Age-period-cohort effects in the incidence of hip fractures: political and economic events are coincident with changes in risk

Introduction: Healthcare improvements have allowed prevention but have also increased life expectancy, resulting in more people being at risk. Our aim was to analyse the separate effects of age, period and cohort on incidence rates by sex in Portugal, 2000–2008. Methods: From the National Hospital Discharge Register, we selected admissions (aged ≥49 years) with hip fractures (ICD9-CM, codes 820.x) caused by low/moderate trauma (falls from standing height or less), readmissions and bone cancer cases. We calculated person-years at risk using population data from Statistics Portugal. To identify period and cohort effects for all ages, we used an age–period–cohort model (1-year intervals) followed by generalised additive models with a negative binomial distribution of the observed incidence rates of hip fractures. Results: There were 77,083 hospital admissions (77.4 % women). Incidence rates increased exponentially with age for both sexes (age effect). Incidence rates fell after 2004 for women and were random for men (period effect). There was a general cohort effect similar in both sexes; risk of hip fracture altered from an increasing trend for those born before 1930 to a decreasing trend following that year. Risk alterations (not statistically significant) coincident with major political and economic change in the history of Portugal were observed around birth cohorts 1920 (stable–increasing), 1940 (decreasing–increasing) and 1950 (increasing–decreasing only among women). Conclusions: Hip fracture risk was higher for those born during major economically/politically unstable periods. Although bone quality reflects lifetime exposure, conditions at birth may determine future risk for hip fractures.

Simulation study of energy efficient scheduling for IEEE 802.15.4/ZigBee cluster-treeWireless Sensor Networks with time-bounded data flows

The simulation analysis is important approach to developing and evaluating the systems in terms of development time and cost. This paper demonstrates the application of Time Division Cluster Scheduling (TDCS) tool for the configuration of IEEE 802.15.4/ZigBee beaconenabled cluster-tree WSNs using the simulation analysis, as an illustrative example that confirms the practical applicability of the tool. The simulation study analyses how the number of retransmissions impacts the reliability of data transmission, the energy consumption of the nodes and the end-to-end communication delay, based on the simulation model that was implemented in the Opnet Modeler. The configuration parameters of the network are obtained directly from the TDCS tool. The simulation results show that the number of retransmissions impacts the reliability, the energy consumption and the end-to-end delay, in a way that improving the one may degrade the others.