940 resultados para Old age assistance.


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Introduction: The objective of this study was to define age-related changes in the human smile. The areas of interest were: upper lip length at smile and repose, upper lip thickness at smile and repose, maxillary incisal display at smile, interlabial gap height at smile, smile index, percent buccal corridors, intercommissural width at rest, smile height, and smile arc. A secondary objective was to study the perioral changes from rest to smile and compare them on the basis of age. Materials and Method: Video equipment was used to capture video for 261 subjects. Two frames for each subject were selected; one frame representing the lips and rest and the second representing the widest smile. After excluding 40 subjects the data for the remaining 221 subjects was analyzed. Results: There was a decrease of 1.5 to 2 mm in the maxillary incisor display during smile, with increase in age. Smile index significantly increased with increase in age. Most (78%) subjects displayed an average smile height. No subjects in the 50 and over age group displayed a high smile while no subjects in the 15-19 year old age group presented with a low smile. All the dynamic measures indicated there was a pattern of decreasing change from rest to smile especially evident after the 30-39 year old age group. Conclusions: This study helps to establish age related dynamic norms. As the person ages the smile gets narrower vertically and wider transversely. The dynamic measures indicate that the muscles' ability to create a smile decreases with increasing age.

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Objective. Although those age 75 and older are the fastest growing age group in the U.S., few studies focus on the course and treatment of depression in this age group. This study examines the differences between the young-old (age 60 to 74) and the old-old (age 75 and older) in regards to their response to a collaborative care model for depression in primary care. We hypothesized that old-old participants would have more severe depression and have a lower rate of treatment response compared to young-old participants. ^ Methods. The sample consisted of 906 participants (n = 606 young-old; n = 300 old-old) who were randomized to receive the intervention with a depression care manager in the IMPACT trial. This study compared young-old and old-old patients on process of care and outcome variables to identify potential differences between the two age groups. Process of care was determined by the type of treatment and level of stepped care received. Clinical outcomes included SCL-20 depression scores, treatment response (defined as a ≥50% decrease in SCL-20 score from baseline) and complete remission (defined as a SCL-20 score <0.5) at 3-, 6-, and 12-months follow-up. ^ Results. The process of care variables did not differ between the two age groups. SCL-20 depression scores did not significantly differ between the two age groups at all follow-up intervals. Treatment response was significantly different between young-old and old-old participants at 6- and 12-months. Complete remission rates were significantly different between the two age-groups at 12-months follow-up. ^ Conclusions. Young-old and old-old patients have a similar clinical response to initial collaborative depression care in a primary care setting, but old-old patients may have lower rates long-term treatment response and complete remission. These findings will help guide future clinical and public health approaches to treat old-old patients with depression. ^

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Strontium isotope stratigraphy was used to date five discrete horizons within CRP-1. Early and late Quaternary (0.87-1.3 Ma and 0-0.67 Ma respectively) age sediments overlie a major sequence boundary at 43.15 meters below sea floor (mbsf). This hiatus is estimated to account for ~16 m.y. of missing section. Early Miocene (16.6-~20.8-25 Ma) age deposits below this boundary are in turn cut by multiple erosion surface representing hiatus is of between 0.2 and 1.2 m.y. Estimated minimum sedimentation rates range between 0.9 and 2.8 cm/k.y. in the Quaternary, and 1.5 and 6.4 cm/ky in the lower Miocene.

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A multiproxy study of palaeoceanographic and climatic changes in northernmost Baffin Bay shows that major environmental changes have occurred since the deglaciation of the area at about 12 500 cal. yr BP. The interpretation is based on sedimentology, benthic and planktonic foraminifera and their isotopic composition, as well as diatom assemblages in the sedimentary records at two core sites, one located in the deeper central part of northernmost Baffin Bay and one in a separate trough closer to the Greenland coast. A revised chronology for the two records is established on the basis of 15 previously published AMS 14C age determinations. A basal diamicton is overlain by laminated, fossil-free sediments. Our data from the early part of the fossiliferous record (12 300 - 11 300 cal. yr BP), which is also initially laminated, indicate extensive seasonal sea-ice cover and brine release. There is indication of a cooling event between 11 300 and 10 900 cal. yr BP, and maximum Atlantic Water influence occurred between 10 900 and 8200 cal. yr BP (no sediment recovery between 8200 and 7300 cal. yr BP). A gradual, but fluctuating, increase in sea-ice cover is seen after 7300 cal. yr BP. Sea-ice diatoms were particularly abundant in the central part of northernmost Baffin Bay, presumably due to the inflow of Polar waters from the Arctic Ocean, and less sea ice occurred at the near-coastal site, which was under continuous influence of the West Greenland Current. Our data from the deep, central part show a fluctuating degree of upwelling after c. 7300 cal. yr BP, culminating between 4000 and 3050 cal. yr BP. There was a gradual increase in the influence of cold bottom waters from the Arctic Ocean after about 3050 cal. yr BP, when agglutinated foraminifera became abundant. A superimposed short-term change in the sea-surface proxies is correlated with the Little Ice Age cooling.

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Sediments from immediately above basalt basement and from between sections of basalt recovered from Deep Sea Drilling Project Legs 5 and 63 were analyzed by atomic absorption spectroscopy for Mg, Al, Si, Ca, Mn, Fe, Co, Ni, Cu, Zn, and Ba. All of these sediments showed enrichment in Fe and Mn over values typical of detritus supplied to the northeastern Pacific Ocean. X-ray diffractometry and differential chemical leaching indicate that up to 50% of the sediment, by weight, is in amorphous phases and that these phases are rich in Mn, Co, Cu, Ni, and Zn. Multivariate statistical analysis and normative partitioning of the chemical data indicate that much of the excess Fe and other transition elements in the sediment originate from hydrothermal sources.

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The rate at which hydrothermal precipitates accumulate, as measured by the accumulation rate of manganese, can be used to identify periods of anomalous hydrothermal activity in the past. From a preliminary study of Sites 597 and 598, four periods prior to 6 Ma of anomalously high hydrothermal activity have been identified: 8.5 to 10.5 Ma, 12 to 16 Ma, 17 to 18 Ma, and 23-to-27 Ma. The 18-Ma anomaly is the largest and is associated with the jump in spreading from the fossil Mendoza Ridge to the East Pacific Rise, whereas the 23-to-27-Ma anomaly is correlated with the birth of the Galapagos Spreading Center and resultant ridge reorganization. The 12-to-16-Ma and 8.5-to-10.5-Ma anomalies are correlated with periods of anomalously high volcanism around the rim of the Pacific Basin and may be related to other periods of ridge reorganization along the East Pacific Rise. There is no apparent correlation between periods of fast spreading at 19°S and periods of high hydrothermal activity. We thus suggest that periods when hydrothermal activity and crustal alteration at mid-ocean ridges are the most pronounced may be periods of large-scale ridge reorganization.

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Changes in Atlantic deep water circulation were reconstructed by comparing the benthic foraminiferal delta13C record at ODP Site 1090 in the South Atlantic with similar records from the North Atlantic (Sites 982, 607, 925, 929) and deep Pacific (Site 849) oceans. Important deep water circulation changes occurred in the early Pleistocene at 1.55 Myr and during the Mid-Pleistocene Transition at 0.9 Myr. At 1.55 Myr, glacial delta13C values in the Southern Ocean became significantly lower than those in the deep Pacific, establishing a pattern that persisted throughout the late Pleistocene. We propose that the lowering of delta13C values of Southern Component Water (SCW) at this time resulted from expansion of sea ice and reduced ventilation of deep water during glacial periods after marine isotope stage 52. Accompanying this change in Southern Ocean deep water circulation was enhanced interhemispheric coupling between the North and South Atlantic after 1.55 Myr. At ~0.9 Myr, the magnitude of glacial-to-interglacial variabilityin delta13C increased and shifted to a longer frequency (100 kyr) along with oceanic delta18O (ice volume). Calculation of percent Northern Component Water (NCW) using Site 1090 as the SCW end member yielded 20-30% less reduction of NCW during glacial periods of the late Pleistocene. Also, a trend toward reduced glacial suppression of NCW during the past 400 kyr is not evident. The apparent decoupling of ice volume and deep water circulation reported previously maybe an artifact of using a Pacific, rather than a Southern Ocean, carbon isotopic record to calculate past mixing ratios of NCW and SCW.

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Atmospheric carbon dioxide concentrations were significantly lower during glacial periods than during intervening interglacial periods, but the mechanisms responsible for this difference remain uncertain. Many recent explanations call on greater carbon storage in a poorly ventilated deep ocean during glacial periods (Trancois et al., 1997, doi:10.1038/40073; Toggweiler, 1999, doi:10.1029/1999PA900033; Stephens and Keeling, 2000, doi:10.1038/35004556; Marchitto et al., 2007, doi:10.1126/science.1138679; Sigman and Boyle, 2000, doi:10.1038/35038000), but direct evidence regarding the ventilation and respired carbon content of the glacial deep ocean is sparse and often equivocal (Broecker et al., 2004, doi:10.1126/science.1102293). Here we present sedimentary geochemical records from sites spanning the deep subarctic Pacific that -together with previously published results (Keigwin, 1998, doi:10.1029/98PA00874)- show that a poorly ventilated water mass containing a high concentration of respired carbon dioxide occupied the North Pacific abyss during the Last Glacial Maximum. Despite an inferred increase in deep Southern Ocean ventilation during the first step of the deglaciation (18,000-15,000 years ago) (Marchitto et al., 2007, doi:10.1126/science.1138679; Monnin et al., 2001, doi:10.1126/science.291.5501.112), we find no evidence for improved ventilation in the abyssal subarctic Pacific until a rapid transition ~14,600 years ago: this change was accompanied by an acceleration of export production from the surface waters above but only a small increase in atmospheric carbon dioxide concentration (Monnin et al., 2001, doi:10.1126/science.291.5501.112). We speculate that these changes were mechanistically linked to a roughly coeval increase in deep water formation in the North Atlantic (Robinson et al., 2005, doi:10.1126/science.1114832; Skinner nd Shackleton, 2004, doi:10.1029/2003PA000983; McManus et al., 2004, doi:10.1038/nature02494), which flushed respired carbon dioxide from northern abyssal waters, but also increased the supply of nutrients to the upper ocean, leading to greater carbon dioxide sequestration at mid-depths and stalling the rise of atmospheric carbon dioxide concentrations. Our findings are qualitatively consistent with hypotheses invoking a deglacial flushing of respired carbon dioxide from an isolated, deep ocean reservoir periods (Trancois et al., 1997, doi:10.1038/40073; Toggweiler, 1999, doi:10.1029/1999PA900033; Stephens and Keeling, 2000, doi:10.1038/35004556; Marchitto et al., 2007, doi:10.1126/science.1138679; Sigman and Boyle, 2000, doi:10.1038/35038000; Boyle, 1988, doi:10.1038/331055a0), but suggest that the reservoir may have been released in stages, as vigorous deep water ventilation switched between North Atlantic and Southern Ocean source regions.

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Accumulation rates for the five sites drilled during Leg 74 of the Glomar Challenger are presented on a common timescale based on calibration of datum levels to paleomagnetic records in Leg 74 sediments for the Paleogene, and a new compilation by Berggren et al. (1985), for the Neogene, and using the seafloor-spreading magnetic anomaly timescale of Kent (1985). We present data on accumulation of total sediment, of foraminifers, of the noncarbonate portion, and of fish teeth that give a history of productivity, winnowing, carbonate dissolution, and nonbiogenic input to what was then a part of the South Atlantic at about 30 deg S.

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ODP Site 1124, located 600 km east of the North Island of New Zealand, records post-middle Oligocene variations in the Pacific Deep Western Boundary Current (DWBC) and New Zealand's climatic and tectonic evolution. Sediment parameters, such as terrigenous grain size, flux, magnetic fabric, and non-depositional episodes, are used to interpret DWBC intensity and Antarctic climate. Interpretations of DWBC velocities indicate that the Antarctic Circumpolar Current reached modern intensities at ~23 Ma, as the tectonic seaways expanded, completing the thermal isolation of Antarctica. Periods of more intense bottom water formation are suggested by the presence of hiatuses formed under the DWBC at 22.5-17.6, 16.5-15, and 14-11 Ma. The oldest interval of high current intensity occurs within a climatically warm period during which the intensity of thermohaline circulation around Antarctica increased as a result of recent opening of circum-Antarctic gateways. The younger hiatuses represent glacial periods on Antarctica and major fluctuations in the East Antarctic Ice Sheet, whereas intervals around the hiatuses represent times of relative warmth, but with continued current activity. The period between 11 to 9 Ma is characterized by conditions surrounding a high velocity DWBC around the time of the formation and stabilization of the West Antarctic Ice Sheet. The increased terrigenous input may result from either changing Antarctic conditions or more direct sediment transport from New Zealand. The Pacific DWBC did not exert a major influence on sedimentation at Site 1124 from 9 Ma to the present; the late Miocene to Pleistocene sequence is more influenced by the climatic and tectonic history of New Zealand. Despite the apparent potential for increased sediment supply to this site from changes in sediment channeling, increasing rates of mountain uplift, and volcanic activity, terrigenous fluxes remain low and constant throughout this younger period.

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The radiocarbon contents of various biomarkers extracted from the varve-counted sediments of Saanich Inlet, Canada, were determined to assess their applicability for dating purposes. Calibrated ages obtained from the marine planktonic archaeal biomarker crenarchaeol compared favorably with varve-count ages. The same conclusion could be drawn for a more general archaeal biomarker (GDGT-0), although this biomarker proved to be less reliable due to its less-specific origin. The results also lend support to earlier indications that marine crenarchaeota use dissolved inorganic carbon (DIC) as their carbon source. The average reservoir age offset DR of 430 years, determined using the crenarchaeol radiocarbon ages, varied by ±110 years. This may be caused by natural variations in ocean-atmosphere mixing or upwelling at the NE Pacific coast but variability may also be due to an inconsistency in the marine calibration curve when used at sites with high reservoir ages.