Age‐related changes in the marmoset gut microbiome

The gut microbiome is known to play a significant role in human health but its role in aging remains unclear. The objective of this study was to compare the gut microbiome composition between young adult and geriatric non‐human primates (marmosets) as a model of human health and disease. Stool samples were collected from geriatric (8+ years) and young adult males (2–5 years). Stool 16S ribosomal RNA V4 sequences were amplified and sequenced on the Illumina MiSeq platform. Sequences were clustered into operational taxonomic units and classified via Mothur's Bayesian classifier referenced against the Greengenes database. A total of 10 young adult and 10 geriatric marmosets were included. Geriatric marmosets had a lower mean Shannon diversity compared with young marmosets (3.15 vs. 3.46; p = 0.0191). Geriatric marmosets had a significantly higher mean abundance of Proteobacteria (0.22 vs. 0.09; p = 0.0233) and lower abundance of Firmicutes (0.15 vs. 0.19; p = 0.0032) compared with young marmosets. Geriatric marmosets had a significantly higher abundance of Succinivibrionaceae (0.16 vs. 0.01; p = 0.0191) and lower abundance of Porphyromonadaceae (0.07 vs. 0.11; p = 0.0494). In summary, geriatric marmosets had significantly altered microbiome diversity and composition compared with young adult marmosets. Further studies are needed to test microbiome‐targeted therapies to improve healthspan and lifespan.     

Formula Fact & Fable

In the light of a decision taken in April 2009 that the arts will be included in a projected national curriculum it seems relevant to examine First We See: The National Review of Visual Education, which was completed in August 2008. That Review recommends the development of a visual education curriculum for the compulsory years of schooling. Under the guiding concept of “visuacy,” a neologism deriving from “visual literacy,” the newly conceived subject is intended to have educational outcomes complementary to literacy and numeracy. I examine the arguments and recommendations of the Review, and briefly examine the methodology of Phase One of the Review (i.e., a literature review, a questionnaire, and school visits) for its relevance to the Review's recommendations.     

Geriatría transversal. Un reto asistencial para el siglo xxi

Increasing numbers of older persons are being treated by specialties other than Geriatric Medicine. Specialists turn to Geriatric Teams when they need to accurately stratify their patients’ risk and prognosis, predict the potential impact of their, often, invasive interventions, optimise their clinical status, and contribute to discharge planning. Oncology and Haematology, Cardiology, General Surgery, and other surgical departments are examples where such collaborative working is already established, to a varying extent. The use of the term “Cross-speciality Geriatrics” is suggested when geriatric care is provided in clinical areas traditionally outside the reach of Geriatric Teams. The core principles of Geriatric Medicine (comprehensive geriatric assessment, patient-centred multidisciplinary targeted interventions, and input at point-of-care) are adapted to the specifics of each specialty and applied to frail older patients in order to deliver a holistic assessment/treatment, better patient/carer experience, and improved clinical outcomes. Using Comprehensive Geriatric Assessment methodology and Frailty scoring in such patients provides invaluable prognostic information, helps in decision making, and enables personalised treatment strategies. There is evidence that such an approach improves the efficiency of health care systems and patient outcomes. This article includes a review of these concepts, describes existing models of care, presents the most commonly used clinical tools, and offers examples of excellence in this new era of geriatric care. In an ever ageing population it is likely that teams will be asked to provide Cross-specialty Geriatrics across different Health Care systems. The fundamentals for its implementation are in place, but further evidence is required to guide future development and consolidation, making it one of the most important challenges for Geriatrics in the coming years.     

Need for gerodontology education in India

Objectives: To evaluate the status and need for education in Geriatric Dentistry in India. Materials and methods: The status of dental education in India was studied. India has 185 dental schools producing 12 000 dental graduates every year. At postgraduate level, there are nine recognised specialities in Dentistry, and approximately 58 institutions offer 1160 places for postgraduate degree courses. Dental education is shaped and administered by the Dental Council of India. Results: So far, Geriatric dentistry has not developed as a separate, independent speciality at postgraduate level. The undergraduate curriculum does not have any significant component of geriatric dentistry. The lack of training results in poor understanding of special needs of older adults in young graduates. Without adequate training and personal experience of growing old, young graduates may not be able to understand the physical, socio‐economic and psychological problems of the elderly and the complexities involved in treatment planning for patients with multiple chronic diseases and medication. Conclusions: It is emphasized that geriatric dentistry should be included in each of the pre‐clinical, para‐clinical and clinical subjects at the undergraduate level. Graduate students should be encouraged to treat elderly patients in clinics under supervision using a multi‐disciplinary approach. Also, postgraduate diploma and degree courses in geriatric dentistry should be developed to address the needs of the vast elderly population in India.     

Undergraduate geriatric education through community service learning

doi: 10.1111/j.1741‐2358.2010.00444.x Undergraduate geriatric education through community service learning Introduction: Despite the exponential growth of the elderly population worldwide, geriatric education has been a formal component of only a few dental schools’ curricula. Objective: To describe the geriatric community service learning (CSL) component of the professionalism and community service (PACS) module, and to explore a CSL project carried out by a group of first year dental students at a long‐term care facility. Methods: A literature review was performed to present and describe the CSL component of the PACS module. Students’ personal reflections were used to illustrate some of the joys and challenges of experiencing a long‐term care facility environment. Results: The newly developed PACS module combines community service learning with the long‐term care experience. Students develop, apply and evaluate an educational health promotion activity in a long‐term care facility. Conclusions: The PACS module has encouraged students to acquire comprehensive knowledge and awareness of the needs and dynamics of a long‐term care as they collaboratively interacted with personnel from the facility to develop their projects. The authors would like to engage other schools in discussing the need to integrate community‐based geriatric education into their dental curricula.     

Guías de práctica clínica para la evaluación y tratamiento de la osteoporosis asociada a enfermedades endocrinas y nutricionales

ObjectiveTo provide practical recommendations for evaluation and treatment of osteoporosis associated to endocrine diseases and nutritional conditions.ParticipantsMembers of the Bone Metabolism Working Group of the Spanish Society of Endocrinology, a methodologist, and a documentalist.MethodsRecommendations were formulated according to the GRADE system (Grading of Recommendations, Assessment, Development, and Evaluation) to describe both the strength of recommendations and the quality of evidence. A systematic search was made in MEDLINE (Pubmed), using the following terms associated to the name of each condition: AND “osteoporosis”, “fractures”, “bone mineral density”, and “treatment”. Papers in English with publication date before 18 October 2011 were included. Current evidence for each disease was reviewed by two group members, and doubts related to the review process or development of recommendations were resolved by the methodologist. Finally, recommendations were discussed in a meeting of the Working Group.ConclusionsThe document provides evidence-based practical recommendations for evaluation and management of endocrine and nutritional diseases associated to low bone mass or an increased risk of fracture. For each disease, the associated risk of low bone mass and fragility fractures is given, recommendations for bone mass assessment are provided, and treatment options that have shown to be effective for increasing bone mass and/or to decreasing fragility fractures are listed.     

The European Federation of Organisations for Medical Physics. Policy Statement No. 12: The present status of Medical Physics Education and Training in Europe. New perspectives and EFOMP recommendations

A recently published EFOMP's survey on the status of Education and Training in Europe, has showed the important role played by the NMOs in the organisation of the Medical Physics education and training in most countries and their efforts to fulfil EFOMP recommendations. However, despite of this, there is still a wide variety of approaches within Europe, not only in the education and training programmes but also in professional practice.There is right now some European issues that can affect not only education and training but also the future of Medical Physics as a profession: 1. the harmonisation of the architecture of the European Higher Education System, arising from the “Bologna Declaration”, for 2010, 2. the recently issued European directive: “Directive 2005/36/EC of the European Parliament and of the Council of 7 September 2005 on the recognition of professional qualifications”.EFOMP is now challenged to make recommendations for education and training in Medical Physics, within the context of the current developments in the European Higher Education Area arising from “The Bologna Declaration”, and with a view to facilitate the free movement of professionals within Europe, according to the new Directive.     

BOOK REVIEW

Books reviewed in this article: A review of Geriatric Dentistry - A Textbook of Oral Gerontology, Edited by Poul Holm-Pedersen and Harald Löe Munksgaard     

Associations among education, cortisol rhythm, and BMI in blue-collar women

Objective: This study sought to test whether a biological measure of chronic stress, Δ cortisol, was related to BMI and whether the relationship between Δ cortisol and BMI varied according to education and positive affect. Research Methods and Procedures: One hundred fifty‐four women from a blue‐collar women's health project in 11 industrial sites in rural North Carolina provided saliva for cortisol assays for a substudy on “stress.” Δ Cortisol, the difference between awakening and midday cortisol measures representing diurnal decline, was calculated (lower values = greater stress). BMI was regressed on Δ cortisol, education, and positive affect. Analyses were controlled for age, race, and worksite. Standardized β‐coefficients were calculated. Results: For participants with complete data (n = 129), BMI was greater (β 95% confidence interval) for women with less than high school education (0.56; 0.18, 0.94) and those who completed high school (0.26; ?0.05, 0.57) relative to women with greater than a high school education (p = 0.009). Δ Cortisol was inversely related to BMI (?0.32; ?0.59, ?0.05; p = 0.022). Education positively modified the inverse relationship between Δ cortisol and BMI (p = 0.047). Positive affect was negatively associated with BMI (?0.44; ?0.82, ?0.06; p = 0.026) and positively modified the inverse association between Δ cortisol and BMI (0.33; ?0.03, 0.69; p = 0.074). Discussion: Education and Δ cortisol were inversely related to BMI, and the magnitude of the association between Δ cortisol and BMI was buffered by higher education. Positive affect was inversely related to BMI. Chronic stress is associated with higher BMI, with this relation attenuated by higher education and, possibly, a positive affect.     

How to make stone soup: Is the “Paleo diet” a missed opportunity for anthropologists?

For the past few years, people everywhere have been “going Paleo.” Websites and social media touting the benefits of eating a “Paleo diet” and following a “Paleolithic life style” serve as calls to arms for health‐conscious individuals seeking information about the latest health and fitness trends. Many of these people participate in programs such as Crossfit, which involve major social and life‐style modification components and therefore facilitate the dissemination of dietary fads.¹ The PALEOf(x)^TM conference, which bills itself as “the world's premier holistic wellness event,” has attracted sellout crowds of thousands of attendees for the last four years.² Consumers can wear Paleo clothing, download Paleo shopping and exercise apps to their smartphones, order prepackaged Paleo food, prepare it using Paleo cooking implements, or expediently buy Paleo convenience foods from Paleodiet? vending machines³ and “Cultured Caveman” food trucks.⁴ The Paleo diet is touted by movie stars, reality TV personalities, and professional athletes, including LeBron James and the entire Miami Dolphins NFL team.^5,6 Books with titles such as The Primal Blueprint,⁷ Cavewomen Don't Get Fat,⁸ and Paleo Perfected⁹ (the latter by the stodgy America's Test Kitchen) are legion, and many are bestsellers.     

Ecological Stability: Reality,Misconceptions, and Implications for Risk Assessment

Over a long time frame, an ecological system may not exhibit constancy due to successional and evolutionary changes in the species composing the system. However, over shorter time frames an ecological system exhibits a certain degree of constancy (i.e., varies within defined bounds). Traditionally, ecologists considered this short-term constancy to reflect a “balance of nature,” which was viewed akin to the simple homeostatic dynamics of physiological systems. This is an appealing perspective because the disruption of the system's “balance” (i.e., its ”health“) can be ascertained by comparing the system's current state after the imposition of a perturbation with the societally desired state (i.e., baseline). Recently, ecologists have started to develop a much more complex, and perhaps more realistic, perspective regarding ecosystem dynamics, which does not depend upon homeostasis with a single baseline state. This new view includes stochastic variation, nonlinear dynamics and alternative states, and poses a challenge for assessing environmental “health” and the risk of creating “unhealthy” ecological systems     

A 30-year review of a geriatric dentistry teaching programme

doi: 10.1111/j.1741‐2358.2011.00471.x A 30‐year review of a geriatric dentistry teaching programme Objective: To review the development of the Geriatric Dental and Special Needs Education programme at the University of Iowa over the last 30 years. Background: The programme at Iowa evolved from a didactic elective programme taught by a single faculty person to a required didactic and clinical programme, which includes a Special Care Clinic in the dental school and a mobile unit with portable dental equipment which serves ten area nursing homes with comprehensive care. Materials and methods: Changes have been made in the programme over time based on formal and informal feedback from students and graduates, and we have also looked at the impact of the programme on dental services to our target population. Results: The factors influencing the curriculum development are identified and discussed. Conclusion: As no dental schools are the same, some general applications are suggested from the Iowa experience.     

Assessment of changes in oral health‐related quality of life among patients with complete denture before and 1 month post‐insertion using Geriatric Oral Health Assessment Index

doi:10.1111/j.1741‐2358.2009.00323.x
Assessment of changes in oral health‐related quality of life among patients with complete denture before and 1 month post‐insertion using Geriatric Oral Health Assessment Index Objective: Geriatric Oral Health Assessment Index (GOHAI) is a 12‐item measure of “patient‐reported oral functional problems” intended for use in the assessment of the effectiveness of dental treatment. Design and Setting: As there is scanty literature available on GOHAI in the Indian population, the present study was undertaken to assess the changes in GOHAI before and 1 month after placement of dentures in completely edentulous patients reporting to a dental hospital at Indore, India. Measurements: The GOHAI questionnaire was completed by the examiner who interviewed the patients (n = 35) before placement of complete dentures and 1 month later. Mean, median values were calculated and the data were analysed using Wilcoxon signed‐rank test. Results: When overall mean was considered, the GOHAI scores increased from 27.48 to 30.19 (p = 0.002; highly significant). Conclusion: Patients reported improvement in functional changes after placement of complete dentures.     

Additional cricetid and dipodid rodent material from the Erden Obo section,Erlian Basin (Nei Mongol,China) and its biochronological implications

New cricetid (Cricetops dormitor, Eocricetodon sp., Eucricetodon cf. E. wangae, Pappocricetodon schaubi) and dipodid (Allosminthus gobiensis n. sp., Allosminthus ernos, Allosminthus uniconjugatus, Allosminthus cf. A. majusculus, Primisminthus shanghenus, Sinosminthus sp.) occurrences from the “Lower Red”, “Middle Red”, “Middle White” and “Upper White” beds of the Erden Obo section in Nei Mongol, China are reported. They are first discovered in these horizons. On the basis of the comparison of the rodent assemblages, we consider that the age of the “Upper White” beds is early Oligocene, the age of the “Middle Red” and “Middle White” beds is probable more similar to the age of late Eocene Houldjin Formation and lower part of Chaijiachong Formation, and the age of the “Lower Red” beds is correlative to the Sharamurunian. The diversity of ctenodactyloid, dipodid, and cricetid appears to change, and the turnover in rodent fauna possibly responded to the environmental and climate change towards the end of middle Eocene.     

Global diversity of dietary intakes and standards for zinc,iron, and copper

BackgroundThe essentiality of trace elements in human diets is well recognized and adequate levels are a critical component of optimal health. To date, public health efforts have focused primarily on macronutrients or trace minerals that are easily analyzed. The goal of this research is to provide assessment of the dietary standards developed for Zn, Fe, and Cu in 100+ developed, marginal, and developing countries. We summarize the current recommendations and changes from the last decade, categorize and provide scientific basis for values established, factors that affect requirements, and current global challenges.MethodsThe electronic databases of Google Scholar, PubMed, Embase, Web of Science and Cochrane Library were searched using the keywords “trace minerals,” “micronutrients, ““zinc,” “iron,” “copper,” “dietary standards” and “recommendations.” A total of 123 studies published from 1965 to 2019 were included.ResultsThe World Health Organization (WHO) has established dietary standards to address nutrient deficiencies, prevent infections and ensure basic metabolic functions; these are utilized by most developing countries. Developed countries or their alliances have established values similar to or higher than the WHO, primarily for promotion of optimal health and well-being. Transitional countries are more concerned with issues of bioavailability, food security and undernutrition. Globally, Zn and Cu recommendations are lower in women than in men; Fe requirements are higher to compensate for menstrual losses. Important considerations in establishing guidelines for these minerals include bioaccessibility, dietary practices and restrictions, food processing, interactions, and chemical forms. The global challenges of the triple burden of malnutrition, hidden hunger, increased consumption of ultra-processed foods and obesity have been associated with Zn, Fe, and Cu deficiencies.ConclusionThis research provides public policy and health professionals evidenced-based information useful for the establishment of dietary standards world-wide.     

‘To bring out the best that is in their blood’: Race,reform, and civilization in the journal of race development (1910–1919)

The Journal of Race Development [JRD], published out of Clark University in the United States between 1910 and 1919, aimed, in its founder's words, “to present … the important facts which bear upon race progress, and the different theories as to the methods by which developed peoples may most effectively aid the progress of the undeveloped”. Its basic premise was that scientific knowledge could harness racial or civilizational “evolution” and turn it into “development”. This article examines that project, the conceptual apparatus that the JRD's writers and editors brought to bear on it, and how racial ideas informed their conceptions of development and progressive social change through elite scientific and political intervention. Central to this project was an organic notion of “civilization” in which “nature” and “culture” did not so much overlap as flow seamlessly one into the other.     

A Screening Project for the Geriatric Mentally Ill—Appraisals to Determine Suitable Care Facilities

The Geriatric Screening Project, the purpose of which is to determine whether referred patients can be dealt with by some means of care less drastic than commitment to a state hospital, has significantly reduced commitments from San Francisco. Geriatric commitments previously numbered almost 500 a year. In its first three calendar years, 1,290 persons were directly served by the project. The commitments dropped successively in the three years to 40, to 12 and then to three.The project has demonstrated that vast reductions of geriatric commitments can be achieved with enlightened screening and recommendations before resort to petition for mental illness is considered. Essential to the dramatic success are home visits, supportive community resources and a dedicated staff unafraid to meet the depressing needs of old people.     

REGIONAL,LOCAL AND MICROGEOGRAPHIC ALLELE FREQUENCY VARIATION BETWEEN APPLE AND HAWTHORN POPULATIONS OF RHAGOLETIS POMONELLA IN WESTERN MICHIGAN

In the preceding study (Feder et al., 1990), we report that paired apple and hawthorn infesting populations of Rhagoletis pomonella are genetically differentiated for six allozymes. Here, we show that patterns of intra- and inter-host allele frequency variation seen for these six loci across the eastern United States are consistent on a more fine grained spatial scale in western Michigan. Malic enzyme, Aconitase-2, Mannose phosphate isomerase, and Hydroxyacid dehydrogenase all displayed significant linear relationships with latitude among five “regional” hawthorn populations sampled along a north-south transect between the cities of Cadillac and Portage, Michigan. Clines were not as evident among “regional” apple populations in western Michigan, although allele frequencies for Malic enzyme¹⁰⁰, Mannose phosphate isomerase¹⁰⁰ and Aconitase-2⁹⁵ varied with latitude among six “local” apple populations within a 60 km² area near the town of Grant. Significant allele frequency differences were observed between hawthorn and apple populations at all “regional” and “local” collecting sites analyzed in the study (a total of 20 different apple and hawthorn populations). As was the case in the geographic survey of the eastern United States, the magnitude and pattern of inter-host frequency differences at “regional” and “local” sites were a function of latitude. Host related genetic differentiation was consistent on a “microgeographic” scale as well. Allele frequencies for Malic enzyme¹⁰⁰ and Aconitase-2⁹⁵ were significantly higher over a four-year period (1984 to 1987) for flies sampled from individual hawthorn trees (N = 6) than apple trees (N = 7) within an old field (0.09-km² area) located near Grant. The fine level of genetic subdivision between hawthorn and apple populations of R. pomonella in western Michigan substantiates the existence of host associated polymorphism in the fly and supports a sympatric mode of divergence for the “apple race”.