High prevalence of osteoporosis in Swiss women aged 60 and older: a 2-year pilot screening campaign.

Background: Osteoporosis (OP) is frequent in postmenopausal women, but remains underdiagnosed and undertreated. In Switzerland, DXA is not reimbursed by the insurances for screening, even if it is recommended to test women's Bone Mineral Density (BMD) at the age of 65. Methods: To assess the feasibility of a screening program for OP, the Bone diseases center of Lausanne has been mandated to perform a 2-year information and screening campaign (3 days per months) for women age 60 and older through the state of Vaud using a mobile unit for bone assessment. This project is still ongoing. Women are informed by media for dates and screening locations. Appointments are taken by phone. Women known for osteoporosis or already treated are excluded. During the evaluation every women is assessed by a questionnaire for risk factors, by a DXA measurement (Discovery C, Hololgic), and by Vertebral Fracture Assessment (VFA) for Genant's grades 2 and 3 prevalent vertebral fractures (VF). Women are considered at high risk of fracture if they have a hip fracture, a VF, another fragility fracture with a BMD T-score ≤-2 or a BMD T-score ≤-2.5. Results: After 17 months (50 days of screening), 752 women were assessed, mean age 66��6 yrs, mean BMI 26��5 kg/m2, mean lowest T-score -1.6��1.0 SD. 215 women (29%) were considered at high risk, 92 of them (12%) having established OP and 50 (7%) having one or more fragility VF. VF were unknown for 83% of the women and discovered by VFA. The number needed to screen (NNS) were 3.5 for high risk women, 8.2 for established OP and 15 for VF. Conclusions: After near �� of the project, prevalence of women at high risk of fracture was high, with a NNS below 4. Knowing the global cost of OP and that current treatment have a high efficacy for fracture risk reduction, such a screening program could have a positive economic impact. VFA allowed discovering many women with unknown VF, who were at very high risk of further fractures. A systematic screening for VF should be added to BMD measurements after the age of 60.

Record of Decision Council Bluffs Interstate System (I-29, I-80 and I-480) Improvements Project TIER 1 Environmental Impact Statement Council Bluffs, Iowa to Omaha, Nebraska FHWA-IA- EIS-04-01F Project Number: IM-029-3(62)54���13-78 Submitted Pursuant to 42 USC 4332(2)(c) and 49 USC 303, October 2008

The Federal Highway Administration (FHWA) approves the selection of the Reconstruction of All or Part of the Interstate (Construction Alternative) as the Preferred Alternative to provide improvements to the interstate system in the Omaha/Council Bluffs metropolitan area, extending across the Missouri River on Interstate 80 to east of the Interstate 480 interchange in Omaha, Nebraska. The study considered long-term, broad-based transportation improvements along Interstate I-29 (I-29), I-80, and I-480, including approximately 18 mainline miles of interstate and 14 interchanges (3 system, 11 service), that would add capacity and correct functional issues along the mainline and interchanges and upgrade the I-80 Missouri River Crossing. FHWA also approves the decisions to provide full access between West Broadway and I-29, design the I-80/I-29 overlap section as a dual-divided freeway, and locating the new I-80 Missouri River Bridge north of the existing bridge. Improvements to the interstate system, once implemented, would bring the segments of I-80 and I-29 (see Figure 1) up to current engineering standards and accommodate future traffic needs. This Record of Decision (ROD) concludes Tier 1 of the Council Bluffs Interstate System (CBIS) Improvements Project. Tier 1 included an examination of the area���s transportation needs, a study of alternatives to satisfy them, and broad consideration of potential environmental and social impacts. The Tier 1 evaluation consisted of a sufficient level of engineering and environmental detail to assist decision makers in selecting a preferred transportation strategy. During Tier 1 a Draft EIS (FHWA-IA- EIS-04-01D) was developed which was approved by FHWA, Iowa DOT, and Nebraska Department of Roads (NDOR) in November 2004 with comments accepted through March 15, 2005. The Draft EIS summarized the alternatives that were considered to address the transportation needs around Council Bluffs; identified reconstruction of all or part of the interstate, the ���Construction Alternative,��� as the Preferred Alternative; identified three system-level decisions that needed to be made at the Tier 1 level; and invited comment on the issues. The Final EIS (FHWA-IA- EIS-04-01F) further documented the Construction Alternative as the Preferred Alternative and identified the recommended decisions for the three system level decisions that needed to be made in Tier 1. This ROD defines the Selected Alternative determined in the Tier 1 studies.

Educational expansion, intergenerational mobility and over-education

[eng] There is a vast literature on intergenerational mobility in sociology and economics. Similar interest has emerged for the phenomenon of over-education in both disciplines. There are no studies, however, linking these two research lines. We study the relationship between social mobility and over-education in a context of educational expansion. Our framework allows for the evaluation of several policies, including those affecting social segregation, early intervention programs and the power of unions. Results show the evolution of social mobility, over-education, income inequality and equality of opportunity under each scenario.

Prevalence, incidence and indications of hypno-sedative treatments in hospitalized patients aged 75 and older

Introduction Sleep impairment is a common problem in older persons and is associated with adverse health and economic consequences. The most prescribed hypnosedatives in Switzerland are benzodiazepines, benzodiazepine-like hypnosedatives and clomethiazole. In the elderly persons, these medications have been associated with decreased cognitive performance, an increased risk of addiction and an increased risk of falls. The main aim of this study was to determine the prevalence, incidence and indications of hypnosedative prescriptions in older in-patients admitted to a Swiss university hospital. Furthermore, we planned to investigate the possible relationship between hypnosedatives' prescription and patients' falls during the hospital stay and we compared the prevalence of hypnosedative drugs' prescribing between geriatric and non-geriatric clinical wards.Materials & Methods This observational study included all patients aged 75 years or older admitted to a Swiss university hospital for 24 h or more. Prescription-related data were recorded every day for 26 consecutive days in the two geriatric wards, and twice, a week apart, in three non-geriatric wards.Results A total of 204 patients (mean age 84.7 �� 0.7 years, 66% women) were included. The prevalence of hypnosedative drugs prescription was 73% and the incidence was 28% on the two geriatric wards. The most common indications for a prescription on geriatric wards was insomnia (51%), followed by continuation of usual treatment (12%). The most frequently prescribed hypnosedative drug was clomethiazole (64% of the patients), followed by lorazepam (11%). We were not able to demonstrate any significant correlation between the number of hypnosedative drugs prescribed and the number of falls during hospital stay. The prevalence of hypnosedative drugs prescriptions was similar between geriatric and non-geriatric wards. The proportion of patients treated by at least one hypnosedative increased between hospital admission (32%) and discharge (45%).Discussions, Conclusion This study reveals a high prevalence of hypnosedative prescription in medical in-patients aged 75 years or older. Main indication was insomnia and the most frequently prescribed hypnosedative molecule was clomethiazole. Prescription incidence was also very high and the proportion of patients being prescribed a hypnosedative increased during hospital stay. Systematic interventions need to be integrated in order to reduce elderly inpatient exposure to treatments that are associated with adverse health outcomes.Conference information: ESCP 40th International Symposium on Clinical Pharmacy. Clinical Pharmacy: Connecting Care and Outcomes Dublin Ireland, 19-21 October 2011

Entrepreneurial skills and over-education five years later. A comparison between Spain and the Netherlands

[cat] El fen��men de la sobre-educaci�� ��s freq��ent i persistent a molts pa��sos. En aquest article estudiem el paper de les habilitats emprenedores en evitar la sobre-educaci�� a la primera feina, i en sortir d���una situaci�� de sobre-educaci�� cinc anys despr��s. Comparem els resultats d���Espanya i Holanda, dos pa��sos que difereixen en el seu sistema educatiu i mercat de treball. Els resultats mostren que les habilitats emprenedores ajuden a evitar i/o sortir de la sobre-educaci�� nom��s a Espanya, on el sistema educatiu ��s m��s flexible i menys vinculat amb el mercat de treball. En general, els nostres resultats recolzen les pol��tiques que promocionen el desenvolupament d���habilitats emprenedores al sistema educatiu espanyol.

Entrepreneurial skills and over-education five years later. A comparison between Spain and the Netherlands

[cat] El fen��men de la sobre-educaci�� ��s freq��ent i persistent a molts pa��sos. En aquest article estudiem el paper de les habilitats emprenedores en evitar la sobre-educaci�� a la primera feina, i en sortir d���una situaci�� de sobre-educaci�� cinc anys despr��s. Comparem els resultats d���Espanya i Holanda, dos pa��sos que difereixen en el seu sistema educatiu i mercat de treball. Els resultats mostren que les habilitats emprenedores ajuden a evitar i/o sortir de la sobre-educaci�� nom��s a Espanya, on el sistema educatiu ��s m��s flexible i menys vinculat amb el mercat de treball. En general, els nostres resultats recolzen les pol��tiques que promocionen el desenvolupament d���habilitats emprenedores al sistema educatiu espanyol.

Comparaisons de projections des niveaux d'incapacit�� de la population canadienne de 65 ans et plus en 2031

Le vieillissement de la population canadienne pr��visible dans les prochaines ann��es entrainera d���importants changements au point de vue social. L���un d���eux est l���augmentation fulgurante du nombre d���a��n��s en ��tat d���incapacit��. Utilisant le mod��le de microsimulation LifePaths, cette recherche compare deux projections, ayant des m��thodologies diff��rentes, du nombre d���individus en incapacit�� de 65 ans et plus vivant en m��nage priv�� en 2031. La premi��re m��thode utilise le module d���incapacit�� de LifePaths pour g��n��rer les individus en incapacit�� tandis que la seconde m��thode utilise plut��t une r��gression logistique ordonn��e pour les obtenir. Les projections du nombre d���individus en ��tat d���incapacit�� des deux m��thodes nous permettent une comparaison entre ces r��sultats. Suite �� l�����laboration de tableaux et de graphiques permettant de tracer un portait de la situation, cette recherche essaie de d��mystifier les sources possibles �� l���origine de ces diff��rences. Les r��sultats montrent d���importantes diff��rences entre les projections, sp��cifiquement pour les individus en ��tat d���incapacit�� s��v��re. De plus, lorsqu���on s���int��resse aux variables d���int��r��ts, on remarque que les diff��rences de projections d���effectifs sont importantes chez les hommes et les gens mari��s. Par contre, lorsque les proportions sont analys��es, c���est plut��t le groupe d�����ges 80 ans et plus ainsi que les projections pour la province du Qu��bec qui cr��ent probl��me. Ces diff��rences sont attribuables aux caract��ristiques d���un mod��le de microsimulation, aux populations de d��part ainsi qu���aux param��tres d��finis. Les r��sultats d��montr��s dans cette recherche mettent en garde sur les travaux ��tudiant le nombre d���individus en incapacit�� dans le futur. Nos deux m��thodes ayant des r��sultats diff��rents, nous ne pouvons pas conclure avec certitude quelle sera la situation dans le futur.

Expression profile of plasticity-related mRNAs in the cortex and hippocampus of young and aged rats and of 3xTg and wild type mice

De r��cents travaux ont mis en ��vidence que des dysfonctionnements dans l���expression de g��nes impliqu��s dans la plasticit�� synaptique contribuent aux d��clins cognitifs qu���on observe chez les gens ��g��s et �� la progression de la maladie d���Alzheimer. Notre ��tude avait comme objectif d�����tudier le profil d���expression d���ARNm sp��cifiques impliqu��s dans la plasticit�� synaptique chez des rats jeunes et ��g��s et chez des souris transg��niques 3xTg et WT. Des exp��riences en qRT-PCR ont ��t�� effectu��es dans des extraits de cortex et d���hippocampe de rats jeunes et ��g��s et de souris 3xTg et WT, respectivement. Les r��sultats ont d��montr�� une augmentation significative de l���expression d���ARNm MAP1B, Stau2, BDNF, CREB et AGO2 principalement dans l���hippocampe (r��gions CA1-CA3) des souris 3xTg compar�� aux souris WT. Une diminution significative a ��galement ��t�� observ��e pour l���ARNm ��CaMKII dans le cortex des souris 3xTg compar�� aux souris WT. Contrairement �� ces observations, aucun changement n���a ��t�� observ�� pour l���expression de g��nes impliqu��s dans la plasticit�� synaptique chez les rats ��g��s compar�� aux rats jeunes. Ces r��sultats d��montrent qu���un dysfonctionnement existe r��ellement au d��but de la maladie d���Alzheimer dans l���expression de g��nes sp��cifiques impliqu��s dans la plasticit�� synaptique et contribue potentiellement �� la progression de la maladie en engendrant un d��s��quilibre entre la LTP et la LTD. De plus, les diff��rences d���expressions sont particuli��rement observ��es dans l���hippocampe (r��gions CA1-CA3) ce qui est consistant avec les ��tudes sur la progression de la maladie d���Alzheimer puisqu���il est connu que la r��gion CA1 de l���hippocampe est la plus vuln��rable �� l���apparition de la maladie. Ces r��sultats permettent une meilleure compr��hension des ��v��nements mol��culaires qui deviennent d��r��gul��s �� l���apparition de la maladie d���Alzheimer.

Under the moon and over the sea : a collection of caribbean poems.

Colecci��n de m��s de cincuenta poes��as, dividida en cinco partes, que evoca las vistas, sonidos, gustos y cuentos del Caribe, as�� como la experiencia de vivir all��. Muchos de estos poemas son in��ditos.

Noise exposure in high school aged youths and distortion product otoacoustic emissions

This paper discusses the effect of noise exposure on high school aged boys' hearing levels and how to measure the effects.

The interannual variability of energy transports within and over the Atlantic Ocean in a coupled climate model

To gain a new perspective on the interaction of the Atlantic Ocean and the atmosphere, the relationship between the atmospheric and oceanic meridional energy transports is studied in a version of HadCM3, the U.K. Hadley Centre's coupled climate model. The correlation structure of the energy transports in the atmosphere and Atlantic Ocean as a function of latitude, and the cross correlation between the two systems are analyzed. The processes that give rise to the correlations are then elucidated using regression analyses. In northern midlatitudes, the interannual variability of the Atlantic Ocean energy transport is dominated by Ekman processes. Anticorrelated zonal winds in the subtropics and midlatitudes, particularly associated with the North Atlantic Oscillation (NAO), drive anticorrelated meridional Ekman transports. Variability in the atmospheric energy transport is associated with changes in the stationary waves, but is only weakly related to the NAO. Nevertheless, atmospheric driving of the oceanic Ekman transports is responsible for a bipolar pattern in the correlation between the atmosphere and Atlantic Ocean energy transports. In the Tropics, the interannual variability of the Atlantic Ocean energy transport is dominated by an adjustment of the tropical ocean to coastal upwelling induced along the Venezuelan coast by a strengthening of the easterly trade winds. Variability in the atmospheric energy transport is associated with a cross-equatorial meridional overturning circulation that is only weakly associated with variability in the trade winds along the Venezuelan coast. In consequence, there is only very limited correlation between the atmosphere and Atlantic Ocean energy transports in the Tropics of HadCM3

Dipeptide nanotubes, with n-terminally located omega-amino acid residues, that are stable proteolytically, thermally, and over a wide range of pH

Two dipeptides containing an N-terminally positioned omega-amino acid residue (beta-alanine/delta-amino valeric acid) self-assembles to form nanotubes in the solid state as well as in aqueous solution. In spite of having hollow nanotubular structures in the solid state and in solution, their self-assembling nature in these two states are different and this leads to the formation of different internal diameters of these nanotubes in solution and in solid state structure. These nanotubes are stable proteolytically, thermally, and over a wide range of pH values (1-13). The role of water molecules in nanotube formation has been investigated in the solid state. These nanotubes can be considered as a new class of dipeptide nanotubes as they are consisting of N-terminally located protease resistant omega-amino acid residues and C-terminally positioned alpha-amino acid residues. These dipeptides can form an interesting class of short peptidic structure that can give rise to stable nanotubular structure upon self-assembly and these nanotubes can be explored in future for potential nanotechnological applications.

Overall and income specific effect on prevalence of overweight and obesity of 20% sugar sweetened drink tax in UK: econometric and comparative risk assessment modelling study

Objective To model the overall and income specific effect of a 20% tax on sugar sweetened drinks on the prevalence of overweight and obesity in the UK. Design Econometric and comparative risk assessment modelling study. Setting United Kingdom. Population Adults aged 16 and over. Intervention A 20% tax on sugar sweetened drinks. Main outcome measures The primary outcomes were the overall and income specific changes in the number and percentage of overweight (body mass index ���25) and obese (���30) adults in the UK following the implementation of the tax. Secondary outcomes were the effect by age group (16-29, 30-49, and ���50 years) and by UK constituent country. The revenue generated from the tax and the income specific changes in weekly expenditure on drinks were also estimated. Results A 20% tax on sugar sweetened drinks was estimated to reduce the number of obese adults in the UK by 1.3% (95% credible interval 0.8% to 1.7%) or 180���000 (110���000 to 247���000) people and the number who are overweight by 0.9% (0.6% to 1.1%) or 285���000 (201���000 to 364���000) people. The predicted reductions in prevalence of obesity for income thirds 1 (lowest income), 2, and 3 (highest income) were 1.3% (0.3% to 2.0%), 0.9% (0.1% to 1.6%), and 2.1% (1.3% to 2.9%). The effect on obesity declined with age. Predicted annual revenue was ��276m (��272m to ��279m), with estimated increases in total expenditure on drinks for income thirds 1, 2, and 3 of 2.1% (1.4% to 3.0%), 1.7% (1.2% to 2.2%), and 0.8% (0.4% to 1.2%). Conclusions A 20% tax on sugar sweetened drinks would lead to a reduction in the prevalence of obesity in the UK of 1.3% (around 180���000 people). The greatest effects may occur in young people, with no significant differences between income groups. Both effects warrant further exploration. Taxation of sugar sweetened drinks is a promising population measure to target population obesity, particularly among younger adults.