Trends in decayed teeth among middle‐aged and older adults in the United States: socioeconomic disparities persist over time

ObjectivesWhile trends in tooth loss among older adults have been well documented and show a decline over the last few decades, little is known about trends in tooth decay which may lead to tooth loss. The study aim was to examine trends in tooth decay among adults ages 50 years and older in the United States and determine whether these trends were consistent across demographic and socioeconomic subgroups of middle‐aged and older adults.MethodsSecondary analysis of data collected through detailed oral health examinations in the National Health and Nutrition Examination (NHANES) surveys 1988–1994 and 1999–2004. Tooth decay was measured as active caries. Multivariable associations were estimated using negative binomial regression models.ResultsAveraged over time, the mean number of decayed teeth was 0.54. Rates of decay remained stable over time. Males, non‐Hispanic Blacks, Mexican‐Americans, and those of other race/ethnicity as well as those with fewer years of education and lower levels of income had more decayed teeth. The increased number of decayed teeth for Mexican‐Americans and those of other race/ethnicity was due in part to differing levels of education and income. Trends over time did not vary by any of these demographic and socioeconomic characteristics. Trends in the number of decayed teeth did not meaningfully change when the numbers of missing and filled teeth were controlled.ConclusionsAlthough studies have shown the number of middle‐aged and older Americans experiencing tooth loss has decreased over time, trends in tooth decay have remained relatively stable, with socioeconomic disparities persisting over time.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/135439/1/jphd12153_am.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/135439/2/jphd12153.pd

Falls, Depression and Antidepressants in Later Life: A Large Primary Care Appraisal

BACKGROUND: Depression and falls are common and co-exist for older people. Safe management of each of these conditions is important to quality of life. METHODS: A cross-sectional survey was used to examine medication use associated with injurious and non-injurious falls in 21,900 community-dwelling adults, aged 60 years or over from 383 Australian general practices recruited for the DEPS-GP Project. Falls and injury from falls, medication use, depressive symptoms (Primary Health Questionnaire (PHQ-9)), clinical morbidity, suicidal ideation and intent, health status (SF-12 Health Survey), demographic and lifestyle information was reported in a standardised survey. FINDINGS: Respondents were 71.8 years (sd 7.7) of age and 58.4% were women. 24% 11% and 8% reported falls, fall related injury, and sought medical attention respectively. Antidepressant use (odds ratio, OR: 1.46; 95% confidence interval, 95%CI: 1.25, 1.70), questionable depression (5-14 on PHQ OR: 1.32, 95%CI: 1.13, 1.53) and clinically significant symptoms of depression (15 or more on PHQ OR: 1.70, 95%CI: 1.14, 1.50) were independently associated with multiple falls. SSRI use was associated with the highest risk of multiple falls (OR: 1.66, 95%CI: 1.36, 2.02) amongst all psychotropic medications. Similar associations were observed for injurious falls. Over 60% of those with four accumulated risk factors had multiple falls in the previous year (OR: 3.40, 95%CI: 1.79, 6.45); adjusted for other demographic and health factors. INTERPRETATION: Antidepressant use (particularly SSRIs) was strongly associated with falls regardless of presence of depressive symptoms. Strategies to prevent falls should become a routine part of the management of older people with depression

The Netherlands study of depression in older persons (NESDO); a prospective cohort study

<p>Abstract</p> <p>Background</p> <p>To study late-life depression and its unfavourable course and co morbidities in The Netherlands.</p> <p>Methods</p> <p>We designed the Netherlands Study of Depression in Older Persons (NESDO), a multi-site naturalistic prospective cohort study which makes it possible to examine the determinants, the course and the consequences of depressive disorders in older persons over a period of six years, and to compare these with those of depression earlier in adulthood.</p> <p>Results</p> <p>From 2007 until 2010, the NESDO consortium has recruited 510 depressed and non depressed older persons (≥ 60 years) at 5 locations throughout the Netherlands. Depressed persons were recruited from both mental health care institutes and general practices in order to include persons with late-life depression in various developmental and severity stages. Non-depressed persons were recruited from general practices. The baseline assessment included written questionnaires, interviews, a medical examination, cognitive tests and collection of blood and saliva samples. Information was gathered about mental health outcomes and demographic, psychosocial, biological, cognitive and genetic determinants. The baseline NESDO sample consists of 378 depressed (according to DSM-IV criteria) and 132 non-depressed persons aged 60 through 93 years. 95% had a major depression and 26.5% had dysthymia. Mean age of onset of the depressive disorder was around 49 year. For 33.1% of the depressed persons it was their first episode. 41.0% of the depressed persons had a co morbid anxiety disorder. Follow up assessments are currently going on with 6 monthly written questionnaires and face-to-face interviews after 2 and 6 years.</p> <p>Conclusions</p> <p>The NESDO sample offers the opportunity to study the neurobiological, psychosocial and physical determinants of depression and its long-term course in older persons. Since largely similar measures were used as in the Netherlands Study of Depression and Anxiety (NESDA; age range 18-65 years), data can be pooled thus creating a large longitudinal database of clinically depressed persons with adequate power and a large set of neurobiological, psychosocial and physical variables from both younger and older depressed persons.</p

Voluntary disclosure of corporate strategy: determinants and outcomes. An empirical study into the risks and payoffs of communicating corporate strategy.

Business leaders increasingly face pressure from stakeholders to be transparent. There appears however little consensus on the risks and payoffs of disclosing vital information such as corporate strategy. To fill this gap, this study analyzes firm-specific determinants and organisational outcomes of voluntary disclosure of corporate strategy. Stakeholder theory and agency theory help to understand whether companies serve their interest to engage with stakeholders and overcome information asymmetries. I connect these theories and propose a comprehensive approach to measure voluntary disclosure of corporate strategy. Hypotheses from the theoretical framework are empirically tested through panel regression of data on identified determinants and outcomes and of disclosed strategy through annual reports, corporate social responsibility reports, corporate websites and corporate press releases by the 70 largest publicly listed companies in the Netherlands from 2003 through 2008. I found that industry, profitability, dual-listing status, national ranking status and listing age have significant effects on voluntary disclosure of corporate strategy. No significant effects are found for size, leverage and ownership concentration. On outcomes, I found that liquidity of stock and corporate reputation are significantly influenced by voluntary disclosure of corporate strategy. No significant effect is found for volatility of stock. My contributions to theory, methodology and empirics offers a stepping-stone for further research into understanding how companies can use transparency to manage stakeholder relations

Social and Environmental Accounting as Symbolic and Substantive Means of Legitimation: The Case of HIV/AIDS Reporting in South Africa

We develop an interpretive framework which combines Suchman's (1995) work on the dynamics of organisational legitimacy and Ashforth and Gibbs’ (1990) concepts of symbolic and substantive management to investigate how and why public corporations rely on symbolic and substantive social disclosures. We apply this framework to the case of the HIV/AIDS health crisis in South Africa (SA) and examine the corporate disclosure behaviour of a sample of 75 SA-listed corporations from 2003 to 2009. We use content analysis procedures to codify the disclosures and devise a disclosure index based on the Global Reporting Initiative guidelines on HIV/AIDS to assess whether corporations have adopted a substantive management strategy. Our findings suggest that public corporations use a combination of substantive and symbolic disclosures in a bid to seek specific forms of moral legitimacy (structural, procedural, and consequential) and pragmatic legitimacy (dispositional, influence, and exchange). Our analysis reveals that the mix of substantive and symbolic disclosures is altered as a result of changes in stakeholder salience, societal attitudes and the corporation's current ‘state’ of legitimacy. Overall, the findings demonstrate that our analytical framework is useful in understanding how substantive and/or symbolic disclosures could be relied upon to achieve specific types of organisational legitimacy