Hand Bone Age Gilsanz, Vicente; Ratib, Osman
2005, 2007, 2004-11-30
eBook
For decades, the determination of bone maturity has relied on a visual evaluation of skeletal development in the hand and wrist, most commonly using the Greulich and Pyle atlas. The Gilsanz and Ratib ...digital atlas takes advantage of the advent of digital imaging and provides a more effective and objective approach to skeletal maturity assessment. This atlas integrates the key morphological features of ossification in the bones of the hand and wrist and provides idealized, sex- and age-specific images of skeletal development. This computer-generated set of images should serve as a reasonable alternative to the reference books currently available.
Eighteen. Twenty-one. Sixty-five. In America today, we recognize these numbers as key transitions in our lives-precise moments when our rights and opportunities change-when we become eligible to cast ...a vote, buy a drink, or enroll in Medicare.This volume brings together scholars of childhood, adulthood, and old age to explore how and why particular ages have come to define the rights and obligations of American citizens.
Since the founding of the nation, Americans have relied on chronological age to determine matters as diverse as who can marry, work, be enslaved, drive a car, or qualify for a pension. Contributors to this volume explore what meanings people in the past ascribed to specific ages and whether or not earlier Americans believed the same things about particular ages as we do. The means by which Americans imposed chronological boundaries upon the variable process of growing up and growing old offers a paradigmatic example of how people construct cultural meaning and social hierarchy from embodied experience. Further, chronological age always intersects with other socially constructed categories such as gender, race, and sexuality. Ranging from the seventeenth century to the present, taking up a variety of distinct subcultures-from frontier children and antebellum slaves to twentieth-century Latinas-Age in America makes a powerful case that age has always been a key index of citizenship.
This book lays out the reasons why we should study cognitive development in adulthood, and presents the history, latest data, and results from the Seattle Longitudinal Study (SLS), which now extends ...to over forty-five years. The SLS is organized around five questions: does intelligence change uniformly throughout adulthood, or are there different life-course-ability patterns? At what age and at what magnitude can decrement in ability be reliably detected? What are the patterns and magnitude of generational differences? What accounts for individual differences in age-related change in adulthood? Can the intellectual decline that increases with age be reversed by educational intervention? Based on work on the SLS, this book presents a conceptual model. The model represents this book's author's view on the factors that influence cognitive development throughout the human lifespan, and provides a rationale for the various influences that have been investigated — genetic factors, early and current family environment, life styles, the experience of chronic disease, and various personality attributes. The data in this volume include the 1998 longitudinal cycle of the SLS. In light of both new data and revised analyses, psychometric and neuropsychological assessments have been linked in long-term data to aid in the early identification of risk for dementia in later life. The book also presents new data and concludes on the impact of personality on cognition. It includes correlation matrices and web-access information for select data sets.
This book asks why some countries devote the lion's share of their social policy resources to the elderly, while others have a more balanced repertoire of social spending. Far from being the outcome ...of demands for welfare spending by powerful age-based groups in society, the 'age' of welfare is an unintended consequence of the way that social programs are set up. The way that politicians use welfare state spending to compete for votes, along either programmatic or particularistic lines, locks these early institutional choices into place. So while society is changing - aging, divorcing, moving in and out of the labor force over the life course in new ways - social policies do not evolve to catch up. The result, in occupational welfare states like Italy, the United States, and Japan, is social spending that favors the elderly and leaves working-aged adults and children largely to fend for themselves.
Carbon dioxide (CO2) using capillary blood gas (CBG) analysis is commonly used children with acute bronchiolitis. Evidence to support its use is limited.A retrospective observational study was ...conducted over two bronchiolitis seasons (2014 -2016) of infants admitted to a tertiary teaching hospital using patient electronic medical records. Using logistical regression models (STATA/IC 12.1) the association between CBG pCO2 and markers of disease severity (length of stay (LOS) and high dependency admission (HDU)) was examined.332 children were assessed with 526 CBG performed in 158 infants (mean age 0.31 years, 54% male, 27% premature, 77% RSV positive). The initial CBG pCO2 was a mean 5.9kPa (SD1.1) and a maximum mean of 6.4kPa (SD1.5). Median LOS was 3 days (range 0–35). A CBG pCO2 >7.0kPa during the admission (in 23% infants (36/158)) was significantly associated with younger age (OR 0.005 (95%CI 0.0007, 0.03); p<0.0001), the use of supplemental oxygen (OR 1.9 (95%CI 1.1, 3.3); p=0.033) (adjusted for age) and inspired fraction of oxygen (FiO2) (slope coefficient 2.01 (95%CI 1.08, 2.94), p<0.0001) (adjusted for age). In 62% (98/158) a CBG was performed in ED and a pCO2 >7kPa (N=26/98) in ED was significantly associated with LOS (IRR 1.4 (95%CI 1.1,1.8); p=0.008) and HDU admission (OR 3.5 (95%CI 1.7,7.8); p=0.001).CBG pCO2 >7 kPa identifies children in ED with more severe disease with longer length of stay and risk of admission to HDU. Our results suggest that CBG pCO2 may be a possible marker of severity in future intervention trials for bronchiolitis.
This book focuses on issues regarding the learning of a foreign language in older adults (aged 60 and over). It details a multidisciplinary study on Japanese older learners of Spanish and discusses ...the influence of learning experiences on vocabulary learning strategy use. It also proposes concrete techniques for teachers of older learners.
BackgroundThe Q-Motor assessment battery has been designed to quantitatively measure motor deficits and progression for use in clinical studies. The assessments have shown to be able to detect subtle ...motor changes reliably and with absence of rater induced bias. The Q-Cog assessment battery adds assessments with an increased cognitive share, with the goal to achieve a comparable level of sensitivity for cognitive deficits of participants. The EUFP 7 funded Repair-HD (www.repair-hd.eu) study is the first to implement the Q-Cog assessments for exploratory analyses.AimsTo identify sensitive and robust measures to quantitatively track cognitive progression in HD.MethodsThe analyzed data set includes 128 participants (52 controls, 76 HD manifest TFC stage I or II, mean age: 51 (22–78), female: 54). Statistical analyses were performed using generalized linear mixed models in R. Motor and cognitive tests were included in the assessment battery.Cognitive Assessments:Force Matching: To match a visually presented force by applying pressure on a force transducer. Blinded Force Matching: Reproduction of presented force by memory (without visual feedback).Morse Code Mimicry: To tap an acoustically presented Morse code (series of short and long beeps) on a force transducer.Trail Making: Connect dots numbered from 1 to 25 (test A) or alternating digits and letters 1,A,2,B … to 13 (test B), using a 6-axis motion tracker pen.Motor Assessments:Speeded Finger Tapping, Metronome Tapping, Grasping & Lifting, Spiral Drawing.ResultsHighly significant differences between control and manifest group could be found for various variables in all performed tests. Assessment of of cognitive function using the tests described is feasible and test-retest assessment shows low variability.ConclusionWhile results from motor tasks reproduce previous findings, the cognitive assessments, too, are able to discriminate control groups from manifest population robustly. The long-term longitudinal performance, robustness and possible redundancy of the novel variables is yet to be explored. Further analysis is required to separate motor and cognitive effects through ratios of variables of the different assessments.
BackgroundOptimizing HIV pre-exposure prophylaxis (PrEP) roll-out requires insight in dosing regimen preferences, frequency and determinants of regimen switches, and PrEP discontinuation. We assessed ...user-initiated switches and factors associated with switching or stopping daily (dPrEP) or event-driven (edPrEP) PrEP regimens among men who have sex with men (MSM) participating in a PrEP demonstration project in Amsterdam.MethodsAt enrolment, participants could choose either dPrEP or edPrEP. Participants were able to switch regimens at each quarterly study visit. We evaluated transition intensities (TI) and (time-varying) factors associated with switching (i) between edPrEP and dPrEP and (ii) from either PrEP regimen to discontinuing PrEP, using a continuous-time, multi-state Markov model.ResultsOf 367 enrolled participants with follow-up, 73.3% chose dPrEP and 26.7% edPrEP at enrolment. During a median follow-up of 2.6 years (IQR=2.4–2.7), 114 (cumulative proportion=36.5%) switched their PrEP regimen at least once. In total, 85 switches from edPrEP to dPrEP (TI=0.41, 95%CI=0.33–0.50) and 98 from dPrEP to edPrEP (TI=0.17, 95%CI=0.14–0.20) occurred, with transitions from edPrEP to dPrEP 2.43-times more likely (95%CI=1.84–3.22) than vice versa. In multivariable analysis, switching from edPrEP to dPrEP was associated with lower age, higher number of sex acts with casual partners, chemsex and living alone, whereas switching from dPrEP to edPrEP was associated with lower age, lower number of casual partners, higher number of sex acts with casual partners and lower score on the New Sexual Satisfaction Scale. A total of 61 individuals discontinued PrEP, with no difference from which regimen: edPrEP (n=22, TI=0.10, 95%CI=0.06–0.15) and dPrEP (n=39, TI=0.06, 95%CI=0.04–0.08). PrEP discontinuation was only associated with lower age (from dPrEP).ConclusionSwitching between PrEP regimens is common and more frequent among younger MSM and MSM with higher number of sex acts, who may benefit from client-centered counseling. Rates of PrEP discontinuation are low and are linked to younger age.DisclosureNo significant relationships.
PDF