Firth, Steven J
Given that a properly formed utilitarian response to healthcare distribution issues should evaluate cost effectiveness against the total utility increase, it follows that any utilitarian cost-effectiveness metric should be sensitive to increases in both individual and social utility afforded by a given intervention. Quality adjusted life year (QALY) based decisionmaking in healthcare cannot track increases in social utility, and as a result, the QALY cannot be considered a strict utilitarian response to issues of healthcare distribution. This article considers arguments against, and a possible defence of, the QALY as a utilitarian concept; in response, the article offers a similar - but properly formed - utilitarian metric called the (IALY). This article also advances a tool called the 'glee factor' (GF) on which the IALY may lean in a similar way to which the QALY leans on the Rosser Index.
La Puma, J; Lawlor, E F
Quality-adjusted life-years have been used in economic analyses as a measure of health outcomes, one that reflects both lives saved and patients' valuations of quality of life in alternative health states. The concept of "cost per quality-adjusted life year" as a guideline for resource allocation is founded on six ethical assumptions: quality of life can be accurately measured and used, utilitarianism is acceptable, equity and efficiency are compatible, projections of community preferences can substitute for individual preferences, the old have less "capacity to benefit" than the young, and physicians will not use quality-adjusted life-years as clinical maxims. Quality-adjusted life-years signal two shifts in the locus of control and the nature of the clinical encounter: first, formal expressions of community preferences and societal usefulness would counterbalance patient autonomy, and second, formal tools of resource allocation and applied decision analysis would counterbalance the use of clinical judgment. These shifts reflect and reinforce a new financial ethos in medical decision making. Presently using quality-adjusted life-years for health policy decisions is problematic and speculative; using quality-adjusted life-years at the bedside is dangerous.
Quality Adjusted Life Years (QALYs) are a popular outcome measure in cost-effectiveness analyses. QALYs are computed by multiplying follow-up or survival by a scaling factor reflecting health related quality of life, and as such capture quantity and quality gains simultaneously. Issues with regard
Hørdam, Britta; Pedersen, P.U.; Søballe, Kjeld
Background: Total hip replacement (THR) is an effective, but also cost-intensive health care procedure for the elderly. Because of demographic changes in Western Europe, THR-associated financial investment for health care has become a question of priorities in society. To provide a quantitative...... rationale for a discussion within Western European health care systems, we undertook a prospective assessment of the benefit of THR from the patients´ perspective and as measured by quality-adjusted life years (QALYs). Aim: To measure the difference in health related quality of life between an intervention...... treatment and telephone intervention. QALYs were calculated from measures of health-related quality of life using questionnaire SF-36. These scores were transformed to QALYs using a formula based on the method developed by Brazier (Brazier 1998). Results: Both the control and the intervention patients...
Nimdet, Khachapon; Ngorsuraches, Surachat
To estimate the willingness to pay (WTP) per quality-adjusted life year (QALY) value for life-saving treatments and to determine factors affecting the WTP per QALY value. A cross-sectional survey with multistage sampling and face-to-face interviews. General population in the southern part of Thailand. A total of 600 individuals were included in the study. Only 554 (92.3%) responses were usable for data analyses. Participants were asked for the maximum amount of WTP value for life-saving treatments by an open-ended question. EQ-5D-3L and visual analogue scale (VAS) were used to estimate additional QALY. The amount of WTP values varied from 0 to 720,000 Baht/year (approximately 32 Baht=US$1). The averages of additional QALY obtained from VAS and EQ-5D-3L were only slightly different (0.872 and 0.853, respectively). The averages of WTP per QALY obtained from VAS and EQ-5D-3L were 244,720 and 243,120 Baht/QALY, respectively. As compared to male participants, female participants were more likely to pay less for an additional QALY (p=0.007). In addition, participants with higher household incomes tended to have higher WTP per QALY values (pper QALY value specifically for life-saving treatments, which would complement the current cost-effectiveness threshold used in Thailand and optimise patient access to innovative treatments or technologies. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Bevan, Gwyn; Hollinghurst, Sandra
Two different paradigms have been proposed for setting priorities for access to healthcare: cost per quality-adjusted life year based on interventions, and disability-adjusted life years based on the burden of disease in a population. These formal paradigms make explicit the assumptions made implicitly every day in delivering and hence rationing access to healthcare. This paper outlines each paradigm's methodological problems and argues that each paradigm is incomplete in terms of providing the information necessary for making budgetary decisions on healthcare. It argues that a scientific revolution is required to create a new paradigm by combining the strengths of each.
Fransen, Heidi P; May, Anne M; Beulens, Joline W J; Struijk, Ellen A; de Wit, G Ardine; Boer, Jolanda M A; Onland-Moret, N Charlotte; Hoekstra, Jeljer; van der Schouw, Yvonne T; Bueno-de-Mesquita, H Bas; Peeters, Petra H M
The aim of our study was to relate four modifiable lifestyle factors (smoking status, body mass index, physical activity and diet) to health expectancy, using quality-adjusted life years (QALYs) in a prospective cohort study. Data of the prospective EPIC-NL study were used, including 33,066 healthy men and women aged 20-70 years at baseline (1993-7), followed until 31-12-2007 for occurrence of disease and death. Smoking status, body mass index, physical activity and adherence to a Mediterranean-style diet (excluding alcohol) were investigated separately and combined into a healthy lifestyle score, ranging from 0 to 4. QALYs were used as summary measure of healthy life expectancy, combining a person's life expectancy with a weight for quality of life when having a chronic disease. For lifestyle factors analyzed separately the number of years living longer in good health varied from 0.12 year to 0.84 year, after adjusting for covariates. A combination of the four lifestyle factors was positively associated with higher QALYs (P-trend healthy lifestyle score of 4 compared to a score of 0 was associated with almost a 2 years longer life in good health (1.75 QALYs [95% CI 1.37, 2.14]).
It is widely accepted that one of the main objectives of government expenditure on health care is to generate health. Since health is a function of both length of life and quality of life, the quality-adjusted life-year (QALY) has been developed in an attempt to combine the value of these attributes into a single index number. The QALY approach--and particularly the decision rule that health care resources should be allocated so as to maximise the number of QALYs generated--has often been equated with the utilitarian philosophy of maximising 'the greatest happiness of the greatest number'. This paper considers the extent to which the measurement and aggregation of QALYs really is utilitarian by developing a new taxonomy in order to classify utilitarianism and the different aspects of the QALY approach. It is shown that the measurement of QALYs is consistent with a number of different moral positions and that QALYs do not have to be aggregated according to the maximisation rule. Therefore it is inappropriate to necessarily equate QALYs with utilitarianism. It is shown that much turns on what in principle the QALY represents and how in practice it can be operationalised. The paper highlights the category confusion that is often present here and suggests possible avenues for future theoretical and empirical research.
Basu, Anirban; Manca, Andrea
To develop regression models for outcomes with truncated supports, such as health-related quality of life (HRQoL) data, and account for features typical of such data such as a skewed distribution, spikes at 1 or 0, and heteroskedasticity. Regression estimators based on features of the Beta distribution. First, both a single equation and a 2-part model are presented, along with estimation algorithms based on maximum-likelihood, quasi-likelihood, and Bayesian Markov-chain Monte Carlo methods. A novel Bayesian quasi-likelihood estimator is proposed. Second, a simulation exercise is presented to assess the performance of the proposed estimators against ordinary least squares (OLS) regression for a variety of HRQoL distributions that are encountered in practice. Finally, the performance of the proposed estimators is assessed by using them to quantify the treatment effect on QALYs in the EVALUATE hysterectomy trial. Overall model fit is studied using several goodness-of-fit tests such as Pearson's correlation test, link and reset tests, and a modified Hosmer-Lemeshow test. The simulation results indicate that the proposed methods are more robust in estimating covariate effects than OLS, especially when the effects are large or the HRQoL distribution has a large spike at 1. Quasi-likelihood techniques are more robust than maximum likelihood estimators. When applied to the EVALUATE trial, all but the maximum likelihood estimators produce unbiased estimates of the treatment effect. One and 2-part Beta regression models provide flexible approaches to regress the outcomes with truncated supports, such as HRQoL, on covariates, after accounting for many idiosyncratic features of the outcomes distribution. This work will provide applied researchers with a practical set of tools to model outcomes in cost-effectiveness analysis.
Martín-Fernández, Jesus; Polentinos-Castro, Elena; del Cura-González, Ma Isabel; Ariza-Cardiel, Gloria; Abraira, Victor; Gil-LaCruz, Ana Isabel; García-Pérez, Sonia
Background This paper examines the Willingness to Pay (WTP) for a quality-adjusted life year (QALY) expressed by people who attended the healthcare system as well as the association of attitude towards risk and other personal characteristics with their response. Methods Health-state preferences, measured by EuroQol (EQ-5D-3L), were combined with WTP for recovering a perfect health state. WTP was assessed using close-ended, iterative bidding, contingent valuation method. Data on demographic an...
Hansen, Kristian Schultz; Østerdal, Lars Peter Raahave
Qualityadjusted life year (QALY) models are widely used for economic evaluation in the health care sector. In the first part of the paper, we establish an overview of QALY models where health varies over time and provide a theoretical analysis of model identification and parameter estimation from...... time tradeoff (TTO) and standard gamble (SG) scores. We investigate deterministic and probabilistic models and consider five different families of discounting functions in all. The second part of the paper discusses four issues recurrently debated in the literature. This discussion includes questioning...... of these two can be used to disentangle risk aversion from discounting. We find that caution must be taken when drawing conclusions from models with chronic health states to situations where health varies over time. One notable difference is that in the former case, risk aversion may be indistinguishable from...
Wichmann, Anne B; Adang, Eddy Mm; Stalmeier, Peep Fm; Kristanti, Sinta; Van den Block, Lieve; Vernooij-Dassen, Myrra Jfj; Engels, Yvonne
In cost-effectiveness analyses in healthcare, Quality-Adjusted Life Years are often used as outcome measure of effectiveness. However, there is an ongoing debate concerning the appropriateness of its use for decision-making in palliative care. To systematically map pros and cons of using the Quality-Adjusted Life Year to inform decisions on resource allocation among palliative care interventions, as brought forward in the debate, and to discuss the Quality-Adjusted Life Year's value for palliative care. The integrative review method of Whittemore and Knafl was followed. Theoretical arguments and empirical findings were mapped. A literature search was conducted in PubMed, EMBASE, and CINAHL, in which MeSH (Medical Subject Headings) terms were Palliative Care, Cost-Benefit Analysis, Quality of Life, and Quality-Adjusted Life Years. Three themes regarding the pros and cons were identified: (1) restrictions in life years gained, (2) conceptualization of quality of life and its measurement, including suggestions to adapt this, and (3) valuation and additivity of time, referring to changing valuation of time. The debate is recognized in empirical studies, but alternatives not yet applied. The Quality-Adjusted Life Year might be more valuable for palliative care if specific issues are taken into account. Despite restrictions in life years gained, Quality-Adjusted Life Years can be achieved in palliative care. However, in measuring quality of life, we recommend to-in addition to the EQ-5D- make use of quality of life or capability instruments specifically for palliative care. Also, we suggest exploring the possibility of integrating valuation of time in a non-linear way in the Quality-Adjusted Life Year.
Lee, Lukas Jyuhn-Hsiarn; Lin, Cheng-Kuan; Hung, Mei-Chuan; Wang, Jung-Der
This study estimates the annual numbers of eight work-related cancers, total losses of quality-adjusted life years (QALYs), and lifetime healthcare expenditures that possibly could be saved by improving occupational health in Taiwan. Three databases were interlinked: the Taiwan Cancer Registry, the National Mortality Registry, and the National Health Insurance Research Database. Annual numbers of work-related cancers were estimated based on attributable fractions (AFs) abstracted from a literature review. The survival functions for eight cancers were estimated and extrapolated to lifetime using a semi-parametric method. A convenience sample of 8846 measurements of patients' quality of life with EQ-5D was collected for utility values and multiplied by survival functions to estimate quality-adjusted life expectancies (QALEs). The loss-of-QALE was obtained by subtracting the QALE of cancer from age- and sex-matched referents simulated from national vital statistics. The lifetime healthcare expenditures were estimated by multiplying the survival probability with mean monthly costs paid by the National Health Insurance for cancer diagnosis and treatment and summing this for the expected lifetime. A total of 3010 males and 726 females with eight work-related cancers were estimated in 2010. Among them, lung cancer ranked first in terms of QALY loss, with an annual total loss-of-QALE of 28,463 QALYs and total lifetime healthcare expenditures of US$36.6 million. Successful prevention of eight work-related cancers would not only avoid the occurrence of 3736 cases of cancer, but would also save more than US$70 million in healthcare costs and 46,750 QALYs for the Taiwan society in 2010.
Hirth, R A; Chernew, M E; Miller, E; Fendrick, A M; Weissert, W G
Cost-benefit analysis (CBA) provides a clear decision rule: undertake an intervention if the monetary value of its benefits exceed its costs. However, due to a reluctance to characterize health benefits in monetary terms, users of cost-utility and cost-effectiveness analyses must rely on arbitrary standards (e.g., implied by the value-of-life literature and compared this value with arbitrary thresholds for cost-effectiveness that have come into common use. A literature search identified 42 estimates of the value of life that were appropriate for inclusion. These estimates were classified by method: human capital (HK), contingent valuation (CV), revealed preference/job risk (RP-JR) and revealed preference/non-occupational safety (RP-S), and by U.S. or non-U.S. origin. After converting these value-of-life estimates to 1997 U.S. dollars, the life expectancy of the study population, age-specific QALY weights, and a 3% real discount rate were used to calculate the implied value of a QALY. An ordinary least-squares regression of the value of a QALY on study type and national origin explained 28.4% of the variance across studies. Most of the explained variance was attributable to study type; national origin did not significantly affect the values. Median values by study type were $24,777 (HK estimates), $93,402 (RP-S estimates), $161,305 (CV estimates), and $428,286 (RP-JR estimates). With the exception of HK, these far exceed the "rules of thumb" that are frequently used to determine whether an intervention produces an acceptable increase in health benefits in exchange for incremental expenditures.
Bachman, Daniel; Nyland, John; Krupp, Ryan
To compare reverse-total shoulder arthroplasty (RSA) cost-effectiveness with total hip arthroplasty cost-effectiveness. This study used a stochastic model and decision-making algorithm to compare the cost-effectiveness of RSA and total hip arthroplasty. Fifteen patients underwent pre-operative, and 3, 6, and 12 mo post-operative clinical examinations and Short Form-36 Health Survey completion. Short form-36 Health Survey subscale scores were converted to EuroQual Group Five Dimension Health Outcome scores and compared with historical data from age-matched patients who had undergone total hip arthroplasty. Quality-adjusted life year (QALY) improvements based on life expectancies were calculated. The cost/QALY was $3900 for total hip arthroplasty and $11100 for RSA. After adjusting the model to only include shoulder-specific physical function subscale items, the RSA QALY improved to 2.8 years, and its cost/QALY decreased to $8100. Based on industry accepted standards, cost/QALY estimates supported both RSA and total hip arthroplasty cost-effectiveness. Although total hip arthroplasty remains the quality of life improvement "gold standard" among arthroplasty procedures, cost/QALY estimates identified in this study support the growing use of RSA to improve patient quality of life.
Shafie, Asrul Akmal; Lim, Yen Wei; Chua, Gin Nie; Hassali, Mohammed Azmi Ahmad
The incremental cost-effectiveness ratio (ICER) is typically compared with a reference value to support the cost-effectiveness of a decision. One method for estimating this value is to estimate the willingness-to-pay (WTP) for a quality-adjusted life-year (QALY). This study was conducted to explore the WTP for a QALY in the Malaysian population. A cross-sectional, contingent valuation study was conducted in Penang, Malaysia. Respondents were selected from randomly chosen geographical grids of Penang. Respondents' sociodemographic information, qualities of life, and WTP for one additional QALY were collected using predesigned questionnaires in face-to-face interviews. WTP values were elicited using a double-bound dichotomous choice via a bidding game approach. The Heckman selection model was applied to the analysis of the mean WTP/QALY values, where the "protest zero" values, which may contribute to selection bias, were excluded. The mean value of WTP for an additional QALY gained was estimated to be MYR (Malaysian Ringgit) 29,080 (~USD 9,000). Key factors that affected the WTP include ethnicity and estimated monthly household income. The study findings suggested that the cost-effectiveness threshold value as studied in Penang, Malaysia was estimated to be MYR 29,080.
Full Text Available INTRODUCTION: Patients who require prolonged mechanical ventilation (PMV are increasing and producing financial burdens worldwide. This study determines the cost per QALY (quality-adjusted life year, out-of-pocket expenses, and lifetime costs for PMV patients stratified by underlying diseases and cognition levels. METHODS: A nationwide sample of 50,481 patients with continual mechanical ventilation for more than 21 days was collected during 1997-2007. After stratifying the patients according to specific diagnoses, a latent class analysis (LCA was performed to categorise PMV patients with multiple co-morbidities into several homogeneous groups. The survival functions were estimated for individual groups using the Kaplan-Meier method and extrapolated to 300 months through a semi-parametric method. The survival functions were adjusted using an EQ-5D utility value derived from a convenience sample of 142 PMV patients to estimate quality-adjusted life expectancies (QALE. Another convenience sample of 165 patients was used to estimate the out-of-pocket expenses. The lifetime expenditures paid by the single-payer National Health Insurance (NHI system and patients' families were estimated by multiplying average monthly expenditures by the survival probabilities and summing the values over lifetime. RESULTS: PMV therapy costs more than 100,000 U.S. dollars (USD per QALY for all patients with poor cognition. For patients with partial cognition, PMV therapy costs less than 56,000 USD per QALY for those with liver cirrhosis, intracranial or spinal cord injuries, and 57,000-69,000 USD for patients with multiple co-morbidities under age of 65. The average lifetime cost of PMV was usually below 56,000 USD. The out-of-pocket expenses were often more than one-third of the total cost of treatment. CONCLUSIONS: PMV treatment for patients with poor cognition would cost more than 5 times Taiwan's GDP (gross domestic products, or less cost-effective. The out
Martín-Fernández, Jesus; Polentinos-Castro, Elena; del Cura-González, Ma Isabel; Ariza-Cardiel, Gloria; Abraira, Victor; Gil-LaCruz, Ana Isabel; García-Pérez, Sonia
This paper examines the Willingness to Pay (WTP) for a quality-adjusted life year (QALY) expressed by people who attended the healthcare system as well as the association of attitude towards risk and other personal characteristics with their response. Health-state preferences, measured by EuroQol (EQ-5D-3L), were combined with WTP for recovering a perfect health state. WTP was assessed using close-ended, iterative bidding, contingent valuation method. Data on demographic and socioeconomic characteristics, as well as usage of health services by the subjects were collected. The attitude towards risk was evaluated by collecting risky behaviors data, by the subject's self-evaluation, and through lottery games. Six hundred and sixty two subjects participated and 449 stated a utility inferior to 1. WTP/QALY ratios varied significantly when payments with personal money (mean €10,119; median €673) or through taxes (mean €28,187; median €915) were suggested. Family income, area income, higher education level, greater use of healthcare services, and the number of co-inhabitants were associated with greater WTP/QALY ratios. Age and female gender were associated with lower WTP/QALY ratios. Risk inclination was independently associated with a greater WTP/QALY when "out of pocket" payments were suggested. Clear discrepancies were demonstrated between linearity and neutrality towards risk assumptions and experimental results. WTP/QALY ratios vary noticeably based on demographic and socioeconomic characteristics of the subject, but also on their attitude towards risk. Knowing the expression of preferences by patients from this outcome measurement can be of interest for health service planning.
Coskeran, Thomas; Denman, Antony; Phillips, Paul; Gillmore, Gavin; Tornberg, Roger
Radon is a naturally occurring radioactive gas, high levels of which are associated with geological formations such as those found in Northamptonshire and North Oxfordshire in the UK. The UK's National Radiological Protection Board have designated both districts as radon Affected Areas. Radiation levels due to radon, therefore, exceed 200 Bq m -3 , the UK's domestic Action Level, in over one percent of domestic properties. Because of radon's radioactivity, exposure to the gas can potentially cause lung cancer, and has been linked to some 2000 deaths a year in the UK. Consequently, when radiation levels exceed the Action Level, remediation against radon's effects is recommended to householders. This study examines the cost-effectiveness of remediation measures in Northamptonshire and North Oxfordshire by estimating cost per quality-adjusted life-year gained in four Primary Care Trusts, organisations that play a key public health policy role in the UK's National Health Service. The study is the first to apply this approach to estimating the cost-effectiveness of radon remediation programmes. Central estimates of cost per quality-adjusted life-year in the four Primary Care Trusts range from Pounds 6143 to Pounds 10 323. These values, when assessed against generally accepted criteria, suggest the remediation programmes in the trusts were cost-effective. Policy suggestions based on the estimates, and designed to improve cost-effectiveness further, are proposed for the four Primary Care Trusts and the UK's National Health Service
Nimdet, Khachapon; Chaiyakunapruk, Nathorn; Vichansavakul, Kittaya; Ngorsuraches, Surachat
A number of studies have been conducted to estimate willingness to pay (WTP) per quality-adjusted life years (QALY) in patients or general population for various diseases. However, there has not been any systematic review summarizing the relationship between WTP per QALY and cost-effectiveness (CE) threshold based on World Health Organization (WHO) recommendation. To systematically review willingness-to-pay per quality-adjusted-life-year (WTP per QALY) literature, to compare WTP per QALY with Cost-effectiveness (CE) threshold recommended by WHO, and to determine potential influencing factors. We searched MEDLINE, EMBASE, Psyinfo, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Center of Research Dissemination (CRD), and EconLit from inception through 15 July 2014. To be included, studies have to estimate WTP per QALY in health-related issues using stated preference method. Two investigators independently reviewed each abstract, completed full-text reviews, and extracted information for included studies. We compared WTP per QALY to GDP per capita, analyzed, and summarized potential influencing factors. Out of 3,914 articles founded, 14 studies were included. Most studies (92.85%) used contingent valuation method, while only one study used discrete choice experiments. Sample size varied from 104 to 21,896 persons. The ratio between WTP per QALY and GDP per capita varied widely from 0.05 to 5.40, depending on scenario outcomes (e.g., whether it extended/saved life or improved quality of life), severity of hypothetical scenarios, duration of scenario, and source of funding. The average ratio of WTP per QALY and GDP per capita for extending life or saving life (2.03) was significantly higher than the average for improving quality of life (0.59) with the mean difference of 1.43 (95% CI, 1.81 to 1.06). This systematic review provides an overview summary of all studies estimating WTP per QALY studies. The variation of ratio of WTP per QALY and GDP per
Mavrodi, A; Aletras, V; Spanou, A; Niakas, D
Contingent valuation is widely used to determine individuals' willingness to pay (WTP) for a health gain. Our study aimed to elicit an empirical estimate of the monetary value of a quality-adjusted life year (QALY) in a Greek outpatient setting in times of economic austerity and assess the impact of patients' characteristics on their valuations. We used a questionnaire as a survey tool to determine the maximum WTP for a health gain of a hypothetical therapy and to evaluate patients' health-related quality of life (EuroQoL-5D-3L) and demographic and socioeconomic characteristics. EuroQoL tariffs were used to estimate health utilities. Mean WTP values were computed and ordinary least squares regressions performed on transformed Box-Cox and logarithmic dependent WTP per QALY variables to remedy observed skewness problems. Analyses were performed for 167 patients with utility values less than unity. Mean WTP per QALY reported was similar for both payment vehicles examined: payments made out-of-pocket (€2629) and payments made through new tax imposition (€2407). Regression results showed that higher net monthly family income was associated with higher WTP per QALY for both payment vehicles. Moreover, the presence of a chronic condition and higher level of education were associated with higher out-of-pocket WTP per QALY and WTP per QALY through taxes, respectively. The very low WTP per QALY estimates could be explained by the recent severe economic depression and austerity in Greece. In fact, family income was found to be a significant predictor of WTP per QALY. Since these estimates deviate significantly from the cost-effectiveness thresholds still employed in economic evaluations in this country, research should be undertaken promptly to further examine this important issue using a nationwide representative sample of the general population along with WTP and other methodologies.
Rodriguez, José Manuel; Paz, Silvia; Lizan, Luis; Gonzalez, Paloma
To appraise economic evaluations of health technologies that included quality-adjusted life-years (QALYs) as an outcome measure conducted over the past 20 years in Spain. A systematic review of the literature was conducted. Economic evaluations that included QALYs as an outcome measure, conducted in Spain and published between January 1990 and December 2009 were identified. Primary and gray literature sources were reviewed. A total of 60 articles and 4 health technology assessment reports were included. Key findings were 1) the vast majority of articles (77.1%) referred to therapeutic interventions; 2) 63.2% dealt with pharmaceutical products and much fewer with preventive strategies, medical devices, or diagnostic interventions; 3) most evaluations referred to cardiovascular- (19.8%), respiratory- (16.3%), and cancer- (13.0%) related processes; 4) 80.3% were based on a theoretical model, most commonly Markov models (71.4%); 5) 67.3% adopted the National Health System perspective; 6) information on the methods used to describe the health states was given in 45.1% of studies; 7) 40.3% used the EuroQoL-5D to elicit preferences, whereas 66.1% gave no details on the methods applied to determine patients' choices; 8) it was possible to state who completed the questionnaires in only 17.7% of studies; 9) 77.1% of the interventions assessed were below the €30,000/QALY suggested affordable threshold in Spain. An increasing number of economic evaluations using QALYs had been conducted. Most of them relied on theoretical models. Several methodological issues remain unsolved. Great disparity exists regarding the reporting of the methods used to determine health states and utility values. Copyright © 2011. Published by Elsevier Inc.
Kerman, Hannah M; Smith, Savannah R; Smith, Karen C; Collins, Jamie E; Suter, Lisa G; Katz, Jeffrey N; Losina, Elena
Total knee replacement (TKR) is an effective treatment for end-stage knee osteoarthritis (OA). American racial minorities undergo fewer TKRs than Whites. We estimated quality-adjusted life years (QALYs) lost for Black knee OA patients due to differences in TKR offer, acceptance, and complication rates. We used the Osteoarthritis Policy Model, a computer simulation of knee OA, to predict QALY outcomes for Black and White knee OA patients with and without TKR. We estimated per-person QALYs gained from TKR as the difference between QALYs with current TKR use and QALYs when no TKR was performed. We estimated average, per-person QALY losses in Blacks as the difference between QALYs gained with White rates of TKR and QALYs gained with Black rates of TKR. We calculated population-level QALY losses by multiplying per-person QALY losses by the number of persons with advanced knee OA. Finally, we estimated QALYs lost specifically due to lower TKR offer and acceptance and higher complications among Black knee OA patients. Black men and women gain 64,100 QALYs from current TKR use. With white offer and complications rates, they would gain an additional 72,000 QALYs. Because these additional gains are unrealized, we call this a loss of 72,000 QALYs. Black Americans lose 67,500 QALYs because of lower offer, 15,800 QALYs because of lower acceptance, and 2,600 QALYs because of higher complications. Black Americans lose 72,000 QALYs due to disparities in TKR offer and complication rates. Programs to decrease disparities in TKR use are urgently needed. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
Thavorncharoensap, Montarat; Teerawattananon, Yot; Natanant, Sirin; Kulpeng, Wantanee; Yothasamut, Jomkwan; Werayingyong, Pitsaphun
This study aims to elicit the value of the willingness to pay (WTP) for a quality-adjusted life year (QALY) and to examine the factors associated with the WTP for a QALY (WTP/QALY) value under the Thai health care setting. A community-based survey was conducted among 1191 randomly selected respondents. Each respondent was interviewed face-to-face to elicit his/her health state preference in each of three pairs of health conditions: (1) unilateral and bilateral blindness, (2) paraplegia and quadriplegia, and (3) mild and moderate allergies. A visual analog scale (VAS) and time trade off (TTO) were used as the eliciting methods. Subsequently, the respondents were asked about their WTP for the treatment and prevention of each pair of health conditions by using a bidding-game technique. With regards to treatment, the mean WTP for a QALY value (WTP/QALY(treatment)) estimated by the TTO method ranged from 59,000 to 285,000 baht (16.49 baht = US$1 purchasing power parity [PPP]). In contrast, the mean WTP for a QALY value in terms of prevention (WTP/QALY(prevention)) was significantly lower, ranging from 26,000 to 137,000 baht. Gender, household income, and hypothetical scenarios were also significant factors associated with the WTP/QALY values. The WTP/QALY values elicited in this study were approximately 0.4 to 2 times Thailand's 2008 GDP per capita. These values were in line with previous studies conducted in several different settings. This study's findings clearly support the opinion that a single ceiling threshold should not be used for the resource allocation of all types of interventions.
Chotai, Silky; Sielatycki, J Alex; Parker, Scott L; Sivaganesan, Ahilan; Kay, Harrison L; Stonko, David P; Wick, Joseph B; McGirt, Matthew J; Devin, Clinton J
Obese patients have greater comorbidities along with higher risk of complications and greater costs after spine surgery, which may result in increased cost and lower quality of life compared with their non-obese counterparts. The aim of the present study was to determine cost-utility following anterior cervical discectomy and fusion (ACDF) in obese patients. This study analyzed prospectively collected data. Patients undergoing elective ACDF for degenerative cervical pathology at a single academic institution were included in the study. Cost and quality-adjusted life years (QALYs) were the outcome measures. One- and two-year medical resource utilization, missed work, and health state values (QALYs) were assessed. Two-year resource use was multiplied by unit costs based on Medicare national payment amounts (direct cost). Patient and caregiver workday losses were multiplied by the self-reported gross-of-tax wage rate (indirect cost). Total cost (direct+indirect) was used to compute cost per QALY gained. Patients were defined as obese for body mass index (BMI) ≥35 based on the WHO definition of class II obesity. A subgroup analysis was conducted in morbidly obese patients (BMI≥40). There were significant improvements in pain (neck pain or arm pain), disability (Neck Disability Index), and quality of life (EuroQol-5D and Short Form-12) at 2 years after surgery (pdirect cost, indirect cost, and total cost between obese and non-obese patients at postoperative 1-year and 2-year follow-up. Mean 2-year direct cost for obese patients was $19,225±$8,065 and $17,635±$6,413 for non-obese patients (p=.14). There was no significant difference in the mean total 2-year cost between obese ($23,144±$9,216) and non-obese ($22,183±$10,564) patients (p=.48). Obese patients had a lower mean cumulative gain in QALYs versus non-obese patients at 2-years (0.34 vs. 0.42, p=.32). Two-year cost-utility in obese ($68,070/QALY) versus non-obese patients ($52,816/QALY) was not
Full Text Available Montarat Thavorncharoensap,1,2 Yot Teerawattananon,2 Sirin Natanant,2 Wantanee Kulpeng,2 Jomkwan Yothasamut,2 Pitsaphun Werayingyong21Department of Pharmacy, Faculty of Pharmacy, Mahidol University, Thailand; 2Health Intervention and Technology Assessment Program (HITAP, Ministry of Public Health, ThailandBackground: This study aims to elicit the value of the willingness to pay (WTP for a quality-adjusted life year (QALY and to examine the factors associated with the WTP for a QALY (WTP/QALY value under the Thai health care setting.Methods: A community-based survey was conducted among 1191 randomly selected respondents. Each respondent was interviewed face-to-face to elicit his/her health state preference in each of three pairs of health conditions: (1 unilateral and bilateral blindness, (2 paraplegia and quadriplegia, and (3 mild and moderate allergies. A visual analog scale (VAS and time trade off (TTO were used as the eliciting methods. Subsequently, the respondents were asked about their WTP for the treatment and prevention of each pair of health conditions by using a bidding-game technique.Results: With regards to treatment, the mean WTP for a QALY value (WTP/QALYtreatment estimated by the TTO method ranged from 59,000 to 285,000 baht (16.49 baht = US$1 purchasing power parity [PPP]. In contrast, the mean WTP for a QALY value in terms of prevention (WTP/QALYprevention was significantly lower, ranging from 26,000 to 137,000 baht. Gender, household income, and hypothetical scenarios were also significant factors associated with the WTP/QALY values.Conclusion: The WTP/QALY values elicited in this study were approximately 0.4 to 2 times Thailand's 2008 GDP per capita. These values were in line with previous studies conducted in several different settings. This study's findings clearly support the opinion that a single ceiling threshold should not be used for the resource allocation of all types of interventions.Keywords: ceiling threshold
Goodwin, Elizabeth; Boddy, Kate; Tatnell, Lynn; Hawton, Annie
Over recent years, public involvement in health research has expanded considerably. However, public involvement in designing and conducting health economics research is seldom reported. Here we describe the development, delivery and assessment of an approach for involving people in a clearly defined piece of health economics research: selecting health states for valuation in estimating quality-adjusted life-years (QALYs). This involvement formed part of a study to develop a condition-specific preference-based measure of health-related quality of life, the Multiple Sclerosis Impact Scale (MSIS-8D), and the work reported here relates to the identification of plausible, or realistic, health states for valuation. An Expert Panel of three people with multiple sclerosis (MS) was recruited from a local involvement network, and two health economists designed an interactive task that enabled the Panel to identify health states that were implausible, or unlikely to be experienced. Following some initial confusion over terminology, which was resolved by discussion with the Panel, the task worked well and can be adapted to select health states for valuation in the development of any preference-based measure. As part of the involvement process, five themes were identified by the Panel members and the researchers which summarised our experiences of public involvement in this health economics research example: proportionality, task design, prior involvement, protectiveness and partnerships. These are described in the paper, along with their practical implications for involving members of the public in health economics research. Our experience demonstrates how members of the public and health economists can work together to improve the validity of health economics research. Plain Language Summary It has become commonplace to involve members of the public in health service research. However, published reports of involving people in designing health economics research are rare. We
Kaplan, Robert M.; Anderson, John P.; Kaplan, Cameron M.
Purpose: To describe the development of a model for estimating the effects of tobacco use upon Quality Adjusted Life Years (QALYs) and to estimate the impact of tobacco use on health outcomes for the United States (US) population using the model. Method: We obtained estimates of tobacco consumption from 6 years of the National Health Interview…
Brønnum-Hansen, Henrik; Juel, Knud; Davidsen, Michael
AIMS: The construct quality-adjusted life years (QALYs) combines mortality and overall health status and can be used to quantify the impact of risk factors on population health. The purpose of the study was to estimate the impact of tobacco smoking, high alcohol consumption, physical inactivity...... Health Survey 2000, and Danish EQ-5D values. RESULTS: The quality-adjusted life expectancy of 25-year-olds was 10-11 QALYs shorter for heavy smokers than for those who never smoke. The difference in life expectancy was 9-10 years. Men and women with high alcohol consumption could expect to lose about 5...... and 3 QALYs, respectively. Sedentary persons could expect to have about 7 fewer QALYs than physically active persons. Obesity shortened QALYs by almost 3 for men and 6 for women. CONCLUSIONS: Smoking, high alcohol consumption, physical inactivity, and obesity strongly reduce life expectancy and health...
Rencz, F.; Pentek, M.; Stalmeier, P.F.M.; Brodszky, V.; Ruzsa, G.; Gradvohl, E.; Baji, P.; Gulacsi, L.
Primary dysmenorrhea (PD), or painful menstruation in the absence of identified uterine pathology, affects 5 to 9 in every 10 reproductive-aged women. Despite its high prevalence, just a few studies with very small patient numbers have focused on health-related quality of life impairment in PD. We
Love-Koh, James; Asaria, Miqdad; Cookson, Richard; Griffin, Susan
To model the social distribution of quality-adjusted life expectancy (QALE) in England by combining survey data on health-related quality of life with administrative data on mortality. Health Survey for England data sets for 2010, 2011, and 2012 were pooled (n = 35,062) and used to model health-related quality of life as a function of sex, age, and socioeconomic status (SES). Office for National Statistics mortality rates were used to construct life tables for age-sex-SES groups. These quality-of-life and length-of-life estimates were then combined to predict QALE as a function of these characteristics. Missing data were imputed, and Monte-Carlo simulation was used to estimate standard errors. Sensitivity analysis was conducted to explore alternative regression models and measures of SES. Socioeconomic inequality in QALE at birth was estimated at 11.87 quality-adjusted life-years (QALYs), with a sex difference of 1 QALY. When the socioeconomic-sex subgroups are ranked by QALE, a differential of 10.97 QALYs is found between the most and least healthy quintile groups. This differential can be broken down into a life expectancy difference of 7.28 years and a quality-of-life adjustment of 3.69 years. The methods proposed in this article refine simple binary quality-adjustment measures such as the widely used disability-free life expectancy, providing a more accurate picture of overall health inequality in society than has hitherto been available. The predictions also lend themselves well to the task of evaluating the health inequality impact of interventions in the context of cost-effectiveness analysis. Copyright © 2015 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.
Coyle, Douglas; Stieb, Dave; Burnett, Richard T; DeCivita, Paul; Krewski, Daniel; Chen, Yue; Thun, Michael J
Air pollution and premature death are important public health concerns. Analyses have repeatedly demonstrated that airborne particles are associated with increased mortality and estimates have been used to forecast the impact on life expectancy. In this analysis, we draw upon data from the American Cancer Society (ACS) cohort and literature on utility-based measures of quality of life in relation to health status to more fully quantify the effects of air pollution on mortality in terms of quality-adjusted life expectancy. The analysis was conducted within a decision analytic model using Monte Carlo simulation techniques. Outcomes were estimated based on projections of the Canadian population. A one-unit reduction in sulfate air pollution would yield a mean annual increase in Quality-Adjusted Life Years (QALYs) of 20,960, with gains being greater for individuals with lower educational status and for males compared to females. This suggests that the impact of reductions in sulfate air pollution on quality-adjusted life expectancy is substantial. Interpretation of the results is unclear. However, the potential gains in QALYs from reduced air pollutants can be contrasted to the costs of policies to bring about such reductions. Based on a tentative threshold for the value of health benefits, analysis suggests that an investment in Canada of over 1 billion dollars per annum would be an efficient use of resources if it could be demonstrated that this would reduce sulfate concentrations in ambient air by 1 microg/m(3). Further analysis can assess the efficiency of targeting such initiatives to communities that are most likely to benefit.
Gheorghe, Maria; Wubulihasimu, Parida; Peters, Frederik; Nusselder, Wilma; Van Baal, Pieter H M
Quality-adjusted life expectancy (QALE) has been proposed as a summary measure of population health because it encompasses multiple health domains as well as length of life. However, trends in QALE by education or other socio-economic measure have not yet been reported. This study investigates changes in QALE stratified by educational level for the Dutch population in the period 2001-2011. Using data from multiple sources, we estimated mortality rates and health-related quality of life (HRQoL) as functions of age, gender, calendar year and educational level. Subsequently, predictions from these regressions were combined for calculating QALE at ages 25 and 65. QALE changes were decomposed into effects of mortality and HRQoL. In 2001-2011, QALE increased for men and women at all educational levels, the largest increases being for highly educated resulting in a widening gap by education. In 2001, at age 25, the absolute QALE difference between the low and the highly educated was 7.4 healthy years (36.7 vs. 44.1) for men and 6.3 healthy years (39.5 vs. 45.8) for women. By 2011, the QALE difference increased to 8.1 healthy years (38.8 vs. 46.9) for men and to 7.1 healthy years (41.3 vs. 48.4) for women. Similar results were observed at age 65. Although the gap was largely attributable to widening inequalities in mortality, widening inequalities in HRQoL were also substantial. In the Netherlands, population health as measured by QALE has improved, but QALE inequalities have widened more than inequalities in life expectancy alone. © The Author 2016. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.
Full Text Available Background: Ethnic health inequalities for males and females among the elderly have not yet been verified in multicultural societies in developing countries. The aim of this study was to assess the extent of disparities in health expectancy among the elderly from different ethnic groups using quality-adjusted life expectancy. Design: A cross-sectional community-based survey was conducted. A total of 6,511 rural elderly individuals aged ≥60 years were selected from eight different ethnic groups in the Guangxi Zhuang Autonomous Region of China and assessed for health-related quality of life (HRQoL. The HRQoL utility value was combined with life expectancy at age 60 years (LE60 data by using Sullivan's method to estimate quality-adjusted life expectancy at age 60 years (QALE60 and loss in quality-adjusted life years (QALYs for each group. Results: Overall, LE60 and QALE60 for all ethnic groups were 20.9 and 18.0 years in men, respectively, and 24.2 and 20.3 years in women. The maximum gap in QALE60 between ethnic groups was 3.3 years in males and 4.6 years in females. The average loss in QALY was 2.9 years for men and 3.8 years for women. The correlation coefficient between LE60 and QALY lost was −0.53 in males and 0.12 in females. Conclusion: Women live longer than men, but they suffer more; men have a shorter life expectancy, but those who live longer are healthier. Attempts should be made to reduce suffering in the female elderly and improve longevity for men. Certain ethnic groups had low levels of QALE, needing special attention to improve their lifestyle and access to health care.
Normilio-Silva, Karina; de Figueiredo, Adelaide Cristina; Pedroso-de-Lima, Antonio Carlos; Tunes-da-Silva, Gisela; Nunes da Silva, Adriana; Delgado Dias Levites, Andresa; de-Simone, Ana Tereza; Lopes Safra, Patrícia; Zancani, Roberta; Tonini, Paula Camilla; Vasconcelos de Andrade E Silva, Ulysses; Buosi Silva, Thiago; Martins Giorgi, Juliana; Eluf-Neto, José; Costa, Anderson; Abrahão Hajjar, Ludhmila; Biasi Cavalcanti, Alexandre
To assess the long-term survival, health-related quality of life, and quality-adjusted life years of cancer patients admitted to ICUs. Prospective cohort. Two cancer specialized ICUs in Brazil. A total of 792 participants. None. The health-related quality of life before ICU admission; at 15 days; and at 3, 6, 12, and 18 months was assessed with the EQ-5D-3L. In addition, the vital status was assessed at 24 months. The mean age of the subjects was 61.6 ± 14.3 years, 42.5% were female subjects and half were admitted after elective surgery. The mean Simplified Acute Physiology Score 3 was 47.4 ± 15.6. Survival at 12 and 18 months was 42.4% and 38.1%, respectively. The mean EQ-5D-3L utility measure before admission to the ICU was 0.47 ± 0.43, at 15 days it was 0.41 ± 0.44, at 90 days 0.56 ± 0.42, at 6 months 0.60 ± 0.41, at 12 months 0.67 ± 0.35, and at 18 months 0.67 ± 0.35. The probabilities for attaining 12 and 18 months of quality-adjusted survival were 30.1% and 19.1%, respectively. There were statistically significant differences in survival time and quality-adjusted life years according to all assessed baseline characteristics (ICU admission after elective surgery, emergency surgery, or medical admission; Simplified Acute Physiology Score 3; cancer extension; cancer status; previous surgery; previous chemotherapy; previous radiotherapy; performance status; and previous health-related quality of life). Only the previous health-related quality of life and performance status were associated with the health-related quality of life during the 18-month follow-up. Long-term survival, health-related quality of life, and quality-adjusted life year expectancy of cancer patients admitted to the ICU are limited. Nevertheless, these clinical outcomes exhibit wide variability among patients and are associated with simple characteristics present at the time of ICU admission, which may help healthcare professionals estimate patients
Heijink, Richard; van Baal, Pieter; Oppe, Mark; Koolman, Xander; Westert, Gert
The validity, reliability and cross-country comparability of summary measures of population health (SMPH) have been persistently debated. In this debate, the measurement and valuation of nonfatal health outcomes have been defined as key issues. Our goal was to quantify and decompose international differences in health expectancy based on health-related quality of life (HRQoL). We focused on the impact of value set choice on cross-country variation. We calculated Quality Adjusted Life Expectancy (QALE) at age 20 for 15 countries in which EQ-5D population surveys had been conducted. We applied the Sullivan approach to combine the EQ-5D based HRQoL data with life tables from the Human Mortality Database. Mean HRQoL by country-gender-age was estimated using a parametric model. We used nonparametric bootstrap techniques to compute confidence intervals. QALE was then compared across the six country-specific time trade-off value sets that were available. Finally, three counterfactual estimates were generated in order to assess the contribution of mortality, health states and health-state values to cross-country differences in QALE. QALE at age 20 ranged from 33 years in Armenia to almost 61 years in Japan, using the UK value set. The value sets of the other five countries generated different estimates, up to seven years higher. The relative impact of choosing a different value set differed across country-gender strata between 2% and 20%. In 50% of the country-gender strata the ranking changed by two or more positions across value sets. The decomposition demonstrated a varying impact of health states, health-state values, and mortality on QALE differences across countries. The choice of the value set in SMPH may seriously affect cross-country comparisons of health expectancy, even across populations of similar levels of wealth and education. In our opinion, it is essential to get more insight into the drivers of differences in health-state values across populations. This
Full Text Available Abstract Background The validity, reliability and cross-country comparability of summary measures of population health (SMPH have been persistently debated. In this debate, the measurement and valuation of nonfatal health outcomes have been defined as key issues. Our goal was to quantify and decompose international differences in health expectancy based on health-related quality of life (HRQoL. We focused on the impact of value set choice on cross-country variation. Methods We calculated Quality Adjusted Life Expectancy (QALE at age 20 for 15 countries in which EQ-5D population surveys had been conducted. We applied the Sullivan approach to combine the EQ-5D based HRQoL data with life tables from the Human Mortality Database. Mean HRQoL by country-gender-age was estimated using a parametric model. We used nonparametric bootstrap techniques to compute confidence intervals. QALE was then compared across the six country-specific time trade-off value sets that were available. Finally, three counterfactual estimates were generated in order to assess the contribution of mortality, health states and health-state values to cross-country differences in QALE. Results QALE at age 20 ranged from 33 years in Armenia to almost 61 years in Japan, using the UK value set. The value sets of the other five countries generated different estimates, up to seven years higher. The relative impact of choosing a different value set differed across country-gender strata between 2% and 20%. In 50% of the country-gender strata the ranking changed by two or more positions across value sets. The decomposition demonstrated a varying impact of health states, health-state values, and mortality on QALE differences across countries. Conclusions The choice of the value set in SMPH may seriously affect cross-country comparisons of health expectancy, even across populations of similar levels of wealth and education. In our opinion, it is essential to get more insight into the drivers
Riesgo cardiovascular, calidad de Vida y años de vida ajustados por calidad: un estudio de caso Risco cardiovascular, qualidade de vida e anos de vida ajustados por qualidade: um estudo de caso Cardiovascular risk, quality of life and quality-adjusted years of life: a case report
Sandra Lorena Duque Henao
ção dos pacientes em programa de promoção e prevenção de ECV está relacionada com redução no risco e melhoria na qualidade de vida.Objective: to determine the ratio cost-utility of cardiovascular diseases (CVD promotion and prevention programs in a health care providing institution in the city of Medellin (Colombia. Methodology: the preventive program was compared before and after with the conventional control scheme under the design of a quasi experimental study evaluation with a non equivalent control group. Between the studied groups’ differences of the following results were evaluated at the end of the first and second year: Framingham score, direct cost of the program, quality of life, health indexes and quality-adjusted years of life. Results: in the evaluated groups a statistically meaningful difference was found between the initial and final moments for the variables:Framingham score, direct cost of the program, quality of life, health indexes and quality-adjusted years of life. Conclusion: the participation of patients in CVD prevention and promotion programs is related with risk reduction and a better quality of life.
Jia, Haomiao; Zack, Matthew M; Gottesman, Irving I; Thompson, William W
To examine associations between four health behaviors (smoking, physical inactivity, heavy alcohol drinking, and obesity) and three health indices (health-related quality of life, life expectancy, and quality-adjusted life expectancy (QALE)) among US adults with depression. Data were obtained from the 2006, 2008, and 2010 Behavioral Risk Factor Surveillance System data. The EuroQol five-dimensional questionnaire (EQ-5D) health preference scores were estimated on the basis of extrapolations from the Centers for Disease Control and Prevention's healthy days measures. Depression scores were estimated using the eight-item Patient Health Questionnaire. Life expectancy estimates were obtained from US life tables, and QALE was estimated from a weighted combination of the EQ-5D scores and the life expectancy estimates. Outcomes were summarized by depression status for the four health behaviors (smoking, physical inactivity, heavy alcohol drinking, and obesity). For depressed adults, current smokers and the physically inactive had significantly lower EQ-5D scores (0.040 and 0.171, respectively), shorter life expectancy (12.9 and 10.8 years, respectively), and substantially less QALE (8.6 and 10.9 years, respectively). For nondepressed adults, estimated effects were similar but smaller. Heavy alcohol drinking among depressed adults, paradoxically, was associated with higher EQ-5D scores but shorter life expectancy. Obesity was strongly associated with lower EQ-5D scores but only weakly associated with shorter life expectancy. Among depressed adults, physical inactivity and smoking were strongly associated with lower EQ-5D scores, life expectancy, and QALE, whereas obesity and heavy drinking were only weakly associated with these indices. These results suggest that reducing physical inactivity and smoking would improve health more among depressed adults. Copyright © 2018. Published by Elsevier Inc.
Jia, Haomiao; Zack, Matthew M; Thompson, William W
Being classified as outside the normal range for body mass index (BMI) has been associated with increased risk for chronic health conditions, poor health-related quality of life (HRQOL), and premature death. To assess the impact of BMI on HRQOL and mortality, we compared quality-adjusted life expectancy (QALE) by BMI levels. We obtained HRQOL data from the 1993-2010 Behavioral Risk Factor Surveillance System and life table estimates from the National Center for Health Statistics national mortality files to estimate QALE among U.S. adults by BMI categories: underweight (BMI overweight (BMI 25.0-29.9 kg/m(2)), obese (BMI 30.0-34.9 kg/m(2)), and severely obese (BMI ≥35.0 kg/m(2)). In 2010 in the United States, the highest estimated QALE for adults at 18 years of age was 54.1 years for individuals classified as normal weight. The two lowest QALE estimates were for those classified as either underweight (48.9 years) or severely obese (48.2 years). For individuals who were overweight or obese, the QALE estimates fell between those classified as either normal weight (54.1 years) or severely obese (48.2 years). The difference in QALE between adults classified as normal weight and those classified as either overweight or obese was significantly higher among women than among men, irrespective of race/ethnicity. Using population-based data, we found significant differences in QALE loss by BMI category. These findings are valuable for setting national and state targets to reduce health risks associated with severe obesity, and could be used for cost-effectiveness evaluations of weight-reduction interventions.
Hornberger, John; Lyman, Gary H; Chien, Rebecca; Meropol, Neal J
Uncertainty exists regarding appropriate and affordable use of adjuvant chemotherapy in stage II colon cancer (T3, proficient DNA mismatch repair). This study aimed to estimate the effectiveness and costs from a US societal perspective of a multigene recurrence score (RS) assay for patients recently diagnosed with stage II colon cancer (T3, proficient DNA mismatch repair) eligible for adjuvant chemotherapy. RS was compared with guideline-recommended clinicopathological factors (tumor stage, lymph nodes examined, tumor grade, and lymphovascular invasion) by using a state-transition (Markov) lifetime model. Data were obtained from published literature, a randomized controlled trial (QUick And Simple And Reliable) of adjuvant chemotherapy, and rates of chemotherapy use from the National Cooperative Cancer Network Colon/Rectum Cancer Outcomes study. Life-years, quality-adjusted life expectancy, and lifetime costs were examined. The RS is projected to reduce adjuvant chemotherapy use by 17% compared with current treatment patterns and to increase quality-adjusted life expectancy by an average of 0.035 years. Direct medical costs are expected to decrease by an average of $2971 per patient. The assay was cost saving for all subgroups of patients stratified by clinicopathologic factors. The most influential variables affecting treatment decisions were projected years of life remaining, recurrence score, and patients' disutilities associated with adjuvant chemotherapy. Use of the multigene RS to assess recurrence risk after surgery in stage II colon cancer (T3, proficient DNA mismatch repair) may reduce the use of adjuvant chemotherapy without decreasing quality-adjusted life expectancy and be cost saving from a societal perspective. These findings need to be validated in additional cohorts, including studies of clinical practice as assay use diffuses into nonacademic settings. Copyright © 2012 International Society for Pharmacoeconomics and Outcomes Research (ISPOR
Daniel Melser; Iqbal A. Syed
The paper explores the extent to which products follow systematic pricing patterns over their life cycle and the impact this has on the measurement of inflation. Using a large US scanner data set on supermarket products and applying exible regression methods, we find that on average prices decline as items age. This life cycle price change is often attributed to quality difference in the construction of CPI as items are replaced due to disappearance and at sample rotations. This introduces a ...
Aproximación a los pesos de calidad de vida de los «años de vida ajustados por calidad» mediante el estado de salud autopercibido An approach to «quality-adjusted life years» quality of life weights from self-assessed health status
Full Text Available Objetivos: Estimar los pesos de calidad de vida para España, para los años 1987, 1993 y 2001, a partir del estado de salud autopercibido declarado en la Encuesta Nacional de Salud. Material y métodos: Los pesos de calidad se han estimado mediante un modelo probit ordenado en el que el estado de salud autopercibido se relacionaba con la presencia de enfermedades crónicas, características demográficas y un error aleatorio, y normalizado a partir de una transformación de los estimadores obtenidos en el modelo. Resultados: La calidad de vida asociada con las enfermedades crónicas difiere según cuáles sean éstas. Las dolencias, las limitaciones y las enfermedades en los últimos 12 meses reducen más la calidad de vida que las enfermedades crónicas. La calidad de vida disminuye a medida que aumenta la edad y se incrementa a medida que aumenta el nivel de estudios. Para una misma enfermedad, y tras ajustar por edad, sexo y nivel de estudios, los pesos de calidad de vida en los años 1993 y 2001 son mayores que en el año 1987. Conclusiones: La metodología propuesta permite calcular los pesos de calidad de vida a partir de los datos de las encuestas de salud, con una aplicación directa en la evaluación económica, el análisis de las desigualdades socioeconómicas en el estado de salud de las poblaciones y el cálculo del capital de salud.Objectives: To estimate quality of life weights in Spain for 1987, 1993 and 2001, based on self-assessed health status reported in the National Health Survey. Material and methods: Quality of life weights were estimated using an ordered probit model. In this model, self-assessed health status was related to the presence of chronic diseases, demographic characteristics, and a random error. Quality of life weights were derived by normalizing the regressors obtained. Results: Quality of life values related to chronic diseases varied depending on the diseases. Pain, limitations, and diseases in the previous
van Nimwegen, Kirsten J M; Lilford, Richard J; van der Wilt, Gert J; Grutters, Janneke P C
The headroom method was introduced for the very early evaluation of the potential value of new technologies. It allows for establishing a ceiling price for technologies to still be cost-effective by combining the maximum effect a technology might yield, the maximum willingness-to-pay (WTP) for this effect, and potential downstream expenses and savings. Although the headroom method is QALY-based, not all innovations are expected to result in QALY gain. This study explores the feasibility and usefulness of the headroom method in the evaluation of technologies that are unlikely to result in QALY gain. This will be illustrated with the diagnostic trajectory of complex pediatric neurology (CPN). Our headroom analysis showed a large room for improvement in the current diagnostic trajectory of CPN in terms of diagnostic yield. Combining this with a maximum WTP value for an additional diagnosis and the potential downstream expenses and savings, resulted in a total headroom of €15,028. This indicates that a new technology in this particular diagnostic trajectory, might be cost-effective as long as its costs do not exceed €15,028. The headroom method seems a useful tool in the very early evaluation of medical technologies, also in cases when immediate QALY gain is unlikely. It allows for allocating healthcare resources to those technologies that are most promising. It should be kept in mind, however, that the headroom assumes an optimistic scenario, and for that reason cannot guarantee future cost-effectiveness. It might be most useful for ruling out those technologies that are unlikely to be cost-effective.
Moradi, Najmeh; Rashidian, Arash; Rasekh, Hamid Reza; Olyaeemanesh, Alireza; Foroughi, Mahnoosh; Mohammadi, Teymoor
The aim of this study was to estimate the monetary value of a QALY among patients with heart disease and to identify its determinants. A cross-sectional survey was conducted through face-to-face interview on 196 patients with cardiovascular disease from two heart hospitals in Tehran, Iran, to estimate the value of QALY using disaggregated and aggregated approaches. The EuroQol-5 Dimension (EQ-5D) questionnaire, Visual Analogue Scale (VAS), Time Trade-Off (TTO) and contingent valuation WTP techniques were employed, first to elicit patients' preferences and then, to estimate WTP for QALY. The association of patients' characteristics with WTP for QALY, was assessed through Heckman selection model. The Mean willingness to pay per QALY, estimated by the disaggregated approach ranged from 2,799 to 3599 US dollars. It is higher than the values, estimated from aggregated methods (USD 2,256 to 3,137). However, in both approaches, the values were less than one Gross Domestic Product (GDP) per capita of Iran. Significant variables were: Current health state, education, age, marital status, number of comorbidities, and household's cost group. Our results challenge two major issues: the first, is a policy challenge which concerns the WHO recommendation to use less than 3 GDP per capita as a cost-effectiveness threshold value. The second, is an analytical challenge related to patients with zero QALY gain. More scrutiny is suggested on the issue of how patients with full health state valuation should be dealt with and what arbitrary value could be included in the estimation value of QALY when the disaggregated approach used.
Schlander, Michael; Garattini, Silvio; Holm, Søren; Kolominsky-Rabas, Peter; Nord, Erik; Persson, Ulf; Postma, Maarten; Richardson, Jeff; Simoens, Steven; De Solà Morales, Oriol; Tolley, Keith; Toumi, Mondher
Drugs for ultra-rare disorders (URDs) rank prominently among the most expensive medicines on a cost-per-patient basis. Many of them do not meet conventional standards for cost-effectiveness. In light of the high fixed cost of R&D, this challenge is inversely related to the prevalence of URDs. The
Luengo-Fernandez, Ramon; Gray, Alastair M; Bull, Linda; Welch, Sarah; Cuthbertson, Fiona; Rothwell, Peter M
To evaluate the 5-year impact of stroke and TIA on utility and quality-adjusted survival. TIA and stroke patients from a UK population-based study (Oxford Vascular Study) were recruited from 2002 to 2007, and followed up until 2012. Quality of life was assessed over 5 years using the EQ-5D (EuroQol-5 Dimensions), with responses converted into utilities ranging from -0.59 (worse than death) to 1 (perfect health), using UK population valuations. Utilities for stroke and TIA patients were compared with those in matched controls obtained from the 2006 Health Survey for England. Five-year quality-adjusted life years were estimated by combining utility and survival information. Four hundred forty TIA and 748 stroke patients were ascertained and included. Utility remained constant at approximately 0.78 over the 5 years after TIA. Utility improved from 0.64 one month after stroke to 0.70 at 6 months (p = 0.006), remaining at approximately 0.70 thereafter. Matched controls had considerably higher utility levels than stroke/TIA patients (0.85, p TIA and 2.21 (2.15-2.37) after stroke, varying considerably by severity (minor: 2.94; moderate: 1.65; and severe: 0.70). Quality-adjusted survival is low over the 5 years after stroke and TIA, with severity and recurrent stroke being major predictors. There remains considerable scope for improvements in acute treatment and secondary prevention to improve the quality of life after TIA and stroke.
Natale, Jo Anna
Minnie Howard School, just outside Washington, D.C., caters exclusively to 14-year olds. Started seven years ago to relieve enrollment pressures, the school protects its 747 9th graders from typical high-school pressures and has reduced suspension and truancy, enrolled more kids in honors classes, and enticed privately educated students back to…
Robine, Jean-Marie; Cambois, Emmanuelle; Nusselder, Wilma
ABSTRACT: BACKGROUND: Life expectancy has been increasing during the last century within the European Union (EU). To measure progress in population health it is no longer sufficient to focus on the duration of life but quality of life should be considered. Healthy Life Years (HLY) allow estimating...... the quality of the remaining years that a person is expected to live, in terms of being free of long-standing activity limitation. The Joint Action on Healthy Life Years (JA: EHLEIS) is a joint action of European Member States (MS) and the European Union aiming at analysing trends, patterns and differences...... in HLY, as well as in other Summary Measures of Population Health (SMPH) indicators, across the European member states. METHODS: The JA: EHLEIS consolidates existing information on life and health expectancy by maximising the European comparability; by analysing trends in HLY within the EU; by analysing...
Jones, M B
A congenital genetic condition does not act either as a cause of death or at the time of death only. Hence, years of life lost through such a conditon cannot be calculated in the same way as for a conventional cause of death. The main difference is that a cause of death acting at age x cuts off as many years of life as the dead person might otherwise have expected to live (life expectancy at age x), whereas a congenital genetic condition exposes an affected person to a different schedule of life-threatening risks from birth onwards. In the latter case, years of life lost is calculated as the difference in life expectancy at birth for affected and non-affected persons. This reasoning is worked out in algebraic form and then applied to Down's syndrome. The data base is provided by two large and recent studies, one in Massachusetts and the other in Denmark, of mortality rates among all cases of Down's syndrome, whether in an institution or not, born during a given period of years or living at a given point in time in a fixed geographical area. So calculated, years of life lost through Down's syndrome relative to the United States general population in 1970 was 53.6 years per 1000 livebirths. Prenatal mortality is also discussed.
Hjorthøj, Carsten; Stürup, Anne Emilie; McGrath, John J
was least in the Asian study and greatest in Africa. The overall weighted average life expectancy was 64·7 years (95% CI 61·1-71·3), and was lower for men than women (59·9 years, 95% CI 55·5-64·3 vs 67·6 years, 63·1-72·1). Life expectancy was lowest in Asia and Africa. Timing of publication and risk of bias...... (Africa n=1, Asia n=1, Australia n=1, Europe n=7, and North America n=3) that involved up to 247 603 patients. Schizophrenia was associated with a weighted average of 14·5 years of potential life lost (95% CI 11·2-17·8), and was higher for men than women (15·9, 13·8-18·0 vs 13·6, 11·4-15·8). Loss...
Marino, Patricia; Roché, Henri; Moatti, Jean-Paul
The benefit of high-dose chemotherapy (HDC) has not been clearly demonstrated. It may offer disease-free survival improvement at the expense of major toxicity and increasing cost. We evaluated the trade-offs between toxicity, relapse, and costs using a quality-adjusted time without symptoms or toxicity (Q-TWiST) analysis. The analysis was conducted in the context of a randomized trial (PEGASE 01) evaluating the benefit of HDC for 314 patients with high-risk breast cancer. A Q-TWiST analysis was first performed to compare HDC with standard chemotherapy. We then used the results of this Q-TWiST analysis to inform a cost per quality-adjusted life-year (QALY) comparison between treatments. Q-TWiST durations were in favor of HDC, whatever the weighting coefficients used for the analysis. This benefit was significant when the weighting coefficient related to the time spent after relapse was low (0.78), HDC offered no benefit. For intermediate values, the results depended on the weighting coefficient attributed to the toxicity period. The incremental cost per QALY ranged from 12,691euro/QALY to 26,439euro/QALY, according to the coefficients used to weight toxicity and relapse. The benefits of HDC outweigh the burdens of treatment for a wide range of utility coefficients. Economic impact is not a barrier to HDC diffusion in this situation. Nevertheless, no significant benefit was demonstrated for a certain range of utility values.
Parouty, M. B. Y.; Le, Hoa; Krooshof, D.; Postma, M. J.
Background This study provides an empirical investigation into differential time preferences between money and quality of life. Thus far, time preference investigations in health have mostly involved life-years gained and lives saved. However, the quality-adjusted life-year, which is recommended by
Younossi, Zobair M; Park, Haesuk; Dieterich, Douglas; Saab, Sammy; Ahmed, Aijaz; Gordon, Stuart C
New direct-acting antiviral (DAA) therapy has dramatically increased cure rates for patients infected with hepatitis C virus (HCV), but has also substantially raised treatment costs. The aim of this analysis was to evaluate the therapeutic benefit and net costs (i.e. efficiency frontier) and the quality-adjusted cost of care associated with the evolution of treatment regimens for patients with HCV genotype 1 in the United States. A decision-analytic Markov model. Published literature and clinical trial data. Life Time. Third-party payer. This study compared four approved regimens in treatment-naïve genotype 1 chronic hepatitis C patients, including pegylated interferon and ribavirin (PR), first generation triple therapy (boceprevir + PR and telaprevir + PR), second generation triple therapy (sofosbuvir + PR and simeprevir + PR) and all-oral DAA regimens (ledipasvir/sofosbuvir and ombitasvir + paritaprevir/ritonavir + dasabuvir ± ribavirin). Quality-adjusted cost of care (QACC). QACC was defined as the increase in treatment cost minus the increase in the patient's quality-adjusted life years (QALYs) when valued at $50,000 per QALY. All-oral therapy improved the average sustained virologic response (SVR) rate to 96%, thereby offsetting the high drug acquisition cost of $85,714, which resulted in the highest benefit based on the efficiency frontier. Furthermore, while oral therapies increased HCV drug costs by $48,350, associated QALY gains decreased quality-adjusted cost of care by $14,120 compared to dual therapy. When the value of a QALY was varied from $100,000 to $300,000, the quality adjusted cost of care compared to dual therapy ranged from - $21,234 to - $107,861, - $89,007 to - $293,130, - $176,280 to - $500,599 for first generation triple, second generation triple, and all-oral therapies, respectively. Primary efficacy and safety measurements for drug regimens were sourced from clinical trials data rather than a real
Per Kragh Andersen
Full Text Available Background: A new measure of the number of life years lost due to specific causes of death is introduced. Methods: This measure is based on the cumulative incidence of death, it does not require "independence" of causes, and it satisfies simple balance equations: "total number of life years lost = sum of cause-specific life years lost", and "total number of life years lost before age x + temporary life expectancy between birth and age x = x". Results: The measure is contrasted to alternatives suggested in the demographic literature and allmethods are illustrated using Danish and Russian multiple decrement life-tables.
Smit, Annemieke; Dorren, Luuk; Noord, Van Hans; Veraart, Josja; Cusell, Casper; Sterk, Henk Pieter
For 25 years, Physical Geography students of the University of Amsterdam have experienced a 6-week field training in the cuesta landscape in Luxembourg around Diekirch. They studied the geology of the Gutland and surrounding areas, such as Ardennes and Eiffel. They mapped geomorphological patterns,
R. Heijink (Richard); P.H.M. Van Baal (Pieter); M. Oppe (Mark); A.H.E. Koolman (Xander); G. Westert (Gert)
textabstractBackground: The validity, reliability and cross-country comparability of summary measures of population health (SMPH) have been persistently debated. In this debate, the measurement and valuation of nonfatal health outcomes have been defined as key issues. Our goal was to quantify and
Heijink, R.; Baal, P. van; Oppe, M.; Koolman, X.; Westert, G.P.
ABSTRACT: BACKGROUND: The validity, reliability and cross-country comparability of summary measures of population health (SMPH) have been persistently debated. In this debate, the measurement and valuation of nonfatal health outcomes have been defined as key issues. Our goal was to quantify and
Heijink, R.; Van Baal, P.; Oppe, M.; Koolman, X.; Westert, G.
Background: The validity, reliability and cross-country comparability of summary measures of population health (SMPH) have been persistently debated. In this debate, the measurement and valuation of nonfatal health outcomes have been defined as key issues. Our goal was to quantify and decompose
Fergusson, D M; McLeod, G F H; Horwood, L J; Swain, N R; Chapple, S; Poulton, R
Previous research has found that mental health is strongly associated with life satisfaction. In this study we examine associations between mental health problems and life satisfaction in a birth cohort studied from 18 to 35 years. Data were gathered during the Christchurch Health and Development Study, which is a longitudinal study of a birth cohort of 1265 children, born in Christchurch, New Zealand, in 1977. Assessments of psychiatric disorder (major depression, anxiety disorder, suicidality, alcohol dependence and illicit substance dependence) using DSM diagnostic criteria and life satisfaction were obtained at 18, 21, 25, 30 and 35 years. Significant associations (p life satisfaction and the psychiatric disorders major depression, anxiety disorder, suicidality, alcohol dependence and substance dependence. After adjustment for non-observed sources of confounding by fixed effects, statistically significant associations (p life satisfaction and major depression, anxiety disorder, suicidality and substance dependence. Overall, those reporting three or more mental health disorders had mean life satisfaction scores that were nearly 0.60 standard deviations below those without mental health problems. A structural equation model examined the direction of causation between life satisfaction and mental health problems. Statistically significant (p life satisfaction and mental health problems. After adjustment for confounding, robust and reciprocal associations were found between mental health problems and life satisfaction. Overall, this study showed evidence that life satisfaction influences mental disorder, and that mental disorder influences life satisfaction.
Raičević Jagoš J.
Full Text Available In this paper a new approach for calculation of the years of life lost per excess death due to stochastic health effects is applied to external exposure pathways. The short-term external exposures are due to the passage of radioactive cloud and due to the skin and clothes contamination. The long-term external exposure is the one from the radioactive material deposited on the ground (groundshine. Three nuclides, 131I, 137Cs, and 239Pu, and with the extremely wide range of half-life are considered in order to examine their possible influence on the calculated values of years of life lost. For each of these nuclides, the number of years of life lost has been found as a decreasing function of the age at the expo sure and presented graphically in this paper. For protracted exposures, the fully averaged number of years of life lost is negative correlated with the nuclide’s half-life. On the other hand, the short-term external exposures do not depend on the nuclide’s half-life. In addition, a weak years of life lost dependence of the dose has been commented.
Ilari, Beatriz Senoi
Reviews literature on music perception and cognition in the first year of life and examines their contribution to domains such as child development and music education. Focuses on studies examining musical features and the uses of music in the everyday life of infants and their caretakers. Critiques previous and current literature. Discusses…
Andersen, Per Kragh
A number of suggested measures of life years lost among patients with a given disease are reviewed, and some new ones are proposed. The methods are all phrased in the framework of a (Markov or non-Markov) illness-death model in combination with a population life table. The methods are illustrated...... using data on Danish male patients with bipolar disorder, and some recommendations are given. Copyright © 2017 John Wiley & Sons, Ltd....
Full Text Available Abstract Background Gefitinib, a tyrosine kinase inhibitor, is an effective treatment in advanced non-small cell lung cancer (NSCLC patients with an activating mutation in the epidermal growth factor receptor (EGFR. Randomised clinical trials showed a benefit in progression free survival for gefitinib versus doublet chemotherapy regimens in patients with an activated EGFR mutation (EGFR M+. From a patient perspective, progression free survival is important, but so is health-related quality of life. Therefore, this analysis evaluates the Quality Adjusted progression free survival of gefitinib versus three relevant doublet chemotherapies (gemcitabine/cisplatin (Gem/Cis; pemetrexed/cisplatin (Pem/Cis; paclitaxel/carboplatin (Pac/Carb in a Dutch health care setting in patients with EGFR M+ stage IIIB/IV NSCLC. This study uses progression free survival rather than overall survival for its time frame in order to better compare the treatments and to account for the influence that subsequent treatment lines would have on overall survival analysis. Methods Mean progression free survival for Pac/Carb was obtained by extrapolating the median progression free survival as reported in the Iressa-Pan-Asia Study (IPASS. Data from a network meta-analysis was used to estimate the mean progression free survival for therapies of interest relative to Pac/Carb. Adjustment for health-related quality of life was done by incorporating utilities for the Dutch population, obtained by converting FACT-L data (from IPASS to utility values and multiplying these with the mean progression free survival for each treatment arm to determine the Quality Adjusted progression free survival. Probabilistic sensitivity analysis was carried out to determine 95% credibility intervals. Results The Quality Adjusted progression free survival (PFS (mean, (95% credibility interval was 5.2 months (4.5; 5.8 for Gem/Cis, 5.3 months (4.6; 6.1 for Pem/Cis; 4.9 months (4.4; 5.5 for Pac/Carb and 8
Carson, Mary, Ed.; And Others
The family life sex education unit for eighth graders, "The Years of Uncertainty," consists of a series of daily lesson plans that span a 29-day period of one-hour class sessions. Topics covered are: problem solving, knowledge and attitudes, male and female reproductive systems, conception, pregnancy, birth, birth defects, venereal…
Ricci, P; Mezzarobba, M; Blotière, P O; Polton, D
To measure the reimbursed health expenditures in the last year of life and the proportion it represents in total reimbursement costs in 2008, to analyse the structure of such expenditures and to identify costs by cause of death. Data were obtained from the French national insurance information system (SNIIRAM). Data from the national hospital discharge database were linked to the outpatient reimbursement database for patients covered by the general health insurance scheme (n=49 million persons). The cost of the last year of life was calculated for the exhaustive population (361,328 deaths in 2008). The supposed cause of death was mainly derived from the primary diagnosis of the last hospital stay during which the patient died. The average reimbursed expenses during the last year of life were estimated at 22,000 € per person in 2008, with 12,500 € accounting for public hospital costs. Reimbursed health expenditures varied according to different medical causes of death: 52,300 € for HIV disease and about 40,000 € for tumors. A negative effect of age on the expenditure during the last year of life was observed. Health care spending increased with shorter time before death, the last month of life corresponding to 28% of reimbursed expenditures during the last year of life. Health care use in the last year of life represented 10.5% of the total health expenditures in 2008. This study found results similar to those observed in the past or in other countries. Our results show in particular that the weight of health expenditures during the last year of life on total health expenditures remains stable over the years. Copyright © 2012 Elsevier Masson SAS. All rights reserved.
Savino, Francesco; Grasso, Giulia; Cresi, Francesco; Oggero, Roberto; Silvestro, Leandra
We assessed the bioelectrical impedance vector distribution in a sample of healthy infants in the first year of life, which is not available in literature. The study was conducted as a cross-sectional study in 153 healthy Caucasian infants (90 male and 63 female) younger than 1 y, born at full term, adequate for gestational age, free from chronic diseases or growth problems, and not feverish. Z scores for weight, length, cranial circumference, and body mass index for the study population were within the range of +/-1.5 standard deviations according to the Euro-Growth Study references. Concurrent anthropometrics (weight, length, and cranial circumference), body mass index, and bioelectrical impedance (resistance and reactance) measurements were made by the same operator. Whole-body (hand to foot) tetrapolar measurements were performed with a single-frequency (50 kHz), phase-sensitive impedance analyzer. The study population was subdivided into three classes of age for statistical analysis: 0 to 3.99 mo, 4 to 7.99 mo, and 8 to 11.99 mo. Using the bivariate normal distribution of resistance and reactance components standardized by the infant's length, the bivariate 95% confidence limits for the mean impedance vector separated by sex and age groups were calculated and plotted. Further, the bivariate 95%, 75%, and 50% tolerance intervals for individual vector measurements in the first year of life were plotted. Resistance and reactance values often fluctuated during the first year of life, particularly as raw measurements (without normalization by subject's length). However, 95% confidence ellipses of mean vectors from the three age groups overlapped each other, as did confidence ellipses by sex for each age class, indicating no significant vector migration during the first year of life. We obtained an estimate of mean impedance vector in a sample of healthy infants in the first year of life and calculated the bivariate values for an individual vector (95%, 75%, and 50
Durá-Travé, T; Yoldi-Petri, M E; Hualde-Olascoaga, J; Etayo-Etayo, V
To analyse the epidemiological characteristics and the relative distribution of the different types of epilepsy and epileptic syndromes during the first year of life. An analysis was performed of the patient records of all patients with epilepsy diagnosed during their first year of life who were submitted to a developmental check-up in the year 2007. The sample consisted of 60 patients (27 boys and 33 girls). Epidemiological and clinical data were collected, together with the findings from complementary examinations. The diagnostic criteria applied were those of the International League Against Epilepsy. The mean age at the time of diagnosis was 6.3 months. The mean follow-up time was 7.6 years. The aetiology was symptomatic in 40 cases (66.7%), cryptogenic in 16 (26.7%) and idiopathic in four cases (6.7%). Neuroimaging tests detected abnormalities in 34 patients (56.7%). West's syndrome (30%), symptomatic focal epilepsies (23.3%) and epilepsies linked to specific syndromes (16.7%) were the epileptic syndromes with the highest prevalence. Learning disabilities were observed in 82.5% of the children. Most epilepsies that present during the first year of life are symptomatic and/or cryptogenic, and are accompanied by psychoneurological impairment and/or resistance to therapy, which condition cognitive disorders that are eligible for specialised psycho-pedagogical intervention.
Bryla, Marek; Dziankowska-Zaborszczyk, Elzbieta; Bryla, Pawel; Pikala, Malgorzata
Purpose An evaluation of mortality due to infectious diseases in Poland in 1999–2012 and an analysis of standard expected years of life lost due to the above diseases. Methods The study material included a database created on the basis of 5,219,205 death certificates of Polish inhabitants, gathered between 1999 and 2012 and provided by the Central Statistical Office. Crude Death Rates (CDR), Standardized Death Rates (SDR) and Standard Expected Years of Life Lost (SEYLL) due to infectious and parasitic diseases were also evaluated in the study period as well as Standard Expected Years of Life Lost per living person (SEYLLp) and Standard Expected Years of Life Lost per dead person (SEYLLd). Time trends were evaluated with the application of joinpoint models and an annual percentage change in their values. Results Death certificates report that 38,261 people died due to infectious diseases in Poland in the period 1999–2012, which made up 0.73% of the total number of deaths. SDR caused by these diseases decreased, particularly in the male group: Annual Percentage Change (APC = -1.05; 95% CI:-2.0 to -0.2; p<0.05). The most positive trends were observed in mortality caused by tuberculosis (A15-A19) (APC = -5.40; 95% CI:-6.3 to -4.5; p<0.05) and also meningitis, encephalitis, myelitis and encephalomyelitis (G03-G04) (APC = -3.42; 95% CI:-4.7 to -2.1; p<0.05). The most negative mortality trends were observed for intestinal infectious diseases (A00-A09) Annual Average Percentage Change (AAPC = 7.3; 95% CI:3.1 to 11.7; p<0.05). SDR substantially decreased in the first half of the study period, but then significantly increased in the second half. Infectious and parasitic diseases contributed to a loss of around 37,000 standard expected years of life in 1999 and more than 28,000 in 2012. During the study period, the SEYLLp index decreased from 9.59 to 7.39 per 10,000 population and the SEYLLd index decreased from 14.26 to 10.34 years (AAPC = 2.3; 95% CI:-2,9 to -1.7; p<0
Raicevic, J.J.; Merkle, J.M.; Ehrhardt, J.; Ninkovic, M.M.
A new approach for calculation of the years of life lost per excess death (YLL) due to stochastic health effects is applied to external exposure pathways. The short-term external exposures are due to the passage of radioactive cloud (CL) and due to the skin and clothes contamination (SK). The long-term external exposure is the one from the radioactive material deposited on ground (GR). Three nuclides, 131 I , 137 Cs and 239 Pu with extremely wide range of the half-life are considered to examine its possible influence on the calculated YLL values. For each of these nuclides, the YLL is found as a decreasing function of the age at exposure and presented graphically in this paper. Another negative correlation is established between the fully averaged YLL and the duration of the nuclide's half-life has been found for protracted exposure (GR). On the other hand, the YLL for the short-term external exposures (CL and SK) practically does not depend on the nuclide's half-life. In addition, a weak YLL dependence of the dose was commented. (author)
Johannesen, A; Petersen, Janne; Avlund, K
The purpose of this study was to investigate whether social relations, continuity, self-determination, and use of own resources are associated with everyday life satisfaction among 85-year-old adults with physical disabilities. The population includes 187 frail men and women from the longitudinal......) feel able to manage their own lives; (4) do not live alone; and (5) have not lately lost close friends. Lack of everyday life satisfaction is associated with (1) using home-care services and (2) living in an institution. The findings stress the importance of helping old persons stay active...... study of the 1914 population in Glostrup, Copenhagen. Participants were all interviewed in their homes by an occupational therapist. Findings provide evidence that frail older adults more frequently express satisfaction with their daily lives when they (1) are occupied as usual; (2) have friends; (3...
Johannesen, A; Petersen, Janne; Avlund, K
) feel able to manage their own lives; (4) do not live alone; and (5) have not lately lost close friends. Lack of everyday life satisfaction is associated with (1) using home-care services and (2) living in an institution. The findings stress the importance of helping old persons stay active......The purpose of this study was to investigate whether social relations, continuity, self-determination, and use of own resources are associated with everyday life satisfaction among 85-year-old adults with physical disabilities. The population includes 187 frail men and women from the longitudinal...... study of the 1914 population in Glostrup, Copenhagen. Participants were all interviewed in their homes by an occupational therapist. Findings provide evidence that frail older adults more frequently express satisfaction with their daily lives when they (1) are occupied as usual; (2) have friends; (3...
Messina, G; Quercioli, C; Troiano, G; Russo, C; Barbini3, E; Nisticò, F; Nante, N
Quality of Life (QoL) is a concept used to indicate the general wellness of persons or societies. University students report a low quality of life and a worse perception of their health status, because of a situation of greater discomfort in which they live during the course of the study, especially in faculties with an important emotional burden, such as medical schools. The aim of the study was to evaluate the perceived health status of first year medical students. We conducted a cross sectional study in the time span 2005-2015, administering the questionnaire Short Form 36 (SF-36) to first-year students of the School of Medicine of the University of Siena, Italy. In addition to demographic information such as gender and the age we investigated the region of residence, marital status, employment status, and smoking habits; height and weight were required to calculate the body mass index (BMI) to evaluate a possible physical discomfort connected with the perception of health status. The data from the questionnaires were organized and processed by software Stata® SE, version 12.1. 1,104 questionnaires were collected. Medical students reported lower SF-36 scores, compared to the Italian population of the same age. Female gender and smoking habits influence negatively the score of several scales. Body Mass Index is positively correlated with the Physical Activity, while Age is negatively correlated with Social Activities. The perceived quality of life of the Italian medical students is lower when compared to the general population. This confirms that the condition of student implies additional problems, as other studies reports. It would be better to improve it, developing students' resilience. It would be interesting to extend this research to students of other years, from other faculties and other locations, to gain a broader view about the QoL of the Italian students.
Ross, R. G., Jr.
As part of the United States National Photovoltaics Program, the Jet Propulsion Laboratory's Flat-Plate Solar Array Project (FSA) has maintained a comprehensive reliability and engineering sciences activity addressed toward understanding the reliability attributes of terrestrial flat-plate photovoltaic arrays and to deriving analysis and design tools necessary to achieve module designs with a 30-year useful life. The considerable progress to date stemming from the ongoing reliability research is discussed, and the major areas requiring continued research are highlighted. The result is an overview of the total array reliability problem and of available means of achieving high reliability at minimum cost.
Fosarelli, P.D.; DeAngelis, C.
Young children receive a variety of diagnostic radiographs over time. In some cases the exposure to radiation may be unwarranted because the films may yield confusing results, or may also need to be repeated because of poor technical quality. Even when the results are clearly negative, the subsequent treatment may proceed as if the film had been positive because of the child's clinical condition. The cumulative effect of such low-dose radiation on infants and children over time is unknown. The number and types of outpatient radiographs received by a cohort of poor children from a hospital-based continuity clinic during their first 5 years of life were reviewed. Also noted were the reason for obtaining the film, whether it was positive for that reason or another, whether the child had a chronic condition that prompted the use of radiograph, and the child's sex, race, and age when the film was obtained. Of the 218 children, 132 (60.6%) received 349 sets of films in their first 5 years. There was no difference in the number of films by race or sex. Chest and posttrauma bone or joint films accounted for 315 sets of films or 90.3% of the total. Overall, 25.8% of the 267 chest films were positive; this varied by age. Only 15% of the chest films were positive in the first year compared with 29 to 49% in the second through fifth years (p less than 0.001). Cough was the respiratory symptom most reliably associated with a positive chest film, both for the cohort (p less than 0.0001) and for children in the first year of life (p less than 0.01)
Flávia Emília Cavalcante Valença Fernandes
Full Text Available Introduction: Traffic accidents represent a serious public health problem, because they kill approximately 1.24 million persons annually, and leave another 20 to 50 million with non-fatal lesions and traumatisms worldwide. In Brazil, in the year 2011, motorcyclists alone were responsible for one third of these deaths. Therefore, the aim of this study was to estimate the years of potential life lost due to motorcycle accidents, according to sex and age group, and analyze the trend of the indicator for the state of Pernambuco in the period from 2005 to 2014. Methods and Results an ecological study based on data from the System of Information about Mortality was used. The indicator and rate were calculated by using the age limit of 70 years. The linear regression model and Kruskal-Wallis and Mann-Whitney tests were used, at the level of significance of 5% and confidence of 95%. The most affected sex and age-range were men between 20-29 years of age. The rates followed a trend of growth in both sexes, in the young population with the exception of those from 10 to 19 years of age. Conclusions: This context points out the magnitude and precociousness of motorcycle accidents in both sexes and the young population.
Lopes, Wanessa Casteluber; Marques, Fúlvia Karine Santos; Oliveira, Camila Ferreira de; Rodrigues, Jéssica Alkmim; Silveira, Marise Fagundes; Caldeira, Antônio Prates; Pinho, Lucinéia de
To analyze the prevalence of breastfeeding and the introduction of complementary food for zero to 24-month-old infants. This is a population-based cross-sectional study of children aged less than 24 months in Montes Claros, Minas Gerais, Brazil. Data were collected in 2015, by interviews with people in charge of infant care in the house. The questionnaire administered assessed the sociodemographic status of the family, maternal and infant characteristics and food consumption habits. Survival analysis was used to calculate median prevalence and duration of breastfeeding and the introduction of complementary feeding. With 180 days of life, 4.0% of the children were exclusively breastfed, 22.4% were mostly breastfed and 43.4% were fed breast milk as complementary food. In the third month of life, children were consuming water (56.8%), fruit juice or formula (15.5%) and cow's milk (10.6%). At the age of 12 months, 31.1% were consuming artificial juice and 50.0% were eating candies. Before the age of 1 year, 25.0% of them had already eaten instant noodles. The introduction of drinks, honey, sugar and candies as complementary food was found to be premature; and solid and semi-solid foods were almost appropriate. The habits described can directly affect the success of breastfeeding. Given that the inadequate eating practices identified can compromise the infant's health, actions that promote breastfeeding and provide guidance on the introduction of complementary foods are important.
Thimmig, Lindsay M; Cabana, Michael D; Bentz, Michael G; Potocka, Katherine; Beck, Amy; Fong, Lawrence; Chao, Cewin; Caughey, Aaron B; Wong, Angela; McKean, Michelle
The development of children's mealtime television (TV) habits has not been well studied. We assessed whether mealtime TV habits established in infancy will persist into early childhood. We analyzed data collected through parent surveys at birth and at 6-month intervals from a randomized controlled trial. We used t-tests, χ 2 tests, and a multivariable logistic regression to determine if family characteristics were associated with mealtime TV. A McNemar test was used to assess whether mealtime TV exposure changed over time. College-educated fathers and families with an annual income >$50 000 were associated with less-frequent TV exposure during children's mealtimes. It was found that 84% of children retained their level of exposure to TV during mealtimes from the first 24 months through 48 months of life. Clinicians should counsel families about mealtime TV use within the first 2 years of life because these habits seem to develop early and persist into at least early childhood.
Glass, R.E.; Towne, T.L.
Sandia was presented with an opportunity in 1993 to design containers for the long term storage and transport of fissile material. This program was undertaken at the direction of the US Department of Energy and in cooperation with Lawrence Livermore National Laboratory and Los Alamos National Laboratory which were tasked with developing the internal fixturing for the contents. The hardware is being supplied by Allied Signal Federal Manufacturing and Technologies, and the packaging will occur at Mason and Hangar Corporation's Pantex Plant. The unique challenge was to design a container that could be sealed with the fissile material contents; and, anytime during the next 50 years, the container could be transported with only the need for the pre-shipment leak test. This required not only a rigorous design capable of meeting the long term storage and transportation requirements, but also resulted in development of a surveillance program to ensure that the container continues to perform as designed over the 50-year life. This paper addresses the design of the container, the testing that was undertaken to demonstrate compliance with US radioactive materials transport regulations, and the surveillance program that has been initiated to ensure the 50-year performance
Maree, Jacobus G.
The article discusses the changing world of work and the attendant uncertainty and loss of work-life identity. Little research has been done on career development and life design in the early years of a person's life, especially in developing countries characterized by disadvantage. The underlying theoretical models of career development are…
Kymes, Steven M; Plotzke, Michael R; Kass, Michael A; Boland, Michael V; Gordon, Mae O
To assess the influence of expected life span on the cost-effectiveness of treating ocular hypertension to prevent primary open-angle glaucoma. We used a Markov simulation model to estimate the cost and benefit of ocular hypertension treatment over a person's remaining life. We examined the influence of age on the cost-effectiveness decision in 2 ways: (1) by evaluating specific age cohorts to assess the influence of age at the initiation of treatment; and (2) by evaluating the influence of a specific life span. At a willingness to pay $50,000/quality-adjusted life year to $100,000/quality-adjusted life year, treatment of people with a 2% or greater annual risk of developing glaucoma was cost-effective for people aged 45 years with a life expectancy of at least 18 remaining years. However, to be cost-effective, a person aged 55 years must have a life expectancy of 21 remaining years and someone aged 65 years must have a life expectancy of 23 remaining years. A person with ocular hypertension must have a life expectancy of at least 18 remaining years to justify treatment at a threshold of a 2% or greater annual risk of developing glaucoma. Persons at higher levels of risk require a life expectancy of 7 to 10 additional years to justify treatment.
Reis, R.G.; Lucena, E.A.; Arantes, R.R.; Silva, A.A.; Reis, A.A.
The radiological accident in Goiânia, Brazil, considered the largest urban radiological accident in the world, generated several publications in the technical area that are widely disseminated in the scientific literature, given the importance of the lessons learned. However, in a simple conversation with people who worked on that accident, it is noted that many reports have not been recorded. In this year in which 30 years of the event is completed, it will be of great value to record personal testimonies that are not in technical or scientific books. And what can we tell after a half-life that lasted for a lifetime? The lived stories, the situations, the improvisations, the way to solve, the overcoming, the human side, the emotions, happy or sad, short or long, funny or not. The objective of this work is to preserve, maintain and divulge reports and situations experienced by people who worked on the radiological accident with Cs-137 in Goiânia. Audio or video recordings about experiences lived in Goiânia by people who worked in that emergency situation were carried out. The reports are free and the form of registration is always at the discretion of the narrator. Storing records allows to preserve, maintain, and disclose the accident to other generations
Johnson, Rebecca; Jenkinson, David; Stinton, Chris; Taylor-Phillips, Sian; Madan, Jason; Stewart-Brown, Sarah; Clarke, Aileen
The Quality-Adjusted Life Year (QALY) is a measure that combines life extension and health improvement in a single score, reflecting preferences around different types of health gain. It can therefore be used to inform decision-making around allocation of health care resources to mutually exclusive options that would produce qualitatively different health benefits. A number of quality-of-life instruments can be used to calculate QALYs. The EQ-5D is one of the most commonly used, and is the preferred option for submissions to NICE ( https://www.nice.org.uk/process/pmg9/ ). However, it has limitations that might make it unsuitable for use in areas such as public and mental health where interventions may aim to improve well-being. One alternative to the QALY is a Wellbeing-Adjusted Life Year. In this study we explore the need for a Wellbeing-Adjusted Life Year measure by examining the extent to which a measure of wellbeing (the Warwick-Edinburgh Mental Well-being Scale) maps onto the EQ-5D-3L. Secondary analyses were conducted on data from the Coventry Household Survey in which 7469 participants completed the EQ-5D-3L, Warwick-Edinburgh Mental Well-being Scale, and a measure of self-rated health. Data were analysed using descriptive statistics, Pearson's and Spearman's correlations, linear regression, and receiver operating characteristic curves. Approximately 75 % of participants scored the maximum on the EQ-5D-3L. Those with maximum EQ-5D-3L scores reported a wide range of levels of mental wellbeing. Both the Warwick-Edinburgh Mental Well-being Scale and the EQ-5D-3L were able to detect differences between those with higher and lower levels of self-reported health. Linear regression indicated that scores on the Warwick-Edinburgh Mental Well-being Scale and the EQ-5D-3L were weakly, positively correlated (with R(2) being 0.104 for the index and 0.141 for the visual analogue scale). The Warwick-Edinburgh Mental Well-being Scale maps onto the EQ-5D-3L to only a
I.M.C.M. de Kok (Inge); J.J. Polder (Johan); J.D.F. Habbema (Dik); L.M. Berkers (Louise Maria); W.J. Meerding (Willem Jan); M. Rebolj (Matejka); M. van Ballegooijen (Marjolein)
textabstractIt is under debate whether healthcare costs related to death and in life years gained (LysG) due to life saving interventions should be included in economic evaluations. We estimated the impact of including these costs on cost-effectiveness of cancer screening. We obtained health
Padgett, Ryan D.; Keup, Jennifer R.; Pascarella, Ernest T.
Using longitudinal data from the Wabash National Study of Liberal Arts Education, this study measured the impact of first-year seminars on college students' life-long learning orientations. The findings suggest that first-year seminars enhance students' life-long learning orientations and that the effect of first-year seminars is mediated through…
Janssen, Ian; Carson, Valerie; Lee, I-Min; Katzmarzyk, Peter T; Blair, Steven N
Physical inactivity is an important modifiable risk factor for noncommunicable disease. The degree to which physical activity affects the life expectancy of Americans is unknown. This study estimated the potential years of life gained due to leisure-time physical activity in the U.S. Data from the National Health and Nutrition Examination Survey (2007-2010); National Health Interview Study mortality linkage (1990-2006); and U.S. Life Tables (2006) were used to estimate and compare life expectancy at each age of adult life for inactive (no moderate to vigorous physical activity); somewhat-active (some moderate to vigorous activity but active (≥ 500 MET minutes/week of moderate to vigorous activity) adults. Analyses were conducted in 2012. Somewhat-active and active non-Hispanic white men had a life expectancy at age 20 years that was ~2.4 years longer than that for the inactive men; this life expectancy advantage was 1.2 years at age 80 years. Similar observations were made in non-Hispanic white women, with a higher life expectancy within the active category of 3.0 years at age 20 years and 1.6 years at age 80 years. In non-Hispanic black women, as many as 5.5 potential years of life were gained due to physical activity. Significant increases in longevity were also observed within somewhat-active and active non-Hispanic black men; however, among Hispanics the years-of-life-gained estimates were not significantly different from 0 years gained. Leisure-time physical activity is associated with increases in longevity. Copyright © 2013 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
What do children think of their time in preschool? In the present study, twelve ten-year-old children collected data from their classmates. The children tend to remember their friends, and reflect on what games they played and with whom. Only about one in three respondents even mentioned the day...
Visscher, Tommy L S; Rissanen, Aila; Seidell, Jacob C; Heliövaara, Markku; Knekt, Paul; Reunanen, Antti; Aromaa, Arpo
BACKGROUND: Obesity is more strongly related to morbidity and disability than to mortality. Obese individuals are thus expected to have more unhealthy life-years than normal-weight persons. The objective of the present study was to quantify the number of excess unhealthy life-years in obese
Visser, Chantal A. N.; Garcia-Marcos, Luis; Eggink, Jenny; Brand, Paul L. P.
Factors operating in the first year of life are critical in determining the onset and persistence of wheezing in preschool children. This study was designed to examine the prevalence and risk factors of wheeze in the first year of life in Dutch infants. This was a population-based survey of
Hofhuis, W.; Hanekamp, M.N.; Ijsselstijn, H.; Nieuwhof, E.M.; Hop, W.C.J.; Tibboel, D.; Jongste, J.C. de; Merkus, P.J.F.M.
OBJECTIVE: To collect longitudinal data on lung function in the first year of life after extracorporeal membrane oxygenation and to evaluate relationships between lung function and perinatal factors. Longitudinal data on lung function in the first year of life after extracorporeal membrane
C. Michael Powell
Full Text Available Perhaps no innovation in history has affected marketing management as pervasively as has the advent of e-commerce. This revolutionary new channel has required businesses to acquire an entirely new set of skills and approaches to promotion, pricing, and distribution. The necessity for e-commerce website operators to more deeply understand consumer behavior when engaged in e-commerce has become a central and crucial factor in website success or failure. As predicted nearly 20 years ago, travel bookings have moved almost entirely to the World Wide Web (WWW. For the past 12 years, data have been collected concerning traveler’s preferences, concerns, and perceptions of airline websites in particular. This research reviews and comments on the evolution of those sites and consumer perceptions of efficiency, ease of use, and usefulness. The results of this study are intended to guide airlines in their pursuit of customer satisfaction and increased profits.
Operation and development of the PS have brought a dramatic improvement in its capabilities. This article describes the years of getting to know the machine and of developing its potential, picking out some major landmarks on the way. The article was put together with the help of P.H. Standley (PS Division Head), C.S. Taylor (Linac), G. Plass, W. Richter (Mam Ring), M. Georgijevic (Power Supply), J.H.B. Madsen (Operation), and G.L. Munday (Experimental Areas).
Reis, H.F.; DeMastry, J.A.
The paper suggest that, as a practical matter, interested persons will have to be afforded an opportunity for a hearing in connection with the renewal of operating licenses beyond their current 40-year term. It describes and examines the three types of hearing procedures that might be employed: adjudicatory, legislative and hybrid. It concludes that hearings of any of the three types could be completed in time for a go/no go decision for the lead plants by the mid-1900's. However, if the adjudicatory-type hearing now used for NRC licensing proceedings is employed, certain changes in procedures would be advisable
Kunst Anton E
Full Text Available Abstract Background To avoid strong declines in the quality of life due to population ageing, and to ensure sustainability of the health care system, reductions in the burden of disability among elderly populations are urgently needed. Life style interventions may help to reduce the years lived with one or more disabilities, but it is not fully understood which life style factor has the largest potential for such reductions. Therefore, the primary aim of this paper is to compare the effect of BMI, smoking and alcohol consumption on life expectancy with disability, using the Sullivan life table method. A secondary aim is to assess potential improvement of the Sullivan method by using information on the association of disability with time to death. Methods Data from the Dutch Permanent Survey of the Living Situation (POLS 1997-1999 with mortality follow-up until 2006 (n = 6,446 were used. Using estimated relative mortality risks by risk factor exposure, separate life tables were constructed for groups defined in terms of BMI, smoking status and alcohol consumption. Logistic regression models were fitted to predict the prevalence of ADL and mobility disabilities in relationship to age and risk factor exposure. Using the Sullivan method, predicted age-specific prevalence rates were included in the life table to calculate years lived with disability at age 55. In further analysis we assessed whether adding information on time to death in both the regression models and the life table estimates would lead to substantive changes in the results. Results Life expectancy at age 55 differed by 1.4 years among groups defined in terms of BMI, 4.0 years by smoking status, and 3.0 years by alcohol consumption. Years lived with disability differed by 2.8 years according to BMI, 0.2 years by smoking and 1.6 by alcohol consumption. Obese persons could expect to live more years with disability (5.9 years than smokers (3.8 years and drinkers (3.1 years. Employing
Full Text Available Introduction of solid foods is a fundamental step in the development of an individual. There are many implications that weaning contains not only on a nutritional plan, but also on the contingent and long-term health of an individual. Over time this nutritional passage has evolved through the acquisition of new knowledge about maturation of anatomical and neurosensory structures involved in all the phases of such a complex process. The understanding of a maturing taste of infant and cultural changes is another key to understand the evolution of introduction of solid foods in infants. What is contained in this text encapsulates thus the evolutionary path of weaning in recent years, showing current trends in the light of cultural changes and new scientific acquisitions.
Vogt, Tobias C
In the two decades since reunification, East Germans have experienced a large increase in life expectancy and a convergence with the West German mortality level. This gain in life expectancy appears even more impressive if we assume a different scenario in which the Berlin Wall did not fall, and the old East Germany still existed. This analysis takes into account that East German mortality would not have remained static without reunification. Thus, it shows how many years of life expectancy were actually added by the fall of the Berlin Wall. The analysis shows the improvements for single age groups by projecting life expectancy based on mortality levels during the 1970s and 1980s using the Lee-Carter method. I use national-level data for both sexes for East Germany before reunification. I find that, without reunification, current life expectancy at birth among East Germans would be 4.0 years lower for females and 5.7 years lower for males. I also show that older East Germans were the main demographic beneficiaries of reunification. Female and male mortality improvements in the age groups above 60 contributed up to 80% to the actual gains in life expectancy. Had the Berlin Wall not fallen, East German mortality would not have remained static but improved at a far slower rate. Thus, this counterfactual approach shows for the first time how many years of life were actually gained by reunification and how much of these gains were attributable to mortality improvements among the elderly. Copyright © 2013 S. Karger AG, Basel.
Full Text Available Objectives: To compare the grade of hydronephrosis between the antenatal and first postnatal ultrasound (US and their clinical outcomes. Methods: This retrospective study included all cases of isolated hydronephrosis detected by antenatal US from August 2005 to February 2011. Hydronephrosis was classified based on the standard criteria into mild, moderate, or severe. Cases associated with other major congenital anomalies were excluded. All patients were followed-up postnatally and outcomes available were analyzed at one year of age. Results: A total of 105 cases were included out of which 83 (79.0% were males and 22 (20.9% were females with a median gestational age of 38 weeks. First postnatal US of 105 cases showed that 20 (19.0% were free of hydronephrosis, 39 (37.1% had mild, 29 (27.6% moderate, and 17 (16.1% had severe hydronephrosis. Half (50.4% of hydronephrosis cases improved in their clinical presentation while 13.3% showed deterioration and 36.3% remained the same. Almost half of all cases (52 cases were diagnosed by US at the end of first year without any effect on renal function. Conclusions: Antenatal and postnatal US are sensitive tools for detecting hydronephrosis as well as for postnatal counseling. Fetal anatomy US is usually done at 18 weeks gestation and if this reveals any evidence of hydronephrosis, the patient is followed according to the severity. Postnatal US is not done routinely for cases where hydronephrosis resolves completely during pregnancy. Although newborns with antenatal hydronephrosis due to secondary causes are at greater risk for renal impairment, surgical intervention reserves renal function.
Orabi, Mutaz; Abozaid, Sameh; Sallout, Bahauddin; Abu Shaheen, Amani; Heena, Humariya; Al Matary, Abdulrahman
Objectives To compare the grade of hydronephrosis between the antenatal and first postnatal ultrasound (US) and their clinical outcomes. Methods This retrospective study included all cases of isolated hydronephrosis detected by antenatal US from August 2005 to February 2011. Hydronephrosis was classified based on the standard criteria into mild, moderate, or severe. Cases associated with other major congenital anomalies were excluded. All patients were followed-up postnatally and outcomes available were analyzed at one year of age. Results A total of 105 cases were included out of which 83 (79.0%) were males and 22 (20.9%) were females with a median gestational age of 38 weeks. First postnatal US of 105 cases showed that 20 (19.0%) were free of hydronephrosis, 39 (37.1%) had mild, 29 (27.6%) moderate, and 17 (16.1%) had severe hydronephrosis. Half (50.4%) of hydronephrosis cases improved in their clinical presentation while 13.3% showed deterioration and 36.3% remained the same. Almost half of all cases (52 cases) were diagnosed by US at the end of first year without any effect on renal function. Conclusions Antenatal and postnatal US are sensitive tools for detecting hydronephrosis as well as for postnatal counseling. Fetal anatomy US is usually done at 18 weeks gestation and if this reveals any evidence of hydronephrosis, the patient is followed according to the severity. Postnatal US is not done routinely for cases where hydronephrosis resolves completely during pregnancy. Although newborns with antenatal hydronephrosis due to secondary causes are at greater risk for renal impairment, surgical intervention reserves renal function. PMID:29657681
We back out an estimate of a personal discount rate of between 3 and 4 percent for a person with a life expectancy of 74 years who dies at age 30 (or 40) and has a value of statistical life of $6.3 million. Central to these calculations is the series generated by Murphy and Topel of value of life years (the dollar value of consumption plus the dollar value of leisure, with some smoothing for income in retirement). We employ the Makeham "model" of life expectancy in our calculations.
Janssen, Ian; Carson, Valerie; Lee, I-Min; Katzmarzyk, Peter T.; Blair, Steven N.
Background Physical inactivity is an important modifiable risk factor for non-communicable disease. The degree to which physical activity affects the life expectancy of Americans is unknown. This study estimated the potential years of life gained due to leisure-time physical activity across the adult lifespan in the United States. Methods Data from the National Health and Nutrition Examination Survey (2007–2010), National Health Interview Study mortality linkage (1990–2006), and US Life Tables (2006) were used to estimate and compare life expectancy at each age of adult life for inactive (no moderate-to-vigorous physical activity), somewhat active (some moderate-to-vigorous activity but active (≥500 metabolic equivalent min/week of moderate-to-vigorous activity) adults. Analyses were conducted in 2012. Results Somewhat active and active non-Hispanic white men had a life expectancy at age 20 that was around 2.4 years longer than the inactive men; this life expectancy advantage was 1.2 years at age 80. Similar observations were made in non-Hispanic white women, with a higher life expectancy within the active category of 3.0 years at age 20 and 1.6 years at age 80. In non-Hispanic black women, as many as 5.5 potential years of life were gained due to physical activity. Significant increases in longevity were also observed within somewhat active and active non-Hispanic black men; however, among Hispanics the years of life gained estimates were more variable and not significantly different from 0 years gained. Conclusions Leisure-time physical activity is associated with increases in longevity in the United States. PMID:23253646
Stewart, Susan T.; Cutler, David M.; Rosen, Allison B.
Background Although increases in obesity over the past 30 years have adversely affected the health of the U.S. population, there have been concomitant improvements in health because of reductions in smoking. Having a better understanding of the joint effects of these trends on longevity and quality of life will facilitate more efficient targeting of health care resources. Methods For each year from 2005 through 2020, we forecasted life expectancy and quality-adjusted life expectancy for a representative 18-year-old, assuming a continuation of past trends in smoking (based on data from the National Health Interview Survey for 1978 through 1979, 1990 through 1991, 1999 through 2001, and 2004 through 2006) and past trends in body-mass index (BMI) (based on data from the National Health and Nutrition Examination Survey for 1971 through 1975, 1988 through 1994, 1999 through 2002, and 2003 through 2006). The 2003 Medical Expenditure Panel Survey was used to examine the effects of smoking and BMI on health-related quality of life. Results The negative effects of increasing BMI overwhelmed the positive effects of declines in smoking in multiple scenarios. In the base case, increases in the remaining life expectancy of a typical 18-year-old are held back by 0.71 years or 0.91 quality-adjusted years between 2005 and 2020. If all U.S. adults became nonsmokers of normal weight by 2020, we forecast that the life expectancy of an 18-year-old would increase by 3.76 life-years or 5.16 quality-adjusted years. Conclusions If past obesity trends continue unchecked, the negative effects on the health of the U.S. population will increasingly outweigh the positive effects gained from declining smoking rates. Failure to address continued increases in obesity could result in an erosion of the pattern of steady gains in health observed since early in the 20th century. PMID:19955525
Näsman, Marina; Niklasson, Johan; Saarela, Jan; Nygård, Mikael; Olofsson, Birgitta; Conradsson, Mia; Lövheim, Hugo; Gustafson, Yngve; Nyqvist, Fredrica
The objectives were to study changes in morale in individuals 85 years and older, and to assess the effect of negative life events on morale over a five-year follow-up period. The present study is based on longitudinal data from the Umeå85+/GERDA-study, including individuals 85 years and older at baseline (n = 204). Morale was measured with the Philadelphia Geriatric Center Morale Scale (PGCMS). Negative life events were assessed using an index including 13 negative life events occurring during the follow-up period. Linear regression was used for the multivariate analyses. The majority of the sample (69.1%) had no significant changes in morale during the five-year follow-up. However, the accumulation of negative life events was significantly associated with a greater decrease in PGCMS. A higher baseline PGCMS score did not attenuate the adverse effect negative life events had on morale. Morale seemed to be mainly stable in a five-year follow-up of very old people. It seems, nonetheless, that individuals are affected by negative life events, regardless of level of morale. Preventing negative life events and supporting individuals who experience multiple negative life events could have important implications for the care of very old people.
Lurbe-Puerto, Katia; Baumann, Michèle; Le Bihan, Etienne
This study aims to improve our understanding of the changes in the couple and family lives of stroke survivors’ caregivers and to analyse the relationships between the Caregivers’ Life Satisfaction (CLS) and the social and emotional repercussions of the caregiving role, two years after this event. Life satisfaction, optimism about the future, happiness and other subjective well-being aspects have attracted the European policymakers, leading to the Eurofund to introduce a “life satisfaction” d...
Jagger, Carol; McKee, Martin; Christensen, Kaare
BACKGROUND: The European Innovation Partnership on Active and Healthy Ageing seeks an increase of two healthy life years (HLY) at birth in the EU27 for the next 10 years. We assess the feasibility of doing so between 2010 and 2020 and the differential impact among countries by applying different...... of HLY/LE on year (seven countries retaining same HLY question) or extrapolating the average of HLY/LE in 2008 and 2009 to 2010 (20 countries and EU27). The first scenario continued these trends with three other scenarios exploring different HLY gap reductions between 2010 and 2020. RESULTS......: The estimated gap in HLY in 2010 was 17.5 years (men) and 18.9 years (women). Assuming current trends continue, EU27 HLY increased by 1.4 years (men) and 0.9 years (women), below the European Innovation Partnership on Active and Healthy Ageing target, with the HLY gap between countries increasing to 18.3 years...
Ellen A Struijk
Full Text Available BACKGROUND: Disability-Adjusted Life Years (DALYs have the advantage that effects on total health instead of on a specific disease incidence or mortality can be estimated. Our aim was to address several methodological points related to the computation of DALYs at an individual level in a follow-up study. METHODS: DALYs were computed for 33,507 men and women aged 20-70 years when participating in the EPIC-NL study in 1993-7. DALYs are the sum of the Years Lost due to Disability (YLD and the Years of Life Lost (YLL due to premature mortality. Premature mortality was defined as death before the estimated date of individual Life Expectancy (LE. Different methods to compute LE were compared as well as the effect of different follow-up periods using a two-part model estimating the effect of smoking status on health as an example. RESULTS: During a mean follow-up of 12.4 years, there were 69,245 DALYs due to years lived with a disease or premature death. Current-smokers had lost 1.28 healthy years of their life (1.28 DALYs 95%CI 1.10; 1.46 compared to never-smokers. The outcome varied depending on the method used for estimating LE, completeness of disease and mortality ascertainment and notably the percentage of extinction (duration of follow-up of the cohort. CONCLUSION: We conclude that the use of DALYs in a cohort study is an appropriate way to assess total disease burden in relation to a determinant. The outcome is sensitive to the LE calculation method and the follow-up duration of the cohort.
Krewitt, Wolfram; Pennington, David W.; Olsen, Stig Irving
The main objectives of this task group under SETAC-Europe’s Second Working Group on Life Cycle Impact Assessment (LCIA-WIA2) were to identify and discuss the suitability of toxicological impact measures for human health for use in characterization in LCIA. The current state of the art of defining......, as well as potency. Quantitative severity-based indicators yield measures in terms of Years of Life Lost (YOLL), Disability Adjusted Life Years (DALY), Quality Adjusted Life Years (QALY) and other similar measures. DALYs and QALYs are examples of approaches that attempt to account for both years of life...... such as No Observed Effect Levels (NOEL). NOELs, and similar data, are determined in laboratory studies using rodents and are then extrapolated to more relevant human measures. Many examples also exist of measures and methods beyond potency-based indicators that attempt to account for differences in expected severity...
Klijs, B.; Mackenbach, J.P.; Kunst, A.E.
To avoid strong declines in the quality of life due to population ageing, and to ensure sustainability of the health care system, reductions in the burden of disability among elderly populations are urgently needed. Life style interventions may help to reduce the years lived with one or more
B. Klijs (Bart); J.P. Mackenbach (Johan); A.E. Kunst (Anton)
textabstractBackground: To avoid strong declines in the quality of life due to population ageing, and to ensure sustainability of the health care system, reductions in the burden of disability among elderly populations are urgently needed. Life style interventions may help to reduce the years lived
Scanlon, Kelly A; Gray, George M; Francis, Royce A; Lloyd, Shannon M; LaPuma, Peter
Life cycle assessment (LCA) is a systems-based method used to determine potential impacts to the environment associated with a product throughout its life cycle. Conclusions from LCA studies can be applied to support decisions regarding product design or public policy, therefore, all relevant inputs (e.g., raw materials, energy) and outputs (e.g., emissions, waste) to the product system should be evaluated to estimate impacts. Currently, work-related impacts are not routinely considered in LCA. The objectives of this paper are: 1) introduce the work environment disability-adjusted life year (WE-DALY), one portion of a characterization factor used to express the magnitude of impacts to human health attributable to work-related exposures to workplace hazards; 2) outline the methods for calculating the WE-DALY; 3) demonstrate the calculation; and 4) highlight strengths and weaknesses of the methodological approach. The concept of the WE-DALY and the methodological approach to its calculation is grounded in the World Health Organization's disability-adjusted life year (DALY). Like the DALY, the WE-DALY equation considers the years of life lost due to premature mortality and the years of life lived with disability outcomes to estimate the total number of years of healthy life lost in a population. The equation requires input in the form of the number of fatal and nonfatal injuries and illnesses that occur in the industries relevant to the product system evaluated in the LCA study, the age of the worker at the time of the fatal or nonfatal injury or illness, the severity of the injury or illness, and the duration of time lived with the outcomes of the injury or illness. The methodological approach for the WE-DALY requires data from various sources, multi-step instructions to determine each variable used in the WE-DALY equation, and assumptions based on professional opinion. Results support the use of the WE-DALY in a characterization factor in LCA. Integrating
Grande, Gunn E.; McKerral, Angela; Addington-Hall, Julia M.; Todd, Chris J.
Aim: To investigate whether health service input in the last year of life differs between cancer patients who die at home versus those dying in inpatient care. Methods: Post hoc exploratory case-control study of 127 home deaths and 200 inpatient deaths. Retrospective electronic record linkage of patients' community and inpatient care during the last year of life. Results: Patients who died at home began their home nursing care closer to death than those who died as inpatients. Their first con...
Granbichler, Claudia A; Zimmermann, Georg; Oberaigner, Willi; Kuchukhidze, Giorgi; Ndayisaba, Jean-Pierre; Taylor, Alexandra; Luef, Gerhard; Bathke, Arne C; Trinka, Eugen
Studies using relative measures, such as standardized mortality ratios, have shown that patients with epilepsy have an increased mortality. Reports on more direct and absolute measure such as life expectancy are sparse. We report potential years lost and how life expectancy has changed over 40 years in a cohort of patients with newly diagnosed epilepsy. We analyzed life expectancy in a cohort of adult patients diagnosed with definite epilepsy between 1970 and 2010. Those with brain tumor as cause of epilepsy were excluded. By retrospective probabilistic record linkage, living or death status was derived from the national death registry. We estimated life expectancy by a Weibull regression model using gender, age at diagnosis, epilepsy etiology, and year of diagnosis as covariates at time of epilepsy diagnosis, and 5, 10, 15, and 20 years after diagnosis. Results were compared to the general population, and 95% confidence intervals are given. There were 249 deaths (105 women, age at death 19.0-104.0 years) in 1,112 patients (11,978.4 person-years, 474 women, 638 men). A substantial decrease in life expectancy was observed for only a few subgroups, strongly depending on epilepsy etiology and time of diagnosis: time of life lost was highest in patients with symptomatic epilepsy diagnosed between 1970 and 1980; the impact declined with increasing time from diagnosis. Over half of the analyzed subgroups did not differ significantly from the general population. This effect was reversed in the later decades, and life expectancy was prolonged in some subgroups, reaching a maximum in those with newly diagnosed idiopathic and cryptogenic epilepsy between 2001 and 2010. Life expectancy is reduced in symptomatic epilepsies. However, in other subgroups, a prolonged life expectancy was found, which has not been reported previously. Reasons may be manifold and call for further study. © 2017 The Authors. Epilepsia published by Wiley Periodicals, Inc. on behalf of International
Full Text Available The paper investigates the impact of the selected factors on the healthy life years of men and women in the EU countries. The multiple quantile spatial autoregression models are used in order to account for substantial differences in the healthy life years and life quality across the EU members. Quantile regression allows studying dependencies between variables in different quantiles of the response distribution. Moreover, this statistical tool is robust against violations of the classical regression assumption about the distribution of the error term. Parameters of the models were estimated using instrumental variable method (Kim, Muller 2004, whereas the confidence intervals and p-values were bootstrapped.
Joses Muthuri Kirigia
Full Text Available Background: This article estimates non-health gross domestic product (GDP losses associated with Disability-Adjusted Life Years (DALY lost among 15-59 year olds (most productive age bracket in Kenya in 2015. Methods: This study employs the lost output or human capital approach (HCA to convert the DALYs lost from all causes into their monetary equivalents. The magnitude economic haemorrhage from each disease was obtained by multiplying the per capita non-health GDP in International Dollars by the total number of DALYs lost in a specific age group (15-29 years, 30-49 years, 50-59 years. Per capita non-health GDP equals per capita GDP minus total health expenditure in 2015. Data on DALYs and per capita total health expenditure were obtained from the World Health Organization and per capita GDP data was from IMF databases. Results: Kenya lost 9,405,184 DALYs among 15-59 years olds in 2015. That DALY loss caused a haemorrhage in GDP of Int$ 29,788,392,419. Approximately 48.6% of the GDP haemorrhage resulted from communicable diseases and nutritional conditions, 37.4% from non-communicable diseases, and 14.0% from injuries. Conclusion: There is need to augment domestic and external investments into national health systems and other systems that meet basic needs (education, food, water, sanitation, shelter to reduce disease burden. Key words: Non-health GDP, economic haemorrhage, disability-adjusted life year (DALY
Abrishami, H.; Elgohary, M.
The purpose of this paper is to present the Plant Life Management (PLiM) strategy for the concrete containment structure of the ACR-1000 (Advanced CANDU Reactor) designed by AECL. The ACR-1000 is designed for 100-year plant life including 60-year operating life and additional 40-year decommissioning period of time. The approach adopted for the PLiM strategy of the concrete containment structure is a preventive one, key areas being: 1) design methodology, 2) material performance and 3) life cycle management and ageing management program. In the design phase, in addition to strength and serviceability, durability is a major requirement during the service life and decommissioning phase of the ACR structure. Parameters affecting durability design include: a) concrete performance, b) structural application, and c) environmental conditions. Due to the complex nature of the environmental effects acting on structures during the service life of project, it is considered that true improved performance during the service life can be achieved by improving the material characteristics. Many recent innovations in advanced concrete materials technology have made it possible to produce modern concrete such as high-performance concrete with exceptional performance characteristics. In this paper, the PLiM strategy for the ACR-1000 concrete containment is presented. In addition to addressing the design methodology and material performance areas, a systematic approach for ageing management program for the concrete containment structure is presented. (author)
Vidović, Mirjana; Sinanović, Osman; Smajlović, Dzevdet
The objective of the study was to analyze the quality of life six months after stroke in survivors under sixty years of age, to determine which life activities was the most affected, as well as to correlate the neurological insufficiency and the quality of life. It monitored 200 stroke survivors under sixty years of age treated at the Department of Neurology, University Clinical Centre Tuzla. Average age was 51,83 years (+/-7,02). The ischemic stroke was diagnosed in 77,5% stroke survivors, cerebral hemorrhage in 15%, and subarachnoid hemorrhage in 7,5%. Five stroke survivors suffered hemiplegia (2,5%), 24 (12%) experienced moderate consequences and 143 (71,5%) had mild consequences. No neurological deficit had 28 (14%) stroke survivors. Six months after the onset of disease all stroke survivors have been followed-up and evaluated about quality of life by filling in a modified questionnaire: Questionnaire on Quality of Life after Stroke (2). The questionnaire contained 20 questions covering four fields of life: Working Ability, Home Activity, Family Relations and Leisure Activities. Six months after the onset of stroke a worse quality of life in comparison to the period before the disease was noted in 172 (86%) stroke survivors, the unchanged in 19 (9,5%) and better in 9 (4,5%). The most affected is the field "Leisure Activities", followed by "Family Relations", "Home Activity", and the least affected is "Work Ability". The neurological deficit significantly correlates to the "Home Activities" and "Leisure Activities".
Full Text Available Abstract Background Choosing cost-effective strategies for improving the health of the public is difficult because the relative effects of different types of interventions are not well understood. The benefits of one-shot interventions may be different from the benefits of interventions that permanently change the probability of getting sick, recovering, or dying. Here, we compare the benefits of such types of public health interventions. Methods We used multi-state life table methods to estimate the impact of five types of interventions on mortality, morbidity (years of life in fair or poor health, and years of healthy life (years in excellent, very good, or good health. Results A one-shot intervention that makes all the sick persons healthy at baseline would increase life expectancy by 3 months and increase years of healthy life by 6 months, in a cohort beginning at age 65. An equivalent amount of improvement can be obtained from an intervention that either decreases the probability of getting sick each year by 12%, increases the probability of a sick person recovering by 16%, decreases the probability that a sick person dies by 15%, or decreases the probability that a healthy person dies by 14%. Interventions aimed at keeping persons healthy increased longevity and years of healthy life, while decreasing morbidity and medical expenditures. Interventions focused on preventing mortality had a greater effect on longevity, but had higher future morbidity and medical expenditures. Results differed for older and younger cohorts and depended on the value to society of an additional year of sick life. Conclusion Interventions that promote health and prevent disease performed well, but other types of intervention were sometimes better. The value to society of interventions that increase longevity but also increase morbidity needs further research. More comprehensive screening and treatment of new Medicare enrollees might improve their health and
Lakdawalla, Darius; Shafrin, Jason; Lucarelli, Claudio; Nicholson, Sean; Khan, Zeba M; Philipson, Tomas J
Technology drives both health care spending and health improvement. Yet policy makers rarely see measures of cost growth that account for both effects. To fill this gap, we present the quality-adjusted cost of care, which illustrates cost growth net of growth in the value of health improvements, measured as survival gains multiplied by the value of survival. We applied the quality-adjusted cost of care to two cases. For colorectal cancer, drug cost per patient increased by $34,493 between 1998 and 2005 as a result of new drug launches, but value from offsetting health improvements netted a modest $1,377 increase in quality-adjusted cost of care. For multiple myeloma, new therapies increased treatment cost by $72,937 between 2004 and 2009, but offsetting health benefits lowered overall quality-adjusted cost of care by $67,863. However, patients with multiple myeloma on established first-line therapies saw costs rise without corresponding benefits. All three examples document rapid cost growth, but they provide starkly different answers to the question of whether society got what it paid for. Project HOPE—The People-to-People Health Foundation, Inc.
I have had psoriasis for about 20 years. I can safely say that the care I have received from advanced nurse practitioner Zahira Koreja over the past two years is the best I have ever had. Her care has been instrumental in helping me finally live a normal life by keeping my psoriasis under control.
Vogt, Kristoffer Chelsom
Based on biographical interviews from a three-generation study in Norway, this article examines the place of the contemporary "gap year" within life course transition trajectories and intergenerational relations embedded in wider patterns of social inequality. Under the heading of taking a gap year, young people on "academic…
Full Text Available Objective: To calculate the burden of road traffic accidents in Kathmandu Valley and then extrapolate this to the national level. Methods: A prospective study was performed to compute the burden of road traffic accidents by quantification of disability-adjusted life years (DALYs using the Global Burden of Disease Study method on the basis of 1-year data from nine hospitals in Nepal and the Department of Forensic Medicine and cross-checked with the Nepal Traffic Directorate. Multiple methods were applied to the extrapolated population metrics of the burden of road traffic accidents in Nepal. Results: The total number of years of life lived in disability, years of life lost, and DALYs in Nepal were 38,848±194, 119,935±1464, and 158,783±1658 (95% confidence interval respectively. The number of years lost because of morbidity and death was similar in Kathmandu Valley. Most (75% of the DALYs resulted from years of life lost in Nepal. Males accounted for 73% of DALYs. Almost half (44% of the DALYs were contributed by the group aged 15–29 years. Conclusion: This study is the first to calculate the burden of road traffic accidents in Nepal using Nepal’s own data. Nepal needs to develop and enhance its own system to identify significant public health issues so as to set national priorities for prevention of road traffic accidents.
Almobarak, F; Al-Mobarak, F; Khan, A O
To report complications and 2-year valve survival following Ahmed valve implantation during the first 2 years of life. Retrospective institutional case series. Forty-two eyes of 36 patients with Ahmed valve implantation (without prior drainage device surgery) during the first 2 years of life and 2 years' postsurgical follow-up were identified. Most eyes had primary congenital glaucoma (28/42, 66.7%), aphakic glaucoma (5/42, 11.9%) or Peters anomaly (5/42, 11.9%). All but three eyes had prior ocular surgery. Surgery was at a mean age of 11.83 months (m) (SD 5.63). The most common significant postoperative complications were tube malpositioning requiring intervention (11/42, 26.2%), endophthalmitis (3/42, 7.1%; one with tube exposure) and retinal detachment (3/42, 7.1%). Thirty-six eyes (85.8%) required resumption of antiglaucoma medications to maintain intraocular pressure (IOP) valve survival (IOPendophthalmitis and retinal detachment are known potential complications following any incisional surgery for advanced buphthalmos; however, tube exposure is a unique potential problem following aqueous shunt implantation that can lead to intraocular infection. Cumulative valve survival 2 years following implantation was 63.3%.
Sredzińska-Kita, Dorota; Mrugacz, Małgorzata; Bakunowicz-Łazarczyk, Alina
The main aim of our work was to estimate the physical and psychomotor development and the arrangement to the daily life for a 8-year-old girl with inborn bilateral anophthalmia. The basic ophthalmic, pediatric and neurological examinations were performed with additional genetic and radiological examinations. The ophthalmic and MRI examination find out the absence of the eyeballs, optic nerves, optic chiasm, optic tracts and optic radiation. Anophthalmia limits in a big grade an independent life of the child. However, currently the girl's development indicates for good intellectual abilities what is promising for future independent life and professional work.
Höök, Kristina; Holm, Maria; Brown , Barry
Our overall vision for Mobile Life has been to create a society where happiness, playfulness and creativity are factors in peoples’ everyday lives. Through the ten years of research, the centre has become a strong voice advocating a human centred focus on digitalisation – focusing on what makes a good life for all. More importantly, we have provided a path to how this can be done – in our design processes, in our tools, in new business models, and in how we approach studies of life styles in ...
Williams, David E.; Dake, Jason R.; Gentry, Gregory J
The International Space Station (ISS) Environmental Control and Life Support (ECLS) system includes regenerative and non-regenerative technologies that provide the basic life support functions to support the crew, while maintaining a safe and habitable shirtsleeve environment. This paper provides a summary of the U.S. ECLS system activities over the prior year, covering the period of time between March 2011 and February 2012. The ISS continued permanent crew operations including the continuation of six crew members being on ISS. Work continues on the last of the Phase 3 pressurized elements, the commercial cargo resupply vehicles, and work to try and extend ISS service life from 2015 to at least 2028.
Williams, David E.; Gentry, Gregory J.
The International Space Station (ISS) Environmental Control and Life Support (ECLS) system includes regenerative and non-regenerative technologies that provide the basic life support functions to support the crew, while maintaining a safe and habitable shirtsleeve environment. This paper provides a summary of the U.S. ECLS system activities over the past year and the impacts of the international partners' activities on them, covering the period of time between March 2013 and February 2014. The ISS continued permanent crew operations including the continuation of six crew members being on ISS. Work continues on the commercial crew vehicles, and work to try and extend ISS service life.
Kroczka, Sławomir; Skowronek-Bała, Barbara; Zajac, Anna
Epilepsy in two first years of life needs constant attention due to diagnostic and therapeutic difficulties. The aim of the study was to identify cause of symptomatic epilepsy in two first years of life children from miopolskie and podkarpackie provinces hospitalized in Pediatric Neurology Clinic of Children and Adolescents Neurology Cathedra UJ in Cracow. 102 children with epilepsy aged from 1 week to 24 months hospitalized between 1st of January 2006 and 31st of December 2007. The group included 47 girls and 55 boys. On the basis of clinical characteristics and results of additional examinations idiopathic epilepsy was diagnosed in 16/102 (13.3%) children and in remaining 86 (87.7%) symtopmatic epilepsy was established. Perinatal burdening was cause of epilepsy in 31/86 (33.72%) children. Other causes were identified in 32/54 children (59.3%) and in remaining 231 54 (40.7%) children the cause was not established. In 3/32 epilepsy occured in the course of hydrocephalus and in 3/32 children as one of CNS inflammation complications. Epilepsy as a result of vascular lesions and bleeding to CNS occured in 4 children. Multiple developmental deffects syndrome was diagnosed in 4 children and in 11 specific neurodevelopmental disorders were the cause of epilepsy. In 6 children epilepsy occured in the course of neurometabolic diseases, neurocutaneous syndromes and neoplasms. In children in two first years of life polimorphic seizures were diagnosed the most often (32/86 that is 37.2%) and tonic, tonic-clonic seizures were less often (21/86 that is 24.43%). Focal seizures occured in 20/86 (23.26%) patients, in 4/86 (4.65%) mioclonic jerks were observed and infantile spasms in 9/86 (10.46%). (1) In most hospitalized children in two first years of life symptomatic epilepsy was diagnosed. (2) Epilepsy in two first years of life was more often in boys. (3) The most often cause of symptomatic epilepsy was pathology of perinatal period. (4) Polymorphic seizures were the most
Pikala, Malgorzata; Bryla, Marek; Bryla, Pawel; Maniecka-Bryla, Irena
Background The aim of the study is the analysis of years of life lost due to external causes of death, particularly due to traffic accidents and suicides. Materials and Methods The study material includes a database containing information gathered from 376,281 death certificates of inhabitants of the Lodz province who died between 1999 and 2010. The Lodz province is characterized by the highest mortality rates in Poland. The SEYLLp (Standard Expected Years of Life Lost per living person) and the SEYLLd (per death) indices were used to determine years of life lost. Joinpoint models were used to analyze time trends. Results In 2010, deaths due to external causes constituted 6.0% of the total number of deaths. The standardized death rate (SDR) due to external causes was 110.0 per 100,000 males and was five times higher than for females (22.0 per 100,000 females). In 2010, the SEYLLp due to external causes was 3746 per 100,000 males and 721 per 100,000 females. Among males, suicides and traffic accidents were the most common causes of death (the values of the SEYLLp were: 1098 years and 887 years per 100,000 people, respectively). Among females, the SEYLLp values were 183 years due to traffic accidents and 143 years due to suicides (per 100,000 people). Conclusions A decrease in the number of years of life lost due to external causes is much higher among females. The authors observe that a growing number of suicides contribute to an increase in the value of the SEYLLp index. This directly contributes to over-mortality of males due to external causes. The analysis of the years of life lost focuses on the social and economic aspects of premature mortality due to external causes. PMID:24810942
Blank, Peter M de; Ostrom, Quinn T; Rouse, Chaturia; Wolinsky, Yingli; Kruchko, Carol; Salcido, Joanne; Barnholtz-Sloan, Jill S
Incidence and survival rates are commonly reported statistics, but these may fail to capture the full impact of childhood cancers. We describe the years of potential life lost (YPLL) and years of life lived with disease (YLLD) in children and adolescents who died of cancer in the United States to estimate the impact of childhood cancer in the United States in 2009. We examined mortality data in 2009 among children and adolescents <20 years old in both the National Vital Statistics System (NVSS) and the Surveillance, Epidemiology, and End Results (SEER) datasets. YPLL and YLLD were calculated for all deaths due to cancer. Histology-specific YPLL and YLLD of central nervous system (CNS) tumors, leukemia, and lymphoma were estimated using SEER. There were 2233 deaths and 153,390.4 YPLL due to neoplasm in 2009. CNS tumors were the largest cause of YPLL (31%) among deaths due to cancer and were the cause of 1.4% of YPLL due to all causes. For specific histologies, the greatest mean YPLL per death was due to atypical teratoid/rhabdoid tumor (78.0 years lost). The histology with the highest mean YLLD per death in children and adolescents who died of cancer was primitive neuroectodermal tumor (4.6 years lived). CNS tumors are the most common solid malignancy in individuals <20 years old and have the highest YPLL cost of all cancers. This offers the first histology-specific description of YPLL in children and adolescents and proposes a new measure of cancer impact, YLLD, in individuals who die of their disease. YPLL and YLLD complement traditional indicators of mortality and help place CNS tumors in the context of other childhood malignancies
Full Text Available ABSTRACTBACKGROUND AND OBJECTIVES: Although many recognize that the first year of life and specifically the neonatal period are associated with increased risk of anesthetic morbidity and mortality, there are no studies directed to these pediatric subpopulations. This systematic review of the scientific literature including the last 15 years aimed to analyze the epidemiology of morbidity and mortality associated with general anesthesia and surgery in the first year of life and particularly in the neonatal (first month period.CONTENT: The review was conducted by searching publications in Medline/PubMed databases, and the following outcomes were evaluated: early mortality in the first year of life (<1 year and in subgroups of different vulnerability in this age group (0-30 days and 1-12 months and the prevalence of cardiac arrest and perioperative critical/adverse events of various types in the same subgroups.CONCLUSIONS: The current literature indicates great variability in mortality and morbidity in the age group under consideration and in its subgroups. However, despite the obvious methodological heterogeneity and absence of specific studies, epidemiological profiles of morbidity and mortality related to anesthesia in children in the first year of life show higher frequency of morbidity and mortality in this age group, with the highest peaks of incidence in the neonates' anesthesia.
Rockett, I R; Pollard, J H
The US Year 2000 mortality objectives are model standards cast as targeted changes in age-adjusted cause-specific death rates. This research centred on the projected impact of such changes on life expectancy and the mortality toll for each sex. A computer simulation was conducted using single decrement, multiple decrement and cause-elimination life table techniques, together with a decomposition procedure. Male and female life expectancy at birth was projected to increase by 1.71 and 1.51 years, respectively, between the designated 1987 baseline and 2000. The leading beneficiaries would be those aged 65 and older, followed by those aged 45-64, and infants. Declines in coronary heart disease, stroke and injury death rates would most influence the projected life expectancy changes, irrespective of sex. Approximately 782,000 male deaths and 730,000 female deaths would be averted under Year 2000 assumptions. Life expectancy would be a useful summary measure to incorporate into official evaluations of the Year 2000 mortality objectives. Targeting of excess male mortality in the US and other highly industrialized nations is recommended.
Urdinguio, Rocio G; Torró, María Isabel; Bayón, Gustavo F; Álvarez-Pitti, Julio; Fernández, Agustín F; Redon, Pau; Fraga, Mario F; Lurbe, Empar
Early life epigenetic programming influences adult health outcomes. Moreover, DNA methylation levels have been found to change more rapidly during the first years of life. Our aim was the identification and characterization of the CpG sites that are modified with time during the first years of life. We hypothesize that these DNA methylation changes would lead to the detection of genes that might be epigenetically modulated by environmental factors during early childhood and which, if disturbed, might contribute to susceptibility to diseases later in life. The study of the DNA methylation pattern of 485577 CpG sites was performed on 30 blood samples from 15 subjects, collected both at birth and at 5 years old, using Illumina(®) Infinium 450 k array. To identify differentially methylated CpG (dmCpG) sites, the methylation status of each probe was examined using linear models and the Empirical Bayes Moderated t test implemented in the limma package of R/Bioconductor. Surogate variable analysis was used to account for batch effects. DNA methylation levels significantly changed from birth to 5 years of age in 6641 CpG sites. Of these, 36.79 % were hypermethylated and were associated with genes related mainly to developmental ontology terms, while 63.21 % were hypomethylated probes and associated with genes related to immune function. Our results suggest that DNA methylation alterations with age during the first years of life might play a significant role in development and the regulation of leukocyte-specific functions. This supports the idea that blood leukocytes experience genome remodeling related to their interaction with environmental factors, underlining the importance of environmental exposures during the first years of life and suggesting that new strategies should be take into consideration for disease prevention.
Christiansen, Elisabeth Soegaard; Kjaer, Henrik Fomsgaard; Eller, Esben
to groups of and to individual allergens and asthma and RC at 6 and 14 years compared to a reference group with no sensitization. RESULTS: Both transient and persistent early-life sensitization to cow's milk or hen's egg proteins were associated with asthma (aOR 3.99(1.41-11.32) and 5.95(1.78-19.92)) and RC...... (aOR 2.94(1.19-7.28) and 6.18(1.86-20.53)) at 14 years, this association being driven mainly by sensitization to hen's egg. Transient early-life sensitization to HDM had increased risk of asthma (aOR 3.80(1.17-12.41)) at 14 years. CONCLUSIONS: Early transient and persistent IgE sensitization to hen......'s egg was associated with asthma and RC at 14 years. Furthermore, sensitization to HDM was associated with asthma at 14 years. This article is protected by copyright. All rights reserved....
Ghorbani, Z; Peres, M A; Liu, P; Mejia, G C; Armfield, J M; Peres, K G
The aim of this study was to investigate the association between early-life family income and dental pain experience from childhood to early adulthood. Data came from a 14-year prospective study (1991/1992-2005/2006) carried out in South Australia, which included children and adolescents aged 4-17 years (N = 9875) at baseline. The outcome was dental pain experience obtained at baseline, 14 years later in adulthood and at a middle point of time. The main explanatory variable was early-life family income collected at baseline. The prevalence of dental pain was 22.8% at baseline, 19.3% at 'middle time' and 39.3% at follow up. The proportion of people classified as 'poor' at baseline was 27.7%. Being poor early in life was significantly associated with dental pain at 14-year follow up (odds ratio = 1.45; 95% confidence interval = 1.27-1.66). Early-life relative poverty is associated with more frequent dental pain across the 14-year follow up and may be a key exposure variable for later dental conditions. © 2017 Australian Dental Association.
Fernández de Larrea-Baz, Nerea; Morant-Ginestar, Consuelo; Catalá-López, Ferrán; Gènova-Maleras, Ricard; Álvarez-Martín, Elena
The health indicator disability-adjusted life years combines the fatal and nonfatal consequences of a disease in a single measure. The aim of this study was to evaluate the burden of ischemic heart disease in 2008 in Spain by calculating disability-adjusted life years. The years of life lost due to premature death were calculated using the ischemic heart disease deaths by age and sex recorded in the Spanish National Institute of Statistics and the life-table in the 2010 Global Burden of Disease study. The years lived with disability, calculated for acute coronary syndrome, stable angina, and ischemic heart failure, used hospital discharge data and information from population studies. Disability weights were taken from the 2010 Global Burden of Disease study. We calculated crude and age standardized rates (European Standard Population). Univariate sensitivity analyses were performed. In 2008, 539 570 disability-adjusted life years were lost due to ischemic heart disease in Spain (crude rate, 11.8/1000 population; standardized, 8.6/1000). Of the total years lost, 96% were due to premature death and 4% due to disability. Among the years lost due to disability, heart failure accounted for 83%, stable angina 15%, and acute coronary syndrome 2%. In the sensitivity analysis, weighting by age was the factor that changed the results to the greatest degree. Ischemic heart disease continues to have a huge impact on the health of our population, mainly because of premature death. The results of this study provide an overall vision of the epidemiologic situation in Spain and could serve as the basis for evaluating interventions targeting the acute and chronic manifestations of cardiac ischemia. Copyright © 2014 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.
Hernandez, Caitlin L; Elliott, Timothy R; Berry, Jack W; Underhill, Andrea T; Fine, Philip R; Lai, Mark H C
We studied the predictive impact of family satisfaction, marital status, and functional impairment on the trajectories of life satisfaction over the first 5 years following medical treatment for traumatic spinal cord injury, burns, or interarticular fractures (total N = 662). It was anticipated that fewer functional impairments, being married, and greater family satisfaction would predict higher life satisfaction trajectories. The Functional Independence Measure, the Family Satisfaction Scale, and the Life Satisfaction Index were administered 12, 24, 48, and 60 months postdischarge. Trajectory modeling revealed that greater functional impairment significantly predicted lower life satisfaction, regardless of injury type. However, this association diminished when marital status and family satisfaction were entered into the models. Greater family satisfaction and being married predicted greater life satisfaction across time. Moreover, there was no evidence for increases in life satisfaction trajectories over time: Trajectories were stable across time for all injury groups. Results suggest that being married and greater family satisfaction promote life satisfaction among those who traumatically acquire disability, and these beneficial effects may be more salient than the degree of functional impairment imposed by the condition. (c) 2014 APA, all rights reserved.
Full Text Available Background: Eczema or atopic dermatitis (AD is one of the most prevalent skin diseases in the world. Although, the disorder is not fatal, it can cause life quality reduction. The aim of the current study was to investigate the impact of atopic dermatitis on life quality of 1-6-year-old children. Materials and Methods: The current study is a descriptive and analytical one designed to assess quality of life (QOL in 1-6-year-old children with atopic dermatitis in Kurdistan province (West of Iran. All the children who attended skin clinic of Besat Hospital, Sanandaj- Iran, during 2014 and 2016, participated in the study. Quality of life questionnaires were used to obtain data. Parents of the participating children were asked to complete the questionnaire. Index of Scoring Atopic Dermatitis (SCORAD was used to determine the severity of the disease. The study data were analysis using Stata-12 software. Results: During the study, 53 children with atopic dermatitis were identified and 66.04% were male. According to the classification of SCORAD index, 54.36% of the children (19 subjects were included in the moderate group (SCORAD 14-40 and 63.46% (33 persons in the severe group (SCORAD> 40. Mean of life quality score was 9.24 ± 10.48 (range 0-30 and there was no statistically significant difference between the genders (P >0.05. Conclusion: There was a positive correlation between the quality of life and pain severity in AD children; and children with atopic dermatitis had low quality of life and itching, wound, discomfort and sleep disorder, were the factors that mainly impact on their life quality.
Full Text Available The objective of the study was to analyze the quality of life six months after the stroke in survivors under the sixty years of age, to determine which life activities was the most affected, as well as to correlate the neurological insufficiency and the quality of life.It was monitored 200 stroke survivors under the sixty years of age treated at the Department of Neurology, University Clinical Centre Tuzla. Average age was 51,83 years (±7,02. The ischemic stroke was diagnosed in 77,5% stroke survivors, cerebral hemorrhage in 15%, and subarahnoid hemorrhage in 7,5%. Five stroke survivors suffered hemi-plegia (2,5%, 24 (12% experienced moderate consequences and 143 (71,5% had mild consequences. No neurological deficit had 28 (14% stroke survivors. Six months after the onset of disease all stroke survivors have been at follow-up and evaluated about quality of life by filling in a modified questionnaire: Questionnaire on Quality of Life after Stroke (2. The questionnaire contained 20 questions covering four fields of life: Working Ability, Home Activity, Family Relations and Leisure Activities.Six months after the onset of stroke a worse quality of life in comparison to the period before the disease was noted in 172 (86% stroke survivors, the unchanged in 19 (9,5% and better in 9 (4,5%. The most affected is the field “Leisure Activities’, followed by “Family Relations’, “Home Activity’, and the least affected is “Work Ability’, The neurological deficit significantly correlates to the “Home Activities” and “Leisure Activities’.
Full Text Available Introduction: The external causes of mortality are constituted as a public health problem which affect young population, have social relevance, are avoidable and their impact is reducible in the long term. Objective: To describe the behavior of mortality due to external causes and the potential years of life lost in the Colombian population from 1998 to 2015. Materials and methods: An analytical study was conducted by using 641,837 death certificates which were classified in four large groups of external mortality: homicide, suicide, traffic accident and other causes. Mortality rates (crude and standardized were calculated with direct method in three periods of time and potential years of life lost, for each group. Results: The risk of dying from external causes was 81.66 per hundred thousand inhabitants, with a decrease of 47.1% and 37.6 potential years of life lost. For homicide, a rate of 47.3 per hundred thousand inhabitants was recorded, with a reduction of 59.3% and 23 potential years of life lost. Traffic accidents recorded a reduction of 30.3% with a rate of 15.7. Suicide documented less reduction in 18 years of age (9.8% and an average rate of 5.1. Conclusion: Deaths caused by external causes are priorities when it comes to raising public policies, mainly for the reduction of homicides that are a reflection of the armed conflict and the crime presented in the country, generating the loss of years of productive life for society. It is necessary to outline the perpetrators to focus and intervene the most affected populations.
Wolke, Dieter; Baumann, Nicole; Busch, Barbara; Bartmann, Peter
Parents of preterm children experience increased distress early in their children's lives. Whether the quality of life of parents of preterm children is comparable to that of parents of term children by the time their offspring reach adulthood is unknown. What precursors in their offspring's childhood predict parental quality of life? A prospective whole-population study in Germany followed very preterm (VP) (parents (VP or VLBW: N = 219; term: N = 227) from birth to adulthood. Parental quality of life was evaluated with the World Health Organization Quality of Life assessment and the Satisfaction with Life questionnaire when their offspring were adults (mean age 27.3 years, 95% confidence interval [CI]: 27.2 to 27.3). Childhood standard assessments of VP or VLBW and term offspring included neurosensory disability, academic achievement, mental health, and parent-child and peer relationships. Overall quality of life of parents of VP or VLBW adults was found to be comparable to parents of term individuals ( P > .05). Parental quality of life was not predicted by their children being born VP or VLBW, experiencing disability, academic achievement, or the parent-child relationship in childhood but by their offspring's mental health (B = 0.15, 95% CI: 0.08 to 0.22) and peer relationships (B = 0.09, 95% CI: 0.02 to 0.16) in childhood. As a testament to resilience, parents of VP or VLBW adults had quality of life comparable to parents of term adults. Support and interventions to improve mental health and peer relationships in all children are likely to improve parents' quality of life. Copyright © 2017 by the American Academy of Pediatrics.
Bose, Anuradha; Konradsen, Flemming; John, Jacob
We calculated mortality rates and years of life lost because of unintentional injuries and suicides using community based information obtained prospectively over a 7-year period, from 1998 to 2004, among a rural and peri-urban population of 108,000 in South India. Per 100,000 population the total...... in this study is significantly higher than the figures reflected in available reports for India and is likely due to the under reporting in routine mortality statistics, particularly of suicides....
Kim, Jeong Chul; Wang, Li; Shen, Dinggang; Lin, Weili
The first year of life is the most critical time period for structural and functional development of the human brain. Combining longitudinal MR imaging and finite strain theory, this study aimed to provide new insights into normal brain development through a biomechanical framework. Thirty-three normal infants were longitudinally imaged using MRI from 2 weeks to 1 year of age. Voxel-wise Jacobian determinant was estimated to elucidate volumetric changes while Lagrange strains (both normal and...
Woo, Jessica G; Guerrero, M Lourdes; Guo, Fukun; Martin, Lisa J; Davidson, Barbara S; Ortega, Hilda; Ruiz-Palacios, Guillermo M; Morrow, Ardythe L
Serum adiponectin (APN) is associated with lower childhood obesity, and APN concentration in human milk is associated with slower growth during active breast-feeding. We examined infant weight gain in the second year of life after exposure to high or low levels of mother's milk APN. Breast-feeding mother-infant pairs were recruited in Mexico City and studied for 2 years; 192 infants with at least 12 months' follow-up were analyzed. Monthly milk samples were assayed for APN; mothers were classified as producing high or low levels of milk APN. Infant and maternal serum APN were assessed during year 1. Infant anthropometry was measured monthly (year 1) or bimonthly (year 2), and World Health Organization z scores were calculated. Longitudinal adjusted models assessed weight-for-age and weight-for-length z score trajectories from 1 to 2 years. Maternal serum APN modestly correlated with milk APN (r=0.37, Pmilk APN experienced increasing weight-for-age and weight-for-length z scores between age 1 and 2 years in contrast to low milk APN exposure (P for group × time=0.02 and 0.054, respectively), adjusting for growth in the first 6 months and other covariates. In contrast, infant serum APN in year 1 was not associated with the rate of weight gain in year 2. High human milk APN exposure was associated with accelerated weight trajectory during the second year of life, suggesting its role in catch-up growth after slower weight gain during the first year of life.
Downs, C. T.
First year students' academic performance in three Life Science courses (Botany, Zoology and Bioscience) was compared. Pass rates, as well as the means and distributions of final marks were analysed. Of the three components (coursework, practical and theory examinations) contributing to the final mark of each course, students performed best in the…
Donna M. Wilson
Full Text Available Context. Little is known about the number and types of moves made in the last year of life to obtain healthcare and end-of-life support, with older adults more vulnerable to care setting transition issues. Research Objective. Compare care setting transitions across older (65+ years and younger individuals. Design. Secondary analyses of provincial hospital and ambulatory database data. Every individual who lived in the province for one year prior to death from April 1, 2005 through March 31, 2007 was retained (N=19,397. Results. Transitions averaged 3.5, with 3.9 and 3.4 for younger and older persons, respectively. Older persons also had fewer ER and ambulatory visits, fewer procedures performed in the last year of life, but longer inpatient stays (42.7 days versus 36.2 for younger persons. Conclusion. Younger and older persons differ somewhat in the number and type of end-of-life care setting transitions, a matter for continuing research and healthcare policy.
van Koppenhagen, C.F.
In Chapter 1 an overview was given of the research context of this thesis. The health condition spinal cord injury and its accompanying health complications were described The results of Chapter 2 showed a marked decrease in life satisfaction of persons with spinal cord injury at one year after
Palmer, Stephanie Baker; Fais, Laurel; Golinkoff, Roberta Michnick; Werker, Janet F.
Over their 1st year of life, infants' "universal" perception of the sounds of language narrows to encompass only those contrasts made in their native language (J. F. Werker & R. C. Tees, 1984). This research tested 40 infants in an eyetracking paradigm and showed that this pattern also holds for infants exposed to seen language--American Sign…
Shumway, Stacy; Wetherby, Amy M.
Purpose: To examine the communicative profiles of children with autism spectrum disorders (ASD) in the second year of life. Method: Communicative acts were examined in 125 children 18 to 24 months of age: 50 later diagnosed with ASD; 25 with developmental delays (DD); and 50 with typical development (TD). Precise measures of rate, functions, and…
Owusu-Bempah, Akwasi; Kanters, Steve; Druyts, Eric; Toor, Kabirraaj; Muldoon, Katherine A; Farquhar, John W; Mills, Edward J
Aboriginal representation in Canadian correctional institutions has increased rapidly over the past decade. We calculated "years of life lost to incarceration" for Aboriginal and non-Aboriginal Canadians. Incarceration data from provincial databases were used conjointly with demographic data to estimate rates of incarceration and years of life lost to provincial incarceration in (BC) and federal incarceration, by Aboriginal status. We used the Sullivan method to estimate the years of life lost to incarceration. Aboriginal males can expect to spend approximately 3.6 months in federal prison and within BC spend an average of 3.2 months in custody in the provincial penal system. Aboriginal Canadians on average spend more time in custody than their non-Aboriginal counterparts. The ratio of the Aboriginal incarceration rate to the non-Aboriginal incarceration rate ranged from a low of 4.28 in Newfoundland and Labrador to a high of 25.93 in Saskatchewan. Rates of incarceration at the provincial level were highest among Aboriginals in Manitoba with an estimated rate of 1377.6 individuals in prison per 100,000 population (95% confidence interval [CI]: 1311.8-1443.4). The results indicate substantial differences in life years lost to incarceration for Aboriginal versus non-Aboriginal Canadians. In light of on-going prison expansion in Canada, future research and policy attention should be paid to the public health consequences of incarceration, particularly among Aboriginal Canadians.
van Mierlo, Maria L.; van Heugten, Caroline M.; Post, Marcel W. M.; Hajos, Tibor R. S.; Kappelle, L. Jaap; Visser-Meily, Johanna M. A.
BACKGROUND: Little information is available about the course of quality of life (QoL) post stroke and how dependency on activities of daily living (ADL) influences this course. The aim of this study was therefore to describe the course of QoL from 2 months up to 2 years post stroke and to study the
Petrill, Stephen A.; Lipton, Paul A.; Hewitt, John K.; Plomin, Robert; Cherny, Stacey S.; Corley, Robin; DeFries, John C.
The genetic and environmental contributions to the development of general cognitive ability throughout the first 16 years of life were examined using sibling data from the Colorado Adoption Project. Correlations were analyzed along with structural equation models to characterize the genetic and environmental influences on longitudinal stability…
Høgh, Vibeke; Cummings, Elisabeth; Riahi, Sam
Healthcare services target delivery of a connected patient journey as an indicator of a high quality of care, but knowledge of the patients’ experience is sparse. This case study explores the lived experience of the quality of life and perception of health during the first year of the journey...
Kim, Hyoun K.; Pears, Katherine C.; Fisher, Philip A.; Connelly, Cynthia D.; Landsverk, John A.
Objective: Despite the high prevalence rates of harsh parenting, the nature of developmental change in this domain early in life and the factors that contribute to changes in harsh parenting over time are not well understood. The present study examined developmental patterns in maternal harsh parenting behavior from birth to age 3 years and their…
Beuker, K.T.; Lambregts-Rommelse, N.N.J.; Donders, R.; Buitelaar, J.K.
The first two years of life is a crucially important period for the development of communication skills. In this study joint attention and language development were monthly assessed between 8 and 24 months of age in a sample of 23 typically developing children to establish the developmental
Anaemia, Malaria and malnutrition in the first two years of life in Nigeria. B M Afolabi, A G Mafe. Abstract. No Abstract. Journal of Malaria in Africa and the Tropics Vol. 1 (3) 2005: pp. 15-27. Full Text: EMAIL FULL TEXT EMAIL FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT.
Krishnamurthi, Rita V; Moran, Andrew E; Feigin, Valery L
in younger adults. OBJECTIVES: This study aims to estimate prevalence, mortality and disability-adjusted life years (DALYs) and their trends for total, ischemic stroke (IS) and hemorrhagic stroke (HS) in the world for 1990-2013 in adults aged 20-64 years. METHODOLOGY: Stroke prevalence, mortality and DALYs......BACKGROUND: Recent evidence suggests that stroke is increasing as a cause of morbidity and mortality in younger adults, where it carries particular significance for working individuals. Accurate and up-to-date estimates of stroke burden are important for planning stroke prevention and management...... were estimated using the Global Burden of Disease (GBD) 2013 methods. All available data on rates of stroke incidence, excess mortality, prevalence and death were collected. Statistical models were used along with country-level covariates to estimate country-specific stroke burden. Stroke...
Westerdahl, Elisabeth; Jonsson, Marcus; Emtner, Margareta
Pulmonary function is severely reduced in the early period after cardiac surgery, and impairments have been described up to 4-6 months after surgery. Evaluation of pulmonary function in a longer perspective is lacking. In this prospective study pulmonary function and health-related quality of life were investigated 1 year after cardiac surgery. Pulmonary function measurements, health-related quality of life (SF-36), dyspnoea, subjective breathing and coughing ability and pain were evaluated before and 1 year after surgery in 150 patients undergoing coronary artery bypass grafting, valve surgery or combined surgery. One year after surgery the forced vital capacity and forced expiratory volume in 1 s were significantly decreased (by 4-5 %) compared to preoperative values (p < 0.05). Saturation of peripheral oxygen was unchanged 1 year postoperatively compared to baseline. A significantly improved health-related quality of life was found 1 year after surgery, with improvements in all eight aspects of SF-36 (p < 0.001). Sternotomy-related pain was low 1 year postoperatively at rest (median 0 [min-max; 0-7]), while taking a deep breath (0 [0-4]) and while coughing (0 [0-8]). A more pronounced decrease in pulmonary function was associated with dyspnoea limitations and impaired subjective breathing and coughing ability. One year after cardiac surgery static and dynamic lung function measurements were slightly decreased, while health-related quality of life was improved in comparison to preoperative values. Measured levels of pain were low and saturation of peripheral oxygen was same as preoperatively.
Köber, Christin; Habermas, Tilmann
Considering life stories as the most individual layer of personality (McAdams, 2013) implies that life stories, similar to personality traits, exhibit some stability throughout life. Although stability of personality traits has been extensively investigated, only little is known about the stability of life stories. We therefore tested the influence of age, of the proportion of normative age-graded life events, and of global text coherence on the stability of the most important memories and of brief entire life narratives as 2 representations of the life story. We also explored whether normative age-graded life events form more stable parts of life narratives. In a longitudinal life span study covering up to 3 measurements across 8 years and 6 age groups (N = 164) the stability of important memories and of entire life narratives was measured as the percentage of events and narrative segments which were repeated in later tellings. Stability increased between ages 8 and 24, leveling off in middle adulthood. Beyond age, stability of life narratives was also predicted by proportion of normative age-graded life events and by causal-motivational text coherence in younger participants. Memories of normative developmental and social transitional life events were more stable than other memories. Stability of segments of life narratives exceeded the stability of single most important memories. Findings are discussed in terms of cognitive, personality, and narrative psychology and point to research questions in each of these fields. (PsycINFO Database Record (c) 2017 APA, all rights reserved).
King, Victoria; Wickrama, K A S; Klopack, Erick; Lorenz, Frederick O
Using data from 416 middle-aged mothers gathered over the course of a decade, this study examined the influence of mastery trajectories (the initial level and change), on change in physical health. Mastery is defined as one's ability to control and influence his/her life and environment to reach a desired outcome or goal. Both the initial level and change in mastery from 1991 to 1994 were associated with decreased physical health problems over the middle years (1991-2001). Contextual moderation of this association by stressful life contexts including negative life events and work-family conflict was investigated. Moderation analysis showed that under conditions of low contextual life stressors, the level and increase in mastery significantly contributed to decreases in physical health problems in middle-aged mothers. Alternatively, conditions of high contextual life stressors inhibited the ability of mastery to influence physical health of mothers, suggesting that the positive health impact of mastery on physical health is mitigated by stressful life experiences. Implications for the need to maintain important personal resources, such as mastery, during times of stress are discussed. Copyright © 2018 John Wiley & Sons, Ltd.
Maniecka-Bryła, Irena; Paciej-Gołębiowska, Paulina; Dziankowska-Zaborszczyk, Elżbieta; Bryła, Marek
In Poland, as in most other European countries, diseases of the respiratory system are the 4th leading cause of mortality; they are responsible for about 8% of all deaths in the European Union (EU) annually. To assess the socio-economic aspects of mortality, it has become increasingly common to apply potential measures rather than conventionally used ratios. The aim of this study was to analyze years of life lost due to premature deaths caused by diseases of the respiratory system in Poland from 1999 to 2013. The study was based on a dataset of 5,606,516 records, obtained from the death certificates of Polish residents who died between 1999 and 2013. The information on deaths caused by diseases of the respiratory system, i.e., coded as J00-J99 according to the International Statistical Classification of Diseases and Related Health Problems, 10th revision (ICD-10), was analyzed. The Standard Expected Years of Life Lost (SEYLL) indicator was used in the study. In the years 1999-2013, the Polish population suffered 280,519 deaths caused by diseases of the respiratory system (4.69% of all deaths). In the period analyzed, a gradual decrease in the standardized death rate was observed - from 46.31 per 100,000 inhabitants in 1999 to 41.02 in 2013. The dominant causes of death were influenza and pneumonia (J09-J18) and chronic lower respiratory diseases (J40-J47). Diseases of the respiratory system were the cause of 4,474,548.92 lost life years. The Standard Expected Years of Life Lost per person (SEYLLp) was 104.72 per 10,000 males and 52.85 per 10,000 females. The Standard Expected Years of Life Lost per death (SEYLLd) for people who died due to diseases of the respiratory system was 17.54 years of life on average for men and 13.65 years on average for women. The use of the SEYLL indicator provided significant information on premature mortality due to diseases of the respiratory system, indicating the fact that they play a large role in the health status of the Polish
Dubrova, Iu E; Korzeneva, I B; Stiazhkina, T V
The incidence of common diseases among children in the first three years of life was studied in relation to the degree of outcrossing in family history, the level of education of both parents, and the age of entering nursery school. A total of 526 children (274 boys and 252 girls) were inspected. The factors under study proved to have no effect on morbidity among children under one year of age. However, morbidity during the second and third years of life depended on the degree of outcrossing in the children's family background, the educational level of their mothers, and the age of their entrance into nursery school. Higher morbidity at this age was characteristic of children born of parents belonging to different ethnic groups, and this situation was independent of social factors. The role of genetic coadaptation and epistasis in determining the relationship between outcrossing and morbidity is discussed.
The health care cost analysis for VZP clients during their last year of life Abstract Objective of this thesis is a health care cost analysis for VZP clients, who died in 2014. An analysis of cost has been approached from a few different aspects, but mainly by segmentation of health care providers and chapters of diagnosis by ICD-10. Following analysis has been also processed in this thesis - the analysis of average health care costs of one day in life and the regional analysis of average hea...
Gæde, Peter; Oellgaard, Jens; Carstensen, Bendix
Aims/hypothesis: The aim of this work was to study the potential long-term impact of a 7.8Â years intensified, multifactorial intervention in patients with type 2 diabetes mellitus and microalbuminuria in terms of gained years of life and years free from incident cardiovascular disease. Methods...... for all microvascular complications was decreased in the intensive-therapy group in the range 0.52 to 0.67, except for peripheral neuropathy (HR 1.12). Conclusions/interpretation: At 21.2Â years of follow-up of 7.8Â years of intensified, multifactorial, target-driven treatment of type 2 diabetes......: The original intervention (mean treatment duration 7.8Â years) involved 160 patients with type 2 diabetes and microalbuminuria who were randomly assigned (using sealed envelopes) to receive either conventional therapy or intensified, multifactorial treatment including both behavioural and pharmacological...
Shyu, Yea-Ing L; Maa, Suh-Hwa; Chen, Sien-Tsong; Chen, Min-Chi
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
de Kok, I M C M; Polder, J J; Habbema, J D F
life year. We calculated the change in cost-effectiveness ratios (CERs) if unrelated healthcare costs in the LastYL or in LYsG would be included. Costs in the LastYL were on average 33% higher for persons dying from cancer than from any cause. Including costs in LysG increased the CER by 4040 euro...... in women, and by 4100 euro in men. Of these, 660 euro in women, and 890 euro in men, were costs in the LastYL. Including unrelated healthcare costs in the LastYL or in LYsG will change the comparative cost-effectiveness of healthcare programmes. The CERs of cancer screening programmes will clearly increase......, with approximately 4000 euro. However, because of the favourable CER's, including unrelated healthcare costs will in general have limited policy implications....
Høgh, Vibeke; Cummings, Elisabeth; Riahi, Sam
Healthcare services target delivery of a connected patient journey as an indicator of a high quality of care, but knowledge of the patients’ experience is sparse. This case study explores the lived experience of the quality of life and perception of health during the first year of the journey......, and recognizing bodily reactions, are elaborated. In conclusion, hope for a better future is evident throughout the journey. Difficulties of balancing responsibility, conflicting information and lack of support and connection between general practice and the hospital result in putting the participant’s dignity...... at stake. Despite two ablations the participant is affected in his daily life and family life due to physical limitations. Along the study adjustment to the situation is seen, and his new status as grandfather is surprisingly seen to facilitate this adjustment....
Bäckhed, Gert Fredrik; Roswall, Josefine; Peng, Yangqing
The gut microbiota is central to human health, but its establishment in early life has not been quantitatively and functionally examined. Applying metagenomic analysis on fecal samples from a large cohort of Swedish infants and their mothers, we characterized the gut microbiome during the first...... of the microbiome. Our findings establish a framework for understanding the interplay between the gut microbiome and the human body in early life....... year of life and assessed the impact of mode of delivery and feeding on its establishment. In contrast to vaginally delivered infants, the gut microbiota of infants delivered by C-section showed significantly less resemblance to their mothers. Nutrition had a major impact on early microbiota...
Kim, Jeong Chul; Wang, Li; Shen, Dinggang; Lin, Weili
The first year of life is the most critical time period for structural and functional development of the human brain. Combining longitudinal MR imaging and finite strain theory, this study aimed to provide new insights into normal brain development through a biomechanical framework. Thirty-three normal infants were longitudinally imaged using MRI from 2 weeks to 1 year of age. Voxel-wise Jacobian determinant was estimated to elucidate volumetric changes while Lagrange strains (both normal and shear strains) were measured to reveal directional growth information every 3 months during the first year of life. Directional normal strain maps revealed that, during the first 6 months, the growth pattern of gray matter is anisotropic and spatially inhomogeneous with higher left-right stretch around the temporal lobe and interhemispheric fissure, anterior-posterior stretch in the frontal and occipital lobes, and superior-inferior stretch in right inferior occipital and right inferior temporal gyri. In contrast, anterior lateral ventricles and insula showed an isotropic stretch pattern. Volumetric and directional growth rates were linearly decreased with age for most of the cortical regions. Our results revealed anisotropic and inhomogeneous brain growth patterns of the human brain during the first year of life using longitudinal MRI and a biomechanical framework.
Climent, M; Munarriz, M; Blazeby, J M; Dorcaratto, D; Ramón, J M; Carrera, M J; Fontane, L; Grande, L; Pera, M
Malnutrition is common in patients undergoing gastric cancer resection, leading to weight loss, although little is known about how this impacts on health-related quality of life (HRQL). This study aimed to explore the association between HRQL and weight loss in patients 2 years after curative gastric cancer resection. Consecutive patients undergoing curative gastric cancer resection and surviving at least 2 years without disease recurrence were recruited. Patients completed the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) and the specific module for gastric cancer (STO22) before and 2 years postoperatively and associations between HRQL scores and patients with and without ≥ 10% body weight loss (BWL) were examined. A total of 76 patients were included, of whom 51 (67%) had BWL ≥10%. At 2 years postoperatively, BWL ≥10% was associated with deterioration of all functional aspects of quality of life, with persistent pain (21.6%), diarrhoea (13.7%) and nausea/vomiting (13.7%). By contrast, none of the patients with BWL patients with ≥10% BWL than in those with Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.
Full Text Available Abstract Background The control of growth and nutritional status in the foetus and neonate is a complex mechanism, in which also hormones produced by adipose tissue, such as adiponectin and leptin are involved. The aim of this study was to evaluate levels of adiponectin, leptin and insulin in appropriate (AGA and small for gestational age (SGA children during the 1st year of life and to correlate these with auxological parameters. Methods In 33 AGA and 29 SGA infants, weight, length, head circumference, glucose, insulin, adiponectin and leptin levels were evaluated at the second day of life, and at one, six and twelve months, during which a portion of SGA could show catch-up growth (rapid growth in infants born small for their gestational age. Results Both total and isoform adiponectin levels were comparable between AGA and SGA infants at birth and until age one year. These levels significantly increased from birth to the first month of life and then decreased to lower values at 1 year of age in all subjects. Circulating leptin concentrations were higher in AGA (2.1 ± 4.1 ng/ml than in SGA neonates (0.88 ± 1.03 ng/ml, p st and the 6th month of age, but they increased in SGA from six months to one year, when they showed catch-up growth. Circulating insulin levels were not statistically different in AGA and SGA neonates at any study time point. Insulin levels in both AGA and SGA infants increased over the study period, and were significantly lower at birth compared to one, six and 12 months of age. Conclusions During the first year of life, in both AGA and SGA infants a progressive decrease in adiponectin levels was observed, while a difference in leptin values was correlated with the nutritional status.
Chang, Angela Y; Robinson, Lisa A; Hammitt, James K; Resch, Stephen C
In "Global health 2035: a world converging within a generation," The Lancet Commission on Investing in Health (CIH) adds the value of increased life expectancy to the value of growth in gross domestic product (GDP) when assessing national well-being. To value changes in life expectancy, the CIH relies on several strong assumptions to bridge gaps in the empirical research. It finds that the value of a life year (VLY) averages 2.3 times GDP per capita for low- and middle-income countries (LMICs) assuming the changes in life expectancy they experienced from 2000 to 2011 are permanent. The CIH VLY estimate is based on a specific shift in population life expectancy and includes a 50 percent reduction for children ages 0 through 4. We investigate the sensitivity of this estimate to the underlying assumptions, including the effects of income, age, and life expectancy, and the sequencing of the calculations. We find that reasonable alternative assumptions regarding the effects of income, age, and life expectancy may reduce the VLY estimates to 0.2 to 2.1 times GDP per capita for LMICs. Removing the reduction for young children increases the VLY, while reversing the sequencing of the calculations reduces the VLY. Because the VLY is sensitive to the underlying assumptions, analysts interested in applying this approach elsewhere must tailor the estimates to the impacts of the intervention and the characteristics of the affected population. Analysts should test the sensitivity of their conclusions to reasonable alternative assumptions. More work is needed to investigate options for improving the approach.
Sun, Xiangyu; Bernabé, Eduardo; Liu, Xuenan; Gallagher, Jennifer E; Zheng, Shuguo
This study aimed to explore the association between early life factors and dental caries among 5-year-old Chinese children. Data from 9722 preschool children who participated in the third National Oral Health Survey of China were analysed. Information on early life (birth weight, breastfeeding and age when toothbrushing started), child (sex, ethnicity, birth order and dental behaviours) and family factors (parental education, household income, place of residence, number of children in the family, respondent's age and relation to the child) were obtained from parental questionnaires. Children were also clinically examined to assess dental caries experience using the decayed, missing and filled teeth (dmft) index. The association of early life factors with dmft was evaluated in negative binomial regression models. We found that birth weight was not associated with dental caries experience; children who were exclusively and predominantly formula-fed had lower dmft values than those exclusively breastfed; and children who started brushing later in life had higher dmft values than those who were brushing within the first year. Only one in seven of all children received regular toothbrushing twice per day, and only 34.7% had commenced toothbrushing by the age of 3 years. This study shows certain early life factors play a role in dental caries among Chinese preschool children and provides important insights to shape public health initiatives on the importance of introducing early toothbrushing. The early environment, especially the age when parents introduce toothbrushing to their children, can be an important factor to prevent childhood dental caries. Copyright © 2017 Elsevier Ltd. All rights reserved.
DuPre, Elizabeth; Spreng, R Nathan
Structural covariance examines covariation of gray matter morphology between brain regions and across individuals. Despite significant interest in the influence of age on structural covariance patterns, no study to date has provided a complete life span perspective-bridging childhood with early, middle, and late adulthood-on the development of structural covariance networks. Here, we investigate the life span trajectories of structural covariance in six canonical neurocognitive networks: default, dorsal attention, frontoparietal control, somatomotor, ventral attention, and visual. By combining data from five open-access data sources, we examine the structural covariance trajectories of these networks from 6 to 94 years of age in a sample of 1,580 participants. Using partial least squares, we show that structural covariance patterns across the life span exhibit two significant, age-dependent trends. The first trend is a stable pattern whose integrity declines over the life span. The second trend is an inverted-U that differentiates young adulthood from other age groups. Hub regions, including posterior cingulate cortex and anterior insula, appear particularly influential in the expression of this second age-dependent trend. Overall, our results suggest that structural covariance provides a reliable definition of neurocognitive networks across the life span and reveal both shared and network-specific trajectories.
Durak, Halil Ibrahim; Certuğ, Agah; Calişkan, Ayhan; van Dalen, Jan
Although the Basic Life Support (BLS) ability of a medical student is a crucial competence, poor BLS training programs have been documented worldwide. Better training designs are needed. This study aims to share detailed descriptions and the test results of two cognitive-constructivist training models for the BLS skills in the first year of medical curriculum. A BLS skills training module was implemented in the first year curriculum in the course of 6 years (1997-2003). The content was derived from the European Resuscitation Council Guidelines. Initially, a competence-based model was used and was upgraded to a cognitive apprenticeship model in 2000. The main performance-content type that was expected at the end of the course was: competent application of BLS procedures on manikins and peers at an OSCE as well as 60% achievement in a test consisting of 25 MCQ items. A retrospective cohort survey design using exam results and a self-completed anonymous student ratings' questionnaire were used in order to test models. Training time for individual students varied from 21 to 29 hours. One thousand seven hundred and sixty students were trained. Fail rates were very low (1.0-2.2%). The students were highly satisfied with the module during the 6 years. In the first year of the medical curriculum, a competence-based or cognitive apprenticeship model using cognitive-constructivist designs of skills training with 9 hours theoretical and 12-20 hours long practical sessions took place in groups of 12-17 students; medical students reached a degree of competence to sufficiently perform BLS skills on the manikins and their peers. The cognitive-constructivist designs for skills training are associated with high student satisfaction. However, the lack of controls limits the extrapolation of this conclusion.
Gale, Catharine R; Booth, Tom; Mõttus, René; Kuh, Diana; Deary, Ian J
Neuroticism and Extraversion are linked with current wellbeing, but it is unclear whether these traits in youth predict wellbeing decades later. We applied structural equation modelling to data from 4583 people from the MRC National Survey of Health and Development. We examined the effects of Neuroticism and Extraversion at ages 16 and 26 years on mental wellbeing and life satisfaction at age 60-64 and explored the mediating roles of psychological and physical health. Extraversion had direct, positive effects on both measures of wellbeing. The impact of Neuroticism on both wellbeing and life satisfaction was largely indirect through susceptibility to psychological distress and physical health problems. Personality dispositions in youth have enduring influence on wellbeing assessed about forty years later. PMID:24563560
Zauli Sajani, Stefano; Battista, Alessandra; Frova, Luisa; Lauriola, Paolo
In several public debates, scientific conferences and, recently, also in the scientific literature, some figures from EUROSTAT have been presented; they show a relevant decrease in the healthy life expectancy in Italy. This idea is based on the analysis of the trend of Healthy Life Years (HLY), an indicator synthesizing the grade of functional limitation of individuals based on the answers to a self-completed questionnaire. In particular, the dramatic decrease of HLY in Italy from 2005 to 2007 raised concerns. This paper analyses the reasons suggesting caution in interpreting these data considering first and foremost the changes across years in the formulation of questions and answers. Even though HLY and the other indicators selected by the European Union have a great potential in terms of communication and synthetic view, caution is needed in using these data and in drawing conclusions from figures and instruments of recent application that are still evolving.
Goodridge, Donna; Buckley, Alan; Marko, Josh; Steeves, Megan; Turner, Hollie; Whitehead, Steve
To compare demographic, social, medical, and health care characteristics of home care clients in the last year of life by quintile of deprivation and examine associations between material deprivation and service characteristics. This retrospective study used administrative data for 700 clients who died while receiving home care services. Outcome measures were the receipt of supportive or palliative home care. Associations were assessed using multiple logistic regression. Material deprivation was not associated with either the hours of home care received or the receipt of supportive home care services. Clients with dementia or stroke, those were older than 80 years and those who were single were less likely to receive palliative care services than other groups. Inequalities in allocation of home care services based on age, diagnosis, and marital status, but not material deprivation, suggest the need to carefully match service with need at the end of life.
He, Tianfeng; Yang, Zuyao; Liu, Tao; Shen, Yueping; Fu, Xiaohong; Qian, Xujun; Zhang, Yuelun; Wang, Yong; Xu, Zhiwei; Zhu, Shankuan; Mao, Chen; Xu, Guozhang; Tang, Jinling
To evaluate the burden of air pollution on years of life lost (YLL) in addition to mortality, we conducted a time series analysis based on the data on air pollution, meteorological conditions and 163,704 non-accidental deaths of Ningbo, China, 2009-2013. The mean concentrations of particulate matter with aerodynamic diameter population for both outcomes. These findings clarify the burden of air pollution on YLL and highlight the importance and urgency of air pollution control in China.
Lidija Dimitrijević; Hristina Čolović
The adoption of the basic motor skills in the first year of life (postural head control, lateral transfers into a lying position, sitting, standing, walking, crawling, grasping...) goes on quite spontaneously. A child learns all the motor actions by itself and that is why it is not necessary to “teach” a child to seat, grasp, stand, walk... Teaching a child the basic motor skills stands for a rough, unnecessary and undesirable involvement into spontaneous motor development, and, due to this, ...
This paper revisits the notion of ‘postfeminism’ ten years after its formulation in critical terms as a sensibility characterising cultural life. The paper has two broad aims: first to reflect upon postfeminism as a critical term – as part of the lexicon of feminist scholarship - and secondly to discuss the current features of postfeminism as a sensibility. The first part of the paper discusses the extraordinary uptake of the term, and considers its continuing relevance in a changed context m...
May, Anne M; Struijk, Ellen A; Fransen, Heidi P; Onland-Moret, N Charlotte; de Wit, G Ardine; Boer, Jolanda M A; van der Schouw, Yvonne T; Hoekstra, Jeljer; Bueno-de-Mesquita, H Bas; Peeters, Petra H M; Beulens, Joline W J
The association between single health behaviours and incidence of and premature mortality from major chronic diseases, including myocardial infarction, stroke, diabetes mellitus, and cancer, has been demonstrated thoroughly. However, the association of several healthy behaviours with Disability-Adjusted Life Years (DALYs), which is a measure for total health combining Years Lost due to Disability and the Years of Life Lost due to premature mortality, has not been studied yet. A prospective cohort study was conducted among 33,066 healthy men and women aged 20 to 70 years recruited into the EPIC-NL study during 1993 to 1997. Participants' smoking status, BMI, physical activity, and adherence to a Mediterranean-style diet (excluding alcohol) were investigated separately and combined into a simple health behaviour score ranging from 0 to 4. Participants were followed until the end of 2007 for occurrence of and mortality from the most important chronic diseases. The association between lifestyle (separate lifestyle factors and a simple health behaviour score) and DALYs were adjusted for relevant confounders. After a median follow-up of 12.4 years, 6,647 disease incidences and 1,482 deaths were documented. Non-smoking, low BMI (BMI healthy lifestyle characteristics lived a minimum of 2 years longer in good health (DALYs: -2.13; 95% CI: -2.65 to -1.62) than persons with none. Due to our non-extinct cohort, the total number of DALYs, and consequently the estimates, is underestimated. Therefore, true lifetime health benefits of a healthy lifestyle will be even larger. Non-smoking, a low BMI, being physically active, and adherence to a Mediterranean diet were associated with a lower disease burden. Each additional healthy lifestyle factor contributed to a longer life in good health.
Alcilene Maria Gomes
Full Text Available Abstract Introduction: In the child’s first year of life, motor development is critical for the other areas of child development. Beliefs and parenting practices influence the parents’ care and encouragement of their children, reflecting in their motor development; however, the Brazilian literature on this subject is scarce. Objective: to characterize the parental practices and beliefs associated with motor development in the first year of life; and to verify if practices and beliefs are interrelated. Methods: Two questionnaires were developed and applied, one about parenting practices and the other about parental beliefs on motor development in the first year life, to 27 caregivers of children between 12 and 24 months of age, who participated in an aquatic stimulation program. The agreement between practices and beliefs was verified by a graphical method, based on the transformation of ordinal scores to an interval scale using Rasch analysis. Results: The participants had higher levels of education and economic status. They reported a variety of practices focused on the motor development of their children, such as family interaction through playing, toy offers, lap time and free movement space. Conclusion: Most of the practices were based on parental beliefs, for some activities, however, beliefs and practices diverged, demonstrating the complexity inherent to the formation of parental beliefs.
Sugiyama, Mikio; Arakawa, Hirokazu; Ozawa, Kiyoshi; Mizuno, Takahisa; Mochizuki, Hiroyuki; Tokuyama, Kenichi; Morikawa, Akihiro
In a prospective birth cohort study, we sought to identify perinatal predictors of the occurrence of atopic dermatitis in the first year of life. Associations of family history, infection during pregnancy, cord blood cytokine concentrations, and skin function parameters with atopic dermatitis were analyzed. Stratum corneum hydration was measured with an impedance meter until 5 days after delivery and again at 1 month. Complete data were obtained for 213 infants, including 27 diagnosed by a physician as having atopic dermatitis during their first year and 26 diagnosed as having infantile eczema during their first month. The risk of atopic dermatitis during the first year of life was related to maternal atopic dermatitis, lower concentrations of macrophage inflammatory protein-1beta in cord blood, and greater skin moisture in the surface and stratum corneum of the forehead and cheek at 1 month of age but not to viral or bacterial infection during pregnancy or breastfeeding. Paternal hay fever was associated negatively with the development of atopic dermatitis. High concentrations of interleukin-5, interleukin-17, and macrophage chemotactic protein-1 and only surface moisture in the cheek were associated with greater risk of infantile eczema in the first month. The association of atopic dermatitis in infancy with reduced neonatal macrophage inflammatory protein-1beta levels suggests a link with immature immune responses at birth. Stratum corneum barrier disruption in atopic dermatitis may involve impairment of cutaneous adaptation to extrauterine life. The majority of risk factors had different effects on infant eczema and atopic dermatitis, indicating different causes.
Hofhuis, Ward; Hanekamp, Manon N; Ijsselstijn, Hanneke; Nieuwhof, Eveline M; Hop, Wim C J; Tibboel, Dick; de Jongste, Johan C; Merkus, Peter J F M
To collect longitudinal data on lung function in the first year of life after extracorporeal membrane oxygenation and to evaluate relationships between lung function and perinatal factors. Longitudinal data on lung function in the first year of life after extracorporeal membrane oxygenation are lacking. Prospective longitudinal cohort study. Outpatient clinic of a tertiary level pediatric hospital. The cohort consisted of 64 infants; 33 received extracorporeal membrane oxygenation for meconium aspiration syndrome, 14 for congenital diaphragmatic hernia, four for sepsis, six for persistent pulmonary hypertension of the neonate, and seven for respiratory distress syndrome of infancy. Evaluation was at 6 mos and 12 mos; 39 infants were evaluated at both time points . None. Functional residual capacity and forced expiratory flow at functional residual capacity were measured and expressed as z score. Mean (sem) functional residual capacities in z score were 0.0 (0.2) and 0.2 (0.2) at 6 mos and 12 mos, respectively. Mean (sem) forced expiratory flow was significantly below average (z score = 0) (p capacity significantly above normal: mean (sem) z score = 1.2 (0.5). Infants treated with extracorporeal membrane oxygenation have normal lung volumes and stable forced expiratory flows within normal range, although below average, within the first year of life. There is reason to believe, therefore, that extracorporeal membrane oxygenation either ameliorates the harmful effects of mechanical ventilation or somehow preserves lung function in the very ill neonate.
Full Text Available Structural covariance examines covariation of gray matter morphology between brain regions and across individuals. Despite significant interest in the influence of age on structural covariance patterns, no study to date has provided a complete life span perspective—bridging childhood with early, middle, and late adulthood—on the development of structural covariance networks. Here, we investigate the life span trajectories of structural covariance in six canonical neurocognitive networks: default, dorsal attention, frontoparietal control, somatomotor, ventral attention, and visual. By combining data from five open-access data sources, we examine the structural covariance trajectories of these networks from 6 to 94 years of age in a sample of 1,580 participants. Using partial least squares, we show that structural covariance patterns across the life span exhibit two significant, age-dependent trends. The first trend is a stable pattern whose integrity declines over the life span. The second trend is an inverted-U that differentiates young adulthood from other age groups. Hub regions, including posterior cingulate cortex and anterior insula, appear particularly influential in the expression of this second age-dependent trend. Overall, our results suggest that structural covariance provides a reliable definition of neurocognitive networks across the life span and reveal both shared and network-specific trajectories. The importance of life span perspectives is increasingly apparent in understanding normative interactions of large-scale neurocognitive networks. Although recent work has made significant strides in understanding the functional and structural connectivity of these networks, there has been comparatively little attention to life span trajectories of structural covariance networks. In this study we examine patterns of structural covariance across the life span for six neurocognitive networks. Our results suggest that networks exhibit
Robert M Shavelle
Full Text Available Robert M Shavelle1, David R Paculdo1, Scott J Kush1, David M Mannino2, David J Strauss11Life Expectancy Project, San Francisco, CA, USA; 2Pulmonary Epidemiology Research Laboratory, University of Kentucky School of Medicine, Division of Pulmonary and Critical Care Medicine, Lexington, KY, USARationale: Previous studies have demonstrated that chronic obstructive pulmonary disease (COPD causes increased mortality in the general population. But life expectancy and the years of life lost have not been reported.Objectives: To quantify mortality, examine how it varies with age, sex, and other risk factors, and determine how life expectancy is affected.Methods: We constructed mortality models using the Third National Health and Nutrition Examination Survey, adjusting for age, sex, race, and major medical conditions. We used these to compute life expectancy and the years of life lost. Measurements and main results: Pulmonary function testing classifi ed patients as having Global Initiative on Obstructive Lung Disease (GOLD stage 0, 1, 2, 3 or 4 COPD or restriction. COPD is associated with only a modest reduction in life expectancy for never smokers, but with a very large reduction for current and former smokers. At age 65, the reductions in male life expectancy for stage 1, stage 2, and stages 3 or 4 disease in current smokers are 0.3 years, 2.2 years, and 5.8 years. These are in addition to the 3.5 years lost due to smoking. In former smokers the reductions are 1.4 years and 5.6 years for stage 2 and stages 3 or 4 disease, and in never smokers they are 0.7 and 1.3 years.Conclusions: Persons with COPD have an increased risk of mortality compared to those who do not, with consequent reduction in life expectancy. The effect is most marked in current smokers, and this is further reason for smokers to quit.Keywords: survival, mortality, longevity, COPD
Angarne-Lindberg, Teresia; Wadsby, Marie
The children who experienced their parents' divorce when the divorce rate in Sweden had begun to grow to higher levels than in preceding decades are today adults. The aim of this study was to investigate if adults who had experienced parental divorce 15 years before the time of our study, differed in mental health from those with continuously married parents, taking into account life events other than the divorce. Instruments used were the Symptom Checklist (SCL-90) measuring mental health and the Life Event questionnaire capturing the number and experience of occurred events. Forty-eight persons, who were 7-18 years old when their parents divorced, constituted the divorce group, and 48 persons matched on age, sex and growth environment formed the study groups. The SCL-90 showed a limited difference between the groups, but not concerning total mental health. A main finding was a difference with regard to sex and age; women aged 22-27 in the divorce group displayed poorer mental health than other participants in both groups. The results from the Life Event questionnaire showed that the divorce group had experienced a significantly larger number of events, and more life events were described as negative with difficult adjustment. A regression analysis showed a significant relation between the SCL-90, Global Severity Index and life events experienced as negative with difficult adjustment, divorce events excluded, but not with the divorce itself. It seems highly desirable to pay more attention than has thus far been paid to girls with experience of childhood divorce at age 7-12.
Full Text Available Background: Alopecia areata (AA is the most common cause of localized, non-scarring alopecia. Stress and other psychological factors have been implicated in the causation of the disease, and it is also found to alter the course of the disease process. Unfortunately no one has studied the impact of AA on the quality of life, which includes the social life of the patients. Aim: To study the clinical profile and impact of alopecia areata on the quality of life, including the social life of adult patients with severe forms of the disease. Methods: The present study determined the clinical pattern of AA and its impact on the quality of life (QOL in all the patients with severe forms of alopecia areata attending the Dermatology Outpatient Department. Results: The male : female ratio was 1.86 : 1. Most (58.03% of the patients were between 21 and 40 years of age. Almost 40% of the patients had associated systemic disease or other dermatological disorders. A family history of AA was found in 593 (20.02% of the patients. Nail changes were observed in 297 (10% of the patients. There were significant differences between the mean Dermatology Life Quality Index (DLQI score in cases with severe forms of AA and controls ( p0 < 0.001. Conclusions: Severe forms of alopecia areata had a major impact on the psychosocial well-being of the patients. These individuals had to be treated early, and they required more than just prescription drugs. Educational and psychological support in addition to medical therapy for AA could improve their long-term physical outcomes.
Paul R Torgerson
Full Text Available Leptospirosis, a spirochaetal zoonosis, occurs in diverse epidemiological settings and affects vulnerable populations, such as rural subsistence farmers and urban slum dwellers. Although leptospirosis can cause life-threatening disease, there is no global burden of disease estimate in terms of Disability Adjusted Life Years (DALYs available.We utilised the results of a parallel publication that reported global estimates of morbidity and mortality due to leptospirosis. We estimated Years of Life Lost (YLLs from age and gender stratified mortality rates. Years of Life with Disability (YLDs were developed from a simple disease model indicating likely sequelae. DALYs were estimated from the sum of YLLs and YLDs. The study suggested that globally approximately 2.90 million DALYs are lost per annum (UIs 1.25-4.54 million from the approximately annual 1.03 million cases reported previously. Males are predominantly affected with an estimated 2.33 million DALYs (UIs 0.98-3.69 or approximately 80% of the total burden. For comparison, this is over 70% of the global burden of cholera estimated by GBD 2010. Tropical regions of South and South-east Asia, Western Pacific, Central and South America, and Africa had the highest estimated leptospirosis disease burden.Leptospirosis imparts a significant health burden worldwide, which approach or exceed those encountered for a number of other zoonotic and neglected tropical diseases. The study findings indicate that highest burden estimates occur in resource-poor tropical countries, which include regions of Africa where the burden of leptospirosis has been under-appreciated and possibly misallocated to other febrile illnesses such as malaria.
Henning, Marcus A; Sollers, John; Strom, Joanna M; Hill, Andrew G; Lyndon, Mataroria P; Cumin, David; Hawken, Susan J
There is a burgeoning interest in, and evidence of, quality of life and burnout issues among doctors. It was hypothesized that the junior doctors in this study would experience psychosocial and physiological changes over time, and that the obtained measures would indicate psychosocial and physiological anomalies. In addition, it was hypothesized that their psychosocial perceptions would be significantly associated with their physiological measures. A total sample of 17 junior doctors in their first year of training volunteered for this study. Over four time periods separated by 6 week phases, the doctors completed a set of quality of life and psychosocial inventories and wore a Polar RS800 Heart Rate Monitor over a day and night time interval. The findings showed that this sample of doctors did not report any problems associated with depression, anxiety, stress, burnout or quality of life (psychosocial measures). In addition, their heart rate variability scores (physiological measures) did not show any significant fluctuations. Furthermore, the responses from the self-report instruments measuring stress, anxiety, depression, quality of life and burnout did not consistently correlate with the HRV information suggesting a mind-body disconnection. More work needs to be done on larger samples to investigate these findings further given that the literature shows that junior doctors are likely to be stressed and working in stress-provoking environments.
Holland, Jason M; Schutte, Kathleen K; Brennan, Penny L; Moos, Rudolf H
Past studies of the underlying structure of depressive symptoms have yielded mixed results, with some studies supporting a continuous conceptualization and others supporting a categorical one. However, no study has examined this research question with an exclusively older adult sample, despite the potential uniqueness of late-life depressive symptoms. In the present study, the underlying structure of late-life depressive symptoms was examined among a sample of 1,289 individuals across 3 waves of data collection spanning 20 years. The authors employed a taxometric methodology using indicators of depression derived from the Research Diagnostic Criteria (R. L. Spitzer, J. Endicott, & E. Robins, 1978). Maximum eigenvalue analyses and inchworm consistency tests generally supported a categorical conceptualization and identified a group that was primarily characterized by thoughts about death and suicide. However, compared to a categorical depression variable, depressive symptoms treated continuously were generally better predictors of relevant criterion variables. These findings suggest that thoughts of death and suicide may characterize a specific type of late-life depression, yet a continuous conceptualization still typically maximizes the predictive utility of late-life depressive symptoms.
The aim of this thesis is to study early life risk exposures in relation to adult health and mortality in Sweden during 250 years. A number of causal mechanisms by which exposure to diseases and stressful economic and social conditions early in life may lead to increased morbidity and mortality later in life are discussed (paper I). The early life exposures investigated are the foetal origins (nutrition) and the inflammation hypotheses. Longitudinal demographic and socioeconomic data for indi...
Zhu, Bifan; Li, Fen; Wang, Changying; Wang, Linan; He, Zhimin; Zhang, Xiaoxi; Song, Peipei; Ding, Lingling; Jin, Chunlin
One aim of the current study was to track end-of-life care using individual data in Shanghai, China to profile hospital costs for decedents and those for the entire population. A second aim of this study was to clarify the effect of proximity to death. Data from the Information Center of the Shanghai Municipal Commission of Health and Family Planning (SMCHFP) were examined. For decedents who died in medical facilities in 2015, inpatient care was tracked for 1 year before death. A total of 43,765 decedents were included in the study, accounting for 35% of total deaths in 2015 in Shanghai. Hospital costs were higher for people who died before the age of 45 (14,228.62 USD) than for those aged 90 or older (8,696.34 USD). The ratio of costs for decedents to the entire population declined significantly with age. Women received less care than men in the last year of life (t = -15.1244, p gender equity when examining end-of-life medical costs in the future.
Williamson, Meredith L C; Elliott, Timothy R; Bogner, Jennifer; Dreer, Laura E; Arango-Lasprilla, Juan Carlos; Kolakowsky-Hayner, Stephanie A; Pretz, Christopher R; Lequerica, Anthony; Perrin, Paul B
This study investigated the influence of race, gender, functional ability, and an array of preinjury, injury-related, and sociodemographic variables on life satisfaction trajectories over 10 years following moderate to severe traumatic brain injury (TBI). A sample of 3157 individuals with TBI from the TBI Model Systems database was included in this study. Hierarchical linear modeling (HLM) analyses were conducted to examine the trajectories of life satisfaction. The Functional Independence Measure, Glasgow Coma Scale, and the Satisfaction With Life Scale were utilized. Initial models suggested that life satisfaction trajectories increased over the 10-year period and Asian/Pacific Islander participants experienced an increase in life satisfaction over time. In a comprehensive model, time was no longer a significant predictor of increased life satisfaction. Black race, however, was associated with lower life satisfaction, and significant interactions revealed that black participants' life satisfaction trajectory decreased over time while white participants' trajectory increased over the same time period. Life satisfaction trajectories did not significantly differ by gender, and greater motor and cognitive functioning were associated with increasingly positive life satisfaction trajectories over the 10 years. Individuals with more functional impairments are at risk for decreases in life satisfaction over time. Further research is needed to identify the mechanisms and factors that contribute to the lower levels of life satisfaction observed among black individuals post-TBI. This work is needed to determine strategic ways to promote optimal adjustment for these individuals.
Chin, Wei-Shan; Guo, Yue Leon; Liao, Shih-Cheng; Wu, Hsueh-Ching; Kuo, Chun-Ya; Chen, Chih-Chieh; Shiao, Judith Shu-Chu
Occupational injuries have considerable impact on workers' lives. However, data regarding workers' health-related quality of life (HRQOL) at several years after the injury are lacking. This study assessed workers' HRQOL at 6 years after occupational injury and determined related factors in each HRQOL domain. Workers who sustained an occupational injury in 2009 and who responded to a previous survey at 3 or 12 months after their injury were followed up in 2015. A total of 1715 participants were candidates for this study. The Taiwanese version of the World Health Organization Quality of Life scale-abbreviated version (WHOQOL-BREF) was used to assess their HRQOL. Multiple linear regression analysis identified predictive factors for HRQOL at 6 years after occupational injury. A total of 563 workers completed the questionnaire (response rate, 32.8%). Adverse life events and additional severe occupational injuries that occurred within the follow-up period, and decreased salary after the injury were significant factors for low scores in all domains of the WHOQOL-BREF. In addition, unmarried participants had low scores in the social relationship domain. Workers with family members requiring care scored low in the physical and environment domains. Workers whose injuries had major effects on their physical appearance had low scores in the physical and psychological domains. Workers with unstable employment had low scores in physical, psychological, and environment domains. At 6 years after occupational injury, workers' HRQOL was poor among those whose salaries decreased after the injury, after adjustment for other factors.
Arbuckle, T.E.; Hauser, R.; Swan, S.H.
An international workshop tided "Assessing Endocrine-Related Endpoints within the First Years of Life" was held 30 April-1 May 2007, in Ottawa, Ontario, Canada. Representatives from a number of pregnancy cohort studies in North America and Europe presented options for measuring various endocrine......-sensitive endpoints in early life and discussed issues related to performing and using those measures. The workshop focused on measuring reproductive tract developmental endpoints [e.g., anogenital distance (AGD)], endocrine status, and infant anthropometry. To the extent possible, workshop participants strove...... on the genital exam. Although a number of outcome measures recommended during the genital exam have been associated with exposure to endocrine-disrupting chemicals, little is known about how predictive these effects are of later reproductive health or other chronic health conditions....
Kleijkers, Sander H. M.; van Montfoort, Aafke P. A.; Smits, Luc J. M.; Viechtbauer, Wolfgang; Roseboom, Tessa J.; Nelissen, Ewka C. M.; Coonen, Edith; Derhaag, Josien G.; Bastings, Lobke; Schreurs, Inge E. L.; Evers, Johannes L. H.; Dumoulin, John C. M.
Is post-natal growth during the first 2 years of life in IVF singletons affected by type of medium used for culturing human embryos during an IVF treatment? The in vitro culture of human embryos in medium from Cook resulted in singletons with a lower weight during the first 2 years of life compared
Melle, Ingrid; Røssberg, Jan Ivar; Joa, Inge
The main aim of this study was to examine changes in subjective quality of life (general s-QoL) in patients with first-episode psychosis from baseline to 2 years follow-up. A total of 201 of 252 patients had full quality of life assessment at both baseline and at 2 years. Repeated measure analyse...
Conclusions: The main source of varicella virus among hospitalized children in the first year of life is home contact. An infant may become infected from its mother suffering from zoster. Children who are exclusively breastfed and are born of mothers who have previously had varicella may develop varicella with a severe course during the first year of life.
Gana, Kamel; Bailly, Nathalie; Saada, Yaël; Joulain, Michèle; Alaphilippe, Daniel
The unexpected positive relationship between aging and happiness was called "the paradox of well-being," which is still a matter of debate. This study examined longitudinal change in life satisfaction (LS) in older adults. LS was assessed with the satisfaction with life scale, in a sample of individuals (N = 899; aged 62-95 years, at first occasion; M = 72.73, SD = 5.68) for a period of 8 years (5 waves of data). A multiple indicator (e.g., second order) growth modeling was used to assess change in LS. Findings from both unconditional and conditional model (in which time-invariant, i.e., age, gender, and education, and time-varying, i.e., self-perceived health, covariates were incorporated in the model) indicated a linear increase in LS for the 8-year period. As expected, the results showed significant random variation in both intercept and slope, indicating that participants start at different levels and change at different rates. Our findings contribute to the debate concerning the paradox of well-being, which calls for explanation. There are few theories that provide some explanation (e.g., the socioemotional selectivity theory). However, to enhance researchers' understanding of developmental changes that contribute to the paradox of well-being, a more integrative theoretical model is needed.
Bibi, S.; Iqblal, A.; Ayaz, S.B.; Khan, A.A.; Matee, S.
Objective: To evaluate the demographics of individuals presented with oropharyngeal dysphagia, correlation of different demographic factors with the quality of life (QOL) after validation of the Urdu translation of Swallowing Quality of Life (SWAL-QOL) questionnaire. Methodology: A cross-sectional survey, carried out at the speech and language therapy department of Armed Forces Institute of Rehabilitation Medicine, Rawalpindi from July 2013 to January 2014 enrolling patients > 50 years of age with oropharyngeal dysphagia and scoring them on Urdu translation of SWAL-QOL questionnaire. The reliability of the tool was measured through Cronbach's alpha coefficient. Results: Of 40 patients, majority (60%) were males, married (62.5 %), illiterate (80%) and settling in age group of 51- 61 years. Most of them were from Punjab (30%) and Sindh (30%). The most common primary pathology was stroke (47.5%).The mean SWAL-QOL score was 147±13 (Range: 124 - 176). Most domains of questionnaire had Cronbach's alpha coefficient = 0.7. No variable was found to be significantly affecting SWAL-QOL score. Conclusion: The Urdu-translated version of SWAL-QOL is a valid tool. QOL in Pakistani patients of age > 50 years with oropharyngeal dysphagia is adversely affected, however, it does not depend on age, gender, marital status, education, ethnicity based on provinces or primary pathology for dysphagia. (author)
Costa-Requena, Gema; Cantarell, M Carmen; Moreso, Francesc; Parramon, Gemma; Seron, Daniel
Health related quality of life (HRQoL) is recognized as an outcome measure in kidney transplantation. In this study was assessed changes on HRQoL and kidney-specific symptoms, also was evaluated the effect of socio-demographic and clinical parameters on patient's perceived HRQoL. A longitudinal study was done, at 5 time-points over 2 years after transplantation. To evaluate HRQoL the Kidney Disease Quality of Life Questionnaire Short Form was administrated, and Hospital Anxiety and Depression Scale was used to assess psychological distress. At 6-months after transplantation, patients had similar HRQoL scores compared to the general population. The improvement on effects of kidney disease domain could be considered as large (η 2 =0.29), and medium on burden of kidney disease domain (η 2 =0.12), work status domain (η 2 =0.12), and sexual function domain (η 2 =0.13). Psychological distress, depressive symptoms, haemoglobin, and serum creatinine had significant influence on patient's perceived HRQoL over 2 years after transplantation. An improvement of HRQoL was observed on general and specific-targeted symptoms over 2 years after renal transplantation. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.
Hernandez, M.; Sanchez, E.; Sobradillo, B.; Rincon, J.M.; Narvaiza, J.L.
We present an original scoring method for assessing skeletal maturity in the first 2 years of life. We propose a lateral radiograph of the ankle and foot. Five different bony centers were examined: The calcaneus, the cuboid, the third cuneiform, the distal tibial epiphysis and the distal fibular epiphysis. The maturity scores given to the different stages of each bony center were calculated in proportion to the coefficients of regression between the skeletal maturity and a factor that expresses the influence of weight and head circumference as high multiple correlation coefficients of skeletal maturity with the factor obtained (0.920 for boys ad 0.929 for girls). Our method was standardized in a children population of less than two years of life in Biscaye, where 1,164 radiographs were taken. The distribution of scores in this study shows the discriminative ability of our method and its validity as an adequate method for skeletal maturity assessment in children less than 2 years of age. (orig.)
Garced, Sheyla; Torres-Sánchez, Luisa; Cebrián, Mariano E.; Claudio, Luz; López-Carrillo, Lizbeth
Background: Due to its long-term persistence in the environment and its ability to cross the placental barrier, prenatal p,p′-dichlorodiphenyldichloroethene (DDE) exposure continues to be a public health concern. This study aimed to evaluate the association between prenatal DDE exposure and child growth, at birth and during the first year of life. Methods: 253 pregnant women were recruited between January 2001 and June 2005 in a prospective cohort in Morelos, Mexico. Serum levels of DDE were measured during each trimester of pregnancy by gas chromatography with an electron capture detector. Using the generalized mixed-effects models, the association between DDE and child growth parameters (weight-for-age, length-for-age, weight-for-length, BMI-for-age and head circumference-for-age Z-scores) from birth to 1 year of age was assessed. Maternal dietary intake was considered as covariable among others. Results: DDE levels were 6.3±2.8 ng/mL (first trimester), 6.6±2.9 ng/mL (second trimester), and 7.6±2.9 ng/mL (third trimester). After adjusting for potential confounder variables, no significant associations were observed with prenatal DDE exposure and each of the selected parameters. Conclusions: Our results show no evidence of an association between prenatal DDE exposure and child growth during the first year of life.
Schanz, Stefan; Reimer, Thorisa; Eichner, Martin; Hautzinger, Martin; Häfner, Hans-Martin; Fierlbeck, Gerhard
To describe the long-term effects of infertility on life and partnership satisfaction. Longitudinal cohort study. A university outpatient andrology and gynecology infertility clinic. 275 men and 272 women treated for infertility between August 2000 and December 2001. None. The Life Satisfaction Questionnaire (FLZ), the Partnership Questionnaire (PFB), and sociodemographic items at baseline (T1) and 5 years later (T2). Compared with a representative sample, our male and female participants had higher Finance and Partnership scores and lower Health scores on the FLZ at T1. They also had markedly higher PFB scores, with the exception of Conflict Behavior. After 5 years (T2), 101 men and 113 women rated the Partnership and Sexuality FLZ subscales as well as all the PFB subscales statistically significantly lower than at baseline. Only the women rated the Self-esteem FLZ subscale lower than at baseline (T1). Participants who became parents had lower Leisure and Partnership FLZ subscale scores, and fathers had lower Finance FLZ subscale scores. Satisfaction declined over 5 years for both men and women, but only in the partnership-related domains. Women were more affected than men. The success of infertility treatment had only a minor influence on a couple's future satisfaction. Copyright © 2011. Published by Elsevier Inc.
Hotoura, Efthalia; Giapros, Vasilios; Drougia, Aikaterini; Argyropoulou, Maria; Papadopoulou, Frederica; Nikolopoulos, Panayiotis; Andronikou, Styliani
Small-for-gestational-age (SGA) infants have been reported to have a significantly reduced number of nephrons that could be a risk factor for development of hypertension later in life. To evaluate kidney size prospectively in relation to other anthropometric parameters during the first year of life in SGA babies. The babies in the study were 31-36 weeks' gestational age (GA) at birth and were matched with control preterm infants of similar GA, but appropriate for gestational age (AGA). The SGA infants were further classified as symmetrical and asymmetrical according to the anthropometric parameters. The total number of measurements in symmetrical SGA preterm infants was 324, in asymmetrical SGA preterm infants 295, and in AGA infants 536. In symmetrical SGA preterm infants (31-36 weeks' GA) mean kidney length (± SD) of 56±4 mm was significantly different from the controls (58.9±4.6 mm) up to 6 months' chronological age (P < 0.05). In the asymmetrical SGA preterm infants, mean kidney length (45.3±4.0 mm) was significantly different from the controls (48.2±4.4 mm) up to 40 weeks' corrected age. At 1 year chronological age, all preterm infants (symmetrical and asymmetrical SGA and AGA) had similar mean kidney length (61.6±4.6, 62.8±4.3, and 62.3±4.0 mm, respectively). The ratio of kidney length to crown-to-heel length was similar in all preterm groups. Kidney length in preterm SGA infants (symmetrical and asymmetrical) follows closely the other auxological parameters during the first year of life. (orig.)
Braam, Arjan W; Schaap-Jonker, Hanneke; van der Horst, Marleen H L; Steunenberg, Bas; Beekman, Aartjan T F; van Tilburg, Willem; Deeg, Dorly J H
Growing evidence shows several possible relations between religiousness and late-life depression. Emotional aspects of religiousness such as facets of the perceived relationship with God can be crucial in this connection. The aim of the current study was to examine the association between the course of late-life depression and feelings about God and religious coping. Longitudinal survey study; naturalistic; 12-year follow-up. Longitudinal Aging Study Amsterdam; population-based, in three regions in The Netherlands. A subsample of 343 respondents (mean age: 77.2 years), including all respondents with high levels of depressive symptoms at any measurement cycle between 1992 and 2003 (assessed by using the Center for Epidemiologic Studies Depression Scale and the Diagnostic Interview Schedule) and a random sample of nondepressed respondents who completed a postal questionnaire in 2005. Scales on God Image and Religious Coping. Twelve-year depression course trajectories serve as predicting variables and are specified according to recency and seriousness. Persistent and emergent depression are significantly associated with fear of God, feeling wronged by God, and negative religious coping. In terms of negative religious coping, significant associations were observed after adjustment for concurrent depression with a history of repeated minor depression and previous major depression. Late-life depression seems to maintain a pervasive relationship over time with affective aspects of religiousness. Religious feelings may parallel the symptoms of anhedonia or a dysphoric mood and could represent the experience of an existential void. Copyright © 2014 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.
Choe, Young June; Kim, Jong-Hee; Son, Hyun Jin; Bae, Geun-Ryang; Lee, Duk-hyoung
Because the peak age for incidence of sudden deaths in infancy temporally coincides with the age of infant primary immunization, some have raised the question as to whether immunization is a risk factor for sudden death in infancy. Recent occurrence of two sudden deaths in infants in Korea has renewed concerns about the causal association between immunization and sudden deaths in infants. We carried out a retrospective review of data from the Korea Centers for Disease Control and Prevention Adverse Events Following Immunization Surveillance System and Vaccine Compensation programs. From 1994 to 2011, a total of 45 cases of sudden deaths in the first 2 years of life following immunization were reported in Korea. The causes of death were classified as follows: infectious diseases (n= 13); accidental injuries (n= 7); congenital abnormalities (n= 2); and malignancy (n= 1). Of 20 sudden deaths in infancy, nine deaths met Brighton Collaboration case definition level I and II, and therefore were classified as possible sudden infant death syndrome cases. Hepatitis B vaccine (n= 13) was the most frequent vaccine with temporal association with sudden deaths in the first 2 years of life. Few sudden deaths in the first 2 years of life following immunization have been reported, despite the use of universal immunization in Korea. The majority of deaths in infancy did not meet case definition for sudden infant death syndrome. Encouraging investigators to perform thorough investigation, including postmortem autopsy and death scene examination, may promote data comparability and provide guidance on decision-making in the vaccine-safety monitoring and response system in Korea. © 2012 The Authors. Pediatrics International © 2012 Japan Pediatric Society.
Simony, A.; Christensen, Steen Bach; Carreon, L. Y.
Introduction: The purpose of this study was to evaluate the long term clinical outcomes using validated measures of health-related qualityof- life (HRQOL), 25 years after termination of scoliosis treatment, in a cohort of Adolescent Idiopathic Scoliosis Patients. Method: 219 consecutive patients...... neurological disease and 2 were deceased. The total follow up was 170 patients (83 %), and the average follow up was 24.5 years (range 22-30 years). In the Brace group, the Cobb angel prior to treatment was 37.5degree (35.1degree-40.0degree), after treatment 34.7degree (31.9degree-37.5degree). Cobb angel after...... 20 years 40.2degree (36.7degree-43.6degree). In the surgical group the Cobb angel prior to treatment was 54.5degree (50.4degree-58.8degree), 1 year postoperative 29.5degree (25.7degree-33.9degree).Cobb angel after 20 years 32.35degree (27.9degree-39.5degree). 26 patients had distal segment...
Gerstorf, Denis; Ram, Nilam; Schupp, Jürgen; Sprangers, Mirjam A. G.; Wagner, Gert G.
Objective. We examined the extent to which retrospective proxy reports of well-being mirror participant self-reports at 12–24 months before death and how proxy reports of well-being change over the last year of life. We also explored the role of sociodemographic, cognitive, and health factors of both participants and proxies in moderating such associations. Method. We used retrospective proxy ratings obtained in the German Socio-Economic Panel Study (N = 164; age at death = 19–99 years). Results. Results revealed moderate agreement between self- and proxy reports (r = .42), but proxies, on average, overestimated participants’ life satisfaction by two thirds of a scale point on a 0–10 scale (or 0.4 SD). Discrepancies were particularly pronounced when proxies themselves reported low life satisfaction. Over the last year of life, participants were viewed to have experienced declines in life satisfaction (−0.54 SD). Declines were stronger for ill participants and proxies who reported low life satisfaction. Discussion. Results qualify theoretical expectations and empirical results based on self-report data that are typically available 1 or 2 years before death. We discuss that retrospective proxy reports in panel surveys can be used as a hypothesis-generating tool to gather insights into late life. PMID:23766436
van Leeuwen, Christel M C; Post, Marcel W M; van Asbeck, Floris W A; Bongers-Janssen, Helma M H; van der Woude, Lucas H V; de Groot, Sonja; Lindeman, Eline
To describe the course of life satisfaction in persons with spinal cord injury (SCI) during the first 5 years after discharge from inpatient rehabilitation and to examine its determinants. Multi-centre prospective cohort study with four measurements, the first at discharge from inpatient rehabilitation, the last 5 years after discharge. Data of 162 persons with SCI were analyzed. Life satisfaction was measured as the sum score of 'current life satisfaction' and 'current life satisfaction compared to life satisfaction before SCI'. Lesion characteristics, functional independence, secondary impairments, pain, social support and self-efficacy were analyzed as possible determinants of life satisfaction. Random coefficient analysis was used for the analyses. No significant changes in life satisfaction were found between discharge and 2 years later, however there were significant increases from two to 5 years post discharge. High functional independence, low pain, high everyday social support and high self-efficacy were significant determinants of a positive course of life satisfaction after discharge. Increases in life satisfaction were found in persons with SCI in the long run. High functional status, low pain, good social skills and high self-efficacy were related to high life satisfaction.
Brossard Alejo, Julio S; Rodriguez Herrera, Ernesto; Tablada, Ricardo Hodelin; Romero Garcia, Lazaro I.
A descriptive, longitudinal and retrospective study of 8 patients with tumors of the central nervous system in the first year of life was carried out. They were diagnosed in the Southern Children Hospital of Santiago de Cuba from 1987 to 2008, 5 of them (62,5%) had died when the present article was made. The treatments indicated in this case are the resection of the tumor mass, the most radical surgery depending on its size and localization, as well as the chemotherapy according to the tissular type
Høgh, Vibeke; Cummings, Elisabeth; Riahi, Sam
Healthcare services target delivery of a connected patient journey as an indicator of a high quality of care, but knowledge of the patients’ experience is sparse. This case study explores the lived experience of the quality of life and perception of health during the first year of the journey...... of a person recently diagnosed with atrial fibrillation. Data sources include field notes, transcripts, medical records, letters, and scores from standardized questionnaires. A phenomenologically inspired approach for qualitative data analysis and a descriptive approach for discovering exceptional changes...
Erlangsen, Annette; Andersen, Per Kragh; Toender, Anita
mortality due to medical diseases and disorders among people with mental disorders emphasises the need for future interventions to address these aspects as well as the continued high shares of excess mortality due to alcohol misuse, suicide, and accidents. FUNDING: The Lundbeck Foundation Initiative...... diseases (men: 1·2; women: 0·3), and respiratory diseases (men: 0·3; women: 0·2), and a decrease for suicide (men: -0·7; women: -0·5) and accidents (men: -0·9; women: -0·5). INTERPRETATION: By applying a novel approach, more precise estimates of life-years lost were obtained. The increase in excess...
Nancy Amor Pérez
Full Text Available In this article, some considerations are explicit about the role of the family in the most sensitive period of life, the first year. It highlights the changes that have occurred in this educational agency today and its impact on child development, with emphasis on socio - affective area. It is a lso emphasized the stimulatin g role that everyone in the household must meet with the child, indicating affection as the fundamental nutrient not only to the physical development but also the psychological development of the child, since the leadership activity of the age is the emoti onal communication with the adult.
Meulen, Philipp an de; Mitze, Timo Friedel
In this work, we use residual values obtained from an estimated hedonic pricing model to assess the role of district-level neighbourhood effects for the spatial variation in quality-adjusted rental prices in Berlin between 2008 and 2013. By doing so, we also aim at identifying hot and cold spots ...... analysis (ESDA) toolbox, we finally pinpoint particular hot spots of the city’s residential property market associated with a significant spatial clustering of similar rental price values around individual observations....... proximity to the city centre compared to similar properties in Berlin’s periphery once we control for the properties’ physical characteristics. The observed temporal evolution of the rental price distribution between 2008 and 2013 thereby hints at an ongoing gentrification process in Germany’s capital...... associated with the current housing market boom. This visual impression is also confirmed by the application of quantile regressions for a correlation analysis between quality-adjusted rental price values and Berlin district-level characteristics obtained from the last census in 2011. Among other factors, we...
Houben, Carmen H M; Spruit, Martijn A; Schols, Jos M G A; Wouters, Emiel F M; Janssen, Daisy J A
Patient-clinician communication is an important prerequisite to delivering high-quality end-of-life care. However, discussions about end-of-life care are uncommon in patients with advanced chronic organ failure. The aim was to examine the quality of end-of-life care communication during one year follow-up of patients with advanced chronic organ failure. In addition, we aimed to explore whether and to what extent quality of communication about end-of-life care changes toward the end of life and whether end-of-life care communication is related to patient-perceived quality of medical care. Clinically stable outpatients (n = 265) with advanced chronic obstructive pulmonary disease, chronic heart failure, or chronic renal failure were visited at home at baseline and four, eight, and 12 months after baseline to assess quality of end-of-life care communication (Quality of Communication questionnaire). Two years after baseline, survival status was assessed, and if patients died during the study period, a bereavement interview was done with the closest relative. One year follow-up was completed by 77.7% of the patients. Quality of end-of-life care communication was rated low at baseline and did not change over one year. Quality of end-of-life care communication was comparable for patients who completed two year follow-up and patients who died during the study. The correlation between quality of end-of-life care communication and satisfaction with medical treatment was weak. End-of-life care communication is poor in patients with chronic organ failure and does not change toward the end of life. Future studies should develop an intervention aiming at initiating high-quality end-of-life care communication between patients with advanced chronic organ failure and their clinicians. Copyright © 2015 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.
Gabriela Maldonado Guzmán
Full Text Available The quality of life in patients with chronic problems as the asthma, at present performs major importance in view of the increase of the life expectancy. Nevertheless, often this one does not accompany of conditions biopsicosocial acceptable, that allow to the person to enjoy good emotional condition, as well as the accomplishment of his or her physical, social and school activities. The objective of this study is to know the quality life of the physical, emotional, social, and scholar valuation. Methodology: This study was realized with a number of 124 children sample in ages of 8 to 12 years old with asthma diagnostic.Results: The most damage aspects within quality life dimension were run, work out; lower energy and feeling pain. Emotional aspects were be worried about the future and insomnia, respect to social dimension the problem was children can’t keep in the same condition than others while they are playing; and about school dimension the problem was school absence because of their need of going to the doctor or hospital. Discussion: The aspects of the physical dimension that were more affected to are the follow: run, to do exercise, to have little energy, and to feel pain. Both first ones have relation with the (reported by the Spanish Society of Neumología and Paediatrics (s.f., Where they brought (reported that the children more affected because of the asthma to were those that run and to do exercise. With regard to having little energy and feeling pain, this can owe to persistent accesses of cough, that really they cause weakness and pain in the thoracic box. Conclusions: These results suggest that it is important to stimulate the self-esteem of the children who endure asthma across his participation in an equipment or group.
Moos, Rudolf H; Schutte, Kathleen K; Brennan, Penny L; Moos, Bernice S
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.
Moos, Rudolf H.; Schutte, Kathleen K.; Brennan, Penny L.; Moos, Bernice S.
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
Nazzi, T; Nishibayashi, L L; Berdasco-Muñoz, E; Baud, O; Biran, V; Gonzalez-Gomez, N
Previous studies have shown that preterm children are at a higher risk for cognitive and language delays than full-term children. Most of these studies have concentrated on the effects of prematurity during the preschool or school years, while the effect of preterm birth on the early development of language, much of which occurs during the first year of life, remains very little explored. This article focuses on this crucial period and reviews the studies that have explored early phonological and lexical development in preterm infants. The results of these studies show uneven proficiency in different language subdomains in preterm infants. This raises the possibility that different constraints apply to the acquisition of different linguistic subcomponents in this population, in part as a result of a complex interaction between maturation, experience, and language subdomains. Copyright © 2015 Elsevier Masson SAS. All rights reserved.
Katcher Brian S
Full Text Available Abstract Background A core function of local health departments is to conduct health assessments. The analysis of death certificates provides information on diseases, conditions, and injuries that are likely to cause death – an important outcome indicator of population health. The expected years of life lost (YLL measure is a valid, stand-alone measure for identifying and ranking the underlying causes of premature death. The purpose of this study was to rank the leading causes of premature death among San Francisco residents, and to share detailed methods so that these analyses can be used in other local health jurisdictions. Methods Using death registry data and population estimates for San Francisco deaths in 2003–2004, we calculated the number of deaths, YLL, and age-standardized YLL rates (ASYRs. The results were stratified by sex, ethnicity, and underlying cause of death. The YLL values were used to rank the leading causes of premature death for men and women, and by ethnicity. Results In the years 2003–2004, 6312 men died (73,627 years of life lost, and 5726 women died (51,194 years of life lost. The ASYR for men was 65% higher compared to the ASYR for women (8971.1 vs. 5438.6 per 100,000 persons per year. The leading causes of premature deaths are those with the largest average YLLs and are largely preventable. Among men, these were HIV/AIDS, suicide, drug overdose, homicide, and alcohol use disorder; and among women, these were lung cancer, breast cancer, hypertensive heart disease, colon cancer, and diabetes mellitus. A large health disparity exists between African Americans and other ethnic groups: African American age-adjusted overall and cause-specific YLL rates were higher, especially for homicide among men. Except for homicide among Latino men, Latinos and Asians have comparable or lower YLL rates among the leading causes of death compared to whites. Conclusion Local death registry data can be used to measure, rank, and
Carvalho-Neto, Arnolfo de; Ono, Sergio Eiji; Cardoso, Georgina de Melo; Santos, Mara Lucia Schmitz Ferreira; Celidonio, Izabela [Hospital Pequeno Principe, Curitiba, PR (Brazil)], e-mail: firstname.lastname@example.org
The oculocerebrorenal syndrome of Lowe (OCRL), was first recognized as a distinct disease in 1952 by Drs. Lowe, Terrey and MacLachlan at Massachusetts General Hospital, in Boston, USA, describing three male children with organic aciduria, decreased renal ammonia production, hydrophtalmos and mental retardation. The X-linked recessive inheritance pattern was recognized first by LeFebvre. It is present in all races, with a predominance in those of Caucasian and Asian ancestries. Rarely females are affected. It is a very rare disease, with estimated prevalence in the general population of 1 in 500,000. In USA the Lowe Syndrome Association (LSA) documented 190 living patients in the year 2000 (0.67 x million inhabitants). It is caused by a mutation in the gene encoding oculocerebrorenal- Lowe protein (OCRL1), isolated in 1992, linked to the Xq24-q26 region of the X chromosome,4-6. Approximately 60% of OCRL patients demonstrate a loss of OCRL gene expression, and the definitive laboratory test, that can be used for prenatal diagnosis, is the biochemical assay for deficiency of phosphatidylinositol 4,5-biphosphate 5-phosphate in cultured fibroblasts. The classic triad of eye, central nervous system, and kidney involvement are required for the diagnosis of Lowe's syndrome. Cataract is present at birth in all patients and glaucoma is detected within the first year of life. Hypotonia compromises suction and causes serious respiratory problems in the first period of life. Motor development is retarded and mental retardation is moderate or severe in almost all cases. Obsessive-compulsive behavior is typical. Seizure is seen in approximately 50% of the patients over 18 years old. Renal disease is primarily characterized by renal Fanconi syndrome but many children are asymptomatic at birth. Renal involvement is initially related to bicarbonate, salt and water wasting, causing failure to thrive. Later, a significant number of patients develop chronic renal failure. The
Carvalho-Neto, Arnolfo de; Ono, Sergio Eiji; Cardoso, Georgina de Melo; Santos, Mara Lucia Schmitz Ferreira; Celidonio, Izabela
The oculocerebrorenal syndrome of Lowe (OCRL), was first recognized as a distinct disease in 1952 by Drs. Lowe, Terrey and MacLachlan at Massachusetts General Hospital, in Boston, USA, describing three male children with organic aciduria, decreased renal ammonia production, hydrophtalmos and mental retardation. The X-linked recessive inheritance pattern was recognized first by LeFebvre. It is present in all races, with a predominance in those of Caucasian and Asian ancestries. Rarely females are affected. It is a very rare disease, with estimated prevalence in the general population of 1 in 500,000. In USA the Lowe Syndrome Association (LSA) documented 190 living patients in the year 2000 (0.67 x million inhabitants). It is caused by a mutation in the gene encoding oculocerebrorenal- Lowe protein (OCRL1), isolated in 1992, linked to the Xq24-q26 region of the X chromosome,4-6. Approximately 60% of OCRL patients demonstrate a loss of OCRL gene expression, and the definitive laboratory test, that can be used for prenatal diagnosis, is the biochemical assay for deficiency of phosphatidylinositol 4,5-biphosphate 5-phosphate in cultured fibroblasts. The classic triad of eye, central nervous system, and kidney involvement are required for the diagnosis of Lowe's syndrome. Cataract is present at birth in all patients and glaucoma is detected within the first year of life. Hypotonia compromises suction and causes serious respiratory problems in the first period of life. Motor development is retarded and mental retardation is moderate or severe in almost all cases. Obsessive-compulsive behavior is typical. Seizure is seen in approximately 50% of the patients over 18 years old. Renal disease is primarily characterized by renal Fanconi syndrome but many children are asymptomatic at birth. Renal involvement is initially related to bicarbonate, salt and water wasting, causing failure to thrive. Later, a significant number of patients develop chronic renal failure. The treatment
Pham, B; Krahn, M
The annual cost of providing care for patients in their last year of life is estimated to account for approximately 9% of the Ontario health care budget. Access to integrated, comprehensive support and pain/symptom management appears to be inadequate and inequitable. To evaluate the cost-effectiveness of end-of-life (EoL) care interventions included in the EoL care mega-analysis. Multiple sources were used, including systematic reviews, linked health administration databases, survey data, planning documents, expert input, and additional literature searches. We conducted a literature review of cost-effectiveness studies to inform the primary economic analysis. We conducted the primary economic analysis and budget impact analysis for an Ontario cohort of decedents and their families and included interventions pertaining to team-based models of care, patient care planning discussions, educational interventions for patients and caregivers, and supportive interventions for informal caregivers. The time horizon was the last year of life. Costs were in 2013 Canadian dollars. Effectiveness measures included days at home, percentage dying at home, and quality-adjusted life-days. We developed a Markov model; model inputs were obtained from a cohort of Ontario decedents assembled from Institute for Clinical Evaluative Sciences databases and published literature. In-home palliative team care was cost-effective; it increased the chance of dying at home by 10%, increased the average number of days at home (6 days) and quality-adjusted life-days (0.5 days), and it reduced costs by approximately $4,400 per patient. Expanding in-home palliative team care to those currently not receiving such services (approximately 45,000 per year, at an annual cost of $76-108 million) is likely to improve quality of life, reduce the use of acute care resources, and save $191-$385 million in health care costs. Results for the other interventions were uncertain. The cost-effectiveness analysis was
Tuchner, Maya; Meiner, Zeev; Parush, Shula; Hartman-Maeir, Adina
During the past few decades, terrorist acts have been an unfortunate reality worldwide. There is a striking paucity of research investigating the multitude of long-term outcomes after severe physical injury due to terrorist attacks, a unique subgroup of trauma patients. The purpose of this study was to provide a profile of the long-term health-related quality of life (HR-QOL) after injury due to terrorist attacks and to explore the relationships between Post Traumatic Stress Disorder (PTSD), occupational status and injury severity with HR-QOL. We included 35 survivors of terrorist attacks living in the community, two years on average after the injury, mean age at follow-up = 32.1 (±13.8), mean Injury Severity Score (ISS) = 27 (±14.2). The subjects were recruited from consecutive admissions to a rehabilitation department in a tertiary care center between September 2000 - June 2004. Most of the subjects suffered multiple trauma. The main outcome measures were the Short-Form Health Survey (SF-36), Post Traumatic Diagnostic Scale and return to work rates. The mean scores on 6/8 of the SF-36 subscales were significantly lower among the survivors compared to normative population norms. Post Traumatic Stress Disorder (PTSD) was found in 39% of the sample and 43% did not resume their main occupation two years after the injury. Multivariate analysis of variance of PTSD and occupational status (returned vs. did not return to work) on quality of life scores revealed significant main effects for both PTSD (p=. 000) and occupational status (p=. 005) with no interaction effect (p=. 476). No significant correlations were found between injury severity and the SF-36 scores. This study demonstrated the long-term impact of injury due to terrorism. Results showed independent effects of PTSD and occupational status on health related quality of life, two years after injury. These findings suggest that this group may benefit from intervention focusing on their emotional and
Todd, Paul; Kurk, Michael Andy
A planetary environment simulator in Indiana, USA has been in use for about 5 years with visiting investigators having logged nearly one year of exposure time in intervals ranging from 7 days to 5 weeks. More than 20 investigators have studied a similar number of organisms in experiments ranging from the chemistry of the origin of life to the survival of invertebrate organisms in regolith. The simulator allows investigators to canvass several independent planetary variables, including diurnal temperature cycle, solar spectrum, light intensity, daytime shade, day length, depth and compositon of regolith, atmospheric pressure and composition, and moisture level. Gravity and ionizing radiation, of course, are not variable. Many experiments were performed at higher atmospheric pressure and moisture level than found on Mars, for example. The most popular conditions were simulations of light and temperature cycles resembling those at equatiorial and low latitudes and medium altitudes on Mars. Examples of completed and published studies include amino acid evolution, macroscopic microbial viability assays, the role of microbial community relationships in survival in extreme conditions, genomics of microbial communities, biological photoprotection by regolith, adaptability of cyanobacteria, and survival of extremophiles and small invertebrates as a function of regolith depth. Investigators have worked individually and as consortia exposing sometimes a few hundred samples at a time. As a general result, the survival of extremophiles has been found to be highly dependent on regolith cover, which is the dominant factor in affecting ultraviolet radiation exposure and moisture. A summary of the results of these investigations points the way toward further utilization of simulated extreme conditions relevant to the chemical origin of life, cellular evolution, gene expression in environmental adaptation, habitability parameters, life support systems, ecopoiesis and terraforming
Bui, Anthony L; Coates, Matthew M; Matthay, Ellicott C
To inform discussions on rates, burden and priority-setting in relation to police violence, we quantified the number and rate of years of life lost (YLLs) due to police violence by race/ethnicity and age in the USA, 2015-2016. We used data on the number of deaths due to police violence from 'The Counted', a media-based source compiled by The Guardian . YLLs are the difference between an individual's age at death and their corresponding standard life expectancy at age of death. There were 57 375 and 54 754 YLLs due to police violence in 2015 and 2016, respectively. People of colour comprised 38.5% of the population, but 51.5% of YLLs. YLLs were greatest among those aged 25-34 years, and the number of YLLs at younger ages was greater among people of colour than whites. The number of YLLs due to police violence is substantial. YLLs highlight that police violence disproportionately impacts young people, and the young people affected are disproportionately people of colour. Framing police violence as an important cause of deaths among young adults provides another valuable lens to motivate prevention efforts. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Madden-Fuentes, Ramiro J; McNamara, Erin R; Nseyo, Unwanaobong; Wiener, John S; Routh, Jonathan C; Ross, Sherry S
Diagnosis of low-grade hydronephrosis often occurs prenatally, during evaluation after urinary tract infection (UTI), or imaging for non-urologic reasons within the first year of life. Its significance in terms of resolution, need for antibiotic prophylaxis, or progression to surgery remains uncertain. We hypothesized that isolated low-grade hydronephrosis in this population frequently resolves, UTIs are infrequent, and progression to surgical intervention is minimal. Children hydronephrosis (Society for Fetal Urology [SFU] grade 1 or 2) between January 2004 and December 2009 were identified by ICD9 code. Patients with other urological abnormalities were excluded. Stability of hydronephrosis, UTI (≥ 100,000 CFU/mL bacterial growth) or need for surgical intervention was noted. Of 1496 infants with hydronephrosis, 416 (623 renal units) met inclusion criteria. Of 398 renal units with grade 1 hydronephrosis, 385 (96.7%) resolved or remained stable. Only 13 (3.3%) worsened, of which one underwent ureteroneocystostomy. Of 225 renal units with grade 2 hydronephrosis, 222 (98.7%) resolved, improved or remained stable, three (1.3%) worsened, of which one required pyeloplasty. Only 0.7% of patients in the ambulatory setting had a febrile UTI. Low-grade hydronephrosis diagnosed within the first year of life remains stable or improves in 97.4% of renal units. Given the low rate of recurrent UTI in the ambulatory setting, antibiotic prophylaxis has a limited role in management. Copyright © 2014. Published by Elsevier Ltd.
Ibinda, Fredrick; Wagner, Ryan G; Bertram, Melanie Y; Ngugi, Anthony K; Bauni, Evasius; Vos, Theo; Sander, Josemir W; Newton, Charles R
Objectives The burden of epilepsy, in terms of both morbidity and mortality, is likely to vary depending on the etiology (primary [genetic/unknown] vs. secondary [structural/metabolic]) and with the use of antiepileptic drugs (AEDs). We estimated the disability-adjusted life years (DALYs) and modeled the remission rates of active convulsive epilepsy (ACE) using epidemiologic data collected over the last decade in rural Kilifi, Kenya. Methods We used measures of prevalence, incidence, and mortality to model the remission of epilepsy using disease-modeling software (DisMod II). DALYs were calculated as the sum of Years Lost to Disability (YLD) and Years of Life Lost (YLL) due to premature death using the prevalence approach, with disability weights (DWs) from the 2010 Global Burden of Disease (GBD) study. DALYs were calculated with R statistical software with the associated uncertainty intervals (UIs) computed by bootstrapping. Results A total of 1,005 (95% UI 797–1,213) DALYs were lost to ACE, which is 433 (95% UI 393–469) DALYs lost per 100,000 people. Twenty-six percent (113/100,000/year, 95% UI 106–117) of the DALYs were due to YLD and 74% (320/100,000/year, 95% UI 248–416) to YLL. Primary epilepsy accounted for fewer DALYs than secondary epilepsy (98 vs. 334 DALYs per 100,000 people). Those taking AEDs contributed fewer DALYs than those not taking AEDs (167 vs. 266 DALYs per 100,000 people). The proportion of people with ACE in remission per year was estimated at 11.0% in males and 12.0% in females, with highest rates in the 0–5 year age group. Significance The DALYs for ACE are high in rural Kenya, but less than the estimates of 2010 GBD study. Three-fourths of DALYs resulted from secondary epilepsy. Use of AEDs was associated with 40% reduction of DALYs. Improving adherence to AEDs may reduce the burden of epilepsy in this area. PMID:25131901
Platts, Loretta G.; Webb, Elizabeth; Zins, Marie; Goldberg, Marcel; Netuveli, Gopalakrishnan
Objectives: This article aims to contribute to the literature on life course influences upon quality of life by examining pathways linking social position in middle age to quality of life following retirement in French men and women. Method: Data are from the GAZEL cohort study of employees at the French national gas and electricity company. A finely grained measure of occupational grade in 1989 was obtained from company records. Annual self-completion questionnaires provided information on quality of life in 2005, measured with the CASP-19 scale, and on participants’ recent circumstances 2002–2005: mental health, physical functioning, wealth, social status, neighbourhood characteristics, social support and social participation. Path analysis using full information maximum likelihood estimation was performed on 11,293 retired participants. Results: Higher occupational grade in 1989 was associated, in a graded relationship, with better quality of life 16 years later. This association was accounted for by individuals’ more recent circumstances, particularly their social status, mental health, physical functioning and wealth. Conclusion: The graded relationship between occupational grade in mid-life and quality of life after labour market exit was largely accounted for by more recent socio-economic circumstances and state of health. The results support a pathway model for the development of social disparities in quality of life, in which earlier social position shapes individual circumstances in later life. PMID:25220504
Full Text Available Introduction: Tonsillectomy with or without adenoidectomy is one of the most frequent surgical procedures especially in children. Several indications and contraindications have been suggested for this procedure. The benefits and the negative results of this operation have been studied by different researchers; nevertheless, to date, it is still a common procedure. The main purpose of this study is to obtain extensive information on the outcomes of adenotonsillectomy, according to the patient's physical, emotional and behavioral changes and also on the overall changes in his/her quality of life (QOL. Materials and Methods: All the children, aged 1-14, referred to the Besat Hospital clinics (Hamadan, Iran between March 2008 and March 2009 were included in this study. Overall, 86 children with documented indications underwent adenotonsillectomy, and were followed up for one year. Two modified standard questionnaires for QOL were completed before and one year after the tonsillectomy. Upon the completion of this two-year study, statistical analyses were performed, and the demographic data of the study groups were compared with those of a same-age group. Results: Changes were observed in five main complaints as follow: Acute Recurrent tonsillitis was present in 86 patients preoperatively, but in only three cases postoperatively (pharyngitis. Confirmed chronic sinusitis was present in 24 patients preoperatively, but only in three cases during the year after the surgery. Oral breathing was seen in 82 patients preoperatively, but only in one patient during the year after the surgery. Nocturnal snoring was seen in 83 children preoperatively, but in 25 cases during the year after the surgery. Halitosis was present in 71 patients, while and halitosis was seen in 27 during the year after the surgery. Conclusion: Overall, the majority of the parameters studied showed significant differences after surgery.
Altintaş, Kerim Hakan; Aslan, Dilek; Yildiz, Ali Naci; Subaşi, Nüket; Elçin, Melih; Odabaşi, Orhan; Bilir, Nazmi; Sayek, Iskender
In Turkey, the first aiders are few in quantity and yet they are required in many settings, such as earthquakes. It was thought that training first year university students in first aid and basic life support (FA-BLS) techniques would serve to increase the number of first aiders. It was also thought that another problem, the lack of first aid trainers, might be addressed by training medical students to perform this function. A project aimed at training first year university students in FA-BLS was conducted at Hacettepe University. In the first phase, medical student first aid trainers (MeSFAT) were trained in FA-BLS training techniques by academic trainers and in the second phase, first year university students were trained in FA-BLS techniques by these peer trainers under the academic trainers' supervision. The purpose of this study was to assess the participants' evaluation of this project and to propose a new program to increase the number of first aiders in the country. In total, 31 medical students were certified as MeSFATs and 12 of these trained 40 first year university students in FA-BLS. Various questionnaires were applied to the participants to determine their evaluation of the training program. Most of the participants and the authors considered the program to be successful and effective. This method may be used to increase the number of first aid trainers and first aiders in the community.
Moos, Rudolf H; Brennan, Penny L; Schutte, Kathleen K; Moos, Bernice S
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.
Full Text Available The disability-adjusted life years (DALYs were used to estimate the regional (state of Colima, Mexico cancer burden in 2010–2014. The years of life lost (YLL were estimated with mortality data and years lived with disability (YLD using incidence data. The DALYs were calculated as the arithmetic addition of YLL and YLD. Sex and cancer site-specific estimations were made and DALY rates were used to identify the leading causes of disease burden. Data from 2532 deaths were analyzed and, for all malignant tumors combined, 18,712.9 DALYs and 20,243.3 DALYs were estimated in males and females respectively. The overall contribution of YLL in DALY estimates was higher among females (93.7% vs. 87.4%. Age-standardized DALY rates (and 95% confidence intervals, CI per 100,000 inhabitants were used to rank the leading causes of disease burden and, among males, malignant tumors from the prostate, lower respiratory tract, and colon and rectum accounted the highest rates (45.7, 95% CI 32.7–59.3; 37.6, 95% CI 25.7–49.9; and 25.9, 95% CI 16.0–36.1 DALYs. Breast, cervix uteri, and lower respiratory tract cancer showed the highest burden in females (66.0, 95% CI 50.3–82.4; 44.4, 95% CI 31.5–57.7; and 20.9, 95% CI 12.0–30.0 DALYs. The present study provides an indication of the burden of cancer at the regional level, underscoring the need to expand cancer prevention, screening, and awareness programs, as well as to improve early diagnosis and medical treatment.
Melani, Federico; Mei, Davide; Pisano, Tiziana; Savasta, Salvatore; Franzoni, Emilio; Ferrari, Anna Rita; Marini, Carla; Guerrini, Renzo
Cyclin-dependent kinase-like 5 (CDKL5) gene abnormalities cause an early-onset epileptic encephalopathy. We performed video-electroencephalography (video-EEG) monitoring early in the course of CDKL5-related epileptic encephalopathy in order to examine the early electroclinical characteristics of the condition. We used video-EEG to monitor six infants (five females, one male) with CDKL5-related epileptic encephalopathy (five mutations; one deletion), at ages 45 days to 12 months and followed them up to the ages of 14 months to 5 years (mean age 23 mo). We focused our analysis on the first year of life. The results were evaluated against those of a comparison group of nine infants (aged below 1y) with epileptic encephalography who had tested negative for CDKL5 mutations and deletions. One infant exhibited normal background activity, three exhibited moderate slowing, and two exhibited a suppression burst pattern. Two participants had epileptic spasms and four had a stereotyped complex seizure pattern, which we defined as a 'prolonged' generalized tonic-clonic event consisting of a tonic-tonic/vibratory contraction, followed by a clonic phase with series of spasms, gradually translating into repetitive distal myoclonic jerks. Seizure duration ranged from 2 to 4 minutes. The EEG correlate of each clinical phase included an initial electrodecremental event (tonic vibratory phase), irregular series of sharp waves and spike slow waves (clonic phase with series of spasms), and bilateral rhythmic sharp waves (time locked with myoclonus). Infants with CDKL5-related early epileptic encephalopathy can present in the first year of life with an unusual electroclinical pattern of 'prolonged' generalized tonic-clonic seizures. © The Authors. Journal compilation © Mac Keith Press 2011.
Johnson, Kay M; Simon, Nancy; Wicks, Mark; Barr, Karen; O'Connor, Kim; Schaad, Doug
The authors describe the sleep habits of second year medical students and look for associations between reported sleep duration and depression, burnout, overall quality of life, self-reported academic success, and falling asleep while driving. The authors conducted a cross-sectional descriptive study of two consecutive cohorts of second year medical students at a large public university in the USA. Participants completed an anonymous survey about their sleep habits, daytime sleepiness (Epworth sleepiness scale), burnout (Maslach burnout inventory), depression (PRIME MD), and perceived stress (perceived stress scale). Categorical and continuous variables were compared using chi square tests and t tests, respectively. Sixty-eight percent of the students responded. Many (34.3%) reported fewer than 7 h of sleep on typical weeknights, including 6.5% who typically sleep less than 6 h. Twenty-five students (8.4%) reported nodding off while driving during the current academic year. Low typical weeknight sleep (fewer than 6 h vs 6-6.9 h vs 7 or more hours) was associated with (1) higher Epworth sleepiness scale scores, (2) nodding off while driving, (3) symptoms of burnout or depression, (4) decreased satisfaction with quality of life, and (5) lower perceived academic success (all p values ≤0.01). Students reporting under 6 h of sleep were four times more likely to nod off while driving than those reporting 7 h or more. Educational, behavioral, and curricular interventions should be explored to help pre-clinical medical students obtain at least 7 h of sleep most on weeknights.
Holahan, Charles J; Schutte, Kathleen K; Brennan, Penny L; Holahan, Carole K; Moos, Rudolf H
Research on moderate drinking has focused on the average level of drinking. Recently, however, investigators have begun to consider the role of the pattern of drinking, particularly heavy episodic drinking, in mortality. The present study examined the combined roles of average drinking level (moderate vs. high) and drinking pattern (regular vs. heavy episodic) in 20-year total mortality among late-life drinkers. The sample comprised 1,121 adults ages 55-65 years. Alcohol consumption was assessed at baseline, and total mortality was indexed across 20 years. We used multiple logistic regression analyses controlling for a broad set of sociodemographic, behavioral, and health status covariates. Among individuals whose high level of drinking placed them at risk, a heavy episodic drinking pattern did not increase mortality odds compared with a regular drinking pattern. Conversely, among individuals who engage in a moderate level of drinking, prior findings showed that a heavy episodic drinking pattern did increase mortality risk compared with a regular drinking pattern. Correspondingly, a high compared with a moderate drinking level increased mortality risk among individuals maintaining a regular drinking pattern, but not among individuals engaging in a heavy episodic drinking pattern, whose pattern of consumption had already placed them at risk. Findings highlight that low-risk drinking requires that older adults drink low to moderate average levels of alcohol and avoid heavy episodic drinking. Heavy episodic drinking is frequent among late-middle-aged and older adults and needs to be addressed along with average consumption in understanding the health risks of late-life drinkers.
Wernroth, Mona-Lisa; Svennblad, Bodil; Fall, Katja; Fang, Fang; Almqvist, Catarina; Fall, Tove
The association between early exposure to animals and type 1 diabetes in childhood is not clear. To determine whether exposure to dogs during the first year of life is associated with the development of type 1 diabetes in childhood. A nationwide cohort study utilizing high-quality Swedish national demographic and health registers was conducted. A total of 840 593 children born in Sweden from January 1, 2001, to December 31, 2010, were evaluated. Type 1 diabetes was identified using diagnosis codes from hospitals and dispensed prescriptions of insulin. Cox proportional hazards regression models were used to assess the association between exposure to dogs and risk of type 1 diabetes in childhood. The possible association was further investigated by performing dose-response and breed group-specific analyses. The cohort was followed up until September 30, 2012. Data analysis was conducted from October 15, 2015, to February 8, 2017. Having a parent who was registered as a dog owner during the child's first year of life. Childhood-onset type 1 diabetes. Of the 840 593 children reviewed, 408 272 (48.6%) were girls; mean (SD) age at diagnosis of type 1 diabetes was 5.1 (2.6) years. Dog exposure was identified in 102 035 children (12.1%). Follow-up started at age 1 year, and the children were followed up for as long as 10.7 years (median, 5.5 years). During follow-up, 1999 children developed type 1 diabetes. No association was found between exposure to dogs (adjusted hazard ratio [HR], 1.00; 95% CI, 0.86-1.16) and type 1 diabetes in childhood. The size of the dog (adjusted HR per 10-cm increase in height, 0.96; 95% CI, 0.86-1.06) or number of dogs in the household (1 dog: adjusted HR, 1.07; 95% CI, 0.91-1.26; 2 dogs: 0.79; 95% CI, 0.54-1.15; ≥3 dogs: 0.50; 95% CI, 0.23-1.12; compared with nonexposed children) also was not associated with type 1 diabetes risk. An analysis of children whose parent had type 1 diabetes (210 events) yielded an adjusted HR of 0.71 (95% CI, 0
Mai, X-M; Neuman, A; Ostblom, E; Pershagen, G; Nordvall, L; Almqvist, C; van Hage, M; Wickman, M
The predictive value of reported early symptoms to pollen or fruits on later allergic disease is unclear. Our aim is to evaluate if symptoms to pollen and/or to fruits early in life are associated with allergic disease and sensitization to pollen at 4 years. The study included 3619 children from the Barn (Children), Allergy, Milieu, Stockholm, Epidemiology project (BAMSE) birth cohort. Reported symptoms of wheeze, sneeze or rash to birch, grass or weed, symptoms (vomiting, diarrhea, rash, facial edema, sneeze, or wheeze) to fruits including tree-nuts at 1 or 2 years of age, and definitions of asthma, rhinitis and eczema at 4 years were derived from questionnaire data. Sensitization to pollen allergens was defined as allergen-specific IgE-antibodies to any pollen (birch/timothy/mugwort) > or =0.35 kU(A)/l. At 1 or 2 years of age, 6% of the children were reported to have pollen-related symptoms, 6% had symptoms to fruits, and 1.4% to both pollen and fruits. Children with symptoms to both pollen and fruits at 1 or 2 years of age had an increased risk for sensitization to any pollen allergen at age 4 (OR(adj) = 4.4, 95% CI = 2.1-9.2). This group of children also had a substantially elevated risk for developing any allergic disease (asthma, rhinitis, or eczema) at 4 years irrespective of sensitization to pollen (OR(adj) = 8.6, 95% CI = 4.5-16.4). The prevalence of reported symptoms to pollen and fruits is very low in early childhood. However, children with early symptoms to both pollen and fruits appear to have a markedly elevated risk for allergic disease.
Albuquerque, Gabriela; Severo, Milton; Oliveira, Andreia
To assess early life characteristics associated with appetite-related eating behaviors in 7-year-old children. The participants are children from the population-based birth cohort Generation XXI. Data on sociodemographics, health, and lifestyles and anthropometrics were collected at birth, and 4- and 7-year-old evaluations. A Portuguese version of the Children's Eating Behavior Questionnaire was completed by mothers (n = 3562 children) with children aged 7 years old. A 2-factor solution was identified: factor 1-appetite restraint and factor 2-appetite disinhibition. Associations were estimated through generalized linear models adjusted for maternal age, education, body mass index (BMI) before birth, family structure, number of siblings, and child's sex (β regression coefficients and 95% CIs). Higher appetite restraint at 7 years old was associated with higher maternal age and educational level, families with both parents (1- vs 2-parent: β = -0.074, 95% CI -0.140, -0.007) and no siblings (≥2 vs 0: β = -0.152, 95% CI -0.224, -0.081), and more sedentary lifestyles at 4 years old. It was also associated with lower child and maternal BMI and waist circumference at 4 years old. In contrast, higher appetite disinhibition was associated with lower maternal educational background, having a 1-parent family, more sedentary behaviors (≥120 vs <120 min/d of media: β = 0.055, 95% CI 0.018, 0.093), and higher BMI and waist circumference at 4 years old. Higher maternal age and education, and a family with both parents at 4 years old seem to influence higher appetite restraint, but less appetite disinhibition at 7 years old. More sedentary lifestyles at 4 years old were associated with higher appetite restraint and appetite disinhibition scores later in childhood. These results can be useful for the development of prevention guidelines and educational strategies aimed at improving healthy eating behaviors. Copyright © 2016 Elsevier Inc. All rights reserved.
Tainio, Marko; Olkowicz, Dorota; Teresiński, Grzegorz; de Nazelle, Audrey; Nieuwenhuijsen, Mark J
Health impact assessment (HIA) studies are increasingly predicting the health effects of mode shifts in traffic. The challenge for such studies is to combine the health effects, caused by injuries, with the disease driven health effects, and to express the change in the health with a common health indicator. Disability-adjusted life year (DALY) combines years lived disabled or injured (YLD) and years of life lost (YLL) providing practical indicator to combine injuries with diseases. In this study, we estimate the average YLDs for one person injured in a transport crash to allow easy to use methods to predict health effects of transport injuries. We calculated YLDs and YLLs for transport fatalities and injuries based on the data from the Swedish Traffic Accident Data Acquisition (STRADA). In STRADA, all the fatalities and most of the injuries in Sweden for 2007-2011 were recorded. The type of injury was recorded with the Abbreviated Injury Scale (AIS) codes. In this study these AIS codes were aggregated to injury types, and YLDs were calculated for each victim by multiplying the type of injury with the disability weight and the average duration of that injury. YLLs were calculated by multiplying the age of the victim with life expectancy of that age and gender. YLDs and YLLs were estimated separately for different gender, mode of transport and location of the crash. The average YLDs for injured person was 14.7 for lifelong injuries and 0.012 for temporal injuries. The average YLDs per injured person for lifelong injuries for pedestrians, cyclists and car occupants were 9.4, 12.8 and 18.4, YLDs, respectively. Lifelong injuries sustained in rural areas were on average 31% more serious than injuries in urban areas. The results show that shifting modes of transport will not only change the likelihood of injuries but also the severity of injuries sustained, if injured. The results of this study can be used to predict DALY changes in HIA studies that take into account
Moore, Aimee M; Ahmadi, Sara; Patel, Sanket; Gibson, Molly K; Wang, Bin; Ndao, Malick I; Deych, Elena; Shannon, William; Tarr, Phillip I; Warner, Barbara B; Dantas, Gautam
The early life of the human host marks a critically important time for establishment of the gut microbial community, yet the developmental trajectory of gut community-encoded resistance genes (resistome) is unknown. We present a longitudinal study of the fecal antibiotic resistome of healthy amoxicillin-exposed and antibiotic-naive twins and their mothers during the first year of life. We extracted metagenomic DNA (mgDNA) from fecal samples collected from three healthy twin pairs at three timepoints (1 or 2 months, 6 or 7 months, and 11 months) and from their mothers (collected at delivery). The mgDNA was used to construct metagenomic expression libraries in an Escherichia coli host. These libraries were screened for antibiotic resistance, and functionally selected resistance genes were sequenced and annotated. A diverse fecal resistome distinct from the maternal resistome was apparent by 2 months of age, and infants' fecal resistomes included resistance to clinically important broad-spectrum beta-lactam antibiotics (e.g., piperacillin-tazobactam, aztreonam, cefepime) not found in their mothers. Dissemination of resistance genes among members of a given family was positively correlated with sharing of those same resistance genes between unrelated families, potentially identifying within-family sharing as a marker of resistance genes emerging in the human community at large. Finally, we found a distinct developmental trajectory for a community-encoded function: chloramphenicol resistance. All study subjects at all timepoints harbored chloramphenicol resistance determinants, but multidrug efflux pumps (rarely found in mothers) were the primary effectors of chloramphenicol resistance in young infants. Chloramphenicol acetyltransferases were more common in mothers than in infants and were found in nearly all the infants at later timepoints. Our results suggest that healthy 1-2-month-old infants' gut microbes harbor clinically relevant resistance genes distinct from
Taylor, Tim; Auerbach, Joshua E; Bongard, Josh
We present a survey of the first 21 years of web-based artificial life (WebAL) research and applications, broadly construed to include the many different ways in which artificial life and web technologies might intersect. Our survey covers the period from 1994—when the first WebAL work appeared...
Westerhof, Gerben Johan; Bohlmeijer, Ernst Thomas
Fifty years ago, psychiatrist Robert Butler (1963) published an influential article on the recollection and evaluation of personal memories in later life. We discuss the major insights and applications in psychological gerontology that were inspired by Butler. Reminiscence and life review serve to
Fakunmoju, Sunday; Donahue, Gilpatrick R.; McCoy, Shandria; Mengel, Alison S.
Knowledge about life satisfaction and learning experience among first-year graduate students is sparse, despite its relevance to instructional decisions, academic support, and success of students. Adequate knowledge is crucial, as it may help graduate students manage personal and professional life changes associated with graduate education. Using…
van der Meer, Helene G.; Taxis, Katja; Pont, Lisa G.
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
Vidmachenko, A. P.
In its early years, Mars was like the ancient Earth. If life on Mars today there is, then, certainly, it is microbial. The proof of the presence of liquid water on Mars does not mean that there is life on Mars. But this gives some hope.
Chow, Angela; Galambos, Nancy L.; Krahn, Harvey J.
This 25-year longitudinal study of a sample of Canadian high school seniors (N = 373) examined pathways from work values at age 18 to mid-life (age 43) career satisfaction and life satisfaction through several possible mediators: age 25 and 32 work values, months of postsecondary education (PSE) by age 25, and age 43 work rewards. Gender and…
Full Text Available Psychomotor development in premature infants has specific characteristics with increased tendency towards neuro-developmental difficulties, such as the fact that certain percent of the developmentally challenged people belongs in this category of children.Many factors contribute to the neuro-developmental difficulties in premature infants. A large number of studies have shown that the birth weight (BW and gestational age (GA have strong correlation with the neuro-developmental outcome.In order to establish the general developmental outcome and the developmental outcome in specific areas of early development, that is the first three years of life in preemies, we have conducted a research on our own population. We conducted a longitudinal study on 20 premature newborns with very low birth weight (VLBW, with a follow-up period from 4 weeks CGA until 36 weeks GA.The research results showed that the largest difference in developmental areas between the group of premature infants with VLBW and the control group is present at the end of the 36th month of life and the general development quotient (GDQ in the premature group was significantly lower during the whole follow-up period, except at the end of month 4 - in different developmental areas. We also concluded that 20% of the premature infants with VLBW have developmental difficulties and severe difficulties in their motor development.
Grilo, Carlos M.; Pagano, Maria E.; Stout, Robert L.; Markowitz, John C.; Ansell, Emily B.; Pinto, Anthony; Zanarini, Mary C.; Yen, Shirley; Skodol, Andrew E.
Objective To examine prospectively the natural course of bulimia nervosa (BN) and eating disorder not-otherwise-specified (EDNOS) and test for the effects of stressful life events (SLE) on relapse after remission from these eating disorders. Method 117 female patients with BN (N = 35) or EDNOS (N = 82) were prospectively followed for 72 months using structured interviews performed at baseline, 6- and 12-months, and then yearly thereafter. ED were assessed with the structured clinical interview for DSM-IV, and monitored over time with the longitudinal interval follow-up evaluation. Personality disorders were assessed with the diagnostic interview for DSM-IV-personality-disorders, and monitored over time with the follow-along-version. The occurrence and specific timing of SLE were assessed with the life events assessment interview. Cox proportional-hazard-regression-analyses tested associations between time-varying levels of SLE and ED relapse, controlling for comorbid psychiatric disorders, ED duration, and time-varying personality-disorder status. Results ED relapse probability was 43%; BN and EDNOS did not differ in time to relapse. Negative SLE significantly predicted ED relapse; elevated work and social stressors were significant predictors. Psychiatric comorbidity, ED duration, and time-varying personality-disorder status were not significant predictors. Discussion Higher work and social stress represent significant warning signs for triggering relapse for women with remitted BN and EDNOS. PMID:21448971
Full Text Available The paper focuses on how adolescents aged 14—16 years use the topic of life and death in their verbal creativity. The authors carried out an experimental research on the genesis of this process and describe how the topic evolves as a specific new formation of verbal creativity in adolescence. At the center of the research were conditions of verbal creativity. The subjects in three samples (traditional learning; spontaneous development; project-based-learning were asked to write an essay on any topic; these essays were subsequently assessed using content analysis. The outcomes revealed that the topic of life and death is likely to appear in the essays of those adolescents whose reference group is more comfortable psychologically. The literary merit of writing statistically correlates with the effectiveness of verbal creativity acquisition. In its psychological content the topic was actually a challenge, a manifestation of rebellion of a young man, an important attempt to get closer to the hidden boundary of the known, a significant step in initiation.
Nie, Jingxin; Li, Gang; Wang, Li; Gilmore, John H; Lin, Weili; Shen, Dinggang
Human cerebral cortex develops extremely fast in the first year of life. Quantitative measurement of cortical development during this early stage plays an important role in revealing the relationship between cortical structural and high-level functional development. This paper presents a computational growth model to simulate the dynamic development of the cerebral cortex from birth to 1 year old by modeling the cerebral cortex as a deformable elastoplasticity surface driven via a growth model. To achieve a high accuracy, a guidance model is also incorporated to estimate the growth parameters and cortical shapes at later developmental stages. The proposed growth model has been applied to 10 healthy subjects with longitudinal brain MR images acquired at every 3 months from birth to 1 year old. The experimental results show that our proposed method can capture the dynamic developmental process of the cortex, with the average surface distance error smaller than 0.6 mm compared with the ground truth surfaces, and the results also show that 1) the curvedness and sharpness decrease from 2 weeks to 12 months and 2) the frontal lobe shows rapidly increasing cortical folding during this period, with relatively slower increase of the cortical folding in the occipital and parietal lobes.
Yap, Pew-Thian; Fan, Yong; Chen, Yasheng; Gilmore, John H; Lin, Weili; Shen, Dinggang
The human brain is organized into a collection of interacting networks with specialized functions to support various cognitive functions. Recent research has reached a consensus that the brain manifests small-world topology, which implicates both global and local efficiency at minimal wiring costs, and also modular organization, which indicates functional segregation and specialization. However, the important questions of how and when the small-world topology and modular organization come into existence remain largely unanswered. Taking a graph theoretic approach, we attempt to shed light on this matter by an in vivo study, using diffusion tensor imaging based fiber tractography, on 39 healthy pediatric subjects with longitudinal data collected at average ages of 2 weeks, 1 year, and 2 years. Our results indicate that the small-world architecture exists at birth with efficiency that increases in later stages of development. In addition, we found that the networks are broad scale in nature, signifying the existence of pivotal connection hubs and resilience of the brain network to random and targeted attacks. We also observed, with development, that the brain network seems to evolve progressively from a local, predominantly proximity based, connectivity pattern to a more distributed, predominantly functional based, connectivity pattern. These observations suggest that the brain in the early years of life has relatively efficient systems that may solve similar information processing problems, but in divergent ways.
St John, Philip D; Mackenzie, Corey; Menec, Verena
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.
Altintaş, Kerim Hakan; Yildiz, Ali Naci; Aslan, Dilek; Ozvariş, Sevkat Bahar; Bilir, Nazmi
We developed 24 and 12-h programs for first aid and basic life support (FA-BLS) training for first-year medical students and evaluated the opinions of both the trainers and trainees on the effectiveness of the programs. The trainees were the first-year students of academic years 2000-2001 (316 students) and 2001-2002 (366 students). The evaluations of the participants were collected from short questionnaires created specifically for the study. For the 24-h training program, most of the students stated that FA-BLS sessions met their expectations (85.9%) and they were satisfied with the training (91.1%). Of the participants, 75.6% stated that they could apply FA confidently in real situations simulating the topics they learned in the FA-BLS sessions. For the 12-h training program, 84.4% of the students felt themselves competent in FA-BLS applications. The trainers considered both of the programs as effective.
Full Text Available The human brain is organized into a collection of interacting networks with specialized functions to support various cognitive functions. Recent research has reached a consensus that the brain manifests small-world topology, which implicates both global and local efficiency at minimal wiring costs, and also modular organization, which indicates functional segregation and specialization. However, the important questions of how and when the small-world topology and modular organization come into existence remain largely unanswered. Taking a graph theoretic approach, we attempt to shed light on this matter by an in vivo study, using diffusion tensor imaging based fiber tractography, on 39 healthy pediatric subjects with longitudinal data collected at average ages of 2 weeks, 1 year, and 2 years. Our results indicate that the small-world architecture exists at birth with efficiency that increases in later stages of development. In addition, we found that the networks are broad scale in nature, signifying the existence of pivotal connection hubs and resilience of the brain network to random and targeted attacks. We also observed, with development, that the brain network seems to evolve progressively from a local, predominantly proximity based, connectivity pattern to a more distributed, predominantly functional based, connectivity pattern. These observations suggest that the brain in the early years of life has relatively efficient systems that may solve similar information processing problems, but in divergent ways.
Full Text Available In order to visualize, evaluate and measure the maxillary growth in patients with cleft palate and to identify the reactive morphological pattern that could be identified from the dimensional changes produced along the first six years of life, maxillary impressions were made in two groups of study, by means of standard trays and silicone impression materials. The maxillary casts resulted had been 3D scanned at Multinr, in Sf. Gheorghe. The study was carried on a number of 34 patients with cleft palate, 16 boys and 18 girls, with ages between 2 months and 6 years, operated by the same surgical team in “St. Mary” University Children Hospital of Iaşi, as well as on 60 normal children. Bivariate Student’s t test established statistically significant negative differences between the mean values of the anterior and posterior width of the maxillary alveolar arch, positive non significant differences for the length and positive differences for the depth of the dehiscent palate in the experimental group, comparatively with normal children. Cleft palate patients have narrowed and shorter maxillary alveolar arch and flattened palate. At least therapeutically, the cleft palate group, operated at different ages, from 2 to 4 years, could not react like other groups of study from important European Cleft Centers and benefit from a good residual growth.
BACKGROUND: This article systematically monitors the quality of life (QOL) of patients with schizophrenia from seven different sites across four European countries: France, Ireland, Portugal and Spain. METHODS: A one-year prospective cohort study was carried out. Inclusion criteria for patients were: a clinical lifetime diagnosis of schizophrenia according to ICD-10 (F20) diagnostic criteria for research, age between 18 and 65 years and at least one contact with mental health services in 1993. Data concerning QOL were recorded in seven sites from four countries: France, Portugal, Ireland and Spain, and were obtained using the Baker and Intagliata scale. At baseline, 339 patients answered the QOL questionnaire. At one-year follow-up, Spain could not participate, so only 263 patients were contacted and 219 agreed to take part. QOL was compared across centres by areas and according to a global index. QOL was correlated with presence of clinical and social problems, needs for care and interventions provided during the one-year follow-up. RESULTS: We did not find any link between gender and QOL. There were some significant differences between centres concerning many items. What is more, these differences were relative: in Lisbon where the lowest level of satisfaction was recorded, people were satisfied with food but highly dissatisfied with finances, whereas in St Etienne, where the highest level of satisfaction was recorded, people were less satisfied with food when they were more satisfied with finances. The evolution in one year among those respondents who took part in the follow-up (excluding the subjects from Granada) showed different patterns depending on the items. CONCLUSION: The four countries have different resources and patients live in rather different conditions. However, the main differences as far as their QOL is concerned very much depend on extra-psychiatric variables, principally marital status and income.
Headey, Bruce; Muffels, R.J.A.
An adequate theory of life satisfaction (LS) needs to take account of both factors that tend to stabilise LS and those that change it. The most widely accepted theory in the recent past—set-point theory—focussed solely on stability (Brickman and Campbell, in:Appley (ed) Adaptation level theory,
Travers, Alice; Taylor, Vanessa
Improving end of life care is a national imperative. Unsatisfactory care persists particularly in acute hospitals, with shortcomings, variability in communication and advance care planning identified as fundamental issues. This review explored the literature to identify what is known about the barriers to initiating end-of-life conversations with patients from the perspective of doctors and nurses in the acute hospital setting. Six electronic databases were searched for potentially relevant records published between 2008 and 2015. Studies were included if the authors reported on barriers to discussing end of life with families or patients as described by doctors or nurses in hospital settings, excluding critical care. Of 1267 potentially relevant records, 12 were included in the review. Although there is limited high-quality evidence available, several barriers were identified. Recurrent themes within the literature related to a lack of education and training, difficulty in prognostication, cultural differences and perceived reluctance of the patient or family. This study illustrated that, in addressing barriers to communication, consideration needs to be extended to include how to embed good communication practice between patients and health professionals into the culture of this setting. Board level commitment is required to raise awareness of, and familiarity with, policies and protocols concerning communication and end-of-life care. Communication training should include practical skills and tools, opportunities to explore the personal beliefs of practitioners and managing their emotions, opportunities to analyse the local organisational (physical and social environment) and team barriers.
Headey, Bruce; Muffels, Ruud
An adequate theory of Life Satisfaction (LS) needs to take account of both factors that tend to stabilise LS and those that change it. The most widely accepted theory in the recent past – set-point theory – focussed solely on stability (Brickman and Campbell, 1971; Lykken and Tellegen, 1996). That
Analysis of premature mortality variations via standardized expected years of life lost (SEYLL) measures raises questions about suitable modelling for mortality data, especially when developing SEYLL profiles for areas with small populations. Existing fixed effects estimation methods take no account of correlations in mortality levels over ages, causes, socio-ethnic groups or areas. They also do not specify an underlying data generating process, or a likelihood model that can include trends or correlations, and are likely to produce unstable estimates for small-areas. An alternative strategy involves a fully specified data generation process, and a random effects model which "borrows strength" to produce stable SEYLL estimates, allowing for correlations between ages, areas and socio-ethnic groups. The resulting modelling strategy is applied to gender-specific differences in SEYLL rates in small-areas in NE London, and to cause-specific mortality for leading causes of premature mortality in these areas.
Blaymore Bier, Jo-Ann; Oliver, Tanya; Ferguson, Anne; Vohr, Betty R
To determine if ingestion of human milk after discharge reduces symptoms of infections in premature infants. Follow-up of 39 infants with birth weights milk and 15 of whom received only formula after discharge, was carried out. Mothers were given a calendar on which they recorded any signs of infections and feeding and day-care information. Data were collected at 1 month after discharge and at 3, 7, and 12 months corrected age. Results show no differences between groups in birth weight, gestation, gender, maternal age, parental tobacco use, number of siblings, and day-care attendance. Socioeconomic status score was higher in the human milk group. Infants who received human milk had fewer days of upper respiratory symptoms at 1 month after discharge (pmilk post discharge is associated with a reduction of upper respiratory symptoms in premature infants during their first year of life.
Full Text Available Establishment and maintenance of the contact is a major condition of the successful advising of parents on questions of feeding. An author is divided his own experience with parents not only after the birth of child, but also in the period of pregnancy, as it is particularly important in forming of correct relation of mother to the breast-feeding. The aims of consulting physician are not only a revival of culture of breast-feeding but also providing and control of the correct feeding and care of kid on the first year of life.Key words: advising, breast-feeding, extra feed. (Pediatric Pharmacology. – 2010; 7(3:106-112
Full Text Available Le immense potenzialità del primo anno di vita ed il loro essere a fondamento dello sviluppo della personalità vengono discusse qui in una prospettiva relazionale, evidenziando il significato fondamentale della qualità delle interazioni precoci, verbali e non verbali, tra il bambino ed i suoi caregiver. Viene sottolineato anche il ruolo-chiave delle emozioni e dei vissuti interpersonali nella costruzione dell’architettura della mente infantile. The extraordinary potentialities during the first year of life and the fact that they are at the basis of the development of personality are proposed here using a relational prospective. The fundamental significance connected to the quality of the precocious verbal and non–verbal interactions between infants and their caregiver is evidenced as well. The key-role of the interpersonal emotions and feelings inside the construction of the infants’ mind architecture is highlighted.
Fernando Henrique Ferreira
Full Text Available Social transformations have raised reflection about the paternal role and pointed to new fatherhoods, characterized by more effective involvement of the father in the family routine and in childcare. The present integrative review of qualitative studies aimed to synthetize the literature evidence about fatherhood experience throughout the first year of the child’s life, attentive to gender questions. Twenty three studies integrated this review. It was observed that fathers had positive experience with their babies and, still, craved for more time and space to dedicate to the family. However, inequality between genders, continuous requirement of financial provision at home and their inaptitude for breastfeeding moment impeded more paternal involvement. We concluded that new fatherhoods movement is present in the father experience and contemporary gender tendencies are challenges for parenting support.
Full Text Available The adoption of the basic motor skills in the first year of life (postural head control, lateral transfers into a lying position, sitting, standing, walking, crawling, grasping... goes on quite spontaneously. A child learns all the motor actions by itself and that is why it is not necessary to “teach” a child to seat, grasp, stand, walk... Teaching a child the basic motor skills stands for a rough, unnecessary and undesirable involvement into spontaneous motor development, and, due to this, the normal adoption of motor skills is slowed down. For the normal motor development, children do not need helping devices (baby buggy, baby jump.... Helping devices suppress in children their natural urge to walk, complicate its development and may have harmful effects like equinus feet, deformed feet and spine and so on.
Full Text Available Steel reinforcing bars are often coated with rusts formed during service in reinforced concrete (RC structures. Rust layers growing on steel rebars induce expansive stresses and cause cracking on cover concrete. This study uses steel corrosion rate results measured on reinforced concrete buildings of more than 50 years of age located in marine environments and considers the pressure generated by the volume expansion of corrosion product layers to calculate the service life of the RC structures using a numerical simulation, estimating the time to corrosion cracking of the concrete cover. Akaganeite, goethite, lepidocrocite, hematite, magnetite and maghemite were identified by X-ray diffraction as crystalline phase constituents of the rust layers.
Knaap, M.S. van der; Valk, J.
The normal process of myelination of the brain mainly occurs during the first year of life. This process as known from histology can be visualized by MRI. Because of the very long T1 and T2 of immature brain tissue it is necessary to use adjusted pulse sequences with a long TR in order to obtain sufficient tissue contrast. With long TR SE images five stages can be recognized in the process of normal myelination and brain maturation. During the first month of life long TR short TE SE images show what are believed to be myelinated structures by correlation with published histological studies with a high signal intensity, unmyelinated white matter with a low signal intensity and gray matter with an intermediate signal intensity. The signal intensity of unmyelinated and myelinated white matter is reversed on long TR long TE SE images. In the course of a few weeks the signal intensity of unmyelinated white matter becomes high and the signal intensity of myelinated white matter becomes low also on long TR short TE SE images. These changes are believed to be caused by a loss of water and a change in chemical composition of brain tissue just prior to the onset of a wave of myelination. With progression of myelination the signal intensity of white matter changes from high to intermediate to low. These changes result in stages of isointensity, first in the central parts of the brain, later in the lobar parts. At the end of the first year the adult contrast pattern is reached in all parts of the brain. IR images are also able to depict the progress of myelination, but appear to be less sensitive to subtle changes in the degree of myelination. The precise normal values for the five stages depend on the magnetic field strength and the pulse sequences used. (orig.)
Härkönen, Kati; Kivekäs, Ilkka; Rautiainen, Markus; Kotti, Voitto; Vasama, Juha-Pekka
To explore long-term hearing results, quality of life (QoL), quality of hearing (QoH), work-related stress, tinnitus, and balance problems after idiopathic sudden sensorineural hearing loss (ISSNHL). Cross-sectional study. We reviewed the audiograms of 680 patients with unilateral ISSNHL on average 8 years after the hearing impairment, and then divided the patients into two study groups based on whether their ISSNHL had recovered to normal (pure tone average [PTA] ≤ 30 dB) or not (PTA > 30 dB). The inclusion criteria were a hearing threshold decrease of 30 dB or more in at least three contiguous frequencies occurring within 72 hours in the affected ear and normal hearing in the contralateral ear. Audiograms of 217 patients fulfilled the criteria. We reviewed their medical records; measured present QoL, QoH, and work-related stress with specific questionnaires; and updated the hearing status. Poor hearing outcome after ISSNHL was correlated with age, severity of hearing loss, and vertigo together with ISSNHL. Quality of life and QoH were statistically significantly better in patients with recovered hearing, and the patients had statistically significantly less tinnitus and balance problems. During the 8-year follow-up, the PTA of the affected ear deteriorated on average 7 dB, and healthy ear deteriorated 6 dB. Idiopathic sudden sensorineural hearing loss that failed to recover had a negative impact on long-term QoL and QoH. The hearing deteriorated as a function of age similarly both in the affected and the healthy ear, and there were no differences between the groups. The cumulative recurrence rate for ISSNHL was 3.5%. 4 Laryngoscope, 127:927-931, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.
Buchanich, Jeanine M; Doerfler, Shannon M; Lann, Michael F; Marsh, Gary M; Burke, Donald S
To examine changes in cause-specific Years of Life Lost (YLL) by age, race, and sex group in the USA from 1990 to 2014. 60 million death reports from the National Center for Health Statistics (NCHS) were categorized by age group, sex, race, and cause of death. YLL were calculated using age-specific life expectancies. Age groups were: infants USA. In the year 1990 the YLL per 100,000 population was 21,103 for blacks, 14,160 for whites, and 7,417 for others. Between 1990 and 2014 overall YLL in the USA improved by 10%, but with marked variations in the rate of change across age, race, and sex groups. Blacks (all ages, both sexes) showed substantial improvement with a 28% reduction in YLL, compared to whites (all ages, both sexes) who showed a 4% reduction. Among blacks, improvements were seen in all age groups: reductions of 43%, 48%, 28%, and 25% among infants, children, adults, and older adults, respectively. Among whites, reductions of 33%, 44%, and 18% were seen in infants, children, and older adults, but there was a 6% increase in YLL among white adults. YLL increased by 18% in white adult females and declined 1% in white adult males. American Indian/Alaska Native women also had worsening in YLL, with an 8% increase. Asian Pacific Islanders consistently had the lowest YLL across all ages. Whites had a higher proportion of YLL due to overdose; blacks had a higher proportion due to homicide at younger ages and to heart disease at older ages. Race-based disparities in YLL in the USA since 1990 have narrowed considerably, largely as a result of improvements among blacks compared to whites. Adult white and American Indian / Alaskan Native females have experienced worsening YLL, while white males have experienced essentially no change. If recent trajectories continue, adult black/white disparities in YLL will continue to narrow.
Santos, S V; Margarido, M R R A; Caires, I S; Santos, R A N; Souza, S G; Souza, J M A; Martimiano, R R; Dutra, C S K; Palha, P; Zanetti, A C G; Pazin-Filho, A
We aimed to evaluate knowledge of first aid among new undergraduates and whether it is affected by their chosen course. A questionnaire was developed to assess knowledge of how to activate the Mobile Emergency Attendance Service - MEAS (Serviço de Atendimento Móvel de Urgência; SAMU), recognize a pre-hospital emergency situation and the first aid required for cardiac arrest. The students were also asked about enrolling in a first aid course. Responses were received from 1038 of 1365 (76.04%) new undergraduates. The questionnaires were completed in a 2-week period 1 month after the beginning of classes. Of the 1038 respondents (59.5% studying biological sciences, 11.6% physical sciences, and 28.6% humanities), 58.5% knew how to activate the MEAS/SAMU (54.3% non-biological vs 61.4% biological, P=0.02), with an odds ratio (OR)=1.39 (95%CI=1.07-1.81) regardless of age, sex, origin, having a previous degree or having a relative with cardiac disease. The majority could distinguish emergency from non-emergency situations. When faced with a possible cardiac arrest, 17.7% of the students would perform chest compressions (15.5% non-biological vs 19.1% biological first-year university students, P=0.16) and 65.2% would enroll in a first aid course (51.1% non-biological vs 74.7% biological, Pbasic life support skills to help with cardiac arrest. A significant proportion would not enroll in a first aid course. Biological first-year university students were more prone to enroll in a basic life support course.
Allsop, Susan; Rumbold, Penny Louise Sheena; Debuse, Dorothée; Dodd-Reynolds, Caroline
In the laboratory, active gaming has been shown to increase physical activity levels in children compared with seated media activities. The information is sparse, however, about children's real life active gaming practices, and the laboratory protocols used thus far might not be representative. The purpose of the present study was to establish the sociodemographic characteristics, real life active gaming practices, and reasons for gameplay, to later inform intervention studies. An "Active Gaming Questionnaire" was purposely developed and distributed to 44 7-11-year-old children and their parents. Forty questionnaires were completed and returned. Analysis found 95 percent of the children had access to active gaming consoles "at home." The favorite console was the Nintendo (Kyoto, Japan) Wii™, and the favorite game was Nintendo "Wii Sports." The majority of children frequently played active games against other people. The average reported gameplay time was 81 minutes on 1-2 days per week, usually on a Saturday. More than half of the children (52.5 percent) consumed foods and/or drinks during play, which was significantly associated (P=0.000) with an extended average gameplay time (increased by 25 minutes). The majority of participants (65 percent) considered active gaming to be an alternative form of exercise, and main reasons for active videogame play included for entertainment, health benefits, and the environment. In conclusion, children 9.3±1.4 years old typically play Nintendo "Wii Sports," once or twice per week for 81 minutes. Reported active gameplay time is extended by 25 minutes when food and/or drinks are consumed.
Sindi, Shireen; Hagman, Göran; Håkansson, Krister; Kulmala, Jenni; Nilsen, Charlotta; Kåreholt, Ingemar; Soininen, Hilkka; Solomon, Alina; Kivipelto, Miia
To investigate the associations between midlife work-related stress and mild cognitive impairment (MCI), dementia, and Alzheimer's disease later in life, in a large representative population. Cardiovascular Risk Factors, Aging and Dementia (CAIDE) study participants were randomly selected from independent population-based surveys (mean age 50 years). A random sample of 2,000 individuals was invited for two reexaminations including cognitive tests (at mean age 71 and mean age 78), and 1,511 subjects participated in at least one reexamination (mean follow-up 28.5 years). Work-related stress was measured using two questions on work demands that were administered in midlife. Analyses adjusted for important confounders. Higher levels of midlife work-related stress were associated with higher risk of MCI (odds ratio [OR], 1.38; 95% confidence interval [CI], 1.08-1.76), dementia (OR, 1.53; CI, 1.13-2.07), and Alzheimer's disease (OR, 1.55; CI, 1.19-2.36) at the first follow-up among the CAIDE participants. Results remained significant after adjusting for several possible confounders. Work-related stress was not associated with MCI and dementia during the extended follow-up. Midlife work-related stress increases the risk for MCI, dementia, and Alzheimer's disease in later life. The association was not seen after the extended follow-up possibly reflecting selective survival/participation, heterogeneity in dementia among the oldest old, and a critical time window for the effects of midlife stress. © The Author 2016. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: email@example.com.
Al-Turki, Yousef Abdullah
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
Svarch, E; Nordet, I; Machín, S; Fernández, L; Muñiz, A; Wade, M
A programme for antenatal diagnosis of sickle-cell anaemia (SA) and SC haemoglobinopathy (SC) was started in Cuba in 1983. The purpose of this paper is to report the clinical and haematological data of a group of children diagnosed before birth or in the first few months of life. Between June 1986 and December 1992, 78 children under 5 years of age were studied at the Haemoglobinpathies Clinic of the Instituto de Hematología e Inmunologia in La Habana; of them, 53 had SA and 25 had SC, there were 41 girls and 37 boys. A comprehensive questionnaire was carried out during the first visit to the clinic, about the onset of the clinical manifestations, as well as a careful physical examination plus peripheral blood study and Hb A2 and Hb F assay. Parents were informed, and folate and prophylactic penicillin were given orally to the children. The yearly average admissions to hospital were 1.6 +/- 3.8 for SA and 0.1 +/- 0.6 for SC. The average number of veno-occlusive crises was 0.2 +/- 0.6 in SA and 0.1 +/- 0.6 in SC (p < 0.04); the average hand-foot crises were 0.3 +/- 1.1. for SA and nil for SC. The average number of infections per year was 0.3 +/- 0.6 in SA and 0.1 +/-0.3 in SC, without any significant difference. Significant differences were found in the haemoglobin rates and reticulocyte counts between both haemoglobinopathies. Hb F rate was 7.80 +/- 4.78% in SA and 2.83 +/- 3.45% in SC. Admission to hospital, hand-foot crises, infections and splenic sequestration are the commonest clinical events during the first 5 years of life. The number of infections episodes decreases with prophylactic oral penicillin, and overacute pneumococcal infection is suppressed. Parent education allows one to early treat sequestration crises, and partial splenectomy avoids repetition of this complication, while preserving the splenic function.
Choo, Soo-Young; Lee, Sang-Yi; Kim, Chul-Woung; Kim, Su Young; Yoon, Tae-Ho; Shin, Hai Rim; Moon, Ok Ryun
There have been few studies examining the differences in health care utilization across social classes during the last year of life. Therefore, in this study we analyzed the quantitative and qualitative differences in health care utilization among cancer patients across educational classes in their last year of life, and derived from it implications for policy. To evaluate health care utilization by cancer patients in the last year of life, Death certificate data from 2004 were merged with National Health Insurance data (n = 60,088). In order to use educational level as a social class index, we selected the individuals aged 40 and over as study subjects (n = 57,484). We analyzed the differences in the medical expenditures, admission days, and rates of admission experience across educational classes descriptively. Multiple regression analysis was conducted to evaluate the association between medical expenditures and independent variables such as sex, age, education class, site of death and type of cancer. The upper educational class spent much more on medical expenditures in the last one year of life, particularly during the last month of life, than the lower educational class did. The ratio of monthly medical expenditures per capita between the college class and no education class was 2.5 in the last 6-12 months of life, but the ratio was 1.6 in the last 1 month. Also, the lower the educational class, the higher the proportion of medical expenditures during the last one month of life, compared to total medical expenditures in the last one year of life. The college educational class had a much higher rate of admission experiences in tertiary hospitals within Seoul than the other education classes did. This study shows that the lower educational classes had qualitative and quantitative disadvantages in utilizing health care services for cancer in the last year of life.
Schlaud, Martin; Schmitz, Roma; Poethko-Müller, Christina; Kuhnert, Ronny
The study focused on the question of whether and - if so - to what direction and extent immunisations in the 1st year may be associated with the risk of being diagnosed with atopic diseases after the 1st year of life. Data from the German Health Interview and Examination Survey for Children and Adolescents (KiGGS, 2003-2006) were analysed. For analyses of potential associations between vaccination status and risk of hay fever, atopic dermatitis or asthma, sample sizes of 15254, 14297, and 15262, respectively, were available. Children with a sufficient TDPHiHeP vaccination at the end of the 1st year of life had a lower risk of being diagnosed with hay fever after the 1st year of life (adjusted prevalence ratio 0.85, 95% confidence interval 0.76-0.96). Analyses for associations between TDPHiHeP vaccination and risk of atopic dermatitis or asthma, or between age at onset of vaccination or of the number of antigens vaccinated in the 1st year of life and risk of atopic disease failed to yield statistical significance. Our results provide no evidence that immunisations in the 1st year of life may increase the risk of atopic disease. If any association exists at all, our results may be interpreted as weakly supportive of the hypothesis that immunisations may slightly decrease the risk of atopy in later life. Copyright © 2017 Elsevier Ltd. All rights reserved.
Full Text Available Introduction : Omalizumab, a monoclonal anti-immunoglobulin E antibody, has been successfully used as a supplementary therapy to improve asthma control in children aged ≥ 6 years with severe persistent allergic asthma. Aim : To demonstrate the quality of life in children with severe asthma and their caregivers, and changes from baseline in forced expiratory volume in 1 s (FEV 1 and daily inhaled corticosteroids (ICS dose after 2-year treatment with omalizumab. Material and methods : Participants were seen in the clinic at enrollment (visit 1, after 16 weeks (visit 2, after 52 weeks (visit 3 and after 104 weeks (visit 4 of treatment with omalizumab. We evaluated lung function, ICS use and the quality of life with the Pediatric Asthma Quality of Life Questionnaire (PAQLQ and the Pediatric Asthma Caregiver’s Quality of Life Questionnaire (PACQLQ. Results : Nineteen children and caregivers were enrolled. Significant improvement was observed in PAQLQ and PACQLQ scores, both in all domains and in total scores. Significant differences were found between the first and the other visits. A positive correlation between PAQLQ and PACQLQ at the first and at the second visit was found, 63.3% of patients achieved reduction in ICS doses. We did not notice any significant improvement in FEV 1 . Conclusions : The improvement in quality of life in asthmatic children and adolescents observed after omalizumab correlates with the improvement of quality of life in caregivers, reduction in ICS use but not with FEV 1 .
Headey, Bruce; Muffels, Ruud
An adequate theory of Life Satisfaction (LS) needs to take account of both factors that tend to stabilise LS and those that change it. The most widely accepted theory in the recent past - set-point theory - focussed solely on stability (Brickman and Campbell, 1971; Lykken and Tellegen, 1996). That theory is now regarded as inadequate by most researchers, given that national panel surveys in several Western countries show that substantial minorities of respondents have recorded large, long ter...
van der Beek, Eva S J; Geenen, Rinie; de Heer, Francine A G; van der Molen, Aebele B Mink; van Ramshorst, Bert
Bariatric surgery for morbid obesity results in massive weight loss and improvement of health and quality of life. A downside of the major weight loss is the excess of overstretched skin, which may influence the patient's quality of life by causing functional and aesthetic problems. The purpose of the current study was to evaluate the patient's quality of life long-term after body contouring following bariatric surgery. Quality of life was measured with the Obesity Psychosocial State Questionnaire in 33 post-bariatric surgery patients 7.2 years (range, 3.2 to 13.3 years) after body contouring surgery. Data were compared with previous assessments 4.1 years (range, 0.7 to 9.2 years) after body contouring surgery of the quality of life at that time and before body contouring surgery. Compared with appraisals of quality of life before body contouring surgery, a significant, mostly moderate to large, sustained improvement of quality of life was observed in post-bariatric surgery patients 7.2 years after body contouring surgery in six of the seven psychosocial domains. A small deterioration occurred between 4.1- and 7.2-year follow-up on two of the seven domains except for the domain efficacy toward eating, which showed a significant improvement. At 7-year follow-up, 18 patients (55 percent) were satisfied with the result of body contouring surgery. This study indicates a sustained quality-of-life improvement in post-bariatric surgery patients after body contouring surgery. This suggests the importance of including reconstructive surgery as a component in the multidisciplinary approach in the surgical treatment of morbid obesity. Therapeutic, IV.
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...
Yang, Jun; Ou, Chun-Quan; Guo, Yuming; Li, Li; Guo, Cui; Chen, Ping-Yan; Lin, Hua-Liang; Liu, Qi-Yong
Limited evidence is available on the association between temperature and years of life lost (YLL). We applied distributed lag non-linear model to assess the nonlinear and delayed effects of temperature on YLL due to cause-/age-/education-specific mortality in Guangzhou, China. We found that hot effects appeared immediately, while cold effects were more delayed and lasted for 14 days. On average, 1 °C decrease from 25th to 1st percentile of temperature was associated with an increase of 31.15 (95%CI: 20.57, 41.74), 12.86 (8.05, 17.68) and 6.64 (3.68, 9.61) YLL along lag 0-14 days for non-accidental, cardiovascular and respiratory diseases, respectively. The corresponding estimate of cumulative hot effects (1 °C increase from 75th to 99th percentile of temperature) was 12.71 (-2.80, 28.23), 4.81 (-2.25, 11.88) and 2.81 (-1.54, 7.16). Effect estimates of cold and hot temperatures-related YLL were higher in people aged up to 75 years and persons with low education level than the elderly and those with high education level, respectively. The mortality risks associated with cold and hot temperatures were greater on the elderly and persons with low education level. This study highlights that YLL provides a complementary method for assessing the death burden of temperature.
Goldstein, Risë B.; Dawson, Deborah A.; Smith, Sharon M.; Grant, Bridget F.
Objective To examine 3-year quality-of-life (QOL) outcomes among United States adults with Diagnostic and Statistical Manual of Mental Disorders – Fourth Edition (DSM-IV) antisocial personality disorder (ASPD), syndromal adult antisocial behavior without conduct disorder (CD) before age 15 (AABS, not a DSM-IV diagnosis), or no antisocial behavioral syndrome at baseline. Method Face-to-face interviews (n= 34,653). Psychiatric disorders were assessed using the Alcohol Use Disorder and Associated Disabilities Interview Schedule – DSM-IV Version. Health-related QOL was assessed using the Short-Form 12-Item Health Survey, version 2 (SF-12v2). Other outcomes included past-year Perceived Stress Scale-4 (PSS-4) scores, employment, receipt of Supplemental Security Income (SSI), welfare, and food stamps, and participation in social relationships. Results ASPD and AABS predicted poorer employment, financial dependency, social relationship, and physical health outcomes. Relationships of antisociality to SSI and food stamp receipt and physical health scales were modified by baseline age. Both antisocial syndromes predicted higher PSS-4, AABS predicted lower SF-12v2 Vitality, and ASPD predicted lower SF-12v2 Social Functioning scores in women. Conclusion Similar prediction of QOL by ASPD and AABS suggests limited utility of requiring CD before age 15 to diagnose ASPD. Findings underscore the need to improve prevention and treatment of antisocial syndromes. PMID:22375904
Brain development during the first year of life was assessed quantitatively using apparent diffusion coefficient (ADC) images constructed from diffusion-weighted MR image data. The imaging plane was coronal at the section of the pons. The cerebral peduncle, internal capsule, corona radiata, superior longitudinal fasciculus and thalamus were selected for evaluation of their ADC values. A diffusion sensitive gradient was added in the anteroposterior direction. Thus the orientation of nerve fibers in the cerebral peduncle, internal capsule and corona radiata was perpendicular to it, and that in the superior longitudinal fasciculus was parallel to it. In neonates, the cerebral peduncle and internal capsule, having been moderately myelinated at birth, showed the slowest diffusion. The corona radiata and superior longitudinal fasciculus, having been unmyelinated at birth, showed the fastest diffusion. The thalamus had intermediate diffusion. These neonatal diffusions tended to be promptly restricted within the first five months, followed by additional slight restriction thereafter. ADC values in the first year were significantly reduced in all regions compared with those in the neonatal period, particularly in the corona radiata and thalamus. This study showed that ADC analysis can estimate normal brain development in detail and might be useful for investigating various neonatal brain diseases. (author)
Barker-Collo, Suzanne; Bennett, Derrick A; Krishnamurthi, Rita V
BACKGROUND: Accurate information on stroke burden in men and women are important for evidence-based healthcare planning and resource allocation. Previously, limited research suggested that the absolute number of deaths from stroke in women was greater than in men, but the incidence and mortality...... incidence, prevalence, mortality, disability-adjusted life years (DALYs) and healthy years lost due to disability were estimated as part of the Global Burden of Disease (GBD) 2013 Study. Data inputs included all available information on stroke incidence, prevalence and death and case fatality rates...... ischemic stroke (IS) and hemorrhagic stroke (HS) incidence (per 100,000) in men (IS 132.77 (95% UI 125.34-142.77); HS 64.89 (95% UI 59.82-68.85)) exceeded those of women (IS 98.85 (95% UI 92.11-106.62); HS 45.48 (95% UI 42.43-48.53)). IS incidence rates were lower in 2013 compared with 1990 rates for both...
Merzlikin, Oleg V; Louie, Brian E; Farivar, Alexander S; Shultz, Dale; Aye, Ralph W
Paraesophageal hernias (PEHs) involve herniation of stomach and/or other viscera into the mediastinum. These commonly occur in the elderly and can severely limit quality of life. Short term outcomes of repaired PEH demonstrated low morbidity and significant improvement in quality of life, but long-term data for all patients, especially the elderly, are lacking. Retrospective chart review of a prospectively collected database of patients aged 70 or greater with a symptomatic PEH repaired 5+ years ago. Quality of life data were assessed preoperatively, at 12-24 months, and at 5+ years using QOLRAD, GERD-HRQL, and DSS. We identified 137 patients who met the age criteria, with 69 patients undergoing surgery 5+ years ago. With ten patients were lost to follow-up, 59 patients were analyzed, including 24 males and 35 females. Median age at repair was 77 years. There were two 90-day mortalities, with one occurring within 30 days of surgery. Patients alive at evaluation had a median age of 74 years and were followed a median 7.4 years. From baseline, QOLRAD improved from 4 to 6.5, GERD-HRQL improved from 11 to 5, and swallowing improved from 11 to 38. During follow-up, 21 patients died. Deceased patients lived a median of 4 years after repair, with a median age at repair of 80 years. At a median time follow-up of 2 years, this group's QOLRAD improved from 5.1 to 7, GERD-HRQL improved from 16 to 4, and swallowing improved from 14.5 to 35. In elderly patients with symptomatic PEH undergoing surgical repair more than 5 years ago, there was sustained improvement in quality of life. This justifies surgical repair of symptomatic PEH in elderly patients.
Tielemans, Susanne M A J; Geleijnse, Johanna M; Menotti, Alessandro; Boshuizen, Hendriek C; Soedamah-Muthu, Sabita S; Jacobs, David R; Blackburn, Henry; Kromhout, Daan
Blood pressure (BP) trajectories derived from measurements repeated over years have low measurement error and may improve cardiovascular disease prediction compared to single, average, and usual BP (single BP adjusted for regression dilution). We characterized 10-year BP trajectories and examined their association with cardiovascular mortality, all-cause mortality, and life years lost. Data from 2 prospective and nearly extinct cohorts of middle-aged men—the Minnesota Business and Professional Men Study (n=261) and the Zutphen Study (n=632)—were used. BP was measured annually during 1947-1957 in Minnesota and 1960-1970 in Zutphen. BP trajectories were identified by latent mixture modeling. Cox proportional hazards and linear regression models examined BP trajectories with cardiovascular mortality, all-cause mortality, and life years lost. Associations were adjusted for age, serum cholesterol, smoking, and diabetes mellitus. Mean initial age was about 50 years in both cohorts. After 10 years of BP measurements, men were followed until death on average 20 years later. All Minnesota men and 98% of Zutphen men died. Four BP trajectories were identified, in which mean systolic BP increased by 5 to 49 mm Hg in Minnesota and 5 to 20 mm Hg in Zutphen between age 50 and 60. The third systolic BP trajectories were associated with 2 to 4 times higher cardiovascular mortality risk, 2 times higher all-cause mortality risk, and 4 to 8 life years lost, compared to the first trajectory. Ten-year BP trajectories were the strongest predictors, among different BP measures, of cardiovascular mortality, all-cause mortality, and life years lost in Minnesota. However, average BP was the strongest predictor in Zutphen. © 2015 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.
Newman, M F; Grocott, H P; Mathew, J P; White, W D; Landolfo, K; Reves, J G; Laskowitz, D T; Mark, D B; Blumenthal, J A
The importance of perioperative cognitive decline has long been debated. We recently demonstrated a significant correlation between perioperative cognitive decline and long-term cognitive dysfunction. Despite this association, some still question the importance of these changes in cognitive function to the quality of life of patients and their families. The purpose of our investigation was to determine the association between cognitive dysfunction and long-term quality of life after cardiac surgery. After institutional review board approval and patient informed consent, 261 patients undergoing cardiac surgery with cardiopulmonary bypass were enrolled and followed for 5 years. Cognitive function was measured with a battery of tests at baseline, discharge, and 6 weeks and 5 years postoperatively. Quality of life was assessed with well-validated, standardized assessments at the 5-year end point. Our results demonstrate significant correlations between cognitive function and quality of life in patients after cardiac surgery. Lower 5-year overall cognitive function scores were associated with lower general health and a less productive working status. Multivariable logistic and linear regression controlling for age, sex, education, and diabetes confirmed this strong association in the majority of areas of quality of life. Five years after cardiac surgery, there is a strong relationship between neurocognitive functioning and quality of life. This has important social and financial implications for preoperative evaluation and postoperative care of patients undergoing cardiac surgery.
Postma, Froukje M; Ågren, Jon
Incomplete information regarding both selection regimes and the genetic basis of fitness limits our understanding of adaptive evolution. Among-year variation in the genetic basis of fitness is rarely quantified, and estimates of selection are typically based on single components of fitness, thus potentially missing conflicting selection acting during other life-history stages. Here, we examined among-year variation in selection on a key life-history trait and the genetic basis of fitness covering the whole life cycle in the annual plant Arabidopsis thaliana. We planted freshly-matured seeds of >200 recombinant inbred lines (RILs) derived from a cross between two locally-adapted populations (Italy and Sweden), and both parental genotypes at the native site of the Swedish population in three consecutive years. We quantified selection against the nonlocal Italian genotype, mapped quantitative trait loci (QTL) for fitness and its components, and quantified selection on timing of germination during different life stages. In all three years, the local Swedish genotype outperformed the non-local Italian genotype. However, both the contribution of early life stages to relative fitness, and the effects of fitness QTL varied among years. Timing of germination was under conflicting selection through seedling establishment vs. adult survival and fecundity, and both the direction and magnitude of net selection varied among years. Our results demonstrate that selection during early life stages and the genetic basis of fitness can vary markedly among years, emphasizing the need for multi-year studies considering the whole life cycle for a full understanding of natural selection and mechanisms maintaining local adaptation. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
Kunnavil, Radhika; Thirthahalli, Chethana; Nooyi, Shalini Chandrashekar; Shivaraj, N S; Murthy, Nandagudi Srinivasa
Competing Risk Approach (CRA) has been used to compute burden of disease in terms of Disability Adjusted Life Years (DALYs) based on a life table for an initially disease-free cohort over time. To compute Years of Life Lost (YLL) due to premature mortality, Years of life lost due to Disability (YLD), DALYs and loss in expectation of life (LEL) using competing risk approach for female breast cancer patients for the year 2008 in India. The published data on breast cancer by age & sex, incidence & mortality for the year 2006-2008 relating to six population based cancer registries (PBCR) under Indian Council of Medical Research (ICMR), general mortality rates of 2007 in India, published in national health profile 2010; based on Sample Registration System (SRS) were utilized for computations. Three life tables were constructed by applying attrition of factors: (i) risk of death from all causes ('a'; where a is the general death rate); (ii) risk of incidence and that of death from causes other than breast cancer ('b-a+c'; where 'b' is the incidence of breast cancer and 'c' is the mortality of breast cancer); and (iii) risk of death from all other causes after excluding cancer mortality ('a-c'). Taking the differences in Total Person Years Lived (TPYL), YLD and YLL were derived along with LEL. CRA revealed that the DALYs were 40209 per 100,000 females in the life time of 0-70+ years with a LEL of 0.11 years per person. Percentage of YLL to DALYs was 28.20% in the cohort. The method of calculation of DALYs based on the CRA is simple and this will help to identify the burden of diseases using minimal information in terms of YLL, YLD, DALYs and LEL.
Gustavo de los Campos
Full Text Available Genetic factors are believed to account for 25% of the interindividual differences in Years of Life (YL among humans. However, the genetic loci that have thus far been found to be associated with YL explain a very small proportion of the expected genetic variation in this trait, perhaps reflecting the complexity of the trait and the limitations of traditional association studies when applied to traits affected by a large number of small-effect genes. Using data from the Framingham Heart Study and statistical methods borrowed largely from the field of animal genetics (whole-genome prediction, WGP, we developed a WGP model for the study of YL and evaluated the extent to which thousands of genetic variants across the genome examined simultaneously can be used to predict interindividual differences in YL. We find that a sizable proportion of differences in YL--which were unexplained by age at entry, sex, smoking and BMI--can be accounted for and predicted using WGP methods. The contribution of genomic information to prediction accuracy was even higher than that of smoking and body mass index (BMI combined; two predictors that are considered among the most important life-shortening factors. We evaluated the impacts of familial relationships and population structure (as described by the first two marker-derived principal components and concluded that in our dataset population structure explained partially, but not fully the gains in prediction accuracy obtained with WGP. Further inspection of prediction accuracies by age at death indicated that most of the gains in predictive ability achieved with WGP were due to the increased accuracy of prediction of early mortality, perhaps reflecting the ability of WGP to capture differences in genetic risk to deadly diseases such as cancer, which are most often responsible for early mortality in our sample.
Rusconi, F; Castagneto, M; Gagliardi, L; Leo, G; Pellegatta, A; Porta, N; Razon, S; Braga, M
Raised respiratory rate is a useful sign to diagnose lower respiratory infections in childhood. However, the normal range for respiratory rate has not been defined in a proper, large sample. To assess the respiratory rate in a large number of infants and young children in order to construct percentile curves by age; to determine the repeatability to the assessment using a stethoscope and compare it with observation. Respiratory rate was recorded for 1 minute with a stethoscope in 618 infants and children, aged 15 days to 3 years old, without respiratory infections or any other severe disease when awake and calm and when asleep. In 50 subjects we compared respiratory rate taken 30 to 60 minutes apart to assess repeatability, and in 50 others we compared simultaneous counts obtained by stethoscope versus observation. Repeatability was good as the standard deviation of differences was 2.5 breaths/minute in awake and 1.7 breaths/minute in asleep children. Respiratory rate obtained with a stethoscope was systematically higher than that obtained by observation (mean difference 2.6 breaths/minute in awake and 1.8 breaths/minute in asleep children; P = .015 and P respiratory rate with age was seen for both states, and it was faster in the first few months of life when also a greater dispersion of values was observed. A second degree polynomial curve accurately fitted the data. Reference percentile values were developed from these data. The repeatability of respiratory rate measured with a stethoscope was good. Percentile curves would be particularly helpful in the first months of life when the decline in respiratory rate is very rapid and prevents to use cut off values for defining "normality."
Tansug, Nermin, E-mail: firstname.lastname@example.org [Celal Bayar University, Faculty of Medicine, Department of Pediatrics, 45020 Manisa (Turkey); Yildirim, Sule Aslan, E-mail: email@example.com [Celal Bayar University, Faculty of Medicine, Department of Pediatrics, 45020 Manisa (Turkey); Canda, Ebru, E-mail: firstname.lastname@example.org [Celal Bayar University, Faculty of Medicine, Department of Pediatrics, 45020 Manisa (Turkey); Ozalp, Deniz, E-mail: email@example.com [Celal Bayar University, Faculty of Medicine, Department of Pediatrics, 45020 Manisa (Turkey); Yilmaz, Ozge, E-mail: firstname.lastname@example.org [Celal Bayar University, Faculty of Medicine, Department of Pediatrics, 45020 Manisa (Turkey); Taneli, Fatma, E-mail: email@example.com [Celal Bayar University, Faculty of Medicine, Department of Biochemistry, 45020 Manisa (Turkey); Ersoy, Betuel, E-mail: firstname.lastname@example.org [Celal Bayar University, Faculty of Medicine, Department of Pediatrics, 45020 Manisa (Turkey)
Since most of in utero bone mass accretion occurs during the third trimester and postnatal need for bone nutrients is increased, preterm infants have an increased risk of low bone mass. Early identification of the risk is of crucial importance. Quantitative ultrasound, which is a relatively inexpensive, portable, noninvasive, and radiation-free method, gives information about bone density, cortical thickness, elasticity and microarchitecture. The aim of this study was to obtain quantitative ultrasound measurements of tibial speed of sound of preterm and term infants and to assess clinical factors associated with these measurements during the first year of life. Seventy-eight preterm and 48 term infants were enrolled in this study. Measurements were made on the 10th day of life in both groups, and were repeated on the 2nd, 6th and 12th months for preterm infants and on the12th month for the term infants. Speed of sound on preterm infants was significantly decreased on the 2nd month but significantly increased on the 12th month (P = 0.00). Comparing speed of sound of term and preterm infants, 10th day measurements were significantly different (P = 0.00), but there was not any significant difference between the 12th month values (P = 0.26). There was not any relation between biochemical parameters and speed of sound. The technique has potential clinical value for assessment of bone status. Further studies with long term follow up are needed to evaluate the value of quantitative ultrasound with other bone markers to predict the risk of fracture.
Tansug, Nermin; Yildirim, Sule Aslan; Canda, Ebru; Ozalp, Deniz; Yilmaz, Ozge; Taneli, Fatma; Ersoy, Betuel
Since most of in utero bone mass accretion occurs during the third trimester and postnatal need for bone nutrients is increased, preterm infants have an increased risk of low bone mass. Early identification of the risk is of crucial importance. Quantitative ultrasound, which is a relatively inexpensive, portable, noninvasive, and radiation-free method, gives information about bone density, cortical thickness, elasticity and microarchitecture. The aim of this study was to obtain quantitative ultrasound measurements of tibial speed of sound of preterm and term infants and to assess clinical factors associated with these measurements during the first year of life. Seventy-eight preterm and 48 term infants were enrolled in this study. Measurements were made on the 10th day of life in both groups, and were repeated on the 2nd, 6th and 12th months for preterm infants and on the12th month for the term infants. Speed of sound on preterm infants was significantly decreased on the 2nd month but significantly increased on the 12th month (P = 0.00). Comparing speed of sound of term and preterm infants, 10th day measurements were significantly different (P = 0.00), but there was not any significant difference between the 12th month values (P = 0.26). There was not any relation between biochemical parameters and speed of sound. The technique has potential clinical value for assessment of bone status. Further studies with long term follow up are needed to evaluate the value of quantitative ultrasound with other bone markers to predict the risk of fracture.
Malatesta, C Z; Culver, C; Tesman, J R; Shepard, B
This study examines the course of emotion expression development over the first 2 years of life in a sample of full-term and preterm children. 58 mother/infant pairs were videotaped at infant ages of 2 1/2, 5, 7 1/2, and 22 months, recording face-to-face interaction involving play and separation/reunion sessions. The tapes were coded on a second-to-second basis using Izard's facial affect coding system. Data analysis focused on (1) differences in expressive behavior at 22 months as a function of risk status, gender, attachment status, and patterns of earlier maternal contingency behavior; (2) stability of specific emotional expressive patterns across assessment periods; and (3) the relation of expressive behavior and security of attachment at 2 years to qualities of earlier affective interchange. Mother's contingency behavior (both general level and specific contingency patterns) appeared to have a material effect on the course of emotional development, as did birth status and gender. Prematurity was associated with differential socioemotional development well into the second year, much in contrast to the "catch-up effect" observed in linguistic and cognitive functioning. Discrete emotions analysis of attachment groups yielded differentiation along a broad negative/positive dimension, but it also showed that insecurely attached children can be characterized as showing inhibited anger expression. The results of this study are discussed within the framework of organizational models of infant affective development; attachment theory and discrete emotions approaches were found to yield different yet equally informative data on the course of socioemotional development.
Paciej, Paulina; Ciabiada, Beata; Maniecka-Bryła, Irena
In order to evaluate the health status of a population, besides indicators measuring the incidence of diseases and deaths, potential measures are becoming more frequently used, ie. measures that take into account life-time potential of the individuals in the population. They can particularly by applied to analyse the problem of premature mortality, which is measured by lost life years. The aim of the study was to evaluate life years lost due to diseases of digestive system in Polish population in 2013. The study was based on a dataset containing 387,312 death certificates of Poles who died in 2013, provided by the Central Statistical Office in Poland. Data on deaths caused by diseases of digestive system (K00-K93 by ICD-10) were used in the study – that were 16,543 records (4.3% of all the deaths). Lost life years were assessed with the measures: SEYLL (Standard Expected Years of Life Lost), SEYLLp (Standard Expected Years of Life Lost per living person), SEYLLd (Standard Expected Years of Life Lost per death). In the analysed year among men there were 9,275 deaths caused by diseases of digestive system and in women 7,268 deaths. SEYLL in the group of men amounted to 102 230.7 and in the group of women it was 53,475.5. The number of lost life years calculated per 10 000 male inhabitants was 54.9, and for 10,000 females it was 26.9. The highest share in lost life years had alcoholic liver disease (SEYLLp for men – 20.87, for women – 6.1), fibrosis and cirrhosis of the liver (SEYLLp for men- 9.7, for women- 5.6) and acute pancreatitis (SEYLLp for men – 5.3, for women – 2.1). The results of the study indicate that diseases of digestive system have an important contribution to the loss of life-time potential in Polish population (6.6% of all SEYLL in 2013). The dominant role in this class of diseases played alcoholic liver disease – K70, fibrosis and cirrhosis of the liver – K74 and acute pancreatitis – K85.
Valera-Gran, Desirée; García de la Hera, Manuela; Navarrete-Muñoz, Eva María; Fernandez-Somoano, Ana; Tardón, Adonina; Julvez, Jordi; Forns, Joan; Lertxundi, Nerea; Ibarluzea, Jesús María; Murcia, Mario; Rebagliato, Marisa; Vioque, Jesús
Folate intake during pregnancy has been associated with improved neuropsychological development in children, although the effects of high dosages of folic acid (FA) supplements are unclear. To examine the association between the use of high dosages of FA supplements during pregnancy and child neuropsychological development after the first year of life. The multicenter prospective mother-child cohort Infancia y Medio Ambiente (INMA) Project recruited pregnant women from 4 areas of Spain (Asturias, Sabadell, Gipuzkoa, and Valencia) between November 2003 and January 2008. Pregnant women completed an interviewer-administered questionnaire on the usual dietary folate intake and FA supplements at 10 to 13 weeks and 28 to 32 weeks of gestation. The main analyses were based on a sample of 2213 children with complete information on neuropsychological development and FA supplement intake during pregnancy. Multiple linear and logistic regression analyses were used to explore the effects of FA supplements on child neuropsychological development. Neuropsychological development was assessed using the Bayley Scales of Infant Development. We calculated mental scale and psychomotor scale scores. One SD below the mean established a delay in neurodevelopment (score 5000 μg/d). In multivariate analysis, we observed that children whose mothers used FA supplement dosages higher than 5000 μg/d during pregnancy had a statistically significantly lower mean psychomotor scale score (difference, -4.35 points; 95% CI, -8.34 to -0.36) than children whose mothers used a recommended dosage of FA supplements (400-1000 μg/d). An increased risk of delayed psychomotor development (psychomotor scale score <85) was also evident among children whose mothers took FA supplement dosages higher than 5000 μg/d, although the association was not statistically significant (odds ratio = 1.59; 95% CI, 0.82-3.08). To our knowledge, this is the first time a detrimental effect of high dosages of FA supplements
Vasiliadis, Helen-Maria; Lesage, Alain; Latimer, Eric; Seguin, Monique
,979 per life year saved. Suicide prevention programs such as the NAD trial are cost-effective and can result in important potential cost-savings due to averted suicide deaths and reduced life years lost. Implementation of suicide prevention programs at the population level in Canada is cost-effective. Community mental health programs aimed at increasing awareness and the treatment of depression and better follow-up of high risk individuals for suicide are associated with a minimal per capita investment. These programs can result in important potential cost-savings due to averted suicide deaths and decreased disability due to depression. Additional research should focus on whether the outcomes of multi-modal suicide programs are specific or synergistic and most effective for which population subgroups. This may help inform how best to invest resources for the highest return.
Hu, Shunbo; Wei, Lifang; Gao, Yaozong; Guo, Yanrong; Wu, Guorong; Shen, Dinggang
Many brain development studies have been devoted to investigate dynamic structural and functional changes in the first year of life. To quantitatively measure brain development in such a dynamic period, accurate image registration for different infant subjects with possible large age gap is of high demand. Although many state-of-the-art image registration methods have been proposed for young and elderly brain images, very few registration methods work for infant brain images acquired in the first year of life, because of (a) large anatomical changes due to fast brain development and (b) dynamic appearance changes due to white-matter myelination. To address these two difficulties, we propose a learning-based registration method to not only align the anatomical structures but also alleviate the appearance differences between two arbitrary infant MR images (with large age gap) by leveraging the regression forest to predict both the initial displacement vector and appearance changes. Specifically, in the training stage, two regression models are trained separately, with (a) one model learning the relationship between local image appearance (of one development phase) and its displacement toward the template (of another development phase) and (b) another model learning the local appearance changes between the two brain development phases. Then, in the testing stage, to register a new infant image to the template, we first predict both its voxel-wise displacement and appearance changes by the two learned regression models. Since such initializations can alleviate significant appearance and shape differences between new infant image and the template, it is easy to just use a conventional registration method to refine the remaining registration. We apply our proposed registration method to align 24 infant subjects at five different time points (i.e., 2-week-old, 3-month-old, 6-month-old, 9-month-old, and 12-month-old), and achieve more accurate and robust registration
S. V. Santos
Full Text Available We aimed to evaluate knowledge of first aid among new undergraduates and whether it is affected by their chosen course. A questionnaire was developed to assess knowledge of how to activate the Mobile Emergency Attendance Service - MEAS (Serviço de Atendimento Móvel de Urgência; SAMU, recognize a pre-hospital emergency situation and the first aid required for cardiac arrest. The students were also asked about enrolling in a first aid course. Responses were received from 1038 of 1365 (76.04% new undergraduates. The questionnaires were completed in a 2-week period 1 month after the beginning of classes. Of the 1038 respondents (59.5% studying biological sciences, 11.6% physical sciences, and 28.6% humanities, 58.5% knew how to activate the MEAS/SAMU (54.3% non-biological vs 61.4% biological, P=0.02, with an odds ratio (OR=1.39 (95%CI=1.07-1.81 regardless of age, sex, origin, having a previous degree or having a relative with cardiac disease. The majority could distinguish emergency from non-emergency situations. When faced with a possible cardiac arrest, 17.7% of the students would perform chest compressions (15.5% non-biological vs 19.1% biological first-year university students, P=0.16 and 65.2% would enroll in a first aid course (51.1% non-biological vs 74.7% biological, P<0.01, with an OR=2.61 (95%CI=1.98-3.44 adjusted for the same confounders. Even though a high percentage of the students recognized emergency situations, a significant proportion did not know the MEAS/SAMU number and only a minority had sufficient basic life support skills to help with cardiac arrest. A significant proportion would not enroll in a first aid course. Biological first-year university students were more prone to enroll in a basic life support course.
Dingemans, Ellen; Henkens, Kène
Empirical studies have consistently shown the negative impact of involuntary retirement on mental well-being. However, few studies have thus far investigated the degree to which post-retirement work affects late-life outcomes. The present study improves our understanding of the impact of retirement on the self-efficacy and life satisfaction among older adults by focusing on the combined impact of retirement voluntariness and participation in post-retirement work. By using panel data on retirement behavior in the Netherlands, we estimate fixed effects and multilevel models to explain (intra-)individual changes in self-efficacy and life satisfaction over a 10-year period in which most participants made the transition to retirement. The results indicate that involuntary retirement is associated with decreases in both self-efficacy and life satisfaction in later life. Whereas involuntary retirees who participate in bridge jobs show no changes in life satisfaction, those involuntary retirees without bridge jobs experience a decline in life satisfaction. In addition, we found enhanced levels of life satisfaction for voluntary retirees in bridge employment. The association with self-efficacy was less pronounced. These results suggest that the characteristics of the retirement process influence changes in mental well-being in later life. Specifically, bridge employment alleviates the negative consequences of involuntary retirement and even seems to enhance post-retirement well-being for voluntary retirees.
... 10 Energy 4 2010-01-01 2010-01-01 false Lack of alternate fuel supply for the first 10 years of useful life. 503.31 Section 503.31 Energy DEPARTMENT OF ENERGY (CONTINUED) ALTERNATE FUELS NEW FACILITIES Permanent Exemptions for New Facilities § 503.31 Lack of alternate fuel supply for the first 10 years of...
Lapsley, Hilary; Pattie, Alison; Starr, John M; Deary, Ian J
This research report presents findings on 'start in life' from a qualitative study of 90-year-olds from the Lothian Birth Cohort 1921. The study aimed to contextualise the LBC1921 cohort in time and place, describe cohort members' experiences of family and schooling and stimulate further inquiry into the relationships between 'start in life' and risk and resilience factors relating to longevity and healthy ageing. Scottish education and family life in the early 1930s are briefly described. Life review questionnaire: A qualitative Life Review Questionnaire was developed, requiring free-text handwritten responses. Its 'Start in Life' section focused on schooling and family support. Wave 4 of the Lothian Birth Cohort 1921 involved testing 129 members near to their 90(th) birthday. They reside largely in Edinburgh and its environs. The Life Review Questionnaire was administered to 126 participants, 54 % women. Qualitative analysis: Thematic analysis was the qualitative technique used to categorise, code and extract meaning from questionnaire text. Narratives were extracted from the data to present illustrative stories. Narratives of start in life gave contextual description. Thematic analysis showed LBC1921 members enjoying their schooling, highlighting teachers, academic achievement, school activities and school friendships. Personal qualities, family circumstances and aspects of schooling sometimes hindered educational performance. Family life was recalled mostly with warmth and parents were often portrayed as valuing education and supporting learning and development. Family adversity from poverty, parental illness and parental death was often mitigated by support from parents (or the remaining parent). Overall, most cohort members believed that they had got off to a good 'start in life'. This qualitative investigation of 'start in life' adds context and richness to quantitative investigations of the sizeable LBC1921 cohort, stimulating fresh insights and hypotheses
Shield, Kevin D; Taylor, Benjamin; Kehoe, Tara; Patra, Jayadeep; Rehm, Jürgen
Alcohol is a substantial risk factor for mortality according to the recent 2010 World Health Assembly strategy to reduce the harmful use of alcohol which outlined the need to characterize and monitor this burden. Accordingly, using new methodology we estimated 1) the number of deaths caused and prevented by alcohol consumption, and 2) the potential years of life lost (PYLLs) attributable to alcohol consumption in Canada in 2005. Mortality attributable to alcohol consumption was estimated by calculating Alcohol-Attributable Fractions (AAFs) (defined as the proportion of mortality that would be eliminated if the exposure was eliminated) using data from various sources. Indicators for alcohol consumption were obtained from the Canadian Alcohol and Drug Use Monitoring Survey 2008 and corrected for adult per capita recorded and unrecorded alcohol consumption. Risk relations were taken from the Comparative Risk Assessment within the current Global Burden of Disease (GBD) study. Due to concerns about the reliability of information specifying causes of death for people aged 65 or older, our analysis was limited to individuals aged 0 to 64 years. Calculation of the 95% confidence intervals (CIs) for the AAFs was performed using Monte Carlo random sampling. Information on mortality was obtained from Statistics Canada. A sensitivity analysis was performed comparing the mortality results obtained using our study methods to results obtained using previous methodologies. In 2005, 3,970 (95% CI: 810 to 7,170) deaths (4,390 caused and 420 prevented) and 134,555 (95% CI: 36,690 to 236,376) PYLLs were attributable to alcohol consumption for individuals aged 0 to 64 years. These figures represent 7.7% (95% CI: 1.6% to 13.9%) of all deaths and 8.0% (95% CI: 2.2% to 14.1%) of all PYLLs for individuals aged 0 to 64 years. The sensitivity analysis showed that the number of deaths as measured by this new methodology is greater than that if mortality was estimated using previous
Shield Kevin D
Full Text Available Abstract Background Alcohol is a substantial risk factor for mortality according to the recent 2010 World Health Assembly strategy to reduce the harmful use of alcohol which outlined the need to characterize and monitor this burden. Accordingly, using new methodology we estimated 1 the number of deaths caused and prevented by alcohol consumption, and 2 the potential years of life lost (PYLLs attributable to alcohol consumption in Canada in 2005. Methods Mortality attributable to alcohol consumption was estimated by calculating Alcohol-Attributable Fractions (AAFs (defined as the proportion of mortality that would be eliminated if the exposure was eliminated using data from various sources. Indicators for alcohol consumption were obtained from the Canadian Alcohol and Drug Use Monitoring Survey 2008 and corrected for adult per capita recorded and unrecorded alcohol consumption. Risk relations were taken from the Comparative Risk Assessment within the current Global Burden of Disease (GBD study. Due to concerns about the reliability of information specifying causes of death for people aged 65 or older, our analysis was limited to individuals aged 0 to 64 years. Calculation of the 95% confidence intervals (CIs for the AAFs was performed using Monte Carlo random sampling. Information on mortality was obtained from Statistics Canada. A sensitivity analysis was performed comparing the mortality results obtained using our study methods to results obtained using previous methodologies. Results In 2005, 3,970 (95% CI: 810 to 7,170 deaths (4,390 caused and 420 prevented and 134,555 (95% CI: 36,690 to 236,376 PYLLs were attributable to alcohol consumption for individuals aged 0 to 64 years. These figures represent 7.7% (95% CI: 1.6% to 13.9% of all deaths and 8.0% (95% CI: 2.2% to 14.1% of all PYLLs for individuals aged 0 to 64 years. The sensitivity analysis showed that the number of deaths as measured by this new methodology is greater than that if
Katz, Alan J; Santoro, Michael; Diblasio, Fred; Ashley, Richard
Stereotactic body radiotherapy (SBRT) may yield disease control for prostate cancer in a brief, hypofractionated treatment regimen without increasing treatment toxicity. Our report presents a 6-year update from 304 low- (n = 211), intermediate- (n = 81), and high-risk (n = 12) prostate cancer patients who received CyberKnife SBRT. The median PSA at presentation was 5.8 ng/ml. Fifty-seven patients received neoadjuvant hormonal therapy for up to one year. The first 50 patients received a total dose of 35 Gy in 5 fractions of 7 Gy. The subsequent 254 patients received a total dose of 36.25 Gy in 5 fractions of 7.25 Gy. Toxicity was assessed with the Expanded Prostate Cancer Index Composite questionnaire and the Radiation Therapy Oncology Group urinary and rectal toxicity scale. Biochemical failure was assessed using the nadir + 2 definition. No patients experienced Grade III or IV acute complications. Fewer than 5% of patients experienced any acute Grade II urinary or rectal toxicities. Late urinary Grade II complications were observed in 4% of patients treated to 35 Gy and 9% of patients treated to 36.25 Gy. Five (2%) late Grade III urinary toxicities occurred in patients who were treated with 36.25 Gy. Late Grade II rectal complications were observed in 2% of patients treated to 35 Gy and 5% of patients treated to 36.25 Gy. Bowel and urinary quality of life (QOL) scores initially decreased, but later returned to baseline values. An overall decrease of 20% in the sexual QOL score was observed. QOL in each domain was not differentially affected by dose. For patients that were potent prior to treatment, 75% stated that they remained sexually potent. Actuarial 5-year biochemical recurrence-free survival was 97% for low-risk, 90.7% for intermediate-risk, and 74.1% for high-risk patients. PSA fell to a median of 0.12 ng/ml at 5 years; dose did not influence median PSA levels. In this large series with long-term follow-up, we found excellent biochemical control rates and
Nevalainen, Olli; Simola, Mikko; Ansakorpi, Hanna; Raitanen, Jani; Artama, Miia; Isojärvi, Jouko; Auvinen, Anssi
We systematically quantified excess mortality in epilepsy patients by cause of death using the population-attributable fraction and epilepsy-attributable years of potential life lost (YPLL) by age 75 years at ages 15 and over. We updated and undertook a re-review of mortality studies from our previous systematic review following PRISMA guidelines to identify cohort studies of general epilepsy populations reporting a relative risk (RR) of death by cause relative to the background rates in the population. Studies on epilepsy prevalence were identified through published reviews. Country-specific mortality figures were obtained from the WHO World Mortality Database. We performed a pooled analysis with the DerSimonian-Laird random effects method. In countries with very high Human Development Indices, epilepsy contributed to 0.5-1.1 % of all deaths in the total population. Among external causes, suicides (RR 2.9, 95 % confidence interval 2.2-3.8; I(2) 52 %) were the major contributor to YPLL, corresponding to 6.7 % and 4.2 % of excess YPLL due to epilepsy in the United States (US) and in the United Kingdom (UK) in 2010, with 541 (346-792) and 44 (28-65) excess suicide cases, respectively. Fatal accidental falls were more common, with 813 (610-1064) and 95 (71-125) excess deaths in the US and in the UK, but these caused only 2.0 % of excess YPLL as they occurred in older age groups. Suicides were the most important external cause of death in epilepsy patients in terms of excess YPLL, whereas other external causes were either more common in older ages or caused less excess deaths.
This study examined the experiences of women who lived and worked on remote and isolated Antarctic stations for up to 15 months at a time. The study employed purposeful sampling and a longitudinal - processual approach to study women's experiences over the first 15 years of mixed gender Antarctic expeditions. The retrospective analysis was based on a semi-structured interview administered to 14 women upon their return to Australia. The results showed that women referred to the natural physical Antarctic environment as one of the best aspects of their experience and the reason they would recommend the Antarctic to their friends as a good place to work. In describing the worst aspect of their experience, women referred to aspects of Antarctic station life, including: (i) the male dominated nature of station culture; (ii) the impact of interpersonal conflict, including gender based conflict and friction between scientists and trades workers; and (iii) the lack of anonymity associated with living and working with the same group of individuals, mainly men, for up to 12 months or more. The results are discussed within the context of the evolution of Antarctic station culture and recommendations are made in terms of the demography of expeditions, expeditioner selection and recruitment and the ongoing monitoring of Antarctic station culture. The study presents a framework that can be applied to groups and teams living and working in analogous isolated, confined and extreme work environments, including outer space missions.
Gao, Tingting; Wang, Xiaochang C; Chen, Rong; Ngo, Huu Hao; Guo, Wenshan
Disability adjusted life year (DALY) has been widely used since 1990s for evaluating global and/or regional burden of diseases. As many environmental pollutants are hazardous to human health, DALY is also recognized as an indicator to quantify the health impact of environmental pollution related to disease burden. Based on literature reviews, this article aims to give an overview of the applicable methodologies and research directions for using DALY as a tool for quantitative assessment of environmental pollution. With an introduction of the methodological framework of DALY, the requirements on data collection and manipulation for quantifying disease burdens are summarized. Regarding environmental pollutants hazardous to human beings, health effect/risk evaluation is indispensable for transforming pollution data into disease data through exposure and dose-response analyses which need careful selection of models and determination of parameters. Following the methodological discussions, real cases are analyzed with attention paid to chemical pollutants and pathogens usually encountered in environmental pollution. It can be seen from existing studies that DALY is advantageous over conventional environmental impact assessment for quantification and comparison of the risks resulted from environmental pollution. However, further studies are still required to standardize the methods of health effect evaluation regarding varied pollutants under varied circumstances before DALY calculation. Copyright © 2014 Elsevier B.V. All rights reserved.
Kim, Seung Cheol
The purpose of this study is to ascertain the normal maturation of proximal epiphyseal ossification centers by monthly age during the first years of life. The distribution of age was 0 to 24 months. Six hundred and seventy-five infants were male and 436 were female; their ages were measured in months, and there was no evidence of developmental problems. Proximal humeral epiphyseal ossification centers were evaluated from chest radiographs ; if not visualized, they were graded as 0, and otherwise, as follows : grade 1 : visualized with poor margin or a diameter of less than 1/4 of metaphyseal width; grade 2: visualized with good margin or a diameter of more than 1/4 of metaphyseal width; in grade 3 and 4, two ossification centers were visualized. Grade 3 indicated that one ossification center had the morphology of grade 2. Grade 5 indicated that two ossification centers were fused. We then assessed the relationship between the development of an ossification center and monthly age. A proximal humeral epiphyseal ossification center shows regular maturational features according to monthly age. 6 refs., 2 tabs., 5 figs
Conclusions: Using the world population age distribution as the standard, the age-adjusted mortality rate in Mexico per 100,000 inhabitants that died from GC decreased from 7.5 to 5.6 between 2000 and 2012. Chiapas and socioeconomic regions 1, 2, and 5 had the highest mortality from GC (Chiapas: 9.2, 95% CI 8.2-10.3  and 8.2, 95% CI 7.3-9 , region 1: 5.5, 95% CI 5.2-5.9  and 5.3, 95% CI 4.9-5.7 ; region 2: 5.3, 95% CI 5-5.6  and 5.4, 95% CI 5.1-5.8 ; region 5: 6.1, 95% CI 5.6-6.6  and 4.6, 95% CI 4.2-5 . Chiapas and socioeconomic region 1 had the highest rate of years of potential life lost (Chiapas: 97.4  and 79.6  and region 1: 73.5  65 .
Maruyama, Katsuya; Tsuji, Hiroshi; Nomiya, Takuma; Katoh, Hiroyuki; Ishikawa, Hitoshi; Kamada, Tadashi; Wakatsuki, Masaru; Akakura, Koichiro; Shimazaki, Jun; Aoyama, Hidefumi; Tsujii, Hirohiko
The aim of this study was to prospectively assess 5-year health-related quality of life (HRQOL) of patients treated with carbon ion radiotherapy (C-ion RT) for clinically localized prostate cancer. A total of 417 patients received carbon ion radiotherapy at a total dose of 63–66 Gray-equivalents (GyE) in 20 fractions over 5 weeks, and neoadjuvant and adjuvant androgen deprivation therapy (ADT) were administered for intermediate and high-risk patients. A HRQOL assessment was performed at five time points (immediately before the initiation of C-ion RT, immediately after, and at 12, 36 and 60 months after completion of C-ion RT) using Functional Assessment of Cancer Therapy (FACT) questionnaires. FACT-G and FACT-P scores were significantly decreased; however, the absolute change after 60 months was minimal. The transient decreases in the Trial Outcome Index (TOI) score returned to their baseline levels. Use of ADT, presence of adverse events, and biochemical failure were related to lower scores. Scores of subdomains of FACT instruments indicated characteristic changes. The pattern of HRQOL change after C-ion RT was similar to that of other modalities. Further controlled studies focusing on a HRQOL in patients with prostate cancer are warranted.
Beuker, Karin T; Rommelse, Nanda N J; Donders, Rogier; Buitelaar, Jan K
The first two years of life is a crucially important period for the development of communication skills. In this study joint attention and language development were monthly assessed between 8 and 24 months of age in a sample of 23 typically developing children to establish the developmental trajectory of specific joint attention skills, to investigate the developmental interrelations of these different joint attention skills with vocabulary size, and to examine whether the order of development of following and directing attention influences the development of other early communication skills such as language. All joint attention skills emerged between 8 and 15 months of age and responsive joint attention skills tend to emerge before initiative joint attention. Early joint attention skills influenced later language development, but not the other way around. Children in whom directing attention with gaze alternation developed early (in age or order) showed a relatively larger early vocabulary growth. A fine grained mapping of the normal development of early communication skills can be helpful in the early detection of abnormalities in these skills. Copyright © 2012 Elsevier Inc. All rights reserved.
Berry, Vincent; Basson, Laurent; Bogart, Emilie; Mir, Olivier; Blay, Jean-Yves; Italiano, Antoine; Bertucci, François; Chevreau, Christine; Clisant-Delaine, Stéphanie; Liegl-Antzager, Bernadette; Tresch-Bruneel, Emmanuelle; Wallet, Jennifer; Taieb, Sophie; Decoupigny, Emilie; Le Cesne, Axel; Brodowicz, Thomas; Penel, Nicolas
In a placebo-controlled, randomized phase 2 trial (ClinicalTrials.gov identifier NCT01900743), regorafenib improved progression-free survival (PFS) for patients with doxorubicin-pretreated advanced nonadipocytic sarcoma. A quality-adjusted time without symptoms of progression or toxicity (Q-TWiST) post hoc exploratory analysis was applied to provide an integrated measure of its clinical benefit. In the base-case analysis, each patient's overall survival (OS) was partitioned into 3 mutually exclusive health states: the time with a grade 3 or 4 adverse event (TOX), the time without symptoms of disease or grade 3 or 4 toxicity from treatment, and the time after tumor progression or relapse. The time spent in each state was weighted with a health-state utility associated with that state and was summed to calculate the Q-TWiST. The stability of the base-case analysis was explored with several sensitivity analyses. In nonadipocytic sarcoma, the PFS was (4.0 months [2.6-5.5 months] with regorafenib vs 1.0 month [0.9-1.8 months] with a placebo; hazard ratio, 0.36 [0.25-0.53]; P regorafenib and 9.0 months (6.8-12.5 months) with a placebo (hazard ratio, 0.67 [0.44-1.02]). With the classic definition of TOX (including all grade 3 and 4 clinical adverse events), the Q-TWiSTs were 8.0 months (7.0-9.0 months) with regorafenib and 5.7 months (4.9-6.4 months) with a placebo (P regorafenib significantly improved quality-adjusted survival in comparison with a placebo. Cancer 2017;123:2294-2302. © 2017 The Authors. Cancer published by Wiley Periodicals, Inc. on behalf of American Cancer Society. This is an open access article under the terms of the Creative Commons Attribution NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. © 2017 American Cancer Society.
Arrow, Peter; Brennan, David; Spencer, A John
There is little evidence to suggest that orthodontic treatment can prevent or reduce the likelihood of dental caries or of periodontal disease or dental trauma and temporomandibular disorders, but there is a modest association between the presence of malocclusion/orthodontic treatment need and quality of life. However, little is known of the long-term outcomes of orthodontic treatment. This study reports on the longitudinal follow-up of quality of life and psychosocial outcomes of orthodontic treatment among a cohort of adults who were examined as adolescents in 1988/1989. Children who were examined in 1988/1989 were invited to a follow-up in 2005/2006. Respondents completed a questionnaire, which collected information on quality of life, receipt of orthodontic treatment and psychosocial factors, and were invited for a clinical examination. Oral health conditions including occlusal status using the Dental Aesthetic Index were recorded. Analysis of variance and multiple linear regression were used to examine the relationship between the measured factors. There was no statistically significant association between occlusal status at adolescence and quality of life at adulthood. Those individuals who had orthodontic treatment but did not need orthodontic treatment had higher self-esteem (23.1, SD 5.2) and were more satisfied with life (18.5, SD 3.7) than other treatment groups (self-esteem range, 20.0-22.7; life satisfaction range, 16.4-18.1), anovaP life, P life. Orthodontic treatment was negatively associated with psychosocial factors (life satisfaction; fixed orthodontic treatment (FOT) β = -0.91, P = 0.02 and self-esteem; FOT β = -1.39, P life and psychosocial factors. Receipt of fixed orthodontic treatment does not appear to be associated with oral health-related quality of life but appears to be negatively associated with self-esteem and satisfaction with life. © 2011 John Wiley & Sons A/S.
Full Text Available Background and purpose: Mortality Statistics and rates show the development of a country in the world. These statistics are very important for determining the distribution of risk factors of mortality (in age and gender groups, ethnicity and so on and they are useful for improving health and preventing from important diseases in future planning of countries in societies. Materials and Methods: This article is a longitudinal descriptive study. All registered deaths in Bane which occurred during 2006-2010, regardless of the cause, were collected from the department of health in Kurdistan University of Medical Sciences, and they were assigned into 21 categories based on Disease Category (ICD10 of WHO. Then the life table for every year was prepared and Life expectancy was computed for each age and sex and total lost years of life for all chapters of ICD10 were calculated. Results: Based on the ICD10, four chapters with the highest frequencies include circulatory diseases by 1008 cases (32.5%, external causes of death by 522 cases (16.7%, cancers by 480 cases (15.3%, and prenatal death by 382 cases (12.2%. Overall, these chapters include 76.4% of total death. The most years of lost life were reported for prenatal period, external causes, diseases of the circulatory system and cancers. Conclusion: Cardiovascular diseases, incidents and accidents, and cancers are the most important causes of death. Among the main reasons of death in the first group are high blood pressures, lack of movement, smoking, not consuming enough fruits, vegetables. In the second group the reasons include not obeying the traffic rules, high speed and so on. Since the sum years of lost life were the highest in the prenatal period, it is necessary to improve pregnancy care and teach mothers prior to pregnancy.
HOURS, Martine; KHATI, Inès; CHARNAY, Pierrette; CHOSSEGROS, Laetitia; TARDY, Hélène; TOURNIER, Charlène; PERRINE, Anne-Laure; LUAUTE, Jacques; LAUMON, Bernard
Objectives: To compare health status, family and occupational impact and quality of life one year after an accident between casualties with whiplash versus other mild injuries, and to explore the relation between initial injury (whiplash vs. other) and quality of life. Design: Prospective cohort study. Subjects: The study used data from the ESPARR cohort (a representative cohort of road accident casualties) and included 173 casualties with 'pure' whiplash and a population of 207 casualties wi...
Nie, Jingxin; Li, Gang; Wang, Li; Shi, Feng; Lin, Weili; Gilmore, John H.; Shen, Dinggang
Quantitatively characterizing the development of cortical anatomical networks during the early stage of life plays an important role in revealing the relationship between cortical structural connection and high-level functional development. The development of correlation networks of cortical-thickness, cortical folding, and fiber-density is systematically analyzed in this article to study the relationship between different anatomical properties during the first 2 years of life. Specifically, ...
30 years life with Chernobyl, 5 years life with Fukushima. Health consequences of the nuclear catastrophes of Chernobyl and Fukushima; 30 Jahre Leben mit Tschernobyl, 5 Jahre Leben mit Fukushima. Gesundheitliche Folgen der Atomkatastrophen von Tschernobyl und Fukushima
Claussen, Angelika; Rosen, Alex
The IPPNW report on health consequences of the nuclear catastrophes of Chernobyl and Fukushima covers the following issues: Part.: 30 years life with Chernobyl: Summarized consequences of Chernobyl, the accident progression, basic data of the catastrophe, estimation of health hazards as a consequence of the severe accident of Chernobyl, health consequences for the liquidators, health consequences for the contaminated population, mutagenic and teratogenic effects. Part B: 5 years life with Fukushima: The start of the nuclear catastrophe, emissions and contamination, consequences of the nuclear catastrophe on human health, thyroid surveys in the prefecture Fukushima, consequences of the nuclear catastrophe on the ecosystem, outlook.
Johansen, Jeanne Duus; Smith, Else; Juel, Knud
accounted for 8% of all PYLL in men and showed an increasing tendency from 1983 to 1991, when it became the leading cause of PYLL. AIDS had most impact in men in the age group 25-44 years and accounted for 29% of all PYLL in this group at the peak in 1993, decreasing significantly after the introduction...
Mountain, Gail A; Hind, Daniel; Gossage-Worrall, Rebecca; Walters, Stephen J; Duncan, Rosie; Newbould, Louise; Rex, Saleema; Jones, Carys; Bowling, Ann; Cattan, Mima; Cairns, Angela; Cooper, Cindy; Edwards, Rhiannon Tudor; Goyder, Elizabeth C
Loneliness in older people is associated with poor health-related quality of life (HRQoL). We undertook a parallel-group randomised controlled trial to evaluate the effectiveness and cost-effectiveness of telephone befriending for the maintenance of HRQoL in older people. An internal pilot tested the feasibility of the trial and intervention. Participants aged >74 years, with good cognitive function, living independently in one UK city were recruited through general practices and other sources, then randomised to: (1) 6 weeks of short one-to-one telephone calls, followed by 12 weeks of group telephone calls with up to six participants, led by a trained volunteer facilitator; or (2) a control group. The main trial required the recruitment of 248 participants in a 1-year accrual window, of whom 124 were to receive telephone befriending. The pilot specified three success criteria which had to be met in order to progress the main trial to completion: recruitment of 68 participants in 95 days; retention of 80% participants at 6 months; successful delivery of telephone befriending by local franchise of national charity. The primary clinical outcome was the Short Form (36) Health Instrument (SF-36) Mental Health (MH) dimension score collected by telephone 6 months following randomisation. We informed 9,579 older people about the study. Seventy consenting participants were randomised to the pilot in 95 days, with 56 (80%) providing valid primary outcome data (26 intervention, 30 control). Twenty-four participants randomly allocated to the research arm actually received telephone befriending due to poor recruitment and retention of volunteer facilitators. The trial was closed early as a result. The mean 6-month SF-36 MH scores were 78 (SD 18) and 71 (SD 21) for the intervention and control groups, respectively (mean difference, 7; 95% CI, -3 to 16). Recruitment and retention of participants to a definitive trial with a recruitment window of 1 year is feasible. For
Longfield, Kim; Smith, Brian; Gray, Rob; Ngamkitpaiboon, Lek; Vielot, Nadja
Implementing organizations are pressured to be accountable for performance. Many health impact metrics present limitations for priority setting; they do not permit comparisons across different interventions or health areas. In response, Population Services International (PSI) adopted the disability-adjusted life year (DALY) averted as its bottom-line performance metric. While international standards exist for calculating DALYs to determine burden of disease (BOD), PSI's use of DALYs averted is novel. It uses DALYs averted to assess and compare the health impact of its country programs, and to understand the effectiveness of a portfolio of interventions. This paper describes how the adoption of DALYs averted influenced organizational strategy and presents the advantages and constraints of using the metric. Health impact data from 2001-2011 were analyzed by program area and geographic region to measure PSI's performance against its goal of doubling health impact between 2007-2011. Analyzing 10 years of data permitted comparison with previous years' performance. A case study of PSI's Asia and Eastern European (A/EE) region, and PSI/Laos, is presented to illustrate how the adoption of DALYs averted affected strategic decision making. Between 2007-2011, PSI's programs doubled the total number of DALYs averted from 2002-2006. Most DALYs averted were within malaria, followed by HIV/AIDS and family planning (FP). The performance of PSI's A/EE region relative to other regions declined with the switch to DALYs averted. As a result, the region made a strategic shift to align its work with countries' BOD. In PSI/Laos, this redirection led to better-targeted programs and an approximate 50% gain in DALYs averted from 2009-2011. PSI's adoption of DALYs averted shifted the organization's strategic direction away from product sales and toward BOD. Now, many strategic decisions are based on "BOD-relevance," the share of the BOD that interventions can potentially address. This switch
Versteegen, GJ; Dijkstra, PU; Jaspers, JPC; Meijler, WJ; ten Duis, HJ; Klip, EC
Aim of the study was to analyse quality of life and psychological functioning in patients with sprain of the neck, to analyse the relationship between complaints, quality of life, psychological functioning and personality factors, and to analyse the pro. le of patients with whiplash associated
Zara, Federico; Specchio, Nicola; Striano, Pasquale; Robbiano, Angela; Gennaro, Elena; Paravidino, Roberta; Vanni, Nicola; Beccaria, Francesca; Capovilla, Giuseppe; Bianchi, Amedeo; Caffi, Lorella; Cardilli, Viviana; Darra, Francesca; Bernardina, Bernardo Dalla; Fusco, Lucia; Gaggero, Roberto; Giordano, Lucio; Guerrini, Renzo; Incorpora, Gemma; Mastrangelo, Massimo; Spaccini, Luigina; Laverda, Anna Maria; Vecchi, Marilena; Vanadia, Francesca; Veggiotti, Pierangelo; Viri, Maurizio; Occhi, Guya; Budetta, Mauro; Taglialatela, Maurizio; Coviello, Domenico A; Vigevano, Federico; Minetti, Carlo
To dissect the genetics of benign familial epilepsies of the first year of life and to assess the extent of the genetic overlap between benign familial neonatal seizures (BFNS), benign familial neonatal-infantile seizures (BFNIS), and benign familial infantile seizures (BFIS). Families with at least two first-degree relatives affected by focal seizures starting within the first year of life and normal development before seizure onset were included. Families were classified as BFNS when all family members experienced neonatal seizures, BFNIS when the onset of seizures in family members was between 1 and 4 months of age or showed both neonatal and infantile seizures, and BFIS when the onset of seizures was after 4 months of age in all family members. SCN2A, KCNQ2, KCNQ3, PPRT2 point mutations were analyzed by direct sequencing of amplified genomic DNA. Genomic deletions involving KCNQ2 and KCNQ3 were analyzed by multiple-dependent probe amplification method. A total of 46 families including 165 affected members were collected. Eight families were classified as BFNS, 9 as BFNIS, and 29 as BFIS. Genetic analysis led to the identification of 41 mutations, 14 affecting KCNQ2, 1 affecting KCNQ3, 5 affecting SCN2A, and 21 affecting PRRT2. The detection rate of mutations in the entire cohort was 89%. In BFNS, mutations specifically involve KCNQ2. In BFNIS two genes are involved (KCNQ2, six families; SCN2A, two families). BFIS families are the most genetically heterogeneous, with all four genes involved, although about 70% of them carry a PRRT2 mutation. Our data highlight the important role of KCNQ2 in the entire spectrum of disorders, although progressively decreasing as the age of onset advances. The occurrence of afebrile seizures during follow-up is associated with KCNQ2 mutations and may represent a predictive factor. In addition, we showed that KCNQ3 mutations might be also involved in families with infantile seizures. Taken together our data indicate an important
Foss, Line; Gravseth, Hans Magne; Kristensen, Petter; Claussen, Bjørgulf; Mehlum, Ingrid Sivesind; Skyberg, Knut
In 2001, the Norwegian authorities and major labour market partners signed an agreement regarding 'inclusive working life' (IW), whereby companies that participate are committed to reducing sickness absence. Our main aim was to determine the effect of the IW program and work characteristics by gender on long-term (>8 weeks) sickness absence (LSA). Self-reported data on work characteristics from the Oslo Health Study were linked to registry-based data on IW status, education and LSA. From 2001-2005, 10,995 participants (5,706 women and 5,289 men) aged 30, 40, 45 and 60 years were followed. A Cox regression was used to compute hazard ratios (HR) for LSA risk. The cohort was divided into an IW group (2,733 women and 2,058 men) and non-IW group (2,973/3,231). 43.2% and 41.6% of women and 22.3%/24.3% of men (IW / non-IW, respectively) experienced at least one LSA. In a multivariate model, statistically significant risk factors for LSA were low education (stronger in men), shift work/night work or rotating hours (strongest in men in the non-IW group), and heavy physical work or work involving walking and lifting (men only and stronger in the non-IW group). Among men who engaged in shift work, the LSA risk was significantly lower in the IW group. Our results could suggest that IW companies that employ many men in shift work have implemented relevant efforts for reducing sickness absence. However, this study could not demonstrate a significant effect of the IW program on the overall LSA risk.
Giovannini, M; Riva, E; Banderali, G; Scaglioni, S; Veehof, S H E; Sala, M; Radaelli, G; Agostoni, C
To investigate infant feeding practices through the first year of life in Italy, and to identify factors associated with the duration of breastfeeding and early introduction of solid foods. Structured phone interviews on feeding practices were conducted with 2450 Italian-speaking mothers randomly selected among women who delivered a healthy-term singleton infant in November 1999 in Italy. Interviews were performed 30 d after delivery and when the infants were aged 3, 6, 9 and 12 mo. Type of breastfeeding was classified according to the WHO criteria. Breastfeeding started in 91.1% of infants. At the age of 6 and 12 mo, respectively, 46.8% and 11.8% of the infants was still breastfed, 68.4% and 27.7% received formula, and 18.3% and 65.2% were given cow's milk. Solids were introduced at the mean age of 4.3 mo (range 1.6-6.5 mo). Introduction of solids occurred before age 3 and 4 mo in 5.6% and 34.2% of infants, respectively. The first solids introduced were fruit (73.1%) and cereals (63.9%). The main factors (negatively) associated with the duration of breastfeeding were pacifier use (p introduction of formula (p introduction of solids (p = 0.05). Factors (negatively) associated with the introduction of solids foods before the age of 3 mo were mother not having breastfed (p introduction of formula (p introduction of complementary foods. National guidelines, public messages and educational campaigns should be promoted in Italy.
Full Text Available Abstract Objective To systematically review the methodology of general burden of disease studies. Three key questions were addressed: 1 what was the quality of the data, 2 which methodological choices were made to calculate disability adjusted life years (DALYs, and 3 were uncertainty and risk factor analyses performed? Furthermore, DALY outcomes of the included studies were compared. Methods Burden of disease studies (1990 to 2011 in international peer-reviewed journals and in grey literature were identified with main inclusion criteria being multiple-cause studies that quantified the burden of disease as the sum of the burden of all distinct diseases expressed in DALYs. Electronic database searches included Medline (PubMed, EMBASE, and Web of Science. Studies were collated by study population, design, methods used to measure mortality and morbidity, risk factor analyses, and evaluation of results. Results Thirty-one studies met the inclusion criteria of our review. Overall, studies followed the Global Burden of Disease (GBD approach. However, considerable variation existed in disability weights, discounting, age-weighting, and adjustments for uncertainty. Few studies reported whether mortality data were corrected for missing data or underreporting. Comparison with the GBD DALY outcomes by country revealed that for some studies DALY estimates were of similar magnitude; others reported DALY estimates that were two times higher or lower. Conclusions Overcoming “error” variation due to the use of different methodologies and low-quality data is a critical priority for advancing burden of disease studies. This can enlarge the detection of true variation in DALY outcomes between populations or over time.
McNally, Janet; Hugh-Jones, Siobhan; Caton, Samantha; Vereijken, Carel; Weenen, Hugo; Hetherington, Marion
Responsive feeding has been identified as important in preventing overconsumption by infants. However, this is predicated on an assumption that parents recognise and respond to infant feeding cues. Despite this, relatively little is understood about how infants engage parental feeding responses. Therefore, the aim of this systematic review was to identify what is known about infant communication of hunger and satiation and what issues impact on the expression and perception of these states. A search of Medline, CINAHL, Web of Science, PsycINFO, Science Direct and Maternal and Infant care produced 27 papers. Eligibility criteria included peer reviewed qualitative and/or quantitative publications on feeding behaviours, hunger, and satiation/satiety cues of typically developing children in the first 2 years of life. Papers published between 1966 and 2013 were included in the review. The review revealed that feeding cues and behaviours are shaped by numerous issues, such as infants' physical attributes, individual psychological factors and environmental factors. Meanwhile, infant characteristics, external cues and mothers' own characteristics affect how feeding cues are perceived. The existing literature provides insights into many aspects of hunger and satiation in infancy; however, there are significant gaps in our knowledge. There is a lack of validated tools for measuring hunger and satiation, a need to understand how different infant characteristics impact on feeding behaviour and a need to extricate the respective contributions of infant and maternal characteristics to perceptions of hunger and satiation. Further research is also recommended to differentiate between feeding driven by liking and that driven by hunger. © The Authors. Maternal & Child Nutrition published by John Wiley & Sons Ltd.
Šmit, Renata; Postma, Maarten J
Tick-borne encephalitis (TBE) presents an increasing burden in many parts of Europe, Asian Russia, Siberia, Asian former USSR and Far East. Incidence can be considered as one way to express the burden. A more comprehensive measure concerns disability-adjusted life years (DALYs), better characterizing the full burden of TBE. TBE burden in DALYs has not yet been estimated, nor has it been specified by the Global Burden of Disease (GBD) studies. The purpose of the present study is to estimate the burden of TBE in Slovenia, expressed in DALYs, both from the population and individual perspectives. We discuss the impact of TBE burden on public health and potential strategies to reduce this burden in Slovenia. The burden of TBE is estimated by using the updated DALYs' methodology first introduced in the GBD project. The DALYs᾽ calculations are based on the health outcomes of the natural course of the disease being modelled. Corrections for under-reporting and under-ascertainment are applied. The impact of uncertainty in parameters in the model was assessed using sensitivity analyses. From the population perspective, total DALYs amount to 3,450 (167.8 per 100,000 population), while from the individual perspective they amount to 3.1 per case in 2011. Notably, the consequences of TBE present a larger burden than TBE itself. TBE presents a relatively high burden expressed in DALYs compared with estimates for other infectious diseases from the GBD 2010 study for Slovenia. Raising awareness and increasing vaccination coverage are needed to reduce TBE and its consequences.
D'Atri, Aurora; Novelli, Luana; Ferrara, Michele; Bruni, Oliviero; De Gennaro, Luigi
Massive changes in brain morphology and function in the first years of life reveal a postero-anterior trajectory of cortical maturation accompanied by regional modifications of NREM sleep. One of the most sensible marker of this maturation process is represented by electroencephalographic (EEG) activity within the frequency range of sleep spindles. However, direct evidence that these changes actually reflect maturational modifications of fast and slow spindles still lacks. Our study aimed at answering the following questions: 1. Do cortical changes at 11.50 Hz frequency correspond to slow spindles? 2. Do fast and slow spindles show different age trajectories and different topographical distributions? 3. Do changes in peak frequency explain age changes of slow and fast spindles? We measured the antero-posterior changes of slow and fast spindles in the first 60 min of nightly sleep of 39 infants and children (0-48 mo.). We found that (A) changes of slow spindles from birth to childhood mostly affect frontal areas (B) variations of fast and slow spindles across age groups go in opposite direction, the latter progressively increasing across ages; (C) this process is not merely reducible to changes of spindle frequency. As a main finding, our cross-sectional study shows that the first form of mature spindle (i.e., corresponding to the adult phasic event of NREM sleep) is marked by the emergence of slow spindles on anterior regions around the age of 12 months. Copyright © 2017 Elsevier B.V. All rights reserved.
Mosli, Rana H; Kaciroti, Niko; Corwyn, Robert F; Bradley, Robert H; Lumeng, Julie C
This study examined the longitudinal association between birth of a sibling and changes in body mass index z-score (BMIz) trajectory during the first 6 years of life. Children (n = 697) were recruited across 10 sites in the United States at the time of birth. Sibship composition was assessed every 3 months. Anthropometry was completed when the child was age 15 months, 24 months, 36 months, 54 months, and in first grade. Children were classified based on the timing of their sibling's birth. A piecewise quadratic regression model adjusted for potential confounders examined the association of the birth of a sibling with subsequent BMIz trajectory. Children whose sibling was born when they were 24 to 36 months or 36 to 54 months old, compared with children who did not experience the birth of a sibling by first grade, had a lower subsequent BMIz trajectory and a significantly lower BMIz at first grade (0.27 vs 0.51, P value = 0.04 and 0.26 vs 0.51, P value = 0.03, respectively). Children who did not experience the birth of a sibling by the time they were in first grade had 2.94 greater odds of obesity (P value = 0.046) at first grade compared with children who experienced the birth of a sibling when they were between 36 to 54 months old. A birth of a sibling when the child is 24 to 54 months old is associated with a healthier BMIz trajectory. Identifying the underlying mechanism of association can help inform intervention programs. Copyright © 2016 by the American Academy of Pediatrics.
Full Text Available Abstract Background Complementary feeding is currently recommended after six months of age, when the nutrients in breast milk alone are no longer adequate to support growth. Few studies have examined macro- and micro-nutrient intakes from complementary foods (CF only. Our purpose was to assess the sources and nutritional contribution of CF over the first year of life. Methods In July 2003, a cross-sectional survey was conducted on a nationally representative sample of mothers with infants aged three to 12 months. The survey was administered evenly across all regions of the country and included a four-day dietary record to assess infants' CF intakes in household (tablespoon measures (breast milk and formula intakes excluded. Records from 2,663 infants were analyzed for nutrient and CF food intake according to 12 categories. Mean daily intakes for infants at each month of age from CF were pooled and compared to the Dietary Reference Intakes for the respective age range. Results At three months of age, 83% of infants were already consuming infant cereals. Fruits and vegetables were among the most common foods consumed by infants at all ages, while meats were least common at all ages except 12 months. Macro- and micro-nutrient intakes from CF generally increased with age. All mean nutrient intakes, except vitamin D and iron, met CF recommendations at seven to 12 months. Conclusions Complementary foods were introduced earlier than recommended. Although mean nutrient intakes from CF at six to 12 months appear to be adequate among Canadian infants, further attention to iron and vitamin D intakes and sources may be warranted.
Bauer, Patricia J; Wiebe, Sandra A; Carver, Leslie J; Waters, Jennie M; Nelson, Charles A
Coincident with developments in the temporal-cortical explicit memory network, long-term recall abilities are newly emergent late in the first year of human life. We recorded event-related potentials (ERPs) in 9-month-olds as an index of the integrity of the neural substrate underlying a task thought to reflect explicit memory, namely, deferred imitation. ERP measures of recognition memory 1 week after unique laboratory experiences predicted whether and how much infants recalled of the experiences 1 month later. The findings further imply that memory storage and consolidation processes are a major source of variability in long-term recall memory late in the first year of life.
Torgerson, Paul R.; Hagan, José E.; Costa, Federico; Calcagno, Juan; Kane, Michael; Martinez-Silveira, Martha S.; Goris, Marga G. A.; Stein, Claudia; Ko, Albert I.; Abela-Ridder, Bernadette
Background Leptospirosis, a spirochaetal zoonosis, occurs in diverse epidemiological settings and affects vulnerable populations, such as rural subsistence farmers and urban slum dwellers. Although leptospirosis can cause life-threatening disease, there is no global burden of disease estimate in
Jian, Wen-Shan; Huang, Chen-Ling; Iqbal, Usman; Nguyen, Phung-Anh; Hsiao, George; Li, Hsien-Chang
The purpose of the study was to probe into the changes in life expectancy associated with schooling years found by the Organization for Economic Co-operation and Development (OECD). The study was based on the OECD database from the period 2000 to 2006. The data of thirty countries were constructed to allow comparisons over time and across these countries. Panel data analysis was used to estimate the relationship of national education, as defined as school years, with life expectancy. The control factors considered were numbers of practicing physicians, practicing nurses, hospital beds, and GDP. We used fixed effects of both country and time through linear regression, the coefficient of school years in relation to life expectancy was statistically significant but negative. This finding is not in accord with the hypothesis that investing in human capital through education stimulates better health outcomes. Within developing countries, educational attainment is no longer keeping the same pace with life expectancy as before. Therefore, we suggest that an effective education policy should cover diverse topics, for example, balancing economic growth and mental hygiene, to improve national life expectancy. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.
Jagger, Carol; McKee, Martin; Christensen, Kaare; Lagiewka, Karolina; Nusselder, Wilma; Van Oyen, Herman; Cambois, Emmanuelle; Jeune, Bernard; Robine, Jean-Marie
The European Innovation Partnership on Active and Healthy Ageing seeks an increase of two healthy life years (HLY) at birth in the EU27 for the next 10 years. We assess the feasibility of doing so between 2010 and 2020 and the differential impact among countries by applying different scenarios to current trends in HLY. Data comprised HLY and life expectancy (LE) at birth 2004-09 from Eurostat. We estimated HLY in 2010 in each country by multiplying the Eurostat projections of LE in 2010 by the ratio HLY/LE obtained either from country and sex-specific linear regression models of HLY/LE on year (seven countries retaining same HLY question) or extrapolating the average of HLY/LE in 2008 and 2009 to 2010 (20 countries and EU27). The first scenario continued these trends with three other scenarios exploring different HLY gap reductions between 2010 and 2020. The estimated gap in HLY in 2010 was 17.5 years (men) and 18.9 years (women). Assuming current trends continue, EU27 HLY increased by 1.4 years (men) and 0.9 years (women), below the European Innovation Partnership on Active and Healthy Ageing target, with the HLY gap between countries increasing to 18.3 years (men) and 19.5 years (women). To eliminate the HLY gap in 20 years, the EU27 must gain 4.4 HLY (men) and 4.8 HLY (women) in the next decade, which, for some countries, is substantially more than what the current trends suggest. Global targets for HLY move attention from inter-country differences and, alongside the current economic crisis, may contribute to increase health inequalities.
Gronvold Nina T
Full Text Available Abstract Background This study examined the relationship between life satisfaction among medical students and a basic model of personality, stress and coping. Previous studies have shown relatively high levels of distress, such as symptoms of depression and suicidal thoughts in medical undergraduates. However despite the increased focus on positive psychological health and well-being during the past decades, only a few studies have focused on life satisfaction and coping in medical students. This is the first longitudinal study which has identified predictors of sustained high levels of life satisfaction among medical students. Methods This longitudinal, nationwide questionnaire study examined the course of life satisfaction during medical school, compared the level of satisfaction of medical students with that of other university students, and identified resilience factors. T-tests were used to compare means of life satisfaction between and within the population groups. K-means cluster analyses were applied to identify subgroups among the medical students. Analysis of Variance (ANOVA and logistic regression analyses were used to compare the subgroups. Results Life satisfaction decreased during medical school. Medical students were as satisfied as other students in the first year of study, but reported less satisfaction in their graduation year. Medical students who sustained high levels of life satisfaction perceived medical school as interfering less with their social and personal life, and were less likely to use emotion focused coping, such as wishful thinking, than their peers. Conclusion Medical schools should encourage students to spend adequate time on their social and personal lives and emphasise the importance of health-promoting coping strategies.
Kjeldstadli, Kari; Tyssen, Reidar; Finset, Arnstein; Hem, Erlend; Gude, Tore; Gronvold, Nina T; Ekeberg, Oivind; Vaglum, Per
Background This study examined the relationship between life satisfaction among medical students and a basic model of personality, stress and coping. Previous studies have shown relatively high levels of distress, such as symptoms of depression and suicidal thoughts in medical undergraduates. However despite the increased focus on positive psychological health and well-being during the past decades, only a few studies have focused on life satisfaction and coping in medical students. This is the first longitudinal study which has identified predictors of sustained high levels of life satisfaction among medical students. Methods This longitudinal, nationwide questionnaire study examined the course of life satisfaction during medical school, compared the level of satisfaction of medical students with that of other university students, and identified resilience factors. T-tests were used to compare means of life satisfaction between and within the population groups. K-means cluster analyses were applied to identify subgroups among the medical students. Analysis of Variance (ANOVA) and logistic regression analyses were used to compare the subgroups. Results Life satisfaction decreased during medical school. Medical students were as satisfied as other students in the first year of study, but reported less satisfaction in their graduation year. Medical students who sustained high levels of life satisfaction perceived medical school as interfering less with their social and personal life, and were less likely to use emotion focused coping, such as wishful thinking, than their peers. Conclusion Medical schools should encourage students to spend adequate time on their social and personal lives and emphasise the importance of health-promoting coping strategies. PMID:16984638
Dahl, Sigrun; Loge, Jon Håvard; Berge, Viktor; Dahl, Alv Andreas; Cvancarova, Milada; Fosså, Sophie Dorothea
The purpose of this study is to study the influence of radical prostatectomy (RP) for prostate cancer on work status and working life in men 3 years after surgery. In a prospective, questionnaire-based study on adverse effects after RP, 330 prostate cancer (PCa) patients who had been active in the workforce before RP described their work status 3 years after having surgery. We dichotomized their postoperative work status into "unchanged or increased" versus "reduced." The participants also reported whether their working life was influenced by the PCa trajectory to no, some, or a great extent. Univariate and multiple logistic regression models were established with sociodemographic and clinical characteristics as independent variables and "work status" or "influence of PCa trajectory on working life" as dependent variables. Twenty-five percent of the participants had retired. Of the remaining participants, approximately 20 % had a reduced work status, which in the multivariate analyses was significantly associated with increasing age. One third of the men still active in the workforce considered the PCa to negatively influence their working life. This was independently associated with bother related to urinary leakage, fatigue, and having undergone additional oncological therapy (pelvic radiotherapy and/or hormone treatment). Though RP does not affect work status in most men, approximately one third of them experience problems in their working life due to adverse effects related to RP and/or additional post-RP anti-cancer therapy. Most PCa survivors can expect to remain in the workforce for at least 3 years after RP, but for some, persistent adverse effects after RP and /or additional anti-cancer treatment negatively affect their working life. Pre-RP counseling of men within the workforce should cover possible post-RP changes concerning work status and working life.
Saro, Cristina; Ceballos, Daniel; Muñoz, Fernando; de la Coba, Cristóbal; Aguilar, María Dolores; Lázaro, Pablo; García-Sánchez, Valle; Hernández, Mariola; Barrio, Jesús; de Francisco, Ruth; Fernández, Luis I; Barreiro-de Acosta, Manuel
Clinical trials have shown the efficacy of adalimumab in Crohn's disease, but the outcome in regular practice remains unknown. The aim of the study was to examine clinical status, quality of life, and work productivity of Crohn's disease patients receiving adalimumab for one year in the context of usual clinical practice. This was a prospective, observational study with a one-year follow-up. After baseline, Crohn's disease patients were evaluated at 1, 3, 6, 9, and 12 months after starting treatment with adalimumab. Outcome variables included: clinical status (measured with CDAI), quality of life (measured with EuroQoL-5D and IBDQ), and work productivity (measured with WPAI questionnaire). These outcome variables were compared using the Student's t test or Wilcoxon test for paired comparison data according to the data distribution. Statistical significance was set at two-sided p work productivity impact decreased from 53% to 24% (p quality of life and work productivity.
Overbeek, Anouk; Van den Block, Lieve; Korfage, Ida J; Penders, Yolanda W H; van der Heide, Agnes; Rietjens, Judith A C
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.
Mathematics anxiety in primary pre-service teachers' affects their future teaching of mathematics and achievement of students. Data collected via Critical Incident Technique were used to investigate this anxiety as perceived and identified by first year pre-service teachers. This paper proposes the application of the Quality of Life conceptual…
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The purpose of this study was to assess the correlation and predictive relationship between self-determination and quality of life of college students with disabilities. Subjects were 145 senior college students recruited from northern Taiwan. Subjects' age ranged from 22 to 25 years and their disabilities varied, including visual impairments (n =…
Stewart, Anita L.; And Others
Evaluated health-related quality of life in relation to endurance exercise over prior year for 194 previously sedentary, healthy men and women aged 50 to 65. In three exercise regimens studied, subjects who participated more had better physical health; no differences were observed in general psychological well-being. Extent of participation was…
van Mierlo, Maria; van Heugten, Caroline; Post, Marcel W M; Hoekstra, Trynke; Visser-Meily, Anne
PURPOSE: To identify trajectories of physical and psychosocial health-related quality of life (HRQoL) from two months to one-year post stroke and to determine the factors that are associated with trajectory membership. METHOD: Multicenter prospective cohort study in which 351 stroke patients were
Xie, Meng-Yao; Yuan, Yong-Hua; Liu, Li-Mei; Gu, Rong; Zhao, Xiao-Dong
To evaluate the association between the use of antibacterial agents in the first years of life and childhood asthma. The Chinese and English databases CNKI, Wanfang Data, VIP, PubMed, and EBSCO were searched for prospective cohort studies on the association between the use of antibacterial agents in the first years of life and childhood asthma. Stata12.0 software was used to analyze the association through a Meta analysis. The articles with a high quality score and adjusted effective values for factors for lower respiratory tract infection were pooled, and a total of 8 studies were included. The results of the Meta analysis showed that the use of antibacterial agents in the first years of life increased the risk of childhood asthma (OR=1.14, 95%CI: 1.10-1.17, Pasthma (OR=1.28, 95%CI: 1.19-1.38, Pasthma) who used antibacterial agents had an increased risk of asthma (OR=1.47, 95%CI: 1.20-1.81, Pchildhood asthma. High-risk children who use antibacterial agents have an increased risk of asthma. The increased frequency of use of antibacterial agents in the first years of life is associated with an increased risk of childhood asthma, but the detailed dose relationship needs further investigation.
Isik, Serife; Ergüner-Tekinalp, Bengü
This study examined the effects of gratitude journaling on first-year college students' adjustment, life satisfaction, and positive affect. Students who scored high (i.e., scores between 35 and 56) on the Perceived Stress Scale (Cohen et al. in "Journal of Health and Social Behavior," 24, 385-396, 1983) and low (i.e., scores between 48…
Colzani, Edoardo; Cassini, Alessandro; Lewandowski, Daniel; Mangen, Marie Josee J.; Plass, Dietrich; McDonald, Scott A; van Lier, Alies; Haagsma, Juanita A.; Maringhini, Guido; Pini, Alessandro; Kramarz, Piotr; Kretzschmar, Mirjam E.
The burden of disease framework facilitates the assessment of the health impact of diseases through the use of summary measures of population health such as Disability- Adjusted Life Years (DALYs). However, calculating, interpreting and communicating the results of studies using this methodology
Colzani, E. (Edoardo); A. Cassini (Alessandro); D. Lewandowski (Daniel); M.J.J. Mangen; Plass, D. (Dietrich); S.A. McDonald (Scott); R.A.W. Van Lier (Rene A. W.); J.A. Haagsma (Juanita); Maringhini, G. (Guido); Pini, A. (Alessandro); P Kramarz (Piotr); M.E.E. Kretzschmar (Mirjam)
textabstractThe burden of disease framework facilitates the assessment of the health impact of diseases through the use of summary measures of population health such as Disability- Adjusted Life Years (DALYs). However, calculating, interpreting and communicating the results of studies using this
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...
I. Soerjomataram (Isabelle); J.G.A. Lortet-Tieulent (Joannie); J. Ferlay (J.); D. Forman (David); C. Mathers (Colin); D.M. Parkin; F. Bray (Freddie)
textabstractBackground: Disability-adjusted life years (DALYs) link data on disease occurrence to health outcomes, and they are a useful aid in establishing country-specific agendas regarding cancer control. The variables required to compute DALYs are however multiple and not readily available in
van Leeuwen, Christel M. C.; Post, Marcel W. M.; van Asbeck, Floris W. A.; Bongers-Janssen, Helma M. H.; van der Woude, Lucas H. V.; de Groot, Sonja; Lindeman, Eline
Purpose: To describe the course of life satisfaction in persons with spinal cord injury (SCI) during the first 5 years after discharge from inpatient rehabilitation and to examine its determinants. Methods: Multi-centre prospective cohort study with four measurements, the first at discharge from
Dewrang, Petra; Sandberg, Annika Dahlgren
Development and behavior during the first 2 years of life was assessed retrospectively by the parents to 23 adolescents and young adults with Asperger syndrome and 13 typically developing adolescents and young adults. The groups were matched on chronological age and the participants were within the normal range of intelligence. The questionnaire,…
Language development in infants born very preterm is often compromised. Poor language skills have been described in preschoolers and differences between preterms and full terms, relative to early vocabulary size and morphosyntactical complexity, have also been identified. However, very few data are available concerning early speech perception abilities and their predictive value for later language outcomes. An overview of the results obtained in a prospective study exploring the link between early speech perception abilities and lexical development in the second year of life in a population of very preterm infants (≤32 gestation weeks) is presented. Specifically, behavioral measures relative to (a) native-language recognition and discrimination from a rhythmically distant and a rhythmically close nonfamiliar languages, and (b) monosyllabic word-form segmentation, were obtained and compared to data from full-term infants. Expressive vocabulary at two test ages (12 and 18 months, corrected age for gestation) was measured using the MacArthur Communicative Development Inventory. Behavioral results indicated that differences between preterm and control groups were present, but only evident when task demands were high in terms of language processing, selective attention to relevant information and memory load. When responses could be based on acquired knowledge from accumulated linguistic experience, between-group differences were no longer observed. Critically, while preterm infants responded satisfactorily to the native-language recognition and discrimination tasks, they clearly differed from full-term infants in the more challenging activity of extracting and retaining word-form units from fluent speech, a fundamental ability for starting to building a lexicon. Correlations between results from the language discrimination tasks and expressive vocabulary measures could not be systematically established. However, attention time to novel words in the word segmentation
Dahl, K E; Wang, N J; Ohrn, K
The aim of this study was to assess the effect of oral health on aspects of daily life measured by the Dental Impact Profile (DIP) in 35- to 47-year-old individuals in Norway, and to study associations between reported effects and demographic variables, subjectively assessed oral health, general health, oral health behaviour and clinical oral health. A stratified randomized sample of 249 individuals received a questionnaire regarding demographic questions, dental visits, oral hygiene behaviour, self-rated oral health and general health and satisfaction with oral health. The DIP measured the effects of oral health on daily life. Teeth present and caries experience were registered by clinical examination. Bi- and multivariate analyses and factor analysis were used. Items most frequently reported to be positively or negatively influenced by oral health were chewing and biting, eating, smiling and laughing, feeling comfortable and appearance. Only 1% reported no effects of oral health. Individuals with fewer than two decayed teeth, individuals who rated their oral health as good or practised good oral health habits reported more positive effects than others on oral quality of life (P ≤ 0.05). When the variables were included in multivariate analysis, none was statistically significant. The subscales of the DIP were somewhat different from the originally suggested subscales. This study showed that most adults reported oral health to be important for masticatory functions and confirmed that oral health also had impacts on other aspects of life. © 2011 John Wiley & Sons A/S.
Krishnamurthi, Rita V; deVeber, Gabrielle; Feigin, Valery L
, childhood stroke burden in terms of absolute numbers of prevalent strokes, deaths and DALYs remained much higher in developing countries. There is an urgent need to address these disparities with both global and country-level initiatives targeting prevention as well as improved access to acute and chronic...... increases in the global prevalence rates of childhood IS, as well as significant decreases in the global death rate and DALYs rate of all strokes in those of age 0-19 years. While prevalence rates for childhood IS and HS decreased significantly in developed countries, a decline was seen only in HS......, with no change in prevalence rates of IS, in developing countries. The childhood stroke DALY rates in 2013 were 13.3 (95% UI 10.6-17.1) for IS and 92.7 (95% UI 80.5-109.7) for HS per 100,000. While the prevalence of childhood IS compared to childhood HS was similar globally, the death rate and DALY rate of HS...
Chawes, Bo Lund Krogsgaard; Bønnelykke, Klaus; Bisgaard, Hans
-prostaglandin-F2a was associated with any of the atopic phenotypes. Conclusion Eosinophil protein-X in urine from asymptomatic neonates is a biomarker significantly associated with later development of allergic sensitization, nasal eosinophilia and eczema during the first 6 years of life. These findings suggest...... D2 metabolite) assessed in urine from healthy at-risk neonates precede development of atopic disease during the first 6 years of life. Methods We measured eosinophil protein-X (N=369), leukotriene-C4/D4/E4 (N=367), and 11ß-prostaglandin-F2a (N=366) in urine from 1-month-old children participating...... untill age 6 years. Associations between urinary biomarkers and development of atopic traits were investigated using general estimating equations, logistic regression and Cox regression. Measurements and Main Results Eosinophil protein-X in the urine of the asymptomatic 1-month-old neonates...
Full Text Available Brain and nervous system development in human infants during the first 1000 days (conception to two years of age is critical, and compromised development during this time (such as from under nutrition or poverty can have life-long effects on physical growth and cognitive function. Cortical mapping of cognitive function during infancy is poorly understood in resource-poor settings due to the lack of transportable and low-cost neuroimaging methods. Having established a signature cortical response to social versus non-social visual and auditory stimuli in infants from 4 to 6 months of age in the UK, here we apply this functional Near Infrared Spectroscopy (fNIRS paradigm to investigate social responses in infants from the first postnatal days to the second year of life in two contrasting environments: rural Gambian and urban UK. Results reveal robust, localized, socially selective brain responses from 9 to 24 months of life to both the visual and auditory stimuli. In contrast at 0–2 months of age infants exhibit non-social auditory selectivity, an effect that persists until 4–8 months when we observe a transition to greater social stimulus selectivity. These findings reveal a robust developmental curve of cortical specialisation over the first two years of life.
The birth of the first child brings with it considerable changes in the lives of the parents, and the transfer to parenthood is felt to be very demanding in particular by many mothers. There is a marked decrease in the mean satisfaction with the partnership. A stress-resources model is used to analyse which factors influence partnership satisfaction and the health-related quality of life of parents in the first two years of the life of their first child, drawing on data from a controlled inte...
Juniper, EF; Svensson, K; O'Byrne, PM; Barnes, PJ; Bauer, CA; Lofdahl, CGA; Postma, DS; Pauwels, RA; Tattersfield, AE; Ullman, A
The Formoterol and Corticosteroids Establishing Therapy (FACET) study has provided the first opportunity to examine the long-term effects of inhaled steroids and long-acting beta(2)-agonists on asthma-specific quality of life. The objectives of the present study were to: evaluate the effects of
Monhart, Z.; Grünfeldová, H.; Zvárová, Jana; Janský, P.
Roč. 122, č. 2 (2010), e69 ISSN 0009-7322. [World Congress of Cardiology . 16.06.2010-19.06.2010, Beijing] Institutional research plan: CEZ:AV0Z10300504 Keywords : cardiology * reperfusion treatment * real-life practice Subject RIV: FA - Cardiovascular Diseases incl. Cardiotharic Surgery
Braam, A.W.; Schaap - Jonker, H.; Horst, M.H.L.; Steunenberg, B.; Beekman, A.T.F.; Tilburg, W. van; Deeg, D.J.H.
Objectives: Growing evidence shows several possible relations between religiousness and late-life depression. Emotional aspects of religiousness such as facets of the perceived relationship with God can be crucial in this connection. The aim of the current study was to examine the association
Braam, A.W.; Schaap-Jonker, H.; van der Horst, M.H.L.; Steunenberg, B.; Beekman, A.T.F.; van Tilburg, W.; Deeg, D.J.H.
Objectives Growing evidence shows several possible relations between religiousness and late-life depression. Emotional aspects of religiousness such as facets of the perceived relationship with God can be crucial in this connection. The aim of the current study was to examine the association between
OECD Publishing (NJ1), 2009
In the past few decades there has been an increasing interest in the different educational experiences, success and eventual outcomes that prevail for males and females. Women often excel at school, however men often earn more and are more likely to hold positions of power in political and economic life. Looking at these inequalities, government…
Objective: The availability of highly active antiretroviral therapy (HAART) has resulted in a number of achievements as well as challenges. The aim of this study was to assess the influence of 48 weeks HAART of stavudine, lamivudine and nevirapine on the quality of life of HIVinfected Nigerians. Materials and Method: ...
Houtzager, B. A.; Grootenhuis, M. A.; Caron, H. N.; Last, B. F.
Several studies have been conducted on sibling psychosocial adaptation to cancer in a brother or sister, but little is known on how the long-term adaptation of siblings to the illness develops. The concept quality of life has primarily been applied in research on the effects of chronic illness on
The best interests of the child are paramount, and should the child unreasonably refuse to consent to life-saving treatment, the Minister of Social Development may give consent for such treatment in terms of the Children's Act. Otherwise, should a parent, guardian, caregiver or healthcare provider believe that such a refusal ...
Tabak, Izabela; Mazur, Joanna; Oblacińska, Anna; Jodkowska, Maria
The aim of the study was to analyse the relationships between objective body mass index and subjective body image, life satisfaction and self-esteem of adolescents. the study was carried in 5 regions in Poland, on the sample of over 8,000 pupils aged 13-15 yrs, from randomly chosen 112 lower secondary schools. School nurses measured the height and weight of pupils, calculated the BMI and qualified overweight pupils (BMI> or =85 percentile) to the obese group (n = 953). Matching gender and age, from the rest of pupils, they found the non-obese group with BMI between 15 and 75 percentile (n = 953). Pupils from both groups participated in a questionnaire study containing the Rosenberg Self-Esteem Scale, Cantril ladder and Stunkard Body Figure Perception Questionnaire. Hierarchic regression analyses and structural equation models were calculated. in the obese group the percentage of pupils satisfied with their life was lower (76% vs 82%, pself-esteem higher than in the non-obese (37% vs 23%, plife satisfaction and self-esteem was subjective body image, and not the objective body mass index. Objective body mass (BMI) determined the body image and relationship between BMI and life satisfaction or self-esteem of adolescents was only indirect. change of subjective body image in obese adolescents is a chance for improving their quality of life and in consequence undertaking effective struggle with obesity.
McGrath, John; Saari, Kaisa; Hakko, Helinä; Jokelainen, Jari; Jones, Peter; Järvelin, Marjo-Riitta; Chant, David; Isohanni, Matti
Based on clues from epidemiology and animal experiments, low vitamin D during early life has been proposed as a risk factor for schizophrenia. The aim of this study was to explore the association between the use of vitamin D supplements during the first year of life and risk of developing schizophrenia. Subjects were drawn from the Northern Finland 1966 Birth Cohort (n=9,114). During the first year of life, data were collected about the frequency and dose of vitamin D supplementation. Our primary outcome measures were schizophrenia, psychotic disorders other than schizophrenia, and nonpsychotic disorders as diagnosed by age 31 years. Males and females were examined separately. In males, the use of either irregular or regular vitamin D supplements was associated with a reduced risk of schizophrenia (Risk ratio (RR)=0.08, 95% CI 0.01-0.95; RR=0.12, 95% CI 0.02-0.90, respectively) compared with no supplementation. In males, the use of at least 2000 IU of vitamin D was associated with a reduced risk of schizophrenia (RR=0.23, 95% CI 0.06-0.95) compared to those on lower doses. There were no significant associations between either the frequency or dose of vitamin D supplements and (a) schizophrenia in females, nor with (b) nonpsychotic disorder or psychotic disorders other than schizophrenia in either males or females. Vitamin D supplementation during the first year of life is associated with a reduced risk of schizophrenia in males. Preventing hypovitaminosis D during early life may reduce the incidence of schizophrenia.
Chen, Po-Chuan; Lee, Jenq-Chang; Wang, Jung-Der
Life-expectancy of colon cancer patients cannot be accurately answered due to the lack of both large datasets and long-term follow-ups, which impedes accurate estimation of lifetime cost to treat colon cancer patients. In this study, we applied a method to estimate life-expectancy of colon cancer patients in Taiwan and calculate the lifetime costs by different stages and age groups. A total of 17,526 cases with pathologically verified colon adenocarcinoma between 2002 and 2009 were extracted from Taiwan Cancer Registry database for analysis. All patients were followed-up until the end of 2011. Life-expectancy, expected-years-of-life-lost and lifetime costs were estimated, using a semi-parametric survival extrapolation method and borrowing information from life tables of vital statistics. Patients with more advanced stages of colon cancer were generally younger and less co-morbid with major chronic diseases than those with stages I and II. The LE of stage I was not significantly different from that of the age- and sex-matched general population, whereas those of stages II, III, and IV colon cancer patients after diagnosis were 16.57 ± 0.07, 13.35 ± 0.07, and 4.05 ± 0.05 years, respectively; the corresponding expected-years-of-life-lost were 1.28 ± 0.07, 5.93 ± 0.07 and 16.42 ± 0.06 years, significantly shorter than the general population after accounting for lead time bias. Besides, the lifetime cost of managing stage II colon cancer patients would be US $8,416 ± 1939, 14,334 ± 1,755, and 21,837 ± 1,698, respectively, indicating a big saving for early diagnosis and treatment after stratification for age and sex. Treating colon cancer at younger age and earlier stage saves more life-years and healthcare costs. Future studies are indicated to apply these quantitative results into the cost-effectiveness evaluation of screening program for colon cancers.
Full Text Available An unavoidable reciprocal influence characterizes mother-infant’s dyad.Within this relationship,the presence of depression,somatization,hostility,paranoid ideation and interpersonal sensitivity symptoms at a subclinical level and their possible input on infant motor competences has not been yet considered.Bearing in mind that motor abilities represent not only an indicator of infant’s health-status,but also the principal field to infer his/her needs, eelings and intentions,in this study the quality of infants’movements were assessed and analyzed in relationship with the maternal attitudes.The aim of this research was to investigate if/how maternal symptomatology may lead infant's motor development during his/her first year of life by observing the characteristics of motor development in infants aged 0-11months.Participants included 123 mothers and their infants (0-11months-old.Mothers’ symptomatology was screened with SymptomChecklist-90-Revised(SCL-90-R,while infants were tested with Peabody Developmental Motor Scale-Second Edition.All dyads belonged to a non-clinical population, however,on the basis of SCL-90-Rscores, mothers’sample was divided into two groups: normative and subclinical.Descriptive,T-test,correlational analysis between PDMS-2scores and SCL-90-R results are reported,as well as regression models results.Both positive and negative correlations were found between maternal perceived symptomatology,Somatization(SOM,Interpersonal Sensitivity(IS,Depression(DEP,Hostility(HOSand Paranoid Ideation(PARand infants’motor abilities.These results were then further verified by applying regression models to predict the infant motor outcomes on the basis of babies’ age and maternal status.The presence of positive symptoms in SCL-90-Rquestionnaire (subclinical group predicted good visual-motor integration and stationary competences in the babies.In particular,depressive and hostility feelings in mothers seemed to induce an infant
Maria Lidia Bueno Fernandes
Full Text Available This article presents reflections on the teaching of geography and history in the early years of schooling, considering the possibilities of establishing pedagogical dialogue between them. Related to this the paper reports the experience developed in the Faculty of Education at the University of Brasilia. The Federal District became the object of teaching in the classroom. Considering this it proposes that the pedagogical approach - field work - is incorporated into the apprenticeship of the future teachers in their professional performance. Thus addresses the challenge of working with everyday reality of professional training from the perspective of its approach to concepts of Geography and History. The theoretical background bases on the works of: Santos, Cavalcanti and Callai with regard to the discussion of the geographic knowledge, Revel and Pesavento about reflections about micro-history and Alarcão and Brzezinski on teacher education. As a summary, one can recognize the transformative potential of the subjects that establish dialogue with the prior knowledge of the students and their everyday life. It can be seen to the survey, the potential of the field work as an ally in the classroom. O presente artigo apresenta reflexões a respeito do Ensino da Geografia e da História nos anos iniciais da escolarização, considerando as possibilidades de estabelecer diálogo de natureza pedagógica entre ambas. Nesse sentido, relata a experiência desenvolvida na Faculdade de Educação da Universidade de Brasília, em que o Distrito Federal tornou-se objeto de ensino em sala de aula. Para tanto propõe que a abordagem pedagógica denominada estudo do meio seja incorporada à formação do futuro pedagogo em sua atuação profissional. Dessa forma, considera o desafio de trabalhar com a realidade cotidiana do profissional em formação na perspectiva de sua aproximação com conceitos da Geografia e da História. Em termos teóricos a pesquisa
Williams, David E.; Dake, Jason R.; Gentry, Gregory J.
The International Space Station (ISS) Environmental Control and Life Support (ECLS) system includes regenerative and non-regenerative technologies that provide the basic life support functions to support the crew, while maintaining a safe and habitable shirtsleeve environment. This paper provides a summary of the U.S. ECLS system activities over the prior year, covering the period of time between March 2010 and February 2011. The ISS continued permanent crew operations including the continuation of six crew members being on ISS. Work continues on the last of the Phase 3 pressurized elements, the commercial cargo resupply vehicles, and work to try and extend ISS service life from 2015 to no later than 2028.
Saier, Tim; Plath, Johannes E; Waibel, Sabrina; Minzlaff, Philipp; Feucht, Matthias J; Herschbach, Peter; Imhoff, Andreas B; Braun, Sepp
To report general life and health satisfaction after arthroscopic Bankart repair in patients with post-traumatic recurrent anterior glenohumeral instability and to investigate postoperative time lost to return to work at 2-year follow-up. Between 2011 and 2013 patients treated with arthroscopic Bankart repair in the beach chair position for acute shoulder instability were included in this study. Questions on Life Satisfaction Modules (FLZ M ) and the Short Form 12 (SF-12) were used as quality-of-life outcome scales. Oxford Instability Score (OIS), Quick Disabilities of the Arm, Shoulder and Hand questionnaire (QuickDASH), and self-reported American Shoulder and Elbow Surgeons (ASES) shoulder index were used as functional outcome scales. Return to work (months) was monitored and analyzed depending on physical workload. Data were assessed the day before surgery and prospectively monitored until 24 months postoperatively. Quality-of-life outcome was correlated with functional shoulder outcome and compared with normative age-adjusted data. Paired t-test, Wilcoxon test, Mann-Whitney U-Test, and Spearman's correlation coefficient were used for statistical analysis. Fifty-three patients were prospectively included. The mean age at surgery was 29.4 years. Satisfaction with general life and satisfaction with health (FLZ M ) as well as physical component scale (SF-12) improved significantly to values above normative data within 6 to 12 months after surgery (each P quality of life and functional outcome scores (P work was 2 months (range, 0-10; standard deviation, 1.9), with significantly longer time intervals observed in patients with heavy physical workload (3.1 months; range, 0 to 10; standard deviation, 2.4; P = .002). Following arthroscopic Bankart repair, quality of life was impaired during early course after surgery and increased significantly above preoperative levels within 6 to 12 months after the procedure. A steady state of excellent quality-of-life and
Oberle, D; von Mutius, E; von Kries, R
There are controversial data as to interdependencies of exposure to furred pets in infancy and the prevalence of asthma and hay fever in children. Does the timing, intensity and type of pet exposure matter? Cross-sectional questionnaire data on 8216 German schoolchildren aged 5-7 years not living on a farm in ten rural districts in Bavaria in 1997 were analysed. The diagnosis of asthma and hay fever was ascertained with the International Study of Asthma and Allergies in Childhood (ISAAC) core questions. Wheeze and asthma were classified as 'atopic' in children who also had hay fever or atopic dermatitis. Prevalence and intensity of exposure to pets in the first year of life and at present were assessed via questionnaire. Although the study was of considerable size we found no convincing association between atopic disease and pet exposure in general. Exposure to cats from the first year of life to school entry, however, was associated with a reduced prevalence of atopic asthma, if cats were allowed to be in the child's bedroom: no case of atopic asthma in 296 children exposed and an aOR 0.11 (95% CI:0.01-0.52) for atopic wheeze in the last 12 months. Allowing cats to be in the child's bedroom from the first year of life onwards may be an indicator of intensive exposure to cats and appears to prevent the development of childhood asthma.
Ubels, Rutger J; Mokhles, Sahar; Andrinopoulou, Eleni R; Braat, Cornelia; Voort van Zyp, Noëlle C van der; Aluwini, Shafak; Aerts, Joachim G J V; Nuyttens, Joost J
To determine the long-term impact of stereotactic radiotherapy (SRT) on the quality of life (QoL) of inoperable patients with early-stage non-small cell lung cancer (NSCLC). From January 2006 to February 2008, 39 patients with pathologically confirmed T1-2N0M0 NSCLC were treated with SRT. QoL, overall survival and local tumor control were assessed. The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ)-C30 and the lung cancer-specific questionnaire QLQ-LC13 were used to investigate changes in QoL. Assessments were done before treatment, at 3 weeks, every 2–3 months during the first two years, and then every 6 months until 5 years after the treatment or death or progressive disease. The median follow up was 38 months. During the 5 years after treatment with SRT for stage I NSCLC, the level of QoL was maintained: There was a slow decline (slope: −0.015) of the global health status over the 5 years (p < 0.0001). The physical functioning and the role functioning improved slowly (slope: 0.006 and 0.004, resp.) over the years and this was also significant (p < 0.0001). The emotional functioning (EF) improved significantly at 1 year compared to the baseline. Two years after the treatment dyspnea slowly increased (slope: 0.005, p = 0.006). The actuarial overall survival was 62% at 2 years and 31% at 5-years. QoL was maintained 5 years after SRT for stage I NSCLC and EF improved significantly. Dyspnea slowly increased 2 years after the treatment
Al-Mobarak, Faisal; Khan, Arif O
To evaluate the effect of intraoperative mitomycin-C (MMC) on polypropylene Ahmed glaucoma valve (AGV) survival 2 years after implantation during the first 2 years of life. Retrospective institutional comparative series (1995-2005). Thirty-one eyes of 27 patients (23 unilateral, 4 bilateral; 16 boys, 11 girls) undergoing AGV implantation at a mean age of 11.1 months (standard deviation [SD], 5.46), all of which had 2 years of regular postoperative follow-up. MMC was applied intraoperatively in those cases in the area of AGV implantation in 16 (52%) and was not applied in 15 (48%). In some eyes, MMC was applied intraoperatively in cases done by the surgeons who routinely used MMC for all AGV implantation in young children. Failure was defined as intraocular pressure (IOP) > 22 mmHg with or without glaucoma medications, the need for an additional procedure for IOP control, or the occurrence of significant complications (e.g., endophthalmitis, retinal detachment, persistent hypotony [IOP < 5 mmHg]). Survival was the absence of failure. Failure or significant complications as defined. Mean survival for the non-MMC eyes (22.15 months; standard error [SE], 1.93) was significantly longer than survival for the MMC eyes (16.25 months; SE, 2.17) by the log-rank test (P = 0.025). The difference in cumulative survival at 2 years was also significantly different by log-rank test (P = 0.001): 80.0% (SE 10.3) and 31.3% (SE 11.6), respectively. Rather than improved survival, intraoperative use of MMC was associated with shorter survival 2 years after AGV implantation during the first 2 years of life. We speculate that MMC-induced tissue death can stimulate a reactive fibrosis around the AGV in very young eyes.
Full Text Available Abstract Background Rising rates of obesity and overweight is an increasing public health problem all over the world. Recent research has shown the importance of early life factors in the development of child overweight. However, to the best of our knowledge there are no studies investigating the potential synergistic effect of early life factors and presence of parental overweight on the development of child overweight. Methods The study was population-based and cross-sectional. The study population consisted of children who visited the Child Health Care (CHC centers in Malmö for their 4-year health check during 2003-2008 and whose parents answered a self-administered questionnaire (n = 9009 children. Results The results showed that having overweight/obese parents was strongly associated with the child being overweight or obese. Furthermore, there was an association between unfavorable early life factors (i.e., mother smoking during pregnancy, presence of secondhand tobacco smoke early in life, high birth weight and the development of child overweight/obesity at four years of age, while breastfeeding seemed to have a protective role. For example, maternal smoking during pregnancy was associated with an odds ratio (OR of 1.47 (95% CI: 1.22, 1.76 for overweight and 2.31 (95% CI: 1.68, 3.17 for obesity. The results further showed synergistic effects between parental overweight and exposure to unfavourable early life factors in the development of child overweight. Conclusions The present study shows the importance of early life factors in the development of child overweight and obesity, and thus puts focus on the importance of early targeted interventions.
Full Text Available Abstract Background Measures of premature mortality have been used to guide debates on future health priorities and to monitor the population health status. Standard expected years of life lost (SEYLL is one of the methods used to assess the time lost due to premature death. This article affords an overview of premature mortality in Spain for the year 2008. Methods A population-based study was conducted estimating SEYLL by sex and age groups. SEYLL, a key component of the disability-adjusted life years measure of disease burden, was calculated using Princeton West standard life tables with life expectancy at birth fixed at 80 years for males and 82.5 years for females. Population data and specific death records were obtained from the official registers of the National Institute of Statistics. All data were analysed and prepared in GesMor and Epidat software packages. Results The burden of premature mortality was estimated at 2.1 million SEYLL when age at death is taken into account. Males lost 60.9% and females lost 39.1% of total SEYLL. Malignant tumors (34.5% and cardiovascular diseases (24.0% were the leading categories in terms of SEYLL. Ischaemic heart disease (8.5% and lung cancers (8.0% were the most common specific causes of SEYLL followed by cerebrovascular diseases (5.9%, colorectal cancer (4.1%, road traffic accidents (3.5%, Alzheimer and other dementias (2.9%, chronic obstructive pulmonary disease (2.8%, breast cancer (2.8% and suicides (2.6%. Conclusions In Spain, premature mortality was essentially due to chronic non-communicable diseases. Data provided in this study are relevant for a more balanced health agenda aimed at reducing the burden of premature mortality. This study also represents a first step in estimating the overall burden of disease in terms of premature death and disability.
Catalá-López, Ferrán; Fernández de Larrea-Baz, Nerea; Morant-Ginestar, Consuelo; Álvarez-Martín, Elena; Díaz-Guzmán, Jaime; Gènova-Maleras, Ricard
The aim of the present study was to determine the national burden of cerebrovascular diseases in the adult population of Spain. Cross-sectional, descriptive population-based study. We calculated the disability-adjusted life years (DALY) metric using country-specific data from national statistics and epidemiological studies to obtain representative outcomes for the Spanish population. DALYs were divided into years of life lost due to premature mortality (YLLs) and years of life lived with disability (YLDs). DALYs were estimated for the year 2008 by applying demographic structure by sex and age-groups, cause-specific mortality, morbidity data and new disability weights proposed in the recent Global Burden of Disease study. In the base case, neither YLLs nor YLDs were discounted or age-weighted. Uncertainty around DALYs was tested using sensitivity analyses. In Spain, cerebrovascular diseases generated 418,052 DALYs, comprising 337,000 (80.6%) YLLs and 81,052 (19.4%) YLDs. This accounts for 1,113 DALYs per 100,000 population (men: 1,197 and women: 1,033) and 3,912 per 100,000 in those over the age of 65 years (men: 4,427 and women: 2,033). Depending on the standard life table and choice of social values used for calculation, total DALYs varied by 15.3% and 59.9% below the main estimate. Estimates provided here represent a comprehensive analysis of the burden of cerebrovascular diseases at a national level. Prevention and control programmes aimed at reducing the disease burden merit further priority in Spain. Copyright © 2013 Elsevier España, S.L.U. All rights reserved.
Beijers, Roseriet; Jansen, Jarno; Riksen-Walraven, Marianne; de Weerth, Carolina
: Night wakings are common in infancy. Although a link between infant night wakings and attachment to the primary caregiver has been previously proposed, empirical support is limited so far. The aim of this longitudinal study was to examine the early history of night waking in infants who were later classified as securely or insecurely (avoidantly, resistantly, or disorganized) attached. : Participants in the study were 193 infants and their mothers. Information on infant night wakings was collected with the use of daily sleep diaries for the first 6 months of life and again for 2 weeks at 12 months of age. Infant-mother attachment was assessed using the Strange Situation (Ainsworth et al, Patterns of Attachment: A Psychological Study of the Strange Situation. New York: Hillsdale; 1978) when the infants were 12 months of age. : Longitudinal regression analyses showed that, after controlling for many covariates, infants with an insecure-resistant attachment at 12 months of age awoke more during the night in their first 6 months of life than the other infants. Furthermore, infants with different attachment classifications developed different patterns of night wakings over the first 6 months, with the insecure-avoidant infants waking the least toward the end of the 6 months. Hierarchical multiple regression analyses showed no associations between attachment and night wakings at 12 months of age. : This study is the first in showing that attachment at 12 months of age is related to infant night waking patterns in the first 6 months of life. Patterns of infant night wakings early in life apparently reflect the emerging attachment relationship.
van Solinge, Hanna; Henkens, Kène
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.
Lele Mookerjee, Anuradha; Fischer, Bradford D; Cavanaugh, Susan; Rajput, Vijay
Behavioral and social science integration in clinical practice improves health outcomes across the life stages. The medical school curriculum requires an integration of the behavioral and social science principles in early medical education. We developed and delivered a four-week course entitled "LifeStages" to the first year medical students. The learning objectives of the bio-behavioral and social science principles along with the cultural, economic, political, and ethical parameters were integrated across the lifespan in the curriculum matrix. We focused on the following major domains: Growth and Brain Development; Sexuality, Hormones and Gender; Sleep; Cognitive and Emotional Development; Mobility, Exercise, Injury and Safety; Nutrition, Diet and Lifestyle; Stress and coping skills, Domestic Violence; Substance Use Disorders; Pain, Illness and Suffering; End of Life, Ethics and Death along with Intergenerational issues and Family Dynamics. Collaboration from the clinical and biomedical science departments led to the dynamic delivery of the course learning objectives and content. The faculty developed and led a scholarly discussion, using the case of a multi-racial, multi-generational family during Active Learning Group (ALG) sessions. The assessment in the LifeStages course involved multiple assessment tools: including the holistic assessment by the faculty facilitator inside ALGs, a Team-Based Learning (TBL) exercise, multiple choice questions and Team Work Assessment during which the students had to create a clinical case on a LifeStages domain along with the facilitators guide and learning objectives.
Orgilés, Mireia; Samper, M A Dolores
To examine differences in quality of life according to family structure in Spanish children for the first time, and to determine whether the quality of life of children with divorced parents differs according to perceived interparental conflict. A cross-sectional, descriptive study was carried out in 1,025 children aged between 8 and 12 years old, recruited from seven randomly-selected schools in the province of Alicante. Of the total sample, 861 children had married parents and 164 had divorced parents. The children completed the Child Health and Illness Profile-Child Edition and those with divorced parents also provided information on the current relationship between their parents. Quality of life was higher in children with married parents than in those with divorced parents, with higher scores in all dimensions. Children who reported conflict between their parents after the divorce had worse quality of life. These results confirm significant differences in quality of life according to family structure and revealed the relationship between children's self-perceived health and interparental conflict after divorce. We emphasize the importance of health professionals in providing guidance to divorced parents on preventing their children's health problems and facilitating adaptation to the new family situation. Copyright © 2011 SESPAS. Published by Elsevier Espana. All rights reserved.
Sundblad, Britt-Marie; Jansson, Sven-Arne; Nyström, Lennarth; Arvidsson, Peter; Lundbäck, Bo; Larsson, Kjell
Background Little is known about the management of patients suffering from chronic obstructive pulmonary disease (COPD) during the last years of life. The aim of the study was to describe how management of COPD is performed in Sweden during the last two years of life. Methods From the nationwide Cause of Death register all individuals with COPD as the underlying cause of death during two years were identified in one sparsely and one densely populated area of Sweden. Data were collected from medical records using a pre-defined protocol, especially developed for this purpose. Results Of 822 individuals with COPD as underlying cause of death, medical records from 729 were available. The COPD diagnosis was based on lung function measurements in approximately half of the patients and median age at COPD diagnosis was 74 years (range 34-95). Women died at younger age, median 78 years (range 52-96) than did men (80 years (51-99)). The median survival time from diagnosis to death was 6 years in men and women in both areas. Among women and men 8.3% and 4.3% were never smokers, respectively. The structure of COPD management differed between the two areas, with utilization of physiotherapists, dieticians and working therapists being more used in the northern area, likely because of differences in accessibility to care institutions. Conclusions In Sweden COPD is mostly diagnosed late in life and often not verified by lung function measurements. Opposite to the general population, women with COPD die at a lower age than men. PMID:24367631
Bhandari, Nita; Rongsen-Chandola, Temsunaro; Bavdekar, Ashish; John, Jacob; Antony, Kalpana; Taneja, Sunita; Goyal, Nidhi; Kawade, Anand; Kang, Gagandeep; Rathore, Sudeep Singh; Juvekar, Sanjay; Muliyil, Jayaprakash; Arya, Alok; Shaikh, Hanif; Abraham, Vinod; Vrati, Sudhanshu; Proschan, Michael; Kohberger, Robert; Thiry, Georges; Glass, Roger; Greenberg, Harry B; Curlin, George; Mohan, Krishna; Harshavardhan, G V J A; Prasad, Sai; Rao, T S; Boslego, John; Bhan, Maharaj Kishan
Rotavirus gastroenteritis is one of the leading causes of diarrhea in Indian children less than 2 years of age. The 116E rotavirus strain was developed as part of the Indo-US Vaccine Action Program and has undergone efficacy trials. This paper reports the efficacy and additional safety data in children up to 2 years of age. In a double-blind placebo controlled multicenter trial, 6799 infants aged 6-7 weeks were randomized to receive three doses of an oral human-bovine natural reassortant vaccine (116E) or placebo at ages 6, 10, and 14 weeks. The primary outcome was severe (≥11 on the Vesikari scale) rotavirus gastroenteritis. Efficacy outcomes and adverse events were ascertained through active surveillance. We randomly assigned 4532 and 2267 subjects to receive vaccine and placebo, respectively, with over 96% subjects receiving all three doses of the vaccine or placebo. The per protocol analyses included 4354 subjects in the vaccine and 2187 subjects in the placebo group. The overall incidence of severe RVGE per 100 person years was 1.3 in the vaccine group and 2.9 in the placebo recipients. Vaccine efficacy against severe rotavirus gastroenteritis in children up to 2 years of age was 55.1% (95% CI 39.9 to 66.4; pvaccine efficacy in the second year of life of 48.9% (95% CI 17.4 to 68.4; p=0.0056) was only marginally less than in the first year of life [56.3% (95% CI 36.7 to 69.9; pvaccine dose and all were reported only after the third dose. The sustained efficacy of the 116E in the second year of life is reassuring. The trial is registered with Clinical Trial Registry-India (# CTRI/2010/091/000102) and Clinicaltrials.gov (# NCT01305109). Copyright © 2014. Published by Elsevier Ltd.
Plassman, B L; Welsh, K A; Helms, M; Brandt, J; Page, W F; Breitner, J C
We evaluated the relation of education and intelligence in early adult life to cognitive function in a group of elderly male twins. The Army General Classification Test (AGCT) was administered to US armed forces inductees in the early 1940s. Fifty years later, as part of a study of dementia in twins, we tested the cognitive status of 930 of these men using the modified Telephone Interview for Cognitive Status (TICS-m). TICS-m scores obtained in later life were correlated with AGCT scores (r = 0.457) and with years of education (r = 0.408). Thus, in univariate analyses, the AGCT score accounted for 20.6% and education accounted for 16.7% of variance in cognitive status. However, these two effects were not fully independent. A multivariable model using AGCT score, education, and the interaction of the two variables as predictors of the TICS-m score explained 24.8% of the variance, a slightly but significantly greater proportion than was explained by either factor alone. In a separate analysis based on 604 pairs of twins who took the AGCT, heritability of intelligence (estimated by AGCT score) was 0.503. Although this study does not address the issue of education and premorbid IQ as risk factors for dementia, the findings suggest that basic cognitive abilities in late life are related to cognitive performance measures from early adult life (ie, education and IQ).
Wisborg, Kirsten; Kesmodel, Ulrik; Bech, Bodil Hammer
pregnancy had an increased risk of stillbirth compared with women who did not drink coffee (odds ratio=3.0, 95% confidence interval 1.5 to 5.9). After adjustment for smoking habits and alcohol intake during pregnancy, the relative risk of stillbirth decreased slightly. Adjustment for parity, maternal age......Objective To study the association between coffee consumption during pregnancy and the risk of stillbirth and infant death in the first year of life. Design Prospective follow up study. Setting Aarhus University Hospital, Denmark, 1989-96. Participants 18 478 singleton pregnancies in women...... with valid information about coffee consumption during pregnancy. Main outcome measures Stillbirth (delivery of a dead fetus at >28 weeks’ gestation) and infant death (death of a liveborn infant during the first year of life). Results Pregnant women who drank eight or more cups of coffee per day during...
This volume contains information on cost estimates, planning schedules, yearly cost flowcharts, and life-cycle costs for the six options described in Volume 1, Section 2: Option 1 -- Total removal clean closure; No subsequent use; Option 2 -- Risk-based clean closure; LLW fill; Option 3 -- Risk-based clean closure; CERCLA fill; Option 4 -- Close to RCRA landfill standards; LLW fill; Option 5 -- Close to RCRA landfill standards; CERCLA fill; and Option 6 -- Close to RCRA landfill standards; Clean fill. This volume is divided into two portions. The first portion contains the cost and planning schedule estimates while the second portion contains life-cycle costs and yearly cash flow information for each option
Boecker, H.; Scheef, L.; Jankowski, J.; Zimmermann, N.; Born, M.; Heep, A.
Currently, a paradigm shift towards expanded early use of cranial MRI in newborns at risk and infants in the first year of life can be observed in neonatology. Beyond clinical MRI applications, there is progressive use of functional MRI (fMRI) in this age group. On the one hand, fMRI allows monitoring of functional developmental processes depending on maturational stage; on the other hand, this technique may provide the basis for early detection of pathophysiological processes as a prerequisite for functionally guided therapeutic interventions. This article provides a comprehensive review of current fMRI applications in neonates and infants during the first year of life and focuses on the associated methodological issues (e.g. signal physiology, sedation, safety aspects). (orig.)
Belfort, Mandy B; Kuban, Karl C K; O'Shea, T Michael; Allred, Elizabeth N; Ehrenkranz, Richard A; Engelke, Stephen C; Leviton, Alan
To examine the extent to which weight gain and weight status in the first 2 years of life relate to the risk of neurodevelopmental impairment in extremely preterm infants. In a cohort of 1070 infants born between 23 and 27 weeks' gestation, we examined weight gain from 7-28 days of life (in quartiles) and weight z-score at 12 and 24 months corrected age (in 4 categories: Weight gain in the lowest quartile from 7-28 days was not associated with higher risk of adverse outcomes. Children with a 12-month weight z-score weight z-score weight z-score at 24 months with adverse outcomes were attenuated with exclusion of children with motor impairment. Excluding children who have gross motor impairment appears to eliminate the association of low weight status with neurodevelopmental impairments at 2 years in extremely preterm infants. Copyright © 2016 Elsevier Inc. All rights reserved.
Tang, Siew Tzuh; Chang, Wen-Cheng; Chen, Jen-Shi; Chou, Wen-Chi; Hsieh, Chia-Hsun; Chen, Chen H
Whether prognostic awareness benefits terminally ill cancer patients' psychological-existential well-being and quality of life (QOL) is unclear because of lack of well-controlled longitudinal studies. This study longitudinally evaluated the associations of accurate prognostic awareness and prognostic acceptance with psychological distress, existential suffering, and QOL while comprehensively controlling for confounders in Taiwanese terminally ill cancer patients' last year of life. A convenience sample of 325 cancer patients was followed until death. Psychological distress and existential suffering were assessed by severe anxiety and depressive symptoms and high self-perceived sense of burden to others, respectively. Dichotomized and continuous (QOL) outcome variables were evaluated by multivariate logistic and linear regression modeling with the generalized estimating equation, respectively. Accurate prognostic awareness was not associated with the likelihood of severe anxiety or depressive symptoms but significantly increased the likelihood of high self-perceived sense of burden to others and was associated with poorer QOL in participants' last year of life. Participants who knew and highly accepted their prognosis were significantly less likely to experience severe anxiety symptoms than those who were unaware of or knew their prognosis but had difficulty accepting it. Knowing one's poor prognosis and confronting one's impending death without full acceptance and adequate professional psycho-spiritual support may harm more than benefit terminally ill cancer patients' psychological state, existential well-being, and QOL. These findings highlight the importance of tailoring psycho-spiritual support to cancer patients' psychological and existential needs when prognostic information is disclosed. Copyright © 2015 John Wiley & Sons, Ltd.
Boo, N Y; Chandran, V; Zulfiqar, M A; Zamratol, S M; Nyein, M K; Haliza, M S; Lye, M S
To identify the types of early cranial ultrasound changes that were significant predictors of adverse outcome during the first year of life in asphyxiated term infants. This was a prospective cohort study. Shortly after birth, cranial ultrasonography was carried out via the anterior fontanelles of 70 normal control infants and 104 asphyxiated infants with a history of fetal distress and Apgar scores of less than 6 at 1 and 5 min of life, or requiring endotracheal intubation and manual intermittent positive pressure ventilation for at least 5 min after birth. Neurodevelopmental assessment was carried out on the survivors at 1 year of age. Abnormal cranial ultrasound changes were detected in a significantly higher proportion (79.8%, or n = 83) of asphyxiated infants than controls (39.5%, or n = 30) (P < 0.0001). However, logistic regression analysis showed that only three factors were significantly associated with adverse outcome at 1 year of life among the asphyxiated infants. These were: (i) decreasing birthweight (for every additional gram of increase in birthweight, adjusted odds ratio (OR) = 0.999, 95% confidence interval (CI) 0.998, 1.000; P = 0.047); (ii) a history of receiving ventilatory support during the neonatal period (adjusted OR = 8.3; 95%CI 2.4, 28.9; P = 0.0009); and (iii) hypoxic-ischaemic encephalopathy stage 2 or 3 (adjusted OR = 5.8; 95%CI 1.8, 18.6; P = 0.003). None of the early cranial ultrasound changes was a significant predictor. Early cranial ultrasound findings, although common in asphyxiated infants, were not significant predictors of adverse outcome during the first year of life in asphyxiated term infants.
Havelaar, A H; De Hollander, A E; Teunis, P F; Evers, E G; Van Kranen, H J; Versteegh, J F; Van Koten, J E; Slob, W
To evaluate the applicability of disability adjusted life-years (DALYs) as a measure to compare positive and negative health effects of drinking water disinfection, we conducted a case study involving a hypothetical drinking water supply from surface water. This drinking water supply is typical in The Netherlands. We compared the reduction of the risk of infection with Cryptosporidium parvum by ozonation of water to the concomitant increase in risk of renal cell cancer arising from the produc...
Colzani, Edoardo; Cassini, Alessandro; Lewandowski, Daniel; Mangen, Marie-Josee J.; Plass, Dietrich; McDonald, Scott A.; van Lier, Alies; Haagsma, Juanita A.; Maringhini, Guido; Pini, Alessandro; Kramarz, Piotr; Kretzschmar, Mirjam E.
textabstractThe burden of disease framework facilitates the assessment of the health impact of diseases through the use of summary measures of population health such as Disability- Adjusted Life Years (DALYs). However, calculating, interpreting and communicating the results of studies using this methodology poses a challenge. The aim of the Burden of Communicable Disease in Europe (BCoDE) project is to summarize the impact of communicable disease in the European Union and European Economic Ar...
Galler, Janina R.; Bryce, Cyralene P.; Zichlin, Miriam L.; Waber, Deborah P.; Exner, Natalie; Fitzmaurice, Garrett M.; Costa, Paul T.
Background: Early childhood malnutrition is associated with cognitive and behavioral impairment during childhood and adolescence, but studies in adulthood are limited. Methods: Using the NEO-PI-R personality inventory, we compared personality profiles at 37-43 years of age ("M" 40.3 years, "SD" 1.9) of Barbadian adults who had…
Thomas, F; Empana, J P; Charles, M A; Boutouyrie, P; Jouven, X; Pannier, B; Danchin, N
In epidemiological studies, recall of weight and height are not readily available at different ages of life. In order to improve the knowledge of the weight history, Sörensen et al. in 1983, developed a tool from silhouettes allowing an individual to evaluate his corpulence at different ages of life. Validity studies showed that measured weight and size were correlated to 80% in the reported silhouette. Studies have also shown that silhouettes are a good way to trace the weight history in an individual's life. Very few epidemiological studies have used this tool. A French study revealed a decrease of the risk of breast cancer in obese girls between the age of 8 and adolescence. Another study showed that a low birth weight or a thin silhouette before adulthood was associated with an increased risk of diabetes. On the basis of these findings, it was interesting to evaluate the relationship between the silhouette at 20years and the risk of hypertension at the age of 60years. It was shown that the prevalence of hypertension at age 60 was higher among obese subjects at 20years than among thin subjects (45.3% vs 36.7% (P<0.05). The classification between slimness and obesity is relevant using this tool. The history of corpulence is an important element to consider in the determinants of pathology, especially in hypertension. Copyright © 2017 Elsevier Masson SAS. All rights reserved.
Full Text Available Estimate the Years of Life Lost (YLL for overall and avoidable causes of death (CoD in Colombia for the period 1998-2011.From the reported deaths to the Colombian mortality database during 1998-2011, we classified deaths from avoidable causes. With the reference life table of the Global Burden of Disease (GBD 2010 study, we estimated the overall YLL and YLL due to avoidable causes. Calculations were performed with the difference between life expectancy and the age of death. Results are reported by group of cause of death, events, sex, year and department. Comparative analysis between number of deaths and YLL was carried out.A total of 83,856,080 YLL were calculated in Colombia during period 1998-2011, 75.9% of them due to avoidable CoD. The year 2000 reported the highest number of missed YLL by both overall and avoidable CoD. The departments with the highest YLL rates were Caquetá, Guaviare, Arauca, Meta, and Risaralda. In men, intentional injuries and cardiovascular and circulatory diseases had the higher losses, while in women YLL were mainly due to cardiovascular and circulatory diseases.The public health priorities should focus on preventing the loss of YLL due to premature death and differentiated interventions by sex.
Fleming, Dr Ted
Life expectancy has increased by 30 years during the past century. By 2150 the percentage of the worldâs 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 ...
The effect of intensive radiotherapy on 1-5 year survival rates of patients with inoperable lung cancer is investigated. Some 123 cases were treated with 200 kV X-rays (> 3500 cGy tumour dose) and 1046 with cobalt-60 ν-rays (> 5000 cGy tumour dose). All patients had inoperable, histologically confirmed tumours, limited to one side of the thorax. Survival rates for 1 year were 22% and 37% respectively; for 3 years 1% and 5%; and for 5 years 0 and 2.5%. In all highly differentiated tumours the authors obtained a 5-year survival with telecobalt therapy of 6.5%, and for all oat-cell cases, 2.5%. By comparing the total result with their own control group of 'untreated', but prognostically more favourable patients (122 thoracotomized cases without resection) the increase of survival rates achieved by Cobalt-60 therapy is convincing (2.5 times for 1 year, 5 times for 2 years). Nevertheless, the very unfavourable prognosis for more than half of the cases justifies trials with systemic therapy. To date chemotherapy does not appear to influence survival times (except for small-cell tumours). Therefore randomized trials with two half-body irradiations (800 cGy each, 'Toronto method') are recommended. (Auth.)
von Bonsdorff, Mikaela B; von Bonsdorff, Monika E; Haanpää, Maija; Salonen, Minna; Mikkola, Tuija M; Kautiainen, Hannu; Eriksson, Johan G
Early exit from the workforce has been proposed to be one of the unfavorable consequences of diabetes. We examined whether early exit from the workforce differed between persons who were and were not diagnosed with diabetes during their work career. The cohort included 12,726 individuals of the Helsinki Birth Cohort Study, born between 1934 and 1944. Using data from nationwide registers, the cohort was followed up from early adulthood until they transitioned into retirement or died. Work-loss years were estimated using the restricted mean work years method. During a follow-up of 382,328 person-years for men and 349 894 for women, 36.8% transitioned into old age pension and 63.2% exited workforce early. Among men, 40.5% of those with and 32.8% of those without diabetes transitioned into old age pension (p=0.003). The corresponding numbers for women were 48.6% and 40.4% (p = 0.013), respectively. Mean age at exit from the workforce was 60.1 (95% confidence interval [CI], 59.6 to 60.7) years among men with diabetes and 57.6 (95% CI, 57.2 to 58.0) years among men without diabetes (p = 0.016). Among women, corresponding ages were 61.4 (95% CI, 60.8 to 61.9) years for those with diabetes and 59.5 (95% CI, 59.3 to 59.7) years for those without diabetes (p work-loss years according to diabetes was 2.5 (95% CI 0.5 to 4.6) for men and 1.9 (95% CI 1.0 to 2.8) for women. Among individuals followed up throughout their work career, those with a diabetes diagnosis exited the workforce approximately two years later compared to those without diabetes.
Shimada, K; Kai, M
This paper has proposed that disability-adjusted life year (DALY) can be used as a measure of radiation health risk. DALY is calculated as the sum of years of life lost (YLL) and years lived with disability (YLD). This multidimensional concept can be expressed as a risk index without a probability measure to avoid the misuse of the current radiation detriment at low doses. In this study, we calculated YLL and YLD using Japanese population data by gender. DALY for all cancers in Japan per 1 Gy per person was 0.84 year in men and 1.34 year in women. The DALY for all cancers in the Japanese baseline was 4.8 in men and 3.5 in women. When we calculated the ICRP detriment from the same data, DALYs for the cancer sites were similar to the radiation detriment in the cancer sites, excluding leukemia, breast and thyroid cancer. These results suggested that the ICRP detriment overestimate the weighting fraction of leukemia risk and underestimate the weighting fraction of breast and thyroid cancer. A big advantage over the ICRP detriment is that DALY can calculate the risk components for non-fatal diseases without the data of lethality. This study showed that DALY is a practical tool that can compare many types of diseases encountered in public health. (paper)
Hakanen, Jari J; Schaufeli, Wilmar B
Burnout and work engagement have been viewed as opposite, yet distinct states of employee well-being. We investigated whether work-related indicators of well-being (i.e. burnout and work engagement) spill-over and generalize to context-free well-being (i.e. depressive symptoms and life satisfaction). More specifically, we examined the causal direction: does burnout/work engagement lead to depressive symptoms/life satisfaction, or the other way around? Three surveys were conducted. In 2003, 71% of all Finnish dentists were surveyed (n=3255), and the response rate of the 3-year follow-up was 84% (n=2555). The second follow-up was conducted four years later with a response rate of 86% (n=1964). Structural equation modeling was used to investigate the cross-lagged associations between the study variables across time. Burnout predicted depressive symptoms and life dissatisfaction from T1 to T2 and from T2 to T3. Conversely, work engagement had a negative effect on depressive symptoms and a positive effect on life satisfaction, both from T1 to T2 and from T2 to T3, even after adjusting for the impact of burnout at every occasion. The study was conducted among one occupational group, which limits its generalizability. Work-related well-being predicts general wellbeing in the long-term. For example, burnout predicts depressive symptoms and not vice versa. In addition, burnout and work engagement are not direct opposites. Instead, both have unique, incremental impacts on life satisfaction and depressive symptoms. Copyright © 2012 Elsevier B.V. All rights reserved.
Rolving, Nanna; Obling, Kirstine H; Christensen, Finn B; Fonager, Kirsten
Lumbar decompression surgery (LDS) and total hip arthroplasty (THA) are frequently performed in the elderly population, but very little is known about their subsequent physical capacity and participation in leisure activities. Despite similar demographics and comorbidities, it is questionable whether LDS patients achieve equally high levels of physical capacity and quality of life postoperatively as do THA patients. The aim was to compare the physical activity level, participation in leisure activities and related quality of life 1 year after an LDS and THA procedure. Data from 95 THA patients and 83 LDS patients were gathered from questionnaires on self-reported physical activity level, leisure activities and quality of life. LDS and THA patients reported equally moderate levels of physical activity. The median score was 42.3 METs/day (IQR 37.9; 47.7) for the LDS group and 41.0 METs/day (IQR 38.5; 48.5) for the THA group (p = 0.79). Weekly time consumption for leisure activities in the LDS group was a median of 420 min/week (IQR 210; 660) compared to a median of 480 min/week (IQR 240; 870) in the THA group (p = 0.16). Regarding quality of life, LDS patients reported significantly worse Euroqol Five Dimensions scores with a median value of 0.740 (IQR 0.68; 0.82) compared to THA patients' median of 0.824 (IQR 0.72; 1.0), p leisure activities, LDS patients did not achieve a quality of life comparable to that of THA patients 1 year postoperatively.
Nagpal, Ravinder; Kurakawa, Takashi; Tsuji, Hirokazu; Takahashi, Takuya; Kawashima, Kazunari; Nagata, Satoru; Nomoto, Koji; Yamashiro, Yuichiro
Bifidobacteria are important members of human gut microbiota; however, quantitative data on their early-life dynamics is limited. Here, using a sensitive reverse transcription-qPCR approach, we demonstrate the carriage of eight signature infant-associated Bifidobacterium species (B. longum, B. breve, B. bifidum, B. catenulatum group, B. infantis, B. adolescentis, B. angulatum and B. dentium) in 76 healthy full-term vaginally-born infants from first day to three years of life. About 21% babies carry bifidobacteria at first day of life (6.2 ± 1.9 log 10 cells/g feces); and this carriage increases to 64% (8.0 ± 2.2), 79% (8.5 ± 2.1), 97% (9.3 ± 1.8), 99% (9.6 ± 1.6), and 100% (9.7 ± 0.9) at age 7 days, 1, 3 and 6 months, and 3 years, respectively. B. longum, B. breve, B. catenulatum group and B. bifidum are among the earliest and abundant bifidobacterial clades. Interestingly, infants starting formula-feed as early as first week of life have higher bifidobacterial carriage compared to exclusively breast-fed counterparts. Bifidobacteria demonstrate an antagonistic correlation with enterobacteria and enterococci. Further analyses also reveal a relatively lower/ delayed bifidobacterial carriage in cesarean-born babies. The study presents a quantitative perspective of the early-life gut Bifidobacterium colonization and shows how factors such as birth and feeding modes could influence this acquisition even in healthy infants.
Nutman, Allen P.; Bennett, Vickie C.; Friend, Clark R. L.; van Kranendonk, Martin J.; Chivas, Allan R.
Biological activity is a major factor in Earth’s chemical cycles, including facilitating CO2 sequestration and providing climate feedbacks. Thus a key question in Earth’s evolution is when did life arise and impact hydrosphere-atmosphere-lithosphere chemical cycles? Until now, evidence for the oldest life on Earth focused on debated stable isotopic signatures of 3,800-3,700 million year (Myr)-old metamorphosed sedimentary rocks and minerals from the Isua supracrustal belt (ISB), southwest Greenland. Here we report evidence for ancient life from a newly exposed outcrop of 3,700-Myr-old metacarbonate rocks in the ISB that contain 1-4-cm-high stromatolites—macroscopically layered structures produced by microbial communities. The ISB stromatolites grew in a shallow marine environment, as indicated by seawater-like rare-earth element plus yttrium trace element signatures of the metacarbonates, and by interlayered detrital sedimentary rocks with cross-lamination and storm-wave generated breccias. The ISB stromatolites predate by 220 Myr the previous most convincing and generally accepted multidisciplinary evidence for oldest life remains in the 3,480-Myr-old Dresser Formation of the Pilbara Craton, Australia. The presence of the ISB stromatolites demonstrates the establishment of shallow marine carbonate production with biotic CO2 sequestration by 3,700 million years ago (Ma), near the start of Earth’s sedimentary record. A sophistication of life by 3,700 Ma is in accord with genetic molecular clock studies placing life’s origin in the Hadean eon (>4,000 Ma).
Bent, N; Tennant, A; Neumann, V; Chamberlain, M A
Thalidomide was first synthesized in 1953 and was subsequently marketed as a mild hypnotic and sedative in more than 20 countries. By 2001 it was estimated that there were 5,000 survivors from the 10,000 - 12,000 babies who were, as a result, born with severe abnormalities. For these survivors, recent concerns have emerged about their physical state, in particular their levels of pain and their ability to maintain independence. It was therefore wished to ascertain health status and current concerns amongst a sample of survivors living in the UK. A combination of qualitative and quantitative methodologies was employed. Qualitative interviews were undertaken with a sample drawn from the population affected by thalidomide known to the Thalidomide Trust. Selection of participants was based upon a theoretical sample frame. Postal questionnaires to examine health status and various psychosocial aspects concerned with living with the consequences of thalidomide were sent subsequently to these same participants and to a random sample of those not originally drawn for the qualitative interviews. For the qualitative interviews, 28 agreed to take part; two refused and the remainder did not respond. Those agreeing to interview were representative of the original compensation bands (Chi-Square = 3.929; p = 0.416). Several themes emerged from these interviews, including the effects on work and career; coping in terms of attitude to life, self-image, confidence, self-esteem, stress and emotion; relationships, independent living issues and emergent problems such as pain, quality of life, and anxiety about the future. A postal questionnaire was then sent to those who had agreed to interview (28), plus a random sample of the remaining group who were not initially chosen for the qualitative interviews. In total 82 people were sent the questionnaire, of whom 41 (50%) responded. Two-thirds of responders were female. Seven out of ten lived with a partner, and over half (56%) had
Katoh, Hiroyuki; Tsuji, Hiroshi; Ishikawa, Hitoshi
To assess 3-year health-related quality of life of patients treated with carbon ion radiotherapy for prostate cancer. A total of 213 patients received carbon-ion radiotherapy at a total dose of 66 Gy equivalent in 20 fractions over 5 weeks, and neoadjuvant and adjuvant androgen deprivation therapy were administered for high-risk patients for at least 12 months. A health-related quality of life assessment was carried out at four time-points (immediately before the initiation of carbon-ion radiotherapy, immediately after, 12 and 36 months after completion of carbon-ion radiotherapy) using Functional Assessment of Cancer Therapy General and for Prostate Cancer Patients. The evaluable response rates among all responses were more than 94%. Overall, a significant decrease in the scores of the health-related quality of life 12 months after carbon-ion radiotherapy returned to their baseline levels at 36 months. Additionally, no significant decrease was observed in the scores at any of the assessment time-points compared with their baseline scores in the group of carbon-ion radiotherapy without androgen deprivation therapy; however, the presence of morbidity and biochemical failure significantly worsened the scores, and the decreases in the scores did not improve even at 36 months after carbon-ion radiotherapy. An assessment based on a subjective scoring system shows a significant decrease in health-related quality of life at 12 months after carbon-ion radiation therapy, which tends to return to baseline levels at 36 months. The presence of morbidity and bio-chemical failure significantly worsen health-related quality of life scores. Further controlled studies focusing on health-related quality of life assessment in patients with prostate cancer are warranted. (author)
Escribano, J; Luque, V; Canals-Sans, J; Ferré, N; Koletzko, B; Grote, V; Weber, M; Gruszfeld, D; Szott, K; Verduci, E; Riva, E; Brasselle, G; Poncelet, P; Closa-Monasterolo, R
In humans, maximum brain development occurs between the third trimester of gestation and 2 years of life. Nutrition during these critical windows of rapid brain development might be essential for later cognitive functioning and behaviour. In the last few years, trends on protein recommendations during infancy and childhood have tended to be lower than that in the past. It remains to be demonstrated that lower protein intakes among healthy infants, a part of being able to reduce obesity risk, is safe in terms of mental performance achievement. Secondary analyses of the EU CHOP, a clinical trial in which infants from five European countries were randomised to be fed a higher or a lower protein content formula during the 1st year of life. Children were assessed at the age of 8 years with a neuropsychological battery of tests that included assessments of memory (visual and verbal), attention (visual, selective, focused and sustained), visual-perceptual integration, processing speed, visual-motor coordination, verbal fluency and comprehension, impulsivity/inhibition, flexibility/shifting, working memory, reasoning, visual-spatial skills and decision making. Internalising, externalising and total behaviour problems were assessed using the Child Behaviour Checklist 4-18. Adjusted analyses considering factors that could influence neurodevelopment, such as parental education level, maternal smoking, child's gestational age at birth and head circumference, showed no differences between feeding groups in any of the assessed neuropsychological domains and behaviour. In summary, herewith we report on the safety of lower protein content in infant formulae (closer to the content of human milk) according to long-term mental performance.
Koposova, Natalia; Eriksen, Harald M; Widstrãm, Eeva; Eisemann, Martin; Opravin, Alexander; Koposov, Roman
To assess self-perceived oral health-related quality of life (OHRQoL) in 12-year-olds living in two areas in the Barents region: North-West Russia (Arkhangelsk) and Northern Norway (TromsÃ¸). Sampling was performed according to a stratified cluster design and consisted of 590 Russian and 264 Norwegian 12-year-olds and their parents. After written consent from their parents, 514 Russian (87% attendance) and 124 Norwegian (47% attendance) children entered the study. The study included clinical examination (children) and questionnaires (children and parents). Dental caries and the aesthetic dental appearance were recorded under field conditions. Self-reports on background variables and oral health-related quality of life questions (CPQ11-14) were completed in classroom settings by children and at home by parents. OHRQoL was found to vary depending on country of origin, with higher scores of CPQ11-14 domains among 12-year-olds from Russia. OHRQoL was found to be associated with dental caries, with higher scores among 12-year olds with caries. Inferior emotional and social well-being were established as having the strongest association with quality of life. Dental caries showed an independent effect on OHRQoL scores, but this effect disappeared when controlling for background variables, with country of origin, family economy, parental education and aesthetic appearance as the most influential (RÂ²=0.14). Norwegian 12-year-olds had better oral health and OHRQoL than their Russian counterparts. The impact of dental caries on OHRQoL was weak and aesthetic dental appearance and socio-economic determinants were found to be more important, probably reflecting the great differences in the standards of living between Northern Norway and North-West Russia.
Full Text Available BACKGROUND: Few research studies have addressed the long-term effects caused by catastrophes, and no study has ever explored the life quality, physical diseases, and psychological impairment of earthquake survivors at the same time. This study seeks to reveal survivors' quality of life, physical diseases, and mental health. METHODS: A cross-sectional survey was conducted through multi-stage sampling approach three years after the Wenchuan earthquake. RESULTS: A total of 2525 subjects were interviewed. Symptoms of PTSD were reported by 8.8% of the respondents from the seriously affected areas and 0.5%, the less hit areas. Prevalence of chronic diseases was 39.2% and 22.1% respectively, and two-week prevalence rate, 24.9% and 12.7% respectively. In the multivariate analysis, two-week prevalence, displacement, no regular income, receiving mental health support after the disaster, family members died or missing, injured due to the quake, and person who witnessed someone being killed or injured were independently associated with higher prevalence for symptoms of PTSD. Most subscales of SF-12 negatively correlated with age, chronic diseases, two-week prevalence, injured due to the disaster, home or property loss, and score of the 3-year PTSD symptoms, but positively correlated with higher education and higher household income. CONCLUSIONS: The rates of physical diseases and symptoms of PTSD were relatively high, and the quality of life was poor among victims in the hard-hit areas 3 years after the earthquake. Physical impairment correlated with symptom of PTSD, and both were negatively associated with quality of life.
MELiSSA (Micro-Ecological Life Support System Alternative) is a collaborative project with the European Space Agency ESA and various other scientific partners. The objective of MELiSSA is to develop a system that is able to provide manned space missions with food, drinking water and oxygen autonomously in space. Drinkable water and oxygen are currently being made in the international space station ISS by filtering waste water and by electrolysing water. However, such physiochemical technologies do not offer a solution for food. The MELiSSA project intends to reuse waste products, which include CO2, water, stools and urine from the astronauts, and even the perspiration moisture in the cabin and to transfer these into food through the use of micro-organisms.
Cuadrón Andrés, L; Samper Villagrasa, M P; Álvarez Sauras, M L; Lasarte Velillas, J J; Rodríguez Martínez, G
To study the current prevalence of breastfeeding (BF) in Aragon (Spain) during the first 12 months of life, and analyse its demographic, perinatal and social influential factors. Obstetric, perinatal and feeding aspects were evaluated in a longitudinal and observational study, in a representative cohort of infant population from Aragon born between March 2009 to March 2010, controlled until 12 months of age (N=1.602). Exclusive or predominant BF was more frequent than the rest of feeding modalities during the first 4 months of life. Maintenance prevalence of any BF modality was 82.5% at 1(st) month of age, 71.8% at 3(rd), 54.3% at 6(th), and 27.8% at 12 months of age. Maternal variables that were significantly associated with BF maintenance both at 1 and 6 months of age were: delivery modality (higher probability in case of vaginal delivery), academic level (higher probability if university studies), origin (higher probability in mothers from Africa), adiposity (higher probability of normal weight or overweight mothers compared with obese ones), and not to smoke during gestation. BF prevalence in Aragon (Spain) during the first 12 months of age is high and has increased compared with previous data. BF continues in more than half of infants at six months and in a quarter of infants at 12 months of age. Maternal factors that significantly influence BF initiation and maintenance are, delivery modality, academic level, origin (immigration), adiposity and smoking habit. Copyright © 2013 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.
Hagen, Egon; Erga, Aleksander H; Hagen, Katrin P; Nesvåg, Sverre M; McKay, James R; Lundervold, Astri J; Walderhaug, Espen
Polysubstance use disorder is prevalent in treatment-seeking patients with substance use disorder (SUD), with a higher risk of developing comorbid psychiatric symptoms, more pervasive deficits in cognitive functions, and inferior treatment results. The present study investigates if individuals with polysubstance use disorder who achieve at least one year of abstinence show greater improvements in satisfaction with life, executive functions, and psychological distress, compared to relapsers and controls. The prospective recovery from polysubstance use disorder assessed with broad output indicators remains understudied. A better understanding of the pattern of recovery of the chosen output indicators could shed light on the recovery process for this group of patients. We investigated changes in satisfaction with life, executive functions and psychological distress over a period of 12months in patients who remained abstinent and in those who relapsed. Subjects with polysubstance use disorder (N=115) were recruited from outpatient and residential treatment facilities; healthy controls (N=34) were recruited by posters exhibited at social welfare and GP offices. Executive functions were assessed by the Behaviour Rating Inventory of Executive Function-Adult self-report version (BRIEF-A), psychological distress by the Symptom Checklist-90-R (SCL-90-R), and satisfaction with life by the Satisfaction With Life Scale (SWLS). Substance use was assessed by self-reports on the Alcohol Use Disorders Identification Test (AUDIT) and the Drug Use Disorders Identification Test (DUDIT). Participants were categorized as "relapsers" if they had AUDIT score ≥8, or DUDIT score ≥2 for women and ≥6 for men. Results indicated that the abstinent group had the greatest improvement on all the indicators compared with relapsers and controls. Participants who successfully quit substance use for one year showed improved satisfaction with life, executive functions, and psychological distress
Adesina, Oluwatomilayo; DeBellis, Anita; Zannettino, Lana
Nurses have a vital role in providing end-of-life care to patients and their families, and it is important that nursing students are adequately prepared for this role. This article reports on qualitative findings from research that explored a cohort of third-year undergraduate Australian nursing students' attitudes, experiences, knowledge, and education concerning end-of-life care. The study used open-ended questions in a purpose-designed, self-administered questionnaire and thematic analysis of the responses. Five themes emerged from the analysis: the importance of the students' values and beliefs, the influence of experience, their views on what constitutes a good or bad death, their knowledge of ethics and legislation surrounding end-of-life care, and how they perceived their level of education and knowledge. The need for more education on end-of-life care has implications for curriculum development in undergraduate nursing programmes, which need to provide graduating nurses with the necessary knowledge and skills to deliver quality care to patients who are dying and their families.
Abbott, Megan M; Rogers, Gary F; Proctor, Mark R; Busa, Kathleen; Meara, John G
Endoscopically assisted suturectomy (EAS) has been reported to reduce the morbidity and cost of treating sagittal synostosis when compared with traditional open cranial vault remodeling (CVR) procedures. Whereas the former claim is well substantiated and intuitive, the latter has not been validated by rigorous cost analysis. Patient medical records and financial database reports were culled retrospectively to determine the total cost associated with both EAS and CVR during 1 year of care. Recorded cost data included physician and hospital services, orthotic equipment and fittings, and indirect patient cost. Ten patients treated with CVR were compared with 10 patients who underwent EAS. The CVR patients incurred greater costs in nearly all categories studied, including overall 1-year costs, physician services, hospital services, supplies/equipment, medications/intravenous fluids, and laboratory and blood bank services. Postoperative costs were greater in the EAS group, primarily because of the cost associated with orthotic services and indirect patient costs for travel and lost work. However, overall indirect patient costs for the whole year did not differ between the groups. One-year median costs were $55,121 for CVR and $23,377 for EAS. Early clinical results were similar for the 2 groups. Cranial vault remodeling was more costly in the first year of treatment than EAS, although indirect patient costs were similar. The favorable cost of EAS compared with CVR provides further justification to consider this procedure as first-line treatment of sagittal synostosis in young infants.
Halkjær, Liselotte Brydensholt; Loland, Lotte; Buchvald, Frederik F
, followed up for 3 years with scheduled visits every 6 months as well as visits for onset or acute exacerbations of skin symptoms. SETTING: The cohort was recruited from greater Copenhagen, Denmark, and followed up at a clinical research unit, which controlled all diagnoses and treatment of skin diseases....... PARTICIPANTS: A total of 411 infants were enrolled in the cohort; 55 had incomplete follow-up and were excluded from certain analyses. MAIN OUTCOME MEASURES: Atopic dermatitis was defined based on the criteria of Hanifin and Rajka, and severity was assessed by the SCORAD (Scoring Atopic Dermatitis) index...... predicted AD at age 3 years. CONCLUSIONS: Atopic dermatitis begins at the scalp, forehead, ear, and neck in a balaclava-like pattern. Eczema at the arms and joints provides the highest predictive value for the development of AD at age 3 years. This may be used for early prediction and intervention of AD....
López Tiro, J Jesús; Contreras, E Angélica Contreras; del Pozo, M Elena Ramírez; Gómez Vera, J; Larenas Linnemann, D
Even though there are multiple options for the treatment of asthma, there still exists a fair group of patients with difficult-to-control asthma. We describe for the first time the real-world effects of three-year omalizumab treatment on patients with difficult-to-control asthma, seen in a social security hospital in a Latin American country. Difficult-to-control asthmatic patients from the out-patient clinic of a regional hospital were recruited to receive a three-year omalizumab course. Efficacy parameters were asthma control test (ACT) score; FEV1; daily beclomethasone maintenance dose; and unplanned visits for asthma exacerbations (emergency room (ER), hospitalisations, intensive care). 52 patients were recruited, 47 completed the three-year treatment (42 female, 15-67 years, mean age 43.5). Comparing efficacy parameters of the year before omalizumab with the 3rd year of omalizumab: mean ACT improved from 12.4 to 20.5, mean FEV1 from 66.3% (standard deviation (SD) 19.1%) to 88.4% (SD 16.2%) of predicted, while mean beclomethasone dose reduced from 1750 to 766 mcg/day and there was a significant reduction in patients experiencing ER visits (from 95% to 19%, pomalizumab, two because of an adverse event (anaphylaxis, severe headache, both resolved without sequelae). Omalizumab improved most clinical parameters of Mexican patients with difficult-to-control asthma. Especially the rates of ER visits and hospitalisation were significantly reduced, thus reducing costs. Omalizumab was generally well tolerated. Copyright © 2013 SEICAP. Published by Elsevier Espana. All rights reserved.
Simoens, Steven; Dunselman, Gerard; Dirksen, Carmen; Hummelshoj, Lone; Bokor, Attila; Brandes, Iris; Brodszky, Valentin; Canis, Michel; Colombo, Giorgio Lorenzo; DeLeire, Thomas; Falcone, Tommaso; Graham, Barbara; Halis, Gülden; Horne, Andrew; Kanj, Omar; Kjer, Jens Jørgen; Kristensen, Jens; Lebovic, Dan; Mueller, Michael; Vigano, Paola; Wullschleger, Marcel; D'Hooghe, Thomas
This study aimed to calculate costs and health-related quality of life of women with endometriosis-associated symptoms treated in referral centres. A prospective, multi-centre, questionnaire-based survey measured costs and quality of life in ambulatory care and in 12 tertiary care centres in 10 countries. The study enrolled women with a diagnosis of endometriosis and with at least one centre-specific contact related to endometriosis-associated symptoms in 2008. The main outcome measures were health care costs, costs of productivity loss, total costs and quality-adjusted life years. Predictors of costs were identified using regression analysis. Data analysis of 909 women demonstrated that the average annual total cost per woman was €9579 (95% confidence interval €8559-€10 599). Costs of productivity loss of €6298 per woman were double the health care costs of €3113 per woman. Health care costs were mainly due to surgery (29%), monitoring tests (19%) and hospitalization (18%) and physician visits (16%). Endometriosis-associated symptoms generated 0.809 quality-adjusted life years per woman. Decreased quality of life was the most important predictor of direct health care and total costs. Costs were greater with increasing severity of endometriosis, presence of pelvic pain, presence of infertility and a higher number of years since diagnosis. Our study invited women to report resource use based on endometriosis-associated symptoms only, rather than drawing on a control population of women without endometriosis. Our study showed that the economic burden associated with endometriosis treated in referral centres is high and is similar to other chronic diseases (diabetes, Crohn's disease, rheumatoid arthritis). It arises predominantly from productivity loss, and is predicted by decreased quality of life.
Savino, F; Pugliese, M; Quarto, M; Adamo, P; Loffredo, F; De Cicco, F; Roca, V
It has been widely shown that nuclear fallout includes substances, which accumulate in organisms such as crustaceans, fish, mushrooms and lichens, helping to evaluate the activity concentration of contaminants accumulated on a long time. In this context, radiocaesium deposited in soil following the Chernobyl accident on 26 April 1986 is known to have remained persistently available for plant uptake in many areas of Europe. Studies on the lichen Stereocaulon vesuvianum show the plant's high capacity to retain radionuclides from the substrate and the air. After the Chernobyl accident, starting from September 1986, at the Radioactivity Laboratory (LaRa) of the University of Naples Federico II, four monitoring campaigns to evaluate the activity concentration of four isotopes of the two elements caesium and ruthenium ( 134 Cs, 137 Cs, 103 Ru and 106 Ru) were carried out until 1999. This study allowed the effective half-life of 134 Cs and 137 Cs to be estimated. Twenty-eight years after the accident, in December 2014, a further sampling was carried out; only 137 Cs was revealed beyond the detection limits, measuring activity concentrations ranging from 20 to 40 Bq/kg, while the other radionuclides were no longer observed due to their shorter half-life. The last sampling allowed more precise determination of the effective half-life of 137 Cs (6.2 ± 0.1 year), due to the larger dataset on a large time period. Copyright © 2017 Elsevier Ltd. All rights reserved.
Glambek, Mats; Skogstad, Anders; Einarsen, Ståle
Workplace bullying is often held as a precursor of expulsion in working life, but the claim builds on sparse empirical groundwork. In the present study, bullying is investigated as an antecedent to indicators of expulsion, be it from the workplace (change of employer) or from working life itself (disability benefit recipiency and unemployment), using a nationally representative sample (n=1,613), a five-year time-lag as well as two separate measures of workplace bullying. In line with the hypotheses, logistic regression analyses revealed that both exposure to bullying behaviors and self-labeled bullying are significantly associated with change of employer (OR=1.77 and 2.42, respectively) and disability benefit recipiency (OR=2.81 and 2.95, respectively). Moreover, exposure to bullying behaviors was found to be significantly related to unemployment five years on (OR=4.6). For the self-labeling measure of bullying, this tendency only held true at the 0.1 significance level (OR=3.69, p=0.098). Together, the present results indicate that targets of bullying are at a greater risk of expulsion, both from the workplace and from working life itself, thus representing strong incentives to combat bullying both from the perspective of the individual, the organization and society at large.
GLAMBEK, Mats; SKOGSTAD, Anders; EINARSEN, Ståle
Workplace bullying is often held as a precursor of expulsion in working life, but the claim builds on sparse empirical groundwork. In the present study, bullying is investigated as an antecedent to indicators of expulsion, be it from the workplace (change of employer) or from working life itself (disability benefit recipiency and unemployment), using a nationally representative sample (n=1,613), a five-year time-lag as well as two separate measures of workplace bullying. In line with the hypotheses, logistic regression analyses revealed that both exposure to bullying behaviors and self-labeled bullying are significantly associated with change of employer (OR=1.77 and 2.42, respectively) and disability benefit recipiency (OR=2.81 and 2.95, respectively). Moreover, exposure to bullying behaviors was found to be significantly related to unemployment five years on (OR=4.6). For the self-labeling measure of bullying, this tendency only held true at the 0.1 significance level (OR=3.69, p=0.098). Together, the present results indicate that targets of bullying are at a greater risk of expulsion, both from the workplace and from working life itself, thus representing strong incentives to combat bullying both from the perspective of the individual, the organization and society at large. PMID:25475094
Seyed Basir Hashemi
Full Text Available Introduction: Cochlear implant has been established as effective option in rehabilitation of individuals with profound hearing impairment. As much of the studies about cochlear implants concentrated on aspects of speech perception and production, so we decided to study the quality of life of pre-lingual deaf children after at least 2 years of implantation. Materials and Methods: Twenty four patients’ parents in Fars Center were selected that had been implanted for at least 2 years and they filled the quality of life questionnaire. Three months later this questionnaire was filled again and results of two stages were analyzed. Results: In part of assessments p-value shows significant change in parent’s satisfaction. They believe that they can be beneficial for their children and in another part of this study, parents believe that the children communicate better, but still they need special care to do school homework and they have some difficulties in articulation. Conclusion: cochlear implantation is associated with improvement in quality of life. The improvement is significant in aspects of social communications and happiness.
Lee, Seung Soo; Chung, Ho Young; Kwon, Oh Kyoung; Yu, Wansik
This study investigated how total gastrectomy (TG), along with memories of cancer, affect the subjective wellness of survivors long after surgery. Rational approaches for effectively improving the quality of life (QoL) of these survivors were suggested. Between 2008 and 2013, QoL data of gastric cancer patients who underwent a curative TG, were obtained at 5-year postoperative follow-up visits (5-year survivors) and at visits beyond 5 years (long-term survivors). The control groups for these survivor groups were constructed from volunteers who visited our health-examination center for annual medical checkups. The Korean versions of the European Organization for Research and Treatment (EORTC) Quality of Life Questionnaire Core 30 (QLQ-C30) and the gastric cancer specific module, the EORTC QLQ-STO22, were used to assess QoL. Five-year survivors showed worse QoL compared to the control group in role functioning, social functioning, nausea/vomiting, appetite loss, financial difficulties, reflux, eating restrictions, taste, and body image, and better QoL in the emotional and cognitive functioning scales. In long-term survivors, deterioration in QoL were still apparent in financial difficulties, reflux, and eating restrictions, while QoL differences in the remaining scales had diminished. Surviving 5 years after TG does not result in living in a carefree state in terms of QoL. After 5 postoperative years, survivors still need extended care for deteriorated QoL indicators due to symptomatic, behavioral, and financial consequences of surgery. While relevant clinical and institutional approaches are required for corresponding declines in QoL, such efforts must extend beyond 5 postoperative years. Copyright © 2014 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.
Marková, Gabriela; Legerstee, M.
Roč. 34, APR-JUN (2015), s. 3-15 ISSN 0885-2014 R&D Projects: GA ČR GPP407/10/P610 Institutional support: RVO:68081740 Keywords : Maternal scaffolding * Pretense * imitation Subject RIV: AN - Psychology Impact factor: 1.571, year: 2015
Koch, Shirley Lois
This study describes and analyzes, in a critical literary manner, selected biographies for children eight to twelve years of age. Biographies of Jane Addams, Cesar Chavez, Mohandas Gandhi, Toyohiko Kagawa, Martin Luther King, Jr., and Albert Schweitzer are viewed from the perspective of a literary criterion based on the principles of design to…
National Health Act (section 6(1)(d)) and the common law. Constitutional ... the right to bodily and psychological integrity (section 12(2)) and the right to privacy ... development; (iii) any disability that the child may have; and (iv) any chronic ... healthcare provider in deciding whether a child of 12 years of age or more is 'of ...
The book, written in a journalistic style, reports on the visit of the author on her visit to the Ukraine 10 years after the Chernobyl accident. It is based on interviews with the affected population, with scientists (doctors, veterinarians, biologists, psychologists, ecologists), parliamentarians and representatives of the state administration. figs., refs
Aureli, Tiziana; Perucchini, Paola; Genco, Maria
Two tasks were administered to 40 children aged from 16 to 20 months (mean age = 18;1), to evaluate children's understanding of declarative and informative intention [Behne, T., Carpenter, M., & Tomasello, M. (2005). One-year-olds comprehend the communicative intentions behind gestures in a hiding game. "Developmental Science", 8, 492-499;…
Wolfe, John R.; Strange, C. Carney
This case study of faculty culture focused on the dynamics of a small, rural, two-year branch campus of a large state university. It reports descriptive themes concerning the isolation and rural location of the campus, its diminutive size, faculty role perspectives, and factors related to faculty role implementation. It provides a portrait of this…
Kowalska, Małgorzata; Marcinkowska, Urszula; Jośko, Jadwiga
Quality of life is an important issue of public health. It becomes essential in the population of active workers, especially women who besides their occupational activity have to perform other important roles, such as care of their children or older parents. The presented study is an attempt to answer the question on whether occupational activity, especially job satisfaction, provides better quality of live in the population of women aged 45-60 years. The obtained results confirm that a better quality of live, measured by the status of physical and mental health, is characteristic of occupationally active women with a higher level of education, who also experience job satisfaction. Care of children or older parents has no impact on the decline of quality of life. The improvement of qualifications and occupational activity can contribute to a better quality of live in the population of women.
Taylor, Tim; Auerbach, Joshua E; Bongard, Josh; Clune, Jeff; Hickinbotham, Simon; Ofria, Charles; Oka, Mizuki; Risi, Sebastian; Stanley, Kenneth O; Yosinski, Jason
We present a survey of the first 21 years of web-based artificial life (WebAL) research and applications, broadly construed to include the many different ways in which artificial life and web technologies might intersect. Our survey covers the period from 1994-when the first WebAL work appeared-up to the present day, together with a brief discussion of relevant precursors. We examine recent projects, from 2010-2015, in greater detail in order to highlight the current state of the art. We follow the survey with a discussion of common themes and methodologies that can be observed in recent work and identify a number of likely directions for future work in this exciting area.
Roeloffzen, Ellen M.A.; Lips, Irene M.; Gellekom, Marion P.R. van; Roermund, Joep van; Frank, Steven J.; Battermann, Jan J.; Vulpen, Marco van
Purpose: Health-related quality of life (HRQOL) after prostate brachytherapy has been extensively described in published reports but hardly any long-term data are available. The aim of the present study was to prospectively assess long-term HRQOL 6 years after 125 I prostate brachytherapy. Methods and Materials: A total of 127 patients treated with 125 I brachytherapy for early-stage prostate cancer between December 2000 and June 2003 completed a HRQOL questionnaire at five time-points: before treatment and 1 month, 6 months, 1 year, and 6 years after treatment. The questionnaire included the RAND-36 generic health survey, the cancer-specific European Organization for Research and Treatment of Cancer core questionnaire (EORTCQLQ-C30), and the tumor-specific EORTC prostate cancer module (EORTC-PR25). A change in a score of ≥10 points was considered clinically relevant. Results: Overall, the HRQOL at 6 years after 125 I prostate brachytherapy did not significantly differ from baseline. Although a statistically significant deterioration in HRQOL at 6 years was seen for urinary symptoms, bowel symptoms, pain, physical functioning, and sexual activity (p 125 I prostate brachytherapy. HRQOL scores returned to approximately baseline values at 1 year and remained stable up to 6 years after treatment. 125 I prostate brachytherapy did not adversely affect patients' long-term HRQOL.
...) (pertaining to certain limitations on the use of prescribed tables), for determination of the present value of.... The present value of annuities, life estates, terms of years, remainders, and reversions for estates... determined under paragraph (d) of this section. The present value of annuities, life estates, terms of years...
Rothermel, Juliane; Lass, Nina; Toschke, Christina; Reinehr, Thomas
Familial short stature (FSS) and constitutional delay of growth (CDG) are the most frequent norm variants in children presenting with short stature. Knowing the growth patterns of these entities in the first years of life might be helpful to distinguish them from growth hormone deficiency (GHD) or other chronic diseases. We studied the height in the first 5 years of life in 26 children with FSS, in 38 children with CDG and in 14 children with idiopathic GHD. Height standard deviation scores (SDS) did not change between birth and 6 months of life, while height SDS decreased significantly afterwards in GHD, FSS, and CDG. The loss of height SDS was higher in the first 2 years of life than between 2 and 5 years of life in children with CDG (-0.92 vs. -0.11; p = 0.003) or FSS (-0.79 vs. -0.01; p = 0.002). In idiopathic GHD, the loss of height SDS did not differ between the first 2 years of life and the next 3 years (-0.78 vs. -0.77; p = 0.821). Children with FSS and CDG showed a decline in height SDS mainly in the first 2 years of life, whereas the height SDS of children with idiopathic GHD decreased almost continuously over the first 5 years of life. © 2016 S. Karger AG, Basel.
Tang, Siew Tzuh; Wen, Fur-Hsing; Hsieh, Chia-Hsun; Chou, Wen-Chi; Chang, Wen-Cheng; Chen, Jen-Shi; Chiang, Ming-Chu
The stability of life-sustaining treatment (LST) preferences at end of life (EOL) has been established. However, few studies have assessed preferences more than two times. Furthermore, associations of LST preferences with modifiable variables of accurate prognostic awareness, physician-patient EOL care discussions, and depressive symptoms have been investigated in cross-sectional studies only. To explore longitudinal changes in LST preferences and their associations with accurate prognostic awareness, physician-patient EOL care discussions, and depressive symptoms in terminally ill cancer patients' last year. LST preferences (cardiopulmonary resuscitation, intensive care unit [ICU] care, intubation, and mechanical ventilation) were measured approximately every two weeks. Changes in LST preferences and their associations with independent variables were examined by hierarchical generalized linear modeling with logistic regression. Participants (n = 249) predominantly rejected cardiopulmonary resuscitation, ICU care, intubation, and mechanical ventilation at EOL without significant changes as death approached. Patients with inaccurate prognostic awareness were significantly more likely than those with accurate understanding to prefer ICU care, intubation, and mechanical ventilation than to reject these LSTs. Patients with more severe depressive symptoms were less likely to prefer ICU care and to be undecided about wanting ICU care and mechanical ventilation than to reject such LSTs. LST preferences were not associated with physician-patient EOL care discussions, which were rare in our sample. LST preferences are stable in cancer patients' last year. Facilitating accurate prognostic awareness and providing adequate psychological support may counteract the increasing trend for aggressive EOL care and minimize emotional distress during EOL care decisions. Copyright © 2016 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights
Dickinson, George E
The purpose of this longitudinal study of US medical schools over a 40-year period was to ascertain their offerings on end-of-life (EOL) issues. At 5-year intervals, beginning in 1975, US medical schools were surveyed via a questionnaire to determine their EOL offerings. Data were reported with frequency distributions. The Institute of Medicine has encouraged more emphasis on EOL issues over the past 2 decades. Findings revealed that undergraduate medical students in the United States are now exposed to death and dying, palliative care, and geriatric medicine. The inclusion of EOL topics has definitely expanded over the 40-year period as findings reveal that US undergraduate medical students are currently exposed in over 90% of programs to death and dying, palliative care, and geriatric medicine, with the emphasis on these topics varying with the medical programs. Such inclusion should produce future favorable outcomes for undergraduate medical students, patients, and their families.
von Linstow, Marie-Louise; Holst, Klaus Kähler; Larsen, Karina
. Determinants for respiratory symptoms were increasing age, winter season, household size, size of residence, day-care attendance, and having siblings aged 1-3 years attending a day nursery. In conclusion, the present study provides detailed data on the occurrence of disease symptoms during the first year......Respiratory symptoms are common in infancy. Most illnesses occurring among children are dealt with by parents and do not require medical attention. Nevertheless, few studies have prospectively and on a community-basis assessed the amount of respiratory symptoms and general illness in normal infants...... out by multiple logistic regression analysis. On average, children had general symptoms for 3.5 months during their first year of life, nasal discharge being most frequent followed by cough. Frequency of all symptoms increased steeply after 6 months of age. Each child had on average 6.3 episodes...
Bjerregaard, Lise G; Jensen, Britt W; Baker, Jennifer L
measured at ages 7-13 years. Hazard ratios (HR) of type 2 diabetes (age ≥30 years) were estimated without and with adjustment for birthweight and BMI. RESULTS: In men, associations between height and type 2 diabetes changed from inverse for below-average heights at age 7 years to positive for above...... for BMI, short childhood height at all ages and greater growth during childhood are associated with an increased risk of type 2 diabetes, suggesting that this period of life warrants mechanistic investigations.......BACKGROUND: Short adults have an increased risk of type 2 diabetes. Although adult height results from childhood growth, the effects of height and growth trajectories during childhood are sparsely investigated. We investigated sex-specific associations between childhood height, growth and adult...
Enoki, Kaori; Matsuda, Ken-Ich; Ikebe, Kazunori; Murai, Shunsuke; Yoshida, Minoru; Maeda, Yoshinobu; Thomson, William Murray
Xerostomia and tooth loss are major oral health problems in the elderly. The aim of this longitudinal study was to characterize the influence of xerostomia on oral health-related quality of life (OHRQoL) among elderly Japanese people. A total of 99 community-dwelling, independently living individuals aged 60 years and older were interviewed and underwent dental examination at baseline and at a 5-year follow-up. The Oral Health Impact Profile-14 and the Xerostomia Inventory were used to assess OHRQoL and xerostomia severity, respectively. Participants whose xerostomia worsened over the 5-year period had a significantly poorer follow-up OHRQoL. Linear regression models showed that tooth loss and worsening xerostomia were significant predictors of poorer follow-up OHRQoL. Tooth loss and worsening xerostomia result in poorer OHRQoL among older Japanese people. Copyright © 2014 Elsevier Inc. All rights reserved.
Mehnert, Anja; Koch, Uwe
Since a growing number of patients are likely to return to work (RTW) after cancer diagnosis and treatment, there is an increasing recognition of the work situation, and the physical as well as psychosocial functioning among those survivors who returned to work. To prospectively examine Health Related quality of Life (HRQoL) and different aspects of work satisfaction in cancer survivors. N=702 employed cancer patients (85% women) were recruited on average 11 months post diagnosis and assessed at the beginning (t_1), the end (t_2) and 12 months after cancer rehabilitation program (t_3). Participants completed validated measures assessing work satisfaction, working conditions, job strain and HRQoL. Participants showed a high work satisfaction and were most satisfied with job related activities and least satisfied with work organization and leadership. Total work satisfaction was significantly associated with older age, higher monthly income, higher school education, and HRQoL, but not with any cancer- or treatment related characteristics. No significant changes in work satisfaction over time were observed except for a significant deterioration in satisfaction with job related activities (p=0.002; η ^2 =0.019), professional acknowledgement (p=0.036; η ^2 =0.009), and overall work satisfaction (p ^2 =0.087) with small to moderate effect sizes. Our findings emphasize the need for comprehensive cancer rehabilitation programs and specific vocational interventions.
Wood, Joanna; Schmidt, Lacey; Lugg, Desmond; Ayton, Jeff; Phillips, Terry; Shepanek, Marc
In the late 1980s the Australian Antarctic Division collaborated with NASA to use the Australian National Antarctic Research Expeditions' (ANARE) stations to pursue research of benefit to both programs. This article outlines the data collection efforts, the development of analyses, and selected results, and describes some of the benefits for the aerospace, health, and environmental psychology communities. The Behavior and Performance Laboratory at Johnson Space Center developed a questionnaire to sample broadly the many aspects of life in extreme environments analogous to space missions. Data were collected from volunteers involved in various ANAREs conducted from 1994 to 2003. Pool-timed series regression, hierarchical models, and content analysis have all enhanced the understanding of the kinds of psychosocial variables relevant in extreme environments, and how these variables relate to each other; examples are given. Observations gathered over the last 10 yr comprise a unique, comprehensive, and advanced representation of psychosocial factors in this extreme environment and provide a strong base for future research and application.
Ekhard E. Ziegler
Full Text Available The birth iron endowment provides iron for growth in the first months of life. We describe the iron endowment under conditions of low dietary iron supply. Subjects were infants participating in a trial of Vitamin D supplementation from 1 to 9 months. Infants were exclusively breastfed at enrollment but could receive complementary foods from 4 months but not formula. Plasma ferritin (PF and transferrin receptor (TfR were determined at 1, 2, 4, 5.5, 7.5, 9 and 12 months. At 1 month PF ranged from 38 to 752 µg/L and was only weakly related to maternal PF. PF declined subsequently and flattened out at 5.5 months. PF of females was significantly higher than PF of males except at 12 months. TfR increased with age and was inversely correlated with PF. PF and TfR tracked strongly until 9 months. Iron deficiency (PF < 10 µg/L began to appear at 4 months and increased in frequency until 9 months. Infants with ID were born with low iron endowment. We concluded that the birth iron endowment is highly variable in size and a small endowment places infants at risk of iron deficiency before 6 months. Boys have smaller iron endowments and are at greater risk of iron deficiency than girls.
Full Text Available Anaemia is an increasingly recognized health problem in Africa, particularly in infants and pregnant women. Although malaria is known to be the main risk factor of anaemia in both groups, the consequences of maternal factors, particularly malaria in pregnancy (MiP, on infant haemoglobin (Hb concentrations during the first months of life are still unclear.We followed-up a cohort of 1005 Beninese pregnant women from the beginning of pregnancy until delivery. A subsample composed of the first 400 offspring of these women were selected at birth and followed until the first year of life. Placental histology and blood smear at 1st clinical antenatal visit (ANC, 2nd ANC and delivery were used to assess malaria during pregnancy. Infant Hb concentrations were measured at birth, 6, 9 and 12 months of age. A mixed multi-level model was used to assess the association between MiP and infant Hb variations during the first 12 months of life.Placental malaria (difference mean [dm] = - 2.8 g/L, 95% CI [-5.3, -0.3], P = 0.03 and maternal peripheral parasitaemia at delivery (dm = - 4.6 g/L, 95% CI [-7.9, -1.3], P = 0.007 were the main maternal factors significantly associated with infant Hb concentrations during the first year of life. Poor maternal nutritional status and malaria infection during infancy were also significantly associated with a decrease in infant Hb.Antimalarial control and nutritional interventions before and during pregnancy should be reinforced to reduce specifically the incidence of infant anaemia, particularly in Sub-Saharan countries.
Hartley, Sigan L.; Barker, Erin T.; Baker, Jason K.; Seltzer, Marsha Mailick; Greenberg, Jan S.
We examined the extent to which marital satisfaction across 7 years in 199 mothers was associated with the characteristics (gender, age, and intellectual disability status) of their adolescent or adult child with an autism spectrum disorder (ASD) and whether fluctuations in marital satisfaction covaried with the child’s autism symptoms, health, behavior problems, and closeness in the parent–child relationship. We also examined the impact of the departure of the adult child out of the family h...
Gaetan, S; Bonnet, A; Pedinielli, J-L
Video games are part of our society's major entertainments. This is now a global industry that covers the preferential activity of adolescents. But for some, the practice goes beyond a game and becomes an addictive functioning. Clinical practice is then faced with a new problem. It is important to understand the special bond that develops between a player and his/her video game in order to understand the addictive process. The game consists of a virtual world, a graphical construction that is a simulation of reality and which reinvents the laws that govern it. It also consists of a character embodied by the player who controls it: the avatar. Through the virtual world and avatar, the game offers the player a virtual personification that matches his/her expectations and projected ideal. The avatar allows the subject to compensate, or even to modify some aspects of the Self and thus enhance his/her perception of him/herself; the virtual life become more satisfying than real life. The aim of this research is to propose, from the study of the relationship between psychosocial variables (self-perception and life satisfaction) and the adolescent's practice of video games, elements of construction of an explanatory model of video gambling addiction. The population of this research is composed of 74 adolescents aged 11-14 years (m(age)=12.78 and SD=0.921). Fourteen are identified as addicted to video games by the results of the Game Addiction Scale. The quantitative methodology allows measurement of the different psychosocial variables which appear important in the addictive process. The instruments used are: the Game Addiction Scale, the Self-Perception Profile and the Satisfaction with Life Scale. The results show that adolescents addicted to video games see their virtual and current Self as being less proficient than other teenagers. Furthermore, teenagers addicted to video games see their virtual Self as more proficient and adapted to the environment than their current
Quitian-Reyes, Hoover; Gómez-Restrepo, Carlos; Gómez, Maria Juliana; Naranjo, Salome; Heredia, Patricia; Villegas, John
This study aimed to quantify the number of years of life lost in traffic accidents in Bogota, Colombia. The years of life lost were calculated using the 'age-standardized expected years of life lost' method, the table of Japanese adjusted life expectancy and the database of the Institute of Legal Medicine and Forensic Science between September 2012 and August 2013. During a period of 1 year, 430 people died and 10,056.3 years of life were lost in Bogota due to traffic accidents. The mortality burden of traffic accidents in Bogota is high. Further studies are required in order to characterize the accidents and develop effective policy decisions. Copyright © 2016 Elsevier Inc. All rights reserved.
Verduci, Elvira; Banderali, Giuseppe; Peroni, Diego; Lassandro, Carlotta; Radaelli, Giovanni
Wheezing is the most common symptom associated with asthma in young children. There is a lack of well-designed prospective studies on the relationship of exclusive breastfeeding with wheezing in infants. This prospective cohort study investigated whether a relationship exists of exclusive breastfeeding with wheezing at 12 months of age. A series of 1632 mother-infant pairs were sequentially recruited. Mothers were trained at hospital on breastfeeding practices and how to recognise wheezing. At hospital discharge they received a calendar-diary to record the date at stopping breastfeeding and at onset of wheezing. Data were collected by telephone interviews through 12 months post-delivery. Breastfeeding was in accordance with the World Health Organisation and wheezing with the International Classification of Diseases (ICD-10-CM code R06.2). At 12 months 1522 mother-infant pairs were participating. Breastfeeding started in 95.9% of them and was exclusive in 86.1%. The incidence of wheezing ever and recurrent wheezing at 12 months of age was 33.7% and 10.0%, respectively. Duration of exclusive breastfeeding was shorter in wheezing than non-wheezing infants (median 2.6 months vs. 4.1 months, Pever by 11% and of recurrent wheezing by 15%, at 12 months of age. Longer duration of exclusive breastfeeding reduces the risk of wheezing throughout the first 12 months of life. These findings would be relevant to all healthcare operators and mothers, also to improve their awareness about the best feeding practices for the infant's health. Copyright © 2016 SEICAP. Published by Elsevier España, S.L.U. All rights reserved.
Shoaff, Jessica; Papandonatos, George D; Calafat, Antonia M; Ye, Xiaoyun; Chen, Aimin; Lanphear, Bruce P; Yolton, Kimberly; Braun, Joseph M
Early-life phthalate exposure may influence child adiposity, but prior studies have not determined if there are periods of enhanced vulnerability to phthalates. To examine the relationship between child adiposity at 8 y of age and repeated urinary biomarkers of phthalate exposure from gestation through childhood to determine if there are distinct periods of vulnerability. In 219 mother-child pairs from Cincinnati, Ohio, we quantified nine urinary phthalate metabolites up to two times prenatally and six times from 1-8 y of age. We measured child body mass index (BMI), waist circumference, and percent body fat at 8 y of age. To identify periods of vulnerability, we used two statistical methods to estimate phthalate-adiposity associations at each visit, test differences in phthalate-adiposity associations across visits, and model trajectories of phthalate concentrations for children at different levels of adiposity. Prenatal phthalate concentrations were not associated with excess child adiposity. Monobenzyl phthalate (MBzP) concentrations during pregnancy and childhood were inversely associated with adiposity. The associations of di(2-ethylhexyl) phthalate (∑DEHP) metabolites and monoethyl phthalate (MEP) with child adiposity depended on the timing of exposure. A 10-fold increase in ∑DEHP at 1 and 5 y was associated with a 2.7% decrease [95% confidence interval (CI): -4.8, -0.5] and 2.9% increase (95% CI: 0.3, 5.5) in body fat, respectively. MEP concentrations at 5 and 8 y of age were associated with higher child adiposity, but earlier childhood concentrations were not. In this cohort, we did not find evidence of an obesogenic effect of prenatal phthalate exposure. Positive associations between postnatal MEP and ∑DEHP concentrations depended on the timing of exposure. https://doi.org/10.1289/EHP1022.
Hours, Martine; Khati, Inès; Charnay, Pierrette; Chossegros, Laetitia; Tardy, Hélène; Tournier, Charlène; Perrine, Anne-Laure; Luauté, Jacques; Laumon, Bernard
To compare health status, effect on family, occupational consequences, and quality of life (QOL) 1 year after an accident between patients with whiplash versus other mild injuries, and to explore the relationship between initial injury (whiplash vs other) and QOL. This was a prospective cohort study. The study used data from the ESPARR cohort (a representative cohort of road accident victims) and included 173 individuals with "pure" whiplash and 207 with other mild injuries. QOL at 1-year followup was assessed on the World Health Organization Quality of Life questionnaire. Correlations between explanatory variables and QOL were explored by Poisson regression to provide adjusted relative risks, with ANOVA for the various QOL scores explored. One year post-accident, more patients who had whiplash than other casualties complained of nonrecovery of health status (56% vs 43%) and of the occupational effect of pain (31% vs 23%). QOL and posttraumatic stress disorder (PTSD) were similar in the 2 groups. Impaired QOL did not correlate with whiplash when models were adjusted on sociodemographic variables and history of psychological distress. Whatever the initial lesion, PTSD was a determining factor for poorer QOL. Sociodemographic factors, preaccident psychological history prior to the accident, and PTSD were the main factors influencing QOL, rather than whether the injury was whiplash. PTSD may also be related to pain.
Chapman, Glyn; Hansen, Kristian Schultz; Jelsma, Jennifer
Objective To rank health problems contributing most to the burden of disease in Zimbabwe using Disability-Adjusted Life Years as the population health measure. Methods Epidemiological information was derived from multiple sources. Population size and total number of deaths by age and sex for the ...... pattern of Zimbabwe differed substantially from regional estimates for sub-Saharan Africa justifying the need for countries to develop their own burden of disease estimates.......Objective To rank health problems contributing most to the burden of disease in Zimbabwe using Disability-Adjusted Life Years as the population health measure. Methods Epidemiological information was derived from multiple sources. Population size and total number of deaths by age and sex...... for the year 1997 were taken from a nationwide census. The cause of death pattern was determined based on data from the Vital Registration System, which was adjusted for underreporting of human immunodeficiency virus (HIV) and reallocation of ill-defined causes. Non-fatal disease figures were estimated based...
Noal, Sabine; Levy, Christelle; Hardouin, Agnes; Rieux, Chantal; Heutte, Natacha; Segura, Carine; Collet, Fabienne; Allouache, Djelila; Switsers, Odile; Delcambre, Corinne; Delozier, Thierry; Henry-Amar, Michel; Joly, Florence
Purpose: Most patients with localized breast cancer (LBC) who take adjuvant chemotherapy (CT) complain of fatigue and a decrease in quality of life during or after radiotherapy (RT). The aim of this longitudinal study was to compare the impact of RT alone with that occurring after previous CT on quality of life. Methods and Materials: Fatigue (the main endpoint) and cognitive impairment were assessed in 161 CT-RT and 141 RT patients during RT and 1 year later. Fatigue was assessed with Functional Assessment of Cancer Therapy-General questionnaires, including breast and fatigue modules. Results: At baseline, 60% of the CT-RT patients expressed fatigue vs. 33% of the RT patients (p <0.001). Corresponding values at the end of RT were statistically similar (61% and 53%), and fatigue was still reported at 1 year by more than 40% of patients in both groups. Risk factors for long-term fatigue included depression (odds ratio [OR] = 6), which was less frequent in the RT group at baseline (16% vs. 28 %, respectively, p = 0.01) but reached a similar value at the end of RT (25% in both groups). Initial mild cognitive impairments were reported by RT (34 %) patients and CT-RT (24 %) patients and were persistent at 1 year for half of them. No biological disorders were associated with fatigue or cognitive impairment. Conclusions: Fatigue was the main symptom in LBC patients treated with RT, whether they received CT previously or not. The correlation of persistent fatigue with initial depressive status favors administering medical and psychological programs for LBC patients treated with CT and/or RT, to identify and manage this main quality-of-life-related symptom.
Harris, R. A.; Denhard, W. G.
The paper describes the in-orbit performance of the gyroscopes and strapdown attitude reference system for the OAO-C (Copernicus) satellite, launched on Aug. 21, 1972. In order to fulfill NASA requirements, the inertial system had to: (1) operate for at least one year in orbit without failure, (2) maintain an inertial reference with an uncertainty of 50 microradians or less for at least one hour, and (3) control attitude changes with an accuracy of at least 30 parts per million. During the orbit period, the inertial system has demonstrated a capability for maintaining an inertial reference that is significantly better than these performance goals.
Lannerö, Eva; Wickman, Magnus; Pershagen, Goran; Nordvall, Lennart
Exposure to cigarette smoking during foetal and early postnatal life may have implications for lung health. The aim of this study was to assess the possible effects of such exposure in utero on lower respiratory disease in children up to two years of age. A birth cohort of 4089 newborn infants was followed for two years using parental questionnaires. When the infant was two months old the parents completed a questionnaire on various lifestyle factors, including maternal smoking during pregnancy and after birth. At one and two years of age information was obtained by questionnaire on symptoms of allergic and respiratory diseases as well as on environmental exposures, particularly exposure to environmental tobacco smoke (ETS). Adjustments were made for potential confounders. When the mother had smoked during pregnancy but not after that, there was an increased risk of recurrent wheezing up to two years' age, ORadj = 2.2, (95% CI 1.3-3.6). The corresponding OR was 1.6, (95% CI 1.2-2.3) for reported exposure to ETS with or without maternal smoking in utero. Maternal smoking during pregnancy but no exposure to ETS also increased the risk of doctor's diagnosed asthma up to two years of age, ORadj = 2.1, (95% CI 1.2-3.7). Exposure to maternal cigarette smoking in utero is a risk factor for recurrent wheezing, as well as doctor's diagnosed asthma in children up to two years of age.
Full Text Available Objective: To investigate life satisfaction in spouses of middle-aged stroke survivors from the long-term perspective and to identify factors that explain their life satisfaction. Design: Cross-sectional, case-control study. Subjects: Cohabitant spouses of survivors of ischaemic stroke aged < 70 years at stroke onset (n = 248 and spouses of controls (n = 246. Methods: Assessments were made 7 years after inclusion to the study. Spouses’ life satisfaction was assessed with the Fugl-Meyer’s Life Satisfaction Check-List (LiSAT 11. Stroke-related factors were examined with the National Institutes of Health stroke scale, Mini-Mental State Examination, Barthel Index and modified Rankin Scale. Results: Spouses of stroke survivors had significantly lower satisfaction with general life, leisure, sexual life, partner relationship, family life, and poorer somatic and psychological health than spouses of controls. Caregiving spouses had significantly lower scores on all life domains except vocation and own activities of daily living than non-caregiving spouses. Spouses’ satisfaction on different life domains was explained mainly by their age, sex, support given to the partner, and the survivor’s level of global disability, to which both physical and cognitive impairments contributed. Conclusion: Seven years after stroke, spouses of stroke survivors reported lower life satisfaction compared with spouses of controls. Life satisfaction in stroke survivors’ spouses was associated with spouses’ age, sex, giving support, and the stroke survivors’ level of global disability.
Hellfritzsch, Maja; Grove, Erik Lerkevang
. Based on a case of life-threatening COC-associated pulmonary embolism in a girl heterozygous for the prothrombin G20210A mutation and with a family history of thrombotic disease, we discuss the importance of assessing not just the genotype but also the phenotype when considering initiation of COCs...... in patients with thrombophilia. CASE REPORT: A 14-year-old girl presented with acute onset of chest pain and dyspnea followed by syncope. She was hypoxic and hemodynamically compromised at admission. Computed tomography pulmonary angiography revealed a large central "saddle" pulmonary embolism causing nearly...
Slemming, W; Kagura, J; Saloojee, H; Richter, L M
Stunting is a measure of overall nutritional status and is a major public health concern because of its association with child mortality and morbidity and later adult performance. This study examined the effects of pregnancy events, birth characteristics and infant risk exposure on stunting at age 2 years. The study, established in 1990 in Soweto, an urban South African township, included 1098 mother-infant pairs enroled in the Birth to Twenty Plus longitudinal birth cohort study. In total, 22% of children were stunted at age 2 years, with males at greater risk than females [24.8 v. 19.4%, odds ratio (OR)=1.38; 95% confidence interval (CI): 1.03, 1.83]. In unadjusted analysis, male sex, household socio-economic status (SES), overcrowding, maternal age, maternal education, single motherhood, ethnicity, birth weight, gestational age and duration of infant breastfeeding were all significantly associated with stunting. In multivariable analysis, higher birth weight was protective against stunting for both sexes. Higher maternal education was protective for females only (adjusted odds ratio (AOR)=0.35; 95% CI: 0.14, 0.87), whereas wealthier household SES protected males (AOR for richest SES group=0.39; 95% CI: 0.16, 0.92). In this and other similar settings, current stunting prevention efforts focussing on primarily providing targeted proximal interventions, such as food supplements, risk undermining the critical importance of addressing key distal determinants of stunting such as SES and maternal education.
Agarwal, D K; Awasthy, A; Upadhyay, S K; Singh, P; Kumar, J; Agarwal, K N
In a rural cohort of 625 children registered from 1981 to 1983 in 10 villages of K.V. Block, Varanasi, 196 children were assessed for physical growth, development, intelligence and concept development between 1 and 3 years of age. Home environment was also assessed using Caldwell Home inventory. These rural children remained below 3rd centile of NCHS standard for weight, height, skull and mid-arm circumferences throughout the study. Malnourished children scored poorly in all the areas of development, i.e., motor, adaptive, language and personal social, 9% in Grade I and 16.6% children in Grade II + III had IQ less than 79 (inferior). Concept for color shape and size was poorly developed in malnourished children. Maternal involvement and stimulation was strongly associated with better behavior development and intelligence. Multiple regression analysis showed that the effect of home environment on development and intelligence was of a higher magnitude as compared to status and family variables and nutritional status during 1-3 years of age.
Séguin, Louise; Nikiema, Beatrice; Gauvin, Lise; Lambert, Marie; Thanh Tu, Mai; Kakinami, Lisa; Paradis, Gilles
Early childhood poverty is associated with adult chronic diseases. The objectives of this study were to examine patterns of exposure to poverty during the first 10 years of life in the Quebec Longitudinal Study of Child Development (QLSCD) cohort according to three measures of poverty and to explore family characteristics associated with different poverty exposures. Data from 1,334 participants from the QLSCD were collected annually at home from ages 5 months through 10 years. Household income (previous 12 months) and sources of income were recorded at each data round. Poverty status was operationalized as 1) living below the low income cut-off of Statistics Canada, 2) receiving social welfare and 3) being in the lowest quintile of socio-economic status. We plotted trends in the prevalence of child poverty over time. We used latent class growth modelling to identify subgroups with similar poverty trajectories. Duration of poverty according to each measure was computed separately for early childhood, middle childhood, and the entire 10 years of life. Four trajectories of poverty were identified: stable poor, decreasing likelihood, increasing likelihood, and never poor. The three measures of poverty do not cover the same population, yet the characteristics of those identified as poor are similar. Children of non-European, immigrant mothers were most likely to be poor, and there was a higher likelihood of children from single-parent families to live in chronic poverty during the first 10 years. A large proportion of children are exposed to poverty before 10 years of age. More effective public policies could reduce child poverty.
Lim, Dohee; Lee, Won Kyung; Park, Hyesook
The purpose of this study was to estimate the national burden of mental substance disorders on medical care utilization in Korea using National Health Insurance System (NHIS) data and updated disability weight, in terms of disability-adjusted life years (DALYs). For each of the 24 disorders, the incident years lived with disability (YLDs) was calculated, using NHIS data to estimate prevalence and incidence rates. The DisMod-II software program was used to model duration and remission. The years of life lost (YLLs) due to premature death were calculated from causes of death statistics. DALYs were computed as the sum of YLDs and YLLs, and time discounting and age weighting were applied. The year examined was 2012, and the subjects were divided into 9 groups according to age. In 2012, the Korean burden of mental and substance use disorders was 945,391 DALYs. More than 98% of DALYs were from YLDs, and the burden in females was greater than that in males, though the burden in males aged less than 19 years old was greater than that in females. Unipolar depressive disorders, schizophrenia, and anxiety disorders were found to be major diseases that accounted for more than 70% of the burden, and most DALYs occurred in their 30-59. Mental and substance use disorders accounted for 6.2% of the total burden of disease and were found to be the 7th greatest burden of disease. Therefore, mental and substance use disorders need to be embraced by mainstream health care with resources commensurate with the burden.
Black, Sarah R; Lerner, Matthew D; Shirtcliff, Elizabeth A; Klein, Daniel N
Previous investigations have explored stress and pubertal hormones in parallel; it has been a recent development, however, to explore the relationships between different hormones during puberty, and how this hormonal cross-talk may be influenced by the environment. The current study investigated neuroendocrine coupling, or the extent to which hormones are correlated within the individual, and also investigated early life stressors that may influence coupling. Participants were 405 adrenarcheal children (mean Tanner stage=1.73 for girls and 1.38 for boys) from a longitudinal study who provided saliva samples for analysis of cortisol, dehydroepiandrosterone (DHEA), and testosterone. Saliva was collected when children were 9-years-old, while early life stressors were assessed at each longitudinal assessment (ages 3, 6, and 9). Results from multi-level modeling (MLM) analyses provided evidence of positive cortisol-dehydroepiandrosterone (DHEA) and cortisol-testosterone coupling in middle childhood, and identified body mass index as a predictor of the strength of hormone coordination. While exposure to stressful life events did not impact cortisol-DHEA coupling patterns, stress interacted with sex to predict looser cortisol-testosterone coupling in girls, but not boys. The current study adds to the existing literature on the development of neuroendocrine coupling, and provided further evidence of sex differences in the impact of stress. Furthermore, hormone coupling may be investigated in the future as a mechanism by which puberty is associated with negative behavioral outcomes. Copyright © 2017 Elsevier B.V. All rights reserved.
Tutel'ian, V A; Baturin, A K; Kon', I Ia; Safronova, A M; Keshabiants, E E; Starovoĭtov, M L; Gmoshinskaia, M V
The study of the nutrition and the nutritional status children of the first year age and children earliest age were conducted on nationally representative surveys (2500 children, 2-24 months) the Institute of Nutrition, Russian Academy of Medical Sciences with the Institute of Sociology Russian of Academy of Sciences, Gerber Product Company and Nestle Company in 2006. The level the frequency of breast feeding had among children 1 m.--80%, 2-4 m.--70%, 4-6 m.--60%. The lowest body mass Z-scores were registered 0.5-5.0% among of children, the tendency of obesity increase in the age were registered from 1.6 to 13% of children. Calculations of chemical composition and energy value of actual nutrition have show according to the values requirements.
Víctor JUAN BORROY
Full Text Available The Pedagogical Museum of Aragon will be 10 years old in spring 2016. In this paper, a brief summary of the work done during this period of time is set out, paying particular attention to some relevant signs to assess the work achieved by the museum such as the number of visits, items comprising the museum’s collection, cataloguing system, works published by the Pedagogical Museum of Aragon –which reflect the research and diffusion activities of the educational-historical heritage that have been undertaken– or temporary loans for exhibitions organised by other institutions.Finally, the author will present a series of considerations on matters he had not taken into account before being appointed Director of the Pedagogical Museum of Aragon. These may be useful for those interested in pedagogical museums and the preservation and diffusion of the educational-historical heritage.
Kleijkers, Sander H M; van Montfoort, Aafke P A; Smits, Luc J M; Viechtbauer, Wolfgang; Roseboom, Tessa J; Nelissen, Ewka C M; Coonen, Edith; Derhaag, Josien G; Bastings, Lobke; Schreurs, Inge E L; Evers, Johannes L H; Dumoulin, John C M
Is post-natal growth during the first 2 years of life in IVF singletons affected by type of medium used for culturing human embryos during an IVF treatment? The in vitro culture of human embryos in medium from Cook resulted in singletons with a lower weight during the first 2 years of life compared with singletons born after embryo culture in medium from Vitrolife. In a previous study, we reported that type of medium used for culturing human IVF embryos during the first few days after fertilization until fresh embryo transfer significantly affects fetal growth and consequently birthweight of the resulting singletons. From July 2003 to December 2006, a total of 1432 IVF treatment cycles with fresh embryo transfer were randomly allocated to have all embryos cultured in medium from Vitrolife AB (n = 715) or from Cook (n = 717). Two years after delivery, questionnaires were sent to the parents of all children requesting data about weight, height and head circumference around 1, 2, 3, 4, 6, 7.5, 9, 11, 14, 18 and 24 months of age. These measurements were collected as part of the children's health programme at municipal infant welfare centres in the Netherlands by health professionals unaware of this study. Patients requiring donor oocytes or applying for PGD were excluded from the study. From the 294 live born singletons that fulfilled our inclusion criteria, 29 were lost to follow-up. The remaining 265 singletons (Cook group: 117, Vitrolife group: 148) were included in the analysis. Data analysis included linear regression, to compare cross-sectionally weight standard deviation score (SDS), height SDS and head circumference, and the first order Berkey-Reed model for a longitudinal analysis of the growth data. Singletons in the Vitrolife group were heavier during the first 2 years of life compared with singletons in the Cook group. Cross-sectional analyses showed that adjusted weight SDS differed between groups at 1 (0.35 ± 0.14, P = 0.010), 2 (0.39 ± 0.14, P = 0
Duran, Xavier; Martínez, José Miguel; Benavides, Fernando G
To analyze the association between occupational factors (number of contracts and occupational category) and potential years of working life lost (PYWLL) due to non-work related permanent disability (PD). The study design was a retrospective cohort of 11,812 workers affiliated with the Social Security System in Spain that began a non-work related PD between 2004 and 2009. The PYWLL was defined as the time in years between the age at which a worker initiates a PD and age 65 or the age of reinstatement to a job. The PYWLL was analyzed by calculating the quartiles and using an approach based on a median regression. The difference in medians of PYWLL between men and women was 2.49 years (95% CI: 2.01-2.97); between skilled non-manual and unskilled manual workers was 1.88 years (95% CI: 1.08-2.69); between workers with three or more contracts and workers with a single contract in the period was 3.78 years (95% CI: 3.28-4.29). Women, non-skilled workers and employees that have had more contracts within the period of study are those with greatest loss of PYWLL. This suggests that individuals with poorer working and employment conditions could have more PYWLL.
Sansavini, Alessandra; Pentimonti, Jill; Justice, Laura; Guarini, Annalisa; Savini, Silvia; Alessandroni, Rosina; Faldella, Giacomo
Survival rate of extremely low gestational age (ELGA) newborns has increased over 80% in the last 15 years, but its consequences on the short- and longer-term developmental competencies may be severe. The aim of this study was to describe growth trajectories of linguistic, motor and cognitive skills among ELGA children, compared to full-term (FT) peers, from the first to the third year of life, a crucial period for development. Growth curve analysis was used to examine individual and group differences in terms of initial status at 12 months and rate of growth through the second and the third year of life with five points of assessment. Twenty-eight monolingual Italian children, of whom 17 were ELGA (mean GA 25.7 weeks) and 11 were FT children, were assessed through the BSID-III at 12, 18, 24, 30 and 36 months for language skills and at 12, 24 and 30 months for motor and cognitive skills. ELGA children presented significantly lower scores than FT peers in language, motor and cognitive skills and they did not overcome their disadvantage by 3 years, even if their corrected age was taken into account. Concerning growth curves, in motor development a significant increasing divergence was found showing a Matthew effect with the preterm sample falling further behind the FT sample. In linguistic and cognitive development, instead, a stable gap between the two samples was found. In addition, great inter-individual differences in rate of change were observed for language development in both samples. Our findings highlight the theoretical and clinical relevance of analyzing, through growth curve analyses, the developmental trajectories of ELGA children in language skills taking into account their inter-individual variability also across motor and cognitive domains. After reading this article, the reader will interpret: (a) characteristics and growth trajectories of ELGA children from the first to the third year of life with respect to FT children in language, motor and
Kolotkin Ronette L
Full Text Available Abstract Background The literature on changes in health-related quality of life (HRQOL in weight loss studies is inconsistent, and few studies use more than one type of measure. The purpose of the current study was to compare one-year changes in HRQOL as a function of weight change using three different measures: a weight-related measure (Impact of Weight on Quality of Life-Lite [IWQOL-Lite] and two generic measures (SF-36; EQ-5D. Methods Data were obtained from 926 participants (mean Body Mass Index (BMI (kg/m2 = 35.4; 84% female; mean age = 49.5 years in a placebo-controlled randomized trial for weight loss. At baseline and one-year, participants completed all three HRQOL measures. HRQOL was compared across weight change categories (≥ 5% and 0–4.9% gain, 0–4.9%, 5.0–9.9% and ≥ 10% loss, using effect sizes. Results The weight-related measure of HRQOL exhibited greater improvements with one-year weight loss than either of the generic instruments, with effect sizes ranging from 0.24 to 0.62 for 5–9.9% weight reductions and 0.44 to 0.95 for ≥ 10% reductions. IWQOL-Lite Self-Esteem also showed a small improvement with weight gain. Changes in the two generic measures of HRQOL were inconsistent with each other, and in the case of the SF-36, variable across domains. For participants gaining ≥ 5% of weight, the greatest reductions in HRQOL occurred with respect to SF-36 Mental Health, MCS, and Vitality, with effect sizes of -0.82, -0.70, and -0.63 respectively. Conclusion This study found differences between weight-related and generic measures of health-related quality of life in a one-year weight loss trial, reflecting the potential value of using more than one measure in a trial. Although weight loss was generally associated with improved IWQOL-Lite, physical SF-36 subscale and EQ-5D scores, a small amount of weight gain was associated with a slight improvement on weight-specific HRQOL and almost no change on the EQ-5D, suggesting the
Hartley, Sigan L.; Barker, Erin T.; Baker, Jason K.; Seltzer, Marsha Mailick; Greenberg, Jan S.
We examined the extent to which marital satisfaction across 7 years in 199 mothers was associated with the characteristics (gender, age, and intellectual disability status) of their adolescent or adult child with an autism spectrum disorder (ASD) and whether fluctuations in marital satisfaction covaried with the child’s autism symptoms, health, behavior problems, and closeness in the parent–child relationship. We also examined the impact of the departure of the adult child out of the family home on mothers’ marital satisfaction. The effect of family context variables including the presence of an additional child with a disability, maternal education, and household income on marital satisfaction were also examined. We found that closeness in the mother–child relationship and household income had a significant effect on level of marital satisfaction, and that variability in the slope of mothers’ marital satisfaction was significantly predicted by fluctuations in the behavior problems of the adolescent or adult child with an ASD. The grown child’s departure out of the family home was not related to change in marital satisfaction. Interventions aimed at managing the behavior problems of adolescents and adults with ASDs may help strengthen parents’ marital relationship. PMID:22866933
Subotic, U; Hosie, S; Waag, K L; Reinshagen, K
The therapeutic gold standard of cystic hygroma is its complete resection. Because of its growth pattern and its main location in the head and neck region complete resection is not always possible. An alternative is the local injection of Picibanil, but only few cases have been published about its use in infants. We retrospectively analyzed the data of 8 infants (age: 2 weeks-12 months) who got Picibanil therapy because of cystic hygroma in the time period 2002 until 2006. Follow up ranged from 3 months up to 3 years. During the postoperative period all patients had local swelling, in 4 cases accompanied with local inflammation and fever. Tumor reduction of >50% was obtained in 7 of 8 patients. Local injection of Picibanil in infants with cystic hygroma seems to be a safe alternative to surgical therapy, especially when complete tumor resection means damage of important neighbouring structures. Prospective trials are necessary to confirm the better outcome after therapy with Picibanil compare to primary surgery.
Full Text Available Up to the eighties, the psychological interpretations of early cognitive development had been dominated by Piaget's theory of sensori-motor development, according to which infants' knowledge of the world is constructed through their actions upon the world. Older empirical findings also led to a conclusion that infants' basic concepts of objects and representations of objects develop relatively late during the infancy period. Searching for new answers to the old questions about infants' cognitive competence in the first year after birth, and when and how it is manifested in their behaviours, encouraged researchers to re-examine the existing knowledge about the milestones and the mechanisms of early cognitive development, as well as to use new research techniques, and revealed new empirical evidence. These show that infants are much more cognitively competent and that some of their cognitive capacities develop much earlier than Piaget suggested. In the article, some recent findings in the field of infants' development of knowledge about physical world are presented and discussed. Some fundamental points of Piaget's sensori-motor stage of development which were not supported by the recent empirical evidence are highlightened.
Hartley, Sigan L; Barker, Erin T; Baker, Jason K; Seltzer, Marsha Mailick; Greenberg, Jan S
We examined the extent to which marital satisfaction across 7 years in 199 mothers was associated with the characteristics (gender, age, and intellectual disability status) of their adolescent or adult child with an autism spectrum disorder (ASD) and whether fluctuations in marital satisfaction covaried with the child's autism symptoms, health, behavior problems, and closeness in the parent-child relationship. We also examined the impact of the departure of the adult child out of the family home on mothers' marital satisfaction. The effect of family context variables including the presence of an additional child with a disability, maternal education, and household income on marital satisfaction were also examined. We found that closeness in the mother-child relationship and household income had a significant effect on level of marital satisfaction, and that variability in the slope of mothers' marital satisfaction was significantly predicted by fluctuations in the behavior problems of the adolescent or adult child with an ASD. The grown child's departure out of the family home was not related to change in marital satisfaction. Interventions aimed at managing the behavior problems of adolescents and adults with ASDs may help strengthen parents' marital relationship. (PsycINFO Database Record (c) 2012 APA, all rights reserved).
Carignan, Courtney C; Karagas, Margaret R; Punshon, Tracy; Gilbert-Diamond, Diane; Cottingham, Kathryn L
Arsenic is a carcinogen that can also affect the cardiac, respiratory, neurological and immune systems. Children have higher dietary arsenic exposure than adults owing to their more restricted diets and greater intake per unit body mass. We evaluated the potential contributions of breast milk and formula to arsenic exposure throughout the first year of life for 356 infants in the prospective New Hampshire Birth Cohort Study (NHBCS) using infant diets reported by telephone at 4, 8 and 12 months of age; measured household water arsenic concentrations; and literature data. Based on our central-tendency models, population-wide geometric mean (GM) estimated arsenic exposures in the NHBCS were relatively low, decreasing from 0.1 μg/kg/day at 4 months of age to 0.07 μg/kg/day at 12 months of age. At all three time points, exclusively formula-fed infants had GM arsenic exposures ~8 times higher than exclusively breastfed infants owing to arsenic in both tap water and formula powder. Estimated maximum exposures reached 9 μg/kg/day among exclusively formula-fed infants in households with high tap water arsenic (80 μg/l). Overall, modeled arsenic exposures via breast milk and formula were low throughout the first year of life, unless formula was prepared with arsenic-contaminated tap water.
Dallazen, Camila; Silva, Sara Araújo da; Gonçalves, Vivian Siqueira Santos; Nilson, Eduardo Augusto Fernandes; Crispim, Sandra Patricia; Lang, Regina Maria Ferreira; Moreira, Júlia Dubois; Tietzmann, Daniela Cardoso; Vítolo, Márcia Regina