertension. We elucidate the associations between dietary pattern and change in BMI, Wt, WC and hypertension in a 7-year follow-up study. The strong association between favourable body composition and traditional diet, compared with an increase in BMI, WC and Wt

  12. Food security: the challenge of feeding 9 billion people.

    Science.gov (United States)

    Godfray, H Charles J; Beddington, John R; Crute, Ian R; Haddad, Lawrence; Lawrence, David; Muir, James F; Pretty, Jules; Robinson, Sherman; Thomas, Sandy M; Toulmin, Camilla

    2010-02-12

    Continuing population and consumption growth will mean that the global demand for food will increase for at least another 40 years. Growing competition for land, water, and energy, in addition to the overexploitation of fisheries, will affect our ability to produce food, as will the urgent requirement to reduce the impact of the food system on the environment. The effects of climate change are a further threat. But the world can produce more food and can ensure that it is used more efficiently and equitably. A multifaceted and linked global strategy is needed to ensure sustainable and equitable food security, different components of which are explored here.

  13. Lifestyle factors and site-specific risk of hip fracture in community dwelling older women – a 13-year prospective population-based cohort study

    Science.gov (United States)

    2012-01-01

    Background Several risk factors are associated to hip fractures. It seems that different hip fracture types have different etiologies. In this study, we evaluated the lifestyle-related risk factors for cervical and trochanteric hip fractures in older women over a 13-year follow-up period. Methods The study design was a prospective, population-based study consisting of 1681 women (mean age 72 years). Seventy-three percent (n = 1222) participated in the baseline measurements, including medical history, leisure-time physical activity, smoking, and nutrition, along with body anthropometrics and functional mobility. Cox regression was used to identify the independent predictors of cervical and trochanteric hip fractures. Results During the follow-up, 49 cervical and 31 trochanteric fractures were recorded. The women with hip fractures were older, taller, and thinner than the women with no fractures (p trochanteric fractures (HR = 3.4, 95% CI 1.8-6.6, and HR = 5.3, 95% CI 2.5-11.4, respectively). Low baseline physical activity was associated with an increased risk of hip fracture, especially in the cervical region (HR = 2.5, 95% CI 1.3-4.9). A decrease in cervical fracture risk (p = 0.002) was observed with physically active individuals compared to their less active peers (categories: very low or low, moderate, and high). Moderate coffee consumption and hypertension decreased the risk of cervical fractures (HR = 0.4, 95% CI 0.2-0.8, for both), while smoking was a predisposing factor for trochanteric fractures (HR = 3.2, 95% CI 1.1-9.3). Conclusions Impaired functional mobility, physical inactivity, and low body mass may increase the risk for hip fractures with different effects at the cervical and trochanteric levels. PMID:22978821

  14. Outcomes of vaginal hysterectomy and constricting colporrhaphy with concurrent levator myorrhaphy and high perineorrhaphy in women older than 75 years of age

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    Töz E

    2015-06-01

    Full Text Available Emrah Töz, Aykut Özcan, Nesin Apaydin, İbrahim Uyar, Betül Kocakaya, Gülin Okay Department of Gynecology and Obstetrics, Tepecik Education and Research Hospital, İzmir, Turkey Objectives: We performed constricting anterior and posterior colporrhaphy, levator myorrhaphy, and high perineorrhaphy with concurrent hysterectomy, and investigated the intraoperative complications, and short-term outcomes of these constricting procedures in patients aged 75 years or older.Methods: We searched our hospital database for cases, between January 2011 and January 2014, of women aged over 75 years who underwent surgery for pelvic organ prolapse of stage 2 or higher, via vaginal hysterectomy, constricting anterior and posterior colporrhaphy, levator myorrhaphy, and high perineorrhaphy, with or without treatment of urinary incontinence. All volunteers were evaluated via pelvic examination using the pelvic organ prolapse quantification system, the modified Decision Regret Scale–Pelvic Floor Disorders form, the Satisfaction Decision Scale–Pelvic Floor Disorders form, and the Pelvic Floor Distress Inventory form.Results: Fifty-four patients were included in the study. The mean follow-up time was 24.4 months after constricting surgery (range: 8–44 months. There were four cases (7% of de novo urge incontinence (the symptoms resolved upon prescription of anticholinergic medication. Two patients developed de novo stress urinary incontinence after the procedure and were treated via transobturator sling surgery using Safyre T® polypropylene monofilament slings. No anatomical or subjective recurrence of prolapse was noted during the follow-up period. No patient required additional surgery for recurrence of prolapse.Conclusion: Constricting anterior and posterior colporrhaphy, levator myorrhaphy, and high perineorrhaphy with concurrent hysterectomy is a feasible, safe, and effective surgical option in elderly patients at low anesthesiological risk. The decision

  15. Mortality 1950-1964 and disease and survivorship 1958-1964 among sample members aged 50 years or older, October 1, 1950

    Energy Technology Data Exchange (ETDEWEB)

    Ciocco, A

    1965-01-01

    Persons who were 50 years or older in 1950, or 45 years or older at the time of the atomic bomb (ATB), constitute that portion of the Life Span Study sample subject to the highest disability and mortality risks, from malignancies as well as from other chronic disease conditions. Furthermore, this age class is rapidly approaching the modal age of death. Hence, whatever late effects of exposure to the bomb in 1945 are to occur they should be perceptible by this time. With this view in mind, mortality, and the occurrence of selected diseases subsequent to 1950 have been compared for the following purposes among designated exposure groups: to specify the size and trend of differences among the exposure groups; and to point up some of the issues which must be met in planning future statistical-epidemiologic studies at ABCC. The three exposure groups compared were: persons within 1400 m from the hypocenter (0 to 1399 m); those beyond 1400 m (1400 to 9999 m); and persons not in the city ATB. Each group has been examined for: cumulative mortality pattern from 1 October 1950 to 30 September 1964, for all causes of death, for deaths from tuberculosis, lung cancer, stomach cancer, and leukemia; occupation characteristics and their relation to mortality; selective factors related to inclusion in the ABCC-JNIH Adult Health Study, and prevalance and incidence of, and survivorship from, tuberculosis among participants in the Adult Health Study, 1958 to 1964; and selective factors related to frequency of autopsy, 1961 to 1964. 11 references, 2 figures, 22 tables.

  16. Drug Perscription Patterns of Out Patient Medication for Older People Insured by Social Organization Insurance in Year 2009

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    Khalil No Kohan Ahvazi

    2012-03-01

    Full Text Available Objectives: Life expectancy and adolescents’ increment, as a threat or opportunity attracted researchers’ attention. Studies show an increase in treatment expenditures and adults care needs in comparison to other age groups. The goal of this study has been evaluating of medicine prescription in Iranian SSO insured adolescents and comparison in adolescence groups. Methods & Materials: It has been a retrospective, descriptive-analytical-cross sectional study by evaluating of SSO insured out patients’ prescriptions during the Year 1388. The information includes basic pattern tables consist of Drug name, pattern of specific prescribed drugs, Mean price of specific prescribed drugs, Expenditure of specific prescribed drugs, pattern More prescribed drug groups based on ATC classification, pattern The most prescribed drug groups based on adolescents’ age groups, non-adolescent group and WHO’s separated adolescents’ age groups. Results: The prescribed pattern drugs mean in under and over 60 years old people showed meaningful difference (P<0.005. The prescribed pattern drugs mean in three groups of adolescents, also showed meaningful difference (P<0.001. In addition the expenditure mean of prescribed drugs in under and over 60 years old people and in three groups of adolescents shows meaningful difference as P<0.004 and P<0.001 respectively. Conclusion: Based on the results of this study, adolescence has direct and increasing effect on refers to physicians and pharmacies. Among the adolescents' groups the expenditure mean increases although the number of refers decrease with in age increasing. By determining the most prescribed medicines, prevention of chronic diseases could be possible by education and training of families.

  17. Construct validity of the BESTest, mini-BESTest and briefBESTest in adults aged 50 years and older.

    Science.gov (United States)

    O'Hoski, Sachi; Sibley, Kathryn M; Brooks, Dina; Beauchamp, Marla K

    2015-09-01

    The Balance Evaluation Systems Test (BESTest) and its two abbreviated versions (mini-BESTest and briefBESTest) are functional balance tools that have yet to be validated in middle aged and elderly people living in the community. Determine the construct validity of the three BESTest versions by comparing them with commonly-used measures of balance, balance confidence and physical activity, and examining their ability to discriminate between groups with respect to falls and fall risk. This was a secondary analysis of data from 79 adults (mean age 68.7±10.57 years). Pearson correlation coefficients were used to examine the relationships between each BESTest measure and the Activities-Specific Balance Confidence (ABC) scale, the Physical Activity Scale for the Elderly (PASE), the Timed Up and Go (TUG) and the Single Leg Stance (SLS) test. Independent t-tests were used to examine differences in balance between fallers (≥1 fall in previous year) and non-fallers and individuals classified at low versus high fall risk using the Elderly Falls Screening Test (EFST). The BESTest measures showed moderate associations with the ABC scale and TUG (r=0.62-0.67 and -0.60 to -0.68 respectively), fair associations (r=0.33-0.40) with the PASE and moderate to high associations (r=0.67-0.77) with the SLS. Fallers showed a trend (p=0.054) for lower scores on the original BESTest, and people at high risk for falls had significantly lower scores on all BESTest versions. These findings support the construct validity of the BESTest, mini-BESTest and briefBESTest in adults over 50 years old. Copyright © 2015 Elsevier B.V. All rights reserved.

  18. Chronic renal disease in spain: prevalence and related factors in persons with diabetes mellitus older than 64 years.

    Science.gov (United States)

    Martínez Candela, Juan; Sangrós González, Javier; García Soidán, Francisco Javier; Millaruelo Trillo, José Manuel; Díez Espino, Javier; Bordonaba Bosque, Daniel; Ávila Lachica, Luis

    2018-02-07

    Type 2 diabetes mellitus and chronic kidney disease (CKD) are conditions which have a high prevalence in individuals ≥ 65 years of age and represent a major public health problem. To determine the prevalence of CKD, its categories and its relationship with various demographic and clinical factors in elderly patients with type 2 diabetes mellitus in Spain. Observational, cross-sectional, multicenter, Spanish epidemiological study. Patients with known type 2 diabetes mellitus, age ≥ 65 years of age treated in Primary Care were included. We collected demographic, anthropometric and analytical variables from the previous 12 months, including the albumin-to-creatinine ratio and estimated glomerular filtration rate to evaluate renal function. The prevalence of CKD was 37.2% (95% CI, 34.1-40.3%), renal failure was 29.7% (95% CI, 26.8-32.6%) and increased albuminuria was 20.6% (95% CI, 17.3-23.9%), moderately increased albuminuria was 17.8% (95% CI, 14.7-20.9%) and severely increased albuminuria was 2.8% (95% CI, 1.4-4.2%). In turn, the prevalence of CKD categories were: G1 1.3% (95% CI, 0.6-2%), G2 6.2% (95% CI, 4.6-7.8%), G3a 17.2% (95% CI, 14.8-19.6%), G3b 9.8% (95% CI, 7.9-11.7%), G4 2% (95% CI, 1.1-2.9%) and G5 0.7% (95% CI, 0.2-1.2%). In the multivariate analysis, after adjusting for the remaining variables, CKD was associated with elderly age (OR 5.13, 95% CI, 3.15-8.35), high comorbidity (OR 3.36. 95% CI, 2.2-5.12) and presence of antihypertensive treatment (OR 2.43. 95% CI, 1.48-4.02). CKD is frequent in the diabetic population ≥ 65 years of age and is associated with elderly age, high comorbidity and with treated hypertension. No relationship has been found with gender and time in years since onset of diabetes. Copyright © 2018 Sociedad Española de Nefrología. Published by Elsevier España, S.L.U. All rights reserved.

  19. Urodynamics in a community-dwelling population of females 80 years or older: which motive? Which diagnosis?

    Directory of Open Access Journals (Sweden)

    Françoise A. Valentini

    2010-04-01

    Full Text Available PURPOSE: To determine why community-dwelling women aged 80 years or over were referred for urodynamic evaluation despite their advanced age and which urodynamic diagnosis was made. MATERIALS AND METHODS: One hundred consecutive females (80-93 years were referred to our urodynamics outpatient clinic for evaluation of lower urinary tract symptoms (LUTS between 2005 and 2008. Clinical evaluation comprised of a previous history of LUTS, previous medical history of neurological disease or dementia, pelvic floor dysfunction or prior pelvic surgery. Exclusion criteria were complete retention and severe dementia involving failure to understand simple instructions. Assessed items were results of uroflows (free flow and intubated flow, cystometry and urethral pressure profilometry, and final urodynamic diagnosis. RESULTS: The main complaint evoked by the patients was incontinence (65.0% of which 61.5% was "complicated" and urgency was reported by 70.0%. Interpretable free flow at arrival was very low (44.0%. Prevalence of detrusor overactivity was high, found in 45 patients of whom 16 had detrusor hyperactivity with impaired detrusor contractility. Detrusor overactivity and urgency were strongly associated (p = 0.004. Twenty-five patients had intrinsic sphincteric deficiency alone and 15 detrusor underactivity. CONCLUSION: In this particular community-dwelling with an elderly female population, urodynamics is easily feasible. Incontinence, mainly "complicated" is the more frequent complaint and urgency the more frequent symptom. Urodynamic diagnosis underlines the high incidence of detrusor overactivity as well as impaired detrusor function.

  20. Tailoring Breast Cancer Screening Intervals by Breast Density and Risk for Women Aged 50 Years or Older: Collaborative Modeling of Screening Outcomes.

    Science.gov (United States)

    Trentham-Dietz, Amy; Kerlikowske, Karla; Stout, Natasha K; Miglioretti, Diana L; Schechter, Clyde B; Ergun, Mehmet Ali; van den Broek, Jeroen J; Alagoz, Oguzhan; Sprague, Brian L; van Ravesteyn, Nicolien T; Near, Aimee M; Gangnon, Ronald E; Hampton, John M; Chandler, Young; de Koning, Harry J; Mandelblatt, Jeanne S; Tosteson, Anna N A

    2016-11-15

    Biennial screening is generally recommended for average-risk women aged 50 to 74 years, but tailored screening may provide greater benefits. To estimate outcomes for various screening intervals after age 50 years based on breast density and risk for breast cancer. Collaborative simulation modeling using national incidence, breast density, and screening performance data. United States. Women aged 50 years or older with various combinations of breast density and relative risk (RR) of 1.0, 1.3, 2.0, or 4.0. Annual, biennial, or triennial digital mammography screening from ages 50 to 74 years (vs. no screening) and ages 65 to 74 years (vs. biennial digital mammography from ages 50 to 64 years). Lifetime breast cancer deaths, life expectancy and quality-adjusted life-years (QALYs), false-positive mammograms, benign biopsy results, overdiagnosis, cost-effectiveness, and ratio of false-positive results to breast cancer deaths averted. Screening benefits and overdiagnosis increase with breast density and RR. False-positive mammograms and benign results on biopsy decrease with increasing risk. Among women with fatty breasts or scattered fibroglandular density and an RR of 1.0 or 1.3, breast cancer deaths averted were similar for triennial versus biennial screening for both age groups (50 to 74 years, median of 3.4 to 5.1 vs. 4.1 to 6.5 deaths averted; 65 to 74 years, median of 1.5 to 2.1 vs. 1.8 to 2.6 deaths averted). Breast cancer deaths averted increased with annual versus biennial screening for women aged 50 to 74 years at all levels of breast density and an RR of 4.0, and those aged 65 to 74 years with heterogeneously or extremely dense breasts and an RR of 4.0. However, harms were almost 2-fold higher. Triennial screening for the average-risk subgroup and annual screening for the highest-risk subgroup cost less than $100 000 per QALY gained. Models did not consider women younger than 50 years, those with an RR less than 1, or other imaging methods. Average-risk women

  1. For better or worse: Factors predicting outcomes of family care of older people over a one-year period. A six-country European study

    Science.gov (United States)

    Bien, Barbara; McKee, Kevin; Krevers, Barbro; Mestheneos, Elizabeth; Di Rosa, Mirko; von dem Knesebeck, Olaf; Kofahl, Christopher

    2018-01-01

    Objectives Demographic change has led to an increase of older people in need of long-term care in nearly all European countries. Informal carers primarily provide the care and support needed by dependent people. The supply and willingness of individuals to act as carers are critical to sustain informal care resources as part of the home health care provision. This paper describes a longitudinal study of informal care in six European countries and reports analyses that determine those factors predicting the outcomes of family care over a one-year period. Methods Analyses are based on data from the EUROFAMCARE project, a longitudinal survey study of family carers of older people with baseline data collection in 2004 and follow-up data collection a year later in six European countries (Germany, Greece, Italy, Poland, Sweden, and the United Kingdom), N = 3,348. Descriptive statistics of the sample characteristics are reported. Binary logistic random-intercept regressions were computed, predicting the outcome of change of the care dyad’s status at follow-up. Results Where care is provided by a more distant family member or by a friend or neighbour, the care-recipient is significantly more likely to be cared for by someone else (OR 1.62) or to be in residential care (OR 3.37) after one year. The same holds true if the care-recipient has memory problems with a dementia diagnosis (OR 1.79/OR 1.84). Higher dependency (OR 1.22) and behavioural problems (OR 1.76) in the care-recipient also lead to a change of care dyad status. Country of residence explained a relatively small amount of variance (8%) in whether a care-recipient was cared for by someone else after one year, but explained a substantial amount of variance (52%) in whether a care-recipient was in residential care. Particularly in Sweden, care-recipients are much more likely to be cared for by another family or professional carer or to be in residential care, whereas in Greece the status of the care dyad is much

  2. Somatic parameters of 17 year old soccer players in the older youth category in relation to sports performance

    Directory of Open Access Journals (Sweden)

    Petr Kutáč

    2013-09-01

    Full Text Available BACKGROUND: Somatic parameters are included not only in the general structure of sporting performance, but also in the structure of sporting performance in soccer. In light of this structure, higher performance players should have better somatic performance prerequisites, and their somatic parameters should differ from players with lower performance levels. OBJECTIVE: The aim of the study is to assess the somatic parameters of players with different performance levels. METHODS: The research included 90 soccer players in the age of 17 years in three performance categories playing in the junior competition in the Czech Republic. Average age of the individual levels – highest performance 17.61 ± 0.48, middle performance 17.50 ± 0.50, lowest performance 17.50 ± 0.50 years. The following was monitored – basic anthropometric parameters (body weight, body height, somatotype (Heath-Carter, representation of body fat (BF, fat free mass (FFM and the total body water (TBW. The Tanita 418 MA tetrapolar bioelectrical impedance (BIA scale was used for the determination of the representation of BF and the TBW. All players were measured at the beginning of the competition period in the same year. All measurements were implemented in the morning hours by the same person with corresponding experience. RESULTS: The average values of somatic parameters measured in the individual performance categories show that we can only consider them to be an indicator of sporting performance up to a particular performance level. The boundary was the middle performance level (teams playing regional competition as their mean values of the monitored somatic parameters significantly differed from the mean values of players at the lowest performance level (teams playing at the district and municipal levels but they did not differ when compared with the mean values of the players at the highest performance level (teams playing the top junior league. CONCLUSIONS

  3. Neurodegenerative changes in the brainstem and olfactory bulb in people older than 50 years old: a descriptive study

    Directory of Open Access Journals (Sweden)

    Francine Hehn de Oliveira

    2015-07-01

    Full Text Available With the increase in life expectancy in Brazil, concerns have grown about the most prevalent diseases in elderly people. Among these diseases are neurodegenerative diseases, such as Alzheimer’s and Parkinson’s diseases. Protein deposits related to the development of these diseases can pre-date the symptomatic phases by years. The tau protein is particularly interesting: it might be found in the brainstem and olfactory bulb long before it reaches the limbic cortex, at which point symptoms occur. Of the 14 brains collected in this study, the tau protein was found in the brainstems of 10 (71.42% and in olfactory bulbs of 3 out 11. Of the 7 individuals who had a final diagnosis of Alzheimer’s disease (AD, 6 presented tau deposits in some region of the brainstem. Our data support the idea of the presence of tau protein in the brainstem and olfactory bulb in the earliest stages of AD.

  4. Economic burden of informal care attributable to stroke among those aged 65 years or older in China.

    Science.gov (United States)

    Joo, Heesoo; Liang, Di

    2017-02-01

    Stroke is a leading cause of disability in China, frequently resulting in the need for informal care. No information, however, is available on costs of informal care associated with stroke, required to understand the true cost of stroke in China. Using the 2011 China Health and Retirement Longitudinal Study, we identified 4447 respondents aged ≥65 years suitable for analyses, including 184 stroke survivors. We estimated the economic burden of informal care associated with stroke using a two-part model. The monthly number of hours of informal caregiving associated with stroke was 29.2 h/stroke survivor, and the average annual cost of informal care associated with stroke was 10,612 RMB per stroke survivor. The findings stress the necessity of proper interventions to prevent stroke and will be useful for estimating the economic burden of stroke.

  5. Association between Self-reported Snoring and Prediabetes among Adults Aged 40 Years and Older without Diabetes.

    Science.gov (United States)

    Wang, Hai-Bin; Yan, Wen-Hua; Dou, Jing-Tao; Lu, Zhao-Hui; Wang, Bao-An; Mu, Yi-Ming

    2017-04-05

    Several previous studies have shown that snoring is associated with glucose metabolism and the development of diabetes, but rare study has shown the association between snoring frequency and prediabetes, particularly in China. We hypothesized that individuals who snore might have a higher risk of prediabetes. This study aimed to investigate the association between self-reported snoring and prediabetes in a Chinese population. A cross-sectional study was performed in three large communities of Beijing from December 2011 to August 2012 by recruiting individuals aged ≥40 years old. All participants were requested to complete a detailed questionnaire and undergo anthropometric measurements. A 75 g oral glucose tolerance test was performed in individuals without diabetes. Blood samples of all participants were collected; blood glucose and blood fat levels were measured. Multivariate logistic regression models were built to assess the association between snoring frequency and prediabetes. A total of 13,592 participants (female: 66.56%; mean age: 56.8 ± 7.9 years; mean body mass index: 25.5 ± 3.4 kg/m2) were included in the final analysis. Of these, 30.9% were diagnosed with prediabetes, while 41.3% and 25.4% had occasional and habitual snoring, respectively. Habitual snoring was associated with an increased risk of prediabetes (odds ratio [OR]: 1.3, 95% confidence interval [CI]: 1.1-1.4, Pprediabetes was observed only in individuals with TC prediabetes, but only in individuals with TC <5.6 mmol/L. Further prospective studies are needed to confirm this finding.

  6. Feeding nine billion: the challenge to sustainable crop production.

    Science.gov (United States)

    Gregory, Peter J; George, Timothy S

    2011-11-01

    In the recent past there was a widespread working assumption in many countries that problems of food production had been solved, and that food security was largely a matter of distribution and access to be achieved principally by open markets. The events of 2008 challenged these assumptions, and made public a much wider debate about the costs of current food production practices to the environment and whether these could be sustained. As in the past 50 years, it is anticipated that future increases in crop production will be achieved largely by increasing yields per unit area rather than by increasing the area of cropped land. However, as yields have increased, so the ratio of photosynthetic energy captured to energy expended in crop production has decreased. This poses a considerable challenge: how to increase yield while simultaneously reducing energy consumption (allied to greenhouse gas emissions) and utilizing resources such as water and phosphate more efficiently. Given the timeframe in which the increased production has to be realized, most of the increase will need to come from crop genotypes that are being bred now, together with known agronomic and management practices that are currently under-developed.

  7. Comparison of immunization rates of adults ages 65 years and older managed within two nurse practitioner-owned clinics with national immunization rates.

    Science.gov (United States)

    Wright, Wendy L; Morrell, Elise; Lee, Jennie; Cuellar, Norma Graciela; White, Patricia

    2017-07-01

    Adults ages ≥65 years are at increased risk for infectious diseases. Ensuring these individuals are fully vaccinated is imperative. The purpose of this study was to assess the immunization rates of adults ages ≥65 years managed by nurse practitioners (NPs) and compare the results with national immunization rates and Healthy People 2020 goals. A convenience sample of adults ages ≥65 years was obtained from two NP-managed clinics. The vaccine records of each subject were reviewed for documentation of having received five vaccines (tetanus, diphtheria, and pertussis; influenza; pneumococcal polysaccharide vaccine 23; pneumococcal conjugate vaccine 13; and herpes zoster vaccine). One hundred and fifty females (70.8%) and 62 males (29.2%) met inclusion criteria. NP-managed patients had higher immunization rates than the national averages across all five major vaccines. The herpes zoster vaccination rates exceeded the recommendations from Healthy People 2020 whereas pneumococcal and influenza rates were below. The stocking of vaccines within the NP-managed clinics, direct billing to Medicare for Part D vaccines, and previsit care planning likely contributed to the high vaccination rates. These high immunization rates in patients managed by NPs provide support for the important role that NPs play in the care of older adults. ©2017 American Association of Nurse Practitioners.

  8. Areva excellent business volume: backlog as of december 31, 2008: + 21.1% to 48.2 billion euros. 2008 revenue: + 10.4% to 13.2 billion euros; Areva excellent niveau d'activite: carnet de commandes au 31/12/2008: + 21,1% a 48,2 Mds d'euros. Chiffre d'affaires de l'exercice 2008: + 10,4% a 13,2 Mds d'euros

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2009-07-01

    AREVA's backlog stood at 48.2 billion euros as of December 31, 2008, for 21.1% growth year-on-year, including 21.8% growth in Nuclear and 16.5% growth in Transmission and Distribution. The Nuclear backlog came to 42.5 billion euros at December 31, 2008. The Transmission and Distribution backlog came to 5.7 billion euros at year-end. The group recognized revenue of 13.2 billion euros in 2008, for year-on-year growth of 10.4% (+9.8% like-for-like). Revenue outside France was up 10.5% to 9.5 billion euros, representing 72% of total revenue. Revenue was up 6.5% in the Nuclear businesses (up 6.3% LFL), with strong performance in the Reactors and Services division (+10.9% LFL) and the Front End division (+7.2% LFL). The Transmission and Distribution division recorded growth of 17% (+15.8% LFL). Revenue for the fourth quarter of 2008 rose to 4.1 billion euros, up 5.2% (+1.6% LFL) from that of the fourth quarter of 2007. Revenue for the Front End division rose to 3.363 billion euros in 2008, up 7.1% over 2007 (+7.2% LFL). Foreign exchange (currency translations) had a negative impact of 53 million euros. Revenue for the Reactors and Services division rose to 3.037 billion euros, up 11.8% over 2007 (+10.9% LFL). Foreign exchange (currency translations) had a negative impact of 47 million euros. Revenue for the Back End division came to 1.692 billion euros, a drop of 2.7% (-2.5% LFL). Foreign exchange (currency translations) had a negative impact of 3.5 million euros. Revenue for the Transmission and Distribution division rose to 5.065 billion euros in 2008, up 17.0% (+15.8% LFL)

  9. Arthroscopic debridement for grade III and IV chondromalacia of the knee in patients older than 60 years.

    Science.gov (United States)

    van den Bekerom, Michel P J; Patt, Thomas W; Rutten, Sjoerd; Raven, Eric E J; van de Vis, Harm M V; Albers, G H Rob

    2007-10-01

    Arthroscopic debridement has been used to treat patients with degenerative knee osteoarthritis, although there is sometimes conflicting evidence documenting its efficacy. This study evaluates the success of arthroscopic debridement in elderly patients with grade III and IV chondromalacia of the knee as measured by patient satisfaction and the need for additional surgery. From December 1998 to August 2001, a total of 102 consecutive cases of knee arthroscopy in 99 patients > 60 years were performed. Average follow-up was 34 months (range: 7-104 months). Patients were asked about their satisfaction using a visual analog scale, and the presence of meniscal lesions during arthroscopy and the treatment for these lesions were evaluated. Knees also were assessed for articular surface degeneration using Outerbridge's classification for chondromalacia. The need for and type of additional surgery was evaluated. During arthroscopy, meniscal lesions requiring a partial meniscectomy were found in 95 knees. Chondromalacia was found in 92 knees; 53 knees had grade I or II chondromalacia and 39 knees had grade III or IV chondromalacia. Additional surgery was performed in 17 knees. Mean patient satisfaction score was 73 (range: 50-100) in the 39 knees with grade III or IV chondromalacia after arthroscopic debridement was performed. These findings suggest arthroscopic debridement in elderly patients has a place in the treatment algorithm for grade III or IV chondromalacia of the knee.

  10. Large artery stiffness and carotid intima-media thickness in relation to markers of calcium and bone mineral metabolism in African women older than 46 years.

    Science.gov (United States)

    Gafane, L F; Schutte, R; Kruger, I M; Schutte, A E

    2015-03-01

    Vascular calcification and cardiovascular diseases have been associated with altered bone metabolism. We explored the relationships of arterial pressures and carotid intima-media thickness (CIMT) with parathyroid hormone, 25-hydroxycholecalciferol and their ratio (PTH:25(OH)D3) as well as a marker of bone resorption (CTX) in lean and overweight/obese African women. A population of 434 African women older than 46 years was divided into lean and overweight/obese groups. We assessed brachial blood pressure, central pulse pressure (cPP) and CIMT, and determined PTH, 25(OH)D3 and CTX concentrations. Overweight/obese women had elevated PTH and PTH:25(OH)D3 compared with lean women (both Pwomen had higher CTX (Pwomen CIMT was independently associated with PTH:25(OH)D3 (R(2)=0.22; β=0.26; P=0.003), whereas in obese women cPP was associated with both PTH:25(OH)D3 (R2=0.20; β=0.17; P=0.017) and CTX (R2=0.20; β=0.17; P=0.025). In conclusion, we found that in African women with increased adiposity, cPP (as a surrogate measure of arterial stiffness), was positively associated with alterations in bone metabolism and calciotropic hormones, whereas CIMT of lean women was positively associated with PTH:25(OH)D3. Our results suggest that alterations in bone and calcium metabolism may contribute to arterial calcification in older African women.

  11. Association between edentulism and angina pectoris in Mexican adults aged 35 years and older: a multivariate analysis of a population-based survey.

    Science.gov (United States)

    Medina-Solís, Carlo Eduardo; Pontigo-Loyola, América Patricia; Pérez-Campos, Eduardo; Hernández-Cruz, Pedro; Ávila-Burgos, Leticia; Kowolik, Michael J; Maupomé, Gerardo

    2014-03-01

    The possible association between oral infection and chronic inflammation and cardiovascular disease risk has been studied intensively. The present study is designed to determine the strength of association between edentulism and angina pectoris in Mexican adults aged 35 years and older. Using the tools and sampling strategies of the World Health Survey of the World Health Organization, cross-sectional data were collected in Mexico in the National Performance Assessment Survey (probabilistic, multistage, and cluster sampling). Dental information was available for 20 of the 32 states of Mexico. Angina and edentulism are self-reported in this study. Statistical analysis was performed using binary logistic regression adjusting for complex samples. A total of 13,966 participants, representing a population of 29,853,607 individuals, were included. Of the complete study population, 3,052,263 (10.2%) were completely toothless, and 673,810 (2.3%) were diagnosed with angina pectoris. After adjusting for smoking, alcohol consumption, diabetes, body mass index, and sex, the effect of edentulism on angina was modified by age (interaction), being more marked in the younger age group (odds ratio [OR] = exp(2.5597) =12.93) than in the older individuals surveyed (OR = exp(2.5597 + (-0.0334)) =12.51). Additionally, low physical activity (OR = 1.51; 95% confidence interval [CI] = 1.03 to 2.22) and higher socioeconomic status (OR = 1.37; 95% CI = 1.00 to 1.90) were more likely to be associated with angina pectoris. Overall, the results of this study, conducted in a representative sample of Mexican adults, suggest that an association exists between edentulism and angina pectoris. Additional studies are necessary to elucidate the underlying mechanism for this association.

  12. Validation of a new mortality risk prediction model for people 65 years and older in northwest Russia: The Crystal risk score.

    Science.gov (United States)

    Turusheva, Anna; Frolova, Elena; Bert, Vaes; Hegendoerfer, Eralda; Degryse, Jean-Marie

    2017-07-01

    Prediction models help to make decisions about further management in clinical practice. This study aims to develop a mortality risk score based on previously identified risk predictors and to perform internal and external validations. In a population-based prospective cohort study of 611 community-dwelling individuals aged 65+ in St. Petersburg (Russia), all-cause mortality risks over 2.5 years follow-up were determined based on the results obtained from anthropometry, medical history, physical performance tests, spirometry and laboratory tests. C-statistic, risk reclassification analysis, integrated discrimination improvement analysis, decision curves analysis, internal validation and external validation were performed. Older adults were at higher risk for mortality [HR (95%CI)=4.54 (3.73-5.52)] when two or more of the following components were present: poor physical performance, low muscle mass, poor lung function, and anemia. If anemia was combined with high C-reactive protein (CRP) and high B-type natriuretic peptide (BNP) was added the HR (95%CI) was slightly higher (5.81 (4.73-7.14)) even after adjusting for age, sex and comorbidities. Our models were validated in an external population of adults 80+. The extended model had a better predictive capacity for cardiovascular mortality [HR (95%CI)=5.05 (2.23-11.44)] compared to the baseline model [HR (95%CI)=2.17 (1.18-4.00)] in the external population. We developed and validated a new risk prediction score that may be used to identify older adults at higher risk for mortality in Russia. Additional studies need to determine which targeted interventions improve the outcomes of these at-risk individuals. Copyright © 2017 Elsevier B.V. All rights reserved.

  13. Natural gas. The LNG trade exceeds the 100 billions of m3 limit

    International Nuclear Information System (INIS)

    Anon.

    1997-01-01

    1996 has been a particularly favourable year for the international natural gas industry with a 10% increase of the international trade. The worldwide commercialized production of natural gas (2310 billions of m 3 ) has shown a 5% increase with respect to the previous year, with a strong increase in the OECD countries (+15.5%), in particular in the North Sea. High growing rates were recorded also in Latin America (9.5%) and Middle East (8%). Natural gas production in the CIS (Community of Independent States) reached 714 Gm 3 in 1996 with 600 Gm 3 from the Russian federation. The international trade has shown a 10% increase and reached 429.3 Gm 3 . The methane tanker ship trade has shown a 10 Gm 3 increase mainly in the Asian market (Japan and South Korea). Natural gas consumption growth has been high too (+4.9%) and reached 11.6% in Europe due to the climate conditions and to an increasing electric power demand. (J.S.)

  14. Providing safe drinking water to 1.2 billion unserved people

    Energy Technology Data Exchange (ETDEWEB)

    Gadgil, Ashok J.; Derby, Elisabeth A.

    2003-06-01

    Despite substantial advances in the past 100 years in public health, technology and medicine, 20% of the world population, mostly comprised of the poor population segments in developing countries (DCs), still does not have access to safe drinking water. To reach the United Nations (UN) Millennium Goal of halving the number of people without access to safe water by 2015, the global community will need to provide an additional one billion urban residents and 600 million rural residents with safe water within the next twelve years. This paper examines current water treatment measures and implementation methods for delivery of safe drinking water, and offers suggestions for making progress towards the goal of providing a timely and equitable solution for safe water provision. For water treatment, based on the serious limitations of boiling water and chlorination, we suggest an approach based on filtration coupled with ultraviolet (UV) disinfection, combined with public education. Additionally, owing to the capacity limitations for non-governmental organizations (NGOs) to take on this task primarily on their own, we suggest a strategy based on financially sustainable models that include the private sector as well as NGOs.

  15. Vitamin D status and physical function in older Finnish people: A one-year follow-up study.

    Science.gov (United States)

    Salminen, Marika; Saaristo, Pilvi; Salonoja, Maritta; Vaapio, Sari; Vahlberg, Tero; Lamberg-Allardt, Christel; Aarnio, Pertti; Kivelä, Sirkka-Liisa

    2015-01-01

    The aim was to describe vitamin D status and its association with changes in PF during 12 months in Finnish community-dwelling elderly (≥65 years). Baseline serum 25-hydroxyvitamin D (25OHD) concentration was measured by enzymeimmunoassay, and participants (n=518) were divided according to 25OHD to three groups (I <50 nmol/l, II 50-74.9 nmol/l, and III ≥75 nmol/l). PF (maximal isometric extension strength of right and left knee, and time in five-repetition sit-to-stand test (5STS) and 10-m walking test) was measured at baseline and after 12 months. 25OHD deficiency (<50 nmol/l) was found in 20.5% of the participants. During a 12-month follow-up, differences in changes in knee extensor strength of right (p=0.044) and left (p=0.010) lower extremity and in 10-m walking test (p=.040) between the groups were significant. According to further pairwise comparisons these differences were between groups I and III (right knee, p=0.036; left knee, p=0.009; 10-m walk, p=0.044), with the exception of left knee extensor strength in which there were also significant difference between groups I and II (p=0.039). All significant differences in changes were in favour of group II or III. Significant differences in changes in knee extensor strengths maintained after adjustments for group (intervention/control), parathyroid hormone, and baseline level of knee extensor strength. Prospective analyses showed low 25OHD concentrations (<50 nmol/l) to be associated with deterioration in PF during 12 months compared with high 25OHD concentrations (≥75 nmol/l). Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  16. The association between orthostatic hypotension and cognitive state among adults 65 years and older who underwent a comprehensive geriatric assessment

    Science.gov (United States)

    Punchick, Boris; Freud, Tamar; Press, Yan

    2016-01-01

    Abstract The prevalence of cognitive impairment and orthostatic hypotension (OH) increases with age, but the results of studies that assessed possible associations between them are inconsistent. The aim of this study is to assess possible associations between cognitive impairment and OH in patients ≥65 years of age who underwent a comprehensive geriatric assessment. A retrospective analysis was conducted of the computerized medical records of the study population from 2005 to 2013. Data collected included blood pressure measurements that enabled the calculation of OH, results of the mini-mental state examination (MMSE), results of the Montreal cognitive assessment (MoCA) test, and cognitive diagnoses that were determined over the course of the assessment. The rate of OH in the study population of 571 adults was 32.1%. The mean MMSE score was 22.5 ± 5.2 among participants with OH and 21.6 ± 5.8 among those without OH (P = 0.09). The absence of a significant association between OH and MMSE remained after adjusting the MMSE score for age and education level. The mean MoCA score was 16.4 ± 5.0 among participants with OH and 16.4 ± 4.8 among those without (P = 0.33). The prevalence of OH was 39% among participants without cognitive impairment, 28.9% among those with mild cognitive impairment (MCI), and 30.6% among those with dementia (P = 0.13). There was no association between OH and cognitive impairment in adults who underwent a comprehensive geriatric assessment. PMID:27442658

  17. Major food sources contributing to energy intake--a nationwide survey of Brazilians aged 10 years and older.

    Science.gov (United States)

    Sichieri, Rosely; Bezerra, Ilana Nogueira; Araújo, Marina Campos; de Moura Souza, Amanda; Yokoo, Edna Massae; Pereira, Rosangela Alves

    2015-05-28

    Identification of major sources of energy in the diet helps to implement dietary recommendations to reduce obesity. To determine the food sources of energy consumed by Brazilians, we used the traditional method of ranking energy contribution of selected food groups and also compared days with and without consumption of specific food groups. Analysis was based on two non-consecutive days of dietary record from the Brazilian National Dietary Survey, conducted among 34,003 Brazilians (aged 10 years or more), taking into account the complex design of the survey. Comparison of days with and without consumption gave more consistent results, with sweets and cookies as the most important contributors to energy intake, increasing 992 kJ/d (95% CI 883, 1096) for those days when consumption of cakes, cookies and desserts was reported compared to days without their consumption. Savoury snacks, cheese and sugar-sweetened beverages (SSB) also increase energy intake by about 600 kJ. The only group associated with decreased energy intake was vegetable (-155 kJ; 95% CI -272, -37). Consumption of beans, milk and fruits increased the energy intake by about 210 kJ. In total, the mean energy intake of the group was 8000 kJ. Except for the consumption of vegetables, all of the other ten food groups analysed were associated with increased energy intake. Sweets and cookies may increase the energy intake by 12% and SSB by 7%, indicating that these two groups are major targets for improving healthy eating by reducing energy intake; whereas vegetable intake is associated with the reduction of energy content of the diet.

  18. Epidemiology of Traumatic Spinal Cord Injury Among Persons Older Than 21 Years: A Population-Based Study in South Carolina, 1998-2012.

    Science.gov (United States)

    Selassie, Anbesaw; Cao, Yue; Saunders, Lee L

    2015-01-01

    A gap exists in the current knowledge regarding the epidemiology of traumatic spinal cord injury (TSCI) in a statewide population. To describe population-based epidemiology and trend of TSCI in persons 22 years and older in South Carolina over a 15-year period from 1998 through 2012. Data on patients with TSCI were obtained from ongoing statewide TSCI surveillance and follow-up registry. Deaths were ascertained by linking surveillance files and the multiple cause-of-death dataset. Descriptive analyses were completed, and incidence and mortality rates were calculated based on the civilian adult population of the state. Over the 15 years, 3,365 persons with incident TSCI were discharged alive from acute care hospitalization, of whom 555 died during the period of observation. Age-standardized cumulative mortality rate was 14 per million, and the average incidence rate was estimated at 70.8 per million population per year. Age-standardized incidence rate of TSCI increased significantly from 66.9 in 1998 to 111.7 per million in 2012. Standardized incidence rates were significantly higher among non-Whites and males. Motor vehicle crashes and falls were the leading causes, accounting for nearly 70% of TSCI. Standardized incidence and mortality rates of TSCI in South Carolina are higher than reported rates for the US population. Motor vehicle crashes and falls are the leading causes of TSCI. There was a significant increase in the overall trend of the incidence rates over the 15 years. A well-coordinated preventive strategy is needed to reduce incidence and improve survival of persons with TSCI.

  19. Older Motorcyclists in Ireland

    LENUS (Irish Health Repository)

    Fitzpatrick, D

    2017-06-01

    Older motorcyclists are under-recognised as vulnerable road users. Using Irish data from the Central Statistics Office, the Road Safety Authority and the Healthcare Pricing Office, we explored the trend of ageing riders and factors in older motorcyclist collisions and injuries. In 2005, 17 motorcyclists ≥55 were injured compared to 31 in 2012. Motorcyclists aged between 30 and 49 years and ≥50 have longer lengths of stay compared to riders <30. The percentage of motorcycles with an engine capacity of ≥750cc increased from 39.6% in 2007 to 46.7% in 2015. Older motorcyclists are less likely to be fatally injured in single vehicle collisions. Older motorcyclists are generally safer than younger riders but the proportion of older motorcyclist injury is rising. Irish road safety strategies and trauma services need to incorporate these findings into planning and development of preventive and treatment approaches

  20. Development of web-based computer-tailored advice to promote physical activity among people older than 50 years.

    Science.gov (United States)

    Peels, Denise A; van Stralen, Maartje M; Bolman, Catherine; Golsteijn, Rianne Hj; de Vries, Hein; Mudde, Aart N; Lechner, Lilian

    2012-03-02

    The Active Plus project is a systematically developed theory- and evidence-based, computer-tailored intervention, which was found to be effective in changing physical activity behavior in people aged over 50 years. The process and effect outcomes of the first version of the Active Plus project were translated into an adapted intervention using the RE-AIM framework. The RE-AIM model is often used to evaluate the potential public health impact of an intervention and distinguishes five dimensions: reach, effectiveness, adoption, implementation, and maintenance. To gain insight into the systematic translation of the first print-delivered version of the Active Plus project into an adapted (Web-based) follow-up project. The focus of this study was on the reach and effectiveness dimensions, since these dimensions are most influenced by the results from the original Active Plus project. We optimized the potential reach and effect of the interventions by extending the delivery mode of the print-delivered intervention into an additional Web-based intervention. The interventions were adapted based on results of the process evaluation, analyses of effects within subgroups, and evaluation of the working mechanisms of the original intervention. We pretested the new intervention materials and the Web-based versions of the interventions. Subsequently, the new intervention conditions were implemented in a clustered randomized controlled trial. Adaptations resulted in four improved tailoring interventions: (1) a basic print-delivered intervention, (2) a basic Web-based intervention, (3) a print-delivered intervention with an additional environmental component, and (4) a Web-based version with an additional environmental component. Pretest results with participants showed that all new intervention materials had modest usability and relatively high appreciation, and that filling in an online questionnaire and performing the online tasks was not problematic. We used the pretest results

  1. Incidence and predictors of asymptomatic atrial fibrillation in patients older than 70 years with complete atrioventricular block and dual chamber pacemaker implantation.

    LENUS (Irish Health Repository)

    Radeljic, Vjekoslav

    2012-01-31

    AIM: To evaluate predictors of asymptomatic atrial fibrillation in patients older than 70 years with complete atrioventricular (AV) block, normal left ventricular systolic function, and implanted dual chamber (DDD) pacemaker. METHODS: Hundred and eighty six patients with complete AV block were admitted over one year to the Sisters of Mercy University Hospital. The study recruited patients older than 70 years, with no history of atrial fibrillation, heart failure, or reduced left ventricular systolic function. All the patients were implanted with the same pacemaker. Out of 103 patients who were eligible for the study, 81 (78%) were evaluated. Among those 81 (78%) were evaluated. Eighty one (78%) patients were evaluated. Follow-up time ranged from 12 to 33 months (average +\\/-standard deviation 23 +\\/- 5 months). Primary end-point was asymptomatic atrial fibrillation occurrence recorded by the pacemaker. Atrial fibrillation occurrence was defined as atrial high rate episodes (AHRE) lasting >5 minutes. Binary logistic regression was used to identify the predictors of development of asymptomatic atrial fibrillation. Results. The 81 patients were stratified into two groups depending on the presence of AHRE lasting >5 minutes (group 1 had AHRE>5 minutes and group 2 AHRE<5 minutes). AHRE lasting >5 minutes were detected in 49 (60%) patients after 3 months and in 53 (65%) patients after 18 moths. After 3 months, only hypertension (odds ratio [OR], 17.63; P = 0.020) was identified as a predictor of asymptomatic atrial fibrillation. After 18 months, hypertension (OR, 14.0; P = 0.036), P wave duration >100 ms in 12 lead ECG (OR, 16.5; P = 0.001), and intracardial atrial electrogram signal amplitude >4 mV (OR, 4.27; P = 0.045) were identified as predictors of atrial fibrillation. CONCLUSION: In our study population, hypertension was the most robust and constant predictor of asymptomatic atrial fibrillation after 3 months, while P wave duration >100 ms in 12-lead ECG and

  2. Low serum albumin and total lymphocyte count as predictors of 30 day hospital readmission in patients 65 years of age or older

    Directory of Open Access Journals (Sweden)

    Robert Robinson

    2015-08-01

    Full Text Available Introduction. Hospital readmission within 30 days of discharge is a target for health care cost savings through the medicare Value Based Purchasing initiative. Because of this focus, hospitals and health systems are investing considerable resources into the identification of patients at risk of hospital readmission and designing interventions to reduce the rate of hospital readmission. Malnutrition is a known risk factor for hospital readmission.Materials and Methods. All medical patients 65 years of age or older discharged from Memorial Medical Center from January 1, 2012 to March 31, 2012 who had a determination of serum albumin level and total lymphocyte count on hospital admission were studied retrospectively. Admission serum albumin levels and total lymphocyte counts were used to classify the nutritional status of all patients in the study. Patients with a serum albumin less than 3.5 grams/dL and/or a TLC less than 1,500 cells per mm3 were classified as having protein energy malnutrition. The primary outcome investigated in this study was hospital readmission for any reason within 30 days of discharge.Results. The study population included 1,683 hospital discharges with an average age of 79 years. The majority of the patients were female (55.9% and had a DRG weight of 1.22 (0.68. 219 patients (13% were readmitted within 30 days of hospital discharge. Protein energy malnutrition was common in this population. Low albumin was found in 973 (58% patients and a low TLC was found in 1,152 (68% patients. Low albumin and low TLC was found in 709 (42% of patients. Kaplan–Meier analysis shows any laboratory evidence of PEM is a significant (p < 0.001 predictor of hospital readmission. Low serum albumin (p < 0.001 and TLC (p = 0.018 show similar trends. Cox proportional-hazards regression analysis showed low serum albumin (Hazard Ratio 3.27, 95% CI [2.30–4.63] and higher DRG weight (Hazard Ratio 1.19, 95% CI [1.03–1.38] to be significant

  3. Clinical features of recently diagnosed papillary thyroid carcinoma in elderly patients aged 65 and older based on 10 years of sonographic experience at a single institution in Korea

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Eun Sil; Lee, Young Hen; Seo, Hyun Suk [Dept. of Korea University Ansan Hospital, Korea University College of Medicine, Ansan (Korea, Republic of); and others

    2017-10-15

    The aim of this study was to assess the characteristics of papillary thyroid carcinoma (PTC) in patients aged 65 and older in order to predict postoperative recurrence based on the results of ultrasonographic surveillance. Among 1,494 patients (200 male and 1,294 female; mean age, 46.6±11.3 years) who underwent surgery for thyroid cancer at our institution between 2006 and 2015, we retrospectively enrolled 150 PTC patients (29 male and 121 female; mean age, 69.4±4.2 years). To identify the risk factors for recurrence, we analyzed age, gender, multiplicity, size, number, extrathyroidal extension (ETE) of the tumor, lymph node metastasis (LNM), type of surgery, and the dose of radioactive ablation using a Cox regression model to identify hazard ratios (HRs). Among the 115 asymptomatic patients with PTCs detected by screening ultrasonography (n=86), other cross-sectional imaging modalities (computed tomography or positron emission tomography-computed tomography, n=13), or incidentally through a surgical specimen (n=16), 78 patients were confirmed to have papillary thyroid microcarcinomas (PTMCs). The other 35 patients presented with palpable neck masses (n=25), vocal cord palsy (n=9) or blood-tinged sputum (n=1). During the follow-up period (mean, 43.6 months), 17 patients (12.5%) experienced recurrence in the neck. None of the patients died due to PTC-related recurrence or distant metastasis during the follow-up period. Cox regression analysis demonstrated that tumor size (HR, 2.12; P<0.001) and LNM (central LNM: HR, 9.08; P=0.004; lateral LNM: HR, 14.71; P=0.002; both central and lateral LNM: HR, 58.41; P<0.001) significantly increased the recurrence rate. ETE, LNM, and recurrence were significantly less frequent in PTMCs than in non-PTMC (all P<0.001). PTCs of small size and absent LNM showed significantly better prognoses in patients 65 years and older.

  4. U.S. Billion-Ton Update: Biomass Supply for a Bioenergy and Bioproducts Industry

    Energy Technology Data Exchange (ETDEWEB)

    Downing, Mark [ORNL; Eaton, Laurence M [ORNL; Graham, Robin Lambert [ORNL; Langholtz, Matthew H [ORNL; Perlack, Robert D [ORNL; Turhollow Jr, Anthony F [ORNL; Stokes, Bryce [Navarro Research & Engineering; Brandt, Craig C [ORNL

    2011-08-01

    The report, Biomass as Feedstock for a Bioenergy and Bioproducts Industry: The Technical Feasibility of a Billion-Ton Annual Supply (generally referred to as the Billion-Ton Study or 2005 BTS), was an estimate of 'potential' biomass based on numerous assumptions about current and future inventory, production capacity, availability, and technology. The analysis was made to determine if conterminous U.S. agriculture and forestry resources had the capability to produce at least one billion dry tons of sustainable biomass annually to displace 30% or more of the nation's present petroleum consumption. An effort was made to use conservative estimates to assure confidence in having sufficient supply to reach the goal. The potential biomass was projected to be reasonably available around mid-century when large-scale biorefineries are likely to exist. The study emphasized primary sources of forest- and agriculture-derived biomass, such as logging residues, fuel treatment thinnings, crop residues, and perennially grown grasses and trees. These primary sources have the greatest potential to supply large, reliable, and sustainable quantities of biomass. While the primary sources were emphasized, estimates of secondary residue and tertiary waste resources of biomass were also provided. The original Billion-Ton Resource Assessment, published in 2005, was divided into two parts-forest-derived resources and agriculture-derived resources. The forest resources included residues produced during the harvesting of merchantable timber, forest residues, and small-diameter trees that could become available through initiatives to reduce fire hazards and improve forest health; forest residues from land conversion; fuelwood extracted from forests; residues generated at primary forest product processing mills; and urban wood wastes, municipal solid wastes (MSW), and construction and demolition (C&D) debris. For these forest resources, only residues, wastes, and small

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

    Science.gov (United States)

    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

  6. Salivary Parameters (Salivary Flow, pH and Buffering Capacity) in Stimulated Saliva of Mexican Elders 60 Years Old and Older.

    Science.gov (United States)

    Islas-Granillo, H; Borges-Yañez, S A; Medina-Solís, C E; Galan-Vidal, C A; Navarrete-Hernández, J J; Escoffié-Ramirez, M; Maupomé, G

    2014-12-01

    To compare a limited array of chewing-stimulated saliva features (salivary flow, pH and buffer capacity) in a sample of elderly Mexicans with clinical, sociodemographic and socio-economic variables. A cross-sectional study was carried out in 139 adults, 60 years old and older, from two retirement homes and a senior day care centre in the city of Pachuca, Mexico. Sociodemographic, socio-economic and behavioural variables were collected through a questionnaire. A trained and standardized examiner obtained the oral clinical variables. Chewing-stimulated saliva (paraffin method) was collected and the salivary flow rate, pH and buffer capacity were measured. The analysis was performed using non-parametric tests in Stata 9.0. Mean age was 79.1 ± 9.8 years. Most of the subjects included were women (69.1%). Mean chewing-stimulated salivary flow was 0.75 ± 0.80 mL/minute, and the pH and buffer capacity were 7.88 ± 0.83 and 4.20 ± 1.24, respectively. Mean chewing-stimulated salivary flow varied (p pH varied across the type of retirement home (p salivary features (salivary flow rate, pH and buffer capacity) and outline the variability of those features across selected sociodemographic, socio-economic and behavioural variables in a group of Mexican elders.

  7. Cognitive impairment and dependence of patients with diabetes older than 65 years old in an urban area (DERIVA study).

    Science.gov (United States)

    Rodríguez-Sánchez, Emiliano; Mora-Simón, Sara; Patino-Alonso, María C; Pérez-Arechaederra, Diana; Recio-Rodríguez, José I; Gómez-Marcos, Manuel A; Valero-Juan, Luis F; García-Ortiz, Luis

    2016-02-01

    We analyzed the associations between diabetes and cognitive impairment (CI) and dependence in a population of patients 65 years or older. Cross-sectional study. We randomly selected 311 participants over the age of 65 living in an urban area of Spain. The mean age of the cohort was 75.89 ± 7.12 years, and 69 of the individuals (22.2%) had diabetes. Two questionnaires were used to assess cognitive performance (MMSE and Seven Minute Screen Test), and two assessments were used to evaluate patient dependence (Barthel Index and Lawton-Brody Index). Clinical information and sociodemographic data were also gathered. Nearly one quarter of patients with diabetes (21.7%) lived alone. Diabetic patients were more sedentary (p = .033) than non-diabetic patients. Roughly one sixth (15.3%) of the diabetics and 10.1% of the non-diabetics were depressed (p = .332). CI was present in 26.1% of the diabetics and 14.5% of non-diabetics (p = .029). Diabetic patients had a MMSE score that was significantly worse than non-diabetics (24.88 ± 4.74 vs 26.05 ± 4.03; p cognitive assessment as necessary components in a standard evaluation in both clinical guides and randomized trials of therapeutic interventions in patients with diabetes.

  8. Cost-Effectiveness Analysis of a Skin Awareness Intervention for Early Detection of Skin Cancer Targeting Men Older Than 50 Years.

    Science.gov (United States)

    Gordon, Louisa G; Brynes, Joshua; Baade, Peter D; Neale, Rachel E; Whiteman, David C; Youl, Philippa H; Aitken, Joanne F; Janda, Monika

    2017-04-01

    To assess the cost-effectiveness of an educational intervention encouraging self-skin examinations for early detection of skin cancers among men older than 50 years. A lifetime Markov model was constructed to combine data from the Skin Awareness Trial and other published sources. The model incorporated a health system perspective and the cost and health outcomes for melanoma, squamous and basal cell carcinomas, and benign skin lesions. Key model outcomes included Australian costs (2015), quality-adjusted life-years (QALYs), life-years, and counts of skin cancers. Univariate and probabilistic sensitivity analyses were undertaken to address parameter uncertainty. The mean cost of the intervention was A$5,298 compared with A$4,684 for usual care, whereas mean QALYs were 7.58 for the intervention group and 7.77 for the usual care group. The intervention was thus inferior to usual care. When only survival gain is considered, the model predicted the intervention would cost A$1,059 per life-year saved. The likelihood that the intervention was cost-effective up to A$50,000 per QALY gained was 43.9%. The model was stable to most data estimates; nevertheless, it relies on the specificity of clinical diagnosis of skin cancers and is subject to limited health utility data for people with skin lesions. Although the intervention improved skin checking behaviors and encouraged men to seek medical advice about suspicious lesions, the overall costs and effects from also detecting more squamous and basal cell carcinomas and benign lesions outweighed the positive health gains from detecting more thin melanomas. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  9. "You're Awfully Old to Have This Disease": Experiences of Stigma and Ageism in Adults 50 Years and Older Living with HIV/AIDS

    Science.gov (United States)

    Emlet, Charles A.

    2006-01-01

    Purpose: Older adults living with HIV infection may be doubly stigmatized, as they are branded by both age as well as HIV status. Through semistructured interviews, this study sought to examine whether older adults with HIV/AIDS experience both ageism and HIV stigma and how those experiences manifest in their lives. Design and Methods: This was a…

  10. Criterion validity of an Attention Deficit Hyperactivity Disorder (ADHD) screening list for screening ADHD in older adults aged 60-94 years

    NARCIS (Netherlands)

    Semeijn, E.J.; Michielsen, M.; Comijs, H.C.; Deeg, D.J.H.; Beekman, A.T.; Kooij, J.J.

    2013-01-01

    Objective: To identify Attention Deficit Hyperactivity disorder (ADHD) in older adults, a validated screener is needed. This study evaluates the reliability and criterion validity of an ADHD screener for younger adults on its usefulness in a population-based sample of older adults. Methods: Data

  11. Improved Outcome of Enteric Peritonitis in Peritoneal Dialysis Patients Aged 50 Years and Older with Temporary Discontinuation of Peritoneal Dialysis and Intravenous Meropenem.

    Science.gov (United States)

    Abrahams, Alferso C; Rüger, Wim; Ter Wee, Pieter M; van Ittersum, Frans J; Boer, Walther H

    2017-01-01

    ♦ BACKGROUND: Peritonitis is a major cause of morbidity, mortality, and technique failure in peritoneal dialysis (PD) patients, especially when caused by enteric microorganisms (EM). We have implemented a treatment protocol specifically aimed at improving the outcome in EM peritonitis. The adapted protocol was applied in all PD patients 50 years and older presenting with peritonitis who were considered to be at risk of EM peritonitis and involves 3 interventions: 1) temporary discontinuation of PD without removing the catheter (peritoneal rest), 2) intravenous meropenem, and 3) meropenem intracatheter as lock (Mero-PerRest protocol). ♦ METHODS: In this observational study, we compared the outcome of 203 peritonitis episodes in 71 patients treated with the Mero-PerRest protocol, with 217 episodes in 104 patients treated with a more traditional intraperitoneal gentamicin-rifampicin-based regimen. ♦ RESULTS: In EM peritonitis episodes, the Mero-PerRest protocol resulted in a higher primary cure rate (90.0% vs 65.3%, adjusted odds ratio [OR] 4.54 [95% confidence interval (CI) 1.46 - 14.15]) and better technique survival (90.0% vs 69.4%, adjusted OR 3.41 [95% CI 1.07 - 10.87]). This effect was most distinct in patients with polymicrobial EM peritonitis (cure rate 87.5% vs 34.8%, p = 0.0003). Interestingly, primary cure rate (95.6% vs 84.7%, adjusted OR 3.92 [95% CI 1.37 - 11.19]) and technique survival (95.6% vs 85.6%, adjusted OR 3.60 [95% CI 1.25 - 10.32]) were also excellent in non-EM peritonitis episodes. Patient survival did not differ significantly. ♦ CONCLUSION: The poor outcome of peritonitis caused by EM in PD patients aged 50 years and older could be improved by applying a treatment protocol involving temporary discontinuation of PD without catheter removal and intravenous and intracatheter meropenem. Copyright © 2017 International Society for Peritoneal Dialysis.

  12. Detection of oncogenic genital human papillomavirus (HPV) among HPV negative older and younger women after 7 years of follow-up

    DEFF Research Database (Denmark)

    Brogaard, Kim Agerholm; Munk, Christian; Iftner, Thomas

    2014-01-01

    " observed among older women. Recent sexual partners were a strong determinant of HPV appearance irrespective of age. Lifetime number of sexual partners was a significant risk factor for HPV appearance among older women, even after adjustment for recent sexual behavior. In addition, menopause was associated...... in older women using multiple logistic regression. For comparison, a younger cohort of women examined under identical study settings was included. This prospective cohort study comprised 1,577 older women (age 40-50 at enrolment) and 2,920 women aged 22-32. Participants were interviewed and underwent...... with a non-significantly increased risk of HPV appearance at follow-up. In conclusion, appearance of HPV in previously HPV-negative older women may be due to both recent sexual behavior and previous exposure that is, reactivation of a latent HPV infection....

  13. Nordic energy co-operation can save the equivalent of 4 - 10 billion USD

    International Nuclear Information System (INIS)

    Lind, Oddvar

    2000-01-01

    Better co-ordination of the energy- and environment policies among the Nordic countries can be very profitable from the socio-economic point of view and facilitate the fulfilment of the Kyoto agreement. A Swedish calculation shows that up to 10 billion USD can be saved by building a trans-nordic gasline and at the same time preparing for a common implementation of the Kyoto agreement, combined with increased electricity trade, improving the efficiency and increasing the use of renewable energy sources. The consumption of natural gas must then increase threefold the next 25 years. There is no alternative to natural gas of the same potential if coal and oil are to be replaced to reduce the emission of carbon dioxide. The importance of natural gas is further increased by the phase-out of nuclear energy in Sweden. After 2025 the use of natural gas will be reduced and in 2040 biomass energy, wind energy and solar energy will contribute as much as the natural gas, that is, 250 TWh. Throughout the entire period more than half of the electricity production will be hydropower. It is presupposed that the cogeneration sector and the district heating network are substantially expanded, even in South Norway. The Nordic energy system is quite flexible with respect to fulfilling future CO 2 targets. Although the different Nordic countries have different commitments with respect to the Kyoto agreement, they will profit economically from acting jointly within the sum of their individual emission quotas

  14. Development of multicomponent parts-per-billion-level gas standards of volatile toxic organic compounds

    International Nuclear Information System (INIS)

    Rhoderick, G.C.; Zielinski, W.L. Jr.

    1990-01-01

    This paper reports that the demand for stable, low-concentration multicomponent standards of volatile toxic organic compounds for quantifying national and state measurement of ambient air quality and hazardous waste incineration emissions has markedly increased in recent years. In response to this demand, a microgravimetric technique was developed and validated for preparing such standards; these standards ranged in concentration from several parts per million (ppm) down to one part per billion (ppb) and in complexity from one organic up to 17. Studies using the gravimetric procedure to prepare mixtures of different groups of organics. including multi-components mixtures in the 5 to 20 ppb range, revealed a very low imprecision. This procedure is based on the separate gravimetric introduction of individual organics into an evacuated gas cylinder, followed by the pressurized addition of a precalculated amount of pure nitrogen. Additional studies confirmed the long-term stability of these mixtures. The uncertainty of the concentrations of the individual organics at the 95% confidence level ranged from less than 1% relative at 1 ppm to less than 10% relative at 1 ppb. Over 100 primary gravimetric standards have been developed, validated, and used for certifying the concentrations of a variety of mixtures for monitoring studies

  15. Large data analysis: automatic visual personal identification in a demography of 1.2 billion persons

    Science.gov (United States)

    Daugman, John

    2014-05-01

    The largest biometric deployment in history is now underway in India, where the Government is enrolling the iris patterns (among other data) of all 1.2 billion citizens. The purpose of the Unique Identification Authority of India (UIDAI) is to ensure fair access to welfare benefits and entitlements, to reduce fraud, and enhance social inclusion. Only a minority of Indian citizens have bank accounts; only 4 percent possess passports; and less than half of all aid money reaches its intended recipients. A person who lacks any means of establishing their identity is excluded from entitlements and does not officially exist; thus the slogan of UIDAI is: To give the poor an identity." This ambitious program enrolls a million people every day, across 36,000 stations run by 83 agencies, with a 3-year completion target for the entire national population. The halfway point was recently passed with more than 600 million persons now enrolled. In order to detect and prevent duplicate identities, every iris pattern that is enrolled is first compared against all others enrolled so far; thus the daily workflow now requires 600 trillion (or 600 million-million) iris cross-comparisons. Avoiding identity collisions (False Matches) requires high biometric entropy, and achieving the tremendous match speed requires phase bit coding. Both of these requirements are being delivered operationally by wavelet methods developed by the author for encoding and comparing iris patterns, which will be the focus of this Large Data Award" presentation.

  16. Obesity Prevention in Older Adults.

    Science.gov (United States)

    Volpe, Stella Lucia; Sukumar, Deeptha; Milliron, Brandy-Joe

    2016-06-01

    The number of older adults living in the USA, 65 years of age and older, has been steadily increasing. Data from the National Health and Nutrition Examination Survey (NHANES), 2007-2010, indicate that more than one-third of older adults, 65 years of age and older, were obese. With the increased rate of obesity in older adults, the purpose of this paper is to present research on different methods to prevent or manage obesity in older adults, namely dietary interventions, physical activity interventions, and a combination of dietary and physical activity interventions. In addition, research on community assistance programs in the prevention of obesity with aging will be discussed. Finally, data on federal programs for older adults will also be presented.

  17. Sensory impairment in hip-fracture patients 65 years or older and effects of hearing/vision interventions on fall frequency

    Directory of Open Access Journals (Sweden)

    Else V Grue

    2008-11-01

    Full Text Available Else V Grue1, Marit Kirkevold2, Petter Mowinchel3, Anette H Ranhoff41Diakonhjemmet University College, Department of Research and Development, Oslo, Norway; 2University of Oslo, Department of Medisin, Institute of Nursing Sciences and Health Profession, Oslo, Norway; 3Department of Paediatrics, Woman-child division, Ullevål University Hospital Oslo, Norway; 4Diakonhjemmet Hospital, Geriatric Unit, Oslo, NorwayAim: Examine the effect of nursing interventions to improve vision and hearing, systematic assessment, and referral to sensory specialists on falling.Methods: Controlled intervention trial targeting hip fracture patients, 65 years and older, living at home and having problems seeing/reading regular print (VI or hearing normal speech (HI. Intervention group = 200, control group = 131. The InterRAI-AcuteCare (RAI-AC and the Combined-Serious-Sensory-Impairment interview guide (KAS-Screen were used. Follow-up telephone calls were done every third month for one year.Results: Mean age was 84.2 years, 79.8% were female, and 76.7% lived alone. HI was detected in 80.7% and VI in 59.8%. Falling was more frequent among the intervention group (P = 0.003 and they also more often moved to a nursing home (P < 0.001 and were dependent walking up stairs (P = 0.003.Conclusions: This study could not document the effect of intervention on falling, possibly because of different base line characteristics (more females, P = 0.018, and more living alone P = 0.011 in the intervention group, differences in nursing care between subjects, and different risk factors. Interventions to improve sensory function remain important in rehabilitation, but have to be studied further.Keywords: vision, hearing, hip fracture, falls, intervention, hospital

  18. The CHADS2 Score to Predict Stroke Risk in the Absence of Atrial Fibrillation in Hypertensive Patients Aged 65 Years or Older.

    Science.gov (United States)

    Morillas, Pedro; Pallarés, Vicente; Fácila, Lorenzo; Llisterri, Jose Luis; Sebastián, María Eugenia; Gómez, Manuel; Castilla, Elena; Camarasa, Raquel; Sandin, Miriam; García-Honrubia, Antonio

    2015-06-01

    The CHADS2 score is a proven, essential tool for estimating cardioembolic risk (mainly stroke) in patients with nonvalvular atrial fibrillation, with the purpose of determining the indication for anticoagulant therapy. In this study we analyzed the use of CHADS2 in hypertensive patients without known atrial fibrillation in a Mediterranean population. The study included 887 hypertensive patients aged 65 years or older without atrial fibrillation or anticoagulant therapy, who attended a medical consultation. Data on the patients' main risk factors, cardiovascular history, and medication were collected, basic laboratory analyses and electrocardiography were performed, and the CHADS2 score (heart failure, hypertension, age ≥ 75 years, diabetes mellitus, and previous stroke or transient ischemic attack) was calculated. A clinical follow-up was carried out, recording hospital admissions for a stroke or transient ischemic attack. The median duration of follow-up was 804 days. Mean age was 72.5 (SD,5.7) years, 46.6% were men, 27.8% had diabetes, and 8.6% were smokers. During follow-up, 40 patients were hospitalized for a stroke or transient ischemic attack (4.5%). The event-free survival analysis showed significant differences according to the CHADS2 score (log rank test, P < .001). On multivariate analysis, smoking and CHADS2 ≥3 were independent predictors of stroke or transient ischemic attack. The CHADS2 may be useful for estimating the risk of stroke or transient ischemic attack in hypertensive patients without known atrial fibrillation. Copyright © 2014 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

  19. Interleukin-6 and C-Reactive Protein Levels and 9-Year Cognitive Decline in Community-Dwelling Older Women: The Women's Health and Aging Study II.

    Science.gov (United States)

    Palta, Priya; Xue, Qian-Li; Deal, Jennifer A; Fried, Linda P; Walston, Jeremy D; Carlson, Michelle C

    2015-07-01

    Elevated inflammation is a proposed mechanism relating chronic diseases to cognitive dysfunction. The objective of this study was to test the hypothesis that greater levels of inflammation, as measured by the proinflammatory cytokine interleukin-6 (IL-6) and C-reactive protein, are associated with faster rates of cognitive decline among cognitively intact community-dwelling older women. We analyzed 336 women from the Women's Health and Aging Study II. Cognitive assessments were performed at baseline and every 18-36 months, and included the following domains: immediate and delayed memory (Hopkins Verbal Learning Test), psychomotor speed (Trail Making Test, Part A), and executive function (Trail Making Test, Part B). Aggregate measures of IL-6 and C-reactive protein, based on the average from visits one and two, were analyzed categorically. Random effects models were employed to test the relationship between tertiles of each inflammatory marker and changes in cognitive domain scores over 9 years. Moderate and high levels of IL-6 predicted early declines in psychomotor speed by 1.0 connection/min per year. There were no differences in baseline scores or rates of change across tertiles of IL-6 in memory or executive function. No differences were observed across tertiles of C-reactive protein for all cognitive domains. Higher levels of serum IL-6 were associated with greater declines in psychomotor speed over 9 years. This finding could suggest that elevated IL-6 may result in microvascular changes that may lead to damage of myelin sheaths that line neuronal axons, leading to decreased neuron propagation and impaired processing speed; however, mechanistic studies are needed to evaluate these hypotheses. © The Author 2014. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  20. The geography of diabetes among the general adults aged 35 years and older in Bangladesh: recent evidence from a cross-sectional survey.

    Directory of Open Access Journals (Sweden)

    Md Mobarak Hossain Khan

    Full Text Available To report geographical variations of sex-specific diabetes by place of residence (large cities/city corporations, small towns/other urban areas, rural areas and region of residence (divided into seven divisions among general adults (35+ years of age in Bangladesh.The recent cross-sectional data, extracted from the nationally representative Bangladesh Demographic and Health Survey 2011, was used. A total of 3,720 men and 3,823 women aged 35+ years, who participated in the fasting blood sugar testing, were analysed. Any person with either fasting plasma glucose level (mmol/L ≥7.0 or taking medication for diabetes was considered as a person with diabetes.The prevalence of diabetes was 10.6% in men and 11.3% in women. Bivariable analyses indicated significant variations of diabetes by both geographical variables. The prevalence was highest in city corporations (men 18.0%, women 22.3%, followed by small towns (men 13.6%, women 15.2% and rural areas (men 9.3%, women 9.5%. Regional disparities in diabetes prevalence were also remarkable, with the highest prevalence in Chittagong division and lowest prevalence in Khulna division. Multivariable logistic regression analyses provided mixed patterns of geographical disparities (depending on the adjusted variables. Some other independent risk factors for diabetes were advancing age, higher level of education and wealth, having TV (a proxy indicator of physical activity, overweight/obesity and hypertension.Over 10% of the general adults aged 35 years and older were having diabetes. Most of the persons with diabetes were unaware of this before testing fasting plasma glucose level. Although significant disparities in diabetes prevalence by geographical variables were observed, such disparities are very much influenced by the adjusted variables. Finally, we underscore the necessities of area-specific strategies including early diagnosis and health education programmes for changing lifestyles to reduce the risk

  1. [Adaptations of psychotropic drugs in patients aged 75 years and older in a departement of geriatric internal medecine: report of 100 cases].

    Science.gov (United States)

    Couderc, Anne-Laure; Bailly-Agaledes, Cindy; Camalet, Joëlle; Capriz-Ribière, Françoise; Gary, André; Robert, Philippe; Brocker, Patrice; Guérin, Olivier

    2011-06-01

    The elderly often with multiple diseases are particularly at risk from adverse drug reactions. Nearly half of iatrogenic drug in the elderly are preventable. Some medications such as psychotropic drugs are particularly involved in iatrogenic accidents. We wanted to know if the tools of the comprehensive geriatric assessment or other factors could influence the changes of psychotropic drugs in a geriatric departement. Our prospective study of four months in 100 patients aged 75 years and older hospitalized in the Geriatric Internal Medecine Departement of University Hospital of Nice investigated what were the clinical or biological reasons and tools used during changes of psychotropic drugs. We compared these changes according to the comprehensive geriatric assessment tools and we analyzed the changes based on lists of potentially inappropriate medications by Laroche et al. and from the instrument STOPP/START. The Mini Mental State Examination (MMSE) was the tool that has most influenced the changes in psychotropic including a tendency to increase and the introduction of anxiolytics when MMSE < 20 (p = 0.007) while neuroleptics instead arrested and decreased (p = 0.012). The comprehensive geriatric assessment has its place in decision support during the potentially iatrogenic prescriptions of drugs such as psychotropic and new tools such as STOPP/START can also be a help to the prescriber informed.

  2. Association between the metabolic syndrome and its components and gait speed among U.S. adults aged 50 years and older: a cross-sectional analysis

    Directory of Open Access Journals (Sweden)

    Strine Tara W

    2006-11-01

    Full Text Available Abstract Background To examine the relationship between the metabolic syndrome and its components and gait speed among older U.S. men and women. Whether these associations are independent of physical activity was also explored. Methods Eight hundred and thirty-five men and 850 women aged ≥50 years from the continuous National Health and Nutrition Examination Survey 1999–2002 were examined. We used the definition of the metabolic syndrome developed by the U.S. National Cholesterol Education Program Adult Treatment Panel III. Gait speed was measured with a 6.10-meter timed walk examination. Results The prevalence of the metabolic syndrome was 40.2% in men and 45.6% in women (P = .127. The prevalence of gait speed impairment was 29.3% in men and 12.5% in women (P Conclusion Among women, gait speed impairment is associated with low HDL cholesterol and inversely with abdominal obesity. These associations may be sex-dependent and warrant further research.

  3. Neuropathological findings in entorhinal cortex of subjects aged 50 years or older and their correlation with dementia in a sample from Southern Brazil

    Directory of Open Access Journals (Sweden)

    Edson Rodrigues Neto

    Full Text Available ABSTRACT Introduction: The aims of this study were to survey neurodegenerative changes detected by abnormal protein deposits in the Entorhinal Cortex (EC of subjects aged 50 years or older and to correlate these findings with suspected dementia, as detected by the IQCODE (Informant Questionnaire on Cognitive Decline in the Elderly . Methods: Fourteen brains were submitted to the immunohistochemistry technique for different proteins (beta-amyloid, tau, -synuclein and phospho-TDP-43 and data obtained compared with IQCODE scores. Results: Fifty-seven percent of the individuals exhibited IQCODE results compatible with dementia, being classified into the demented group (DG: 87.5% of patients had neuropathological findings corresponding to Alzheimer's-like brain pathology (ALBP. Of the patients in the non-demented group (NDG, 16.7% met neuropathological criteria for ALBP. All individuals in the DG showed deposits of more than one kind of protein in the EC. The most common association was hyperphosphorylated tau and beta-amyloid protein (87.5%. Discussion: Most individuals with dementia had neuropathological findings of ALBP, as did one individual with no signs of dementia, characterizing a preclinical stage. The results of this study suggest that deposits of a single type of anomalous protein are normal findings in an aging brain, while more than one kind of protein or the combined presence of anomalous protein deposits indicate the presence of dementia.

  4. Risk Factors for Wheezing, Eczema and Rhinoconjunctivitis in the Previous 12 Months among Six-Year-Old Children in Himeji City, Japan: Food Allergy, Older Siblings, Day-Care Attendance and Parental Allergy History

    Directory of Open Access Journals (Sweden)

    Fumitake Kurosaka

    2011-01-01

    Conclusions: Among Japanese children, food allergy and parents' history of allergy are risk factors for WP, ES or RS. However, early day-care attendance and presence of older siblings might be protective factors against RS. Infections in early life may affect the prevalence of rhinoconjunctivitis in six-year-old children.

  5. Magnitude of Hypotension Based on Office and Ambulatory Blood Pressure Monitoring: Results From a Cohort of 5066 Treated Hypertensive Patients Aged 80 Years and Older.

    Science.gov (United States)

    Divisón-Garrote, Juan A; Ruilope, Luis M; de la Sierra, Alejandro; de la Cruz, Juan J; Vinyoles, Ernest; Gorostidi, Manuel; Escobar-Cervantes, Carlos; Velilla-Zancada, Sonsoles M; Segura, Julián; Banegas, José R

    2017-05-01

    Elderly patients can be particularly susceptible to the adverse effects of excessive blood pressure (BP) lowering by antihypertensive treatment. The identification of hypotension is thus especially important. Ambulatory BP monitoring (ABPM) is a more accurate technique than office for classifying BP status. This study examined the prevalence of hypotension and associated demographic and clinical factors among very old treated hypertensive patients undergoing ABPM. Cross-sectional study in which 5066 patients aged 80 years and older with treated hypertension drawn from the Spanish ABPM Registry were included. Office BP and 24-hour ambulatory BP were determined using validated devices under standardized conditions. Based on previous studies, hypotension was defined as systolic/diastolic BP ABPM, ABPM, and ABPM. Participants' mean age was 83.2 ± 3.1 years (64.4% women). Overall, 22.8% of patients had office hypotension, 33.7% daytime hypotension, 9.2% nighttime hypotension, and 20.5% 24-hour ABPM hypotension. Low diastolic BP values were responsible for 90% of cases of hypotension. In addition, 59.1% of the cases of hypotension detected by daytime ABPM did not correspond to hypotension according to office BP. The variables independently associated with office and ABPM hypotension were diabetes, coronary heart disease, and a higher number of antihypertensive medications. One in 3 very elderly treated hypertensive patients attended in usual clinical practice were potentially at risk of having hypotension according to daytime ABPM. More than half of them had masked hypotension; that is, they were not identified if relying on office BP alone. Thus, ABPM could be especially helpful for identifying ambulatory hypotension and avoiding overtreatment, in particular, in patients with diabetes, heart disease, or on antihypertensive polytherapy. Copyright © 2017 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

  6. Opportunistic detection of atrial fibrillation in subjects aged 65 years or older in primare care: a randomised clinical trial of efficacy. DOFA-AP study protocol

    Directory of Open Access Journals (Sweden)

    Pérula-de-Torres LuisÁ

    2012-10-01

    Full Text Available Abstract Background Clinical Practice Guidelines recommend using peripheral blood pulse measuring as a screening test for Atrial Fibrillation. However, there is no adequate evidence supporting the efficacy of such procedure in primary care clinical practice. This paper describes a study protocol designed to verify whether early opportunistic screening for Atrial Fibrillation by measuring blood pulse is more effective than regular practice in subjects aged 65 years attending primary care centers. Methods/design An cluster-randomized controlled trial conducted in Primary Care Centers of the Spanish National Health Service. A total of 269 physicians and nurses will be allocated to one of the two arms of the trial by stratified randomization with a 3:2 ratio (three practitioners will be assigned to the Control Group for every two practitioners assigned to the Experimental Group. As many as 12 870 patients aged 65 years or older and meeting eligibility criteria will be recruited (8 580 will be allocated to the Experimental Group and 4 290 to the Control Group. Randomization and allocation to trial groups will be carried out by a central computer system. The Experimental Group practitioners will conduct an opportunistic case finding for patients with Atrial Fibrillation, while the Control Group practitioners will follow the regular guidelines. The first step will be finding new Atrial Fibrillation cases. A descriptive inferential analysis will be performed (bivariate and multivariate by multilevel logistic regression analysis. Discussion If our hypothesis is confirmed, we expect Primary Care professionals to take a more proactive approach and adopt a new protocol when a patient meeting the established screening criteria is identified. Finally, we expect this measure to be incorporated into Clinical Practice Guidelines. Trial registration The study is registered as NCT01291953 (ClinicalTrials.gob

  7. Qualitative Assessment of the Impact of Implementing Reiki Training in a Supported Residence for People Older Than 50 Years with HIV/AIDS

    Science.gov (United States)

    Mehl-Madrona, Lewis; Renfrew, Nita M; Mainguy, Barbara

    2011-01-01

    Introduction: Reiki is a Japanese form of energy healing that has become popular in the US. Reiki training involves three stages—levels I, II, and III—to a master practitioner level and requires both giving and receiving Reiki. We set out to implement a program to train clients of a supported residence in Brooklyn, NY. They were all older than age 50 years and had HIV/AIDS and substance-abuse and/or mental-health disorders. Methods: A qualitative, narrative-inquiry study was conducted. The Reiki master kept a journal of her 3 years of providing 90 minutes of Reiki treatment and/or training once weekly at the residence. Forty-five of 50 potential participants attended these sessions with various frequencies. Stories were collected from 35 participants regarding their experience of Reiki training. We posited success as continued involvement in the program. Results: All 35 participants reported receiving benefit from participation in Reiki. Participants first took part in training because of the offered subway tokens; however, 40 continued their involvement despite a lack of compensation. When asked why they continued, participants reported life-changing experiences, including a greater ability to cope with addictions, a greater ability to manage counseling, healing of wounds, improvement of T-cell counts, and improved skills of daily living. Conclusion: Reiki training can be successfully implemented in a supported housing facility with people with HIV/AIDS and comorbid disorders. Some people in our study population reported areas of improvement and life-changing experiences. Our study did not establish the efficacy of Reiki, but our findings support the effect of the entire gestalt of implementing a program related to spirituality and healing and supports the goal of implementing a larger randomized, controlled trial in this setting to establish the efficacy of Reiki. PMID:22058669

  8. Prevalence and determinants of age-related macular degeneration in the 50 years and older population: A hospital based study in Maharashtra, India

    Directory of Open Access Journals (Sweden)

    Sucheta R Kulkarni

    2013-01-01

    Full Text Available Background: We present the magnitude and determinants of age-related macular degeneration (ARMD among the 50 year and older population that visited our hospital. Materials and Methods: This was a cohort of eye patients with ARMD, seen from 2006 to 2009. Optometrist noted the best-corrected vision. Ophthalmologists examined eyes using a slit-lamp bio-microscope. The ARMD was confirmed by fluoresceine angiography and optical coherent tomography. The age, sex, history of smoking, sun exposure, family history of ARMD, diet, body mass index (BMI, hypertension, and diabetes were associated with ARMD. Result: Of the 19,140 persons of ≥ 50 years of age-attending eye clinic in our hospital, 302 persons had ARMD in at least one eye. The proportion of overall ARMD was 1.38% (95% CI 1.21--1.55. The proportion of age-related maculopathy (ARM and late ARMD was 1.14% (95% CI 0.99--1.29 and 0.24% (95% CI 0.21-0.24 respectively. ARM was unilateral and bilateral in 64 (29.2% and 155 (70.8% persons respectively. Dry ARMD was found in 47.8%. On regression analysis, old age (OR = 1.05, male (OR = 0.54, and history of smoking (OR = 2.32 were significant risk factors of ARMD. A total of 4.2% of persons with ARMD were blind (vision <3/60. Only 43% of persons with ARMD had J6 grade of the best-corrected near vision. Conclusion: ARMD does not seem to be of public health magnitude in the study area. Early stages of ARMD were common among patients. ge, being male, and history of smoking were significant risk factors for ARMD.

  9. Withholding or withdrawing of life-sustaining therapy in older adults (≥ 80 years) admitted to the intensive care unit.

    Science.gov (United States)

    Guidet, Bertrand; Flaatten, Hans; Boumendil, Ariane; Morandi, Alessandro; Andersen, Finn H; Artigas, Antonio; Bertolini, Guido; Cecconi, Maurizio; Christensen, Steffen; Faraldi, Loredana; Fjølner, Jesper; Jung, Christian; Marsh, Brian; Moreno, Rui; Oeyen, Sandra; Öhman, Christina Agwald; Pinto, Bernardo Bollen; Soliman, Ivo W; Szczeklik, Wojciech; Valentin, Andreas; Watson, Ximena; Zafeiridis, Tilemachos; De Lange, Dylan W

    2018-05-17

    To document and analyse the decision to withhold or withdraw life-sustaining treatment (LST) in a population of very old patients admitted to the ICU. This prospective study included intensive care patients aged ≥ 80 years in 309 ICUs from 21 European countries with 30-day mortality follow-up. LST limitation was identified in 1356/5021 (27.2%) of patients: 15% had a withholding decision and 12.2% a withdrawal decision (including those with a previous withholding decision). Patients with LST limitation were older, more frail, more severely ill and less frequently electively admitted. Patients with withdrawal of LST were more frequently male and had a longer ICU length of stay. The ICU and 30-day mortality were, respectively, 29.1 and 53.1% in the withholding group and 82.2% and 93.1% in the withdrawal group. LST was less frequently limited in eastern and southern European countries than in northern Europe. The patient-independent factors associated with LST limitation were: acute ICU admission (OR 5.77, 95% CI 4.32-7.7), Clinical Frailty Scale (CFS) score (OR 2.08, 95% CI 1.78-2.42), increased age (each 5 years of increase in age had a OR of 1.22 (95% CI 1.12-1.34) and SOFA score [OR of 1.07 (95% CI 1.05-1.09 per point)]. The frequency of LST limitation was higher in countries with high GDP and was lower in religious countries. The most important patient variables associated with the instigation of LST limitation were acute admission, frailty, age, admission SOFA score and country. ClinicalTrials.gov (ID: NTC03134807).

  10. Hypertension prevalence, awareness, treatment and its correlates among people 35 years and older: Result from pilot phase of the Azar cohort study.

    Science.gov (United States)

    Ghorbani, Zohreh; Shamshirgaran, Seyed Morteza; Ghaffari, Samad; Sarbakhsh, Parvin; Najafipour, Farzad; Aminisani, Nayyereh

    2018-01-01

    There is remarkable alteration in hypertension prevalence and awareness, and their correlates among various geographic locations and ethnic groups. The aim of this study was to report hypertension prevalence, awareness, and its correlates as well as hypertension treatment, and control among Azari people aged 35 years and older. The pilot phase of the Azar Cohort Study; a state level of a nationwide PERSIAN cohort study was conducted in Khameneh city between October 2014 and January 2015. All people 35 years of age and above were invited to take part in this study. A comprehensive range of different biomarkers, lifestyle, socioeconomic factors, and health-related factors was collected. Blood pressure was measured by a trained nurse/midwife. Descriptive statistical methods were used to present general characteristics of the study population as frequency tables. Separate multiple logistic regression models were built to assess the predictors of hypertension prevalence. A total of 1038 people were included in this study. The overall prevalence of hypertension was 22.9%. Awareness of hypertension was 60.5% and in those with known hypertension, 84% were using the antihypertensive medications, of those 68.5% had controlled hypertension. After adjustment; age (odds ratios [OR] adj = 1.12 95% confidence interval [CI]: 1.09-1.15), gender (OR adj = 1.65 95% CI: 1.08-2.51), obesity OR adj = 2.51 (1.40-4.88), waist-to-hip ratio (WHR) (OR adj = 1.70 (1.05-2.75), and comorbidities (OR adj = 2.51 (1.72-3.66) were independent predictors of hypertension. Age, sex, body mass index, WHR, and comorbidities were known as predictors of hypertension in this study, health promotion strategies including lifestyle modification to reduce overweight/obesity and secondary prevention programs for early detection of hypertension in high-risk groups according to age, gender, and disease profile are recommended.

  11. Opportunistic detection of atrial fibrillation in subjects aged 65 years or older in primare care: a randomised clinical trial of efficacy. DOFA-AP study protocol.

    Science.gov (United States)

    Pérula-de-Torres, Luis Á; Martínez-Adell, Miguel Á; González-Blanco, Virginia; Baena-Díez, José M; Martín-Rioboó, Enrique; Parras-Rejano, Juan M; González-Lama, Jesús; Martín-Alvarez, Remedios; Ruiz-Moral, Roger; Fernández-García, José Á; Pérez-Díaz, Modesto; Ruiz-de-Castroviejo, Joaquin; Pérula-de-Torres, Carlos; Valero-Martín, Antonio; Roldán-Villalobos, Ana; Criado-Larumbe, Margarita; Burdoy-Joaquín, Emili; Coma-Solé, Montserrat; Cervera-León, Mercè; Cuixart-Costa, Lluís

    2012-10-30

    Clinical Practice Guidelines recommend using peripheral blood pulse measuring as a screening test for Atrial Fibrillation. However, there is no adequate evidence supporting the efficacy of such procedure in primary care clinical practice. This paper describes a study protocol designed to verify whether early opportunistic screening for Atrial Fibrillation by measuring blood pulse is more effective than regular practice in subjects aged 65 years attending primary care centers. An cluster-randomized controlled trial conducted in Primary Care Centers of the Spanish National Health Service. A total of 269 physicians and nurses will be allocated to one of the two arms of the trial by stratified randomization with a 3:2 ratio (three practitioners will be assigned to the Control Group for every two practitioners assigned to the Experimental Group). As many as 12 870 patients aged 65 years or older and meeting eligibility criteria will be recruited (8 580 will be allocated to the Experimental Group and 4 290 to the Control Group). Randomization and allocation to trial groups will be carried out by a central computer system. The Experimental Group practitioners will conduct an opportunistic case finding for patients with Atrial Fibrillation, while the Control Group practitioners will follow the regular guidelines. The first step will be finding new Atrial Fibrillation cases. A descriptive inferential analysis will be performed (bivariate and multivariate by multilevel logistic regression analysis). If our hypothesis is confirmed, we expect Primary Care professionals to take a more proactive approach and adopt a new protocol when a patient meeting the established screening criteria is identified. Finally, we expect this measure to be incorporated into Clinical Practice Guidelines. The study is registered as NCT01291953 (ClinicalTrials.gob).

  12. [Assessment of the nutritional status of a group of people older than 50 years by means of dietary and body composition parameters].

    Science.gov (United States)

    Martínez Roldán, C; Veiga Herreros, P; Cobo Sanz, J Ma; Carbajal Azcona, A

    2011-01-01

    To assess the nutritional status of elder adults by means of dietary and body composition parameters. The sample comprised 49 adults, older than 50 years (23 men and 26 women) with a mean age of 54.84±4.56 years, working at a private university. The body composition was analyzed by using anthropometric parameters. The energy and nutrients intake was gathered by means of a registry of all the foods and beverages consumed during 3 days that was filled-up by each (previously instructed) participant and estimating the amounts through photographic models. Total energy requirements were estimated by the Harris-Benedict and FAO/WHO calculations. The body mass index was similar (p=0.018) in both men and women (26.1±1.9 and 24.4±2.8 kg/m²). The percentage of fat obtained by anthropometrics was 29.6±3.6 and 36.8±3.1% (p=0.000) in men and women, respectively. The level of physical activity was very light to light. Daily energy intake was appropriate for total energy demands when these were calculated by the calculations proposed by FAO/WHO. The caloric profile indicated an unbalance with high proteins and lipids and low carbohydrates intake. As for the micronutrients, the diets assessed indicated a deficient intake of folic acid and vitamins D and E, in both genders, and zinc and selenium also in women. We have found overweight problems according to the BMI and the waist circumference, and obesity according to the body fat percentage, with the potential risk for the development of an associated complication. It would be advisable to improve the quality of the diets consumed by increasing the amount of some micronutrients and fiber, and by promoting an increase in the physical activity.

  13. Relative association of processing speed, short-term memory and sustained attention with task on gait speed: a study of community-dwelling people 50 years and older.

    Science.gov (United States)

    Killane, Isabelle; Donoghue, Orna A; Savva, George M; Cronin, Hilary; Kenny, Rose Anne; Reilly, Richard B

    2014-11-01

    For single gait tasks, associations have been reported between gait speed and cognitive domains. However, few studies have evaluated if this association is altered in dual gait tasks given gait speed changes with complexity and nature of task. We evaluated relative contributions of specific elements of cognitive function (including sustained attention and processing speed) to dual task gait speed in a nationally representative population of community-dwelling adults over 50 years. Gait speed was obtained using the GaitRite walkway during three gait tasks: single, cognitive (alternate letters), and motor (carrying a filled glass). Linear regression models, adjusted for covariates, were constructed to predict the relative contributions of seven neuropsychological tests to gait speed differences and to investigate gait task effects. The mean age and gait speed of the population (n = 4,431, 55% women) was 62.4 years (SD = 8.2) and 135.85 cm/s (SD = 20.20, single task), respectively. Poorer processing speed, short-term memory, and sustained attention were major cognitive contributors to slower gait speed for all gait tasks. Both dual gait tasks were robust to covariate adjustment and had a significant additional executive function element not found for the single gait task. For community-dwelling older adults processing speed, short-term memory and sustained attention were independently associated with gait speed for all gait tasks. Dual gait tasks were found to highlight specific executive function elements. This result forms a baseline value for dual task gait speed. © The Author 2014. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  14. No psychological distress in sportsmen aged 45 years and older after cardiovascular screening, including cardiac CT: The Measuring Athlete's Risk of Cardiovascular events (MARC) study.

    Science.gov (United States)

    Schurink, M M; Braber, T L; Prakken, N H J; Doevendans, P A F M; Backx, F J G; Grobbee, D E; Rienks, R; Nathoe, H M; Bots, M L; Velthuis, B K; Mosterd, A

    2017-04-01

    Psychological distress caused by cardiovascular pre-participation screening (PPS) may be a reason not to implement a PPS program. We assessed the psychological impact of PPS, including cardiac computed tomography (CT), in 318 asymptomatic sportsmen aged ≥45 years. Coronary artery disease (CAD) was defined as a coronary artery calcium score ≥100 Agatson units and/or ≥50% luminal stenosis on contrast-enhanced cardiac CT. Psychological impact was measured with the Impact of Event Scale (IES) (seven items) on a six-point scale (grade 0-5). A sum score ≥19 indicates clinically relevant psychological distress. A Likert scale was used to assess overall experiences and impact on sports and lifestyle. A total of 275 participants (86.5% response rate, 95% CI 83-90%) with a mean age of 54.5 ± 6.4 years completed the questionnaires, 48 (17.5%, 95% CI 13-22%) of whom had CAD. The median IES score was 1 (IQR 0-2, [0-23]). IES was slightly higher in those with CAD (mean rank 175 vs. 130, p psychological distress (IES = 23). Participants reported numerous benefits, including feeling safer exercising (58.6%, 95% CI 53-65%) and positive lifestyle changes, especially in those with CAD (17.2 vs. 52.1%, p psychological distress in older sportsmen. Psychological distress should not be a reason to forego screening in sportsmen.

  15. The association between exposure to psychosocial work factors and mental health in older employees, a 3-year follow-up study

    NARCIS (Netherlands)

    Havermans, B.M.; Boot, C.R.L.; Hoekstra, T.; Houtman, I.L.D.; Brouwers, E.P.M.; Anema, J.R.; Beek, A.J. van der

    2018-01-01

    Purpose Unfavourable exposure to psychosocial work factors threatens older employees’ mental health, and their sustained employment. This study assesses whether an improved compared to stable unfavourable and stable favourable exposure to psychosocial work factors is associated with a change in

  16. The association between exposure to psychosocial work factors and mental health in older employees : A 3-year follow-up study

    NARCIS (Netherlands)

    Havermans, B.M.; Boot, C.R.L.; Hoekstra, T.; Houtman, I.L.D.; Brouwers, E.P.M.; Anema, J.R.; Van Der Beek, A.J.

    2018-01-01

    Purpose Unfavourable exposure to psychosocial work factors threatens older employees' mental health, and their sustained employment. This study assesses whether an improved compared to stable unfavourable and stable favourable exposure to psychosocial work factors is associated with a change in

  17. Mesenteric blood flow, glucose absorption and blood pressure responses to small intestinal glucose in critically ill patients older than 65 years.

    Science.gov (United States)

    Sim, Jennifer A; Horowitz, M; Summers, M J; Trahair, L G; Goud, R S; Zaknic, A V; Hausken, T; Fraser, J D; Chapman, M J; Jones, K L; Deane, A M

    2013-02-01

    To compare nutrient-stimulated changes in superior mesenteric artery (SMA) blood flow, glucose absorption and glycaemia in individuals older than 65 years with, and without, critical illness. Following a 1-h 'observation' period (t (0)-t (60)), 0.9 % saline and glucose (1 kcal/ml) were infused directly into the small intestine at 2 ml/min between t (60)-t (120), and t (120)-t (180), respectively. SMA blood flow was measured using Doppler ultrasonography at t (60) (fasting), t (90) and t (150) and is presented as raw values and nutrient-stimulated increment from baseline (Δ). Glucose absorption was evaluated using serum 3-O-methylglucose (3-OMG) concentrations during, and for 1 h after, the glucose infusion (i.e. t (120)-t (180) and t (120)-t (240)). Mean arterial pressure was recorded between t (60)-t (240). Data are presented as median (25th, 75th percentile). Eleven mechanically ventilated critically ill patients [age 75 (69, 79) years] and nine healthy volunteers [70 (68, 77) years] were studied. The magnitude of the nutrient-stimulated increase in SMA flow was markedly less in the critically ill when compared with healthy subjects [Δt (150): patients 115 (-138, 367) versus health 836 (618, 1,054) ml/min; P = 0.001]. In patients, glucose absorption was reduced during, and for 1 h after, the glucose infusion when compared with health [AUC(120-180): 4.571 (2.591, 6.551) versus 11.307 (8.447, 14.167) mmol/l min; P AUC(120-240): 26.5 (17.7, 35.3) versus 40.6 (31.7, 49.4) mmol/l min; P = 0.031]. A close relationship between the nutrient-stimulated increment in SMA flow and glucose absorption was evident (3-OMG AUC(120-180) and ∆SMA flow at t (150): r (2) = 0.29; P 65 years, stimulation of SMA flow by small intestinal glucose infusion may be attenuated, which could account for the reduction in glucose absorption.

  18. [An intergenerational health promotion program involving older adults in urban areas. "Research of Productivity by Intergenerational Sympathy (REPRINTS)": first-year experience and short-term effects].

    Science.gov (United States)

    Fujiwara, Yoshinori; Nishi, Mariko; Watanabe, Naoki; Lee, Sangyoon; Inoue, Kazuko; Yoshida, Hiroto; Sakuma, Naoko; Kureta, Youichi; Ishii, Kenji; Uchida, Hayato; Kakuno, Fumihiko; Shinkai, Shoji

    2006-09-01

    We have launched a new intervention study, called "Research of Productivity by Intergenerational Sympathy (REPRINTS)" in which senior volunteers engage in reading picture books to children. The "REPRINTS" program consistently involves social roles and intellectual activity, two higher-level functional capacities. This study reported findings and problems experienced through "REPRINTS" during the first year, ascertained potential effectiveness of social activity, and proposed methods for continued activity. Basic concepts of "REPRINTS"program include "contribution to society", "life-long learning", and "group activity." Sixty seven volunteers and 74 controls, all aged 60 years and over living in three areas, ie., Chuo-ku, central Tokyo, Kawasaki city, suburb of Tokyo and Nagahama city, a local city, participated in a baseline health check-up in June, 2004. After completion of 3-month training seminars (once a week, 2 hr per session), volunteers visited public elementary schools and kindergartens in groups of 6-10 persons for 6 months. They were assessed again by follow-up health check-up in March, 2005. At baseline, the proportion of those who had no grand children (41.8% vs. 20.3%, P= 0.006), average school years (13.4 +/- 2.5 vs. 12.3 +/- 2.5 years, P= 0.008), having any experience of volunteer activities (79.1% vs. 52.7%, P=0.001), and an usual walking speed (86.7 +/- 12.3 vs. 81.3 +/- 12.9 m/min, P=0.012) were significantly higher in volunteers than in controls. There was no significant difference in other baseline characteristics between the two groups. At follow-up, social network scores for 56 volunteers were significantly improved: frequency of contact with grandchildren and others around neighborhood and size of circles of friends and acquaintances were increased, as compared to controls. Social support scores for the volunteers significantly decreased in the receiving aspect, while increased in the giving aspect. In addition, consciousness of loving

  19. Advocating vaccination of adults aged 60 years and older in Western Europe: statement by the Joint Vaccine Working Group of the European Union Geriatric Medicine Society and the International Association of Gerontology and Geriatrics-European Region.

    Science.gov (United States)

    Michel, Jean-Pierre; Chidiac, Christian; Grubeck-Loebenstein, Beatrix; Johnson, Robert W; Lambert, Paul Henri; Maggi, Stefania; Moulias, Robert; Nicholson, Karl; Werner, Hans

    2009-04-01

    Vaccines are an underused public health strategy for healthy aging. Considering the risks of vaccine-preventable diseases and the current low vaccine coverage rates in older European citizens, the two European geriatric and gerontological societies (European Union Geriatric Medicine Society [EUGMS] and International Association of Gerontology and Geriatrics-European Region [IAGG-ER]) convened a Joint Vaccine Working Group to develop a consensus document advocating routine vaccination of aging populations. The mandate of this Working Group was to improve the uptake of routine vaccinations in adults aged 60 years and over. The consensus statement underlines the need to establish, strengthen, and harmonize European policies that continue routine vaccinations to adulthood and that will include older populations. Improved vaccination rates will promote healthy aging by reducing the burden of vaccine-preventable infectious diseases in older populations, a population that is rapidly increasing in Europe.

  20. An ultraluminous quasar with a twelve-billion-solar-mass black hole at redshift 6.30.

    Science.gov (United States)

    Wu, Xue-Bing; Wang, Feige; Fan, Xiaohui; Yi, Weimin; Zuo, Wenwen; Bian, Fuyan; Jiang, Linhua; McGreer, Ian D; Wang, Ran; Yang, Jinyi; Yang, Qian; Thompson, David; Beletsky, Yuri

    2015-02-26

    So far, roughly 40 quasars with redshifts greater than z = 6 have been discovered. Each quasar contains a black hole with a mass of about one billion solar masses (10(9) M Sun symbol). The existence of such black holes when the Universe was less than one billion years old presents substantial challenges to theories of the formation and growth of black holes and the coevolution of black holes and galaxies. Here we report the discovery of an ultraluminous quasar, SDSS J010013.02+280225.8, at redshift z = 6.30. It has an optical and near-infrared luminosity a few times greater than those of previously known z > 6 quasars. On the basis of the deep absorption trough on the blue side of the Lyman-α emission line in the spectrum, we estimate the proper size of the ionized proximity zone associated with the quasar to be about 26 million light years, larger than found with other z > 6.1 quasars with lower luminosities. We estimate (on the basis of a near-infrared spectrum) that the black hole has a mass of ∼1.2 × 10(10) M Sun symbol, which is consistent with the 1.3 × 10(10) M Sun symbol derived by assuming an Eddington-limited accretion rate.