Domicile Preferences in Employment: The Case of Alaska Hire

Background. Regional variations in mortality and morbidity have been shown in Europe and USA. Longitudinal studies have found increased mortality, dissimilarities in mortality pattern, and differences in utilization of healthcare between foreign- and native-born Swedes. No study has been found comparing mortality among foreign-born and native-born Swedes in relation to catchment areas/counties. Methods. The aim was to describe and compare mortality among foreign-born persons and native Swedes during 1970–1999 in 24 counties in Sweden. Data from the Statistics Sweden and the National Board of Health and Welfare was used, and the database consisted of 723,948 persons, 361,974 foreign-born living in Sweden in 1970 and aged 16 years and above and 361,974 matched Swedish controls. Results. Latest county of residence independently explained higher mortality among foreign-born persons in all but four counties; OR varied from 1.01 to 1.29. Counties with a more rural structure showed the highest differences between foreign-born persons and native controls. Foreign-born persons had a lower mean age (1.0–4.3 years) at time of death. Conclusion. County of residence influences mortality; higher mortality is indicated among migrants than native Swedes in counties with a more rural structure. Further studies are needed to explore possible explanations

Are You Sure? Confidence about the Satiating Capacity of a Food Affects Subsequent Food Intake

Expectations about a food’s satiating capacity predict self-selected portion size, food intake and food choice. However, two individuals might have a similar expectation, but one might be extremely confident while the other might be guessing. It is unclear whether confidence about an expectation affects adjustments in energy intake at a subsequent meal. In a randomized cross-over design, 24 subjects participated in three separate breakfast sessions, and were served a low-energy-dense preload (53 kcal/100 g), a high-energy-dense preload (94 kcal/100 g), or no preload. Subjects received ambiguous information about the preload’s satiating capacity and rated how confident they were about their expected satiation before consuming the preload in its entirety. They were served an ad libitum test meal 30 min later. Confidence ratings were negatively associated with energy compensation after consuming the high-energy-dense preload (r = −0.61; p = 0.001). The same relationship was evident after consuming the low-energy-dense preload, but only after controlling for dietary restraint, hunger prior to, and liking of the test meal (p = 0.03). Our results suggest that confidence modifies short-term controls of food intake by affecting energy compensation. These results merit consideration because imprecise caloric compensation has been identified as a potential risk factor for a positive energy balance and weight gain

Are gadolinium contrast media really less nephrotoxic than iodine agents in radiographic examinations? A comparison in relation to their ability to attenuate x-rays in a pig model

Purpose: To confront the statement that gadolinium contrast media (Gd-CM) are less nephrotoxic than iodine contrast media (I-CM) when used in x-ray angiographic and computed tomographic (CT) examinations. Methods: I) For CT measurements (mean density in Hounsfield numbers) 20-mL syringes filled with I- and Gd-CM at 0.01, 0.02, 0.05 and 0.1 mmol attenuating atoms/mL were scanned in air and in a 30 cm polystyrene phantom. For measurements on radiofluoroscopy (RF), X-ray angiography (XA) and direct digital systems (DX) systems (relative contrast values) 20-mL syringes were filled with 0.5M Gd-CM and I-CM at 35, 50, 70, 90, 110 and 140 mg I/mL. The syringes were placed in phantoms equivalent to 13 (thin) and 20 cm (thick) water. Syringes filled with distilled water served as a constancy reference. II) In a non-crossover design in three separate studies 3 ml of each test solution were injected in 8 pigs/study at a rate of 20 mL/min into the balloon-occluded (10-minutes) right renal artery of left-sided nephrectomized pigs. Test solutions: 1) 0.5M gadopentetate (1.96 Osm/kg H2O), 0.5M gadodiamide (0.78 Osm/kg), 0.5M iohexol (190 mg I/mL; 0.42 Osm/kg), 0.18M iohexol (70 mg I/mL; with an x-ray attenuation equal to that of 0.5M Gd-CM at 80 kVp) and saline; 2) 0.5M gadopentetate, 0.5M gadodiamide, 0.5M iohexol and mannitol solutions iso-osmotic to these CM; 3) 1.0M gadobutrol (1.6 Osm/kg), 0.5M gadodiamide, iodixanol 150 and 320 mg I/mL (290 mOsm/kg) and iopromide 150 mg I/mL (340 mOsm/kg). The plasma half-life elimination time of a GFR-marker were used to compare their effects on glomerular filtration rate 1-3 hours post-injection. III) After the experiments the kidneys were evaluated histomorphologically. Results: I) In vitro measurements indicate that 0.5M Gd-CM are equal attenuating with 60-80 mg I/mL at commonly used 70-90 kVp for XRA and with 110 mg I/mL at 120 kVp CT using a body phantom. II) Gadopentetate and iso-osmotic mannitol as well as gadobutrol caused severe impairment of renal function. Gadodiamide caused a 90% prolongation of plasma half-life relative to saline, significantly longer than 0.5M iohexol with a 35% prolongation. GFR following injections of iohexol 70, iopromide 150, and iodixanol 150 and 320 were in the same range as that following saline. III) Gd-CM with the highest osmolality caused marked necroses and haemorrhage/congestion correlating with their marked impairment of renal function, while the plasma iso-osmotic I-CM caused no or only minimal changes. Conclusions: Gd-CM are more nephrotoxic than equal volumes of I-CM resulting in the same or even better attenuation of x-rays. Thus, Gd-CM should not be used as a substitute for I-CM in patients with renal impairment when performing radiographic examinations. Key words: Angiography; Computed tomography; Contrast media, toxicity; Gadolinium; Glomerular filtration; Iodine; Kidney failure; Nephrotoxicity. Key words: Angiography; Computed tomography; Contrast media, toxicity; Osmolality; Renal impairment; Gadolinium, Kidney failure; Iodine, nephrotoxicity, equal attenuation, equi-molar, osmotic load, attenuation, half-life, porcine mode

Orthostatic intolerance predicts mild cognitive impairment: incidence of mild cognitive impairment and dementia from the Swedish general population cohort Good Aging in Skåne

Contradictory results have been reported on the relationship between orthostatic hypotension (OH) and mild cognitive impairment (MCI)

Orthostatic intolerance predicts mild cognitive impairment: incidence of mild cognitive impairment and dementia from the Swedish general population cohort Good Aging in Skåne.

Contradictory results have been reported on the relationship between orthostatic hypotension (OH) and mild cognitive impairment (MCI)

Ambulatory recorded ST segment depression on ECG is associated with lower cognitive function in healthy elderly men

ST segment depression (STDE) has been found to be associated with cardiovascular disease in the elderly. Studies of the relation of ambulatory STDE to cognitive function in elderly persons aged 80 years or above is lacking

Differing pattern of ambulatory blood pressure in very elderly men expresses dynamics in atherosclerotic load in the senescence.

To assess an impact of vascular risk factors on ambulatory blood pressure measurement (ABPM) in the elderly, we followed up a population-based cohort of men from 68 until 82 years, when 104 survivors underwent ABPM. Results. At age 68, hypertension and high clinic blood pressure (CBP) did not predict ABPM level. Smoking and low ankle-brachial index (ABI) predicted higher ABPM variability and pulse pressure (PP), but not absolute ABPM values. At age 82, hypertension, high or increasing CBP, strongly positively correlated with all variables of ABPM. Carotid stenosis, low or declining ABI during followup, correlated with higher nocturnal ABPM and PP. Concluding. Hypertension and vascular risk factors in a cohort of 68-year-old men do not result in higher ABPM at age 82, possibly due to inflection point in their pressure development. Higher ABPM reflects instead an increasing CBP and aggravating atherosclerosis during the preceding decade in that part of the cohort with previously favorable risk factor status

High degree of BMI misclassification of malnutrition among Swedish elderly population: age-adjusted height estimation using knee height and demispan

BACKGROUND/OBJECTIVES: The degree of misclassification of obesity and undernutrition among elders owing to inaccurate height measurements is investigated using height predicted by knee height (KH) and demispan equations. SUBJECTS/METHODS: Cross-sectional investigation was done among a random heterogeneous sample from five municipalities in Southern Sweden from a general population study 'Good Aging in Skane' (GAS). The sample comprised two groups: group 1 (KH) including 2839 GAS baseline participants aged 60-93 years with a valid KH measurement and group 2 (demispan) including 2871 GAS follow-up examination participants (1573 baseline; 1298 new), aged 60-99 years, with a valid demispan measurement. Participation rate was 80%. Height, weight, KH and demispan were measured. KH and demispan equations were formulated using linear regression analysis among participants aged 60-64 years as reference. Body mass index (BMI) was calculated in kg/m2. RESULTS: Undernutrition prevalences in men and women were 3.9 and 8.6% by KH, compared with 2.4 and 5.4% by standard BMI, and more pronounced for all women aged 85+ years (21% vs 11.3%). The corresponding value in women aged 85+ years by demispan was 16.5% vs 10% by standard BMI. Obesity prevalences in men and women were 17.5 and 14.6% by KH, compared with 19.0 and 20.03% by standard BMI. Values among women aged 85+ years were 3.7% vs 10.4% by KH and 6.5% vs 12.7% by demispan compared with the standard. CONCLUSIONS: There is an age-related misclassification of undernutrition and obesity attributed to inaccurate height estimation among the elderly. This could affect the management of patients at true risk. We therefore propose using KH- and demispan-based formulae to address this issue