Functional disability and social participation restriction associated with chronic conditions in middle-aged and older adults

Abstract : Background. We examine the population impact on functional disability and social participation of physical and mental chronic conditions individually and in combination. Methods. Cross-sectional, population-based data from community-dwelling people aged 45 years and over living in the 10 Canadian provinces in 2008–2009 were used to estimate the population attributable risk (PAR) for functional disability in basic (ADL) and instrumental (IADL) activities of daily living and social participation restrictions for individual and combinations of chronic conditions, stratified by age and gender, after adjusting for confounding variables. Results. Five chronic conditions (arthritis, depression, diabetes, heart disease and eye disease) made the largest contributions to ADL-related and IADL-related functional disability and social participation restrictions, with variation in magnitude and ranking by age and gender. While arthritis was consistently associated with higher PARs across gender and most age groups, depression, alone and in combination with the physical chronic conditions, was associated with ADL and IADL disability as well as social participation restrictions in the younger age groups, especially among women. Compared to women, the combinations of conditions associated with higher PARs in men more often included heart disease and diabetes. Conclusions. Our findings suggest that in community dwelling middle-aged and older adults, the impact of combinations of mental and physical chronic conditions on functional disability and social participation restriction is substantial and differed by gender and age. Recognising the differences in the drivers of PAR by gender and age group will ultimately increase the efficiency of clinical and public health interventions

Agenda-Setting With Local and National Issues

Three factors lead to the hypothesis that agenda-setting should be weaker at the local political level compared to the national level: (1) the more directly observable nature of local political problems, (2) the nature and strength of local interpersonal political communication networks, and (3) the relatively heavier media coverage of national political issues. This hypothesis was supported with data from respondents assigned at random to either local or national issue conditions and from a content analysis of television and newspaper coverage in Toledo, Ohio, of local and national issues. Contrary to the findings of certain previous studies, network television was found to exercise a stronger agenda-setting influence than newspapers at the national level. Newspapers, on the other hand, were the dominant agenda-setter at the local level. The relative agenda-setting influences of television versus newspapers are consistent with other data from this study concerning the relative strengths of the various media as sources of issue information.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/67066/2/10.1177_009365027700400404.pd

Cavity-enhanced direct frequency comb spectroscopy

Cavity-enhanced direct frequency comb spectroscopy combines broad spectral bandwidth, high spectral resolution, precise frequency calibration, and ultrahigh detection sensitivity, all in one experimental platform based on an optical frequency comb interacting with a high-finesse optical cavity. Precise control of the optical frequency comb allows highly efficient, coherent coupling of individual comb components with corresponding resonant modes of the high-finesse cavity. The long cavity lifetime dramatically enhances the effective interaction between the light field and intracavity matter, increasing the sensitivity for measurement of optical losses by a factor that is on the order of the cavity finesse. The use of low-dispersion mirrors permits almost the entire spectral bandwidth of the frequency comb to be employed for detection, covering a range of ~10% of the actual optical frequency. The light transmitted from the cavity is spectrally resolved to provide a multitude of detection channels with spectral resolutions ranging from a several gigahertz to hundreds of kilohertz. In this review we will discuss the principle of cavity-enhanced direct frequency comb spectroscopy and the various implementations of such systems. In particular, we discuss several types of UV, optical, and IR frequency comb sources and optical cavity designs that can be used for specific spectroscopic applications. We present several cavity-comb coupling methods to take advantage of the broad spectral bandwidth and narrow spectral components of a frequency comb. Finally, we present a series of experimental measurements on trace gas detections, human breath analysis, and characterization of cold molecular beams.Comment: 36 pages, 27 figure

Evaluation of iron status in European adolescents through biochemical iron indicators: the HELENA Study

BACKGROUND/OBJECTIVES: To assess the iron status among European adolescents through selected biochemical parameters in a cross-sectional study performed in 10 European cities. SUBJECTS/METHODS: Iron status was defined utilising biochemical indicators. Iron depletion was defined as low serum ferritin (SF8.5 mg/l) plus iron depletion. Iron deficiency anaemia (IDA) was defined as ID with haemoglobin (Hb) below the WHO cutoff for age and sex: 12.0 g/dl for girls and for boys aged 12.5-14.99 years and 13.0 g/dl for boys aged ≥15 years. Enzyme linked immunosorbent assay was used as analytical method for SF, sTfR and C-reactive protein (CRP). Subjects with indication of inflammation (CRP >5 mg/l) were excluded from the analyses. A total of 940 adolescents aged 12.5-17.49 years (438 boys and 502 girls) were involved. RESULTS: The percentage of iron depletion was 17.6%, significantly higher in girls (21.0%) compared with boys (13.8%). The overall percentage of ID and IDA was 4.7 and 1.3%, respectively, with no significant differences between boys and girls. A correlation was observed between log (SF) and Hb (r = 0.36, P < 0.01), and between log (sTfR) and mean corpuscular haemoglobin (r = -0.30, P < 0.01). Iron body stores were estimated on the basis of log (sTfR/SF). A higher percentage of negative values of body iron was recorded in girls (16.5%) with respect to boys (8.3%), and body iron values tended to increase with age in boys, whereas the values remained stable in girls. CONCLUSIONS: To ensure adequate iron stores, specific attention should be given to girls at European level to ensure that their dietary intake of iron is adequate.status: publishe

Ideal cardiovascular health and inflammation in European adolescents: The HELENA study

Background and aims Inflammation plays a key role in atherosclerosis and this process seems to appear in childhood. The ideal cardiovascular health index (ICHI) has been inversely related to atherosclerotic plaque in adults. However, evidence regarding inflammation and ICHI in adolescents is scarce. The aim is to assess the association between ICHI and inflammation in European adolescents. Methods and results As many as 543 adolescents (251 boys and 292 girls) from the Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) study, a cross-sectional multi-center study including 9 European countries, were measured. C-reactive protein (CRP), complement factors C3 and C4, leptin and white blood cell counts were used to compute an inflammatory score. Multilevel linear models and multilevel logistic regression were used to assess the association between ICHI and inflammation controlling by covariates. Higher ICHI was associated with a lower inflammatory score, as well as with several individual components, both in boys and girls (p < 0.01). In addition, adolescents with at least 4 ideal components of the ICHI had significantly lower inflammatory score and lower levels of the study biomarkers, except CRP. Finally, the multilevel logistic regression showed that for every unit increase in the ICHI, the probability of having an inflammatory profile decreased by 28.1% in girls. Conclusion Results from this study suggest that a better ICHI is associated with a lower inflammatory profile already in adolescence. Improving these health behaviors, and health factors included in the ICHI, could play an important role in CVD prevention