Socioeconomic Inequalities in Mortality Rates in Old Age in the World Health Organization Europe Region

Socioeconomic adversity is among the foremost fundamental causes of human suffering, and this is no less true in old age. Recent reports on socioeconomic inequalities in mortality rate in old age suggest that a low socioeconomic position continues to increase the risk of death even among the oldest old. We aimed to examine the evidence for socioeconomic mortality rate inequalities in old age, including information about associations with various indicators of socioeconomic position and for various geographic locations within the World Health Organization Region for Europe. The articles included in this review leave no doubt that inequalities in mortality rate by socioeconomic position persist into the oldest ages for both men and women in all countries for which information is available, although the relative risk measures observed were rarely higher than 2.00. Still, the available evidence base is heavily biased geographically, inasmuch as it is based largely on national studies from Nordic and Western European countries and local studies from urban areas in Southern Europe. This bias will hamper the design of European-wide policies to reduce inequalities in mortality rate. We call for a continuous update of the empiric evidence on socioeconomic inequalities in mortality rate

Do good health and material circumstances protect older people from the increased risk of death after bereavement?

This is an open access Article. Copyright @ 2012 The AuthorsAn increased risk of death in persons who have suffered spousal bereavement has been described in many populations. The impact of modifying factors, such as chronic disease and material circumstances, is less well understood. The authors followed 171,120 couples 60 years of age or older in a United Kingdom primary care database between 2005 and 2010 for an average of 4 years. A total of 26,646 (15.5%) couples experienced bereavement, with mean follow up after bereavement of 2 years. In a model adjusted for age, sex, comorbid conditions at baseline, material deprivation based on area of residence, season, and smoking status, the hazard ratio for mortality in the first year after bereavement was 1.25 (95% confidence interval: 1.18, 1.33). Further adjustment for changes in comorbid conditions throughout follow up did not alter the hazard ratio for bereavement (hazard ratio = 1.27, 95% confidence interval: 1.19, 1.35). The association was strongest in individuals with no significant chronic comorbid conditions throughout follow up (hazard ratio = 1.50, 95% confidence interval: 1.28, 1.77) and in more affluent couples (P = 0.035). In the first year after bereavement, the association between bereavement and death is not primarily mediated through worsening or new onset of chronic disease. Good health and material circumstances do not protect individuals from increased mortality rates after bereavement.This study was funded by a grant from the Dunhill Medical Trust

Coupling internal atomic states in a two-component Bose-Einstein condensate via an optical lattice: Extended Mott-superfluid transitions

An ultracold gas of coupled two-component atoms in an optical field is studied. Due to the internal two-level structure of the atoms, three competing energy terms exist; atomic kinetic, atomic internal, and atom-atom interaction energies. A novel outcome of this interplay, not present in the regular Bose-Hubbard model, is that in the single band and tight binding approximations four different phases appear: two superfluid and two Mott phases. When passing through the critical point between the two superfluid or the two Mott phases, a swapping of the internal atomic populations takes place. By means of the strong coupling expansion, we find the full phase diagram for the four different phases.Comment: 9 pages, 7 figure

Depressive symptoms are associated with analgesic use in people with Alzheimer's disease: Kuopio ALSOVA study.

Neuropsychiatric symptoms of Alzheimer's disease (AD) such as depression may be associated with pain, which according to the literature may be inadequately recognized and managed in this population. This study aimed to identify the factors associated with analgesic use in persons with AD; in particular, how AD severity, functional status, neuropsychiatric symptoms of AD, co-morbidities and somatic symptoms are associated with analgesic use. 236 community-dwelling persons with very mild or mild AD at baseline, and their caregivers, were interviewed over five years as part of the prospective ALSOVA study. Generalized Estimating Equations (GEEs) were used to estimate unadjusted and adjusted odds ratios (ORs) for the factors associated with analgesic use over a five year follow-up. The proportion of persons with AD using any analgesic was low (13.6%) at baseline and remained relatively constant during the follow-up (15.3% at Year 5). Over time, the most prevalent analgesic changed from non-steroidal anti-inflammatories (8.1% of persons with AD at Year 1) to acetaminophen (11.1% at Year 5). Depressive symptoms (measured by the Beck Depression Inventory, BDI) were independently associated with analgesic use, after effects of age, gender, education, AD severity, comorbidities and somatic symptoms were taken into account. For every one unit increase in BDI, the odds of analgesic use increased by 4% (OR = 1.04, 95% confidence interval CI = 1.02-1.07). Caregiver depressive symptoms were not statistically significantly associated with analgesic use of the person with AD. Depressive symptoms were significantly associated with analgesic use during the five year follow-up period. Possible explanations warranting investigation are that persons with AD may express depressive symptoms as painful somatic complaints, or untreated pain may cause depressive symptoms. Greater awareness of the association between depressive symptoms and analgesic use may lead to safer and more effective prescribing for these conditions

Dynamical quantum phase transition of a two-component Bose-Einstein condensate in an optical lattice

We study dynamics of a two-component Bose-Einstein condensate where the two components are coupled via an optical lattice. In particular, we focus on the dynamics as one drives the system through a critical point of a first order phase transition characterized by a jump in the internal populations. Solving the time-dependent Gross-Pitaevskii equation, we analyze; breakdown of adiabaticity, impact of non-linear atom-atom scattering, and the role of a harmonic trapping potential. Our findings demonstrate that the phase transition is resilient to both contact interaction between atoms and external trapping confinement.Comment: 8 pages, 8 figure

Controlling two-species Mott-insulator phses in an optical lattice to form an array of dipolar molecules

We consider the transfer of a two-species Bose-Einstein condensate into an optical lattice with a density such that that a Mott-insulator state with one atom per species per lattice site is obtained in the deep lattice regime. Depending on collision parameters the result could be either a `mixed' or a `separated' Mott-insulator phase. Such a `mixed' two-species insulator could then be photo-associated into an array of dipolar molecules suitable for quantum computation or the formation of a dipolar molecular condensate. For the case of a $^{87}$Rb-$^{41}$K two-species BEC, however, the large inter-species scattering length makes obtaining the desired `mixed' Mott insulator phase difficult. To overcome this difficulty we investigate the effect of varying the lattice frequency on the mean-field interaction and find a favorable parameter regime under which a lattice of dipolar molecules could be generated

Bose-Einstein condensation in shallow traps

In this paper we study the properties of Bose-Einstein condensates in shallow traps. We discuss the case of a Gaussian potential, but many of our results apply also to the traps having a small quadratic anharmonicity. We show the errors introduced when a Gaussian potential is approximated with a parabolic potential, these errors can be quite large for realistic optical trap parameter values. We study the behavior of the condensate fraction as a function of trap depth and temperature and calculate the chemical potential of the condensate in a Gaussian trap. Finally we calculate the frequencies of the collective excitations in shallow spherically symmetric and 1D traps.Comment: 6 pages, 4 figure

Effect of Quadratic Zeeman Energy on the Vortex of Spinor Bose-Einstein Condensates

The spinor Bose-Einstein condensate of atomic gases has been experimentally realized by a number of groups. Further, theoretical proposals of the possible vortex states have been sugessted. This paper studies the effects of the quadratic Zeeman energy on the vortex states. This energy was ignored in previous theoretical studies, although it exists in experimental systems. We present phase diagrams of various vortex states taking into account the quadratic Zeeman energy. The vortex states are calculated by the Gross-Pitaevskii equations. Several new kinds of vortex states are found. It is also found that the quadratic Zeeman energy affects the direction of total magnetization and causes a significant change in the phase diagrams.Comment: 6 pages, 5 figures. Published in J. Phys. Soc. Jp

Socioeconomic deprivation, urban-rural location and alcohol-related mortality in England and Wales

Background: Many causes of death are directly attributable to the toxic effects of alcohol and deaths from these causes are increasing in the United Kingdom. The aim of this study was to investigate variation in alcohol-related mortality in relation to socioeconomic deprivation, urban-rural location and age within a national context. Methods: An ecological study design was used with data from 8797 standard table wards in England and Wales. The methodology included using the Carstairs Index as a measure of socioeconomic deprivation at the small-area level and the national harmonised classification system for urban and rural areas in England and Wales. Alcohol-related mortality was defined using the National Statistics definition, devised for tracking national trends in alcohol-related deaths. Deaths from liver cirrhosis accounted for 85% of all deaths included in this definition. Deaths from 1999-2003 were examined and 2001 census ward population estimates were used as the denominators. Results: The analysis was based on 28,839 deaths. Alcohol-related mortality rates were higher in men and increased with increasing age, generally reaching peak levels in middle-aged adults. The 45-64 year age group contained a quarter of the total population but accounted for half of all alcohol-related deaths. There was a clear association between alcohol-related mortality and socioeconomic deprivation, with progressively higher rates in more deprived areas. The strength of the association varied with age. Greatest relative inequalities were seen amongst people aged 25-44 years, with relative risks of 4.73 (95% CI 4.00 to 5.59) and 4.24 (95% CI 3.50 to 5.13) for men and women respectively in the most relative to the least deprived quintiles. People living in urban areas experienced higher alcohol-related mortality relative to those living in rural areas, with differences remaining after adjustment for socioeconomic deprivation. Adjusted relative risks for urban relative to rural areas were 1.35 (95% CI 1.20 to 1.52) and 1.13 (95% CI 1.01 to 1.25) for men and women respectively. Conclusions: Large inequalities in alcohol-related mortality exist between sub-groups of the population in England and Wales. These should be considered when designing public health policies to reduce alcohol-related harm