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2 results

  • Estimating Post-Emergency Fertility Among Disaster-Affected Adolescents: Findings From a Case-Control Study in Aceh Province, Indonesia

  • Mari Kinoshita, Suhardan Suhardan, Damsyik Danila Danila, Chifa Chiang, Atsuko Aoyama
  • Journal:
    Disaster Medicine and Public Health Preparedness / Volume 10 / Issue 1 / February 2016
    Published online by Cambridge University Press:
    22 September 2015, pp. 80-86
  • Objective

    We aimed to retrospectively estimate adolescent fertility rates before and after a large-scale natural disaster.

    Methods

    A case-control study was conducted in Aceh Province, Indonesia, 2 years after the Indian Ocean tsunami in 2004. The age-specific fertility rates of 15–19-year-old-women (ASFR 15–19) was estimated each year from 2004 to 2006 by creating hypothetical age cohorts. The results were compared with data from the closest edition of the Indonesian Demographic Health Survey (IDHS).

    Results

    The pre-disaster ASFR 15–19 (4.4% in 2004) was not significantly different from the 2002–2003 IDHS data (P=0.49), whereas the post-disaster ASFR 15–19 (1.1% in 2005–2006) was significantly lower than the provincial estimation in the 2007 IDHS (P<0.01). ASFR 15–19 was reduced by 76% in the post-disaster period compared with the pre-disaster period (rate ratio: 0.24, P=0.02).

    Conclusions

    The creation of hypothetical age cohorts enabled valid and useful estimation of the ASFR in disaster-affected areas where reliable vital statistics are not available. For pre-disaster fertility estimation, however, we suggest excluding data from the 40-week period preceding the disaster, because the data may be biased by excess mortality in childbearing mothers and newborn babies in the disaster. (Disaster Med Public Health Preparedness. 2016;10:80–86)

  • 17 - Effect of depression and anxiety on sleep in the elderly

  • from Part 3 - Sleepdisorders in the elderly
  • Edited by S. R. Pandi-Perumal, Jaime M. Monti, Universidad de la República, Uruguay, Andrew A. Monjan, National Institute on Aging, Bethesda, Maryland
  • Book:
    Principles and Practice of Geriatric Sleep Medicine
    Published online:
    04 August 2010
    Print publication:
    26 November 2009, pp 183-194

  • Summary

    The chapter focuses on age-related changes in pathophysiological mechanisms in apneic and normal subjects, and on the potential relevance of the findings to obstructive sleep apnea (OSA). Aging has been reported to be a major factor affecting the risk of OSA. In the extremes of aging, some data suggest a survivor effect, such that apnea prevalence may decrease among elderly patients. The upper airway (UAW) requires stiffness of the soft tissue walls around it and activity of the dilator muscles to maintain patency. Any reduction in UAW cross-sectional area, change in its length, muscle activity, or a combination of these variables, may lead to vulnerability of the UAW to collapse. The term loop gain is used to refer to the intrinsic stability or instability in the ventilatory control system. Once the patient with apnea falls asleep and the cycle of repetitive airway obstruction begins, recurrent hypoxemia and hypercapnia develop.