Syphilis among middle-aged female sex workers in China: a three-site cross-sectional study.

ObjectivesThis study addresses the lack of empirical studies about the epidemic of syphilis among middle-aged female sex workers (FSWs). The objectives of this study were to investigate prevalence of syphilis, and its potential risk factors among middle-aged FSWs in China.DesignA cross-sectional study with respondent-driven sampling (RDS).SettingA multisite study conducted at three Chinese cites (Nanning, Hefei, and Qingdao) with different levels of sexually transmitted diseases in 2014.Participants1245 middle-aged female sex workers who were over 35 years old (about 400 per study site).Main outcome measuresUnprotected commercial sex, and syphilis and HIV infection were biologically tested and measured.ResultsThe RDS-adjusted prevalence of active syphilis was 17.3% in Hefei, 9.9% in Qingdao, and 5.4% in Nanning. The RDS-adjusted prevalence of prevalent syphilis was between 6.8% and 33.6% in the three cities. The proportion of unprotected sex in the past 48 h verified by the prostate-specific antigen test (PSA) was between 27.8% and 42.4%. Multiple log-binomial regression analyses indicate that middle-aged FSWs who had 5 or more clients in the past week prior to interviews and engaged in unprotected sex were more likely to be active syphilitic cases. Middle-aged FSWs who had rural residency were less likely to be active syphilitic cases.ConclusionsIn contrast with previous studies that reported low prevalence of syphilis and high prevalence of protected sex among FSWs in China, both the prevalence of syphilis and unprotected sex were high among middle-aged FSWs. Evidence-based intervention programmes should be developed and evaluated among this vulnerable population in China and other countries with similar settings

Bone health of middle-aged and older surfers

Purpose: Given the lack of research investigating surfing and bone health, we aimed to assess the bone mineral density (BMD) of middle-aged and older surfers. Patients and methods: In a cross-sectional observational design, we compared a group of middle-aged and older surfers to a group of non-surfers, age- and sex-matched controls. Participants were males, aged between 50 and 75 years. Volunteers were assessed for body mass index, bone-specific physical activity questionnaire (BPAQ) scores, daily calcium intake, and alcohol intake. Primary outcomes included BMD at the femur and lumbar spine (LS), and T-score, assessed via dual-energy X-ray absorptiometry. Bone biomarkers were also analyzed. Results: A total of 104 participants (59 surfers and 45 controls) were assessed. Groups were similar with regards to all demographic characteristics except for percentage of lean mass (higher in surfers, mean difference [MD] +2.57%; 95% CI 0.05–5.09; p=0.046) and current BPAQ score (lower in surfers; MD −0.967; 95% CI −0.395 to −1.539; p=0.001). Surfers had a mean surfing experience of 41.2 (SD ±11.8) years and mean surfing exposure of 26.9 (SD ±15.0) hours/month. Controls were divided into two groups, according to their main physical activity: weight-bearing/high intensity (WBHI) and non-weight-bearing/low intensity (NWBLI). When compared to NWBLI controls, surfers had higher LS BMD (MD +0.064; 95% CI 0.002–0.126; p=0.041) and higher T-score (MD +0.40; 95% CI 0.01–0.80; p=0.042); however, surfers had a lower T-score than the WBHI group (MD −0.52; 95% CI −0.02 to −1.0; p=0.039). No other differences were found between groups. Conclusion: The findings of this study support our hypothesis that regular surfing may be an effective physical activity for middle-aged and older men to decrease bone deterioration related to aging, as we identified positive results for surfers in relation to primary outcomes.Full Tex

The Retirement Expectations of Middle-Aged Individuals

We use the first three waves of the Household Income and Labour Dynamics in Australia (HILDA) Survey to examine the retirement plans of middle-aged workers (aged 45-55). Our results indicate that approximately two-thirds of men and more then half of women appear to be making standard retirement plans. At the same time, more than one in five individuals seem to have delayed their retirement planning and approximately one in ten either do not know when they expect to retire or expect to never retire. Retirement plans are closely related to current labor market position. Specifically, forming expectations about the age at which one will leave the labor market appears to be easier for workers in jobs with well defined pension benefits and standard retirement ages. Moreover, those who report that they do not know when they expect to retire do in fact appear to face greater uncertainty in their retirement planning. Those who anticipate working forever seem to do so out of concerns about the adequacy of their retirement incomes rather than out of increased job satisfaction or a heightened desire to remain employed. Finally, men alter their retirement plans in response to labor market shocks, while women are more sensitive to their own and their partners’ health changes.retirement, expectations, middle-aged workers

Trends and correlates of marijuana use among late middle-aged and older adults in the United States, 2002–2014

BACKGROUND: Recent trend studies suggest that marijuana use is on the rise among the general population of adults ages 18 and older in the United States. However, little is known about the trends in marijuana use and marijuana-specific risk/protective factors among American adults during the latter part of adulthood. METHOD: Findings are based on repeated, cross-sectional data collected from late middle-aged (ages 50–64) and older adults (ages 65 and older) surveyed as part of the National Survey on Drug Use and Health between 2002 and 2014. RESULTS: The prevalence of past-year marijuana use among late middle-aged adults increased significantly from a low of 2.95% in 2003 to a high of 9.08% in 2014. Similarly, the prevalence of marijuana use increased significantly among older adults from a low of 0.15% in 2003 to a high of 2.04% in 2014. Notably, the upward trends in marijuana use remained significant even when accounting for sociodemographic, substance use, behavioral, and health-related factors. We also found that decreases in marijuana-specific protective factors were associated with the observed trend changes in marijuana use among late middle-aged and older adults, and observed a weakening of the association between late-middle aged marijuana use and risk propensity, other illicit drug use, and criminal justice system involvement over the course of the study. CONCLUSIONS: Findings from the present study provide robust evidence indicating that marijuana use among older Americans has increased markedly in recent years, with the most evident changes observed between 2008 and 2014

Combined In Silico, In Vivo, and In Vitro Studies Shed Insights into the Acute Inflammatory Response in Middle-Aged Mice

We combined in silico, in vivo, and in vitro studies to gain insights into age-dependent changes in acute inflammation in response to bacterial endotoxin (LPS). Time-course cytokine, chemokine, and NO2-/NO3- data from "middle-aged" (6-8 months old) C57BL/6 mice were used to re-parameterize a mechanistic mathematical model of acute inflammation originally calibrated for "young" (2-3 months old) mice. These studies suggested that macrophages from middle-aged mice are more susceptible to cell death, as well as producing higher levels of pro-inflammatory cytokines, vs. macrophages from young mice. In support of the in silico-derived hypotheses, resident peritoneal cells from endotoxemic middle-aged mice exhibited reduced viability and produced elevated levels of TNF-α, IL-6, IL-10, and KC/CXCL1 as compared to cells from young mice. Our studies demonstrate the utility of a combined in silico, in vivo, and in vitro approach to the study of acute inflammation in shock states, and suggest hypotheses with regard to the changes in the cytokine milieu that accompany aging. © 2013 Namas et al

Adaptive female choice for middle-aged mates in a lekking sandfly

Most theoretical models of age-related mate choice predict that females should prefer older males because they have proven survival ability. An alternative view is that older males represent inferior mates because of negative genetic correlations between early and late fitness components, or because older males have traded off longevity against other fitness components, have accumulated deleterious germ-line mutations, or are less well adapted to current conditions than more recently born individuals. While numerous studies have reported female choice for older males, few have explicitly examined the fitness consequences of such a preference. We present evidence from a lekking sandfly, Lutzomyia longipalpis , showing that choosy females discriminate against older males and gain a fitness benefit from their choice. When permitted free choice from an aggregation consisting of males aged zero to two days (young), four to six days (middle-aged) and eight to ten days (old), females preferentially mated with middle-aged males, but all measures of female reproductive success were independent of male age. In contrast, when a second set of females was randomly assigned single virgin males of known age, the eggs of those paired to old mates exhibited lower hatching success than the eggs of females mated to young or middle-aged males. These results suggest that females avoid mating with older males because they represent poorer quality mates. Age-related differences in male quality may have a genetic basis, but could equally well arise through a phenotypic decline in sperm quality or sperm transfer ability with male age. The lack of evidence of female discrimination against older males from other studies may be because these did not explore the reproductive success of the full age range of males