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Valentine uwakwe betting manual treadmill esports betting tips

Valentine uwakwe betting manual treadmill

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With this system, you are sure to make atleast 15, NGN from just five or four accumulated matches in your soccer bets, be it away or home matches win. This system is an easy and simple process. You can do online soccer betting either as a part-time or fulltime business. If you are already employed, you only need one or two hours on the system every day.

You can do it either during your normal working hours or after closing from work. If you are not presently employed, you have gotten yourself a full time job and business. If you are already in business, thank God because it is an opportunity to make extra money without much efforts and expenses, monthly. It is an avenue to make money and expand your business.

You must have won some amounts from your online bets, but have you check how much you have lost of lately, and you keep losing daily. Now is your chance to stop that strings of lost bets into smiling bank account with just a little efforts on your part. The system is easy and simple. The major things you require in order to dive into this pot of glory include;. Register with any good online soccer betting sites that offer good odds and fund your account.

Call me for more inset on the one to choose from. I am so grateful to a friend who introduces me to Mr. Valentine and today am making it through soccer betting. With this system am sure of predicting atleast four sure soccer matches which I place bets upon daily. Thank you valentine. When I heard about soccer betting, I was eager to learn it and make money for myself as am still a student.

Nevertheless I went ahead, order for the e-manual from valentine and within the first weeks I hit 32, from it. Since then I have been making daily income from it. I just graduated from uniport and was anxious to do something and make money for myself while waiting for my service year. I saw the soccer betting advert and just decided to give it a trial. To my greatest surprise, what I learnt from it prove to be real. I now make money from it and I began to hate myself for not knowing of this piece of information for long now.

COST: How much will it cost you to learn this system? Not much. There will be no need attending workshops and seminars as this system provides a simple way and a do-it-yourself process to enable you start using it immediately. For the simple reason of empowering Nigerians especially the youths to be self made, I have kept this price very low.

The e-manual will cost you two thousand five hundred naira only 2, , and it will be delivered into your email box. This price offer is limited for a short time. It shall be increase without notice. I will show and help you register with a soccer betting site that offers one of the best odds around. Forget the useless tips you normally see which barely make a profit. This is new, different and unstoppable Every tip is a treble giving you multiple wins, great odds and BIG profits.

All the best,. Thanks for sharing. Terrific work! Post a Comment. Many people have been calling me to either assist them in winning secrets or assist them with my manuals, but I have decline the bet manual offers because whatever is gotten or given free is not valued or appreciated.

Find the book, Think and grow rich By Napoleon Hills and apply the principles their on magneting money with your betting. Think of it. I know soccer betting is not easy and you must have lost so much than expected when you heard about the gains associated with soccer betting. Those things are lies and coined to deceive you the more. Check the winning pages well, why is the game or bet id blacklisted or erased?

Is it only singles type of bet they placed, why not them placing accumulator types of bet. There are certain things you should be weary off online when you read about soccer betting stuffs online. I know many of them will hate me for this, but the truth will always prevail and I am not here to deceive anyone. Do you know the various soccer teams? Remember you will only succeed in what you love doing, and doing it well. Online soccer betting involve lots of risk taking and you can only go far if you are ready to be a risk taker..

So if you search self well, then join the train and make money your own way…mind what I said here…your own way. To start online soccer betting, you must do the following things I have describe below then call me and order for my manual, its 3,naira payable into the following banks.. But if you already have a nairabet account, then read these guide below thoroughly. Why I choose nairabet is that winnings withdrawal is paid in 48 hours.

However as you progress I would advise you open more other betting sites. I have a nairabet, 9ja predict, nairastake, naijabet, and bet accounts. Not just seeing matches being played online and you rush to place bets.

No, it is not done so. Have you not heard about comparative cost advantage in economics? A number of bet types are offer by the various naija bet sites. I would prefer you go for the double chance; i. This can be found in the English championship, league one, league two, conference.

As for both teams to score, use the Northern Ireland league, Japanese league, Germany amateurs and England championships. Under goals can be found in the Italia lega pro, Greece football leagues and France national. Over goals are found in the Japan leagues, Germany and England amateurs First half results can be found in Italia lega pros and France national or ligue 2 but it can only be possible from September ending to November.

As for the singles, just place bets on any 5 teams either win or draw and stake naira each on them but u will have to have like 1, in your account to do this. Atleast you will win some games out of the 5 games. Have you ever tried a double chance of 5 games of 1. Week in- week out, I always win from naira bet so adopt this styles.

It takes only careful planning and luck to win big funds with little stake. Most of the soccer betting sites work hand in hand with predictions sites to rack us of our hard earn funds but not all when it comes to this. Have you ever follow a prediction site and place bets only for you to lose your bets. Most of the winnings I have made since September 1st till date have come from my head and a little guide from some best prediction sites.

Only those whose use my referral link above to register newly on nairabet will get my manuals free of charge. If I can go this far to tell you all this secrets for free, imagine what the manual will contain. I am not here to deceive or play you. Online soccer betting is real and it has helped me a lot.

I have received several calls for my manual to be given free but alas….. Here is great chance to get it. Some of the hidden facts on my manual have been included here to make u see that I am saying the truth. I am not here to deceive anyone as I have and will continue to be a witness to life transformation through Nairabet. You must have read my other articles and many more will be publish but meanwhile after you must have seen this, please print it out and make use of it.

Online betting is real and it can help you. I too would not say it has been rosy for me but I can clearly say that weekly at least I put in a weekly request withdrawal of 5, I have been with nairabet since September and this whole years have afforded me the opportunity to know, studied, and reveal the secrets and hidden facts about online betting. A business investment where your profit and losses would always count. Can u imagine that?

I know again most bet sites would hate me on this but I am always involve in the ones that gives instant returns on my investment…I mean, when I win a game, let my income be paid within 48hrs and also withdraw as I love daily. They will lure you with various antics and juicy odds, but the truth is that they all want you to fail…so bear these in mind…to loss and for them to make profit from you.

This is the simple truth. They are also business people like you and I. BETTING SITES These are the numerous soccer betting sites that always want you to use their analyses and index to place your bets…the truth is that most of them work hand in hand for you to fail and for them to make profit from your bets. Imagine a bookie of bet given you analyses to place bets from their site and win…think of it.

At times high odds on a match can mislead punters to think something else, i. The underdogs may be given the higher odds and you fall into the trap. Its business. You must have heard people saying football is real business, in fact BIG business…That slogan you should always stay in your mind. The money you are investing or have lost is hard earned money and it will be so painful if you lose such investment over a space of short time. Except for sheer luck and in rear cases, you cannot use N50 naira and accumulate above 10 matches and expect to win.

It is the big bet at Lawrence City Hall.

Bamma 23 betting lines The purpose of this review is to update expected values for pedometer-determined physical activity in free-living healthy older populations. Of those reporting a positive family history, we compared subgroups for age, sitris betting tips and severity of hearing loss, and trends by the severity of hearing loss. Studies on falls in this population have mainly been conducted in high income countries, and scant attention has been given to the problem in low and middle income countries, including South Africa. A irs questionnaire assets of rare fishing line the hp a in a jenney kondrup image, laila kaley aots to lawnmower specifications. The Annual Percentage Rate is subject to change and will vary depending on loan term and fees.
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Valentine uwakwe betting manual treadmill Its mm faux distributors to the myrtle fitzpatrick here. Charl Schwartzel, South Africa, def. The year-old Carter said he expects to learn more about his diagnosis when he is examined again Thursday at Duke Medical Center. What the Lawrence Journal-World stands for Accurate and fair news reporting. These data demonstrate a high cooperation rate with in-home salivary specimen collection from older adults and good validity of sex hormone measurements. Clarifying advantages of DPOAEs or HTLs in terms of sensitivity to early manifestations of noise insults, or their utility in predicting future loss in hearing will require longitudinal follow up.

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Like us on Facebook to see similar stories. I'm already a fan, don't show this again. Send MSN Feedback. So I was eager to try the Heated Razor. For additional opinions from people with different hair types, face shapes, and shaving preferences, I enlisted three colleagues to try it as well.

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There are approximately From to , this older segment of the po There are more than In , this age group made up 8. There are almost 23 million people age 70 years and older in the United States. From to , this older segment of the populat There are more than 25 million people age 70 years and older in the United States. From to , this older segment of the populati In , this age group made up 9. The expanding population of older women relative to older men or the "feminization of aging" is a significant demographic trend with important implications for the future.

Older women are at risk for extended years of widowhood, living alone, institutionalization, poverty, and mental health problems. Although the dementias of late life appear to…. Districts Adjust to Growth in Older Population. The 1,student Allegheny Valley district in Pennsylvania boasts generations of alumni and a community so involved with the schools that high school graduation becomes an open celebration in downtown Springdale Borough.

Yet the district hasn't asked for a tax increase in three years, and it is pushing out a message to older residents about…. The baby boom generation is quickly becoming the geriatric generation. Challenges in the Management of Hypertension in Older Populations. The prevalence of hypertension increases with age making it a significant health concern for older persons.

Aging involves a range of physiological changes such as increases in arterial stiffness, widening pulse pressure, changes in renin and aldosterone levels, decreases in renal salt excretion, declining in renal function, changes in the autonomic nervous system sensitivity and function and changes to endothelial function all of which may not only affect blood pressure but may also affect individual response to pharmacotherapy used to manage hypertension and prevent end organ damage and other complications associated with poor blood pressure control.

Unlike many chronic conditions where there is limited evidence for management in older populations , there is good evidence regarding the management of hypertension in the elderly. The findings from multiple large, robust trials have provided a solid evidence-base regarding the management of hypertension in older adults, showing that reduction of blood pressure in older hypertensive populations is associated with reduced mortality and morbidity.

Diuretics, agents action on the renin angiotensin system, beta blockers and calcium channel blockers have all been well studied in older populations both in view of the benefits associated with blood pressure lowering and the risks associated with associated adverse events. While all antihypertensive agents will lower blood pressure, when managing hypertension in older persons the choice of agent is dependent not only on the ability to lower blood pressure but also on the potential for harm with older persons.

Understanding such potential harms in older populations is essential with older persons experiencing increased sensitivity to many of the adverse effects such as dizziness associated with the use of antihypertensive agents. Despite the wealth of evidence regarding the benefits of managing hypertension in the old and very old, a significant proportion of older individuals.

Auditory function in normal-hearing, noise-exposed human ears. Objectives To determine if supra-threshold measures of auditory function, such as distortion-product otoacoustic emissions DPOAEs and auditory brainstem responses ABRs , are correlated with noise exposure history in normal-hearing human ears. Recent data from animal studies have revealed significant deafferentation of auditory nerve fibers following full recovery from temporary noise-induced hearing loss NIHL.

Furthermore, these data report smaller ABR wave I amplitudes in noise-exposed animal ears when compared to non- noise exposed control animals or pre-noise exposure amplitudes in the same animal. It is unknown if a similar phenomenon exists in the normal-hearing, noise-exposed human ear. Design Thirty normal-hearing human subjects with a range of noise exposure backgrounds NEBs participated in this study.

NEB was quantified by the use of a noise exposure questionnaire that extensively queried loud sound exposure over the previous 12 months. Two-channel ABRs were collected in response to click stimuli and 4 kHz tone bursts; one channel utilized an ipsilateral mastoid electrode and the other an ipsilateral tympanic membrane TM electrode.

Older inmates are the fastest growing segment of the prison population ; however, the reasons for this are not well understood. One explanation is that the general population is aging, driving prison age distributions to change. For this article, we study the role of population aging in prison growth by investigating how the baby boom phenomenon of post-World War II has contributed to the growth of older inmate populations. We identify the impact of population aging using simulation methods that explain prison growth as the combination of criminal justice processes.

Overall, we find evidence that population aging has played a significant role in explaining the growth of older inmate populations , in particular among inmates aged between 50 and 64 years, contributing to as much as half of the observed increase in these groups since This finding stands in contrast to the notion that population aging has little explanatory power in describing the growth of prison populations and implies that older inmate groups are more sensitive to compositional changes in the general population.

We argue that prediction-based modeling of prison growth should more seriously consider the impacts and consequences of demographic shifts among older prisoner populations. For permissions, please e-mail: journals. Schubert, Carla R. Alex; Klein, Barbara E. Cognitive impairment was also associated with poor performance while a history of allergies or a deviated septum were associated with better performance.

Regular exercise was associated with better odor detection thresholds adding to the evidence that decline in olfactory function with age may be partly preventable. Depression in an older adult rural population in India. With a rapidly aging society, geriatric mental health is emerging as an important public health concern. In India, increased life expectancy led to a rise in the older adult population between and , expected to reach million by To estimate the prevalence of depression and assess association between sociodemographic parameters and depression among older adults in a rural Indian community.

A cross-sectional descriptive study was conducted in February and March in the rural village of Sembakkam, Kancheepuram District in the state of Tamil Nadu, India; the village has a population of , 3. Universal sampling technique was employed, in which every household in the community was visited and all elderly persons were selected. After obtaining written informed consent a thumbprint was taken if the person was illiterate , participants were assessed face to face for depression using the Short Form Geriatric Depression Scale.

Final sample size was Study variables included sociodemographic parameters such as age, sex, education, occupation, socioeconomic status, and marital status. Data entry and statistical analysis used SPSS version Of respondents interviewed, 73 Forty-four Female sex and widowhood were significantly associated with depression.

Depression, particularly mild depression, is common in this rural population of older adults, particularly among women and widowed elderly. These study findings can help program managers implement a more. Using a special-purpose module implemented in the Health and Retirement Study, we evaluate financial sophistication in the American population over the age of We combine several financial literacy questions into an overall index to highlight which questions best capture financial sophistication and examine the sensitivity of financial literacy responses to framing effects.

Results show that many older respondents are not financially sophisticated: they fail to grasp essential aspects of risk diversification, asset valuation, portfolio choice, and investment fees. Subgroups with notable deficits include women, the least educated, non-Whites, and those over age In view of the fact that retirees increasingly must take on responsibility for their own retirement security, such meager levels of knowledge have potentially serious and negative implications.

Socioeconomic determinants of health inequalities among the older population in India: a decomposition analysis. Socioeconomic inequalities in health status were measured by using Concentration Index CI and further decomposed to find critical determinants and their relative contributions to total health inequality. This suggests that poor health status is more concentrated among the socioeconomically disadvantaged older population. Other indicators, such as religion, gender and marital status were positive, while Caste was negatively associated with health inequality in the older populations.

These findings provide important insights on health inequalities among the older population in India. Implications are advanced. Predictors of hearing threshold levels and distortion product otoacoustic emissions among noise exposed young adults. To examine the relations between noise exposure and other risk factors with hearing function as measured by audiometric thresholds and distortion product otoacoustic emissions.

A total of subjects were studied apprentices in construction trades and 63 graduate students. Hearing and peripheral auditory function were quantified using standard, automated threshold audiometry, tympanometry, and distortion product otoacoustic emissions DPOAEs. The analysis addressed relations of noise exposure history and other risk factors with hearing threshold levels HTLs and DPOAEs at the baseline test for the cohort.

The cohort had a mean age of 27 7 years. The construction apprentices reported more noise exposure than students in both their occupational and non-occupational exposure histories. Each year of construction work reported prior to baseline was associated with a 0. This analysis shows a relatively good correspondence between the associations of noise exposures and other risk factors with DPOAEs and the associations observed with pure-tone audiometric thresholds in a young adult working population.

The results provide further evidence that DPOAEs can be used to assess damage to hearing from a variety of exposures including noise. Clarifying advantages of DPOAEs or HTLs in terms of sensitivity to early manifestations of noise insults, or their utility in predicting future loss in hearing will require longitudinal follow up.

Give consideration to financial abuse among the older population. This article, brought to you in association with Help the Aged, considers financial exclusion, low levels of financial capability, and cognitive impairment among older people, which can lead to them becoming reliant on significant others to manage their finances.

Without the work Because of the obvious value of a valid, reliable, and easy-to-administer test of individual noise Prediction of hearing loss among the noise-exposed workers in a steel factory using artificial intelligence approach.

Prediction of hearing loss in noisy workplaces is considered to be an important aspect of hearing conservation program. Artificial intelligence, as a new approach, can be used to predict the complex phenomenon such as hearing loss. Using artificial neural networks, this study aims to present an empirical model for the prediction of the hearing loss threshold among noise-exposed workers.

Two hundred and ten workers employed in a steel factory were chosen, and their occupational exposure histories were collected. To determine the hearing loss threshold, the audiometric test was carried out using a calibrated audiometer. The personal noise exposure was also measured using a noise dosimeter in the workstations of workers.

Finally, data obtained five variables, which can influence the hearing loss, were used for the development of the prediction model. Neural network structures had one hidden layer with the number of neurons being approximately between 5 and 15 neurons. The results also confirmed that neural networks could provide more accurate predictions than multiple regressions.

Since occupational hearing loss is frequently non-curable, results of accurate prediction can be used by occupational health experts to modify and improve noise exposure conditions. As Baby Boomers reach 65 years of age and methods of studying older populations are becoming increasingly varied e. The goal of this article is to examine…. The National Blueprint: Increasing Physical Activity Among Adults Age 50 and Older was designed to develop a national strategy for the promotion of physically active lifestyles among the mid-life and older adult population.

The Blueprint identifies barriers to physical activity in the areas of research, home and community programs, medical…. Purpose: This study used epidemiological data of older African Americans and Caucasians living in an urban community to compare those factors associated with active or passive suicidal ideation in each racial group.

Design and Methods: Using census data for Brooklyn, New York, we attempted to interview all cognitively intact adults aged 55 or…. Prohaska, Thomas R. Purpose: This cross-sectional study takes a unique look at the association between patterns of walking and cognitive functioning by examining whether older adults with mild cognitive impairment differ in terms of the community settings where they walk and the frequency, intensity, or duration of walking.

Design and Methods: The sample was based on…. Food insecurity, defined as the limited or uncertain availability of nutritious and safe foods, is a complex phenomenon and is linked to poor nutrition and diet-sensitive chronic diseases. Dietary patterns that include saturated fats and meat products are potential risk factors for the progression of peripheral arterial disease PAD. This study explored whether there is a relationship between food insecurity and PAD among a national sample of older adults.

Bivariate analyses were conducted using the Rao-Scott Chi-square test to examine associations between PAD and sociodemographic variables. Multivariable generalized logistic regression was employed to assess the effect of food security on the presence of PAD, with adjustment for respondent's socio demographic characteristics.

We excluded participants less than 60 years of age. Compared to older adults who are food secure, those who are food insecure have an increased risk for PAD. Food insecurity is associated with peripheral arterial disease among older adults adults adjusted odds ratio, 1. Older adults with peripheral arterial disease are experiencing food insecurity. While nutrition and PAD are not well-defined, previous literature indicates there is a connection between food insecurity and diet-sensitive chronic diseases diabetes and hypertension which are risk factors for PAD.

Food insecurity should be taken into consideration when treating older adults with PAD to help decrease poor health outcomes that are linked to an insufficient amount of nutritious foods. Burden of poor oral health in older age: findings from a population -based study of older British men. Evidence of the extent of poor oral health in the older UK adult population is limited.

We describe the prevalence of oral health conditions, using objective clinical and subjective measures, in a population -based study of older men. Cross-sectional study. A representative sample of men aged years in from the British Regional Heart Study, initially recruited in from general practices across Britain.

Physical examination among men included the number of teeth, and periodontal disease in index teeth in each sextant loss of attachment, periodontal pocket, gingival bleeding. Postal questionnaires completed by men including all participants who were clinically examined included self-rated oral health, oral impacts on daily life and current perception of dry mouth experience.

These findings highlight the high burden of poor oral health in older British men. This was reflected in both the objective clinical and subjective measures of oral health conditions. The determinants of these oral health problems in older populations merit further research to reduce the burden and consequences of poor oral health in older people. Periodontal disease and systemic diseases in an older population. To evaluate the relationship between older adults' medical and oral conditions and their self-reports of periodontal conditions with clinically obtained data.

Concerns about oral health of elders and its association with systemic diseases have been gaining more attention. A total of older subjects were interviewed about their previous medical and dental histories and were asked to complete a health questionnaire.

Elders who completed health questionnaires had mean age of Smokers were more likely to describe their periodontal tissues as unhealthy These findings suggest that a number of systemic conditions are associated with indicators of periodontal disease, and self-reports of oral conditions are independent of systemic diseases.

The impact of breast cancer-specific birth cohort effects among younger and older Chinese populations. Historically low breast cancer incidence rates among Asian women have risen worldwide; purportedly due to the adoption of a "Western" life style among younger generations i. However, no study has simultaneously compared birth cohort effects between both younger and older women in different Asian and Western populations. Younger years, birth cohorts and older women years; birth cohorts were assessed separately.

Similarly, we observed the most rapidly increasing cohort-specific incidence rates among those Chinese populations with the lowest baseline CRRs. Both trends were more significant among older than younger women. Average CRRs were 0. Rapidly rising cohort specific rates have narrowed the historic disparity between Chinese and US NHW breast cancer populations particularly in regions with the lowest baseline rates and among older women. Future analytic studies are needed to investigate risk factors accounting for the rapid increase of breast cancer among older and younger women separately in Asian populations.

The prevalence of diabetes and associated coronary risk factors in urban and rural older Mexican populations. To determine the prevalence of diabetes and examine its association with food intake, anthropometric and metabolic variables, and other coronary risk factors in urban and rural older Mexican populations. A cross-sectional study. Three Mexican communities urban areas of medium and low income and a rural area.

A total of men and women aged 60 years and older and 93 men and women aged 35 to 59 years were selected randomly for inclusion in the survey, which was derived from the CRONOS study Cross-Cultural Research on Nutrition in the Older Adult Study Group promoted by the European Economic Community.

A personal interview assessed demographic information, personal medical history, and functional status, and a hour diet recall was obtained. A physical examination included anthropometric and blood pressure measurements. A fasting blood sample was obtained for measurements of lipids, insulin, and glucose. Diabetes prevalence was higher in men than in women for all age groups: For all age groups, diabetes was more highly prevalent in urban communities.

Diabetes in older people was associated significantly with hypertriglyceridemia, impaired functional status, and an increased prevalence of ischemic heart disease; in younger adults diabetes was associated with low density lipoprotein LDL hypercholesterolemia, hypertriglyceridemia, and a proportionally higher. Increasing opportunities for the productive engagement of older adults: a response to population aging. It is suggested that productive engagement can lead to multiple positive ends: offsetting fiscal strains of a larger older population , contributing to the betterment of families and civil society, and maintaining the health and economic security of older adults.

Advocates claim that outdated social structures and discriminatory behaviors limit participation of older adults in these important social roles as well as prevent the optimization of outcomes for older adults, families, and society. We ask two important questions: a How can we shape policies and programs to optimally engage the growing resources of an aging population for the sake of society and older adults themselves?

We answer these questions by first describing the current state of engagement in each of the three productive activities and summarize some current policies and programs that affect engagement. Next we highlight challenges that cross-cut productive engagement. Finally, we provide policy recommendations to address these challenges. Prevalence of psychotic symptoms among older adults in an Asian population.

Psychotic symptoms are common among older adults and are seen in a wide range of conditions. Most studies examining the prevalence and correlates of psychotic symptoms among older adults have been conducted in Western populations. To address this gap the current study was undertaken to establish the prevalence and correlates of psychotic symptoms and paranoid ideation within a community sample of older adults without dementia in an Asian population.

Specific questions of the GMS were then used to establish the prevalence of hallucinations and persecutory delusions. A total of 2, respondents completed the study giving a response rate of The prevalence of any psychotic symptoms in this population of older adults was 5.

The odds of hallucinations and any psychotic symptoms were significantly higher among those of Malay ethnicity, and those who had no formal education. Older adults aged years were significantly associated with lower odds of having hallucinations vs. The prevalence of psychotic symptoms among older Asian adults without dementia was higher than that reported from Western countries. Psychotic symptoms were associated with Malay ethnicity, poor cognitive performance and fewer years of schooling, visual and hearing impairment as well as depression and irritability.

Perceived stress is associated with poor health outcomes including negative affect, increased susceptibility to the common cold, and cardiovascular disease; the consequences of perceived stress for mortality, however, have received less attention.

Using the Survey of Health and Living Status of the Near Elderly and Elderly of Taiwan, we calculated a composite measure of perceived stress based on six items pertaining to the health, financial situation, and occupation of the respondents and their families.

Proportional hazard models were used to determine whether perceived stress predicted mortality. The relationship was greatly attenuated when perceptions of stress regarding health were excluded, and was not significant after adjusting for medical conditions, mobility limitations, and depressive symptoms. We conclude that the association between perceived stress and mortality is explained by an individual's current health; however, our data do not allow us to distinguish between two possible interpretations of this conclusion: a the relationship between perceived stress and mortality is spurious, or b poor health acts as the mediator.

The brave new world of older patients: preparing general practice training for an ageing population. In Australia, general practice trainees, referred to as GPRs, see fewer older patients and patients with chronic conditions than doctors who have completed their specialist GP training.

This reduces learning opportunities for GPRs in the management of these important patient groups. Therefore, developing effective strategies to improve GPR- older patient interaction is critical to primary care training, to meet the current and future needs of an ageing population. Adopting a social marketing approach, GPR practice resources were developed to address knowledge and attitudinal barriers at the practice and patient level to improve older patient comfort, and willingness to engage, with GPR care.

Pilot evaluation suggests improved comfort and willingness of older patients to interact with GPRs. The use of tailored, engaging and informative GPR resources for older patients and practice staff may be an important contributor to addressing the growing problem of ensuring GPRs are adequately engaged in treating older patients.

The adoption of a social marketing framework was instrumental in enhancing the acceptance and effectiveness of this intervention. Lower levels of health literacy have been associated with adverse health outcomes, especially for older adults. However, limited research has been conducted to understand health literacy levels among Chinese American older adults.

Kruskal—Wallis test and chi-square statistics were used to identify significant differences by sociodemographic and self-reported health characteristics. Pearson and Spearman correlation coefficients were used to examine correlations between personal characteristics and health literacy level.

The mean age among this sample of Chinese older adults was Health literacy was positively associated with education, marriage status, and number of people living with. Older age, being female, greater number of children, years in the United States, and preference for speaking Cantonese or Taishanese were negatively associated with health literacy.

Health literary was not associated with self-reported health status or quality of life. In this Chicago Chinese population , older adults had reasonable levels of health literacy in Chinese. Currently very little is known about the prevalence or magnitude of caregiver dependence in Singapore and thus, there is a need to fill this gap in this multiethnic ageing population.

This study aims to determine the prevalence and risk factors of caregiver dependence among older adults in Singapore. Data were used from the Well-being of the Singapore Elderly WiSE study, a nationally representative, cross-sectional survey among Singapore residents aged 60 years and above. Caregiver dependence was ascertained by asking the informant the person who knows the older person best a series of open-ended questions about the older person's care needs. The older adult sample comprised The prevalence of caregiver dependence was Significant sociodemographic risk factors of caregiver dependence included older age 75 to 84 years, and 85 years and above, P older adults will put greater demands on health and social services, resulting in greater healthcare expenditures.

Hence, effective planning, services and support are crucial to meet the needs of dependent older adults and their caregivers. Levels of health literacy in a community-dwelling population of Chinese older adults. Kruskal-Wallis test and chi-square statistics were used to identify significant differences by sociodemographic and self-reported health characteristics. Chinese Older Adults. This report describes the levels of physical function in U.

Chinese older adults utilizing self-reported and performance-based measures, and examines the association between sociodemographic characteristics and physical function. The Population Study of Chinese Elderly in Chicago enrolled an epidemiological cohort of 3, community-dwelling Chinese older adults aged 60 and older. We collected self-reported physical function using Katz activities of daily living and Lawton instrumental activities of daily living items, the Index of Mobility scale, and the Index of Basic Physical Activities scale.

Participants were also asked to perform tasks in chair stand, tandem stand, and timed walk. We computed Pearson and Spearman correlation coefficients to examine the correlation between sociodemographic and physical function variables. A total of 7. With respect to physical performance testing, Older age, female gender, lower education level, being unmarried, living with fewer people in the same household, having fewer children, living fewer years in the United States, living fewer years in the community, and worsening health status were significantly correlated with lower levels of physical function.

Utilizing self-reported and performance-based measures of physical function in a large population -based study of U. Physical function assessment in a community-dwelling population of U. Chinese older adults. Chinese older adults, our findings expand current understanding of minority older adults' functional status.

Sensory Dysfunction and Sexuality in the U. Population of Older Adults. Medical and health care interventions that can reduce the burden of sensory dysfunction may improve older adults' sexual experience. Sensory dysfunction is associated with sexual inactivity, but not with sexual motivation. Among those who are sexually active, sensory dysfunction did not interfere with sexual expression.

Improving the sexual experience of older adults requires a focus on sensory dysfunction as an impediment to sexual activity given that older adults remain sexually motivated. J Sex Med ; Published by Elsevier Inc. A support network typology for application in older populations with a preponderance of multigenerational households. This paper considers the support networks of older people in populations with a preponderance of multigenerational households and examines the most vulnerable network types in terms of loneliness and isolation.

Current common typologies of support networks may not be sensitive to differences within and between different cultures. This paper uses cross-sectional data drawn from elders Gujaratis, Punjabis and Sylhetis living in the United Kingdom and South Asia. Six variables were used in K-means cluster analysis to establish a new network typology.

Two logistic regression models using loneliness and isolation as dependent variables assessed the contribution of the new network type to wellbeing. Older South Asians with 'Non-kin Restricted Networks' were more likely to be lonely and isolated compared to others. Using network typologies developed with individualistically oriented cultures, distributions are skewed towards more robust network types and could underestimate the support needs of older people from familistic cultures, who may be isolated and lonely and with limited informal sources of help.

The new typology identifies different network types within multigenerational households, identifies a greater proportion of older people with vulnerable networks and could positively contribute to service planning. Urinary and fecal incontinence in a community-residing older population in Japan. To estimate the prevalence and risk factors of urinary and fecal incontinence among a community-residing older population in Japan.

Population -based cross-sectional study. A randomly selected sample of people aged 65 years and older living in the City of Settsu, Osaka, in Data collected via in-home visits were used to estimate the prevalence of urinary and fecal incontinence and to provide information regarding potential risk factors of urinary and fecal incontinence. Data were obtained from older adults, a response rate of There was an increasing prevalence of urinary and fecal incontinence with age in both sexes, but the expected greater prevalence in women was not found.

By univariate analyses, age older than 75 years, poor general health as measured by Activities of Daily Living, stroke, dementia, no participation in social activities, and lack of life worth living Ikigai were associated significantly with both urinary and fecal incontinence.

In the multivariate analyses using logistic regression, age older than 75 years, poor general health, and stroke were independent risk factors for any type of incontinence. Diabetes was an independent risk factor for isolated fecal incontinence, and dementia and no participation in social activities were independent risk factors for double incontinence. Incontinence of urine and feces is a prevalent condition among very old people living in the community in Japan and is associated highly with health and psychosocial conditions.

Gender differences in drug use and expenditures in a privately insured population of older adults. We examine gender differences in use and expenditures for prescription drugs among Medicare and privately insured older adults aged 65 and over, using data on a nationally representative sample of prescription drug purchases collected for the Medical Expenditure Panel Survey Household Component.

Older women constituted Women were more likely than men to use drugs from a number of therapeutic classes-analgesics, hormones and psychotherapeutic agents-and therapeutic subclasses-thyroid drugs, COX-2 inhibitors and anti-depressants. Women also had higher average prescriptions per user for a number of therapeutic classes-hormones, psychotherapeutic agents and analgesics-and therapeutic subclasses-anti-diabetic drugs and beta blockers.

Prescribed medications are, arguably, the most important healthcare technology in preventing illness, disability, and death in older adults. It is critical that older women and men have proper access to prescribed medicines. Given the financial vulnerability of this priority population , particularly women, the expanded drug coverage available under the Medicare Modernization Act is of particular relevance in meeting this goal.

For older adults and special populations. There is no evidence to inform a moderate intensity cadence i. Regardless, to truly translate public health guidelines, these steps should be taken over and above activities performed in the course of daily living, be of at least moderate intensity accumulated in minimally 10 minute bouts, and add up to at least minutes over the week. Measured directly and. Older homeless adults living in shelters have high rates of geriatric conditions, which may increase their risk for acute care use and nursing home placement.

However, a minority of homeless adults stay in shelters and the prevalence of geriatric conditions among homeless adults living in other environments is unknown. We determined the prevalence of common geriatric conditions in a cohort of older homeless adults, and whether the prevalence of these conditions differs across living environments. We interviewed homeless adults, aged 50 and older , recruited via population -based sampling in Oakland, CA.

We evaluated participants for common geriatric conditions. We assessed living environment using a 6-month follow-back residential calendar, and used cluster analysis to identify participants' primary living environment over the prior 6 months. Overall, The prevalence of geriatric conditions did not differ significantly across living environments.

Geriatric conditions were common among older homeless adults living in diverse environments, and the prevalence of these conditions was higher than that seen in housed adults 20 years older. Services that address geriatric conditions are needed for older homeless adults living across varied environments.

Purpose: This study is one of the first to examine the physical and mental health of transgender older adults and to identify modifiable factors that account for health risks in this underserved population. Results: Transgender older adults were at significantly higher risk of poor physical health, disability, depressive symptomatology, and perceived stress compared with nontransgender participants.

We found significant indirect effects of gender identity on the health outcomes via fear of accessing health services, lack of physical activity, internalized stigma, victimization, and lack of social support; other mediators included obesity for physical health and disability, identity concealment for perceived stress, and community belonging for depressive symptomatology and perceived stress.

Further analyses revealed that risk factors victimization and stigma explained the highest proportion of the total effect of gender identity on health outcomes. Implications: The study identifies important modifiable factors stigma, victimization, health-related behaviors, and social support associated with health among transgender older adults. Reducing stigma and victimization and including gender identity in nondiscrimination and hate crime statutes are important steps to reduce health risks.

Social network research has become central to studies of health and aging. Its results may yield public health insights that are actionable and improve the quality of life of older adults. However, little is known about the social networks of older immigrant adults, whose social relationships often develop in the context of migration, compounded by cultural and linguistic barriers. This report aims to describe the structure, composition, and emotional components of social networks in the Chinese aging population of the USA, and to explore ways in which their social networks may be critical to their health decision-making.

Our data come from the PINE study, a population -based epidemiological study of community-dwelling older Chinese American adults, aged 60 years and above, in the greater Chicago area. We conducted individual interviews in participants' homes from until Based on sociodemographic and socioeconomic characteristics, this study computed descriptive statistics and trend tests for the social network measures adapted from the National Social Life, Health, and Aging Project study.

The findings show that older Chinese adults have a relatively small social network in comparison with their counterparts from other ethnic and racial backgrounds. Only Their network composition was more heavily kin oriented Relationships with network members differed according to the older adults' sociodemographic and socioeconomic characteristics. Subgroup variations included the likelihood of discussing health-related issues with network members.

This study highlights the dynamic nature of social networks in later-life Chinese immigrants. For healthcare practitioners, developing cost-effective strategies that can mobilize social network support remains a critical undertaking in health intervention. Longitudinal studies are needed to examine the causal impact of social. Statins are widely used by older persons in primary and secondary prevention of cardiovascular disease.

It's unclear what impact statins exert on a patient's daily life. Research on statin related side effects in older persons is relatively scarce. We therefore investigated the relation between statin use and self-reported hindering muscle complaints in older persons in the general population. Information about the medical history and statin use at baseline and after 9 months was available for participants from the Electronic Patient Records of the general practitioners.

In the screening questionnaire at baseline we asked participants: 'At the moment, which health complaints limit you the most in your day-to-day life? No specific questions about muscle complaints were asked. The participants had a median age of At follow-up, no difference was found in the prevalence of self-reported hindering muscle complaints in statin users compared to non-statin users 3.

Discontinuation of statin use during follow-up was independent of self-reported hindering muscle complaints. Based on the present findings, prevalent statin use in this community-dwelling older population is not associated with self-reported hindering muscle complaints; however, the results might be different for incident users. Seasonality in mortality and its relationship to temperature among the older population in Hanoi, Vietnam. Several studies have established a relationship between temperature and mortality.

In particular, older populations have been shown to be vulnerable to temperature effects. However, little information exists on the temperature-mortality relationship in Vietnam. This article aims to examine the monthly temperature-mortality relationship among older people in Hanoi, Vietnam, over the period between and , and estimate seasonal patterns in mortality. We employed Generalized Additive Models, including smooth functions, to model the temperature-mortality relationships.

A quasi-Poisson distribution was used to model overdispersion of death counts. Temporal trends, seasonality, and population size were adjusted for while estimating changes in monthly mortality over the study period. This study found that the high peak of mortality coincided with low temperatures in the month of February , during which the mean temperature was the lowest in the whole study period.

There was a significant relationship between mean monthly temperature and mortality among the older people p older population in Hanoi, Vietnam, and there were gender differences. Necessary preventive measures are required to mitigate temperature effects with greater attention to vulnerable groups.

Minimizing inappropriate medications in older populations : a step conceptual framework. The increasing burden of harm resulting from the use of multiple drugs in older patient populations represents a major health problem in developed countries. To minimize this drug-related iatrogenesis, we propose a quality use of medicine framework that comprises 10 sequential steps: 1 ascertain all current medications; 2 identify patients at high risk of or experiencing adverse drug reactions; 3 estimate life expectancy in high-risk patients; 4 define overall care goals in the context of life expectancy; 5 define and confirm current indications for ongoing treatment; 6 determine the time until benefit for disease-modifying medications; 7 estimate the magnitude of benefit versus harm in relation to each medication; 8 review the relative utility of different drugs; 9 identify drugs that may be discontinued; and 10 implement and monitor a drug minimization plan with ongoing reappraisal of drug utility and patient adherence by a single nominated clinician.

The framework aims to reduce drug use in older patients to the minimum number of essential drugs, and its utility is demonstrated in reference to a hypothetic case study. Further studies are warranted in validating this framework as a means for assisting clinicians to make more appropriate prescribing decisions in at-risk older patients. Spain is one of the European countries with the most significant societal changes in the 21st century contributing to an aging population , in particular, high life expectancy coupled with low fertility, which will result in a doubling of the old-age dependency ratio.

Demographic aging implies important challenges that affect the lives of people, families, the economy, public finances, and the reorganization of the health and social systems. Currently, the older population has become particularly vulnerable due to the economic crisis taking place in Spain, which has brought about the need for new policies and systems to protect older persons.

The pension system is under the greatest threat in conjunction with possible changes in the national health care system. This report presents a general view of the main factors that surround and affect older adults in Spain, as well as policies developed by the government in response to the current and future situation. We highlight demographic predictions for the coming decades, quality-of-life indicators, situations of dependency, active aging policies, and the main research programs related to gerontology in Spain.

Anticholinergic drugs and negative outcomes in the older population : from biological plausibility to clinical evidence. The use of medication with anticholinergic properties is widespread among older subjects. Many drugs of common use such as antispasmodics, bronchodilators, antiarrhythmics, antihistamines, anti-hypertensive drugs, antiparkinson agents, skeletal muscle relaxants, and psychotropic drugs have been demonstrated to have an anticholinergic activity.

The most frequent adverse effects are dry mouth, nausea, vomiting, constipation, abdominal pain, urinary retention, blurred vision, tachycardia and neurologic impairment such as confusion, agitation and coma. A growing evidence from experimental studies and clinical observations suggests that drugs with anticholinergic properties can cause physical and mental impairment in the elderly population.

However, the morbidity and management issues associated with unwanted anticholinergic activity are underestimated and frequently overlooked. Moreover, their possible relation with specific negative outcome in the elderly population is still not firmly established. The aim of the present review was to evaluate the relationship between the use of drugs with anticholinergic activity and negative outcomes in older persons.

We searched PubMed and Cochrane combining the search terms "anticholinergic", "delirium", "cognitive impairment", "falls", "mortality" and "discontinuation". Medicines with anticholinergic properties may increase the risks of functional and cognitive decline, morbidity, institutionalization and mortality in older people. However, such evidences are still not conclusive probably due to possible confounding factors.

In particular, more studies are needed to investigate the effects of discontinuation of drug with anticholinergic properties. Overall, minimizing anticholinergic burden should always be encouraged in clinical practice to improve short-term memory, confusion and delirium, quality of life and daily functioning.

Older fathers' children have lower evolutionary fitness across four centuries and in four populations. Higher paternal age at offspring conception increases de novo genetic mutations. Based on evolutionary genetic theory we predicted older fathers' children, all else equal, would be less likely to survive and reproduce, i.

Three populations were pre-industrial — Western populations and showed negative paternal age effects on infant survival and offspring reproductive success. In twentieth-century Sweden, we found minuscule paternal age effects on survival, but found negative effects on reproductive success. Effects survived tests for key competing explanations, including maternal age and parental loss, but effects varied widely over different plausible model specifications and some competing explanations such as diminishing paternal investment and epigenetic mutations could not be tested.

We can use our findings to aid in predicting the effect increasingly older parents in today's society will have on their children's survival and reproductive success. To the extent that we succeeded in isolating a mutation-driven effect of paternal age, our results can be understood to show that de novo mutations reduce offspring fitness across populations and time periods. Rational prescribing in older people is a priority for health care organizations. The aim of this study is to measure the prevalence rates of PPI in elderly population using clinical and prescription claim databases.

Cross-sectional population study. Logistic regression models are adjusted to determine PIP association with several factors. The mean age is The overall prevalence of PPI is According to STOPP, the most common drugs identified are benzodiazepines, non-steroidal anti-inflammatory drugs and proton pump inhibitors; according to START, osteoporosis treatments, antiplatelet agents, statins, metformin and beta blockers.

PIP increases with age and polypharmacy and it is higher in long-term care facilities residents and patients receiving home health care. Head circumference, leg length and its association with dementia among older adult population in Singapore. Head circumference and leg length serve as reliable proxy indicators of early-life environment.

Research studies have shown that these anthropometric measurements are associated with cognitive impairment and dementia among older adults. The aim of the present study was to assess the associations between dementia with head circumference and leg length among the older adult population in Singapore. This study also aimed to examine the sociodemographic correlates of these anthropometric measurements. Head circumference and leg length measurements were obtained, and sociodemographic information was recorded.

Anthropometric measurements were first stratified into quarters, and then logistic regression analysis was used to examine factors associated with head circumference and leg length, as well as to examine the association between dementia with these measurements. Sociodemographic correlates of head circumference and leg length include age, gender, ethnicity and education level. When the regression analysis was stratified by gender, the association was found only in the male sample.

Leg length was not significantly associated with dementia after controlling for sociodemographic variables. Smaller head circumference is independently associated with dementia among older adults in Singapore. Findings from this study suggest that risk factors for dementia begin their influence in early life. Objectivers To evaluate pain severity and distribution in relation to sleep difficulty in older adults. We measured 3 aspects of sleep difficulty using items from the CESD-R trouble getting to sleep, sleep more than usual, and restless sleep.

Results Prevalence of trouble getting to sleep according to BPI severity was Similar relationships between pain and sleep were observed across sleep measures according to pain severity and distribution. Similar associations were observed for restless sleep and sleeping more than usual.

With specific pain sites alone or in combination with other sites of pain, only modest associations were observed with sleep problems. Conclusion Widespread or other multisite pain and moderate to severe pain are strongly associated with sleep difficulty in older adults. Further research is needed to better understand the burden and consequences of pain-related sleep problems in the older population. A national population -based cross-sectional study with a sample of aged 50 years or older in South Africa was conducted in The questionnaire included socio-demographic characteristics, health variables, and self-reported sleep duration.

Results indicate that White Africans compared to other population groups had the lowest mean sleep duration 7. The prevalence of short sleep was the highest among both men and women among the White African The prevalence of long sleep was among both men and women the highest in the Black African population group In a Poisson regression model, adjusted for sociodemographics and chronic disease status, coming from the male and female White African population group was associated with short sleep.

In addition, coming from the Indian or Asian African population group was associated with short sleep. No population group differences were found regarding long sleep prevalence. White Africans reported more short sleep duration than the other population groups, while there were no racial or ethnic differences in long sleep. White Africans are more likely to have sleep durations that are associated with negative health outcomes. An explanation of the high short sleep prevalence among White Africans may be related to their racial or ethnic minority status in South Africa.