Heterogeneity in Longitudinal Healthcare Utilisation by Older Adults: A Latent Transition Analysis of the Irish Longitudinal Study on Ageing

BACKGROUND: Older adults likely exhibit considerable differences in healthcare need and usage. Identifying differences in healthcare utilisation both between and within individuals over time may support future service development. OBJECTIVES: To characterise temporal changes in healthcare utilisation among a nationally representative sample of community-dwelling older adults. METHODS: A latent transition analysis of the first three waves of The Irish Longitudinal Study on Ageing (TILDA) (N = 6128) was conducted. RESULTS: Three latent classes of healthcare utilisation were identified, ‘primary care only’; ‘primary care and outpatient visits’ and ‘multiple utilisation’. The classes were invariant across all three waves. Transition probabilities indicated dynamic changes over time, particularly for the ‘primary care and outpatient visits’ and ‘multiple utilisation’ statuses. DISCUSSION: Older adults exhibit temporal changes in healthcare utilisation which may reflect changes in healthcare need and disease progression. Further research is required to identify the factors which influence movement between healthcare utilisation patterns

Economic Impact of South Dakota’s Regional Water Systems

Regional water systems are a primary conduit of water supply for much of South Dakota’s rural and small community populations. As of 2006, greater than one-third of South Dakota’s population was served by water supplied from regional water systems, and when Lewis and Clark Rural Water delivers water to Sioux Falls, over one-half of South Dakota’s population will be served by regional water systems. Greater than 75% of incorporated communities with public water supplies are served by regional water systems, either as bulk communities or as individual customers. Many farms and agricultural industries use rural water for domestic use, livestock watering, and industrial processing. These users have connected to regional water systems to obtain a reliable, safe, and high quality water source. This report summarizes the results of a study of the economic impacts of regional water systems in South Dakota. The scope of this study was limited to soliciting financial information from South Dakota’s regional rural water systems using this information to quantify direct, indirect, and induced economic impacts of these systems as a result of their construction and annual operations

Golden Fields, Generalized Fibonacci Sequences, and Chaotic Matrices

Abstract The diagonals of regular n-gons for odd n are shown to form algebraic fields with the diagonals serving as the basis vectors. The diagonals are determined as the ratio of successive terms of generalized Fibonacci sequences. The sequences are determined from a family of triangular matrices with elements either 0 or 1. The eigenvalues of these matrices are ratios of the diagonals of the n-gons, and the matrices are part of a larger family of matrices that form periodic trajectories when operated on by the Mandelbrot operator. Generalized Mandelbrot operators are related to the Lucas polynomials have similar periodic properties