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PubMed1990

Bone resorption by isolated osteoclasts in living versus devitalized bone: differences in mode and extent and the effects of human recombinant tissue inhibitor of metalloproteinases.

The incubation of isolated osteoclasts with devitalized bone has become a widely used method for the recent study of bone resorption. Although the studies employing this method have definitively demonstrated that isolated osteoclasts have an avid capacity to resorb devitalized bone, the resorption in this model appears to be different from that of living bone as observed in vivo and in organ culture studies. To evaluate how the resorption of living bone is different from that of devitalized bone, we have extended this bone resorption model using isolated osteoclasts by including both devitalized and living bone substrates. Living bone substrates were freshly prepared from calvaria of 8- to 12-month-old mice. Periosteum, cellular components, and osteoid were completely scraped off to leave a rigid, smooth, mineral-exposed surface for the isolated osteoclasts to act upon. Some of the bone pieces were devitalized by repeated freezing and thawing. Living and devitalized bones were cultured with isolated rabbit osteoclasts for 60 h with or without recombinant human tissue inhibitor of metalloproteinases (100 micrograms/ml). The extent of bone resorption was assessed by measuring both the area and the depth of resorption pits. Comparing the areas of the resorption pits showed significantly more resorption in living bone than in devitalized bone (27% of that of living bone). Recombinant human TIMP reduced the resorption of living bone by 73% but did not, however, inhibit the resorption of devitalized bone. Similarly, resorption pits formed on the living bones were significantly deeper (on the average, 12.4 microns) than those formed on the devitalized bones (on the average, 4.3 microns). The average depth of the resorption pits on living bone was significantly reduced by the presence of the inhibitor, whereas there was no difference between the control and inhibitor-treated devitalized bones. These results suggest that the mechanisms underlying the resorption of living bone and that of devitalized bone are not the same and that the resorption of living bone is aided by osteocytes.

Animals↗
PubMed2001

Living musical instruments and inanimate body parts?

In the literature about category effects in semantic memory, body parts and musical instruments are often considered atypical, because in cases with a disproportionate impairment of living categories body parts are relatively spared, while musical instruments are often severely defective. In this study the performance of 57 subjects affected by diseases generally associated with lexical-semantic impairment, for the most part Alzheimer's disease and other forms of cortical degeneration, but also herpetic encephalitis and traumatic brain damage are analyzed. The subjects were given a picture naming task tapping eight categories: three living categories (animals, fruits and vegetables) and three non-living categories (tools, furniture and vehicles), plus body parts and musical instruments. On a preliminary analysis at the group level, body parts were the least impaired category and musical instruments the most severely impaired, the six living and non-living categories being intermediate. However, these differences disappeared after covariance for lexical frequency, name agreement and age of acquisition. The relationship between living categories, non-living categories, musical instruments and body parts was investigated by means of a Lisrel model of Confirmatory Factor Analysis. Two latent variables related to living and non-living categories respectively were defined, and it was found that both body parts and musical instruments were significantly related only with non-living categories. The results showed that the definition of the latent variable expressing the substrate of non-living categories was less satisfactory than that expressing the living categories. On this basis, the conclusions of this study appear statistically definite but their psychological interpretation is less straightforward.

Adolescent↗
PubMed2002

Adrenopause or decline of serum adrenal androgens with age in women living at sea level or at high altitude.

The present study aimed to determine adrenopause or reduction of serum adrenal androgens with age at high altitude and at sea level. It was a cross-sectional study performed in 210 women resident at high altitude (4340 m) and 123 women living in Lima (150 m), aged 20-70 years. Fasting early morning blood samples were obtained. Serum dehydroepiandrosterone (DHEA), DHEA sulphate (DHEAS), androstenedione, testosterone and estradiol were measured by radioimmunoassay. Serum testosterone concentrations were greater in women living at high altitude than in those resident at sea level. Serum concentrations of DHEA, DHEAS and androstenedione were lower in women living at high altitude than in those living at sea level. The DHEAS/DHEA ratio was significantly greater, and the androstenedione/testosterone ratio was lower in samples from women living at high altitude. Among women older than 50 years of age, a greater decline in serum concentrations of DHEA was observed in those living at high altitude than in those living at sea level. Among women 60-70 years of age, serum concentrations of DHEA at high altitude were 46.9% of those in women of the same age living at sea level. Decay of DHEAS at sea level and at high altitude occurred from the age of 40 years. The decline was faster at high altitude than at sea level, and in women aged 60-70 years serum values of DHEAS at high altitude were 56% of those at sea level. In the same age group, serum concentrations of androstenedione among those native to high altitudes were 27.34% of the value at sea level. At sea level, serum testosterone concentrations did not change with age from 20 to 70 years. In women aged 20-39 years and 50-59 years, serum testosterone concentrations were greater at high altitude than at sea level (P<0.05). In those aged 60-70 years, the concentrations were similar in those living at sea level and at high altitude. At sea level and at high altitude, the serum testosterone/estradiol ratio increased with age (P<0.0034 and P<0.0001 respectively). This ratio increased at an earlier age among those living at high altitude (40-49 years) than among those living at sea level (50-59 years). Multivariate analysis showed that altitude (P<0.0001) and greater chronological age (P<0.001) were associated with lower serum DHEAS concentrations. DHEAS was related to chronological age (P<0.0001). Low serum androstenedione concentrations were related to living at high altitude at birth and greater chronological age (P<0.0001). In conclusion, adrenopause is attained earlier and is of greater magnitude at high altitude than at sea level.

Adrenal Glands↗
PubMed2001

[Adolescents living on their own--social control and health related behavior].

BACKGROUND AND OBJECTIVES: Social control is an important dimension in the interaction between members of social groups. Such control may contribute to adherence to group norms and prevent health related risk behaviour. Adolescents moving out from home to live on their own may become left to themselves and lose their social network and mechanisms of control. We wanted to examine to what extent high school students living in lodgings were different from students living at home concerning health and health related behaviour. MATERIAL AND METHODS: The study was based on data from a cross sectional inquiry among 828 high school students (91% of all students) in Førde carried out in 1997. One in four students lived alone in bedsitters. Bivariate analyses were performed separately for the two age groups 15-17 and over 18 years of age. Students living on their own were compared with students living at home concerning self-reported health and health behaviour. Multivariate analyses were performed to control for confounding. RESULTS: Students living in bedsitters more often reported health risk behaviour than their home-living peers. The differences was most conspicuous in the youngest age group. Differences were found for cigarette smoking, alcohol use, unhealthy diet, and age of sexual debut. Health-risk behaviour was most prevalent among students in vocational courses living alone. Self-reported health and emotional wellbeing were as good among students living alone as it was among their home-living peers. CONCLUSION: Reduction of social control among students living alone in lodgings seem correlated with increased health risk behaviour. Students in vocational courses may be at particular risk. Social planning of education should consider the need to belong and the need for new social networks among students leaving home to continue their education.

Adolescent↗
PubMed2003

Clinical and ethnic differences in candidates listed for liver transplantation with and without potential living donors.

The shortage of cadaver livers and improved outcomes in partial liver transplants has led to an increase in adult living donor liver transplantation (LDLT). Only a fraction of potential liver recipients have donors. The characteristics of candidates who have volunteers for living donation may be different than those without donors. We compared adult patients on the waiting list who had potential living donors with those who did not have living donors. Two-hundred and four consecutive patients were listed for transplantation. During evaluation, all were informed and educated about LDLT. To avoid coercion, we did not solicit a living donor. Sixty (29%) potential recipients had at least one living donor volunteer for evaluation. Twenty-eight (14%) patients from the entire cohort and 46% of the 60 patients who had potential living donors underwent LDLT. Compared with Caucasians, Hispanics were more likely to have living donors (P =.006). No patient with alcoholic liver disease (ALD) had a donor come forward (P =.006). Patients with living donors were twice as likely to have cancer (P =.08). Systematic differences exist between patients who have potential living donors versus those without donors. Candidates with potential donors are more likely to be Hispanic and have cancer and less likely to have ALD compared with cadaveric recipients. Only a minority of patients listed for orthotopic liver transplantation (OLT) will lead to LDLT. Further understanding of the cultural differences and motivating factors for why people volunteer for evaluation and subsequently choose to donate may help improve cadaveric and living donor transplant rates.

Cadaver↗
PubMed2004

Socio-personal factors influencing public attitude towards living donation in south-eastern Spain.

OBJECTIVES: Our aim was to determine public attitudes towards living donation compared with cadaveric donation, and to analyse psycho-social factors that may influence this attitude. MATERIALS AND METHODS: An opinion poll was used to study a random sample in two geographical areas (urban and rural). Assessment was made of attitudes towards donation of one's own organs as a living donor to an unknown person, as a living donor to a relative and/or close acquaintance and, as a cadaveric donor, and of the different psycho-social variables that may influence this attitude. RESULTS: In the urban setting, 60% had a favourable response towards cadaveric donation; 29% were in favour of living kidney donation to an unknown person, a percentage which increased to 89% for donation to a relative or a friend. These rates were lower for liver (21 and 74%, respectively). When asked if they would accept an organ donated by a relative or a friend, 67% would accept a kidney and 60% a liver. Attitude towards living donation to an unknown person is more positive among those in favour of cadaveric donation and those who have had previous experience of donation. With respect to level of education, university students are more undecided about living donation to an unknown person than the other groups. In terms of attitude towards donation to relatives and/or friends, there is also the influence of social factors (sex, marital status). However, if the living donation is intended for oneself, there is no variable with which to associate this attitude. In the rural setting, 56% of the respondents refused to complete the survey due to fear of living donation. No statistical study was conducted due to the bias of the rural sample. CONCLUSIONS: There is great fear and ignorance of living donation among the rural population, and uncertainties in the urban population, although attitudes are more positive towards living donation to relatives and/or friends than towards cadaveric donation. These positive attitudes towards living donation are very strongly related to attitudes towards cadaveric donation, previous experience of donation and level of education.

Adult↗
PubMed1998

Prospective study on the relation between living arrangement and change in functional health status of elderly women.

Limited prospective data exist on how living arrangements are associated with change in functional health. This study evaluated whether elderly women living alone were less likely to experience functional decline when compared with women who lived with others. A total of 619 community-dwelling, white women from Baltimore, Maryland, aged 65-99 years at baseline were questioned annually from 1984 to 1986. Functional health was measured as the sum of limitations in seven physical and seven instrumental activities of daily living (Instrumental ADL). A total of 148 women experienced functional decline over the 2 years, primarily as a deterioration in Instrumental ADL. The association between living arrangement and change in Instrumental ADL depended on the level of physical impairment. Among women without severe impairment, Instrumental ADL deterioration was significantly less for those living alone compared with those living with spouses (odds ratio (OR) = 0.60, 95% confidence interval (CI) 0.45-0.92) or nonspouse others (OR = 0.62, 95% CI 0.45-0.96). For women with severe impairment, however, those living alone had a greater decline in Instrumental ADL, especially when compared with those living with nonspouse others (OR = 5.13, 95% CI 1.23-21.28). These results suggest that, unless severely physically impaired, women living independently have less deterioration in functional health when compared with peers in alternate living arrangements.

Activities of Daily Living↗
PubMed2002

Determinants of willingness to donate living related and cadaveric organs: identifying opportunities for intervention.

BACKGROUND: Although low rates of cadaveric organ donation have been attributed to potential cadaveric donors' concerns regarding their religious beliefs and mistrust of the health care system, it is unclear whether similar concerns are important to potential living related donors. It is also not known which factors might be most responsible for low rates of cadaveric and living related donation among the general public. METHODS: We conducted a cross-sectional study of households in Maryland, using a standardized telephone questionnaire, to assess factors associated with willingness to donate cadaveric and living related organs. We compared factors (demographic, cultural, attitudinal, and clinical) related to willingness to donate cadaveric organs with factors related to willingness to donate living related organs. In multivariate analyses, we assessed the independent relation of factors to willingness to donate cadaveric and living related organs, and we assessed the relative importance of these factors in explaining variation in the general public's willingness to donate. RESULTS: Of 385 participants (84% of randomized homes), 254 (66%) were extremely willing to donate to a sibling but only 179 (47%) had designated themselves a cadaveric donor on their drivers' licenses. In bivariate analysis, older age, comorbid conditions, mistrust in hospitals, and concerns about discrimination in hospitals were statistically significantly associated with less willingness to donate living related organs, although African-Americans, older age, lower education, lack of insurance, unemployment, comorbid conditions, and religion/spirituality were associated with less willingness to donate cadaveric organs. After adjusting for potential confounders, only mistrust in hospitals and concerns about discrimination remained strongly and independently associated with 50 to 60% less odds of willingness to donate living related organs [[relative odds [95% confidence intervals (CI)]: 0.4 (0.2-0.7) to 0.5 (0.3-1.0) and 0.4 (0.2-0.9), respectively]] although presence of dependents was associated with 70% higher odds of willingness to donate living related organs [relative odds (95% CI): 1.7 (1.0-3.0)]. In contrast, older age, employment status, religion/spirituality, and mistrust in hospitals were associated with 50 to 90% less odds of willingness to donate living related organs cadaveric organs [relative odds (95% CI): 0.3 (0.1-0.8), 0.4(0.2-0.8), 0.1 (0.1- 0.5) to 0.5 (0.2-0.9), and 0.3 (0.2-0.6), respectively]. Mistrust in hospitals and concerns about the surgical donation procedure contributed most to the variation in willingness to be a living related donor, although race contributed most to the variation in willingness to be a cadaveric donor. CONCLUSIONS: Many factors affect the general public's willingness to donate organs, but their relative contribution is different for living related versus cadaveric donation. Efforts to improve organ donation rates should be directed toward factors that are most important in explaining the existing variation in willingness to donate.

Adult↗
PubMed2003

The economic impact of laparoscopic living-donor nephrectomy on kidney transplantation.

BACKGROUND: End-stage renal disease accounts for $17.9 billion annually in direct medical costs in the United States. This study assessed the flow of expenditures from a Medicare perspective for laparoscopic donor nephrectomy compared with living and cadaveric transplantation and continued dialysis. METHODS: This study involved a nonrandomized, retrospective investigation of patients with end-stage renal disease and charges using institutional and physician/supplier charges from the United States Renal Data System. The subjects were classified as laparoscopic living-donor transplant, living-donor transplant, cadaveric transplant, or dialysis patients. The first treatment date was set as the index date, and monthly charges were plotted from 12 months before and up to 48 months after the index date. RESULTS: There were 230,769 dialysis patients and 44,063 transplant patients (181 laparoscopic living-donor, 11,466 living-donor, and 32,416 cadaveric). Monthly institutional charges were similar in the year preceding the index date, but they were higher for transplantation in the month after the index date and lower in subsequent periods. Two-year post-index cumulative charges were as follows: Monthly institutional charges were similar for the living-donor ($191,374) and laparoscopic living-donor ($192,053) transplant patients, followed by the cadaveric transplant ($229,449) and dialysis ($250,348) patients, whereas physician/supplier charges were highest for the laparoscopic living-donor transplant ($104,583) patients, followed by the dialysis ($73,730), cadaveric transplant ($70,369), and living-donor transplant ($65,897) patients. The break-even points for the living-donor, laparoscopic living-donor, and cadaveric transplant patients compared with the dialysis patients were 10, 14, and 18 months, respectively. CONCLUSIONS: The laparoscopic procedure may be a beneficial alternative to the conventional open donor nephrectomy procedure and cadaveric transplantation, and it provides considerable benefits compared with dialysis.

Cadaver↗
PubMed2006

Living donation decision making: recipients' concerns and educational needs.

CONTEXT: Despite the advantages of living donor transplantation, evidence suggests that some potential recipients with living donors have psychological concerns that prevent them from pursuing living donation. Addressing these concerns through education may increase the rates of living donation. OBJECTIVE: To understand the psychological barriers and educational needs of potential kidney recipients regarding living donation. SUBJECTS AND DESIGN: Qualitative focus group study of kidney transplant recipients, donors, and family members to explore their assessment of the advantages of dialysis and deceased donor transplantation over living donation, their concerns about living donation, and what types of living donation education would be most helpful. RESULTS: Kidney recipients reported that they might not pursue living donation because they felt guilty and indebted to the donor, did not want to harm or inconvenience the donor, did not want to accept a kidney that a family member might need later, and did not want to disappoint the donor if the kidney failed. Recipients were generally unaware that donors could personally benefit from donating and would rather wait for donor volunteers than ask anyone directly. Both donors and recipients thought that training on how to make the donation request and education about living donors' motivations for donation and transplant experience could help more renal patients pursue living donation.

Adaptation, Psychological↗
PubMedDate not supplied

[The contribution of living arrangements in the provision of care for elderly persons with functional impairments in São Paulo, Brazil].

OBJECTIVES: To describe the functional performance, need for assistance, and living arrangements of elderly persons in the city of São Paulo, Brazil, as part of a project called Health, Well-being, and Aging in Latin America and the Caribbean (the "SABE project"). METHODS: In 2000, 2 143 individuals 60 years of age or older were interviewed, using the standardized SABE questionnaire. The sample was obtained in two stages, using census sectors with replacement and probability proportional to population. To have the desired number of respondents 75 or older, additional homes close to the selected census sectors were found, with weighting of the final results. The functional performance of the elderly persons was measured in terms of their ability to perform basic activities of daily living (walking across a room, eating, lying down on a bed and getting up from it, using the bathroom, dressing and undressing, and bathing) and to carry out instrumental activities of daily living (buying and preparing food, performing light and heavy household chores, using the telephone, taking medications, and handling money). Functional impairment was defined as the need for assistance in performing at least one of the basic or instrumental activities. There were 66 types of living arrangements (household composition) identified and grouped into seven categories, according to with whom an elderly person lived and whether the other residents of the household were relatives or not. RESULTS: Of the individuals interviewed, 19.2% presented a functional impairment in basic activities and 26.5% in instrumental activities. The impairments were more common among women and among persons 75 or older. The proportion of elderly persons with an impairment who received help with basic activities ranged from 25.6% (lying down on the bed and getting up) to 70.5% (eating). With instrumental activities, the proportion receiving assistance ranged from 79.7% (light domestic chores) to 97.8% (buying food). With respect to living arrangements, the single largest group (32.1%) of elderly persons lived with the spouse and children or with just the children; the next largest group (20.0%) lived with just the spouse. The living arrangement in which the highest proportion (56.4%) of elderly persons with functional impairments received help was living with nonrelatives. CONCLUSIONS: The elderly persons with functional impairments in São Paulo are not receiving enough assistance from their family members or other persons with whom they live. Further, there are no public policies in Brazil to fill this gap. Taking into account the country's aging population, the health care system in Brazil is at risk of becoming not only inadequate but chaotic.

Activities of Daily Living↗
PubMed2005

Living alone with Alzheimer's disease: cross-sectional and longitudinal analysis in the REAL.FR Study.

OBJECTIVES: The purpose of this study was to examine the characteristics of Alzheimer's disease (AD) patients living alone and to describe the rate of cognitive and functional impairment after a one-year follow-up. DESIGN AND SETTING: In a prospective longitudinal study conducted by the French network on Alzheimer's disease (the REAL.FR study), 677 older community-dwelling AD patients were interviewed and completed questionnaires and evaluation scales every 6 months during a one-year follow-up. MEASUREMENTS: All patients were assessed by trained staff who collected data on neuropsychological status using the Mini Mental State Examination (MMSE), behavioural disturbances with the Neuropsychiatric Inventory (NPI) and nutritional status with the Mini Nutritional Assessment (MNA). Patients were assessed for current mobility and function in activities of daily living (ADL) and instrumental activities of daily living (IADL). RESULTS: At inclusion, 28% of the 677 non-institutionalised individuals with AD lived alone. Those who lived alone were significantly older than those who did not, and among them the percentage of women was significantly higher. Patients living alone were at increased risk of malnutrition and were more likely to have a low income than those living with others. Persons with AD living alone made greater use of health services. Dementia stage evaluated by cognitive impairment (MMSE) and ADL disabilities was similar in both groups. At one-year follow-up, the mortality rate was significantly higher in AD patients living with others. Institutionalisation and hospitalisation rates were similar. CONCLUSION: These results draw attention to the fact that elderly persons with AD living alone are a subpopulation with specific needs which require the development of targeted interventions. Further investigation of the factors associated with the lower mortality rate in AD patients living alone is necessary, and the results of long-term follow-up in this prospective study should shed light on this question.

Activities of Daily Living↗
PubMed2004

[The health status of the long lived elderly in Cracow].

UNLABELLED: The main goal of the work was to assess the health status of the long-lived elderly living in the community of a large city. The research was done in the years 2000--2001. In order to make comparisons possible, considered was a randomized sample of Krakow's citizens in the age of 75-80 (258 people) and 90-95 (172 people). The following tools were used in the research: MFAQ (Older Americans Resources and Services Multidimensional Functional Assessment Questionnaire) and commonly accepted scales: Abbreviated Mental Test, Geriatric Depression Scale and Activity of Daily Living Index. RESULTS: No significant differences in number of chronic diseases reported, in the number of drugs taken and in the level of self-reported depression between the long-lived elderly and people between the ages 75-80, were found. Nevertheless the long-lived elderly more often assess their health status as poor, report disability in vision and hearing, cognition disorders and lower ability to perform activities of daily living. The long-lived women have much worse health status than the long-lived men. CONCLUSIONS: The health-related quality of life of the long-lived elderly is much worse than the quality of life of the people 75-80 y.o. The long-lived women have worse health status than men over 90. The much worse self-reported health status of long-lived elderly seems to be not the result of the number of chronic diseases reported, but is mainly related to the lower level of ADL, more frequent vision and hearing disabilities and cognition disorders present at the age over 90.

Activities of Daily Living↗
PubMed1996

The use of living wills at the end of life. A national study.

BACKGROUND: Knowing more about who uses living wills may help explain their limited acceptance. METHODS: We analyzed the 1986 National Mortality Followback Survey, a random sample of all US deaths linked to a survey about decedents' use of living wills, their social and health status, and their use of medical services. Decedents with and without living wills were compared for differences in social and health characteristics and use of medical services. RESULTS: There were 16,678 decedents; 9.8% had a living will. Rates of use were higher for decedents who were white (10.7%), were female (11.0%), had private insurance (13.8%), had incomes of $22,000 or more (14.5%), or had college educations (18.7%). The use of living wills was lower among blacks (2.7%), Medicaid recipients (6.3%), those with incomes of less than $5,000 (7.5%), or those with less than 8 years of education (4.0%). Health was also related to use of living wills. Functionally independent persons were unlikely to have a living will (5.5%); use increased with dependency. Cognitive impairment made it less likely that a decedent had a living will (6.7%). Persons who died of cancer (16.4%) or pulmonary disease (11.4%) were more likely to have one. All demographic and health characteristics remained significant in multivariate analyses. Controlling for health status, decedents with living wills used more physician visits (five to nine vs two to four, P < .001) and hospital days (37 vs 30, P < .001). Although more likely to use hospices (19.5% vs 8.4%, P < .001) and half as likely to receive cardiopulmonary resuscitation or ventilatory support, they were still 20% more likely to die in the hospital. CONCLUSIONS: Patients who are black, poorly educated, underinsured, or cognitively impaired are least likely to prepare a living will. Decedents with living wills forgo specific treatments, but remain intensive users of routine medical services.

Cardiopulmonary Resuscitation↗
PubMed1999

Live-birth rates and multiple-birth risk using in vitro fertilization.

CONTEXT: To maximize birth rates, physicians who perform in vitro fertilization (IVF) often transfer multiple embryos, but this increases the multiple-birth risk. Live-birth and multiple-birth rates may vary by patient age and embryo quality. One marker for embryo quality is cryopreservation of extra embryos (if embryos are set aside for cryopreservation, higher quality embryos may have been available for transfer). OBJECTIVE: To examine associations between the number of embryos transferred during IVF and live-birth and multiple-birth rates stratified by maternal age and whether extra embryos were available (ie, extra embryos cryopreserved). DESIGN AND SETTING: Retrospective cohort of 300 US clinics reporting IVF transfer procedures to the Centers for Disease Control and Prevention in 1996. SUBJECTS: A total of 35554 IVF transfer procedures. MAIN OUTCOME MEASURES: Live-birth and multiple-birth rates (percentage of live births that were multiple). RESULTS: A total number of 9873 live births were reported (multiple births from 1 pregnancy were counted as 1 live birth). The number of embryos needed to achieve maximum live- birth rates varied by age and whether extra embryos were cryopreserved. Among women 20 to 29 years and 30 to 34 years of age, maximum live-birth rates (43 % and 36%, respectively) were achieved when 2 embryos were transferred and extra embryos were cryopreserved. Among women 35 years of age and older, live-birth rates were lower overall and regardless of whether embryos were cryopreserved, live-birth rates increased if more than 2 embryos were transferred. Multiple-birth rates varied by age and the number of embryos transferred, but not by whether embryos were cryopreserved. With 2 embryos transferred, multiple-birth rates were 22.7%, 19.7%, 11.6%, and 10.8% for women aged 20 to 29, 30 to 34, 35 to 39, and 40 to 44 years, respectively. Multiple-birth rates increased as high as 45.7% for women aged 20 to 29 years and 39.8% for women aged 30 to 34 years if 3 embryos were transferred. Among women aged 35 to 39 years, the multiple-birth rate was 29.4% if 3 embryos were transferred. Among women 40 to 44 years of age, the multiple-birth rate was less than 25% even if 5 embryos were transferred. CONCLUSIONS: Based on these data, the risk of multiple births from IVF varies by maternal age and number of embryos transferred. Embryo quality was not related to multiple birth risk but was associated with increased live-birth rates when fewer embryos were transferred.

Adult↗
PubMed2005

Confrontation of the cybernetic definition of a living individual with the real world.

The cybernetic definition of a living individual proposed previously (Korzeniewski, 2001) is very abstract and therefore describes the essence of life in a very formal and general way. In the present article this definition is reformulated in order to determine clearly the relation between life in general and a living individual in particular, and it is further explained and defended. Next, the cybernetic definition of a living individual is confronted with the real world. It is demonstrated that numerous restrictions imposed on the cybernetic definition of life by physical reality imply a number of particular properties of life that characterize present life on Earth, namely: (1) a living individual must be a dissipative structure (and therefore a low-entropy thermodynamic system out of the state of equilibrium); (2) spontaneously-originated life must be based on organic compounds; (3) evolutionarily stable self-dependent, free-living individuals must have some minimal level of complexity of structure and function; (4) a living individual must have a record of identity separated from an executive machinery; (5) the identity of living individuals must mutate and may evolve; (6) living individuals may collect and accumulate information in subsequent generations over very long periods of time; (7) the degree of complexity of a living individual reflects the degree of complexity of its environment (ecological niche) and (8) living individuals are capable of supple adaptation to varying environmental conditions. Thus, the cybernetic definition of a living individual, when confronted with the real physical world, generates most of the general properties of the present life on Earth.

Biological Evolution↗
PubMed1988

Living arrangements and women's health.

The recent changes in the traditional patterns of living arrangements in the U.S.A. raise interest in their consequences for the well being of the individuals involved. In this paper the physical health of women in different living arrangements was studied. It was suggested that living arrangements differ in the degree of adult support and the nurturant responsibilities that often accompany women's social support. Since previous research seems to indicate that social support promotes health and nurturant obligations constrains it, it was predicted that women whose living arrangements offer steady adult support with slight nurturant responsibilities will be healthier than women whose living arrangements offer both, and that women whose living arrangements involve nurturant responsibilities without adult support will be the least healthy. It was also suggested that the more legitimate and socially acceptable are one's living arrangements, the fewer the social costs incurred. Health was measured by three health status and three illness behaviour indices. Data were taken from the NHIS of 1979, and a multiple regression analyses were conducted. When a health-profiles approach was taken, the health of women in different living arrangements ranked according to the hypotheses: women who live with their parents are the healthiest, followed by those in children/relatives' households; women head of families are the least healthy, just preceded by those living alone; women who live with their husbands or with unrelated persons are intermediate, and do not differ from each other.

Adult↗
PubMed1994

Differences in self-reported morbidity by marital status and by living arrangement.

It has frequently been shown that the never married, divorced and widowed have higher rates of self-reported morbidity than married people. The purpose of this study was to assess to what extent morbidity differences by marital status can be explained by differences in living arrangement (i.e. living with a partner or not). If living arrangement plays a major role, one expects to find that: 1. people who live with a partner have lower morbidity rates than those who live alone; 2. morbidity differences by marital status decrease substantially after controlling for living arrangement. Data from the GLOBE study, a large prospective cohort in the Netherlands, on 18,973 people from Eindhoven and its surroundings, aged 15-74, were used to test the hypotheses. The measures for morbidity were perceived general health, subjective health complaints, chronic conditions and work disability. Multiple logistic regression models were used to calculate odds ratios for morbidity by living arrangement (question 1) and for morbidity by marital status, firstly without control and subsequently with control for living arrangement (question 2). In all models we controlled for other sociodemographic variables (age, sex, educational level, degree of urbanization, religion and country of birth). Our analyses showed that people who live with a partner have lower morbidity rates than those who live alone. They further showed that the excess risks of the never married, widowed and divorced decreased by 40-70% for all health measures (except subjective health complaints) after controlling for living arrangement.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗