Long-term Effects of Famine on Life Expectancy: A Re-analysis of the Great Finnish Famine of 1866-1868

Famines are extreme cases of environmental stress, and have been used by a series of studies to explore the long-term consequences of the fetal or childhood environment. Results are inconsistent and do not support negative long-term effects on mortality. The authors test the hypothesis that selection during famine changes the frailty distributions of cohorts and may hide negative long-term effects. They use death counts from age 60+ from the Human Mortality Data Base for the birth cohorts 1850-1854, 1855-1859, 1860-1865, 1866-1868, 1869-1874, 1875-1879, 1880-1884 and 1885-1889 to explore the effect of being born during the Great Finnish Famine 1866-1868. Swedish cohorts without famine exposure are analysed as a control group. Cohorts born in Finland during the Great Finnish Famine are highly heterogeneous in their distribution of deaths after age 60. By contrast, cohorts born in the years immediately after the famine are particularly homogeneous. Accounting for these differences results into a lower remaining life expectancy at age 60 for cohorts born during the famine. Statistically, long-term effects of famine on mortality become only visible when changes in the frailty distribution of cohorts are explicitly considered.old-age mortality, selection, debilitation, early life circumstances

Outpatient Management of Mood Disorders by the Family Physician

It is well-known that the demand for psychiatric care in the US is higher than the supply of psychiatric clinical providers. Vermont, in particular, has a paucity of psychiatric providers and there are minimal providers in Chittenden County and the greater Burlington area. Many patients with psychiatric conditions are inconsistently managed given the lack of available outpatient providers, particularly for patients on Medicaid. Often times, patients suffer from psychiatric episodes that require an emergency department visit or inpatient stay, and they may leave the hospital with an outpatient medication regimen that can then be carried out by a primary care provider. Patients should not have to endure a psychotic episode bringing them into the hospital in order to receive appropriate psychiatric care. A possible solution to this gap in care would be for primary care providers to be armed with the knowledge and skills to appropriately and sustainably manage psychiatric conditions on an outpatient level. Tools to summarize the evidence and current guidelines around prescribing, testing, surveillance, and other drug-related parameters may enable providers to quickly assess the recommendations during a busy clinical day, especially if such tools were consistently updated and embedded into the electronic medical record. This project focuses on management of mood disorders in the outpatient family medicine clinic; a one-pager table summarizing guidelines around commonly prescribed mood stabilizers in the setting of bipolar disorder was created and displayed in the Hinesburg Family Medicine clinic.https://scholarworks.uvm.edu/fmclerk/1485/thumbnail.jp

Season of birth influences life span of Mediterranean fruit flies, rats and mice

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Control of Footrot in Small Ruminants of Nepal

Footrot, a bacterial disease which attacks the feet of sheep and goats causing lameness and high levels of flock mortality, was endemic in the western districts of Nepal. As a result of the collaborative efforts between Nepalese, Australian and British scientists within ACIAR projects AS2/1991/017 and AS2/1996/021, the virulent form of this disease has been eradicated from the livestock industries of the country. The economic benefits stemming from this achievement are described and quantified in this report. Over the 1993–2022 period, ACIAR invested $A1.5 million in research designed to improve the management of footrot in Nepal. Based on levels of disease prevalence reported at the beginning of the projects and a probability of the disease spreading to other districts, disease eradication will result in a realised net present value of$A2.8 million. A benefit–cost ratio of 2.9:1 was estimated for the projects, which indicates that for each dollar invested, 2.9 dollars of project benefits will be generated. Several other countries, such as Bhutan and possibly Australia, could benefit from the footrot vaccination practices developed in these projects. Sensitivity analysis outlined in the concluding section of the report indicates that these benefits could be substantial and their inclusion would increase the value of ACIAR-supported research.Footrot, ruminants, bacterial disease, Nepal, Australia, livestock, economic benefits, net present value, benefit-cost ratio, disease eradication, Farm Management, International Development, Livestock Production/Industries, Production Economics,

Recalling All the Olympians: W. B. Yeats’s “Beautiful Lofty Things,” On the Boiler and the Agenda of National Rebirth

While it has been omitted by numerous critics in their otherwise comprehensive readings of Yeats’s oeuvre, “Beautiful Lofty Things” has been placed among the mythical poems, partly in accordance with Yeats’s own intention; in a letter to his wife, he suggested that “Lapis Lazuli, the poem called ‘To D. W.’ ‘Beautiful Lofty Things,’ ‘Imitated from the Japanese’ & ‘Gyres’ . . . would go well together in a bunch.” The poem has been inscribed in the Yeats canon as registering a series of fleeting epiphanies of the mythical in the mundane. However, “Beautiful Lofty Things,” evocative of a characteristically Yeatsian employment of myth though it certainly is, seems at the same time to fuse Yeats’s quite earthly preoccupations. It is here argued that the poem is organized around a tightly woven matrix of figures that comprise Yeats’s idea of the Irish nation as a “poetical culture.” Thus the position of the lyric in the poet’s oeuvre deserves to be shifted from periphery towards an inner part of his cultural and political ideas of the time. Indeed, the poem can be viewed as one of Yeats’s central late comments on the state of the nation and, significantly, one in which he is able to proffer a humanist strategy for developing a culturally modern state rather than miring his argument in occasionally over-reckless display of abhorrence of modernit

Constitutional Crisis and Constitutional Rot

No one could accuse Donald Trump\u27s presidency of being boring. The first hundred days have careened wildly through scandals, revelations, outrages, and fracturing of political norms. Because Donald Trump is very unpopular, and because he regularly does things that his opponents consider outrageous, his critics have begun to describe his actions as creating or precipitating a constitutional crisis, especially following his first executive order limiting entry into the United States, and again after his firing of FBI director James Comey

Modeling health inequities research in context and the minority researcher’s role

Current health inequities research templates are flawed and self-defeating because they do not include historical inequalities as the central context that points to the root causes of health inequities. The context includes structural malformations which are products of the history of colonization and slavery that created racial separation and hierarchies which established Whites as the dominant group and non-Whites (minorities) as the subordinate group. Consequently it is difficult for mainstream researchers to capture the minorities’ core knowledge necessary for the creation of relevant and effective interventions for fundamental and sustainable improvement of their health. This paper proposes a health inequities research model that captures the context of health inequities and the essential and unique role of minority researchers

Physical outcome measure for critical care patients following intensive care discharge

Introduction: The aim of this study was to evaluate the most suitable physical outcome measures to be used with critical care patients following discharge. ICU survivors experience physical problems such as reduced exercise capacity and intensive care acquired weakness. NICE guideline ‘Rehabilitation after critical illness’ (1) recommends the use of outcome measures however does not provide any specific guidance. A recent Cochrane review noted wide variability in measures used following ICU discharge (2). Methods: Discharged ICU patients attended a five week multidisciplinary programme. Patients’ physical function was assessed during the programme, at 6 months and 12 months post discharge. Three outcome measures were included in the initial two cohorts. The Six Minute Walk Test (6MWT) and the Incremental Shuttle Walk test (ISWT) were chosen as they have been used within the critical care follow up setting (2). The Chester Step Test (CST) is widely thought to be a good indicator of ability to return to work (one of the programmes primary aims). Ethics approval was waived as the programme was part of a quality improvement initiative. Results: Data was collected for the initial patients attending the programme (n = 13), median age was 52 (IQR = 38-72), median ICU LOS was 19 days (IQR = 4-91), median APACHE II was 23 (IQR = 19-41) and 11 were men. One patient was so physically debilitated that the CST or ISWT could not be completed however a score was achieved using the 6MWT. Another patient almost failed to achieve level 1 of the ISWT. Subsequent patients for this project (total n = 47) have all therefore been tested using the 6MWT. Good inter-rater and intrarater reliability and validity have been reported for the 6MWT (3). Conclusions: Exercise capacity measurement is not achievable for some patients with either the ISWT or the CST due to the severity of their physical debilitation. Anxiety, post-traumatic stress disorder and depression are common psychological problems post discharge (4), therefore using a test with a bleep is not appropriate. Therefore, the 6MWT is the most appropriate physical outcome measure to be used with critical care patients post discharge

Health and socio-demographic conditions as determinants of marriage and social mobility

This paper makes use of data collected from military registers and marriage certificates for the population of Alghero, in Sardinia, for the period 1866-1925, with the aim of investigating the role played by physical characteristics and health in the possibility of social mobility through marriage. Our findings demonstrate that, whereas physical defects and ill health had little impact on the chances of marrying an illiterate woman, these factors did have a negative effect on the chances of marrying a woman who was literate. In a context in which intergenerational social mobility remained limited and the family had the final say on marriage arrangements, it is likely that only healthy individuals were selected for marriages regarded as strategic for the purposes of forming and strengthening family alliances, and/or improving the social position within the community.health, marriage, Sardinia, social mobility