The Role of Early-Life Conditions in the Cognitive Decline due to Adverse Events Later in Life

Cognitive functioning of elderly individuals may be affected by events such as the loss of a (grand)child or partner or the onset of a serious chronic condition, and by negative economic shocks such as job loss or the reduction of pension benefits. It is conceivable that the impact of such events is stronger if conditions early in life were adverse. In this paper we address this using a Dutch longitudinal database that follows elderly individuals for more than 15 years and contains information on demographics, socio-economic conditions, life events, health, and cognitive functioning. We exploit exogenous variation in early-life conditions as generated by the business cycle. We also examine to what extent the cumulative effect of consecutive shocks later in life exceeds the sum of the separate effects, and whether economic and health shocks later in life reinforce each other in their effect on cognitive functioning.cognitive functioning, business cycle, bereavement, developmental origins, retirement, health, long-run effects, dementia

Practical methods for dealing with 'not applicable' item responses in the AMC Linear Disability Score project

Background:\ud Whenever questionnaires are used to collect data on constructs, such as functional status or health related quality of life, it is unlikely that all respondents will respond to all items. This paper examines ways of dealing with responses in a 'not applicable' category to items included in the AMC Linear Disability Score (ALDS) project item bank. \ud \ud Methods:\ud The data examined in this paper come from the responses of 392 respondents to 32 items and form part of the calibration sample for the ALDS item bank. The data are analysed using the one-parameter logistic item response theory model. The four practical strategies for dealing with this type of response are: cold deck imputation; hot deck imputation; treating the missing responses as if these items had never been offered to those individual patients; and using a model which takes account of the 'tendency to respond to items'. \ud \ud Results:\ud The item and respondent population parameter estimates were very similar for the strategies involving hot deck imputation; treating the missing responses as if these items had never been offered to those individual patients; and using a model which takes account of the 'tendency to respond to items'. The estimates obtained using the cold deck imputation method were substantially different. \ud \ud Conclusions:\ud The cold deck imputation method was not considered suitable for use in the ALDS item bank. The other three methods described can be usefully implemented in the ALDS item bank, depending on the purpose of the data analysis to be carried out. These three methods may be useful for other data sets examining similar constructs, when item response theory based methods are used

Laboratory study of the impact of repetitive electrical and mechanical stimulation on brown shrimp Crangon crangon

Pulse trawling is currently the best available alternative to beam trawling in the brown shrimp Crangon crangon and Sole Solea solea (also known as Solea vulgaris) fisheries. To evaluate the effect of repetitive exposure to electrical fields, brown shrimp were exposed to the commercial electrodes and pulse settings used to catch brown shrimp (shrimp startle pulse) or Sole (Sole cramp pulse) 20 times in 4 d and monitored for up to 14 d after the first exposure. Survival, egg loss, molting, and the degree of intranuclear bacilliform virus (IBV) infection were evaluated and compared with those in stressed but not electrically exposed (procedural control) and nonstressed, nonexposed (control) brown shrimp as well as brown shrimp exposed to mechanical stimuli. The lowest survival at 14 d (57.3%) occurred in the Sole cramp pulse treatment, and this was significantly lower than in the group with the highest survival, the procedural control (70.3%). No effect of electrical stimulation on the severity of IBV infection was found. The lowest percentage of molts occurred in the repetitive mechanical stimulation treatment (14.0%), and this was significantly lower than in the group with the highest percentage of molts, the procedural control (21.7%). Additionally, the mechanically stimulated brown shrimp that died during the experiment had a significantly larger size than the surviving individuals. Finally, no effect of the shrimp startle pulse was found. Therefore, it can be concluded that repetitive exposure to a cramp stimulus and mechanical stimulation may have negative effects on the growth and/or survival of brown shrimp. However, there is no evidence that electrical stimulation during electrotrawls would have a larger negative impact on brown shrimp stocks than mechanical stimulation during conventional beam trawling

Bioelectrical Impedance Analysis and Mid-Upper Arm Muscle Circumference Can Be Used to Detect Low Muscle Mass in Clinical Practice

Identification of low muscle mass becomes increasingly relevant due to its prognostic value in cancer patients. In clinical practice, mid-upper arm muscle circumference (MAMC) and bioelectrical impedance analysis (BIA) are often used to assess muscle mass. For muscle-mass assessment, computed tomography (CT) is considered as reference standard. We investigated concordance between CT, BIA, and MAMC, diagnostic accuracy of MAMC, and BIA to detect low muscle mass and their relation with the clinical outcome malnutrition provided with the Patient-Generated Subjective Global Assessment Short Form (PG-SGA SF). This cross-sectional study included adult patients with advanced esophageal and gastrointestinal cancer. BIA, MAMC, and PG-SGA-SF were performed. Routine CT-scans were used to quantify psoas muscle index (PMI) and skeletal muscle area. Good concordance was found between CT(PMI) and both BIA(FFMI (fat free mass index)) (ICC 0.73), and BIA(ASMI (appendicular skeletal muscle index)) (ICC 0.69) but not with MAMC (ICC 0.37). BIA(FFMI) (94%), BIA(ASMI) (86%), and MAMC (86%) showed high specificity but low sensitivity. PG-SGA-SF modestly correlated with all muscle-mass measures (ranging from −0.17 to −0.43). Of all patients with low muscle mass, 62% were also classified with a PG-SGA-SF score of ≥4 points. Although CT remains the first choice, since both BIA and MAMC are easy to perform by dieticians, they have the potential to be used to detect low muscle mass in clinical practice

Psychotropic medication use and cognition in institutionalized older adults with mild to moderate dementia

Background: Most studies examining psychotropic medication use on cognition in older persons with dementia include measures of global cognitive function. The present study examined the relationship between different types of psychotropic medication and specific cognitive functions in older people with dementia. Methods: Two hundred and six institutionalized older adults with dementia (180 women, mean age 85 years) were administered neuropsychological tests. Psychotropic medication use was extracted from their medical status and categorized as: sedatives, antidepressants and antipsychotics. Results: Analysis of covariance revealed that psychotropic consumers, and particularly those who used antipsychotics, performed worse on neuropsychological tests of executive/attentional functioning than non-consumers. There were no differences between consumers of other classes of psychotropic drugs and non-consumers. The number of psychotropic drugs used was inversely related to executive/attentional functioning. Conclusions: These findings show that in institutionalized older adults with dementia, specific impairment of cognitive function, i.e. executive/attentional impairments, are associated with antipsychotic medication use. Future longitudinal studies are recommended. © 2009 International Psychogeriatric Association

Quality of life after esophageal replacement in children

Purpose: Assessing quality of life (QoL) after esophageal replacement (ER) for long gap esophageal atresia (LGEA). Methods: All patients after ER for LGEA with gastric pull-up (GPU n = 9) or jejunum interposition (JI n = 14) at the University Medical Center Groningen and Utrecht (1985–2007) were included. QoL was assessed with 1) gastrointestinal-related QoL using the Gastrointestinal Quality of Life Index (GIQLI)), 2) general QoL (Child Health questionnaire CHF87-BREF (children)/World Health Organization questionnaire WHOQOL-BREF (adults)), and 3) health-related QoL (HRQoL) (TNO AZL TACQoL/TAAQoL). Association of morbidity (heartburn, dysphagia, dyspnea on exertion, recurrent cough) and (HR)QoL was evaluated. Results: Six patients after GPU (75%) and eight patients after JI (57%) responded to the questionnaires (mean age 15.7, SD 5.9, 12 male, two female). Mean gastrointestinal, general and health-related QoL total scores of the patients were comparable to healthy controls. However, young adults reported a worse physical functioning (p = 0.02) but better social functioning compared to peers (p = 0.01). Morbidity was not associated with significant differences in (HR)QoL. Conclusions: With the current validated QoL most patients after ER with GPU and JI for LGEA have normal generic and disease specific QoL scores. Postoperative morbidity does not seem to influence (HR)QoL. Type of Study: Prognosis Study. Level of evidence: III

Environmental impact of wind energy:Synthesis and Review

One purpose of wind turbines is to provide pollution-free electric power at a reasonable price in an environmentally sound way. In this focus issue the latest research on the environmental impact of wind farms is presented. Offshore wind farms affect the marine fauna in both positive and negative ways. For example, some farms are safe havens for porpoises while other farms show fewer harbor porpoises even after ten years. Atmospheric computer experiments are carried out to investigate the possible impact and resource of future massive installations of wind turbines. The following questions are treated. What is the global capacity for energy production by the wind? Will the added turbulence and reduced wind speeds generated by massive wind farms cool or heat the surface? Can wind farms affect precipitation? It is also shown through life-cycle analysis how wind energy can reduce the atmospheric emission of eight air pollutants. Finally, noise generation and its impact on humans are studied

Long-term research challenges in wind energy – a research agenda by the European Academy of Wind Energy

The European Academy of Wind Energy (eawe), representing universities and institutes with a significant wind energy programme in 14 countries, has discussed the long-term research challenges in wind energy. In contrast to research agendas addressing short- to medium-term research activities, this eawe document takes a longer-term perspective, addressing the scientific knowledge base that is required to develop wind energy beyond the applications of today and tomorrow. In other words, this long-term research agenda is driven by problems and curiosity, addressing basic research and fundamental knowledge in 11 research areas, ranging from physics and design to environmental and societal aspects. Because of the very nature of this initiative, this document does not intend to be permanent or complete. It shows the vision of the experts of the eawe, but other views may be possible. We sincerely hope that it will spur an even more intensive discussion worldwide within the wind energy community