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  • ISSN: 2378-9409
    Volume 1, Issue 2
    Research Article
    Shawna McMillin and Ryan AS*
    Abstract: Plasminogen activator inhibitor-1 (PAI-1) over-expression is linked to obesity, insulin resistance, and age. We hypothesized that aerobically trained women athletes would have reduced PAI-1 regardless of age compared to sedentary controls and levels would be associated with hyperinsulinemia. Plasma PAI-1 was measured in women athletes who were young (YA, n=19, VO2max=53.7±1.1ml/kg/min) and older (OA, n=18, VO2max=46.6±1.5ml/kg/min) and compared to 19 sedentary controls (YC, n=6, VO2max=35.9±1.2ml/kg/min; OC, n=13, VO2max=22.1±1.7ml/kg/min). PAI-1 levels did not differ between YA and OA but was 23% higher in OC compared to OA (P<0.05). PAI-1 was inversely associated with VO2max, directly to %body fat, and subcutaneous abdominal fat, fasting leptin, insulin, and first-phase and second-phase insulin response during a hyperglycemic clamp. The current results suggest that older athletes have low PAI-1 levels possibly due to high levels of physical fitness, reduced body fat, and increased insulin action and may contribute to low atherothrombosis and improved cardiovascular health.
    Sandra S. Butler*
    Abstract: As our population ages, there is increasing demand for personal care assistance at home. The personal care aide position is projected to be the fastest growing occupation in the United States between 2010 and 2020, despite its very low pay. Low compensation contributes to high turnover rates, which are costly to employers, society and elders needing care. This article reports on a thematic analysis of interviews with 252 home care aides—employed by agencies throughout a rural state—whose employment status was tracked for 18 months. “Leavers” (n = 88, 34.9%) were interviewed at the point of termination regarding reasons for job separation; “stayers” (n = 164), interviewed at the end of the study period, were asked what might cause them to leave their jobs. The issue of compensation was central to both groups, with low pay; insecure hours; and lack of health insurance, mileage reimbursement, and paid holidays and sick days emerging as themes in most (82.3%) of the interviews. While low pay and lack of health insurance were equally important reasons for terminating for both groups, insecure hours (p < .001) and lack of mileage reimbursement (p < .05) were of greater concern to “leavers” and lack of paid sick time (p < .05) and paid holidays (p < .1), for those who stayed. Themes are illustrated through quotes from study participants. Implications are explored within the context of improving job conditions and increasing retention of this critical component of the long-term care workforce.
    Povoroznyuk V*, Muts V and Balatska N
    Background: Vitamin D deficiency (VDD) is one of the important factors contributing to the development of various chronic and often times debilitating diseases, such as multiple sclerosis, Alzheimer’s disease, atherosclerosis, neoplasms, etc. Yet to date only limited data about VDD in the elderly patients are available.
    Aim of the study: evaluation of the influence of seasonal factors, as well as subjects’ age, on the vitamin D status.
    Study population: 793 subjects aged 60-89 years (women 91.2%). Mean age was 68.7±6.6 years, and mean BMI was 28.3±5.0 kg/m2. The subjects were broken down into 3 age groups: 60-69, 70-79, and 80-89 years, with a subsequent assessment of vitamin D status by season of the year and by month.
    Results: During the winter, mean 25(OH) D levels in serum (31.3±19.4 nmol/l) were significantly lower compared to the summer (38.7±24.6 nmol/l), p<0.001. The lowest VDD frequency across the study population was found in August (45.5%) with severe VDD frequency being 6.8%. The VDD frequency was increasing from September onwards, with the highest value being recorded in February (96.6%), whereas for severe VDD the peak occurs in March with 59.4%.
    Conclusions: considering the frequency of VDD in the Ukrainian population aged between 60 and 89 years, we recommend the vitamin D supplements throughout the year, particularly during the end of the winter season when the vitamin D status is at its worst as compared to the rest of the year.
    Alicia J. Mangram1*, Michael G. Cornielle1, Melissa M. Moyer1, Arlene Stienstra1, Mary Collins1, Shalini Chaliki2, Kalyan Chaliki1, Shaun Stienestra1, James Wycoff3, Kevin Veale4 and James K. Dzandu1
    Objectives: To determine whether Vulnerable Elders Survey (VES-13), an instrument that assesses functional status of uninjured older patients, will predict length of stay (LOS), inpatient mortality (>24 hours) and discharge disposition in geriatric trauma patients.
    Methods: The VES-13 was administered by nurse practitioner on our geriatric trauma service (G-60). The G-60 service is an interdisciplinary team led by trauma surgeons. VES-13 has 4 categories: age, self-rated health, ADLs and physical tasks. Scores range from 0-10 points. Non-vulnerable patients score <3 and vulnerable patients score = 3. Covariates were demographics and clinical variables. Outcomes were LOS, inpatient mortality (>24 hours) and discharge disposition (home vs. elsewhere).
    Results: 322 trauma patients completed the VES-13 from August 2012 to March 2014. Age was 77 years, majority female (62%) and white (83%). Female VES scores were higher (4.56 ± 3.16) than male scores (2.58 ± 3.16), p<0.001. 173 (55.4%) patients were vulnerable, more likely to be female (73.3% vs. 26.5%), p =0.001, and had more co-morbidities (1.11 vs. 0.81, p =0.001). Sixty percent (60%) of non-vulnerable patients went home whereas only 23% of vulnerable patients were discharged home. There were 19 (7.1%) inpatient deaths (>24 hours) but mortality was not associated with VES score.
    Conclusion: Vulnerability, as assessed using VES-13 score, is an important problem for an increasing population of geriatric patients. More than half the geriatric trauma patients we examined were vulnerable and were 4 times more likely to not be discharged home. VES-13 should facilitate early discharge planning for geriatric trauma patients.
    Review Article
    Mammarella N1*, Borella E2 and Fairfield B1
    Abstract: This review rethinks the concept of Cognitive Style (CS) as a renewed and promising approach to cognitive aging. After a brief introduction to CS, the paper outlines its characteristic features: field-dependence vs. independence, intuition vs. rule-based, internal vs. external locus of control and integrated vs. compartmentalization. The paper illustrates each dimension with examples from aging studies. Conclusions bring together various considerations about the future development of CS in aging.
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