Subclinical Thyroid Dysfunction and the Risk of Heart Failure in Older Persons at High Cardiovascular Risk.

Context: Subclinical thyroid dysfunction is common in older people. However, its clinical importance is uncertain. Objective: Our objective was to determine the extent to which subclinical hyperthyroidism and hypothyroidism influence the risk of heart failure and cardiovascular diseases in older people. Setting and Design: The Prospective Study of Pravastatin in the Elderly at Risk (PROSPER) is an prospective cohort study. Patients: Patients included men and women aged 70-82 yr (n = 5316) with known cardiovascular risk factors or previous cardiovascular disease. Main Outcome Measures: Incidence rate of heart failure hospitalization, atrial fibrillation, and cardiovascular events and mortality according to baseline thyroid status were evaluated. Euthyroid participants (TSH =0.45-4.5 mIU/liter) were compared with those with subclinical hyperthyroidism (TSH <0.45 mIU/liter) and those with subclinical hypothyroidism (TSH ≥4.5 mIU/liter, both with normal free T(4)). Results: Subclinical hyperthyroidism was present in 71 participants and subclinical hypothyroidism in 199 participants. Over 3.2 yr follow-up, the rate of heart failure was higher for subclinical hyperthyroidism compared with euthyroidism [age- and sex-adjusted hazard ratio (HR) = 2.93, 95% confidence interval (CI) = 1.37-6.24, P = 0.005; multivariate-adjusted HR = 3.27, 95% CI = 1.52-7.02, P = 0.002). Subclinical hypothyroidism (only at threshold >10 mIU/liter) was associated with heart failure (age- and sex-adjusted HR = 3.01, 95% CI = 1.12-8.11, P = 0.029; multivariate HR = 2.28, 95% CI = 0.84-6.23). There were no strong evidence of an association between subclinical thyroid dysfunction and cardiovascular events or mortality, except in those with TSH below 0.1 or over 10 mIU/liter and not taking pravastatin. Conclusion: Older people at high cardiovascular risk with low or very high TSH along with normal free T(4) appear at increased risk of incident heart failure.

State of Asian Americans and Pacific Islanders Series, September 2014

In this series, the Center for American Progress and AAPI Data bring together the most salient data points on AAPIs in 10 reports on a range of topics, including public opinion, civic participation, immigration, language needs, labor-market outcomes, and consumer and business activity. In doing so, we provide comparisons between AAPIs and other racial groups in the United States, as well as comparisons within the AAPI community by detailed origin—ranging from Chinese Americans and Bangladeshi Americans to Native Hawaiians and Tongan Americans.

African-Americans in Iowa, 2015

To recall and celebrate the positive contributions to our nation made by people of African descent, American historian Carter G. Woodson established Black History Week beginning on Feb. 12, 1926. In 1976, as part of the nation’s bicentennial, the week was expanded into Black History Month.

Iowa Commission on the Status of African-Americans Strategic Plan, 1999-2000

The Commission on the Status of African-Americans, formerly known as the Commission on the Status of Blacks, was created by statute in 1988. The nine members of the commission are appointed by the Governor and represent each region of the State where there is a significant African-American population. Meetings are open to the public. The commission sets policy for and provides direction to the Division of the Status of African-Americans within the Department of Human Rights. The division administrator is appointed by the Governor and confirmed by the Iowa Senate.

Resources for career education, 1977.

This document contains a multitude of resources for career education available to Iowans from many sources.

New diagnoses of dementia among older patients admitted to postacute care.

Objectives: To determine the prevalence of dementia and the proportion of undiagnosed dementia in elderly patients admitted to postacute care, and to identify patients' characteristics associated with undiagnosed dementia. Design: Cross-sectional study. Setting: Academic postacute rehabilitation facility in Lausanne, Switzerland. Participants: Patients (N = 1764) aged 70 years and older. Measurements: Data on socio-demographic, medical, functional, and affective status were collected upon admission. Data on cognitive performance (Mini-Mental State Exam [MMSE]), and cognition-related discharge diagnoses were abstracted through a structured review of discharge summaries. Results: Overall, 24.1% (425/1764) patients had a diagnosis of dementia, most frequently secondary to Alzheimer's disease (260/425, 61.2%). Among dementia cases, 70.8% (301/425) were newly diagnosed during postacute stay. This proportion was lower among patients referred from internal medicine than from orthopedic/surgery services (65.8% versus 74.8%, P = .042). Compared to patients with already diagnosed dementia, those newly diagnosed were older, lived alone more frequently, and had better functional status and MMSE score at admission (all P < .05). In multivariate analysis, previously undetected dementia remained associated with older age (OR = 2.4 for age 85 years and older, 95% CI 1.5-4.0, P = .001) and normal MMSE at admission (OR = 5.9, 95% CI 2.7-12.7, P < .001). Conclusion: Dementia was present in almost a fourth of elderly patients referred to postacute care, but was diagnosed in less than a third before admission. Oldest old patients appear especially at risk for underrecognition. These results emphasize the high diagnostic yield of systematic cognitive assessment in the postacute care setting to improve these patients' management and quality of life.

Asian/Pacific American heritage month, May 2005 (Asian/Pacific Americans in Iowa 2005)

Demographic profile of the Iowa population Asian and Pacific Islander descent.

Asian/Pacific Americans in Iowa May 2006

Demographic profile of the Iowa population Asian and Pacific Islander descent.

Asian/Pacific Americans in Iowa: 2007

Demographic profile of the Iowa population Asian and Pacific Islander descent.

Asian/Pacific Americans in Iowa: 2008

Demographic profile of the Iowa population Asian and Pacific Islander descent.

Asian/Pacific Americans in Iowa: 2009

Demographic profile of the Iowa population Asian and Pacific Islander descent.

Asian/Pacific Americans in Iowa: 2010

Demographic profile of the Iowa population Asian and Pacific Islander descent.

Asian/Pacific Americans in Iowa: 2011

Demographic profile of the Iowa population Asian and Pacific Islander descent.