Age Related Outcome in Acute Subdural Haematoma Following Traumatic Head Injury

Acute subdural haematoma (ASDH) is one of the conditions most strongly associated with severe brain injury. Reports prior to 1980 describe overall mortality rates for acute subdural haematomas (SDH's) ranging from 40% to 90% with poor outcomes observed in all age groups. Recently, improved results have been reported with rapid diagnosis and surgical treatment. The elderly are predisposed to bleeding due to normal cerebral atrophy related to aging, stretching the bridging veins from the dura. Prognosis in ASDH is associated with age, time from injury to treatment, presence of pupillary abnormalities, Glasgow Coma Score (GCS) or motor score on admission, immediate coma or lucid interval, computerized tomography findings (haematoma volume, degree of midline shift, associated intradural lesion, compression of basal cisterns), post-operative intracranial pressure and type of surgery. Advancing age is known to be a determinant of outcome in head injury. The authors present the results of a retrospective study carried out in Beaumont Hospital, Dublin, Ireland's national neurosurgical centre. The aim of this study was to examine the impact of age on outcome in patients with ASDH following severe head injury. Only cases with acute subdural haematoma requiring surgical evacuation were recruited.

Mortality target monitoring (life expectancy and all-age all-cause mortality, overall and inequalities)

The latest annual update on life expectancy data and all age all cause mortality rates, with data updated to 2006-08, which are used to monitor progress against Department of Health targets for overall life expectancy in England, and for the gap in life expectancy between the areas with the worst health and deprivation indicators (the Spearhead group) and the England average, was released on 5th November 2009 according to the arrangements approved by the UK Statistics Authority. �� The key points from the latest release are: �� - The overall life expectancy and all age all cause mortality (AAACM) trends for both males and females are broadly on course to deliver the target of 78.6 years for men and 82.5 years for women by 2010 (2009-11). �� - In 2006-08, life expectancy at birth in England continued to increase for both males and females, and reached its highest level on record at 77.7 years for males and 81.9 years for females. �� - Three-year average AAACM rates for England have fallen in each period since 1995-97. �� - In 2006-08, average life expectancy at birth in the Spearhead Group was 75.8 years for males and 80.4 years for females, having increased in each period since 1995-97. �� - However, England average life expectancy at birth has increased more quickly over this period, and, in 2006-08, the relative gap ��� i.e. percentage difference - in life expectancy at birth between England and the Spearhead Group was wider than at the baseline for the target (1995-97) for both males and females. �� - For males the relative gap was 7% wider than at the baseline (compared with 4% wider in 2005-07), for females 14% wider (compared with 11% wider in 2005-07).�� �� Therefore, the target to narrow the life expectancy gap between the Spearhead Group and the England average, by at least 10% by 2010, remains challenging.��Three-year average AAACM rates for the Spearhead Group have fallen in each period since 1995-97 for both males and females. Download Mortality target monitoring (life expectancy and all-age all-cause mortality, overall and inequalities): update to include data for 2008 (PDF, 683K)Download pre-release access list (PDF, 10k)��

Inequalities in Old Age: The impact of the recession on older people in Ireland, North and South CARDI Grants

Inequalities in Old Age: the impact of the recession on older people in Ireland, North and SouthAbout the research:This research, led by Professor Paddy Hillyard, Emeritus Professor Queen’s University Belfast, was carried out with funding from CARDI’s Grants Programme Call 2. The purpose of the study was to analyse the impact of the recession on older people in Northern Ireland (NI) and the Republic of Ireland (ROI) and the extent to which inequalities within the older population have been affected by the economic crisis.Research Brief:This brief, authored by CARDI staff, is based on the findings of the research project and also contains additional information of interest.Research Team:Professor Paddy Hillyard, Emeritus Professor Queen’s University Belfast - lead researcher;Dr Francesca Lundstr̦m, Research Consultant;Dr Demi Patsios, Policy Research Consultant;Sarah Machniewski, Researcher;David Taylor, Chartered Accountant and Management Consultant;Dr Maureen Lyons, Research Manager, School of Social Justice, UCD.Methodology and availability of data:Several methods were used in the research, including:�� a review of relevant literature;����a detailed analysis of many databases relevant to older people’s incomes and lives;��building a model to assess the impact of the recession on older people;surveys of financial advisers in voluntary, private and public sectors;��six focus groups, three each in NI and RoI.Availability of data:Despite the huge amount of information which is officially collected and published in NI and RoI, very little is directly comparable. ��The development of a mechanism to encourage the production of more comparable data North and South would be very beneficial.��For example, this study identified a basket of 25 factors that can be used to compare the living standards of older people in NI and RoI and to monitor changes in future yearsTo access the full report please click on the following link:Inequalities in Old Age: the impact of the recession on older people in Ireland, North and SouthPlease find the presentation from the launch below:Inequalities, Pensions and the Recession by Prof Paddy Hillyard, Queen’s University Belfast and Dr Demi Patsios, Policy Research Consultant, Dr Francesca Lundstr̦m, Research Consultant.��������

Frontotemporal Dementia Research Coming of Age: Alzheimer Research Forum

Long the obscure cousins of Alzheimer's, the frontotemporal dementias last month stood in the glare of a large three-day meeting devoted specifically to this particular group of diseases. FTD is an isolating and ruinous progressive illness. Sufferers exhibit a range of disturbing, aberrant behaviors and often reckless financial decisions, all coupled with a puzzling emotional flatness that makes it impossible for them to realize it's actually wrong to cheat on a spouse or spend the family savings. In the wake of some recent genetic and biochemical advances, FTD research is now quickly picking up speed, and a new sense of optimism pervaded the 7th International Conference on Frontotemporal Dementias. Madolyn Bowman Rogers captured its essence-read her series to learn what FTD is, and how new research is changing its diagnosis, biological understanding, and the search for new treatments.Frontotemporal Dementia Research Comes of AgeNeuroimaging Opens Window to Disease, Better DiagnosisDissecting the Pathways Behind Frontotemporal DementiaClinical Trials a Ripple, Scientists Hope for a WaveView PDF of the entire series.��

Frontotemporal Dementia Research Coming of Age: Alzheimer Research Forum

Long the obscure cousins of Alzheimer's, the frontotemporal dementias last month stood in the glare of a large three-day meeting devoted specifically to this particular group of diseases. FTD is an isolating and ruinous progressive illness. Sufferers exhibit a range of disturbing, aberrant behaviors and often reckless financial decisions, all coupled with a puzzling emotional flatness that makes it impossible for them to realize it's actually wrong to cheat on a spouse or spend the family savings. In the wake of some recent genetic and biochemical advances, FTD research is now quickly picking up speed, and a new sense of optimism pervaded the 7th International Conference on Frontotemporal Dementias. Madolyn Bowman Rogers captured its essence-read her series to learn what FTD is, and how new research is changing its diagnosis, biological understanding, and the search for new treatments.Frontotemporal Dementia Research Comes of AgeNeuroimaging Opens Window to Disease, Better DiagnosisDissecting the Pathways Behind Frontotemporal DementiaClinical Trials a Ripple, Scientists Hope for a WaveView PDF of the entire series.��

Inequalities in old age - old news or new debate: Presentations

On October 20th, 2010, CARDI hosted an event entitled��'Inequalities in old age - old news or new debate?’. The event marked the launch of a CARDI funded research report Inequalities in Old Age: the impact of the recession on older people in Ireland, North and South��and the launch of a discussion paper prepared for CARDI by Dr. Maria Pierce and Dr.��Virpi Timonen, Trinity College Dublin��Theories of Ageing and Approaches to Welfare in Ireland, North and South [summary]. The event also featured a number of other presentations. Please find a selection of the presentations from the day below:Theories of Ageing: Lenses for Understanding, Signposts for Reforming Social Protection in Old Age by Dr Virpi Timonen, Director of SPARC and Dr Maria Pierce, Research Fellow, Trinity College Dublin.Inequalities, Pensions and the Recession by Prof Paddy Hillyard, Queen’s University Belfast and Dr Demi Patsios, Policy Research Consultant, Dr Francesca Lundstr̦m, Research Consultant.Pensions and Older Women by Dr Aine N�_ L̩ime, Programme Co-ordinator, ICSG (Irish Centre for Social Gerontology), NUI Galway.����

Health Inequality Profiles 2008 - All age, all cause standardised vs. EoE

DSRs (with CIs) for All age, all cause mortality 2001-03 to 2005-07, by gender, for Counties/UAs, County quintiles, County 80/20 standardises - as in previous years - against East of England Census 2001 population.

Frequency of viruses associated with acute respiratory infections in children younger than five years of age at a locality of Mexico City

A locality in the district of Tlalpan, Mexico City, was selected in order to identify the viral agents in children younger than 5 years of age with acute respiratory infection (ARI). A total of 300 children were randomly selected and were included in this study for a period of 13 months. During this period nasopharyngeal exudates were collected for the isolation of viral agents. Monoclonal fluorescent antibodies were used for viral identification after cell culture. Viral infection was detected in 65% of the specimens. The respiratory syncytial virus (RSV) was the most common virus agent detected. Children required an average of two consultations during the study period. Two high incidence peaks were observed, one during the summer and the other during winter; the most frequent viruses during these seasons were influenza A and RSV, respectively. The largest number of viruses was isolated in the group of children between 1 and 2 years of age and in the group between 4 and 5 years of age. This study demonstrated the presence of ARI and of different viruses in a period of 13 months, as well as the most frequent viruses in children younger than 5 years of age from a community of Mexico City.

Early infection and asymptomatic spread of hepatitis A virus in a public child care center in Rio de Janeiro, Brazil: should attending children under two years of age be vaccinated?

A cross-sectional study was conducted in order to identify hepatitis A virus (HAV) serological markers in 418 individuals (mean age, 16.4 years; range, 1 month-80 years) at a public child care center in Rio de Janeiro, Brazil, as well as to analyze risk factors and determine circulating genotypes. Serum samples were tested using an enzyme immunoassay. Reverse transcription polymerase chain reaction (RT-PCR) was used to detect and characterize HAV RNA, and sequencing was performed. Anti-HAV antibodies and IgM anti-HAV antibodies were detected, respectively, in 89.5% (374/418) and 10.5% (44/418) of the individuals tested. Acute HAV infection in children was independently correlated with crawling (p < 0.05). In 56.8% (25/44) of the IgM anti-HAV-positive individuals and in 33.3% (5/15) of the IgM anti-HAV-negative individuals presenting clinical symptoms, HAV RNA was detected. Phylogenetic analysis revealed co-circulation of subgenotypes IA and IB in 93.3% (28/30) of the amplified samples. In present study, we verify that 79% (30/38) of children IgM anti-HAV-positive were asymptomatic. In child care centers, this asymptomatic spread is a more serious problem, promoting the infection of young children, who rarely show signs of infection. Therefore, vaccinating children below the age of two might prevent the asymptomatic spread of hepatitis A.

Age Appropriate Hearing Assessment Diagnostic Testing Guidance

Parental or professional concern regarding an infant/young child's hearing may be identified at any time.� Where such concern is identified, direct referral should be made, irrespective of newborn hearing screening outcomes and with parental agreement.�

Early Carboniferous age of the Versoyen ophiolites and consequences: non-existence of a "Valais ocean'' (Lower Penninic, western Alps)

Ophiolites occur at several places in the Lower Penninic of the W and Central Alps. They are generally ascribed to oceanic crust of a so-called ``Valais ocean'' of Cretaceous age which plays a fundamental role in many models of Alpine paleogeography and geodynamics. The type locality and only observational base for the definition of a ``Valais ocean'' in the W Alps is the Versoyen ophiolitic complex, on the French-Italian boundary W of the Petit St-Bernard col. The idea of a "Valais ocean'' is based on two propositions that are since 40 years the basis for most reconstructions of the Lower Penninic: (1) The Versoyen forms the (overturned) stratigraphic base of the Cretaceous-Tertiary Valais-Tarentaise series; and (2) it has a Cretaceous age. We present new field and isotopic data that severely challenge both propositions. (1) The base of the Versoyen ophiolite is a thrust. It overlies a wildflysch with blocks of Versoyen rocks, named the Mechandeur Formation. This ``supra-Tarentaise'' wildflysch has been confused with an (overturned) stratigraphic transition from the Versoyen to the Valais-Tarentaise series. Thus the contact Versoyen/Tarentaise is not stratigraphic but tectonic, and the Versoyen ophiolite has no link with the Valais basin. This thrust corresponds to an inverse metamorphic discontinuity and to an abrupt change in tectonic style. (2) The contact of the Versoyen complex with the overlying Triassic-Jurassic Petit St-Bernard (PSB) series is stratigraphic (and not tectonic as admitted by all authors since 50 years). Several types of sedimentary structures polarize it and show that the PSB series is younger than the Versoyen. Consequently the Versoyen ophiolitic complex is Paleozoic and forms the basement of the PSB Mesozoic sediments. They both belong to a single tectonic unit, named the Versoyen-Petit St-Bernard nappe. (3) Ion microprobe U-Pb isotopic data on zircons from the main gabbroic intrusion in the Versoyen complex give a crystallization age of 337.0 +/- 4.1 Ma (Visean, Early Carboniferous). These zircons show typical oscillatory zoning and no overgrowth or corrosion. and are interpreted to date the Versoyen magmatism. These U-Pb data are in excellent agreement with our field observations and confirm the Paleozoic age of the Versoyen ophiolite. The existence of a ``Valais ocean'' of Cretaceous age in the W Alps becomes very improbable. The eclogite facies metamorphism of the Versoyen-Petit St-Bernard nappe results from an Alpine intra-continental subduction, guided by a Paleozoic oceanic suture. This is an example of the lone term influence of inherited deep-seated structures on a Much younger orogeny. This might well be a major cause of of the inherent complexity of the Alps.

Effects of dietary protein type on oxidized cholesterol-induced alteration in age-related modulation of lipid metabolism and indices of immune function in rats.

Exogenous oxidized cholesterol disturbs both lipid metabolism and immune functions. Therefore, it may perturb these modulations with ageing. Effects of the dietary protein type on oxidized cholesterol-induced modulations of age-related changes in lipid metabolism and immune function was examined using differently aged (4 weeks versus 8 months) male Sprague-Dawley rats when casein, soybean protein or milk whey protein isolate (WPI) was the dietary protein source, respectively. The rats were given one of the three proteins in diet containing 0.2% oxidized cholesterols mixture. Soybean protein, as compared with the other two proteins, significantly lowered both the serum thiobarbituric acid reactive substances value and cholesterol, whereas it elevated the ratio of high density lipoprotein-cholesterol/cholesterol in young rats, but not in adult. Moreover, soybean protein, but not casein and WPI, suppressed the elevation of Delta6 desaturation indices of phospholipids in both liver and spleen, particularly in young. On the other hand, WPI, compared to the other two proteins, inhibited the leukotriene B4 production of spleen, irrespective of age. Soybean protein reduced the ratio of CD4(+)/CD8(+) T-cells in splenic lymphocytes. Therefore, the levels of immunoglobulin (Ig)A, IgE and IgG in serum were lowered in rats given soybean protein in both age groups except for IgA in adult, although these observations were not shown in rats given other proteins. Thus, various perturbations of lipid metabolism and immune function caused by oxidized cholesterol were modified depending on the type of dietary protein. The moderation by soybean protein on the change of lipid metabolism seems to be susceptible in young rats whose homeostatic ability is immature. These observations may be exerted through both the promotion of oxidized cholesterol excretion to feces and the change of hormonal release, while WPI may suppress the disturbance of immune function by oxidized cholesterol in both ages. This alleviation may be associated with a large amount of lactoglobulin in WPI. These results thus showed a possibility that oxidized cholesterol-induced perturbations of age-related changes of lipid metabolism and immune function can be moderated by both the selection and combination of dietary protein.

The impact of social relationships on the maintenance of independence in advanced old age: findings of a Swiss Longitudinal Study .

The impact of social relationships on the maintenance of independence over periods of 12-18 months in a group of 306 octogenarians is assessed in this study. The study is based on the results of the Swilsoo (Swiss Interdisciplinary Longitudinal Study on the Oldest Old). Participants (80-84 years old at baseline) were interviewed five times between 1994 and 1999. Independence was defined as the capacity to perform without assistance eight activities of daily living. We distinguished in our analyses kinship and friendship networks and evaluated social relationships with the help of a series of variables serving as indicators of network composition and contact frequency. Logistic regression models were used to identify the short-term effects of social relationships on independence, after controlling for sociodemographic and health-related variables; independence at a given wave of interviews was interpreted in the light of social factors measured at the previous wave. Our analyses indicate that the existence of a close friend has a significant impact on the maintenance of independence (OR=1.58, p<0.05), which is not the case with the other variables concerning network composition. Kinship contacts were also observed to have a positive impact on independence (OR=1.12, p<0.01).