Prevention of age-associated dementia.

The advancement of medical sciences during the last century has resulted in a considerable increase in life expectancy. As more people live to old age, one of the most fundamental questions of the 21st century is whether the number of individuals suffering from dementia will also continue to increase. Alzheimer's disease (AD) accounts for the majority of cases of dementia in the elderly, but there is currently no curative treatment available. Several strategies have been introduced for treatment, the most recent strategy of which was the immunization of patients using antibodies against Abeta, which is a naturally occurring, even though misfolded peptide in the AD brain. Both active and passive immunization routes have been shown to reduce the pathology associated with Abeta accumulation in brains of genetically designed animal models. However, despite tremendous efforts, no unequivocal proof of therapeutic efficacy could be shown in AD patients. Particularly, the persistence of the neurofibrillary tangles in immunized brains and the issue of inducing cerebral amyloid angiopathy are major limiting factors of antibody therapy. Furthermore, physical activity, a healthy immune system and nutritional habits are suggested to protect against the onset of age-associated dementia. Thus, accumulative evidence suggests that an early integrated strategy, combining pharmacological, immunological, nutritional and life-style factors, is the most pragmatic approach to delay the onset and progression of age-associated dementia.

Affordable Housing in Iowa: Meeting New Challenges, 2007

Iowa faces a signifi cant challenge over the next decade. In the words of a recent report, “The state faces the danger of worker and skill gaps that could undermine its businesses, erode the earning power of its workers, and slow its economic growth.” (Iowa Works Campaign, 2006) Iowa’s economic and demographic stability depends on attracting new immigrants and slowing the departure of residents. Eroding housing affordability and quality will make this more difficult. Housing alone cannot solve the problem, but it must be part of the solution. This study examines trends in the state’s major housing markets, analyzes the achievements of housing programs in the recent past, and incorporates input from more than 80 housing experts across the state. The second part of this study (included on the attached CD) analyzes housing’s impact on the economy. We developed three major policy recommendations.

Affordable Housing in Iowa: Meeting New Challenges, 2007

Iowa faces a significant challenge over the next decade. In the words of a recent report, “The state faces the danger of worker and skill gaps that could undermine its businesses, erode the earning power of its workers, and slow its economic growth.” (Iowa Works Campaign, 2006) Iowa’s economic and demographic stability depends on attracting new immigrants and slowing the departure of residents. Eroding housing affordability and quality will make this more difficult. Housing alone cannot solve the problem, but it must be part of the solution. This study examines trends in the state’s major housing markets, analyzes the achievements of housing programs in the recent past, and incorporates input from more than 80 housing experts across the state. The second part of this study (included on the attached CD) analyzes housing’s impact on the economy. We developed three major policy recommendations.

European society of hypertension position paper on ambulatory blood pressure monitoring.

Ambulatory blood pressure monitoring (ABPM) is being used increasingly in both clinical practice and hypertension research. Although there are many guidelines that emphasize the indications for ABPM, there is no comprehensive guideline dealing with all aspects of the technique. It was agreed at a consensus meeting on ABPM in Milan in 2011 that the 34 attendees should prepare a comprehensive position paper on the scientific evidence for ABPM.This position paper considers the historical background, the advantages and limitations of ABPM, the threshold levels for practice, and the cost-effectiveness of the technique. It examines the need for selecting an appropriate device, the accuracy of devices, the additional information and indices that ABPM devices may provide, and the software requirements.At a practical level, the paper details the requirements for using ABPM in clinical practice, editing considerations, the number of measurements required, and the circumstances, such as obesity and arrhythmias, when particular care needs to be taken when using ABPM.The clinical indications for ABPM, among which white-coat phenomena, masked hypertension, and nocturnal hypertension appear to be prominent, are outlined in detail along with special considerations that apply in certain clinical circumstances, such as childhood, the elderly and pregnancy, and in cardiovascular illness, examples being stroke and chronic renal disease, and the place of home measurement of blood pressure in relation to ABPM is appraised.The role of ABPM in research circumstances, such as pharmacological trials and in the prediction of outcome in epidemiological studies is examined and finally the implementation of ABPM in practice is considered in relation to the issue of reimbursement in different countries, the provision of the technique by primary care practices, hospital clinics and pharmacies, and the growing role of registries of ABPM in many countries.

To say or not to say: a qualitative study on the disclosure of their condition by human immunodeficiency virus-positive adolescents.

PURPOSE: Human immunodeficiency virus (HIV)-positive adolescents face a number of challenges in dealing with their disease, treatment, and developmental tasks. This qualitative study describes some of the reasons why, and the extent to which, adolescents may or may not disclose their condition to others. METHODS: A semistructured interview lasting 40-110 minutes was conducted with each of 29 adolescents 12-20 years old, 22 female and seven male) living in Switzerland. Interviews were tape recorded and transcribed verbatim. The analysis of the content of interviews allowed us to identify salient topics (e.g., disclosure), which were then explored in detail. RESULTS: Of 29 participants, eight had not disclosed their condition to anyone outside the family, 19 had disclosed it to good friends, and 16 had disclosed it to some teachers. Four participants had engaged in public disclosure, and six of 10 sexually active teenagers disclosed their status to their partners. The attitudes toward disclosure among younger adolescents were mostly related to those of the parents, particularly the mother. Older adolescents, engaged in their search for autonomy, tended to decide independently what to say and to whom. Although foster/adoptive parents would often encourage disclosure, biological parents, especially HIV-positive mothers, insisted on not disclosing the adolescent's status for fear of stigma. CONCLUSION: The health care team should systematically address the issue of disclosure with the adolescent and his family (or foster parents), the aim being to balance the right of the adolescent and that adolescent's family to maintain privacy against the concerns of sexual partners, as well as the adolescent's interest in divulging HIV status to relatives, school staff, and friends.

Too cold may not be so cool: spontaneous hypothermia as a marker of poor outcome after cardiac arrest.

In a recent issue of Critical Care, den Hartog and colleagues show an association between spontaneous hypothermia, defined by an admission body temperature < 35°C, and poor outcome in patients with coma after cardiac arrest (CA) treated with therapeutic hypothermia (TH). Given that TH alters neurological prognostication, studies aiming to identify early markers of injury severity and outcome are welcome, since they may contribute overall to optimize the management of comatose CA patients. This study provides an important message to clinicians involved in post-resuscitation care and raises important questions that need to be taken into account in future studies.

Interiority of the optimal population growth rate with endogenous fertility

This paper analyzes the issue of the interiority of the optimal population growth rate in a two-period overlapping generations model with endogenous fertility. Using Cobb-Douglas utility and production functions, we show that the introduction of a cost of raising children allows for the possibility of the existence of an interior global maximum in the planner¿s problem, contrary to the exogenous fertility case

The costs of soil erosion

The aim of this study was a survey of the estimated costs of soil erosion, an issue of fundamental importance in view of the current worldwide discussions on sustainability. A list was drawn up of research papers on erosion (on-site and off-site effects) and their respective costs. The estimates indicate the amount of resources spent in the process of soil degradation, raising a general awareness of the need for soil conservation. On-site costs affect the production units directly, while off-site costs create a burden borne by the environment, economy and society. In addition, estimating the costs of soil erosion should be effective to alert the agricultural producers, society and government for the need for measures that can be implemented to bring erosion under control. Among the various estimates of soil erosion costs between 1933 a 2010, the highest figure was 45.5 billion dollars a year for the European Union. In the United States, the highest figure was 44 billion dollars a year. In Brazil, estimates for the state of Paraná indicate a value of 242 million dollars a year, and for the state of São Paulo, 212 million dollars a year. These figures show, above all, that conservation measures must be implemented if crop and livestock farming production are to be sustainable.

Lagrangian and Hamiltonian BRST structures of the antysimmetric tensor gauge theory

We study the Becchi-Rouet-Stora-Tyutin (BRST) structure of a self-interacting antisymmetric tensor gauge field, which has an on-shell null-vector gauge transformation. The Batalin-Vilkovisky covariant general formalism is briefly reviewed, and the issue of on-shell nilpotency of the BRST transformation is elucidated. We establish the connection between the covariant and the canonical BRST formalisms for our particular theory. Finally, we point out the similarities and differences with Wittens string field theory.

Pharmacodynamic, pharmacokinetic and pharmacogenetic aspects of drugs used in the treatment of Alzheimer's disease.

With the aging population and its rapidly increasing prevalence, dementia has become an important public health concern in developed and developing countries. To date, the pharmacological treatment is symptomatic and based on the observed neurotransmitter disturbances. The four most commonly used drugs are donepezil, galantamine, rivastigmine and memantine. Donepezil, galantamine and rivastigmine are acetylcholinesterase inhibitors with different pharmacodynamic and pharmacokinetic profiles. Donepezil inhibits selectively the acetylcholinesterase and has a long elimination half-life (t½) of 70 h. Galantamine is also a selective acetylcholinesterase inhibitor, but also modulates presynaptic nicotinic receptors. It has a t½ of 6-8 h. Donepezil and galantamine are mainly metabolised by cytochrome P450 (CYP) 2D6 and CYP3A4 in the liver. Rivastigmine is a so-called 'pseudo-irreversible' inhibitor of acetylcholinesterase and butyrylcholinesterase. The t½ of the drug is very short (1-2 h), but the duration of action is longer as the enzymes are blocked for around 8.5 and 3.5 h, respectively. Rivastigmine is metabolised by esterases in liver and intestine. Memantine is a non-competitive low-affinity antagonist of the NMDA receptor with a t½ of 70 h. Its major route of elimination is unchanged via the kidneys. Addressing the issue of inter-patient variability in treatment response might be of special importance for the vulnerable population taking anti-dementia drugs. Pharmacogenetic considerations might help to avoid multiple medication changes due to non-response and/or adverse events. Some pharmacogenetic studies conducted on donepezil and galantamine reported an influence of the CYP2D6 genotype on the pharmacokinetics of the drugs and/or on the response to treatment. Moreover, polymorphisms in genes of the cholinergic markers acetylcholinesterase, butyrylcholinesterase, choline acetyltransferase and paraoxonase were found to be associated with better clinical response to acetylcholinesterase inhibitors. However, confirmation studies in larger populations are necessary to establish evidence of which subgroups of patients will most likely benefit from anti-dementia drugs. The aim of this review is to summarize the pharmacodynamics and pharmacokinetics of the four commonly used anti-dementia drugs and to give an overview on the current knowledge of pharmacogenetics in this field.

Pathogenèse des maladies cardiovasculaires chez les patients infectés par le VIH: un big bang encore non élucidé [Controversies regarding the pathogenesis of cardiovascular diseases in HIV patients].

Controversies regarding the pathogenesis of cardiovascular diseases in HIV patients Since the introduction of HAART (Highly active anti-retroviral therapy), the incidence of cardiovascular events has risen in patients infected with HIV. This development is mainly due to the increased survival in these patients. Nonetheless, the pathogenic effects of HIV on the principal components of haemostasis (endothelium, platelets and the clotting cascade) are the subject of numerous ongoing research studies, and are becoming an argument for starting HAART or for modifying the components of an established therapy. The aim of this article is to raise clinician awareness regarding the issue of cardiovascular disease in the HIV-infected patient.

Getting down to the core of homologous recombination.

In a paper in this week's issue of Science, Voloshin et al. (p. 868) show that a 20-amino acid peptide from RecA, a bacterial protein that repairs and recombines DNA, can mediate DNA strand exchange--one of the functions of the RecA protein. Stasiak discusses why this result is surprising and what the rest of the RecA protein is for.

LSI-R Scores: Change Matters - Part II, Data Download, Iowa Department of Corrections

In the last issue of the Data Download, we discussed that overall, a 10% drop in LSI-R scores for our highest risk offenders was associated with a 6% reduction in recidivism. However, LSI-R score reductions for the lowest risk offenders don't substantially affect their already low recidivism rates. The issue contained charts that showed this held true for both probationers and parolees. The charts below show that change also matters for women offenders and African-American offenders.

Iowa Private Sector Prison Employment Works, Data Download, Iowa Department of Corrections, November 2006

This issue of the ICON Data Download describes highlights from the findings for the Iowa sample, which tracked 1,091 inmates who worked in private sector prison industries jobs and were released from prison between 1999 and 2001, and compared their results with similar offenders who had worked in either traditional prison industries, or other institutional jobs. All offenders were tracked through mid-2003. This results in a follow-up period of slightly less than two years up to four and one-half years.

LSI-R Assessment is Valid for Iowa Offenders, Data Download, Iowa Department of Corrections, September 2006

Welcome to the first issue of the ICON Data Download, a periodic report intended to communicate findings relevant to those who work directly with offenders, as well as those involved in planning, policy and budgeting. This issue highlights work conducted by research partner Christopher Lowenkamp, Ph.D., of the University of Cincinnati and his research associate, Kristin Bechtel, M.S. Data for this analysis was provided from the Iowa Justice Data Warehouse – and takes advantage of the link between ICON and ICIS (the court database) to readily track offender recidivism.