Miracle-dz/UniFAR-FTUs huggingface dataset:
Intraindividual variability in basic reaction time predicts middle-aged and older pilots' flight simulator performance.

OBJECTIVES Intraindividual variability (IIV) is negatively associated with cognitive test performance and is positively associated with age and some neurological disorders. We aimed to extend these findings to a real-world task, flight simulator performance. We hypothesized that IIV predicts poorer initial flight performance and increased rate of decline in performance among middle-aged and older pilots. METHOD Two-hundred and thirty-six pilots (40-69 years) completed annual assessments comprising a cognitive battery and two 75-min simulated flights in a flight simulator. Basic and complex IIV composite variables were created from measures of basic reaction time and shifting and divided attention tasks. Flight simulator performance was characterized by an overall summary score and scores on communication, emergencies, approach, and traffic avoidance components. RESULTS Although basic IIV did not predict rate of decline in flight performance, it had a negative association with initial performance for most flight measures. After taking into account processing speed, basic IIV explained an additional 8%-12% of the negative age effect on initial flight performance. DISCUSSION IIV plays an important role in real-world tasks and is another aspect of cognition that underlies age-related differences in cognitive performance.
Effect of Systematic Intensive Care Unit Triage on Long-term Mortality Among Critically Ill Elderly Patients in France: A Randomized Clinical Trial

Importance The high mortality rate in critically ill elderly patients has led to questioning of the beneficial effect of intensive care unit (ICU) admission and to a variable ICU use among this population. Objective To determine whether a recommendation for systematic ICU admission in critically ill elderly patients reduces 6-month mortality compared with usual practice. Design, Setting, and Participants Multicenter, cluster-randomized clinical trial of 3037 critically ill patients aged 75 years or older, free of cancer, with preserved functional status (Index of Independence in Activities of Daily Living ≥4) and nutritional status (absence of cachexia) who arrived at the emergency department of one of 24 hospitals in France between January 2012 and April 2015 and were followed up until November 2015. Interventions Centers were randomly assigned either to use a program to promote systematic ICU admission of patients (n=1519 participants) or to follow standard practice (n=1518 participants). Main Outcomes and Measures The primary outcome was death at 6 months. Secondary outcomes included ICU admission rate, in-hospital death, functional status, and quality of life (12-Item Short Form Health Survey, ranging from 0 to 100, with higher score representing better self-reported health) at 6 months. Results One patient withdrew consent, leaving 3036 patients included in the trial (median age, 85 [interquartile range, 81-89] years; 1361 [45%] men). Patients in the systematic strategy group had an increased risk of death at 6 months (45% vs 39%; relative risk [RR], 1.16; 95% CI, 1.07-1.26) despite an increased ICU admission rate (61% vs 34%; RR, 1.80; 95% CI, 1.66-1.95). After adjustments for baseline characteristics, patients in the systematic strategy group were more likely to be admitted to an ICU (RR, 1.68; 95% CI, 1.54-1.82) and had a higher risk of in-hospital death (RR, 1.18; 95% CI, 1.03-1.33) but had no significant increase in risk of death at 6 months (RR, 1.05; 95% CI, 0.96-1.14). Functional status and physical quality of life at 6 months were not significantly different between groups. Conclusions and Relevance Among critically ill elderly patients in France, a program to promote systematic ICU admission increased ICU use but did not reduce 6-month mortality. Additional research is needed to understand the decision to admit elderly patients to the ICU. Trial Registration clinicaltrials.gov Identifier: NCT01508819
A qualitative study: student mothers' perceptions of homogeneous and heterogeneous advisory groupings in secondary settings

v List of Tables xvi Chapter I: Introduction 1 Academic Grouping 2 History 2 Heterogeneous Grouping 3 Academic Implications 3 Homogeneous Grouping 4 Academic Implications 5 Social Implications 5 Heterogeneous Social Implications 6 Homogeneous Social Implications 6 Non-Academic Grouping 7 History 7 Advisory Programs 8 Structure 9 Grouping 9 Homogeneous Advisory Groups for Student Mothers 10 Purpose of the Study 10 Research Questions 11 Significance of the Study 12 Research 12
Cognitive impairment among prostate cancer patients: An overview of reviews

&NA; To identify and clarify definitions and methods of measuring cancer‐related cognitive impairment among prostate cancer patients treated with androgen deprivation therapy (ADT) and to assess the incidence and prevalence of cognitive impairment. A systematic review of Medline, EMBASE, PubMed, PsycINFO and CINAHL up to December 2015 was undertaken to identify English‐language reviews. A total of 28 reviews were identified describing 20 primary studies. There were no studies of incidence. Reported prevalence rates varied between 10% and 69%. Cognitive domains impaired by ADT included: verbal memory, visuospatial ability and executive functions. Cognitive impairment was infrequently defined and four definitions were reported. A variety of measures and methods were used to assess cognitive function including neuropsychological tests, self‐report measures and clinical assessments. The finding that, often, one measure was used to assess more than one aspect of cognition is likely to have contributed to imprecise estimates. There is a need to agree a definition of cognitive impairment in the clinical epidemiology of cancer and to standardise the selection of measures in order to aid accurate assessment and fair comparisons across studies regarding the prevalence of cognitive impairment among prostate cancer patients.
Verletzungsmuster und Verletzungsschwere bei Fahrradunfällen im Großraum Göttingen

Background. Injuries and risks regarding the complete bicycle traffic are inadequately analyzed so far. The goal was to detect potential hazards and to generate strategies of prevention.Patients and methods. All patients treated in the emergency department from bicycle related injuries between 07/2007 and 06/2008. Medical records were analyzed retrospective. Afterwards patients were asked to answer a standardized questionnaire.Results. 717 Patients were counted, 60% male and 40% female. 67% of the injuries were lacerations and contusions. The head was the most injured location (37%). The most severe injuries were cerebral bleedings and hematomas (1,3%). 91% were slightly injured persons and the mean injury severity was ISS=3,47. 74% of the patients were treated ambulant. Risk factors for severe injuries were age above 35-years, accident with a motorized vehicle and commuting accidents. Helmets were able to reduce head injuries significant and to avoid severe head injuries. 25% of the bicycle riders wore a helmet.Conclusion. The injury severity is classified as low. Nevertheless road safety and traffic-education still needs to be improved. A mandatory wearing of helmets is to advice.
Assessment of neighborhood context in a nationally representative study.

OBJECTIVES This paper introduces new measures of neighborhood context that are included in the second wave of the National Social Life, Health, and Aging Project (NSHAP). We describe the use of field interviewer ratings of respondents' neighborhood conditions, as well as the adaptation of existing measures for the assessment of neighborhood social context among urban and nonurban older adults. METHOD We construct scales of neighborhood problems, neighborhood social cohesion, neighborhood social ties, and perceived neighborhood danger, and assess their reliability and validity. We then calculate descriptive statistics for measures of neighborhood context across respondent age, gender, and racial/ethnic background, and across low-, moderate-, and high-density residential blocks. RESULTS We find that older women report greater neighborhood cohesion and more neighborhood ties than older men, but women also perceive more neighborhood danger. Black and Hispanic older adults reside in neighborhoods with more problems, lower cohesion, fewer social ties, and greater perceived danger. Neighborhood characteristics also vary across residential densities. Neighborhood problems and perceived danger increase with block-level density, but neighborhood social cohesion and social ties were lowest among residents of moderate-density blocks. DISCUSSION The inclusion of neighborhood context measures in the second wave of NSHAP provides a unique opportunity to explore associations among neighborhood context, social connectedness, and indicators of health and function among older adults. We discuss limitations of the measures and provide recommendations for their use.
Older adults receiving assistance with physician visits and prescribed medications and their family caregivers: prevalence, characteristics, and hours of care.

OBJECTIVES To profile older adults receiving assistance with physician visits and prescribed medications and the time demands associated with their care. METHODS Observational study of 7,197 community-dwelling adults ages 65+ responding to the 2011 National Health and Aging Trends Study. RESULTS More than one third of older adults receive assistance with either physician visits or prescribed medications (26.3%), or both (9.9%). The 3.3 million older adults who receive assistance with both physician visits and prescribed medications are a high-need subgroup: 3 in 5 have possible (16.5%) or probable (46.1%) dementia and three quarters (76.6%) receive help with mobility, self-care, or household activities. These 3.3 million older adults receive more than twice as many weekly hours of help with all activities (60.5 hr) as those receiving help with either physician visits or prescribed medications (26.5 hr), or neither (18.6 hr). Older adults receiving help with both physician visits and prescribed medications are assisted by 7.2 million helpers, most often adult children (46.6%), or spouses (23.6%). The 3.1 million helpers who assist with both physician visits and prescribed medications provide an average of 45.4 hr of help per week; nearly two thirds (64.3%) also assist with mobility or self-care. DISCUSSION Older adults receiving help with both physician visits and prescribed medications typically have high health and functioning needs that involve significant time demands for caregivers.
The Baltimore Experience Corps Trial: Enhancing Generativity via Intergenerational Activity Engagement in Later Life.

OBJECTIVES Being and feeling generative, defined as exhibiting concern and behavior to benefit others, is an important developmental goal of midlife and beyond. Although a growing body of evidence suggests mental and physical health benefits of feeling generative in later life, little information exists as to the modifiability of generativity perceptions. The present study examines whether participation in the intergenerational civic engagement program, Experience Corps (EC), benefits older adults' self-perceptions of generativity. METHOD Levels of generativity were compared in older adults randomized to serve as EC volunteers or controls (usual volunteer opportunities) in the Baltimore Experience Corps Trial at 4-, 12-, and 24-month evaluation points over the 2-year trial. Analyses utilized intention-to-treat and complier average causal effects (CACE) analyses which incorporate degree of intervention exposure in analytic models. RESULTS Participants randomized to the EC group had significantly higher levels of generative desire and perceptions of generative achievement than controls at each follow-up point; CACE analyses indicate a dose-response effect with a greater magnitude of intervention effect with greater exposure to the EC program. DISCUSSION Results provide the first-ever, large-scale experimental demonstration that participation in an intergenerational civic engagement program can positively alter self-perceptions of generativity in older adulthood.
Childhood Conditions and Multimorbidity Among Older Adults.

OBJECTIVES This research tests whether childhood conditions are associated with trajectories of chronic conditions among older adults. METHODS Using data from the Health and Retirement Study (1992-2008), a series of hierarchical linear models are used to estimate number of chronic conditions at survey midpoint and the rate of increase in chronic conditions across 18 years of data. RESULTS Results suggest that lower childhood socioeconomic status (SES) and poor childhood health are associated with increased number of chronic conditions; however, childhood SES is no longer associated with chronic conditions after adjustment for adult SES and adult health. Poor childhood health continues to be associated with total number of chronic conditions after adjustment for adult SES and health. Rate of change in chronic conditions was not associated with childhood conditions. Results from a multinomial logistic regression model further indicated that the association between childhood conditions and adult multimorbidity increased at higher levels of multimorbidity. DISCUSSION This research adds to the evidence that early life conditions have a lasting influence on adult health, and that their influence may be independent of adult health and SES.
Unequal Inequalities: The Stratification of the Use of Formal Care Among Older Europeans

Objectives The general aim of the article is to incorporate the stratification perspective into the study of (long-term) care systems. In particular, 3 issues are investigated: the extents to which (a) personal and family resources influence the likelihood of using formal care in later life; (b) the unequal access to formal care is mediated by differences in the availability of informal support; (c) the relationship between individuals' resources and the use of formal care in old age varies across care regimes and is related to the institutional design of long-term care policies. Method Data from Waves 1 and 2 of the Survey of Health, Ageing and Retirement in Europe for 4 countries: Denmark, Germany, France, and Italy, and population aged at least 65 (N = 9,824) were used. Population-averaged logit models were used. Results Logit models revealed that in terms of access to formal care: an individual's educational level plays a limited role; family networks function similarly across the countries studied; in general, financial wealth does not have a significant effect; there is a positive relation between income and the use of formal care in Germany and Italy, and no significant relation in France and Denmark; home ownership has a negative effect in Germany and Denmark. On accounting for informal care, inequality associated with individuals' economic resources remains substantially unaltered. Discussion The study shows that care systems based on services provision grant higher access to formal care and create lower inequalities. Moreover, countries where cash-for-care programs and family responsibilities are more important register inequalities in the use of formal care. Access to informal care does not mediate the distribution of formal care.
Associations Among Individuals’ Perceptions of Future Time, Individual Resources, and Subjective Well-Being in Old Age

Objectives Perceptions of future time are of key interest to aging research because of their implications for subjective well-being. Interestingly, perceptions about future time are only moderately associated with age when looking at the second half of life, pointing to a vast heterogeneity in future time perceptions among older adults. We examine associations between future time perceptions, age, and subjective well-being across two studies, including moderations by individual resources. Method Using data from the Berlin Aging Study (N = 516; Mage = 85 years), we link one operationalization (subjective nearness to death) and age to subjective well-being. Using Health and Retirement Study data (N = 2,596; Mage = 77 years), we examine associations of another future time perception indicator (subjective future life expectancy) and age with subjective well-being. Results Consistent across studies, perceptions of limited time left were associated with poorer subjective well-being (lower life satisfaction and positive affect; more negative affect and depressive symptoms). Importantly, individual resources moderated future time perception-subjective well-being associations with those of better health exhibiting reduced future time perception-subjective well-being associations. Discussion We discuss our findings in the context of the Model of Strength and Vulnerability Integration.
Using a Smartphone-Based Ecological Momentary Assessment Protocol With Community Dwelling Older African Americans

Objectives Little is known about the feasibility of smartphone-based Ecological Momentary Assessment (EMA) approaches to collect psychosocial data from older populations, especially disadvantaged older populations. In response to this gap, this report provides evidence of the feasibility and utility of a smartphone-based EMA approach for real-time assessment with older African Americans. In addition, we share lessons learned about how to improve utility. Methods Ninety-seven older African Americans ages 55 and older (range: 55-95 years) used an Android smartphone loaded with an EMA application to provide data about their everyday activities and stress four times per day for seven consecutive days. Results Exit interviews early in the study suggested enhancements to the EMA interface. Adherence was demonstrated with response completion rates of 92-98% on EMA measures and no participant attrition based on the EMA protocol. Discussion Our findings suggest using a smartphone-based EMA approach for data collection is feasible and has utility with older African Americans. We most likely enhanced adherence by testing, training, monitoring, and adapting the EMA protocol using input from older adults early in the EMA design process.
The DASH Diet, 20 Years Later.

This year marks the 20th anniversary of the publication showing the blood pressure–lowering effects of the Dietary Approaches to Stop Hypertension (DASH) diet.1 The DASH diet is considered an important advance in nutritional science. It emphasizes foods rich in protein, fiber, potassium, magnesium, and calcium, such as fruits and vegetables, beans, nuts, whole grains, and low-fat dairy. It also limits foods high in saturated fat and sugar.1 DASH is not a reduced-sodium diet, but its effect is enhanced by also lowering sodium intake.1 Since the creation of DASH 20 years ago, numerous trials have demonstrated that it consistently lowers blood pressure across a diverse range of patients with hypertension and prehypertension.
Partial Mapping of the IL-10 Promoter Region: Identification of New SNPs and Association with Tuberculosis Outcome in Brazilians

L.B. Spinasse1, M.Q. P. Lopes1, A.B. Miranda2, R.L. F. Teixeira1, F.C. Q. Mello3, J.R. Lapa e Silva4, P.N. Suffys1 and A.R. Santos1 1Laboratory of Molecular Biology Applied to Mycobacteria, Oswaldo Cruz Institute, Fiocruz, Rio de Janeiro 2Laboratory of computational Biology and Systems, Oswaldo Cruz Institute, Fiocruz, Rio de Janeiro 3Medical School – Academic TB Program, Hospital Complex HUCFF-IDT, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro 4Multidisciplinar Research Laboratory, Hospital Complex HUCFF-IDT, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro Brazil
Effect of Locking Plate Fixation vs Intramedullary Nail Fixation on 6-Month Disability Among Adults With Displaced Fracture of the Distal Tibia: The UK FixDT Randomized Clinical Trial

Importance The best treatment for fractures of the distal tibia remains controversial. Most such fractures require surgical fixation but outcomes are unpredictable and complications are common. Objective To assess disability, quality of life, and complications in patients with displaced tibial fracture treated with intramedullary nail fixation vs locking plate fixation. Design, Setting, and Participants A multicenter randomized trial recruiting 321 patients 16 years or older with an acute, displaced, extra-articular fracture of the distal tibia from April 2013 through April 2016 with final follow-up in February 2017. Exclusion criteria included open fractures, fractures involving the ankle joint, contraindication to nailing, or inability to complete questionnaires. Interventions Intramedullary nail fixation (nail group; n = 161), a metal rod inserted into the hollow center of the tibia, vs locking plate fixation (plate group; n = 160), a plate attached to the surface of the tibia with fixed-angle screws. Main Outcomes and Measures Disability Rating Index (DRI; score range, 0 [no disability] to 100 [complete disability]) at 6 months was the primary outcome measure, with a minimal clinically important difference of 8 points. DRI measurement was also collected at 3 and 12 months. Secondary outcomes were the Olerud-Molander Ankle Score (OMAS), quality of life, and complications (such as infection and further surgery). Results Among 321 randomized patients (mean age, 45 years [SD, 16.2]; men, 197 [61%]; had experienced traumatic injury after a fall, 223 [69%]), 258 completed the study. There was no statistically significant difference in the DRI score at 6 months between groups (mean score, 29.8 in the nail group vs 33.8 in the plate group; adjusted difference, 4.0 [95% CI, −1.0 to 9.0], P = .11). There was a statistically significant difference in the DRI score at 3 months in favor of nail fixation (mean score, 44.2 in the nail group and 52.6 in the plate group; adjusted difference, 8.8 [95% CI, 4.3 to 13.2], P < .001), but not at 12 months (mean score, 23.1 in the nail group and 24.0 in the plate group; adjusted difference, 1.9 [95% CI, −3.2 to 6.9], P = .47). Secondary outcomes showed the same pattern, including a statistically significant difference in mean OMAS at 3 and 6 months in favor of nail fixation. There were no statistically significant differences in complications, including the number of postoperative infections (9% in the nail group vs 13% in the plate group). Further surgery was more common in the plate group at 12 months (8% in nail group vs 12% in plate group). Conclusions and Relevance Among patients 16 years or older with an acute, displaced, extra-articular fracture of the distal tibia, neither nail fixation nor locking plate fixation resulted in superior disability status at 6 months. Other factors may need to be considered in deciding the optimal approach. Trial Registration clinicaltrials.gov Identifier: ISRCTN99771224