Individuals In Good Health Research Articles

Changes in Physical Fitness Parameters with Increasing Age

It is inevitable to see changes in physical fitness parameters with age. This study compares the physical fitness parameters, body composition, laxity, balance, proprioception, and muscle strength between different age groups. The study comprised 44 individuals in good health, divided into two age groups: 20-39 and 40-65.Body composition was measured with Tanita BC 418; balance was measured with a Biodex Biosway stabilometer device, and laxity was measured with a GNRB knee arthrometer. The isokinetic system (Cybex NORM, Humac, CA, USA) was used for strength and proprioception measurements. Anteroposterior, mediolateral, and overall stability index among the balance parameters between the two groups was significant. Among the groups, a statistically significant difference was observed in terms of body mass index (BMI), total body fat ratio, trunk fat ratio, and dominant leg fat ratio (p 0.05).With increasing age, it is essential to be aware of the negatively changing body composition and deteriorating balance and encourage participation in physical activity and exercise to prevent physical fitness loss, especially from 40.

EEG-based Sleep Deprivation Classification: A Performance Analysis of Channel Selection on Classifier Accuracy

This study analyses the effect of electroencephalogram (EEG) channel selection on the classification accuracy of sleep deprivation using four distinct classifiers: Random Forest (RF), k-Nearest Neighbours (k-NN), Support Vector Machine (SVM), and Artificial Neural Network (ANN). In this study, the EEG data from ten male individuals in good health were collected. Two distinct sets of EEG channels—a limited frontal channel set (Fp1, Fp2) and a thorough 19-channel set—were used to compare the performance of the classifiers. According to our findings, the k-NN classifier produced the greatest classification accuracy of 99.7% when applied to the 19-channel EEG signals. In contrast, both SVM and ANN classifiers were able to obtain the greatest accuracy of 94% with the frontal channels. Though there are not many gaps, these results imply that employing a larger range of EEG channels greatly improves the classification accuracy of sleep deprivation. The present study emphasizes the significance of channel selection in EEG-based sleep deprivation investigations by showcasing the significant advantages of full EEG signal capture over minimum channel configurations.

Exploring the relationship between accommodation and intraocular pressure: a systematic literature review and meta-analysis.

To investigate the relationship between accommodation and intraocular pressure (IOP). Systematic literature search and meta-analysis following PRISMA guidelines was conducted on studies analyzing the relationship between accommodation and intraocular pressure. After removal of duplicates, title and abstract screening, full-text analysis was performed to select relevant articles and meta-analysis was then conducted as well. Of the 1357 records identified, 17 met the selection criteria and were included. Overall, all studies showed that accommodation can influence IOP levels and meta-analysis indicated a significant IOP reduction of 1.10 mmHg (95%CI, -1.77; -0.42) following accommodative stimulus in healthy individuals, albeit with high heterogeneity among studies. Differences in IOP changes between emmetropic and progressing myopic individuals were not significant. Controversial results were obtained in patients with glaucoma with significantly lower IOP fluctuations being noted in eyes with previous trabeculectomy; however, the clinical heterogeneity of enrolled patients among studies made it not possible to combine results. Type of accommodative task, extraocular muscle contraction, head and body position all could potentially play a role in the measured IOP changes with, interestingly, near reading on a smartphone suggesting IOP increase. Accommodation has an impact on IOP measurements and, overall, determines IOP decrease in healthy individuals. While such variations might not hold clinical significance for individuals in good health, their impact in patients with glaucoma should be considered. Further studies focused on specific components of such relationship are required to elucidate their individual impact and to define their potential role as non-pharmacological strategies to reduce IOP levels in selected patient categories.

Correlation Between Serum 25-hydroxyvitamin D Content and Testosterone Content in Young Healthy Males: A Single Center Cross-Sectional Study

Objectives: The current study is conducted to compare serum 25-hydroxyvitamin D concentrations and total testosterone in young, physically fit adult males. Study Design: the study was based on cross sectional design. Study Settings: The research was conducted in Department of Pathology, Shahida Islam Medical and Dental College situated in District Lodhran between 1st July, 2023 and December, 2023. Methods: This cross-sectional research, which took place at the Department of Pathology at Shahida Islam Medical and Dental College in Lodhran from July 1, 2023, to December 31, 2023, had 176 young male volunteers, all between the ages of 18 and 35. Each participant was given questionnaires to fill out on their prior medical history, food habits, and rigorous exercise levels. Every participant had their blood drawn following a 12-hour fast and a 24-hour period without physical exercise. Separating serum was done with a centrifuge. The blood concentration of LH, FSH, total testosterone, and 25-hydroxyvitamin D were measured by electrochemiluminescence (ECLIA). Results: A total of 176 individuals in good health were registered, with a mean age of 26.62±5.20 years. The presence of vitamin D of less than 10 ng/ml, between 10–20 ng/ml, and greater than 20 ng/ml were reported in 70 (39.8%), 76 (43.2%), and 30 (17.0%) individuals, accordingly. The mean hormone levels (TT, FSH, and LH) in the three 25(OH)D groups did not vary statistically. Our findings showed that there existed no statistically substantial relationship in the categories under study between 25(OH)D and LH, FSH, and TT. Conclusion: We found little variation in the condition of the 25(OH)D concentration and the average hormonal measurements (LH, FSH, and TT). Based on these data, we concluded that in young, healthy guys, there is no relationship between testosterone concentrations and deficient or inadequate 25(OH)D level.

Differential expression and analysis of extrachromosomal circular DNAs as serum biomarkers in pulmonary arterial hypertension

BackgroundExtrachromosomal circular DNAs (eccDNAs) have been reported to play a key role in the occurrence and development of various diseases. However, the characterization and role of eccDNAs in pulmonary arterial hypertension (PAH) remain unclear.MethodsIn the discovery cohort, we first explored eccDNA expression profiles by Circle-sequencing analysis. The candidate eccDNAs were validated by routine polymerase chain reaction (PCR), TOPO-TA cloning and Sanger sequencing. In the validation cohort, 30 patients with PAH and 10 healthy controls were recruited for qPCR amplification to detect the candidate eccDNAs. Datas at the baseline were collected, including clinical background, biochemical variables, echocardiography and hemodynamic factors. Receiver operating characteristic curve was used to investigate the diagnostic effect of the eccDNA.ResultsWe identified a total of 21,741 eccDNAs in plasma samples of 3 IPAH patients and 3 individuals in good health, and the expression frequency, GC content, length distribution, and genome distribution of the eccDNAs were thoroughly characterized and analyzed. In the validation cohort, 687 eccDNAs were differentially expressed in patients with IPAH compared with healthy controls (screening threshold: |FC|≥2 and P < 0.05). Gene Ontology (GO) and the Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis showed that the specific eccDNAs in IPAH were significantly enriched in calcium channel activity, the mitogen-activated protein kinase pathway, and the wnt signaling pathway. Verification queue found that the expression of eccDNA-chr2:131208878–131,424,362 in PAH was considerably higher than that in healthy controls and exhibited a high level of accuracy in predicting PAH with a sensitivity of 86.67% and a specificity of 90%. Furthermore, correlation analysis disclosed a significant association between serum eccDNA-chr2:131208878–131,424,362 and mean pulmonary artery pressure (mPAP) (r = 0.396, P = 0.03), 6 min walking distance (6MWD) (r = -0.399, P = 0.029), N-terminal pro-B-type natriuretic peptide (NT-proBNP) (r = 0.685, P < 0.001) and cardiac index (CI) (r = − 0.419, P = 0.021).ConclusionsThis is the first study to identify and characterize eccDNAs in patients with PAH. We revealed that serum eccDNA-chr2:131208878–131,424,362 is significantly overexpressed and can be used in the diagnosis of PAH, indicating its potential as a novel non-invasive biomarker.

Screen for Cognitive Impairment in Psychiatry (SCIP): Adaptation and validation for Portuguese Version

IntroductionCognitive dysfunction has been reported in acute psychiatric patients for a long time and has profound implications for the management of severe mental disorders. The Screen for Cognitive Impairment in Psychiatry (SCIP) is a scale developed for screening cognitive deficits. This tool is simple and easy to administer.ObjectivesTo translate and to validate to Portuguese the SCIP.MethodsThe accepted back-translation method is employed for translating from English into Portuguese. One-hundred individuals in good health were characterized using demographic questionnaires and a neuropsychological battery. Subsequently, the new version of the scale was administered on two distinct occasions with a minimum one-week gap between them.ResultsHigh internal consistencies as well as strong correlations with comparable neuropsychological tests were obtained.ConclusionsThe results obtained from the Portuguese version of SCIP are in line with those from the English version. Effectively, SCIP serves as a key instrument for the initial assessment of cognitive function. Its characteristics, particularly its conciseness and independence from a technological platform, allow it to be integrated into clinical practice. Our aim is to use this version and apply it to different pathologies, comparing patients with controls. This will allow us to study different patients and apply it to our population.Disclosure of InterestNone Declared

Key chromatin regulator-related genes associated with the risk of coronary artery disease regulate the expression of HCFC1, RNF8, TNP1 and SET

Chromatin regulators are indispensable upstream epigenetic regulators.The emergence and progression of atherosclerosis has been demonstrated to be influenced by smooth muscle-related chromatin regulators, such as ZEB2 and MAFF. However, specific chromatin regulators and their possible roles have not been clarified. Information was gathered from 51 patients diagnosed with coronary artery disease (CAD) and 50 individuals in good health from the GEO database. 440 genes were identified as having differential expression across the two datasets, and these genes were linked to cellular reactions. Enrichment of pathways related to histone modification and transcriptional regulatory factors was observed in GO and KEGG analyses. Four machine learning models (RF, SVM, GLM, and XGB) were developed using the expression profiles of 440 chromatin-associated genes in the CAD cohort to pinpoint genes with significant diagnostic potential. After evaluating residuals, root mean square errors, receiver operating characteristic curves, and immune-infiltration, four key genes (HCFC1, RNF8, TNP1, and SET) were identified. Gene expression in different blood vessel levels in atherosclerotic plaques in a mouse model of coronary artery disease showed significant variations. The gene expression levels in macrophages aligned with clinical data from the GEO database as expected. This discovery is crucial for future analysis and the prediction of drug and miRNA targets. In conclusion, we found that the four hub genes are important in the mechanism of CAD. These findings provide new ideas for the study of potential epigenetic predictive markers and therapeutic targets to be used in determining a treatment strategy for CAD.

Determination of Paraoxonase 1 Activity and Phenotype Distribution in Cervical Disk Herniation Patients

Determination of Paraoxonase 1 Activity and Phenotype Distribution in Cervical Disk Herniation Patients&#x0D; &#x0D; Abstract&#x0D; Objectives: Cervical disk herniation (CDH) is a common disease that usually develops as a result of intervertebral disk degeneration (IVDD) or trauma, which can cause pain or neurological deficiency by nevre root or spinal cord compression. Paraoxonase 1 (PON1) has antioxidant qualities, and its function may vary based on genetic variations and ethnic background. This study aims to compare PON1 activity and phenotype distribution in CDH patients and individuals without the condition.&#x0D; Materials and Methods: This study involved 70 CDH patients and 70 individuals in good health. Spectrophotometric tests were conducted to measure the serum PON1 and arylesterase (ARE) activities. The PON1 ratio, which indicates the salt-stimulated PON/ARE level, showed a three-peak distribution. This ratio was utilized to determine the various phenotypes; QQ, QR, and RR for each participant.&#x0D; Results: The PON1 activity was lower in CDH patients compared to the healthy individuals (p &lt; 0.05). CDH patients exhibited a statistically significant QQ phenotype in comparison to the healthy participants (p &lt; 0.05).&#x0D; Conclusion: Patients with CDH exhibited significantly reduced PON1 activity, indicating that low PON1 activity and the PON1 QQ phenotype could potentially be a risk factor for the development of CDH.&#x0D; Keywords: Cervical disk herniation, Paraoxonase, Phenotype, PON1

Widening Health Gap in the US Labor Force Participation at Older Ages

Abstract Using microdata from the CPS and the HRS, we document changes in labor force participation at older ages in the USA since the mid-1990s. Our main finding is that the over two-decade increase in participation is solely driven by individuals in good health, and does not differ across either educational or occupational groups. This phenomenon may importantly affect the results of social security reforms aiming at raising the mandatory retirement age and may exacerbate the health gap in lifetime earnings. (JEL codes: J22 and I14)

Effectiveness of Blood Flow Restriction Training on Functional Mobility and Strength in Neurological Disorders: A Review

Introduction: Research indicates that Blood Flow Restriction (BFR) offers advantages for individuals in good health, older populations, and those experiencing musculoskeletal issues. A comprehensive analysis was carried out to explore the efficacy of BFR in improving functional mobility and strength among individuals with neurological disorders. In recent times, there has been a surge in interest towards BFR research, which entails the regulation of blood flow to the muscles during physical activity, partly for arterial circulation and fully for venous circulation, aiming to optimise training outcomes. Aim: To ascertain how blood flow restriction training affects strength and functional mobility in neurological diseases. Materials and Methods: A comprehensive analysis was conducted. PubMed, Web of Science (WOS), Physiotherapy Evidence Database (PEDro), Google Scholar, Cumulative Index of Nursing and Allied Literature Complete (CINAHL), the Cochrane Library, and Research Gate were the databases that were searched for literature between January 2003 and October 2023. The risk of bias in the research was assessed using the Cochrane Collaboration tool, and the methodological quality of the studies was assessed using the PEDro scale. Total 278 articles were found through literature search, after filtration for all years through 2003 to 2023 yielded (278) articles and removing duplicates yielded 238 articles. Reports assessed for eligibility (N=15). A total of 10 articles were included based on the inclusion criteria. Results: There were no unfavourable results from any of the trials that we reviewed. However, we found out significant improvement in increasing muscular strength and functional mobility among neurological patients. Due to the substantial diversity and small number of publications, the results should be interpreted with caution. Further clinical study ought to be conducted. These studies should improve the methodological quality as well as the consistency of the procedures used in larger samples. Conclusion: Blood flow restriction therapy appears to be helpful in treating neurological problems without having negative side effects, according to the reviews in this study. Progress has been observed in walking endurance, strength, muscle thickness, gluteus density, and step length symmetry, and gait speed. There have also been improvements to the balance.

Acousto-optic stimuli to promote coherent 40-Hz frequency entrainment effect.

Research has shown that a fundamental frequency of 40 Hz in continuous neural oscillation is indicative of normal brain activity; in Alzheimer disease (AD) patients, these oscillations either disappear or are significantly interrupted. Research has also indicated that the degenerative impacts of AD in mice were mitigated by the synchronization of 40-Hz acousto-optic stimulation (AOS). To examine the impact of employing a 40-Hz AOS intervention on the induction of a substantial 40-Hz frequency entrainment and improvement in working memory performance among a sample of young individuals in good health. We conduct an analysis of event-related potentials (ERPs) derived from electroencephalogram (EEG) data following the presentation of AOS. We recruited 20 healthy volunteers (median age: 25 years; 8 female subjects). Following the administration of various stimuli, including no stimuli, 40-Hz AOS, pink noise, and 40Hz acoustic stimuli (AS), the participants were required to complete a working memory task. A total of 62 electrodes were used to record EEG data, which was subsequently analyzed to investigate the impact of AOS on the activity of working memory. We also aimed to determine if AOS lead to a more pronounced 40-Hz frequency entrainment. Following the administration of AOS, a notable enhancement in the 40-Hz power of pertinent cerebral areas was observed, accompanied by a substantial improvement in the performance of the subjects on working memory tests subsequent to the stimulation. The findings unequivocally establish the efficacy of using AOS to enhance the 40-Hz power and working memory.

A Comparative Study on Survivors Versus Non-Survivors Among Diabetic Patients Having Mucormycosis.

Introduction Mucormycosis is a rare opportunistic fungal infection caused by fungi belonging to the Mucorales order and Mucoraceae family. It ranks as the third most prevalent angioinvasive fungal infection, following aspergillosis and candidiasis. This severe infection typically affects individuals with compromised immune systems, including those with hematological malignancies like leukemia and lymphoma, individuals who have undergone stem cell transplants, and people with diabetes mellitus. Individuals in good health are rarely affected, making immunocompromised individuals particularly vulnerable to this potentially fatal fungal disease. The aim of this study was to perform a comparative analysis of survivors versus non-survivors among diabetes patients admitted with mucormycosis. Methodology This was a descriptive observational study. A total of 338 patients were enrolled in the study. The study variables included demographics, COVID-19 infection, diabetes mellitus history, steroid use, use of oxygen support, and steam inhalation. Results Of the total 338 patients enrolled in the study, 253 (74.9%) were male and 85 (25.01%) were female. The number of survivors were 305 (90.2%) and non-survivors were 33(9.8%). The mean age of survivors was 52.50 ± 11.31 and non-survivors was 54.06 ± 8.54 years. Patients who underwent steam inhalation had a higher chance of survival compared to those who did not undergo steam inhalation and this association was statistically significant (p=0.01). Males showed a higher chance of survival (93.7%) as compared to females (80.0%). The associations between oxygen support, steroid use, and COVID-19 infection with the survival status were statistically non-significant. Conclusion There was a strong association between the history of steam inhalation and the outcome of mucormycosis among diabetes patients admitted with mucormycosis. Female patients demonstrated a higher fatality rate than males indicating a significant gender disparity observed in cases. Our findings may help to better identify and treat patients who are at higher risk for severe forms of mucormycosis.

A Genome-Wide Analysis of a Sudden Cardiac Death Cohort: Identifying Novel Target Variants in the Era of Molecular Autopsy.

Sudden cardiac death (SCD) is an unexpected natural death due to cardiac causes, usually happening within one hour of symptom manifestation or in individuals in good health up to 24 h before the event. Genomic screening has been increasingly applied as a useful approach to detecting the genetic variants that potentially contribute to SCD and helping the evaluation of SCD cases in the post-mortem setting. Our aim was to identify the genetic markers associated with SCD, which might enable its target screening and prevention. In this scope, a case-control analysis through the post-mortem genome-wide screening of 30 autopsy cases was performed. We identified a high number of novel genetic variants associated with SCD, of which 25 polymorphisms were consistent with a previous link to cardiovascular diseases. We ascertained that many genes have been already linked to cardiovascular system functioning and diseases and that the metabolisms most implicated in SCD are the lipid, cholesterol, arachidonic acid, and drug metabolisms, suggesting their roles as potential risk factors. Overall, the genetic variants pinpointed herein might be useful markers of SCD, but the novelty of these results requires further investigations.

English

U-Net is adequate for various biomedical image segmentation tasks. Using this in the Age-related Macular Degeneration (AMD) images would be better for segmenting only the affected region. The variant of U-Net uses residual connections. A residual link is a type of connection that allows the network to learn the residual mapping between the input and output rather than the complete mapping. This technique can help the network learn more efficiently and avoid the vanishing gradients problem. This research aims to develop a method for segmenting the retinal pigment epithelium, the Bruch’s membrane, and the Inner Limiting Membranes (ILM) in OCT scans of individuals in good health and with intermediate AMD.

Linking personality and health to use of space in the gray partridge: perspectives for management

Behavioral adjustments are of critical importance for the survival of animals when exposed to risk and resource variations in their environment. Moving to safer habitats allows prey to reduce the risk of mortality triggered by predation. This response has been well studied at the population level to assist in identifying key habitat components for wildlife conservation. However, while individuals may differ in their response to risk and thus in their survival expectancy, the determinants of individual adjustments in space and habitat use are largely unknown in management and conservation studies. Using GPS monitoring, we investigated the relationship between individual traits (morphometry, personality, health status) and adjustments in the use of space relative to risky features (hedgerows, roads/tracks, woodlands, built-up areas) with regard to predation risk. We used the gray partridge (Perdix perdix) as a study model (captive-reared birds released into the farmlands). During the diel cycle, predation risk mainly occurs by carnivores at night, whereas human hunting pressure occurs during the day. We found that personality and health status had an effect on adjustments in the use of space as response to risky features. At night, when carnivore activity is expected to be high, bolder individuals were farther from hedgerows relative to the day. Similarly, individuals in good health were located farther from hedgerows, roads/tracks, and woodland at night relative to the day. We discuss the need for better consideration of individual traits in management and conservation programs, with a particular focus on recovery programs that rely on translocation of captive-reared individuals.

EVALUATION OF HEALTHY LIFESTYLE BEHAVIORS OF B2-B3 VISUALLY IMPAIRED PEOPLE DOING SPORTS

The main purpose of this study was to determine of healthy life style behaviors of B2-B3 visually impaired individuals doing sports, and the second purpose was to test the relationship between these two variables. The sample group of the study consisted of 112 (44 male, 68 female) visually impaired individuals classified B2-B3 doing sports. Individuals in good health, with or without disabilities will provide a balanced life with themselves with their environment. So, the healthy individuals will be able to have a good communication with their environment and they will enjoy life. And this will cause these people to be conscious of being healthy. As a data collection tool, a scale was used which was developed by Walker et al. in 1987 based on Pender’s health promotion model, that measures health promoting behaviors in relation with individual’s healthy life style. The scale was revised in 1996 and named as “Healthy Lifestyle Behaviors Scale”. Regarding the validity and reliability of the scale, “Healthy Lifestyle Behaviors Scale II” was used which was made by Bahar et al. in 2008. Healthy lifestyle behaviors scale consists of 52 items. In order to evaluate the expressions in the scale, 4-point Likert-type scale was used (1: never, 2: sometimes, 3: frequently, 4: regularly). The scale has six subscales which are spirituality, nutrition, physical activity, health responsibility, interpersonal relationship and stress management. Mean, standard deviation, frequency, t-test for independent samples and one way analysis of variance test (One Way ANOVA) were used in the research, in order to determine the scores obtained from the scale used in the study. All these data were obtained, calculated and recorded by using the statistical program named SPSS 22.00. Cronbach’s Alpha value was calculated to determine the reliability of the scale used in the study. There was no significant difference between the mean scores of the participants according to their gender, income level, education level, sports branch, disability status, vision degree (p>0.05). According to this result, we can say that there is no difference in healthy life style behaviors among the participants, and also there is an increase in satisfaction of healthy life. Additionally, due to the same answers given about the healthy living in the scale, we can state that the expectations are also the similar. As a result, it has been determined that the participation in physical activities, staying away from the things deranging the health in their lives, all kinds of motivating factors that are beneficial to them are the most important healthy life style behaviors for visually impaired individuals, so they live their lives long and healthy like non-disabled people. Article visualizations:

Use of Complementary and Alternative Medicine in Japan: A Cross-sectional Internet Survey Using the Japanese Version of the International Complementary and Alternative Medicine Questionnaire.

Introduction: Although there have been several national survey studies on complementary and alternative medicine (CAM) use in Japan, previous studies have not been compared with investigations conducted in other countries. An international CAM questionnaire known as I-CAM-Q was developed through a two-day international workshop in 2006. The purpose of this study was to investigate the use of CAM by the general Japanese population using a modified version of the I-CAM-Q for the Japanese (I-CAM-QJ). Methods: We developed the I-CAM-QJ to conduct an internet survey of 3,208 participants from the general population of Japan in February 2016. The respondents included 1,592 males (49.6%), 1,348 university graduates (38.8%), 1,105 individuals in good health (34.4%), and 1,028 individuals with long-term illness or disability (32.0%). Results: Of the 3,208 respondents, 411 participants reported CAM use during the past 12 months (12.8%). The following therapies and products were used: Kampo medicines (over-the-counter Kampo medicines: 15.7%; prescribed Kampo medicines: 15.4%), dietary supplements 11.8%, massage services 3.9%, and physical therapy 3.5%. Regarding the use of self-care methods during the last 12 months, the following methods and products were used: bath salts 25.8% and walking 25.3%. Conclusions: An internet survey on CAM use by the general Japanese population with a modified I-CAM-Q (I-CAM-QJ) revealed that Kampo medicines and dietary supplements were the most commonly used CAMs in Japan.

Differences in the health transition patterns of migrants and non-migrants aged 50 and older in southern and western Europe (2004\u20132015)

BackgroundMost previous research on migrant health in Europe has taken a cross-sectional perspective, without a specific focus on the older population. Having knowledge about inequalities in health transitions over the life course between migrants and non-migrants, including at older ages, is crucial for the tailoring of policies to the demands of an ageing and culturally diverse society. We analyse differences in health transitions between migrants and non-migrants, specifically focusing on the older population in Europe.MethodsWe used longitudinal data on migrants and non-migrants aged 50 and older in 10 southern and western European countries from the Survey of Health, Ageing and Retirement in Europe (2004–2015). We applied multinomial logistic regression models of experiencing health deterioration among individuals in good health at baseline, and of experiencing health improvement among individuals in poor health at baseline, separately by sex, in which migrant status (non-migrant, western migrant, non-western migrant) was the main explanatory variable. We considered three dimensions of health, namely self-rated health, depression and diabetes.ResultsAt older ages, migrants in Europe were at higher risk than non-migrants of experiencing a deterioration in health relative to remaining in a given state of self-rated health. Western migrants had a higher risk than non-migrants of becoming depressed, while non-western migrants had a higher risk of acquiring diabetes. Among females only, migrants also tended to be at lower risk than non-migrants of experiencing an improvement in both overall and mental health. Differences in the health transition patterns of older migrants and non-migrants remained robust to the inclusion of several covariates, including education, job status and health-related behaviours.ConclusionsOur findings indicate that, in addition to having a health disadvantage at baseline, older migrants in Europe were more likely than older non-migrants to have experienced a deterioration in health over the study period. These results raise concerns about whether migrants in Europe are as likely as non-migrants to age in good health. We recommend that policies aiming to promote healthy ageing specifically address the health needs of the migrant population, thereby distinguishing migrants from different backgrounds.

Anesthesia and Analgesia in the Patient with an Unstable Shoulder.

Introduction:The patient with an unstable shoulder represents a challenge for the anesthesiologist. Most patients will be young individuals in good health but both shoulder dislocation reduction, a procedure that is usually performed under specific analgesia in an urgent setting, and instability surgery anesthesia and postoperative management present certain peculiarities.Material and Methods:For the purpose of the article, 78 references including clinical trials and reviews were included. The review was organized considering the patient that presents an acute shoulder dislocation and the patient with chronic shoulder instability that requires surgery. In both cases the aspects like general or regional anesthesia, surgical positions and postoperative pain management were analyzed.Conclusion:The patient with an acutely dislocated shoulder is usually managed in the emergency room. Although reduction without analgesia is often performed in non-medical settings, an appropriate level of analgesia will ease the reduction procedure avoiding further complications. Intravenous analgesia and sedation is considered the gold standard but requires appropriate monitorization and airway control. Intraarticular local analgesic injection is considered also a safe and effective procedure. General anesthesia or nerve blocks can also be considered. The surgical management of the patient with shoulder instability requires a proper anesthetic management. This should start with an exhaustive preoperative evaluation that should be focused in identifying potential respiratory problems that might be complicated by local nerve blocks. Intraoperative management can be challenging, especially for patients operated in beach chair position, for the relationship with problems related to cerebral hypoperfusion, a situation related to hypotension events directly linked to patient positioning. Different nerve blocks will help attaining excellent analgesia both during and after the surgical procedure. An interescalene nerve block should be considered the best technique, but in certain cases, other blocks can be considered.

Market inefficiency, insurance mandate and welfare: U.S. health care reform 2010

We quantify the effects of the Affordable Care Act (ACA) using a stochastic general equilibrium overlapping generations model with endogenous health capital accumulation calibrated to match U.S. data on health spending and insurance take-up over the lifecycle. We find that the introduction of an insurance mandate and the expansion of Medicaid which are at the core of the ACA increase the insurance take-up rate of workers to almost universal coverage but decrease capital accumulation, labor supply and aggregate output. Penalties for not having insurance as well as subsidies to assist low income individuals' purchase of insurance via health insurance market places do reduce the adverse selection problem in private health insurance markets and do counteract the crowding-out effect of the Medicaid expansion. The redistributional measures embedded in the ACA result in welfare gains for low income individuals in poor health and welfare losses for high income individuals in good health. The overall welfare effect depends on the size of the ex-post moral hazard effect, tax distortions and general equilibrium price adjustments.