The evolution of health status and chronic conditions in Catalonia, 1994-2006: the paradox of health revisited using the Blinder - Oaxaca decomposition

[EN] Background: The paradox of health refers to the improvement in objective measures of health and the increase in the reported prevalence of chronic conditions. The objective of this paper is to test the paradox of health in Catalonia from 1994 to 2006. Methods: Longitudinal cross-sectional study using the Catalonia Health Interview Survey of 1994 and 2006. The approach used was the three-fold Blinder - Oaxaca decomposition, separating the part of the differential in mean visual analogue scale value (VAS) due to group differences in the predictors (prevalence effect), due to differences in the coefficients (severity effect), and an interaction term. Variables included were the VAS value, education level, labour status, marital status, all common chronic conditions over the two cross-sections, and a variable for non-common chronic conditions and other conditions. Sample weights have been applied. Results: Results show that there is an increase in mean VAS for men aged 15-44, and a decrease in mean VAS for women aged 65-74 and 75 and more. The increase in mean VAS for men aged 15-44 could be explained by a decrease in the severity effect, which offsets the increase in the prevalence effect. The decrease in mean VAS for women aged 65-74 and 75 and more could be explained by an increase in the prevalence effect, which does not offset the decrease in the severity effect. Conclusions: The results of the present analysis corroborate the paradox of health hypothesis for the population of Catalonia, and highlight the need to be careful when measuring population health over time, as well as their usefulness to detect population's perceptions.

A dynamic model of oceanic sulfur (DMOS) applied to the Sargasso Sea: Simulating the dimethylsulfide (DMS) summer paradox

[EN]A new one-dimensional model of DMSP/DMS dynamics (DMOS) is developed and applied to the Sargasso Sea in order to explain what drives the observed dimethylsulfide (DMS) summer paradox: a summer DMS concentration maximum concurrent with a minimum in the biomass of phytoplankton, the producers of the DMS precursor dimethylsulfoniopropionate (DMSP). Several mechanisms have been postulated to explain this mismatch: a succession in phytoplankton species composition towards higher relative abundances of DMSP producers in summer; inhibition of bacterial DMS consumption by ultraviolet radiation (UVR); and direct DMS production by phytoplankton due to UVR-induced oxidative stress. None of these hypothetical mechanisms, except for the first one, has been tested with a dynamic model. We have coupled a new sulfur cycle model that incorporates the latest knowledge on DMSP/DMS dynamics to a preexisting nitrogen/carbon-based ecological model that explicitly simulates the microbial-loop. This allows the role of bacteria in DMS production and consumption to be represented and quantified. The main improvements of DMOS with respect to previous DMSP/DMS models are the explicit inclusion of: solar-radiation inhibition of bacterial sulfur uptakes; DMS exudation by phytoplankton caused by solar-radiation-induced stress; and uptake of dissolved DMSP by phytoplankton. We have conducted a series of modeling experiments where some of the DMOS sulfur paths are turned “off” or “on,” and the results on chlorophyll-a, bacteria, DMS, and DMSP (particulate and dissolved) concentrations have been compared with climatological data of these same variables. The simulated rate of sulfur cycling processes are also compared with the scarce data available from previous works. All processes seem to play a role in driving DMS seasonality. Among them, however, solar-radiation-induced DMS exudation by phytoplankton stands out as the process without which the model is unable to produce realistic DMS simulations and reproduce the DMS summer paradox.

Rates Of Obesity And Incidence Of Diabetes In Hispanics In The United States: An Examination Of The Epidemiological Paradox

Using pooled data from the 2008-2011 National Health Interview Survey and employing multinomial and binomial logistic regression methods, this research examines disparities in rates of obesity and incidence of diabetes between individual Hispanic subgroups in comparison to non-Hispanic whites and blacks. Immigration status(including nativity, duration in the United States, and citizenship status) is hypothesized to play a central role in rates and obesity and incidence of diabetes. Unlike Cuban-Americans, Mexican-Americans, Puerto Ricans, and other Hispanics were more likely to be overweight as well as obese when compared to non-Hispanic whites. Mexican-Americans had the only significance in prevalence of type 2 diabetes in comparison to non-Hispanic whites. Both of these health outcomes are strongly associated with the various immigration variables.

Simpson's Paradox: A Graphical Treatment

It is possible for a pair of dichotomous, categorical variables to have an overall positive association (say) in a stratified population, and at the same time be negatively associated in every stratum. This (essentially) is Simpson's paradox. A graphical device, the risk diagram, provides insight into Simpson's paradox and related concepts.

[The paradox of TSH elevation in Sheehan's syndrome]

A 59-year-old woman was examined because of weight gain, increasing fatigue and secondary amenorrhoea, which occurred after a complicated delivery at age 18. The finding of an increased TSH concentration was initially considered as primary hypothyroidism and substitution therapy was commenced. Because of the concomitant secondary amenorrhoea the patient was referred for additional endocrinological investigations.

THREE HUNDRED YEARS OF THE ST. PETERSBURG PARADOX

The St. Petersburg Paradox was first presented by Nicholas Bernoulli in 1713. It is related to a gambling game whose mathematical expected payoff is infinite, but no reasonable person would pay more than $25 to play it. In the history, a number of ideas in different areas have been developed to solve this paradox, and this report will mainly focus on mathematical perspective of this paradox. Different ideas and papers will be reviewed, including both classical ones of 18th and 19th century and some latest developments. Each model will be evaluated by simulation using Mathematica.

FOSSIL PLANTS AND PALYNOMORPHS FROM THE LATE PALEOZOIC CUTLER FORMATION, EASTERN PARADOX BASIN

The late Paleozoic Cutler Formation, where exposed near the modern-day town of Gateway, Colorado, has traditionally been interpreted as the product of alluvial fan deposition within the easternmost portion of the Paradox Basin. The Paradox Basin formed between the western margin of the Uncompahgre Uplift segment of the Ancestral Rocky Mountains and the western paleoshoreline of the North American portion of Pangea. The Paradox Basin region is commonly thought to have experienced semi-arid to arid conditions and warm temperatures during the Pennsylvanian and Permian. Evidence described in this paper support prior interpretations regarding paleoclimate conditions and the inferred depositional environment for the Cutler Formation near Gateway, Colorado. Plant fossils collected from the late Paleozoic Cutler Formation in The Palisade Wilderness Study Area (managed by the U.S. Department of the Interior, Bureau of Land Management) of western Colorado include Calamites, Walchia, Pecopteris, and many calamitean fragments. The flora collected is interpreted to have lived in an arid or semi-arid environment that included wet areas of limited areal extent located near the apex of an alluvial fan system. Palynological analysis of samples collected revealed the presence of the common Pennsylvanian palynomorphs Thymospora pseudothiessenii and Lophotriletes microsaetosus. These fossils suggest that warm and at least seasonally and locally wet conditions existed in the area during the time that the plants were growing. All evidence of late Paleozoic plant life collected during this study was found along the western margin of the Uncompahgre Uplift segment of the Ancestral Rocky Mountains. During the late Paleozoic, sediment was eroded from the Uncompahgre Uplift and deposited in the adjacent Paradox Basin. The preservation of plant fossils in the most proximal parts of the Paradox Basin is remarkable due to the fact that much of the proximal Cutler Formation consists of conglomerates and sandstones deposited as debris flow and by fluvial systems. The plants must have grown in a protected setting, possibly an abandoned channel on the alluvial fan, and been rapidly buried in the subsiding Paradox Basin. It is likely that there was abundant vegetation in and adjacent to low-lying wet areas at the time the Cutler Formation was deposited.

The paradox of adult respiratory distress syndrome in neonates

Six full-term newborn infants are described who suffered from severe adult respiratory distress syndrome (ARDS). The triggering event was intrauterine/perinatal asphyxia in five, and group B streptococcal (GBS) septicemia in three. All had severe respiratory distress/failure and were ventilated mechanically with high concentrations of inspired oxygen and positive end-expiratory pressure. Radiography of the chest showed dense bilateral consolidation with air bronchograms and reduced lung volume. Persistent pulmonary hypertension (PPH) was documented in all cases. The coincidence of ARDS and PPH rendered respiratory management extremely difficult. For this reason high-frequency ventilation was instituted in all patients in order to improve CO2 elimination and induce respiratory alkalosis. Acute complications of respiratory therapy were encountered in five patients (pneumothorax, pulmonary interstitial emphysema, pneumopericardium). Three infants died (irreversible septic shock, progressive severe hypoxemia, and sudden cardiac arrest) after 17, 80, and 175 h of life. Histologic examination of the lungs was possible in all fatal cases and revealed typical changes of acute to subacute stages of ARDS. Three infants survived, the mean time of mechanical respiratory support being 703 h. Two patients were still dependent on oxygen after 1 month of life, and all survivors had increased interstitial markings and increased lung volumes on their chest roentgenograms at this time.