Adult Age Categories Research Articles

Karakteristik profil pasien urtikaria akut di poliklinik kulit dan kelamin Rumah Sakit Umum Pusat (RSUP) Sanglah periode Oktober 2017- 2018

Background: Acute urticaria is a skin disorder that is often encountered that can cause redness to respiratory obstruction so that emergency emergencies and urticaria lesions that last more than 72 hours are indicative of hospitalized patients. This study aims to describe the characteristics of acute urticaria at Dermato-Venerology Polyclinic, Sanglah General Hospital during October 2017-2018 period.Methods: A cross-sectional study was conducted using secondary data from medical records of patients with urticaria in Sanglah General Hospital in the October 2017-2018 period. Data retrieval was taken by the Total Sampling method. Distribution of research variables namely, gender, age, genetic, causative factors, were collected. Data analysis is described in the form of tables and narratives using SPSS version 20 for Windows.Results: The results showed that there were 23 acute urticaria patients in this study, the age of the most research samples was in the Adult age category with a large percentage of 60.87%, the most gender-based study sample was female gender with a percentage of 78.3%, research genetic samples most of them are in the absence of genetics, with a percentage of 91.3%, the work of most research samples in housewives with a percentage of 34.8%, the most common cause of acute urticaria is in food allergies with a percentage of 56.5%.Conclusion: The incidence of acute urticaria is most common in adulthood, female sex, housewives, and food allergies.

Associations between physical health conditions and posttraumatic stress disorder according to age

Objectives Posttraumatic stress disorder (PTSD) is associated with various physical health conditions. However, it is unclear whether the relationship between PTSD and physical health conditions differs according to age. This study aims to examine the associations between PTSD and physical health conditions across four adult age categories. Methods We analyzed data from the 2012 to 2013 National Epidemiologic Survey on Alcohol and Related Conditions (N = 36,309). The Alcohol Use Disorder and Associated Disabilities Interview Schedule-5 assessed past-year DSM-5 PTSD. Multiple regression analyses examined associations between PTSD (reference = no PTSD) with number and type of physical health conditions in each age category (18–34: “younger adults,” 35–49: “middle-aged adults,” 50–64: “young-old adults,” 65+: “older adults”). Results The prevalence of nearly all physical health conditions increased according to age, whereas the prevalence of PTSD tended to decrease with age. After adjustment, PTSD was associated with a greater number of physical health conditions among all age categories (b range: 0.62–1.29). Regardless of age category, PTSD was associated with increased odds of cardiovascular and musculoskeletal conditions (AOR range: 1.54–2.34). PTSD was also associated with increased odds of gastrointestinal, hepatobiliary, endocrine/metabolic, respiratory, neurologic conditions, cancer, sleep disorders, and anemia among select age categories (AOR range: 1.70–3.31). For most physical health conditions, the largest effect sizes emerged for younger and middle-aged adults. Conclusions PTSD is associated with many physical health conditions across the age spectrum, particularly among younger and middle-aged adults. Results may inform targeted screening and intervention strategies to mitigate risk of physical health conditions among adults with PTSD.

Encounter with Bullying in Sport and Its Consequences for Youth: Amateur Athletes' Approach.

In recent years, the problem of bullying, existing in sport and arising in athletes’ relationships, is increasingly emphasized. The aim of this research was to reveal the specificity of bullying in athletes’ interrelationships by elaborating on causes of its emergence, nature of actions, and its consequences. To achieve the research aim, a qualitative research paradigm was chosen. The theoretical part of the research was prepared by applying the methods of scientific literature analysis and analogy. The empirical study involved seven organized sports athletes representing individual, duel, and team sports branches, belonging to the young adult age category. The survey was conducted using the semi-structured interview method. Data were analyzed employing the conceptual content analysis. Emic and etic perspectives were used for data processing. Research results revealed that the specificity of manifestation of bullying in sport unfolded through three generalized categories: intolerable perception of behavior, nature of bullying, and bipolarity of consequences. Every category was detailed by sub-categories, highlighting the nature, causes, and consequences of bullying accepted by athletes in the contexts of their emotional state and career. We found that the factors falling into these categories were interrelated and supplemented each other; therefore, they should be analyzed in a complex way, as bullying is determined not by some single factor but by the totality of them, functioning as a kind of well-established flawed tradition supported by the cultures of the sports organization and the sport.

Phase II Study of the Hyper-CVAD Regimen in Combination with Ofatumumab (HCVAD-O) As Frontline Therapy for Adult Patients (pts) with CD20-Positive B-Cell Acute Lymphoblastic Leukemia (B-ALL)

Phase II Study of the Hyper-CVAD Regimen in Combination with Ofatumumab (HCVAD-O) As Frontline Therapy for Adult Patients (pts) with CD20-Positive B-Cell Acute Lymphoblastic Leukemia (B-ALL)

The Impact of Varicella Vaccination on the Incidence of Varicella and Herpes Zoster in the United States: Updated Evidence From Observational Databases, 1991-2016.

Universal childhood vaccination against varicella began in the United States as a 1-dose schedule in 1996, changing to a 2-dose schedule in 2006. The exogenous boosting hypothesis, which postulates that reexposure to circulating wild-type varicella delays the onset of herpes zoster, predicts a transient increase in the incidence of herpes zoster, peaking in adults 15-35 years after the start of varicella vaccination. This was a retrospective study of administrative claims data from the MarketScan Commercial and Medicare databases between 1991-2016. Outcome measures were the incidences of herpes zoster per 100 000 person-years, by calendar year and age category, and the annual rates of change in herpes zoster by age category, in an interrupted time series regression analysis, for the periods of 1991-1995 (prevaccine), 1996-2006 (1-dose vaccination period), and 2007-2016 (2-dose vaccination period). The annual incidences of herpes zoster increased throughout the period of 1991-2012 in all adult age categories, with a plateau in 2013-2016 that was most evident in the ≥65 age group. In 1991-1995, the herpes zoster incidences increased at annual rates of 4-6% in age categories 18-34, 35-44, 45-54, and 55-64 years. In the same age categories during 1996-2006 and 2007-2016, the herpes zoster incidences increased at annual rates of 1-5%. Although the annual incidence of herpes zoster in adults has continued to increase, the rates of change decreased during both the 1- and 2-dose vaccination periods. The hypothesized increase in herpes zoster predicted from modelling of the exogenous boosting hypothesis was not observed.

Mortality Patterns of Toxoplasmosis and Its Comorbidities in Tanzania: A 10-Year Retrospective Hospital-Based Survey.

Introduction: Toxoplasmosis is a parasitic zoonosis and an important cause of abortions, mental retardation, encephalitis, blindness, and death worldwide. Few studies have quantified toxoplasmosis mortality and associated medical conditions in Sub-Saharan Africa. This retrospective hospital-based study aimed to determine the mortality patterns of toxoplasmosis and its comorbidities among in-patients in Tanzania.Methods: Data on causes of death were collected using customized paper-based collection tools. Sources of data included death registers, inpatient registers, and International Classification of Diseases report forms. All death events from January 2006 to December 2015 were collected. Data used in this study is a subset of deaths where the underlying cause of death was toxoplasmosis. Data was analyzed by STATA programme version 13.Results: Thirty-seven public hospitals were involved in the study. A total of 188 deaths due to toxoplasmosis were reported during the 10-years period. Toxoplasmosis deaths accounted for 0.08% (188/247,976) of the total deaths recorded. The age-standardized mortality rate per 100,000 population increased from 0.11 in 2006 to 0.79 in 2015. Most deaths due to toxoplasmosis affected the adult age category. Of the 188 deaths, males accounted for 51.1% while females for 48.9% of the deaths. Dar es Salaam, Mbeya, Pwani, Tanga, and Mwanza contributed to over half (59.05%) of all deaths due to Toxoplasmosis. Of the total deaths due to toxoplasmosis, 70.7% were associated with other medical conditions; which included HIV/AIDS (52.6%), HIV/AIDS+Cryptococcal meningitis (18.8%) and HIV+Pneumocystis pneumonia (6.8%).Conclusion: The age-standardized mortality rate due to toxoplasmosis has been increasing substantially between 2006 and 2015. Most deaths due to toxoplasmosis affected the adult age category and were highly associated with HIV/AIDS. Appropriate interventions are needed to alleviate the burden of toxoplasmosis in Tanzania.

Perspective: Should Vitamin E Recommendations for Older Adults Be Increased?

Current vitamin E requirements are uniformly applied across the population for those >14 y of age. However, aging is associated with alterations in cellular and physiologic functions, which are affected by vitamin E. Therefore, it is questionable whether vitamin E requirements can be uniformly applied to all adult age categories. With aging, there is dysregulation of the immune system in which there are decreased cell-mediated and pathogen defense responses coupled with an overactive, prolonged inflammatory state. Both animal and human studies in the aged suggest that intake above currently recommended levels of vitamin E may improve immune and inflammatory responses and be associated with a reduced risk of infectious disease. We review the evidence that was considered in establishing the current requirements for vitamin E and highlight data that should be considered in determining the vitamin E requirements in older adults, particularly focusing on the evidence suggesting a benefit of increased vitamin E intake on immune function and inflammatory processes and resistance to infection. The main objective of this Perspective is to initiate the discussion of whether the current Dietary Reference Intake for vitamin E should be increased for the older population. We make this suggestion on the basis of mechanistic studies showing biological plausibility, correction of a major cellular dysfunction in older adults, and strong evidence from several animal and a few human studies indicating a reduction in risk and morbidity from infections.

Cementochronology: A solution to assess mortality profiles from individual age-at-death estimates

ObjectivesBecause of methodological biases and statistical issues, individual age estimation has been considered too imprecise in reconstructing valid palaeodemographic mortality profiles. Recently, the standardized procedure of cementochronology (the tooth cementum annulations method) has reduced technical biases, thus increasing the accuracy of age estimates. This study aims to test the reliability of cementochronology in estimating the age distribution of an archaeological sample to then build the corresponding abridged life table to assess demographic parameters of the living population. Materials and methodsBy combining cementochronology with probability density analysis, we assessed the cumulative probabilistic age-at-death distribution of 109 adults buried between the 16th and 18th centuries in Notre-Dame-du-Bourg Cathedral (France). We compared biological results to the age-at-death structure of the 1382 adults buried in the cathedral, calculated with historical sources from local death registers, and to a model life table specifically established for preindustrial populations. ResultsCementochronology is reliable for estimating the mortality profile of young and middle adult age categories but underestimates older age categories. DiscussionTaphonomy mainly explains the underestimation in elderly individuals. Although some issues remain to be addressedin order to properly implement the method and improve reliability, cementochronology makes a major contribution to palaeodemography, as it provides relatively reliable mortality profiles with a precision never attained before, thus offering new prospects for studying the mortality of past populations.

Age Differences in Daily and Nondaily Cannabis Use in the United States, 2002-2014.

Adult cannabis use has increased in the United States since 2002, particularly after 2007, contrasting with stable/declining trends among youth. We investigated whether specific age groups disproportionately contributed to changes in daily and nondaily cannabis use trends. Participants ages 12 and older (N = 722,653) from the 2002-2014 National Survey on Drug Use and Health reported past-year cannabis use frequency (i.e., daily = ≥300 days/year; nondaily = 1-299 days/year; none). Multinomial logistic regression was used to model change in past-year daily and nondaily cannabis use prevalence by age group (i.e., 12-17, 18-25, 26-34, 35-49, 50-64, ≥65), before and after 2007. Multinomial logistic regressions estimated change in relative odds of cannabis use frequency over time by age, adjusting for other sociodemographics. Daily cannabis use prevalence decreased in ages 12-17 before 2007 and increased significantly across adult age categories only after 2007. Increases did not differ significantly across adult ages 18-64 and ranged between 1 and 2 percentage points. Nondaily cannabis use decreased among respondents ages 12-25 and 35-49 before 2007 and increased across adult age categories after 2007, particularly among adults 26-34 (i.e., 4.5 percentage points). Adjusted odds of daily versus nondaily cannabis use increased after 2007 for ages 12-64. Increases in daily and nondaily cannabis use prevalence after 2007 were specific to adult age groups in the context of increasingly permissive cannabis legislation, attitudes, and lower risk perception. Although any cannabis use may be decreasing among teens, relative odds of more frequent use among users increased in ages 12-64 since 2007. Studies should assess not only any cannabis use, but also frequency of use, to target prevention efforts of adverse effects of cannabis that are especially likely among frequent users.

Trend and causes of adult mortality in Kersa health and demographic surveillance system (Kersa HDSS), eastern Ethiopia: verbal autopsy method

BackgroundThe health problems of adults have been neglected in many developing countries, yet many studies in these countries show high rates of premature mortality in adults. Measuring adult mortality and its cause through verbal autopsy (VA) methods is becoming an important process for mortality estimates and is a good indicator of the overall mortality rates in resource-limited settings. The objective of this analysis is to describe the levels, distribution, and trends of adult mortality over time (2008-2013) and causes of adult deaths using VA in Kersa Health and Demographic Surveillance System (Kersa HDSS).MethodsKersa HDSS is a demographic and health surveillance and research center established in 2007 in the eastern part of Ethiopia. This is a community-based longitudinal study where VA methods were used to assign probable cause of death. Two or three physicians independently assigned cause of death based on the completed VA forms in accordance with the World Health Organization’s International Classification of Diseases. In this analysis, the VA data considered were of all deaths of adults age 15 years and above, over a period of six years (2008–2013). The mortality fractions were determined and the causes of death analyzed. Analysis was done using STATA and graphs were designed using Microsoft Excel.ResultsA total of 1535 adult deaths occurred in the surveillance site during the study period and VA was completed for all these deaths. In general, the adult mortality rate over the six-year period was 8.5 per 1000 adult population, higher for males (9.6) and rural residents (8.6) than females (7.5) and urban residents (8.2). There is a general decrease in the mortality rates over the study period from 9.4 in 2008–2009 to 8.1 in 2012–2013. Out of the total deaths, about one-third (32.4%) occurred due to infectious and parasitic causes, and the second leading cause of death was diseases of circulatory system (11.4%), followed by gastrointestinal disorders (9.2%). Tuberculosis (TB) showed an increasing trend over the years and has been the leading cause of death in 2012 and 2013 for all adult age categories (15–49, 50–64, and 65 years and over). Chronic liver disease (CLD) was indicated as leading cause of death among adults in the age group 15–49 years.ConclusionThe increasing TB-related mortality in the study years as well as the relative high mortality due to CLD among adults of age 15–49 years should be further investigated and triangulated with health service data to understand the root cause of death.

Indexing adult obesity by waist-to-height and weight-to-height ratios

To date a vast evidence exists that the waist circumference to height ratio (WCHR) provides a better measure of obesity comparing to the body mass index (BMI). While weight and height are routinely obtained to calculate BMI, waist circumference, despite easily acquired, is often overlooked because the screening protocols, particularly for diabetes, demand BMI. This creates an obstacle for application of WCHR - a more definite measure than BMI for diagnostic of many linked to obesity metabolic disorders such as diabetes, cardiovascular disease and hypertension. This article is intended to fill the gap in the literature by providing a conversion from BMI to WCHR for five adult age categories. A strong linearity between the measures is demonstrated and equivalent to BMI WCHR thresholds are provided to identify normality, overweight as well as obesity and other points. The analysis is based on the data from NHANES. Different forms of BMI are also discussed and a strong linearity between them is demonstrated. An obesity index based on simple weight to height ratio to match the standard levels is proposed. The equivalence between the proposed and existing obesity indices is tested on the original data with promising results.

Serological Investigation of Peste Des Petits Ruminants in East Shewa and Arsi Zones, Oromia Region, Ethiopia.

Peste des petits ruminant (PPR) is an economically important disease of small ruminants with a rapidly expanding geographical distribution. There are fragmented reports to the occurrence and distribution of the disease in Ethiopia. A total of 700 serum samples were collected from goats and sheep to detect the presence of antibody against PPR virus using Competitive Enzyme-Linked Immunosorbent Assay (C-ELISA). An overall PPR seropositivity was reported to be 48.43% in the area. There is no statistically significant difference in the seroprevalence of the disease between sheep and goats (50.85% and 46.68%), respectively. However, there was statistically significant variation (P < 0.05) in the seroprevalence of the disease in young (33.9%) and adult (55.8%) age categories. The seroprevalence in male and female was 42.07% and 50.09%, respectively, where the variation was statistically not significant (P > 0.05). High seroprevalence of Peste des petites ruminants in the study area indicated the virus circulation and endemicity of the disease. The disease causes substantial economic losses by affecting the livelihood of the farmers. Therefore, control measures should be put in place to minimize the loss associated with the disease.

TU‐D‐201‐08: Experience Complying with The Joint Commission Element of Performance On Radiation Dose Index Monitoring

Purpose:A new Joint Commission element of performance effective July 2015 requires incidents where the radiation dose index exceeds a defined level be reviewed, analyzed and compared to external benchmarks. This work offers a comprehensive review of the CT exams in which the notification level was exceeded and the reason at one academic medical center. This review may help other institutions set reference levels at clinically relevant values.Methods:Radiation Dose Structured Reports from each of the 5 diagnostic CT scanners at our institution are automatically sent to our radiation dose index monitoring software platform, Radimetrics from Bayer Healthcare. Global notification levels for CTDIvol and DLP were configured in Radimetrics for head, chest and abdomen studies for 0–2 year old, 2–13 year old and adult age categories. Global CTDIvol notification levels were set lower than the AAPM recommended values. Additional notification levels were configured for specific protocols that do not use AEC or have better or limited image quality requirements. Notifications of exams exceeding the global or protocol specific notification levels were reviewed on an ongoing basis by a Qualified Medical Physicist and the reason(s) for the acquisition or exam exceeding the level recorded.Results:Out of 80 notifications for acquisitions or exams exceeding notification levels over an 8 month period, 72 occurred due to large patients or due to implants or external hardware in the scan range. Four instances of the incorrect protocol being selected were recorded and 4 instances of incorrect manual technique application were observed.Conclusion:Properly configured notification levels, even below those recommended by AAPM, produce few dose notifications on modern scanners using AEC and/or iterative reconstruction. Using SSDE instead of CTDI for notifications may provide more clinically relevant data on exams well above or below the clinical norm for dose and image quality.Mark P. Supanich: Global Informatics Advisory Board Member: Bayer HealthCare

Intimate partner homicide–suicide: Perpetrator primary intent across young, middle, and elder adult age categories

Intimate partner homicide-suicide (IPHS) is the most violent domestic abuse outcome, devastating families and communities. Nationwide murder-suicide data were collected from news surveillance of 728 events (representing 1611 deaths) reported 1999-2005. Content analysis compared perpetrator's primary intent (homicide or suicide) across 3 age categories: young (18-44), middle aged (45-59) and elder adult (60 +) couples. Based on information obtained, a known history of intimate partner violence (IPV) was most common in young dyads, compared to other age categories. Suicide pacts and mercy killings appear to be very rare. The majority of perpetrators were men who utilized firearms. Female victims varied in their awareness of danger. Evidence suggests there were differences in the primary intentions with young adults reflecting homicidal motive and elders were more often suicidal. Those in middle age indicated a mix, with most similarities to young adults. If substance abuse and mental illness played a significant role in the IPHS events, it was not evident from these data. Triangulation of data analysis methods contributed rich details about themes associated with danger clarity, perceptions of lethality, and evidence of the perpetrator's view of the self and others. Understanding existing distinctions in primary intent is crucial to the development of appropriate lethality assessments and prevention efforts. Language: en

Persepsi Pembudidaya Ikan Terhadap Kompetensi Penyuluh Perikanan di Kawasan Minapolitan (Kasus di Kabupaten Cirebon, Provinsi Jawa Barat)

&lt;p&gt;Research objectives were: 1) to describe the profile fish farmers, 2 ) to analyze the perception of fish farmers towards competence of fisheries extension worker, and 3 ) to analyze the relationship between the profile of fish farmers and fisheries extension services towards of fish farmers perceptions of competence of fisheries extension workers. The study was conducted in Cirebon regency, West Java Province. The sample was 100 respondents of fish farmers is determined by the formula Slovin. Processing and analysis of data using descriptive statistics and inferential statistics (Rank Spearmen). The results showed profiles of fish farmers mostly adult age category (39-57 years). Majority of low educational level or not complete primary school or complete primary school. Participation in fisheries training and experience of fishing bussines is low. Perceptions of fish farmer towards competence of fisheries extension worker is the medium category, except towards personal competence is high category with details of the personal competence is 64%, andragogik competence is 61%, professional competence is 59% and social competence is 60% The better the extension given material, the better the fisheries extension perceptions fish farmers to professional and social competence fisheries extension workers. The better implementation methods and techniques of extension, the better the perception of fish farmers towards personal competence, social and professional of fisheries extension workers.&lt;/p&gt;&lt;p&gt;Keywords: fish farmers’s perception, competence of fisheries extension worker, minapolitan region&lt;/p&gt;

Dietary intake and nutritional status in cancer patients; comparing adults and older adults.

Evaluate the nutrient intake and nutritional status of food in cancer patients admitted to a university hospital, with comparison of adult and older adult age category. Cross-sectional study. This study involved cancer patients admitted to a hospital in 2010. Dietary habits were collected using a Brazilian food frequency questionnaire. Participants were divided in two groups: adults or older adults and in 4-cancer category: hematologic, lung, gastrointestinal and others. Body Mass Index evaluated nutritional status. A total of 86 patients with a mean age of 56.5 years, with 55% males and 42% older adults were evaluated. The older adult category had a higher frequency of being underweight (24.4% vs 16.3%, p < 0.01) and a lower frequency of being overweight (7% vs. 15.1%, p < 0.01) than adults. Both, adult and older adults had a high frequency of smoking, alcohol consumption and physical inactivity. The older adults had lower consumption of calories, intake of iron and folic acid. Inadequacy of vitamin intake was observed in both groups; respectively, 52%, 43%, 95%, 76% and 88% for Vitamin A, C, D, E and folic acid. The older adults had a higher folic acid and calcium inadequacy than the adults (97% vs 82%, p <0.01; 88% vs 72%, p < 0.01). There was no association of micronutrient intake with cancer, nor with nutritional status. The food intake, macro and micronutrients ingestion is insufficient among cancer individuals. Food intake of older adults was inferior, when compared to the adult category. There was a high prevalence of BMI excess in the adult group and a worst nutritional status in the older adult category.

SURVEI MINAT MASYARAKAT TERHADAP PEMANFAATAN RUANG TERBUKA PUBLIK SEBAGAI TEMPAT BEROLAHRAGA DI KOTA SALATIGA TAHUN 2013

This study aims to determine the Salatiga public interest in utilizing public open space as a place to work out in the 2013.The technique to obtain data that is by spreading the sample questionnaire respondents from each age category, the group of children under 15 years, adolescents with age between 15-25 years, adults between the ages of 26-50 years, and older people over the age of 50 years a total of 200 people. The results showed that the public interest in the use of public open space as a place to work out in Salatiga was 76.14 % for the children category, amounting to 74.42 % for the teen category, amounting to 82.08 % for the adult category, and amounted to 76.86 % for the parent category. It can be concluded that the public interest in the use of public open space as a place to work out in Salatiga in 2013 in high categorized or interested . Adult age category ( 26-50 years ) had the highest percentage of interest in the use of public open space as a place to work out in Salatiga in 2013.

THE MULTIPLICATIVE NOISE COMPONENTS OF ISOMETRIC FORCE FLUCTUATIONS

The experiment tested the relative contribution of additive and multiplicative noise components in isometric force fluctuations. We implemented the Hilbert–Huang transform to analyze variability in the steady state region of isometric force time series generated by participants in three adult age categories: (1) young (20–24 yrs); (2) old (60–69 yrs); and older-old (75–90 yrs). Each participant generated isometric force output in response to constant target force levels (5–40% maximum voluntary contraction). The empirical mode decomposition component of the Hilbert–Huang transform was applied to each isometric force time series resulting in a set of intrinsic mode functions (IMFS). The amplitude modulation envelopes of the IMFS obtained from the modulus of the Hilbert transform were random sequences. These random sequences were the source of the multiplicative noise. Analyses showed significant age group differences in the multiplicative noise structure of the force output. The results provide preliminary evidence that multiplicative noise dominates additive noise in isometric force output and can discriminate among the force fluctuations of healthy adult participants of different ages.

Understanding cohort differences in appraisals of reconstruction priorities of mental health systems in postconflict Liberia

This study analyzes the relationship between informants' age and their assessment of mental health needs in postconflict society and examines if mental health needs assessment priorities differ depending upon whether or not the informant was exposed to the Liberian civil war. cross-sectional survey was conducted in March 2009 to obtain data on mental health needs of Liberian children, adolescents and young adults. A total of 171 individuals were interviewed. The data were analyzed using a two- way ANOVA. Elder respondents expressed a preference for young adults to receive services in a church/mosque (F = 4.020, p < .05); for adolescents in volunteer programs (F = 3.987, p < .05) and for children in sports programs (F = 4.396, p < .05). Experiencing conflict did exert some influence on treatment setting preferences. Those who resided outside Liberia during the conflict cited a preference for traditional healers and medical clinics. However, this preference was for the children and young adult age categories. Those who experienced the civil war reported significantly higher preferences for adolescent services to be located in medical clinics, with traditional healers, and in churches/mosques. This study provides additional support for the premise that the utilization of psychiatric services needs to be viewed from the perspective of Liberians and that there are differences in preferences across groups. Our results suggest that service providers and policy makers take into account the age of the patient when deciding where to locate treatment settings for the population.

Unmarked individuals in mark-recapture studies: Comparisons of marked and unmarked southern elephant seals at Marion Island

The presence of unmarked individuals is common in mark–recapture study populations; however, their origin and significance in terms of population dynamics remain poorly understood. At Marion Island, southern Indian Ocean, where virtually all southern elephant seal Mirounga leonina pups born annually (1983–2008) were marked in a long-term mark–resight study, large numbers of unmarked seals occur. Unmarked seals originate either from marker (tag) loss or from immigration. We aimed to identify patterns in the occurrence of marked and unmarked individuals that will allude to the possible origin and significance of the untagged component of the population, predicting that tag loss will add untagged seals to mainly adult age categories whereas migrating untagged individuals will be mostly juveniles. We fitted a generalized linear model using the factors month, year and age-class to explain the relative abundance of untagged seals (tag ratio) from 1997 to 2009. Site usage of untagged seals relative to tagged seals was assessed using a binomial test. Untagged seals, predominantly juveniles, were present in the highest proportions relative to tagged seals during the winter haulout (tagged seals/total seals less than 0.3) and the lowest proportion (approximately 0.5) during the female breeding haulout, increasing in relative abundance from 1997 to 2009. Untagged seals were distributed evenly across suitable haulout sites while tagged seals displayed high local site fidelity and occurred in greater numbers at or near large breeding beaches. Untagged seals are considered to be mostly migrant seals that disperse from other islands within the southern Indian Ocean and haul out at Marion Island during non-breeding haulouts in particular. Some of these seals immigrate to the breeding population, which can be a key component of the local population dynamics. We emphasize the need for mark–recapture studies to evaluate the role of the unmarked component of a population, thereby inducing a more confident estimation of demographic parameters from the marked sample.