The determination of hepatitis A antibodies in epidemiological practice

Epidemiological analysis of hepatitis A morbidity in a city with the population of 500,000 persons in 1960-1987 was carried out. Three periods of morbidity rises among children aged 3-6 years and 7-14 years and living at the same areas (microdistricts) were established. Blood sera from healthy children were tested for the presence of antibodies to hepatitis A in enzyme immunoassay. The data on the sanitary and bacteriological study of tap water were analyzed. Unsatisfactory results of water analysis in different microdistricts correlated with the presence of antibodies in the population of these microregions and with the average morbidity indices for many years.     

Characteristics and behaviour of brushtail possums initially moving into a depopulated area

Brushtail possums are controlled extensively in New Zealand because they are a livestock disease vector and have an impact on native biodiversity. Reinvasion of controlled areas and subsequent population recovery is a significant management problem but little attention has been paid to what influences the settlement of possums in depopulated areas. To address this gap we trapped possums out of an area of about 24?ha in native podocarp–hardwood forest and studied reinvasion and settlement in the central c. 14?ha over 22 months. Most new possums were young males, but adults were also trapped. Many of the new possums caught on the study site post-depopulation did not settle there, most likely because they continued to disperse, but some may have returned to their ranges nearby or were residents with a very low probability of capture. This finding highlights the need for better information about the origins and settlement of possums in depopulated areas to improve management of population recovery and long-term sustained control of possums.     

Associations between self-assessed masticatory ability and some general health factors in a Swedish population

Objectives : The aims of this study were 1) to describe changes in self-assessed masticatory ability over a 14 year period (1975–89); and 2) to describe associations between self-assessed masticatory ability and age, dental state and some other background factors in a sample of the Swedish population in 1988/89. Design: The Swedish National Central Bureau of Statistics investigates annually the living conditions of the Swedish population by means of interviews by trained persons. The data were analysed by means of stepwise logistic regression and calculation of adjusted relative risks. Subjects: In the investigation in 1988/89, 12901 people above 16 years of age participated and the response rate was 80%. Results: In comparison between the investigations, the prevalence of reported impairment was lower in 1988/89 than in 1975 and 1980/81. Prevalence of reported impairment of chewing ability increased with ageing from 2% in young adults (16–34 years old) to 44% in older elderly (>85 years old). In most age groups, edentulous people reported the highest prevalence, and dentate people the lowest. Relative risks for impaired masticatory ability, independent of age, gender and dental state, were higher for people in rural areas, with low income and living single, as well as for those with skeletal, gastrointestinal, psychiatric and tumour diseases. In the elderly, results from the logistic regression showed that some disability and psychosocial factors were also associated with masticatory ability. Conclusions : The results indicated that there was a group of elderly people who reported several functional and health problems including impaired masticatory ability.     

A seroepidemiological survey of Taenia solium cysticercosis in Nabo, Guangxi Zhuang Autonomous Region, China

We have observed the seropositive rate of Taenia solium cysticercosis in residents at Nabo Village, Tiandong County, Guangxi Zhuang Autonomous Region, China by enzyme linked immunosorbent assay. The village had been found to be a relatively high endemic area of porcine cysticercosis among roaming pigs. Of 202 persons examined four males aged 15, 25, 35 and 41 year-old exhibited absorbance (abs) at 0.18, 0.20, 0.35 and 0.55, respectively. In addition, two females whose ages were 35 and 39 years revealed specific antibody levels of abs 0.26 and 0.41 in their sera. Overall positive rate among the people was 2.97%. All of these persons agreed that they had ingested the pork infected with T. solium metacestode (TsM), while history of proglottid discharge was not noticed from all of them. Three males and one female complained of intermittent headache. Our findings reinforced not only that the prevalence of cysticercosis might be related with roaming pigs infected with TsM but also that behavioral and environmental practices in local community constituted risk factors for transmission of the infection.     

Artificial environments and an aging population: designing for age-related functional losses

Over the past century there has been a large and continuing increase in the frequency of persons aged over 65 years; particularly those aged over 100 years. During the 21st century the number of persons over 100 years will continue to increase. This will occur at such a rapid rate that the 21st century may one day be called the century of centenarians. Frailty and disability secondary to senescence, disease, and trauma have accompanied old age (often defined as age 65 and over) as far back as recorded history. However, during the 20th century, age, frailty, disability, and chronic degenerative diseases have been decoupled to some extant in the most long-lived human populations. Until recently, there was little need to design artificial environments for the unique needs of the elderly due to their low representation in most national populations. Today that need is increasing in concert with the number of persons aged 65 and older.The purpose of this review is to suggest areas wherein physiological anthropologists may have an opportunity to contribute to design trends for this rapidly increasing aging population. Major considerations for design of environments for the elderly are based upon altering the environment to accommodate their declining visual, auditory, and kinesthetic senses, thereby enhancing their declining faculties and improving their autonomy, independence, and self perceptions of well-being. To date most design considerations have been directed toward improving environments for those suffering from Alzheimer's disease or residing within assisted living facilities. Many such design improvements also may be effective in improving life satisfaction and functional abilities of the non-institutionalized elderly.     

Prevalence of the antibody to influenza C virus in a northern Luzon Highland Village, Philippines

A total of 101 serum samples were collected from the persons (1 to 85 years of age) living in a Philippine mountain village where the contact with other communities has largely been restricted. These sera were tested for the presence of antibody to influenza C virus with hemagglutination-inhibition and radioimmuno-precipitation tests. The results showed that all the subjects, including the persons who had never been outside the village, contained the antibody to the surface glycoprotein of the virus, and that the age of acquisition of the antibody was significantly lower in this village than in any of the previously studied communities. Thus it appeared that infection with influenza C virus was prevalent even in this small mountain village, presumably with a higher incidence than in the larger, industrialized communities.     

Income, Health Expenses, Medical Debts, and Assets of Older Persons, Report of Bureau of Research and Planning

Recent publicity in the A.M.A. News and in the New York Times regarding income, debts, and medical care expenditures of older persons referred to the 1961 Survey of Consumer Finances by the Survey Research Center of the University of Michigan, and to findings of the 1960 Census. The purpose of this Socio-Economic Report is to provide some of the details of the Michigan survey, to introduce data recently published by the Department of H.E.W., and to present certain income estimates by the Bureau of Research and Planning. The terms "spending unit" and "family unit" can be confusing unless defined.A "spending unit" consists of all related persons living together who pool their income. An individual living alone may also be a spending unit.A "family unit" consists of two or more related persons living in the same dwelling unit.     

Long-term external radiation exposure of inhabitants in the western Bryansk region of Russia as a consequence of the Chernobyl accident

The western Bryansk region in south-western Russia was highly contaminated with ¹³⁷Cs and ¹³⁴Cs due to the Chernobyl accident in 1986. In 1990, a joint Nordic-Russian project was initiated in order to make measurements and estimates of the absorbed doses to selected groups of inhabitants in this area. The participating individuals were living in small villages with contamination levels between 0.9 and 2.7 MBq m^–2. Only some villages had been decontaminated. Both schoolchildren and adults participated in the study and the number of persons was between 100 and 130 each year, residing in 5 villages. Every year in September–October, from 1990 to 1998, we performed individual measurements of external absorbed doses, assessed with thermoluminescent (TL) dosemeters (LiF). The mean effective dose per year from external irradiation due to the Chernobyl accident of the inhabitants in the villages ranged between 0.8 and 2.9 mSv during the study period and decreased with an apparent half-time of 3.7–8.2 years, depending on village and group. The highest individual doses within one village were, on average higher by a factor of 3 than the mean value for that village. Under the conservative assumption of a decrease rate in the external effective dose of 2% per year after 1998, individuals in the most highly exposed village are assumed to receive a life-time effective dose of about 75 mSv (between 1986 and 2056) from external exposure to caesium radionuclides. The mean value for the villages under study was estimated to be around 65 mSv using the assumed rate of decrease. Received: 20 December 2000 / Accepted: 1 October 2001     

Caries and periodontal disease of the elderly in Pomerania, Germany: results of the Study of Health in Pomerania

Objective: The aim of this study was to describe the oral health status of older adults living in north‐eastern Germany. Materials and Methods: Representative samples of adults aged 60 years or older were examined as part of Study of the Health in Pomerania, a cross‐sectional, population‐based study. Data on 1446 subjects aged 60–79 years were evaluated for coronal caries using the decayed/missing/filled teeth (DMFT) index, root caries using the root caries index (RCI), calculus, plaque, bleeding on probing, pocket depth and attachment loss. Results: The prevalence of edentulousness varied from 16% in the 60–65‐year‐old group to 30% in the 75–79‐year‐old group, whereas the median number of remaining natural teeth per subject varied from 14 in the youngest age group (60–65 years) to one in the oldest (75–79 years). Among subjects aged 60–69 years, a quarter (26%) of the teeth examined had coronal restoration against 17% in the oldest age group (70–79 years). Coronal caries was found in 2% of the teeth in both age groups. Among teeth with gingival recession, 6% had fillings on root surfaces and 2% had root caries, irrespective of age. In all, 11% of the subjects had at least one untreated coronal lesion and 27% had at least one untreated root caries lesion. Plaque score, calculus score and bleeding on probing were higher in the oldest age group (70–79 years). The prevalence of periodontal disease expressed as the presence of at least one periodontal pocket of 4 mm and more, was higher in men and among the younger subjects (men aged 60–69 years: 85% vs. 71% in 70–79‐year‐old men; women aged 60–69 years: 71% vs. 62% in 70–79‐year‐olds). The prevalence of attachment loss of 3 mm or more followed a similar pattern. Conclusions: It seems therefore that in this population, the major oral health concern is related to caries and the small number of teeth retained among the dentate subjects.     

Genetic and environmental influences on expression of recurrent headache as a function of the reporting age in twins.

To explore age-related mechanisms in the expression of recurrent headache, we evaluated whether genetic and environmental influences are a function of the reporting age using questionnaire information that was gathered in 1973 for 15- to 47-year-old Swedish twins (n = 12,606 twin pairs). Liability to mixed headache (mild migraine and tension-type headache) was explained by non-additive genetic influences (49%) in men aged from 15 to 30 years and additive genetic plus shared environmental influences (28%) in men aged from 31 to 47 years. In women, the explained proportion of variance, which was mainly due to additive genetic effects, ranged from 61% in adolescent twins to 12% in twins aged from 41 to 47 years, whereas individual specific environmental variance was significantly lower in twins aged from 15 to 20 years than in twins aged from 21 to 30 years. Liability to migrainous headache (more severe migraine) was explained by non-additive genetic influences in men, 32% in young men and 45% in old men, while total phenotypic variance was significantly lower in young men than in old men. In women, the explained proportion of variance ranged from 91% in the youngest age group to 37% in the oldest age group, with major contributions from non-additive effects in young and old women (15-20 years and 41-47 years, respectively) and additive genetic effects in intermediate age groups (21-40 years). While total variance showed a positive age trend, genetic variance tended to be stable across age groups, whereas individual specific environmental variance was significantly lower in adolescent women as compared to older women.     

Homecare monitoring system: A technical proposal for the safety of the elderly experimented in an Alzheimer's care unit

Today, the monitoring of dependent people is a real challenge. This is mainly due to the increase in the number of elderly and reduction of medical staff. However, works done in recent years in France are faced with obstacle of clinical and industrial validation. In this paper, we propose a monitoring system for dependent persons living alone at home or in an institution 24 h/24. This system is based on a presence multisensor network deployed in the living environment of the monitored person coupled with a wireless identification system. A learning algorithm is implemented in order to define a personalized behavioural model (motions deviation, nocturnal activity, falls, mobility). This model allows the nursing staff monitoring the behaviour through a web application accessed remotely, and also intervention in case of dangerous situations thanks to an alert system. In further, we describe the experiments conducted at the Caussade Local Hospital in France with Alzheimer patients and we present the results of data obtained. Finally, we propose the way for an economic model that would allow to industrialize the system with prospects of clinical validation on a larger cohort of patients.     

Saving the young before the old -- a reply to John Harris

For a distribution of health care resources to be fair, it should consider the consequences for the whole lives of the affected persons and not just how badly off they are at the present moment. Since, other things being equal, a person is worse off if he dies young than if he dies old, it is fair to give scarce vital health care resources to young rather than to old persons. In the paper this ageist view is restated and defended against a number of objections raised by John Harris. According to Harris' so-called anti-ageist argument the only relevant consideration in the distribution of vital health care resources is people's desire to go on living. On reflection, this is highly counterintuitive. Instead, it is argued that both present desires to go on living and possible future happiness should weigh together with considerations of fairness. Both fairness and possible future happiness will in most cases speak in favour of saving the young before the old. A number of other problems for the ageist view are discussed, and solutions are suggested.     

Aging, disability, and frailty: implications for universal design

Throughout the world all populations are seeing burgeoning numbers of "elders", defined as persons aged 65 year and older. In many countries, including Japan, the United States, Norway, Sweden and the United Kingdom, those aged over 65 are at or approaching 15% of the population. As their numbers have increased, so have their health care expenses, leading to extensive research on the health, well being, and life expectancy of these increasingly older elders. Today this group is further sub-divided: the young-old ages 65-74, the old-old ages 75-84, and the oldest-old ages 85+, for both health care and research purposes. However broad variation still characterizes even these groupings. Rates of frailty and disability increase with increasing age among these elders. For example, inabilities to complete at least one activity of daily living increased from about 5-7% at ages 65-69 years to about 28-36% at ages 85+ in 1987. Death rates continue to decline at all ages past 50 years and rates of disability seem to be doing the same. For the foreseeable future, we may expect increasing numbers of older, frail elders than in previous decades. Thus, people are not only living longer, they generally are healthier at advanced ages than were previous cohorts, thus "old age" disabilities of the 20th century will be put off to even older ages during the 21st century. As yet there is no clear way to assess senescent changes in humans, although activities of daily living, allostatic load, and frailty indices have all been suggested. One future need is greater development and use of universal and accessible design in all aspects of the built environment.     

Urban-rural differences in the relationship between women's employment and fertility: a preliminary study

A statistical study of data from the Egyptian census for 1960 points up the influence of the employment of women on their fertility. Results show that the child/woman ratio rises with the level of female employment in the rural areas, but falls as the level of employment rises in the urban areas. Subject to confirmation by more detailed methods, it seems that, in urban areas, provision of opportunities for women to work is of major importance in attempting to reduce national fertility levels, but this will have the opposite effect to what is intended in rural areas. Rural and urban fertility levels appear to be similar at a low level of economic activity; however, when this economic activity surpasses 10%, a noticeable fertility differential appears. Industrial or commercial work opportunities change a woman's pattern of living, and are essential to the permanent lowering of fertility to replacement levels.     

村落与农田及土地利用关系的生态学探讨

村落与农田在农村生态系统中既对应又统一；村落与土地利用关系密切。在农村的一切生态经济活动中，都是围绕着村落的建设和土地的耕作进行的。从史前时代直到当今信息社会，村落和土地一直是人类社会生存与发展的基石，因而从生态学角度探讨村落与农田及土地利用关系具有...     

Dental Status in the Elderly: A Review of the Swedish Literature1

1. Elderly persons living in their own homes have over the past 20 years tended to retain an increased number of natural teeth. This tendency is confirmed especially in the ongoing studies by Tor Österberg, nr 12 and 13. These studies indicate a decreasing edentulous part of the 70-year old cohorts from 1971, 1976 and 1981. 2. Elderly persons dependent on institutional care are edentulous in as high degree today as 20 years ago. According to this criterion, therefore, their dental health has not improved. 3. Dentures worn by elderly persons frequently are defective in fit and function. For the general wellbeing and health in later life, mastication of a well-balanced diet and lack of discomfort from denture-bearing mucosal surfaces are important. Information in this respect and measures to improve masticating function are greatly needed among persons in the higher age groups, whether living at home or in institutional care. 4. Caries activity is increasing among elderly persons. 5. Periodontitis (loosening of the teeth) is very frequently found in elderly persons. 6. Oral hygiene requires improvement. 7. Among the elderly, living in their own homes or in institutions, the need for odontologic care is objectively great, but the demands currently made are remarkably low. 8. Of the aged in institutional care, about 75 per cent are suitable for measures of oral care. A change in dental health seems to be slowly taking place among the elderly, in that increasing numbers keep more of their own teeth longer in life. The demands made by the high age groups on the odontologic services, though increasing, are still very low relative to the objective and consequently great accumulated needs. This contrast is especially pronounced among geriatric patients in institutions. An aggressive, searching approach to both restorative and preventive oral care in the higher age groups is of pressing importance if optimum conditions for eating and chewing late in life are to be achieved. For timely counteraction of the tendency to a more passive attitude t o dental care that commonly accompanies rising age, information on these matters should be energetically disseminated among persons due for retirement or new-l y retired.     

Weakening of the ultraviolet ray-induced unscheduled DNA synthesis in human lymphocytes in extreme old age

The intensity of unscheduled DNA synthesis was studied in UV-irradiated (10--15 J/m2) peripheral blood lymphocytes of 80--90 years old persons. In these extreme old age persons, reparative DNA synthesis was found sufficiently reduced in comparison with that in middle aged (20--43 years old) ones. The role of DNA repair processes in ageing is under discussion.     

Projection of older Australians with a history of midlife obesity and overweight 2010–2050

Objective: This study projects midlife obesity status in future older Australians. Design and Methods: Cross‐sectional prevalence of being obese or overweight by broad age groups was interpolated to obtain single‐year‐age data. These estimates were then used to derive prevalence of normal weight and underweight. Data by birth year and year of observation of persons aged 30–70 years were used to construct prediction equations. Results: Results show that older people with a history of midlife obesity is projected to rise substantially in the future. For people aged 65 years, midlife obesity was estimated at 22% in 2010 and is projected to increase to 43% for males and 37% for females in 2050. Conclusion: While the proportion of individuals with midlife normal weight is projected to decline substantially, prevalence of midlife overweight remains almost stable. The number of persons aged 65 years and over having a history of midlife obesity is projected to increase nearly six‐fold from less than 500,000 persons in 2010 to 2.8 million in 2050. In comparison, between 2010 and 2050, Australia's older population aged 65 years and over is projected to increase by only 2.5‐fold. Growing obesity prevalence in the Australian population translates into a large increase in older people with a history of midlife obesity, with major implications for the future burden of disease in older persons.     

Denmark: the elderly living in style.

In the next 20 years every country in Western Europe will see a rise in its total numbers of people aged over 60, and since old people are now living longer the proportion aged over 75 will also rise. Both physical and mental disorders become much more common between 60 and 75, so that if these old people are to be provided with accommodation and medical services at contemporary standards many more places will be needed in sheltered flats, nursing homes, and geriatric hospitals. Yet in the current economic recession most European countries are trying to cut back on public expenditure. How do politicians and administrators reconcile the conflict between the demands created by demographic change and the freeze on public spending? How will the care of the elderly change in response to this conflict? Tony Smith is examining the ways in which old people are looked after in several European countries and their plans for the future. This first article deals with Denmark.     

Malnutrition and Mortality Patterns among Internally Displaced and Non-Displaced Population Living in a Camp,a Village or a Town in Eastern Chad

Background

Certain population groups have been rendered vulnerable in Chad because of displacement of more than 200,000 people over the last three years as a result of mass violence against civilians in the east of the country. The objective of the study was to assess mortality and nutritional patterns among displaced and non-displaced population living in camps, villages and a town in the Ouddaï and Salamat regions of Chad.

Methodology

Between May and October 2007, two stage, 30-cluster household surveys were conducted among 43,900 internally displaced persons (IDPs) living in camps in Ouaddai region (n = 898 households), among 19,400 non-displaced persons (NDPs) living in 42 villages in Ouaddai region (n = 900 households) and among 17,000 NDPs living in a small town in Salamat region (n = 901 households). Data collection included anthropometric measurements, measles vaccination rates and retrospective mortality. Crude mortality rate (CMR), mortality rate among children younger than 5 years (U5MR), causes of death and the prevalence of wasting (weight-for-height z score <−2) among children aged 6 to 59 months were the main outcome measures.

Conclusions

The CMR among the 4902 IDPs in Gozbeida camps, 4477 NDPs living in a village and 4073 NDPs living in a town surveyed was 1.8 (95% CI, 1.2–2.8), 0.3 (95% CI, 0.2–0.4), 0.3 (95% CI, 0.2–0.5) per 10,000 per day, respectively. The U5MR in a camp (n = 904), a village (n = 956) and a town (n = 901) was 4.1 (95% CI, 2.1–7.7), 0.5 (95% CI, 0.3–0.9) and 0.7 (95% CI, 0.4–1.4) per 10,000 per day, respectively. Diarrhoea was reported to be the main cause of death. Acute malnutrition rates (according to the WHO definition) among 904 IDP children, 956 NDPs children living in a village, 901 NDP children living in a town aged 6 to 59 months were 20.6% (95% CI, 17.9%–23.3%), 16.4% (95% CI, 14.0%–18.8%) and 10.1% (95% CI, 8.1%–12.2%) respectively. The study found a high mortality rate among IDPs and an elevated prevalence of wasting not only in IDP camps but also in villages located in the same region. The town-dweller population remains at risk of malnutrition. Appropriate contingency plans need to be made to ensure acceptable living standards for these populations.