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Greater Age (greater + age)
Selected AbstractsManagement of Noncancer Pain in Community-Dwelling Persons with DementiaJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 12 2006Joseph W. Shega MD OBJECTIVES: To explore the pharmacological treatment of noncancer pain in persons with dementia and identify predictors associated with insufficient analgesia. DESIGN: Cross-sectional analysis of an observational cohort study. SETTING: Academic outpatient geriatric clinic in Chicago, Illinois. PARTICIPANTS: A total of 115 dyads, mostly African American, consisting of community-dwelling persons with dementia and their caregivers. MEASUREMENTS: Patient report of demographics, noncancer pain, function, cognition, and depression. Caregiver report of patient agitation and over-the-counter and prescription medications. RESULTS: Sixty-two of 115 (54%) patients reported pain "on an average day." The caregivers of more than half of persons with dementia who reported pain "on an average day" did not report analgesic use. The majority of caregivers who reported analgesic use reported that patients took a World Health Organization Class I medication. No patients had been prescribed a Class III (strong opioid) drug. Fifty-three of 115 (46%) patients had potentially insufficient analgesia. In the logistic regression, insufficient analgesia was associated with greater age, Mini-Mental State Examination score of less than 10, and impairment in daily functioning. Insufficient analgesia was 1.07 times as likely (95% confidence interval (CI)=1.01,1.14) for each additional year of age, 3.0 times as likely (95% CI=1.05,9.10) if the subject had advanced dementia, and 2.5 times as likely (95% CI=1.01,6.25) if the patient had any impairment in activities of daily living. CONCLUSION: In this convenience sample from a geriatric clinic, many persons with dementia and noncancer pain were not receiving pharmacological treatment. Those at greatest risk for insufficient analgesia were older, had moderate to severe dementia, and experienced impairments in activities of daily living. [source] Empirical tests of life-history evolution theory using phylogenetic analysis of plant demographyJOURNAL OF ECOLOGY, Issue 2 2010Jean H. Burns Summary 1. A primary goal of evolutionary ecology is to understand factors selecting for the diversity of life histories. Life-history components, such as time-to-reproduction, adult survivorship and fecundity, might differ among species because of variation in direct and indirect benefits of these life histories in different environments or might have lower-than-expected variability because of phylogenetic constraints. Here, we present a phylogenetic examination of demography and life histories using a data base of 204 terrestrial plant species. 2. Overall, statistical models without phylogeny were preferred to models with phylogeny for vital rates and elasticities, suggesting that they lacked phylogenetic signal and are evolutionarily labile. However, the effect of phylogeny was significant in models including sensitivities, suggesting that sensitivities exhibit greater phylogenetic signal than vital rates or elasticities. 3. Species with a greater age at first reproduction had lower fecundity, consistent with a cost of delayed reproduction, but only in some habitats (e.g. grassland). We found no evidence for an indirect benefit of delayed reproduction via a decrease in variation in fecundity with age to first reproduction. 4. The greater sensitivity and lower variation in survival than in fecundity was consistent with buffering of more important vital rates, as others have also found. This suggests that studies of life-history evolution should include survival, rather than only fecundity, for the majority of species. 5.Synthesis. Demographic matrix models can provide informative tests of life-history theory because of their shared construction and outputs and their widespread use among plant ecologists. Our comparative analysis suggested that there is a cost of delayed reproduction and that more important vital rates exhibit lower variability. The absolute importance of vital rates to population growth rates (sensitivities) exhibited phylogenetic signal, suggesting that a thorough understanding of life-history evolution might require an understanding of the importance of vital rates, not just their means, and the role of phylogenetic history. [source] Growth, maturity and fecundity of wolffish Anarhichas lupus L. in Icelandic watersJOURNAL OF FISH BIOLOGY, Issue 4 2006Á. Gunnarsson Fecundity, maturity and the relationship between growth and maturity of common wolffish Anarhichas lupus were studied in Icelandic waters. A total of 788 female common wolffish were sampled in two areas: one in the relatively warm sea west of Iceland and the other in the colder sea east of Iceland. No difference was detected in fecundity of common wolffish between areas. The time from the onset of the cortical alveolus stage until spawning, was on average, 10 years in the east and 8 years in the west area. Common wolffish in the east area reached cortical alveolus stage, on average, at a greater age but similar size compared to common wolffish in the west area. Similarly, common wolffish started spawning, on average, at greater age and larger size in the east than in the west area. Common wolffish grew faster in the west than in the east area. Spawning common wolffish grew faster than common wolffish at the cortical alveolus stage in both areas. The relationship between growth and maturity for common wolffish in Icelandic waters appeared to be related to temperature, characterized by fast growth and early maturation in the west and slower growth and delayed maturation in the east. [source] Blood pressure and lifestyle on Saba, Netherlands AntillesAMERICAN JOURNAL OF HUMAN BIOLOGY, Issue 3 2009Laura E. Soloway During the 20th century, infectious disease morbidity and mortality generally waned whereas chronic degenerative diseases posed a growing burden at the global level. The population on Saba, Netherlands Antilles has recently experienced such an epidemiologic transition, and hypertension was reported to be extraordinarily high, although no prevalences have been reported and relationships with lifestyle factors associated with rapid modernization have not been explored. In this study, a medical and demographic questionnaires, as well as body composition and blood pressure measures were collected from 278 Saban men and women aged 18,91 years. When age and sex adjusted, 48% of the population was hypertensive. Age, BMI, and Afro-Caribbean descent were all associated with higher blood pressures. In a second phase, 124 individuals of the 278 were invited to receive a longer questionnaire on individual exposure to modernizing influences such as travel and education. Higher blood pressure was associated with having lived in fewer different places in the past; those who stayed only on Saba or Statia had higher blood pressures than those who had also lived in more modernized areas. However, this was no longer statistically significant after adjustment for age and BMI. Lifestyle incongruity was positively associated with higher blood pressure in that those with more discord between material wealth and income were more likely to be hypertensive, and this remained statistically significant after adjustment for age and adiposity. In summary, hypertension is highly prevalent on Saba and tended to be associated with greater age, adiposity, Afro-Caribbean ancestry, and lifestyle incongruity. Am. J. Hum. Biol., 2009. © 2009 Wiley-Liss, Inc. [source] Longitudinal correlates of the persistence of irregular eating from age 5 to 14 yearsACTA PAEDIATRICA, Issue 1 2010BM McDermott Abstract Aim:, To report the stability of parent-perceived child irregular eating from 6 months to 14 years of age and to investigate a predictive model inclusive of child and parent factors. Methods:, Of the 7223 singleton children in a birth cohort, 5122 children were re-interviewed at 5 years and 4554 for the 14-year analysis. Information was obtained from structured interviews including questions answered by parents of the child at birth, 6 months, 5 years and 14 years; and by teenagers at age 14 years and from physical measures of the child. The mother's perception that the child was an irregular eater at age 14 years was the major outcome variable of interest. Results:, Approximately 40% of irregular eaters at age 5 will still be irregular eaters at age 14 years. This was not related to maternal education or socio-economic class. Significant at multivariate analysis were infant feeding problems and the children's ability to regulate their sleep and mood. Significant maternal factors were greater age, not feeling positive about the baby and persistent maternal anxiety during the child's early years. Conclusion:, Irregular eating behaviour displays considerable continuity from childhood to mid-adolescence. Independent contributions to this behavioural phenotype include child biological and psychological factors and maternal anxiety during the child's early years. [source] Well-being among children and adolescents with mobility impairment in relation to demographic data and disability characteristicsACTA PAEDIATRICA, Issue 5 2005Lena Jemtä Abstract Aim: To describe the well-being of children and adolescents with mobility impairment in relation to demographic data and disability characteristics. Methods: The present study is based on interviews with 141 subjects aged 7 to 18 y with impaired mobility. Perceived overall well-being was measured by a nine-grade visual scale, the Snoopy scale. Independence or dependence was evaluated by the Index of Independence in Activities of Daily Living. Motor capacity was assessed with an instrument including active movements, rapidity, locomotion and balance as well as the presence and localization of pain. Results: Since there were no significant differences in well-being regarding the diagnostic-related group, additional disorder/disability or the degree of disability, the impairment per se did not necessarily influence well-being negatively. Even though the majority of the children and adolescents in the study indicated a high level of well-being, several risk factors for a lower level of well-being were identified: greater age, not living with both parents, being a first-generation immigrant, having an acquired disease/injury and experience of pain. Conclusion: These findings increase our limited knowledge of well-being among children/adolescents with mobility impairment and provide a basis for effective care and future research. [source] The Ethics of Life ExpectancyBIOETHICS, Issue 4 2002Robin Small Some ethical dilemmas in health care, such as over the use of age as a criterion of patient selection, appeal to the notion of life expectancy. However, some features of this concept have not been discussed. Here I look in turn at two aspects: one positive , our expectation of further life , and the other negative , the loss of potential life brought about by death. The most common method of determining this loss, by counting only the period of time between death and some particular age, implies that those who die at ages not far from that one are regarded as losing very little potential life, while those who die at greater ages are regarded as losing none at all. This approach has methodological advantages but ethical disadvantages, in that it fails to correspond to our strong belief that anyone who dies is losing some period of life that he or she would otherwise have had. The normative role of life expectancy expressed in the ,fair innings' attitude arises from a particular historical situation: not the increase of life expectancy in modern societies, but a related narrowing in the distribution of projected life spans. Since life expectancy is really a representation of existing patterns of mortality, which in turn are determined by many influences, including the present allocation of health resources, it should not be taken as a prediction, and still less as a statement of entitlement. [source] | |||||||||||||