Utilization of acute and long-term care in the last year of life: comparison with survivors in a population-based study

Background. It is well-known that the use of care services is most intensive in the last phase of life. However, so far only a few determinants of end-of-life care utilization are known. The aims of this study were to describe the utilization of acute and long-term care among older adults in their last year of life as compared to those not in their last year of life, and to examine which of a broad range of determinants can account for observed differences in care utilization. Methods. Data were used from the Longitudinal Aging Study Amsterdam (LASA). In a random, age and sex stratified population-based cohort of 3107 persons aged 55 ? 85 years at baseline and representative of the Netherlands, follow-up cycles took place at 3, 6 and 9 years. Those who died within one year directly after a cycle were defined as the "end-of-life group" (n = 262), and those who survived at least three years after a cycle were defined as the "survivors". Utilization of acute and long-term care services, including professional and informal care, were recorded at each cycle, as well as a broad range of health-related and psychosocial variables. Results. The end-of-life group used more care than the survivors. In the younger-old this difference was most pronounced for acute care, and in the older-old, for long-term care. Use of both acute and long-term home care in the last year of life was fully accounted for by health problems. Use of institutional care at the end of life was partly accounted for by health problems, but was not fully explained by the determinants included. Conclusion. This study shows that severity of health problems are decisive in the explanation of the increase in use of care services towards the end-of-life. This information is essential for an appropriate allocation of professional health care to the benefit of older persons themselves and their informal caregivers. © 2009 Pot et al; licensee BioMed Central Ltd

Life history, climate and biogeography interactively affect worldwide genetic diversity of plant and animal populations.

Understanding how biological and environmental factors interactively shape the global distribution of plant and animal genetic diversity is fundamental to biodiversity conservation. Genetic diversity measured in local populations (GDP) is correspondingly assumed representative for population fitness and eco-evolutionary dynamics. For 8356 populations across the globe, we report that plants systematically display much lower GDP than animals, and that life history traits shape GDP patterns both directly (animal longevity and size), and indirectly by mediating core-periphery patterns (animal fecundity and plant dispersal). Particularly in some plant groups, peripheral populations can sustain similar GDP as core populations, emphasizing their potential conservation value. We further find surprisingly weak support for general latitudinal GDP trends. Finally, contemporary rather than past climate contributes to the spatial distribution of GDP, suggesting that contemporary environmental changes affect global patterns of GDP. Our findings generate new perspectives for the conservation of genetic resources at worldwide and taxonomic-wide scales

The effects of scaling on age, sex and size relationships in Red-legged Partridges

Wild birds differ in size according to their age and sex, adult birds being larger than juveniles. In the galliforms, males are larger than females, in contrast to some groups, such as the raptors, in which the females are larger. Size generally influences the rank hierarchy within a group of birds, although the age, sex, temperament and behaviour of an individual may override its size related rank order. The scaled size of birds according to age and sex affects their physiology and behaviour. Precise details of body-size differences by age and sex are poorly known in most partridge species. We measured 13,814 wild partridges in a homogenous population over 14 years of study to evaluate size differences within a uniform habitat and population management regime. We show that wild Red-legged Partridges have scaled mass, and body- and wing-lengths consistent with age/sex classes. Power functions between mass and body-length (as a proxy for walking efficiency), and between mass and wing-length (for flight efficiency) differ between juvenile females and males, and adult females and males. We discuss these findings and their physiological, behavioural and ecological implications.A.M. was supported by a Ramón y Cajal research contract by the Ministry of Economy and Competitiveness (RYC-2012-11867).Peer reviewe

Recent advances in Surface Plasmon Resonance for biosensing applications and future prospects

International audienc