Background:In Nigeria,the prevailing realities of ageing in poverty and ill health are becoming obvious.This situation,coupled with the fact that Nigeria has no functional national policy on the care and welfare of ol...Background:In Nigeria,the prevailing realities of ageing in poverty and ill health are becoming obvious.This situation,coupled with the fact that Nigeria has no functional national policy on the care and welfare of older persons is worrisome.There are many factors which contribute to later life frailty which could be direct or indirect.These factors include socioeconomic and demographic factors,biological factors like genetics,lifestyle factors,medical factors such as diseases,sleep disturbances as well as psychological factors.These factors are often interwoven.This study aimed to assess the role of selected socio-economic determinants on later life frailty in Southwestern Nigeria.Data was sourced from the Nigerian general household survey-panel 2018–2019,with a total population size of 4,863 persons aged 45 years and above(mean 52.1±6.4 years).Method:Fried's approach was used to develop a frailty index(non-frail(3%);pre-frail(5.3%);frail(38.7%))and Poisson regression model was utilised.Results:We found a high prevalence of frailty in later life,using some socio-economic status such as educational level(b=0.024;p=0.004),wealth status(b=0.029;p=0.001),smoking habit(b=0.073;p=0.003)Rohrer index(b=0.005;p=0.002)and current health status(b=0.020;p=0.001).Our findings provided further evidence that socio-economic status impacts later-life frailty outcomes.This study uses cross sectional data which limits the study of the factors influencing the socioeconomic determinants of frailty.Conclusion:These results underline the need to adopt social protection systems in Nigeria to moderate the impact of health and economic shocks over the lifespan and to maintain the reserve capacity individuals bring in later life.State actors are to mainstream ageing issues into national development planning and the implementation of equal access for all older persons to affordable and quality healthcare and long-term care.展开更多
The phenomenon of marital dissolution in later life,also referred to as“gray divorce”,is described on the rise in contemporary Western societies.This article contributes to the study of marriage breakdown in older a...The phenomenon of marital dissolution in later life,also referred to as“gray divorce”,is described on the rise in contemporary Western societies.This article contributes to the study of marriage breakdown in older age,with a specific focus on Italian society.First,the temporal trends of this phenomenon are reconstructed using official statistics.The data reveal that,although still relatively rare,the dissolution of marriage in later life is expanding in Italy.The analysis of the period from 1974 to 2015 indicates a rise in the average age at separation,a higher percentage of spouses over 50 years on the total number of couples obtaining legal separation,and an increase in the proportion of Italian spouses separating after many years of marriage.Furthermore,data from the national survey“Family and Social Subjects”,conducted in 2016 by the Italian National Institute of Statistics,are utilized to explore the relationship between specific traits of those who separated and their tendency to dissolve marriages before or after the age of 50.The data suggest that individuals with characteristics such as lower educational attainment,residence in the South and Islands,and adherence to more traditional family models are more likely to experience separation in later life.展开更多
Type 2 diabetes mellitus and metabolic disorders have become an epidemic globally.However,the pathogenesis remains largely unclear and the prevention and treatment are still limited.In addition to environmental factor...Type 2 diabetes mellitus and metabolic disorders have become an epidemic globally.However,the pathogenesis remains largely unclear and the prevention and treatment are still limited.In addition to environmental factors during adulthood,early life is the critical developmental window with high tissue plasticity,which might be modified by external environmental cues.Substantial evidence has demonstrated the vital role of early-life nutrition in programming the metabolic disorders in later life.In this review,we aim to overview the concepts of fetal programming and investigate the effects of early-life nutrition on energy metabolism in later life and the potential epigenetic mechanism.The related studies published on PubMed database up to March 2020 were included.The results showed that both maternal overnutrition and undernutrition increased the riskes of metabolic disorders in offspring and epigenetic modifications,including DNA methylation,miRNAs,and histone modification,might be the vital mediators.The beneficial effects of early-life lifestyle modifications as well as dietary and nutritional interventions on these deleterious metabolic remolding were initially observed.Overall,characterizing the early-life malnutrition that reshapes metabolic disease trajectories may yield novel targets for early prevention and intervention and provide a new point of view to the energy metabolism.展开更多
AIM To evaluate the short-term outcomes and quality of life(Qo L) in gastric cancer patients undergoing digestive tract construction using the isoperistaltic jejunum-latercut overlap method(IJOM) after totally laparos...AIM To evaluate the short-term outcomes and quality of life(Qo L) in gastric cancer patients undergoing digestive tract construction using the isoperistaltic jejunum-latercut overlap method(IJOM) after totally laparoscopic total gastrectomy(TLTG).METHODS A total of 507 patients who underwent laparoscopic gastrectomy(D2) from January 2014 to March 2016 were originally included in the study. The patients were divided into two groups to undergo digestive tract construction using either IJOM after TLTG(group T, n = 51) or Roux-en-Y anastomosis after laparoscopic-assisted total gastrectomy(LATG)(group A, n = 456). The short-term outcomes and Qo L were compared between the two groups after 1:2 propensity-score matching(PSM). We used a questionnaire to assess Qo L.RESULTS Before matching, age, sex, tumor size, tumor location, preoperative albumin and blood loss were significantly different between the two groups(P < 0.05). After PSM, the patients were well balanced in terms of their clinicopathological characteristics, although both blood loss and in-hospital postoperative days in group T were significantly lower than those in group A(P < 0.05). After matching, group T reported better Qo L in the domains of pain and dysphagia. Among the items evaluating pain and dysphagia, group T tended to report better Qo L("Have you felt pain" and "Have you had difficulty eating solid food")(P < 0.05).CONCLUSION The IJOM for digestive tract reconstruction after TLTG is associated with reduced blood loss and less pain and dysphagia, thus improving Qo L after laparoscopic gastrectomy.展开更多
文摘Background:In Nigeria,the prevailing realities of ageing in poverty and ill health are becoming obvious.This situation,coupled with the fact that Nigeria has no functional national policy on the care and welfare of older persons is worrisome.There are many factors which contribute to later life frailty which could be direct or indirect.These factors include socioeconomic and demographic factors,biological factors like genetics,lifestyle factors,medical factors such as diseases,sleep disturbances as well as psychological factors.These factors are often interwoven.This study aimed to assess the role of selected socio-economic determinants on later life frailty in Southwestern Nigeria.Data was sourced from the Nigerian general household survey-panel 2018–2019,with a total population size of 4,863 persons aged 45 years and above(mean 52.1±6.4 years).Method:Fried's approach was used to develop a frailty index(non-frail(3%);pre-frail(5.3%);frail(38.7%))and Poisson regression model was utilised.Results:We found a high prevalence of frailty in later life,using some socio-economic status such as educational level(b=0.024;p=0.004),wealth status(b=0.029;p=0.001),smoking habit(b=0.073;p=0.003)Rohrer index(b=0.005;p=0.002)and current health status(b=0.020;p=0.001).Our findings provided further evidence that socio-economic status impacts later-life frailty outcomes.This study uses cross sectional data which limits the study of the factors influencing the socioeconomic determinants of frailty.Conclusion:These results underline the need to adopt social protection systems in Nigeria to moderate the impact of health and economic shocks over the lifespan and to maintain the reserve capacity individuals bring in later life.State actors are to mainstream ageing issues into national development planning and the implementation of equal access for all older persons to affordable and quality healthcare and long-term care.
文摘The phenomenon of marital dissolution in later life,also referred to as“gray divorce”,is described on the rise in contemporary Western societies.This article contributes to the study of marriage breakdown in older age,with a specific focus on Italian society.First,the temporal trends of this phenomenon are reconstructed using official statistics.The data reveal that,although still relatively rare,the dissolution of marriage in later life is expanding in Italy.The analysis of the period from 1974 to 2015 indicates a rise in the average age at separation,a higher percentage of spouses over 50 years on the total number of couples obtaining legal separation,and an increase in the proportion of Italian spouses separating after many years of marriage.Furthermore,data from the national survey“Family and Social Subjects”,conducted in 2016 by the Italian National Institute of Statistics,are utilized to explore the relationship between specific traits of those who separated and their tendency to dissolve marriages before or after the age of 50.The data suggest that individuals with characteristics such as lower educational attainment,residence in the South and Islands,and adherence to more traditional family models are more likely to experience separation in later life.
基金Supported by the grants from the National Natural Science Foundation of China(Nos.81870579,81870545,81170736,81570715).
文摘Type 2 diabetes mellitus and metabolic disorders have become an epidemic globally.However,the pathogenesis remains largely unclear and the prevention and treatment are still limited.In addition to environmental factors during adulthood,early life is the critical developmental window with high tissue plasticity,which might be modified by external environmental cues.Substantial evidence has demonstrated the vital role of early-life nutrition in programming the metabolic disorders in later life.In this review,we aim to overview the concepts of fetal programming and investigate the effects of early-life nutrition on energy metabolism in later life and the potential epigenetic mechanism.The related studies published on PubMed database up to March 2020 were included.The results showed that both maternal overnutrition and undernutrition increased the riskes of metabolic disorders in offspring and epigenetic modifications,including DNA methylation,miRNAs,and histone modification,might be the vital mediators.The beneficial effects of early-life lifestyle modifications as well as dietary and nutritional interventions on these deleterious metabolic remolding were initially observed.Overall,characterizing the early-life malnutrition that reshapes metabolic disease trajectories may yield novel targets for early prevention and intervention and provide a new point of view to the energy metabolism.
基金Supported by National Key Clinical Specialty Discipline Construction program of China,No.[2012]649Key Project of Science and Technology Plan of Fujian Province,No.2014Y0025
文摘AIM To evaluate the short-term outcomes and quality of life(Qo L) in gastric cancer patients undergoing digestive tract construction using the isoperistaltic jejunum-latercut overlap method(IJOM) after totally laparoscopic total gastrectomy(TLTG).METHODS A total of 507 patients who underwent laparoscopic gastrectomy(D2) from January 2014 to March 2016 were originally included in the study. The patients were divided into two groups to undergo digestive tract construction using either IJOM after TLTG(group T, n = 51) or Roux-en-Y anastomosis after laparoscopic-assisted total gastrectomy(LATG)(group A, n = 456). The short-term outcomes and Qo L were compared between the two groups after 1:2 propensity-score matching(PSM). We used a questionnaire to assess Qo L.RESULTS Before matching, age, sex, tumor size, tumor location, preoperative albumin and blood loss were significantly different between the two groups(P < 0.05). After PSM, the patients were well balanced in terms of their clinicopathological characteristics, although both blood loss and in-hospital postoperative days in group T were significantly lower than those in group A(P < 0.05). After matching, group T reported better Qo L in the domains of pain and dysphagia. Among the items evaluating pain and dysphagia, group T tended to report better Qo L("Have you felt pain" and "Have you had difficulty eating solid food")(P < 0.05).CONCLUSION The IJOM for digestive tract reconstruction after TLTG is associated with reduced blood loss and less pain and dysphagia, thus improving Qo L after laparoscopic gastrectomy.
