Nurse practitioners in primary care iv. Impact of an interdisciplinary team on attitudes of a rural population.

Attitudes toward the expanded role of nurse practitioners in primary care (family practice nurses) have been determined for persons from a semirural area who chose as their principal souce of care an interdisciplinary family medical centre (FMC) incorporating two nurse practitioners, and those for whom the FMC was not the usual source of care. Data were obtaine using"before-and-after" structured interviews of a random sample of persons living in a southern Ontario township. Slowly evolving, nonsignificant trends of greater acceptance were observed among patiens who had dealth with family practice nurses. The greatest change observed was an increased acceptance of the nnurse by FMC users as the person who would be contacted as a second choice if theirfirst choice, usually a physician, could not be reached in specific worrry-inducing situations. FMC users depended more on nurses to provide information. A conclusion of increased general acceptance of the family practive nurse by FMC users is supported by a 34 per cent higher use of nurses by FMC patients compared to other persons of comparable characteristics living in the same community.     

Rural-Urban Differences in the Long-Term Care of the Disabled Elderly in China

Background

In China, the rapid rate of population aging and changes in the prevalence of disability among elderly people could have significant effects on the demand for long-term care. This study aims to describe the urban-rural differences in use and cost of long-term care of the disabled elderly and to explore potential influencing factors.

Methods

This study uses data from a cross-sectional survey and a qualitative investigation conducted in Zhejiang province in 2012. The participants were 826 individuals over 60 years of age, who had been bedridden or suffered from dementia for more than 6 months. A generalized linear model and two-part regression model were applied to estimate costs, with adjustment of covariates.

Results

Pensions provide the main source of income for urban elderly, while the principal income source for rural elderly is their family. Urban residents spend more on all services than do rural residents. Those who are married spend less on daily supplies and formal care than the unmarried do. Age, incapacitation time, comorbidity number, level of income, and bedridden status influence spending on medical care (β=-0.0316, -0.0206, 0.1882, 0.3444, and -0.4281, respectively), but the cost does not increase as the elderly grow older. Urban residents, the married, and those with a higher income level tend to spend more on medical equipment. Urban residence and living status are the two significant factors that affect spending on personal hygiene products.

Conclusions

The use of long-term care services varies by living area. Long-term care of the disabled elderly imposes a substantial burden on families. Our study revealed that informal care involves huge opportunity costs to the caregivers. Chinese policy makers need to promote community care and long-term care insurance to relieve the burden of families of disabled elderly, and particular attention should be given to the rural elderly.     

The fall and rise of US inequities in premature mortality: 1960-2002

Background

Debates exist as to whether, as overall population health improves, the absolute and relative magnitude of income- and race/ethnicity-related health disparities necessarily increase—or derease. We accordingly decided to test the hypothesis that health inequities widen—or shrink—in a context of declining mortality rates, by examining annual US mortality data over a 42 year period.

Methods and Findings

Using US county mortality data from 1960–2002 and county median family income data from the 1960–2000 decennial censuses, we analyzed the rates of premature mortality (deaths among persons under age 65) and infant death (deaths among persons under age 1) by quintiles of county median family income weighted by county population size. Between 1960 and 2002, as US premature mortality and infant death rates declined in all county income quintiles, socioeconomic and racial/ethnic inequities in premature mortality and infant death (both relative and absolute) shrank between 1966 and 1980, especially for US populations of color; thereafter, the relative health inequities widened and the absolute differences barely changed in magnitude. Had all persons experienced the same yearly age-specific premature mortality rates as the white population living in the highest income quintile, between 1960 and 2002, 14% of the white premature deaths and 30% of the premature deaths among populations of color would not have occurred.

Conclusions

The observed trends refute arguments that health inequities inevitably widen—or shrink—as population health improves. Instead, the magnitude of health inequalities can fall or rise; it is our job to understand why.     

Evidence of High Out of Pocket Spending for HIV Care Leading to Catastrophic Expenditure for Affected Patients in Lao People's Democratic Republic

Background

The scaling up of antiviral treatment (ART) coverage in the past decade has increased access to care for numerous people living with HIV/AIDS (PLWHA) in low-resource settings. Out-of-pocket payments (OOPs) represent a barrier for healthcare access, adherence and ART effectiveness, and can be economically catastrophic for PLWHA and their family. We evaluated OOPs of PLWHA attending outpatient and inpatient care units and estimated the financial burden for their households in the Lao People''s Democratic Republic. We assumed that such OOPs may result in catastrophic health expenses in this context with fragile economical balance and low health insurance coverage.

Methods

We conducted a cross-sectional survey of a randomized sample of routine outpatients and a prospective survey of consecutive new inpatients at two referral hospitals (Setthathirat in the capital city, Savannaket in the province). After obtaining informed consent, PLWHA were interviewed using a standardized 82-item questionnaire including information on socio-economic characteristics, disease history and coping strategies. All OOPs occurring during a routine visit or a hospital stay were recorded. Household capacity-to-pay (overall income minus essential expenses), direct and indirect OOPs, OOPs per outpatient visit and per inpatient stay as well as catastrophic spending (greater than or equal to 40% of the capacity-to-pay) were calculated. A multivariate analysis of factors associated with catastrophic spending was conducted.

Results

A total of 320 PLWHA [280 inpatients and 40 outpatients; 132 (41.2%) defined as poor, and 269 (84.1%) on ART] were enrolled. Monthly median household income, essential expenses and capacity-to-pay were US$147.0 (IQR: 86–242), $126 (IQR: 82–192) and $14 (IQR: 19–80), respectively. At the provincial hospital OOPs were higher during routine visits, but three fold lower during hospitalization than in the central hospital ($21.0 versus $18.5 and $110.8 versus $329.8 respectively (p<0.01). The most notable OOPs were related to transportation and to loss of income. A total of 150 patients (46.8%; 95%CI: 41.3–52.5) were affected by catastrophic health expenses; 36 outpatients (90.0%; 95%CI: 76.3–97.2) and 114 inpatients (40.7%; 95%CI: 34.9–46.7). A total of 141 (44.0%) patients had contracted loans, and 127 (39.6%) had to sell some of their assets. In the multivariate analysis, being of Lao Loum ethnic group (Coef.-1.4; p = 0.04); being poor (Coef. -1.0; p = 0.01) and living more than 100 km away from the hospital (Coef.-1.0; p = 0.002) were positively associated with catastrophic spending. Conversely being in the highest wealth quartile (Coef. 1.6; p<0.001), living alone (Coef. 1.1; p = 0.04), attending the provincial hospital (Coef. 1.0; p = 0.002), and being on ART (Coef.1.2; p = 0.003), were negatively associated with catastrophic spending.

Conclusion

PLWHA’s households face catastrophic OOPs that are not directly attributable to the cost of ART or to follow-up tests, particularly during a hospitalization period. Transportation, distance to healthcare and time spent at the health facility are the major contributors for OOPs and for indirect opportunity costs. Being on ART and attending the provincial hospital were associated with a lower risk of catastrophic spending. Decentralization of care, access to ART and alleviation of OOPs are crucial factors to successfully decrease the household burden of HIV-AIDS expenses.     

An approach to improving science knowledge about energy balance and nutrition among elementary- and middle-school students

Unhealthy diets, lack of fitness, and obesity are serious problems in the United States. The Centers for Disease Control, Surgeon General, and Department of Health and Human Services are calling for action to address these problems. Scientists and educators at Baylor College of Medicine and the National Space Biomedical Research Institute teamed to produce an instructional unit, "Food and Fitness," and evaluated it with students in grades 3-7 in Houston, Texas. A field-test group (447 students) completed all unit activities under the guidance of their teachers. This group and a comparison group (343 students) completed pre and postassessments measuring knowledge of concepts covered in the unit. Outcomes indicate that the unit significantly increased students' knowledge and awareness of science concepts related to energy in living systems, metabolism, nutrients, and diet. Pre-assessment results suggest that most students understand concepts related to calories in food, exercise and energy use, and matching food intake to energy use. Students' prior knowledge was found to be much lower on topics related to healthy portion sizes, foods that supply the most energy, essential nutrients, what "diet" actually means, and the relationship between body size and basal metabolic rate.     

Social Support,Socio-Economic Status,Health and Abuse among Older People in Seven European Countries

Background

Social support has a strong impact on individuals, not least on older individuals with health problems. A lack of support network and poor family or social relations may be crucial in later life, and represent risk factors for elder abuse. This study focused on the associations between social support, demographics/socio-economics, health variables and elder mistreatment.

Methods

The cross-sectional data was collected by means of interviews or interviews/self-response during January-July 2009, among a sample of 4,467 not demented individuals aged 60–84 years living in seven European countries (Germany, Greece, Italy, Lithuania, Portugal, Spain, and Sweden).

Results

Multivariate analyses showed that women and persons living in large households and with a spouse/partner or other persons were more likely to experience high levels of social support. Moreover, frequent use of health care services and low scores on depression or discomfort due to physical complaints were indicators of high social support. Low levels of social support were related to older age and abuse, particularly psychological abuse.

Conclusions

High levels of social support may represent a protective factor in reducing both the vulnerability of older people and risk of elder mistreatment. On the basis of these results, policy makers, clinicians and researchers could act by developing intervention programmes that facilitate friendships and social activities in old age.     

Commodity aspirations in Easterlin's relative income theory of fertility

This paper presents the preference ordering that underlies Easterlin's relative income theory of fertility. Commodity aspirations are a key component of the theory and the paper explores how the introduction of commodity aspirations into the utility function affects the consumption of commodities and bearing of children. The formation and empirical specification of commodity aspirations are also discussed. Commodity aspirations are formed by the material environment experienced during childhood and are primarily a function of parental income. Easterlin, Leibenstein and Ben-Porath argus that it is the parental consumption or standard of living that determines the child's testes or aspirations. It is the parents' spending on themseleves rather than total parental income that can be used as a proxy for the child's commodity aspirations. Bagozzi and Van Loo identify 4 significant contributions made by Easterlinhs theory of fertility. They cite his stress on potential income flow through time as being pertinent to household decision making; tastes being an explicit determinant of fertility; background charactersticis and norms as to standards of child care and family size affecting fertility indirectly through tastes rather than directly; and the fact that relative income has an effect on fertility in addition to the influence of the absolute level of income. The number of children demanded is a negative function of commodity aspirations, as is the utility of the family. Studies of the demand for commodities and children should include data on parental resources.     

The real life of aged persons living alone in a depopulated area--in case of village a in Nagano Prefecture

Japan adopted a high economic growth policy and developed rapid industrialization since the 1960s. Consequently, Japanese have gotten various positive influences and negative influences. In this paper, we describe various positive influences and also we describe the "real life" of aged persons living alone in depopulated areas as one of the typical negative influences. For the purpose of investigating the actual lives of aged person living alone in depopulated areas, we carried out repeated interviews, research and direct observations of their work and lives in Village A. Village A is located in a mountain area 20 kilometers from Nagano City. The total population of the village was 3,294 in 1993, while it was 6,312 in 1960. The ratio is increasing rapidly year by year. In the village, the number of aged persons over 65 years old living alone, without any family, was 116 in 1994. The highest age is 94 years old. The number is increasing year by year. Through our study, it is made clear that aged persons over 65 years old living alone in the village have to manage everything in their daily lives by themselves to maintain their own safety, while accepting the influences of economic and industrial developments.     

Coping Strategies among Urban Poor: Evidence from Nairobi,Kenya

Aims

In Kenya, it is estimated that 60 to 80% of urban residents live in slum or slum-like conditions. This study investigates expenditures patterns of slum dwellers in Nairobi, their coping strategies and the determinants of those coping strategies.

Method

We use a dataset from the Indicator Development for Surveillance of Urban Emergencies (IDSUE) research study conducted in four Nairobi slums from April 2012 to September 2012. The dataset includes information related to household livelihoods, earned incomes of household members, expenditures, shocks, and coping strategies.

Results

Food spending is the single most important component, accounting for 52% of total households'' income and 42% of total expenditures. Households report a variety of coping strategies over the last four weeks preceding the interview. The most frequently used strategy is related to reduction in food consumption, followed by the use of credit, with 69% and 52% of households reporting using these strategies respectively. A substantial proportion of households also report removing children from school to manage spending shortfalls. Formal employment, owning a business, rent-free housing, belonging to the two top tiers of income brackets, and being a member of social safety net reduced the likelihood of using any coping strategy. Exposure to shocks and larger number of children under 15 years increased the probability of using a coping strategy.

Policy Implications

Policies that contain food price inflation, improve decent-paying job opportunities for the urban poor are likely to reduce the use of negative coping strategies by providing urban slum dwellers with steady and reliable sources of income. In addition, enhancing access to free primary schooling in the slums would help limit the need to use detrimental strategies like “removing” children from school.     

Bias,Discrimination, and Obesity

This article reviews information on discriminatory attitudes and behaviors against obese individuals, integrates this to show whether systematic discrimination occurs and why, and discusses needed work in the field. Clear and consistent stigmatization, and in some cases discrimination, can be documented in three important areas of living: employment, education, and health care. Among the findings are that 28% of teachers in one study said that becoming obese is the worst thing that can happen to a person; 24% of nurses said that they are “repulsed” by obese persons; and, controlling for income and grades, parents provide less college support for their overweight than for their thin children. There are also suggestions but not yet documentation of discrimination occurring in adoption proceedings, jury selection, housing, and other areas. Given the vast numbers of people potentially affected, it is important to consider the research‐related, educational, and social policy implications of these findings.     

Using anthropometric indicators for Mexicans in the United States and Mexico to understand the selection of migrants and the "Hispanic paradox"

Anthropometric measures including height provide an indication of childhood health that allows exploration of relationships between early life circumstances and adult health. Height can also be used to provide some indication of how early life health is related to selection of migrants and the Hispanic paradox in the United States. This article joins information on persons of Mexican nativity ages 50 and older in the United States collected in the National Health and Nutrition Examination Survey IV (NHANES IV 1999-2002) with a national sample of persons of the same age living in Mexico from the Mexican Health and Aging Survey (MHAS 2001) to examine relationships between height, education, migration, and late-life health. Mexican immigrants to the United States are selected for greater height and a high school, rather than higher or lower, education. Return migrants from the United States to Mexico are shorter than those who stay. Height is related to a number of indicators of adult health. Results support a role for selection in the Hispanic paradox and demonstrate the importance of education and childhood health as determinants of late-life health in both Mexico and the United States.     

Geographic and Demographic Variation in the Prevalence of Overweight Canadian Children

Objective : To examine the geographic and demographic variation in the prevalence of overweight Canadian children. Research Methods and Procedures : Using BMI data from the 1981 Canada Fitness Survey and the 1996 National Longitudinal Survey of Children and Youth, this study assessed: 1) the prevalence of overweight and obesity among Canadian boys and girls ages 7 to 13 years; 2) secular trends in the prevalence of overweight from 1981 to 1996, by province and adjusted for age and sex; and 3) provincial variation in the prevalence of overweight, before and after adjusting for socioeconomic and demographic characteristics. Results : The prevalence of boys and girls classified as overweight in 1996 was 33% and 26%, respectively. The corresponding figures for obesity were 10% for boys and 9% for girls. Provincial variation was observed with a trend of increasing risk of being overweight from west to east. Socioeconomic status was inversely related to the prevalence of overweight regardless of geographic region. The risk of being overweight was more related to geography (province) than demographic variables (income and family background); however, the effect of secular trends (1981 to 1996) exceeded the effect of geographic or demographic variables. Discussion : The prevalence of childhood overweight and obesity is increasing in all areas of Canada and can be explained only partially by geographic or demographic characteristics.     

丽江市家庭能耗碳排放特征及影响因素

现代社会中人类活动对碳排放的影响日益显著.家庭作为人类社会的基本单元,其消费活动产生的碳排放是全社会碳排放的重要组成部分.通过对丽江市农村和市区家庭生活用能的调查数据进行分析,发现农村家庭生活用能以木柴为主,沼气和电为辅;市区家庭的生活用能以电为主,其次是液化气和蜂窝煤.从碳排放构成来看,农村地区木柴消费为家庭能源碳排放的主要来源,占总碳排的83.6％;市区电力消费为家庭能源碳排放的主要来源,占总碳排的88.4％.农村地区家庭的碳排放远高于市区家庭,主要原因是木柴的碳排放因子(1.87 kg CO2/kg)远高于电能的边际排放因子(0.7134 kg CO2·kW-1·h-1).从各影响因素与家庭主要能源消费碳排放的回归结果来看,在农村地区,家庭规模、家庭收入、教育水平均对家庭木柴消费碳排放有显著的影响,但影响方向和程度有一定的差别;在市区,年龄结构、教育水平、家庭规模、住房面积均会不同程度增加家庭电能消费碳排放.建议政府在完善“家电下乡”政策、增加农村家庭收入、加强农村居民教育等方面加大投入力度,以减少丽江市整体的家庭能耗碳排放.     

The Cochlear Duct of Lizards and Snakes

The gross morphology of the cochlear ducts of approximatelyhalf (150) of the living genera of lizards and a third (130)of the living genera of snakes have been studied. The differencesin the structure of the cochlear duct are related to both theacoustical capacities and the taxonomic relationships of certainlizards and snakes. The cochlear duct of lizards consists offairly well joined lagenar and limbic portions. By contrast,the cochlear duct of snakes consists of a lagenar sac somewhatconstricted from the limbus. Each family of lizards has a morphologicallycharacteristic cochlear duct, but taxonomic relationships areindicated by certain anatomical similarities. The cochlear ductof snakes is more primitive than that of lizards, and, unlikelizards, does not exhibit marked specializations of its variousparts. Differences in morphology of the cochlear duct in snakesare much more related to habitat than family. The limbus andpapilla basilaris of snakes regardless of family, are most elongatedin bin rowing species, are only moderately elongated or ovoidin terrestrial species, and are small or reduced in certainarboreal and aquatic species.     

Association of socioeconomic status with successful ageing: differences in the components of successful ageing

This study sought to determine which factors among the indicators of socioeconomic status have the most influence on physical, mental and social functions, and on subjective well-being, all of which are components of successful ageing. A representative random sample of 1825 persons aged 65 years or older was surveyed by face-to-face interview. Socioeconomic status was measured by educational level, family household income, personal income and property ownership. The factors measured were chronic diseases, activities of daily living (ADL) for physical functioning, history of mental disease, Mini-Mental Status Examination questionnaire (MMSE) scores for mental functioning, social activity participation per week for social functioning, and the Philadelphia Geriatric Center Morale Scale (PGCMS) for subjective well-being. Multiple logistic regression analyses were performed. Education level was the most important factor in physical and mental functioning, whereas personal income was the most important in social functioning. Educational level, household income and personal income were significantly associated with subjective well-being as assessed by PGCMS scores. Subjects who demonstrated successful ageing were more likely to have a higher education and higher personal income. The results point to the importance of focusing on disparities in each component of successful ageing, which may point to appropriate health-promotion strategies for eliminating inequality in successful ageing.     

Social-economic inequality in mortality among older mem amd women. Research on the role of health, life style, parental socio-economic status and psychosocial conditions

This article describes to what degree socio-economic differences exist among community living older men and women, and to what degree these differences are to be explained by health, behaviour, childhood and psychosocial conditions. The data are available from 1427 men and 1503 women (aged 55-85), participating in the Longitudinal Aging Study Amsterdam (LASA) in 1992/1993. As indicators of socio-economic status (ses) we used the highest level of education and net monthly income. Age-adjusted mortality risks for men and women with low income and for men with a low level of education are about 1.5 times as high as for to the persons with high income and educational level. Among men, but not among women, the difference in mortality risk between low and high status persons remains after adjustment for age, health status, and several risk factors. Differences in lifestyle, parental ses and psychosocial characteristics explain little to nothing of the age-adjusted ses-differentiation in mortality. It is concluded that ses-inequalities in mortality are present among Dutch men and, to a lesser extent among women, until high age, and are partly explained by the relatively large health problems of the lower status group.     

Effects of gender,age, family support,and treatment on perceived stress and coping of patients with type 2 diabetes mellitus

Background

We previously found that the empowerment of patients with type 2 diabetes mellitus can be strongly affected by gender and age in addition to self-managed diet and exercise behaviors and treatment. This study was to examine the effects of gender, age, family support, and treatment on the perceived stress and coping of patients with type 2 diabetes mellitus living with family.

Methods

A survey was conducted of 140 adults with type 2 diabetes mellitus who were living with family. There was no significant difference in hemoglobin A1c (HbA1c) between male and female. Perceived stress and coping were measured with the Japanese version of the Appraisal of Diabetes Scale and the Lazarus Type Stress Coping Inventory. Stepwise regression analysis and path analysis were performed to identify factors that affect the perceived stress and coping of patients.

Results

(1) Perceived stress and coping were strongly affected by gender. (2) Perceived stress and coping were affected by age for males, but perceived stress was not affected by age for females. However, females showed a greater “psychological impact of diabetes” than did males. Females aged between 50 and 69 years engaged in active problem solving, but awareness of diabetes was low. (3) Treatment regimens had an effect on HbA1c for both sexes, and diet therapy affected the awareness of diabetes of males and coping of females. (4) For females, “sense of self-control” was strongly associated with coping, and those who were living with non-spouse family members had a greater psychological impact of diabetes than those living with only their spouse. (5) For males, coping was strongly affected by living with their spouse.

Conclusions

The results suggest that perceived stress, coping, and diet regimen are deeply associated with gender and age and that a male with type 2 diabetes mellitus living with his spouse is strongly dependent on support from the spouse. It is important to take into account gender, age, and family environment to provide patients with an individualized approach to addressing perceived stress and to provide education program for coping that can maximize treatment and maintain better, continuous glycemic control.

     

Making access to health care more equal: the role of general medical services.

The Resource Allocation Working Party (RAWP) recognised the need to consider both health authority and primary care services in achieving its objective. RAWP and the subsequent Advisory Group on Resource Allocation (AGRA) found (but did not publish) considerable variation in resources used by both services but could not find a clear relation between them. Statistics provided by the DHSS were used to compare spending by 80 area health authorities in 1980-1 with expenditure per head on general medical services by their corresponding family practitioner committees. There was considerable variation in the provision of resources for both services and no clear relation between the variations in spending on each service. Only 40 of the 80 areas had both health authority and family practitioner committee spending levels within 10% of "target." Subregional inequalities in resources tend to be related to variations in admission rates, which in turn are related to general practitioners'' referral behaviour. These results emphasise the importance of finding out more about inequalities in the provision of general medical services and their relation to the use of hospital services. They also suggest that RAWP''s aim of equality of opportunity of access to health care resources may be achieved only if general medical services are brought into the equation as well.     

Knowledge,use and management of native wild edible plants from a seasonal dry forest (NE,Brazil)

Background

Despite being an ancient practice that satisfies basic human needs, the use of wild edible plants tends to be forgotten along with associated knowledge in rural communities. The objective of this work is to analyze existing relationships between knowledge, use, and management of native wild edible plants and socioeconomic factors such as age, gender, family income, individual income, past occupation and current occupation.

Methods

The field work took place between 2009 and 2010 in the community of Carão, Altinho municipality, in the state of Pernambuco in northeastern Brazil. We conducted semi-structured interviews with 39 members of the community regarding knowledge, use and management of 14 native wild edible plants from the Caatinga region, corresponding to 12 vegetable species. In parallel, we documented the socioeconomic aspects of the interviewed population (age, gender, family income, individual income, past occupation and current occupation).

Results

Knowledge about edible plants was related to age but not to current occupation or use. Current use was not associated with age, gender or occupation. The association between age and past use may indicate abandonment of these resources.

Conclusion

Because conservation of the species is not endangered by their use but by deforestation of the ecosystems in which these plants grow, we suggest that the promotion and consumption of the plants by community members is convenient and thereby stimulates the appropriation and consequent protection of the ecosystem. To promote consumption of these plants, it is important to begin by teaching people about plant species that can be used for their alimentation, disproving existing myths about plant use, and encouraging diversification of use by motivating the invention of new preparation methods. An example of how this can be achieved is through events like the “Preserves Festival”.

     

Impact of Perinatal Photoperiod on the Chronotype of 11- to 18-Year-Olds in Northern European Russia

The study investigates the effect of the month of birth and ambient light conditions at birth on sleep length and chronotype among residents of high latitudes. The authors surveyed 1172 persons (609 girls, 563 boys) age 11 to 18 yrs living in five villages and four towns located between 59.5°N and 67.6°N latitude. Survey participation was voluntary and anonymous. Sleep length and chronotype were assessed using the Munich chronotype questionnaire (MCTQ). The study showed the sleep length and chronotype of the children and adolescents depended on sex, age, type of settlement (town/village), and latitude of residence. Latitude exerted a stronger impact on sleep length and chronotype of children and adolescents living in villages than on those of their urban counterparts. Month of birth had no effect on sleep length and chronotype. There was a significant effect of the time of sunrise, sunset, and day length at birth on the chronotype of children and adolescents. A later chronotype was observed in the sample of young persons living above the Arctic Circle who were born during the polar day and polar night. (Author correspondence: borisenkov@physiol.komisc.ru)