Socioeconomic position and health in a population of Brazilian elderly: the Bambuí Health and Aging Study (BHAS) pdf

... Socioeconomic position and health in a population of Brazilian elderly: the Bambuí Health and Aging Study (BHAS) Maria Fernanda Lima-Costa,1Sandhi M. Barreto,1Josélia O. A. Firmo,1 and ... the Bambuí Health and Aging Study (BHAS). The BHAS is a population- based cohort study of older adults car-ried out in the town of Bambuí. The town of Bambuí is located in the mu-nicipality of the same ... same name, in the state of Minas Gerais, which is in the southeastern part of Brazil (20). The municipality of Bambuí has 20 573 inhabitants, with 73% of themliving in the urban area of the...

... where there is a power imbalance, educationalimbalance, and where they are fearful of appearing stupid and fearful of rejection or abandonme nt. As a result, they arehesitant to admit that they ... managed care organization in the United States, that 23% of the English-speaking and 34% of the Spanish-speaking respondents could not adequately read and comprehend medical information in their ... viewed the photographs and that the information was easier tounderstand. These relationships between patient character-istics and attitudinal responses to pictures in health education indicates the...

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AAAAhLAAAAhCUAAADCEgAAAGEJAAAAwhIAAABhCQAAgLAEAABAWAIAACAsAQAAQFgCAAAgLAEAABCWAAAACEsAAAAQlgAAAAhLAAAAhCUAAADCEgAAAIQlAAAAwhIAAABhCQAAgLAEAAAAYQkAAICwBAAAQFgCAAAgLAEAAEBYAgAAICwBAAAQlgAAAAhLAAAAhCUAAAAISwAAAIQlAAAAwhIAAABhCQAAAMISAAAAYQkAAICwBAAAQFgCAACAsAQAAEBYAgAAICwBAAAQlgAAACAsAQAAEJYAAAAISwAAAIQlAAAAwhIAAACEJQAAAMISAAAAYQkAAICwBAAAAGEJAACAsAQAAEBYAgAAICwBAABAWAIAACAsAQAAEJYAAAAISwAAABCWAAAACEsAAACEJQAAAMISAAAAYQkAAADCEgAAAGEJAACAsAQAAEBYAgAAgLAEAABAWAIAACAsAQAAEJYAAAAgLAEAABCWAAAACEsAAACEJQAAAAhLAAAAhCUAAADCEgAAAGEJAAAAwhIAAABhCQAAgLAEAABAWAIAACAsAQAAQFgCAAAgLAEAABCWAAAACEsAAAAQlgAAAAhLAAAAhCUAAADCEgAAAIQlAAAAwhIAAABhCQAAgLAEAAAAYQkAAICwBAAAQFgCAAAgLAEAABCWAAAAICwBAAAQlgAAAAhLAAAAhCUAAAAISwAAAIQlAAAAwhIAAABhCQAAAMISAAAAYQkAAICwBAAAQFgCAACAsAQAAEBYAgAAICwBAAAQlgAAAAhLEwAAACAsAQAAEJYAAAAISwAAAIQlAAAACEsAAACEJQAAAMISAAAAYQkAAADCEgAAAGEJAACAsAQAAEBYAgAAgLAEAABAWAIAACAsAQAAEJYAAAAgLAEAABCWAAAACEsAAACEJQAAAMISAAAAhCUAAADCEgAAAGEJAACAsAQAAABhCQAAgLAEAABAWAIAACAsAQAAQFgCAAAgLAEAABCWAAAACEsAAAAQlgAAAAhLAAAAhCUAAADCEgAAAGEJAAAAwhIAAABhCQAAgLAEAABAWAIAAICwBAAAQFgCAAAgLAEAABCWAAAAICwBAAAQlgAAAAhLAAAAhCUAAAAISwAAAIQlAAAAwhIAAABhCQAAAMISAAAAYQkAAICwBAAAQFgCAAAgLAEAAEBYAgAAICwBAAAQlgAAAAhLAAAAEJYAAAAISwAAAIQlAAAAwhIAAACEJQAAAMISAAAAYQkAAICwBAAAAGEJAACAsAQAAEBYAgAAICwBAACotUxwIokRAHhrZowAUFsWn12BuGoAAADc8AoLAACAsAQAAEBYAgAAICwBAAAQlgAAACAsAQAAEJYAAAAISwAAAIQlAAAACEsAAACEJQAAAMISAAAAYQkAAADCEgAAAGEJAACAsAQAAEBYAgAAgLAEAABAWAIAACAsAQAAEJYAAAAISwAAABCWAAAACEsAAACEJQAAAMISAAAAhCUAAADCEgAAAGEJAACAsAQAAABhCQAAgLAEAABAWAIAACAsAQAAQFgCAAAgLAEAABCWAAAACEsAAACEJQAAAAhLAAAAhCUAAADCEgAAAGEJAAAAwhIAAABhCQAAgLAEAABAWAIAAICwBAAAQFgCAAAgLAEAABCWAAAAICwBAAAQlgAAAAhLAAAAhCUAAAAISwAAAIQlAAAAwhIAAABhCQAAgLAEAAAAYQkAAICwBAAAQFgCAAAgLAEAAEBYAgAAICwBAAAQlgAAAAhLAAAAEJYAAAAISwAAAIQlAAAAwhIAAACEJQAAAMISAAAAYQkAAICwBAAAQFgCAACAsAQAAEBYAgAAICwBAAAQlgAAACAsAQAAEJYAAAAISwAAAIQlAAAACEsAAACEJQAAAMISAAAAYQkAAADCEgAAAGEJAACAsAQAAEBYAgAAICwBAABAWAIAACAsAQAAEJYAAAAISwAAABCWAAAACEsAAACEJQAAAMISAAAAhCUAAADCEgAAAGEJAACAsAQAAABhCQAAgLAEAABAWAIAACAsAQAAQFgCAAAgLAEAABCWAAAACEsAAACEJQAAAAhLAAAAhCUAAADCEgAAAGEJAAAAwhIAAABhCQAAgLAEAABAWAIAAICwBAAAQFgCAAAgLAEAABCWAAAAICwBAAAQlgAAAAhLAAAAhCUAAADCEgAAAIQlAAAAwhIAAABhCQAAgLAEAAAAYQkAAICwBAAAQFgCAAAgLAEAAEBYAgAAICwBAAAQlgAAAAhLAAAAEJYAAAAISwAAAIQlAAAAwhIAAABhCQAAAMISAAAAYQkAAICwBAAAQFgCAACAsAQAAEBYAgAAICwBAAAQlgAAACAsAQAAEJYAAAAISwAAAIQlAAAACEsAAACEJQAAAMISAAAAYQkAAADCEgAAAGEJAACAsAQAAEBYAgAAICwBAABAWAIAACAsAQAAEJYAAAAISwAAABCWAAAACEsAAACEJQAAAMISAAAAhCUAAADCEgAAAGEJAACAsAQAAABhCQAAgLAEAABAWAIAACAsAQAAEJYAAAAgLAEAABCWAAAACEsAAACEJQAAAAhLAAAAhCUAAADCEgAAAGEJAAAAwhIAAABhCQAAgLAEAABAWAIAAICwBAAAQFgCAAAgLAEAABCWAAAACEsTAAAAICwBAAAQlgAAAAhLAAAAhCUAAAAISwAAAIQlAAAAwhIAAABhCQAAAMISAAAAYQkAAICwBAAAQFgCAACAsAQAAEBYAgAAICwBAAAQlgAAACAsAQAAEJYAAAAISwAAAIQlAAAAwhIAAACEJQAAAMISAAAAYQkAAICwBAAAAGEJAACAsAQAAEBYAgAAICwBAABAWAIAACAsAQAAEJYAAAAISwAAABCWAAAACEsAAACEJQAAAMISAAAAYQkAAADCEgAAAGEJAACAsAQAAEBYAgAAgLAEAABAWAIAACAsAQAAEJYAAAAgLAEAABCWAAAACEsAAACEJQAAAAhLAAAAhCUAAADCEgAAAGEJAAAAwhIAAABhCQAAgLAEAABAWAIAACAsAQAAQFgCAAAgLAEAABCWAAAACEsAAAAQlgAAAAhLAAAAhCUAAADCEgAAAIQlAAAAwhIAAABhCQAAgLAEAAAAYQkAAICwBAAAQFgCAAAgLAEAABCWAAAAICwBAAAQlgAAAAhLAAAAhCUAAAAISwAAAIQlAAAAwhIAAABhCQAAAMISAAAAYQkAAICwBAAAQFgCAACAsAQAAEBYAgAAICwBAAAQlgAAAAhLAAAAEJYAAAAISwAAAIQlAAAAwhIAAACEJQAAAMISAAAAYQkAAICwBAAAAGEJAACAsAQAAEBYAgAAICwBAABAWAIAACAsAQAAEJYAAAAISwAAABCWAAAACEsAAACEJQAAAMISAAAAYQkAAADCEgAAAGEJAACAsAQAAEBYAgAAgLAEAABAWAIAACAsAQAAEJYAAAAgLAEAABCWAAAACEsAAACEJQAAAAhLAAAAhCUAAADCEgAAAGEJAACAsAQAAABhCQAAgLAEAABAWAIAACAsAQAAQFgCAAAgLAEAABCWAAAACEsAAAAQlgAAAAhLAAAAhCUAAADCEgAAAIQlAAAAwhIAAABhCQAAgLAEAABAWAIAAICwBAAAQFgCAAAgLAEAABCWAAAAICwBAAAQlgAAAAhLAAAAhCUAAAAISwAAAIQlAAAAwhIAAABhCQAA777/hQAACSdJREFUAMISAAAAYQkAAICwBAAAQFgCAACAsAQAAEBYAgAAICwBAAAQlgAAAAhLAAAAEJYAAAAISwAAAIQlAAAAwhIAAACEJQAAAMISAAAAYQkAAICwBAAAAGEJAACAsAQAAEBYAgAAICwBAABAWAIAACAsAQAAEJYAAAAISwAAAIQlAAAACEsAAACEJQAAAMISAAAAYQkAAADCEgAAAGEJAACAsAQAAEBYAgAAgLAEAABAWAIAACAsAQAAEJYAAAAgLAEAABCWAAAACEsAAACEJQAAAMISAAAAhCUAAADCEgAAAGEJAACAsAQAAABhCQAAgLAEAABAWAIAACAsAQAAQFgCAAAgLAEAABCWAAAACEsAAAAQlgAAAAhLAAAAhCUAAADCEgAAAIQlAAAAwhIAAABhCQAAgLAEAABAWAIAAICwBAAAQFgCAAAgLAEAABCWAAAAICwBAAAQlgAAAAhLAAAAhCUAAAAISwAAAIQlAAAAwhIAAABhCQAAAMISAAAAYQkAAICwBAAAQFgCAAAgLAEAAEBYAgAAICwBAAAQlgAAAAhLAAAAEJYAAAAISwAAAIQlAAAAwhIAAACEJQAAAMISAAAAYQkAAICwBAAAAGEJAACAsAQAAEBYAgAAICwBAAAQliYAAABAWAIAACAsAQAAEJYAAAAISwAAABCWAAAACEsAAACEJQAAAMISAAAAhCUAAADCEgAAAGEJAACAsAQAAABhCQAAgLAEAABAWAIAACAsAQAAQFgCAAAgLAEAABCWAAAACEsAAACEJQAAAAhLAAAAhCUAAADCEgAAAGEJAAAAwhIAAABhCQAAgLAEAABAWAIAAICwBAAAQFgCAAAgLAEAABCWAAAAICwBAAAQlgAAAAhLAAAAhCUAAADCEgAAAIQlAAAAwhIAAABhCQAAgLAEAAAAYQkAAICwBAAAQFgCAAAgLAEAAEBYAgAAICwBAAAQlgAAAAhLAAAAEJYAAAAISwAAAIQlAAAAwhIAAACEJQAAAMISAAAAYQkAAICwBAAAQFgCAACAsAQAAEBYAgAAICwBAAAQlgAAACAsAQAAEJYAAAAISwAAAIQlAAAACEsAAACEJQAAAMISAAAAYQkAAADCEgAAAGEJAACAsAQAAEBYAgAAICwBAABAWAIAACAsAQAAEJYAAAAISwAAABCWAAAACEsAAACEJQAAAMISAAAAhCUAAADCEgAAAGEJAACAsAQAAABhCQAAgLAEAABAWAIAACAsAQAAEJYAAAAgLAEAABCWAAAACEsAAACEJQAAAAhLAAAAhCUAAADCEgAAAGEJAAAAwhIAAABhCQAAgLAEAABAWAIAAICwBAAAQFgCAAAgLAEAABCWAAAAICwBAAAQlgAAAAhLAAAAhCUAAADCEgAAAIQlAAAAwhIAAABhCQAAgLAEAAAAYQkAAICwBAAAQFgCAAAgLAEAAEBYAgAAICwBAAAQlgAAAAhLAAAAEJYAAAAISwAAAIQlAAAAwhIAAABhCQAAAMISAAAAYQkAAICwBAAAQFgCAACAsAQAAEBYAgAAICwBAAAQlgAAACAsAQAAEJYAAAAISwAAAIQlAAAACEsAAACEJQAAAMISAAAAYQkAAICwBAAAAGEJAACAsAQAAEBYAgAAICwBAABAWAIAACAsAQAAEJYAAAAISwAAABCWAAAACEsAAACEJQAAAMISAAAAhCUAAADCEgAAAGEJAACAsAQAAABhCQAAgLAEAABAWAIAACAsAQAAEJYAAAAgLAEAABCWAAAACEsAAACEJQAAAAhLAAAAhCUAAADCEgAAAGEJAAAAwhIAAABhCQAAgLAEAABAWAIAAICwBAAAQFgCAAAgLAEAABCWAAAACEsAAAAQlgAAAAhLAAAAhCUAAADCEgAAAIQlAAAAwhIAAABhCQAAgLAEAAAAYQkAAICwBAAAQFgCAAAgLAEAAEBYAgAAICwBAAAQlgAAAAhLAAAAhCUAAAAISwAAAIQlAAAAwhIAAABhCQAAAMISAAAAYQkAAICwBAAAQFgCAACAsAQAAEBYAgAAICwBAAAQlgAAACAsAQAAEJYAAAAISwAAAIQlAAAACEsAAACEJQAAAMISAAAAYQkAAICwBAAAAGEJAACAsAQAAEBYAgAAICwBAABAWAIAACAsAQAAEJYAAAAISwAAABCWAAAACEsAAACEJQAAAMISAAAAhCUAAADCEgAAAGEJAACAsAQAAEBYAgAAgLAEAABAWAIAACAsAQAAEJYAAAAgLAEAABCWAAAACEsAAACEJQAAAAhLAAAAhCUAAADCEgAAAGEJAAAAwhIAAABhCQAAgLAEAABAWAIAACAsTQAAAICwBAAAQFgCAAAgLAEAABCWAAAAICwBAAAQlgAAAAhLAAAAhCUAAAAISwAAAIQlAAAAwhIAAABhCQAAAMISAAAAYQkAAICwBAAAQFgCAACAsAQAAEBYAgAAICwBAAAQlgAA...

... 2008;2(1):42-45Memory loss is one of the most common complaints arising in consultations with elderly people, being reported by 25% to 50% of these individuals.1 However, whether these subjective memory complaints (SMC) are related to objective memory deficits or to subsequent development  of dementia, remains a matter of debate. A recent review found that SMCs are not consistently associated with current cognitive impairment, but rather are associated with a greater risk of future cognitive de-cline.2 Indeed, the diagnosis of mild cognitive impairment (MCI), which entails an increased likelihood of conversion to dementia, demands the existence of SMCs, preferably confirmed by an informant.3High age, female gender and low educational level are generally associated with a higher prevalence of memory complaints.1 In an autopsy study,  SMCs were found to be related to the presence of Alzheimer’s disease (AD) pathol-ogy in elderly with and without dementia, suggesting that memory complaints in older persons may be a sign of self awareness of a degenerative process.4However, SMCs might also be related to depression and some personality traits, such as neuroticism.2 It is also pos-sible that these complaints vary according to the culture of the people studied. In a recent Brazilian study,  Minett et al. found that subjects with and without SMCs performed similarly in a series of cognitive tests, although the former had higher scores on the Geriatric Depression Scale.5 The present study aimed to further investigate this topic  in a group of cognitively healthy Brazilian elderly subjects which were divided into two subgroups according to the presence of SMCs and submitted to brief cognitive tests.MethodsSixty cognitively intact elderly individuals (39 females  and 21 males), aged 69.9±6.3 years (ranging from 60 to 91 years), and with mean educational level of 8.5±5.5 years (ranging from 1 to 20 years), were included in the study.  These individuals were family caregivers of demented pa-tients followed at the Behavioral and Cognitive Neurology Unit of the Faculty of Medicine of the Federal University  of Minas Gerais, in Belo Horizonte (MG), Brazil, and also volunteers recruited from the community.Inclusion criteria were absence of neurological or psy-chiatric diseases according to a clinical interview, absence  of depression (see below), and no use of benzodiazepines, antidepressants or neuroleptics. All participants were submitted to the Mini-Mental State-Examination (MMSE)6,7 and to the Cornell scale of depression.8,9 Performance on the MMSE was adjusted for educational level and had to be greater than or equal to 21 for 1-3 years of schooling, greater than or equal to 24 for 4-7 years and greater than or equal to 26 for individuals with 8 or more years of schooling.10 Scores on the Cornell scale of depression had to be less than or equal to 7 points  in order to rule out depression.8Cognitive evaluation was carried out with the follow-ing tests: the Brief Cognitive Screening Battery (BCSB)11,12, digit span forward and backward and the Frontal Assess-ment Battery (FAB).13,14 The BCSB includes a memory test  of 10 simple figures and yields different scores, namely: incidental and immediate memory, learning, delayed recall  and recognition.15,16 The battery also includes a category fluency test (animals per minute) and clock drawing and has proven very sensitive in the diagnosis of mild AD.12 The FAB is a brief diagnostic instrument for the assessment of executive functions in patients with suspected frontal lobe syndrome.13All individuals were given a structured self-report memory questionnaire, the MAC-Q.17 This questionnaire was devised to assess age-related memory decline. It is composed by six questions related to memory function-ing in everyday situations (e.g., to remember a telephone number that he/she uses at least once a week) in which  the subject is asked to compare and rate his/her current ability to when he/she was 40 years’ old. The total score on  the MAC-Q ranges from 7 to 35, where greater scores in- dicate subjective memory loss. Scores greater than or equal to 25 have been found to be suggestive of age-associated memory impairment. Accordingly, in the present study,   the individuals were divided into two groups: absence of SMCs (MAC-Q scores <25) and presence of SMCs (MAC-Q scores ≥25). The performance of the two groups on the different cognitive tests was compared.One of the authors administered the MMSE, the Cor-nell scale and the MAC-Q. Subsequently, the other inves-tigator, blinded to the subjects’ results for these three mea-sures, administered the cognitive evaluation.Descriptive analysis of the data and statistical compari-sons between the performances of the two groups on the different cognitive tests were carried out with MedCalc software. Student’s t-test was used for comparison of age, educational level and MMSE scores, as well as for the results  of the other cognitive tests (digit span, BCSB and FAB). Chi-square was employed for comparing gender distribu-tion of the two groups. Level of significance was set at 0.05.  The study was approved by the Research Ethics ... 2008;2(1):42-4514 women and 13 men, aged 69.6±5.4 years, with mean educational level of 8.8 years. Mean MMSE score of this group was 27.8. The group of complainers (MAC-Q scores ≥25) was composed by 25 women and 8 men, aged 70.3±7.0 years, with mean educational level of 8.2 years. Mean MMSE score of this group was 27.2.No significant difference for age, gender, education and MMSE scores were found between the two groups. Table 1 depicts the main demographic data as well as the MMSE  and MAC-Q values for both groups.  The comparison between the performance of the groups of complainers and non-complainers on the dif-ferent cognitive tests yielded no significant difference, al-though there was a trend for non-complainers to perform better in incidental memory.Table 2 presents the scores from the two groups in all tests as well as the statistical comparisons between them.Discussion In the present study,  we found no significant difference  in the performance of elderly subjects with and without SMCs on a series of brief cognitive tests assessing attention, episodic and semantic memory, and executive functions. Only a trend toward a significant difference emerged for  the subtest of incidental memory from the BCSB, an item that is more related to attention than to memory itself.Some previous studies have found a relationship be-tween SMCs and objective memory performance, while many others have not.2 The methodology adopted by the different studies in assessing SMC varies, where some use only a simple question about perceived memory problems, while others base this classification on the results of specific questionnaires, such as the MAC-Q used in our study.  Interestingly, a previous Brazilian study compared the use of the MAC-Q with direct questioning about memory problems, and found that a significant percentage of the sample had SMCs, based on the response to the direct ques-tion along with low scores on MAC-Q, while other subjects had no SMCs and high MAC-Q scores.18 Performance on  a memory test did not differ according to the MAC-Q re-sults, mirroring our findings, although was worse in those individuals presenting SMCs upon direct questioning.High age, female gender and low education have all been associated with an increased prevalence of SMCs. Our sample is composed exclusively by elderly subjects (≥60 years), with a predominance of women (39 vs. 21)  and with low to middle educational level, especially com-paring with studies conducted in North America, Europe or Japan. These features might explain the high percentage (55%) of individuals presenting SMCs.Memory complaints are recognized to be frequent within the elderly population,  especially among those with depressive and anxiety symptoms.19,20 In our study,  depres-sion is very unlikely as an explanation for the high preva-lence of SMCs, since the presence of significant depressive symptoms, based on the results from the Cornell scale, was part of the exclusion criteria.SMCs have been more related to future cognitive de-cline rather than to current memory deficits.2 Indeed, in a recent study, the presence of SMCs was found to be a sig-nificant predictor of subsequent decline, although without  a “dose-effect” relationship.21 Moreover, in this same study the investigators observed that the occurrence of SMCs also increased the probability of an unstable diagnosis. We still have no longitudinal data on the cognitive performance  of our study participants to be able to contribute to this debate, but we may be able to re-evaluate at least part of the sample in the future in order to replicate such observations. An issue that has not been addressed in our study is the Table ... 2008;2(1):42-4514 women and 13 men, aged 69.6±5.4 years, with mean educational level of 8.8 years. Mean MMSE score of this group was 27.8. The group of complainers (MAC-Q scores ≥25) was composed by 25 women and 8 men, aged 70.3±7.0 years, with mean educational level of 8.2 years. Mean MMSE score of this group was 27.2.No significant difference for age, gender, education and MMSE scores were found between the two groups. Table 1 depicts the main demographic data as well as the MMSE  and MAC-Q values for both groups.  The comparison between the performance of the groups of complainers and non-complainers on the dif-ferent cognitive tests yielded no significant difference, al-though there was a trend for non-complainers to perform better in incidental memory.Table 2 presents the scores from the two groups in all tests as well as the statistical comparisons between them.Discussion In the present study,  we found no significant difference  in the performance of elderly subjects with and without SMCs on a series of brief cognitive tests assessing attention, episodic and semantic memory, and executive functions. Only a trend toward a significant difference emerged for  the subtest of incidental memory from the BCSB, an item that is more related to attention than to memory itself.Some previous studies have found a relationship be-tween SMCs and objective memory performance, while many others have not.2 The methodology adopted by the different studies in assessing SMC varies, where some use only a simple question about perceived memory problems, while others base this classification on the results of specific questionnaires, such as the MAC-Q used in our study.  Interestingly, a previous Brazilian study compared the use of the MAC-Q with direct questioning about memory problems, and found that a significant percentage of the sample had SMCs, based on the response to the direct ques-tion along with low scores on MAC-Q, while other subjects had no SMCs and high MAC-Q scores.18 Performance on  a memory test did not differ according to the MAC-Q re-sults, mirroring our findings, although was worse in those individuals presenting SMCs upon direct questioning.High age, female gender and low education have all been associated with an increased prevalence of SMCs. Our sample is composed exclusively by elderly subjects (≥60 years), with a predominance of women (39 vs. 21)  and with low to middle educational level, especially com-paring with studies conducted in North America, Europe or Japan. These features might explain the high percentage (55%) of individuals presenting SMCs.Memory complaints are recognized to be frequent within the elderly population,  especially among those with depressive and anxiety symptoms.19,20 In our study,  depres-sion is very unlikely as an explanation for the high preva-lence of SMCs, since the presence of significant depressive symptoms, based on the results from the Cornell scale, was part of the exclusion criteria.SMCs have been more related to future cognitive de-cline rather than to current memory deficits.2 Indeed, in a recent study, the presence of SMCs was found to be a sig-nificant predictor of subsequent decline, although without  a “dose-effect” relationship.21 Moreover, in this same study the investigators observed that the occurrence of SMCs also increased the probability of an unstable diagnosis. We still have no longitudinal data on the cognitive performance  of our study participants to be able to contribute to this debate, but we may be able to re-evaluate at least part of the sample in the future in order to replicate such observations. An issue that has not been addressed in our study is the Table 1. Demographic data, MMSE and MAC-Q scores from the group of non-complainers and complainers. Variable...

... memorials and back-to-school activities. Make mental health services available, including Employee Assistance Program, if applicable. Practice active listening and acknowledge pain and anxiety ... your state or local area: ● Federal laws. The Family Educational Rights and Privacy Act (FERPA) is a federal law that affects the release of student information. ● State laws. California public ... to reassemble stu-dents and staff if the school building is unavailable.● Training and practicing. Training needs, dates and types of training to be offered, and practice schedules for schools.7SCHOOL...

... divided into age classes in order to assess aging induced changes.Patients and MethodsWe evaluated the lipid profile in an elderlyinstitutionalized population of 80 subjects (20males and 60 females ... females divided into four ageclasses) from the town of Catania (Table I). Health state of our study series was evaluatedby anamnesis, clinical examination and com-mon laboratory methods. We ... pharmacological treatment dueto insomnia, anxiety, articular pain and gas-trointestinal diseases, were excluded from the study, because of influences of various drugson lipidic profile. The causes...

... nificant factors (with eigenvaluesgreater than unity) that are capable of explaining 94.5% of the variance and thus most of the infor mation in the original data set. The new “latent” factors are ... the same method for the remaining directvariables we obtained the data shown in table VII.This table shows the discriminating capacity of eachvariable for differentiating the male and female ... NOBJ and VA are the number of objects and varia bles respectively and R is the correlation matrixdeterminant) and comparing it to X²critobtained forVA(VA-1)/2 degrees of freedom and the required...

... primary information sources. Initially, additionalinformation was sought from the databases of SADC and ECSA-HCsecretariats, and from human resources officials at the ministries of health in various ... distancelearning, the decentralisation of operational management to promotelocal decision-making and management of operational budgets, and a disturbance allowance of 50% of basic pay to encourage health ... Christian Health Association of Malawi (CHAM) (85% of this in rural areas) (Aukerman,2006). On top of a basic salary, Malawi public sector health workersreceive a professional allowance, housing allowance...

... number of cases and financial constraints. Ethical Approval The study was approved by the institutional ethics committee of TN Medical College and BYL Nair Charitable Hospital, Mumbai, India. ... similar to ours. An increase in sensitivity can be misleading as it may be accompanied by a decrease in the true positivity, and an increase in the relative number of false positives. This can ... Medical College and BYL Nair Charitable Hospital, Mumbai, India. 3 Department of Biology, Faculty of Science, Jazan University, Jazan, Kingdom of Saudi Arabia. *Corresponding Author: kismail@jazanu.edu.sa,...

... being made, but is unequal. The situation of the interrelated areas of climate, environment and health is increasingly disquieting, jeopardizing the quality of natural and vital resources and ... ill health due to feelings of isolation, and the traumas faced in their countries of origin or on the journey. In Malta, migrants also concentrate in particular areas, increasing the population ... StatesAlbaniaAndorraArmeniaAustriaAzerbaijanBelarusBelgiumBosnia and HerzegovinaBulgariaCroatiaCyprusCzech RepublicDenmarkEstoniaFinlandFranceGeorgiaGermanyGreeceHungaryIcelandIrelandIsraelItalyKazakhstanKyrgyzstanLatviaLithuaniaLuxembourgMaltaMonacoMontenegroNetherlandsNorwayPolandPortugalRepublic...