Assessing health and well-being among older people in rural South Africa

Background: The population in developing countries is ageing, which is likely to increase the burden of noncommunicable diseases and disability. Objective: To describe factors associated with self-reported health, disability and quality of life (QoL) of older people in the rural northeast of South Africa. Design: Cross-sectional survey of 6,206 individuals aged 50 and over. We used multivariate analysis to examine relationships between demographic variables and measures of self-reported health (Health Status), functional ability (WHODASi) and quality of life (WHOQoL). Results: About 4,085 of 6,206 people eligible (65.8%) completed the interview. Women (Odds Ratio (OR) 1.30, 95% CI 1.09, 1.55), older age (OR2.59, 95% CI 1.97, 3.40), lower education (OR1.62, 95% CI 1.31,2.00), single status (OR1.18, 95% CI 1.01, 1.37) and not working at present (OR1.29, 95% CI 1.06, 1.59) were associated with a low health status. Women were also more likely to report a higher level of disability (OR1.38, 95% CI 1.14, 1.66), as were older people (OR2.92, 95% CI 2.25, 3.78), those with no education (OR1.57, 95% CI 1.26, 1.97), with single status (OR1.25, 95% CI 1.06, 1.46) and not working at present (OR1.33, 95% CI 1.06, 1.66). Older age (OR1.35, 95% CI 1.06, 1.74), no education (OR1.39, 95% CI 1.11, 1.73), single status (OR1.28, 95% CI 1.10, 1.49), a low household asset score (OR1.52, 95% CI 1.19, 1.94) and not working at present (OR1.32; 95% CI 1.07, 1.64) were all associated with lower quality of life. Conclusions: This study presents the first population-based data from South Africa on health status, functional ability and quality of life among older people. Health and social services will need to be restructured to provide effective care for older people living in rural South Africa with impaired functionality and other health problems

Characterizing Transition Temperature Gas in the Galactic Corona

We present a study of the properties of the transition temperature (T~10^5 K) gas in the Milky Way corona, based on measurements of OVI, NV, CIV, SiIV and FeIII absorption lines seen in the far ultraviolet spectra of 58 sightlines to extragalactic targets, obtained with Far-Ultraviolet Spectroscopic Explorer (FUSE) and Space Telescope Imaging Spectrograph. In many sightlines the Galactic absorption profiles show multiple components, which are analyzed separately. We find that the highly-ionized atoms are distributed irregularly in a layer with a scaleheight of about 3 kpc, which rotates along with the gas in the disk, without an obvious gradient in the rotation velocity away from the Galactic plane. Within this layer the gas has randomly oriented velocities with a dispersion of 40-60 km/s. On average the integrated column densities are log N(OVI)=14.3, log N(NV)=13.5, log N(CIV)=14.2, log N(SiIV)=13.6 and log N(FeIII)=14.2, with a dispersion of just 0.2 dex in each case. In sightlines around the Galactic Center and Galactic North Pole all column densities are enhanced by a factor ~2, while at intermediate latitudes in the southern sky there is a deficit in N(OVI) of about a factor 2, but no deficit for the other ions. We compare the column densities and ionic ratios to a series of theoretical predictions: collisional ionization equilibrium, shock ionization, conductive interfaces, turbulent mixing, thick disk supernovae, static non-equilibrium ionization (NIE) radiative cooling and an NIE radiative cooling model in which the gas flows through the cooling zone. None of these models can fully reproduce the data, but it is clear that non-equilibrium ionization radiative cooling is important in generating the transition temperature gas.Comment: 99 pages, 11 figures, with appendix on Cooling Flow model; only a sample of 5 subfigures of figure 2 included - full set of 69 available through Ap

PTP1B Regulates Leptin Signal Transduction In Vivo

AbstractMice lacking the protein-tyrosine phosphatase PTP1B are hypersensitive to insulin and resistant to obesity. However, the molecular basis for resistance to obesity has been unclear. Here we show that PTP1B regulates leptin signaling. In transfection studies, PTP1B dephosphorylates the leptin receptor-associated kinase, Jak2. PTP1B is expressed in hypothalamic regions harboring leptin-responsive neurons. Compared to wild-type littermates, PTP1B−/− mice have decreased leptin/body fat ratios, leptin hypersensitivity, and enhanced leptin-induced hypothalamic Stat3 tyrosyl phosphorylation. Gold thioglucose treatment, which ablates leptin-responsive hypothalamic neurons, partially overcomes resistance to obesity in PTP1B−/− mice. Our data indicate that PTP1B regulates leptin signaling in vivo, likely by targeting Jak2. PTP1B may be a novel target to treat leptin resistance in obesity

Young and vulnerable: Spatial-temporal trends and risk factors for infant mortality in rural South Africa (Agincourt), 1992-2007

<p>Abstract</p> <p>Background</p> <p>Infant mortality is an important indicator of population health in a country. It is associated with several health determinants, such as maternal health, access to high-quality health care, socioeconomic conditions, and public health policy and practices.</p> <p>Methods</p> <p>A spatial-temporal analysis was performed to assess changes in infant mortality patterns between 1992-2007 and to identify factors associated with infant mortality risk in the Agincourt sub-district, rural northeast South Africa. Period, sex, refugee status, maternal and fertility-related factors, household mortality experience, distance to nearest primary health care facility, and socio-economic status were examined as possible risk factors. All-cause and cause-specific mortality maps were developed to identify high risk areas within the study site. The analysis was carried out by fitting Bayesian hierarchical geostatistical negative binomial autoregressive models using Markov chain Monte Carlo simulation. Simulation-based Bayesian kriging was used to produce maps of all-cause and cause-specific mortality risk.</p> <p>Results</p> <p>Infant mortality increased significantly over the study period, largely due to the impact of the HIV epidemic. There was a high burden of neonatal mortality (especially perinatal) with several hot spots observed in close proximity to health facilities. Significant risk factors for all-cause infant mortality were mother's death in first year (most commonly due to HIV), death of previous sibling and increasing number of household deaths. Being born to a Mozambican mother posed a significant risk for infectious and parasitic deaths, particularly acute diarrhoea and malnutrition.</p> <p>Conclusions</p> <p>This study demonstrates the use of Bayesian geostatistical models in assessing risk factors and producing smooth maps of infant mortality risk in a health and socio-demographic surveillance system. Results showed marked geographical differences in mortality risk across a relatively small area. Prevention of vertical transmission of HIV and survival of mothers during the infants' first year in high prevalence villages needs to be urgently addressed, including expanded antenatal testing, prevention of mother-to-child transmission, and improved access to antiretroviral therapy. There is also need to assess and improve the capacity of district hospitals for emergency obstetric and newborn care. Persisting risk factors, including inadequate provision of clean water and sanitation, are yet to be fully addressed.</p

Adipocyte-specific protein tyrosine phosphatase 1B deletion increases lipogenesis, adipocyte cell size and is a minor regulator of glucose homeostasis

Peer reviewedPublisher PD

The search for low-mass axion dark matter with ABRACADABRA-10cm

Two of the most pressing questions in physics are the microscopic nature of the dark matter that comprises 84% of the mass in the universe and the absence of a neutron electric dipole moment. These questions would be resolved by the existence of a hypothetical particle known as the quantum chromodynamics (QCD) axion. In this work, we probe the hypothesis that axions constitute dark matter, using the ABRACADABRA-10cm experiment in a broadband configuration, with world-leading sensitivity. We find no significant evidence for axions, and we present 95% upper limits on the axion-photon coupling down to the world-leading level $g_{a\gamma\gamma}<3.2 \times10^{-11}$ GeV$^{-1}$, representing one of the most sensitive searches for axions in the 0.41 - 8.27 neV mass range. Our work paves a direct path for future experiments capable of confirming or excluding the hypothesis that dark matter is a QCD axion in the mass range motivated by String Theory and Grand Unified Theories.Comment: 17 pages, 12 figure