Serum concentrations of 25-hydroxyvitamin D and immunoglobulins in an older Swiss cohort: results of the Senior Labor Study.

BACKGROUND Vitamin D and the components of humoral immunity play important roles in human health. Older people have lower 25-hydroxyvitamin D (25(OH)D) serum levels than younger adults. We aimed to determine the levels of 25(OH)D serum concentrations in healthy senior citizens and to study their relationship to the levels of components of humoral immunity. METHODS A total of 1,470 healthy Swiss men and women, 60 years or older, were recruited for this study. A total of 179 subjects dropped out of the study because of elevated serum concentrations of C-reactive protein. Fasting blood sera were analyzed for 25(OH)D with the high-performance liquid chromatography (HPLC) and for parathyroid hormone (PTH), immunoglobulins and complement C4 and C3 concentrations with immunoassays. The percentage of participants in each of the four 25(OH)D deficiency groups--severely deficient (<10 ng/ml), deficient (10 to 20), insufficient (21 to 29 ng/ml) and normal (>=30 ng/ml)--were statistically compared. The relationship of the major components of the humoral system and age with 25(OH)D levels was also assessed. RESULTS About 66% of the subjects had insufficient levels of 25(OH)D. Normal levels of 25(OH)D were found in 26.1% of the subjects of which 21% were males and 30.5% were females (total study population). Severely deficient levels of 25(OH)D were found in 7.98% of the total study population. Low levels of 25(OH)D were positively associated with IgG2 (P = 0.01) and with C4 (P = 0.02), yet were inversely related to levels of IgG1 and IgA (P < 0.05) and C3 (P = 0.01). Serum levels of total IgA, IgG, IgG2 and IgG4 peaked together with 25(OH)D during late summer. CONCLUSIONS Approximately two-thirds of the healthy, older Swiss population presented with Vitamin D insufficiency. The incremental shift in IgA and C3 levels might not necessarily reflect a deranged humoral immune defense; however, given the high prevalence of vitamin D deficiency, the importance of this condition in humoral immunity will be worth looking at more closely. This study supports the role of vitamin D in the competent immune system.

Determinant factors of senior tourists’ length of stay

The current tendency to undertake more trips, but of shorter duration, throughout the year, has meant that the tourist industry has started to show greater interest in attracting those market segments that opt for more prolonged stays, as they are especially profitable. One of these segments is that of seniors. Given the aging demographic of the population worldwide, which is particularly noticeable in Spain, the object of this study is to identify the variables that determine the length of stay of Spanish seniors at their destination. The Negative Binomial model was adapted to the context of length of stay by Spanish seniors and the determinant factors identified were: age, travel purpose, climate, type of accommodation, group size, trip type and the activities carried out at the destination. This study is a contribution to this field from an empirical point of view, given the scarcity of studies of this type and their eminently descriptive character; as well as from a practical level, with interesting implications for the sector.

Two lectures on population : delivered before the University of Oxford, in Easter term, 1828 ; to which is added, a correspondence between the author and T.R. Malthus.

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Two lectures on population : delivered before the University of Oxford, in Easter term, 1828 /

Goldsmiths'-Kress no. 25495.

Aspects of health among an employed population

This survey collected information on aspects of health amongst an employed population, employees in 14 different organisations in the West Midlands Regional Health Authority; and was a stratified sample of senior managers, middle managers and operatives. Nine hundred and sixty questionnaires were distributed asking for both quantitative and qualitative information on 58 questions covering health, work, family, leisure activities and life-style. A response rate of 48% (459 returned questionnaires) came from 290 men (63%), 165 women (36%) and four people (1%) who did not answer the gender question. The initial findings from this study are unique in that there has not been a specific review of the health of people at work. In answer to the main research questions, 92% felt they were healthy. Compared to others of a similar age, 34% felt their health was `above average', 58% `average', and 7&37 `below average'. Thirty two percent of respondents had visited their GP in the past 1-2 months; the highest reason given was disorders of the respiratory system, 20%. People's perceptions on the effects of work on their health were: good effect, 13% fair effect, 20% no effect, 27% poor effect, 27% and bad effect, 7%. The effects of leisure activities on health were thought to be more positive: good effect, 46% fair effect, 20% no effect, 21% poor effect, 3% and bad effect, 2%. The perceptions of effects of life-style on health were considered to be: good effect, 32% fair effect, 32% no effect, 20% poor effect, 9% and bad effect, 1%.  In this survey, leisure and life-style were seen by employees to have more beneficial effects on health than work. Future implications include a review of occupational health as a major policy development area within primary care. There is a need to influence the education and training of health care practitioners in order to affect their ability to practise effectively in this new and challenging area of work.

The use of the Dade County student assistance profile in the identification of at -risk students at a minority senior high school

Current high school completion rates in Dade County and across the nation are considered to be unacceptable. This has led to the development of student assistance profiles to aid in the early identification of students considered to be at risk to allow for some form of intervention. The purpose of this research was to examine the current Dade County Public Schools profile as applied to one specific high school in which most of the students are Hispanic (mostly of Mexican descent) and Black (African-Americans, as well as recent Haitian immigrants). Additionally, the effectiveness of the alternative intervention program provided at this high school--a school within a school--were evaluated. School records of the 1992 in-coming ninth grade class became the initial data base. The individual student records of this cohort were then examined over a four-year period until their expected date or graduation. The DCPS profile used to identify potential dropouts from this group was evaluated, using chi-square and multivariate analysis, to determine its overall effectiveness, as well as the effectiveness of the individual indicators which comprise the profile. The Student Assistance Profile was found to an effective predictor, but it over-identified students from this cohort, particularly minorities, to the extent that it became largely ineffective, especially considering the limited resources available for intervention. The intervention program was found to be ineffective in reducing the dropout rate. Further analysis of the individual indicators used in the DCPS profile as they applied to this school population resulted in the development of an improved profile. By reducing the number of indicators to those found to be most highly associated with failure to graduate--academic performance and absences--a simpler student assistance profile was developed which appears to be better suited to high schools with similar demographics and budget restraints. ^

Relationship between menopause and periodontal disease: a cross-sectional study in a Portuguese population

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Reducing the global burden of depression : population level analysis of intervention cost-effectiveness in 14 world regions

International evidence on the cost and effects of interventions for reducing the global burden of depression remain scarce. Aims: To estimate the population-level cost-effectiveness of evidence-based depression interventions and their contribution towards reducing current burden. Method: Primary-care-based depression interventions were modelled at the level of whole populations in 14 epidemiological subregions of the world. Total population-level costs (in international dollars or I$) and effectiveness (disability adjusted life years (DALYs) averted) were combined to form average and incremental cost-effectiveness ratios. Results: Evaluated interventions have the potential to reduce the current burden of depression by 10–30%. Pharmacotherapy with older antidepressant drugs, with or without proactive collaborative care, are currently more cost-effective strategies than those using newer antidepressants, particularly in lower-income subregions. Conclusions: Even in resource-poor regions, each DALYaverted by efficient depression treatments in primary care costs less than 1 year of average per capita income, making such interventions a cost-effective use of health resources. However, current levels of burden can only be reduced significantlyif there is a substantialincrease substantial increase intreatment coverage.