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Disability in older adults is associated with a need for support in work, education, and community activities, reduced independence, and poorer quality of life. This study examines potential determinants of disability in a clinical sample of older adults across the continuum of cognitive decline, including sociodemographic, medical, psychiatric, and cognitive factors.
This is a cross-sectional study.
Participants were recruited from a specialty clinic for adults “at risk” of or with early dementia (including subjective cognitive complaints, mild cognitive impairment, and early dementia).
Four hundred forty-two older adults (mean age = 67.11, SD = 9.33) underwent comprehensive medical, neuropsychological, and mood assessments.
Disability was assessed via the self-report World Health Organization Disability Assessment Schedule 2.0. A stepwise (forward) linear regression model was computed to determine factors that contribute to disability within this group.
Depressive symptoms were the largest predictor, uniquely explaining 31.8% of the variance. Other contributing factors in the model included younger age, medical burden, and sleep quality, with all factors together accounting for a total of 50.4% of the variance in disability. Cognitive variables did not contribute to the model.
Depressive symptoms account for a significant portion of the variance in disability, but other factors such as age, medical burden and sleep quality are also important contributors in older adults across the continuum of cognitive decline. The relative association of these variables with disability appears to differ for older (≥65 years) relative to younger (<65 years) participants. Given the relationship between disability and these risk factors, an integrative and multidisciplinary approach to risk reduction will likely be most effective, with potential carry over effects for physical and mental health.
We agree with the authors that putting forward specific models and examining their agreement with experimental data are the best approach for understanding the nature of decision making. Although the authors only consider the likelihood function, prior, cost function, and decision rule (LPCD) framework, other choices are available. Bayesian statistics can be used to estimate essential parameters and assess the degree of optimality.
Herbicide active ingredients, formulation type, ambient temperature, and humidity can influence volatility. A method was developed using volatility chambers to compare relative volatility of different synthetic auxin herbicide formulations in controlled environments. 2,4-D or dicamba acid vapors emanating after application were captured in air-sampling tubes at 24, 48, 72, and 96 h after herbicide application. The 2,4-D or dicamba was extracted from sample tubes and quantified using liquid chromatography and tandem mass spectrometry. Volatility from 2,4-D dimethylamine (DMA) was determined to be greater than that of 2,4-D choline in chambers where temperatures were held at 30 or 40 C and relative humidity (RH) was 20% or 50%. Air concentration of 2,4-D DMA was 0.399 µg m−3 at 40 C and 20% RH compared with 0.005 µg m−3 for 2,4-D choline at the same temperature and humidity at 24 h after application. Volatility from 2,4-D DMA and 2,4-D choline increased as temperature increased from 30 to 40 C. However, volatility from 2,4-D choline was lower than observed from 2,4-D DMA. Volatility from 2,4-D choline at 40 C increased from 0.00458 to 0.0263 µg m−3 and from 0.00341 to 0.025 µg m−3 when humidity increased from 20% to 50% at 72 and 96 h after treatment, respectively, whereas, volatility from 2,4-D DMA tended to be higher at 20% RH compared with 50% RH. Air concentration of dicamba diglycolamine was similar at all time points when measured at 40 C and 20% RH. By 96 h after treatment, there was a trend for lower air concentration of dicamba compared with earlier timings. This method using volatility chambers provided good repeatability with low variability across replications, experiments, and herbicides.
The role that vitamin D plays in pulmonary function remains uncertain. Epidemiological studies reported mixed findings for serum 25-hydroxyvitamin D (25(OH)D)–pulmonary function association. We conducted the largest cross-sectional meta-analysis of the 25(OH)D–pulmonary function association to date, based on nine European ancestry (EA) cohorts (n 22 838) and five African ancestry (AA) cohorts (n 4290) in the Cohorts for Heart and Aging Research in Genomic Epidemiology Consortium. Data were analysed using linear models by cohort and ancestry. Effect modification by smoking status (current/former/never) was tested. Results were combined using fixed-effects meta-analysis. Mean serum 25(OH)D was 68 (sd 29) nmol/l for EA and 49 (sd 21) nmol/l for AA. For each 1 nmol/l higher 25(OH)D, forced expiratory volume in the 1st second (FEV1) was higher by 1·1 ml in EA (95 % CI 0·9, 1·3; P<0·0001) and 1·8 ml (95 % CI 1·1, 2·5; P<0·0001) in AA (Prace difference=0·06), and forced vital capacity (FVC) was higher by 1·3 ml in EA (95 % CI 1·0, 1·6; P<0·0001) and 1·5 ml (95 % CI 0·8, 2·3; P=0·0001) in AA (Prace difference=0·56). Among EA, the 25(OH)D–FVC association was stronger in smokers: per 1 nmol/l higher 25(OH)D, FVC was higher by 1·7 ml (95 % CI 1·1, 2·3) for current smokers and 1·7 ml (95 % CI 1·2, 2·1) for former smokers, compared with 0·8 ml (95 % CI 0·4, 1·2) for never smokers. In summary, the 25(OH)D associations with FEV1 and FVC were positive in both ancestries. In EA, a stronger association was observed for smokers compared with never smokers, which supports the importance of vitamin D in vulnerable populations.
Potential participants seek information about clinical trials for many reasons, but the process can be challenging. We analyzed 101,249 searches in ResearchMatch Trials Today, a free interface to recruiting trials from ClinicalTrials.gov. Searches from March 2015 to November 2016 included a broad range of conditions and healthy volunteer concepts, including 12,649 unique topics. Trials Today data indicate that it is being used to identify trials on a variety of topics.
We study experimentally the flow of light granular material along the free surface of a liquid of greater density. Despite a rich set of related geophysical and environmental phenomena, such as the spreading of calved ice, volcanic ash, debris and industrial wastes, there are few previous studies on this topic. We conduct a series of lock-release experiments of buoyant spherical beads into a rectangular tank initially filled with either fresh or salt water, and record the time evolution of the interface shape and the front location of the current of beads. We find that following the release of the lock the front location obeys a power-law behaviour during an intermediate time period before the nose of beads reaches a maximum runout distance within a finite time. We investigate the dependence of the scaling exponent and runout distance on the total amount of beads, the initial lock length, and the properties of the liquid that fills the tank in the experiments. Scaling arguments are provided to collapse the experimental data into universal curves, which can be used to describe the front dynamics of buoyant granular flows with different size and buoyancy effects and initial lock aspect ratios.
Objectives: The objectives of this study were to determine prevalence estimates of cerebral palsy (CP) among 5-year-old children in northern Alberta; to provide congenital, gestational age– and birth weight–specific, and postneonatal CP rates; and to describe motor subtypes and function. Methods: This population-based prevalence estimate study, part of the Canadian Cerebral Palsy Registry, reports confirmed CP diagnoses at age 5 years made by pediatric rehabilitation and child neurology specialists. Prevalence rates with 95% confidence intervals (CIs) used Alberta government denominators of same-age children and live births. Results: The Northern Alberta CP rate (birth years, 2008-2010) for 173 5-year-old children is 2.22 (95% CI 2.12, 2.32) per 1000 5-year-old children. The congenital CP rate is 1.99 (95% CI, 1.89-2.09) per 1000 live births; unilateral congenital CP, 1.0 (95% CI, 0.64-1.36) per 1000 live births; and postneonatal CP, 0.12 (95% CI, 0.1-0.14) per 1000 live births. Gestational age-specific rates are similar: age <28 weeks, 27.2 (95% CI, 23.05-31.35) and 28 to 31 weeks, 29.5 (95% CI, 25.78-33.22). Motor subtypes for 169 children (data missing, 4; male, 97; postnatal, 9) are: spastic, 148 (87.6%) including 31 (20.9%) with diplegia, 10 (6.8%) triplegia, 33 (22.2%) quadriplegia, 74 (50%) hemiplegia/monoplegia); and dyskinetic, 18 (10.6%) and ataxic, 3 (1.8%). A total of 107 (63.3%) ambulate without assistive devices and 111(65.7%) handle most objects with their hands independently. Conclusions: This is the fourth Canadian CP prevalence study; one from Quebec used a similar case ascertainment approach and two 1980s studies from Alberta and British Columbia used administrative databases. Northern Alberta CP rates are comparable with other developed countries. The hemiplegic subtype is the most common. Rates among preterm children have declined but are similar for the <28 and 28 to 31 gestation-week groups.
Hydrodynamical instabilities may either spin-up or down the pulsar formed in the collapse of a rotating massive star. Using numerical simulations of an idealized setup, we investigate the impact of progenitor rotation on the shock dynamics. The amplitude of the spiral mode of the Standing Accretion Shock Instability (SASI) increases with rotation only if the shock to the neutron star radii ratio is large enough. At large rotation rates, a corotation instability, also known as low-T/W, develops and leads to a more vigorous spiral mode. We estimate the range of stellar rotation rates for which pulsars are spun up or down by SASI. In the presence of a corotation instability, the spin-down efficiency is less than 30%. Given observational data, these results suggest that rapid progenitor rotation might not play a significant hydrodynamical role in the majority of core-collapse supernovae.
Extremely strong magnetic fields of the order of 1015G are required to explain the properties of magnetars, the most magnetic neutron stars. Such a strong magnetic field is expected to play an important role for the dynamics of core-collapse supernovae, and in the presence of rapid rotation may power superluminous supernovae and hypernovae associated to long gamma-ray bursts. The origin of these strong magnetic fields remains, however, obscure and most likely requires an amplification over many orders of magnitude in the protoneutron star. One of the most promising agents is the magnetorotational instability (MRI), which can in principle amplify exponentially fast a weak initial magnetic field to a dynamically relevant strength. We describe our current understanding of the MRI in protoneutron stars and show recent results on its dependence on physical conditions specific to protoneutron stars such as neutrino radiation, strong buoyancy effects and large magnetic Prandtl number.
The angular resolution (~10″) achieved by the Herschel Space Observatory ~3.5 m telescope at FIR wavelengths allowed us to roughly separate the emission toward the inner parsec of the galaxy (the central cavity) from that of the surrounding circumnuclear disk (the CND). The FIR spectrum toward Sgr A* is dominated by intense [O iii], [O i], [C ii], [N iii], [N ii], and [C i] fine-structure lines (in decreasing order of luminosity) arising in gas irradiated by the strong UV field from the central stellar cluster. The high-J CO rotational line intensities observed at the interface between the inner CND and the central cavity are consistent with a hot isothermal component at Tk ≈ 103.1 K and n(H2)≈ 104 cm−3. They are also consistent with a distribution of lower temperatures at higher gas density, with most CO at Tk≈300 K. The hot CO component (either the bulk of the CO column density or just a small fraction depending on the above scenario) likely results from a combination of UV and shock-driven heating. If UV-irradiated and heated dense clumps do not exist, shocks likely dominate the heating of the hot molecular gas component. Although this component is beam diluted in our FIR observations, it may be resolved at much higher angular resolution. An ALMA project using different molecular tracers to characterize UV-irradiated shocks in the innermost layers of the CND is ongoing.
Describing and understanding growth patterns in tropical forests is crucial to assessing their role in carbon balance. Growth and vital rates of a protected gallery forest in central Brazil were estimated, based on six measurement intervals between 1985 and 2009. The sample consisted of all stems ≥ 10 cm diameter at breast height measured in 151 permanent plots (10 × 20 m), distributed in 10 transects perpendicular to the watercourse and 100 m apart from each other. Statistical significance of changes in density, basal area, growth and vital rates were tested using Wilcoxon signed-rank tests. Vital rates oscillated during the study period. Growth, recruitment and turnover rates fluctuated, but had a net decrease over the whole study period, whereas mortality seemed to be affected by a high disturbance event during the 1994–1999 period. The oscillatory behaviour of growth suggests that the forest is pulsating around a stable state (dynamic equilibrium). Nonetheless, persistence of decelerating growth trends may force the site's carrying capacity to a lower density or biomass state.
This article reviews the most likely mechanisms of transmission of the commonly encountered respiratory viruses (influenza, respiratory syncytial virus, parainfluenza, rhinovirus), herpesviruses, and hepatitis viruses, and presents the guidelines used currently for prevention and control that are in use at Strong Memorial Hospital.
The discovery of the fully developed Formative sites of Cotocallao (ca. 3750-2350 cal. B.P.) in the Quito Basin and La Chimba (ca. 2650-1700 cal. B.P.) in the northern highlands of Ecuador has raised questions about their cultural antecedents, which have not been resolved despite decades of archaeological work in the region. Paleoenvironmental coring investigations were conducted at Lake San Pablo in northern highland Ecuador to determine the date for the onset of prehistoric maize farming in the temperate highland valleys of this region. The investigations included analysis of lake sediments for pollen, phytoliths, diatoms, and tephra. Maize pollen was identified as early as 4900 cal. B.P., while maize phytoliths dated even earlier, to 6200 or 6600 cal. B.P. These results demonstrate a long history of maize farming in valleys around Lake San Pablo, but in the context of a punctuated record of major and minor volcanic eruptions. It is concluded that early horticultural sites predating Cotocallao and La Chimba must exist, but to find such sites, archaeologists will have to locate and study deeply buried A-horizon soils.
Virtually from the beginning “collective biography,” or “prosopography,” has been seen as one of the most powerful and useful techniques of the “new” quantitative history. As Lawrence Stone succinctly described that technique, it is “ … the investigation of the common background characteristics of a group of actors by means of a collective study of their lives.” It is not case, of course, as Stone also makes clear, that the new quantitative historians invented collective biography. In fact, the approach was used by historians and other social scientists well before the advent of quantitative history. Even so, the technique has frequently been employed by quantitative historians and may even be seen by some as virtually a hallmark of that approach to historical studies.
Lead contact and lead poisoning have received scant attention in discussions of early West Indian societies but are potentially important issues in considering the health and medical problems of blacks. Although our discussion focuses on Barbados, the West Indian historical literature strongly suggests that our general findings are applicable to other Caribbean areas and have implications for understanding some of the disabilities of early white populations as well. In this paper we also seek to illustrate how bioanthropological and chemical analyses of slave skeletal remains and historical data can complement one another in defining and investigating various dimensions of slave life.
In his 1978 Presidential Address to this Association, Allan Bogue urged us to direct our attention to problems associated with the use and development of computer-readable source material (Bogue, 1979). My remarks are in a similar vein. They are limited, however, to only one of the categories of source material that Bogue discussed: information that is originally recorded and stored in computer-readable form. In this area problems have become substantially larger and more pressing than they seemed in 1978, although possible means to their amelioration are now also becoming more apparent. The problems concern, in the first place, the rapidly growing volume of potential source material that is recorded and stored in computer-readable form; and, in the second place, the danger that much of this material will not be preserved or that it will be preserved only in forms that sacrifice its central and crucial advantage of manipulability.