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The Pension Benefit Guaranty Corporation (PBGC) becomes the trustee for private defined benefit plans that have defaulted. The PBGC pays retirement benefits as provided by the plan and that are consistent with federal guidelines concerning the type and amounts of distributions. In response to a Freedom of Information Request, the PBGC provided us with relevant information on all individuals who received retirement benefits from the PBGC in the last 10 years, over 250,000 retirees. Individuals requesting payouts from PBGC managed plans have the option of selecting either a single-life annuity or a joint-and-survivor (J&S) annuity. We examine the PBGC distributions chosen over the last decade and how they vary by age at retirement, sex, months of service, and other relevant variables. Key findings indicate that men are much more likely to choose a joint and survivor annuity compared to female claimants, and the difference increases with age. Conditional on selecting a J&S annuity, men are more likely to select a 100 percent survivor's annuity, while women tend to choose a 50 percent survivor's benefit.
This chapter draws on experiences of mixing methods in the interdisciplinary research of dance, choreography, immersive performance/participatory performance, and fandom. Reflecting on the methods employed in the author’s book Tandem Dances: Choreographing Immersive Performance, the chapter treats the research process as improvisational and compositional, emerging in tandem with the work being researched. These methods include audience research, choreographic analysis, participant observation, and analysing media content. The aim of the chapter is to make the research process explicit so other researchers might apply a similarly compositional approach in audience research in other performance contexts.
Increased autocorrelation (AR) of system-specific measures has been suggested as a predictor for critical transitions in complex systems. Increased AR of mood scores has been reported to anticipate depressive episodes in major depressive disorder, while other studies found AR increases to be associated with depressive episodes themselves. Data on AR in patients with bipolar disorders (BD) is limited and inconclusive.
Methods
Patients with BD reported their current mood via daily e-diaries for 12 months. Current affective status (euthymic, prodromal, depressed, (hypo)manic) was assessed in 26 bi-weekly expert interviews. Exploratory analyses tested whether self-reported current mood and AR of the same item could differentiate between prodromal phases or affective episodes and euthymia.
Results
A total of 29 depressive and 20 (hypo)manic episodes were observed in 29 participants with BD. Self-reported current mood was significantly decreased during the two weeks prior to a depressive episode (early prodromal, late prodromal), but not changed prior to manic episodes. The AR was neither a significant predictor for the early or late prodromal phase of depression nor for the early prodromal phase of (hypo)mania. Decreased AR was found in the late prodromal phase of (hypo)mania. Increased AR was mainly found during depressive episodes.
Conclusions
AR changes might not be better at predicting depressive episodes than simple self-report measures on current mood in patients with BD. Increased AR was mostly found during depressive episodes. Potentially, changes in AR might anticipate (hypo)manic episodes.
In May of 2018, PulseNet, the national molecular subtyping network for enteric pathogens, detected a multistate cluster of illnesses caused by an uncommon molecular subtype of Salmonella serovar Mbandaka. A case was defined as an illness in a person infected with the outbreak strain of Salmonella Mbandaka with illness onset on or after 3 March 2018 and before 1 September 2018. One-hundred thirty-six cases from 36 states were identified; 35 hospitalisations and no deaths were reported. Ill people ranged in age from <1 year to 95 years (median: 57 years). When standardised questionnaires did not generate a strong hypothesis, opened-ended interviews were performed. Sixty-three of 84 (75%) ultimately reported consuming or possibly consuming a specific sweetened puffed wheat cereal in the week before illness onset. Environmental sampling performed at the cereal manufacturing facility yielded the outbreak strain. The outbreak strain was also isolated from open cereal samples from ill people's homes and from a sealed retail sample. Due to these findings, the brand owner of the product issued a voluntary recall of the cereal on 14 June 2018. Additional investigation of the manufacturing facility identified persistent environmental contamination with Salmonella Mbandaka that was closely genetically related to other isolates in the outbreak. This investigation highlights the ability of Salmonella to survive in low-moisture environments, and the potential for prolonged outbreaks linked to products with long shelf lives and large distribution areas.
The direct carbonate procedure for accelerator mass spectrometry radiocarbon (AMS 14C) dating of submilligram samples of biogenic carbonate without graphitization is becoming widely used in a variety of studies. We compare the results of 153 paired direct carbonate and standard graphite 14C determinations on single specimens of an assortment of biogenic carbonates. A reduced major axis regression shows a strong relationship between direct carbonate and graphite percent Modern Carbon (pMC) values (m = 0.996; 95% CI [0.991–1.001]). An analysis of differences and a 95% confidence interval on pMC values reveals that there is no significant difference between direct carbonate and graphite pMC values for 76% of analyzed specimens, although variation in direct carbonate pMC is underestimated. The difference between the two methods is typically within 2 pMC, with 61% of direct carbonate pMC measurements being higher than their paired graphite counterpart. Of the 36 specimens that did yield significant differences, all but three missed the 95% significance threshold by 1.2 pMC or less. These results show that direct carbonate 14C dating of biogenic carbonates is a cost-effective and efficient complement to standard graphite 14C dating.
(I) Profound alterations of the hypothalamic-pituitary-adrenocortical (HPA) axis regulation were repeatedly shown in depressed patients. The most sensitive challenge test of the HPA axis, the combined dexamethasone/CRH test (DEX/CRH test), shows an overstimulation of ACTH and cortisol in depressed patients. Under tricyclic antidepressant treatment, a normalization of the HPA axis overdrive was found to precede the clinical improvement.
(II) Lithium is a well established drug for the treatment of affective disorders. Yet, its exact mode of action and its effects on the HPA axis are still unknown.
Design and methods
Three 4-week studies with each 30 acutely depressed patients (unipolar, SCID I confirmed) were conducted. In study 1, patients refractory to a treatment trial with an antidepressant of at least four weeks were treated with lithium augmentation. In study 2 and 3, drug free patients were treated with lithium monotherapy or citalopram monotherapy respectively. Weekly HAM-D ratings were performed. In each study, the DEX/CRH test was conducted right before and four weeks after initiation of the pharmacotherapy.
Results
All three pharmacological strategies showed good antidepressive efficacy. Both lithium monotherapy and lithium augmentation led to a (for most parameters significant) increase in the HPA axis activity. In contrast, citalopram monotherapy resulted in a decrease of the hormone response to the DEX/CRH test.
Bipolar disorder is for most patients a life-long illness, associated with a recurrent, chronic course, and functional disability. Primary treatment goals are to stabilize the patient and prevent recurrence of episodes and suicide.
Although bipolar disorder has traditionally been regarded as an illness with good prognosis and most patients returning to normal functioning when a mood episode is over, several longitudinal studies suggest that the long-term outcome is less favorable than previously thought. Combinations of drugs are frequently used in clinical practice for mood stabilization, especially for those who have not responded to monotherapy. Although combination treatments are commonly administered, full interepisode recovery is not achieved in all patients, and as a consequence, bipolar disorder is one of the leading causes of disability.
Among clinicians and in international guidelines, lithium is widely considered as the ‘gold standard’ for long-term treatment. The choice of treatments is undergoing considerable change as new treatments are available, anticonvulsants and atypical antipsychotics are taking a more prominent position. However, the evidence available for the newer treatment options including the various combination treatments varies greatly.
The episodic nature of bipolar disorder requires prophylactic long-term treatment. Many previous worthwhile treatment effects of available mood stabilizing agents and psychotherapeutic interventions on major outcomes in bipolar disorder are only of moderate size and therefore require large-scale studies. Such trials to investigate longer-term outcomes are logistically challenging and expensive, and therefore only feasible within a multisite and multinational approach based on a common documentation system of the illness course.
Two common approaches to identify subgroups of patients with bipolar disorder are clustering methodology (mixture analysis) based on the age of onset, and a birth cohort analysis. This study investigates if a birth cohort effect will influence the results of clustering on the age of onset, using a large, international database.
Methods:
The database includes 4037 patients with a diagnosis of bipolar I disorder, previously collected at 36 collection sites in 23 countries. Generalized estimating equations (GEE) were used to adjust the data for country median age, and in some models, birth cohort. Model-based clustering (mixture analysis) was then performed on the age of onset data using the residuals. Clinical variables in subgroups were compared.
Results:
There was a strong birth cohort effect. Without adjusting for the birth cohort, three subgroups were found by clustering. After adjusting for the birth cohort or when considering only those born after 1959, two subgroups were found. With results of either two or three subgroups, the youngest subgroup was more likely to have a family history of mood disorders and a first episode with depressed polarity. However, without adjusting for birth cohort (three subgroups), family history and polarity of the first episode could not be distinguished between the middle and oldest subgroups.
Conclusion:
These results using international data confirm prior findings using single country data, that there are subgroups of bipolar I disorder based on the age of onset, and that there is a birth cohort effect. Including the birth cohort adjustment altered the number and characteristics of subgroups detected when clustering by age of onset. Further investigation is needed to determine if combining both approaches will identify subgroups that are more useful for research.
This study examines the distribution options of 85 large public retirement plans covering general state employees, teachers, and local government employees. The interest rates used to price annuities vary considerably across the plans. As a result, retirees with the same monthly benefit if a single life benefit is chosen will have substantially different monthly benefits if they select a joint and survivor annuity. We examine the impact of variation in the pricing of annuity options using both cross-plan differences in interest rates and the change in the choice of annuity options in one plan after the price of options changes due to new assumed interest rates and mortality rates.
Sleep alterations are frequent occurrence in Bipolar Disorder (BD), both in acute and interepisodic phases. Sleep alterations have been also described both long before BD onset, as aspecific risk syndromes, or as immediate prodromes of BD onset. The aim of the present study is to systematically review the relationship between sleep alterations anticipating for the full-blown onset of BD, both in general and according to specific polarities of onset.
Methods:
A systematic literature research according to PRISMA statement and considering: 1. prospective studies about BD patients’ offspring with sleep alterations who later developed BD. 2. prospective studies assessing patients with sleep disorders who later developed BD. 3. retrospective studies on BD patients where sleep alterations before BD onset of the disease were reported.
Results:
A total of 16 studies were included in this review. Sleep disturbances may frequently appear 1 year before the onset of BD or more, often during childhood or adolescence. A decreased need for sleep may precede the onset of the illness, specially a manic episode, while insomnia appears to anticipate either a manic or a depressive episode. Hypersomnia seems to precede bipolar depressive episodes.
Conclusions:
Sleep alterations frequently appear long before the onset of BD, and appear to be related specifically to the polarity of the index episode. The detection and treatment of sleep alterations in special high risk populations may help achieving an earlier detection of the illness.
To understand caregivers’ perceptions of children’s linear growth and to identify the cultural meanings and perceptions of risk associated with poor height attainment.
Design
Three investigators from Bangladesh conducted twelve focus group discussions.
Setting
The study was conducted in rural and slum settings in Bangladesh.
Subjects
Participants included mothers and alternative caregivers (n 81) who were recruited by household screening. No eligible, recruited subjects refused participation.
Results
Caregivers reported limited experience with growth monitoring services from the health system. Caregivers mainly use visual cues and developmental milestones to understand if children are growing properly, and recognize that children normally experience both weight gain and linear growth with age. Mothers expressed concern over children’s malnutrition and short stature, but did not discuss children’s failure to attain a ‘growth potential’ or distinguish inherited short stature from stunting. Caregivers interpret the consequences of poor height attainment as primarily social and economic and cite few health risks.
Conclusions
Linear growth interpretation is determined more by community norms than by guidance from nutrition programming or the health system. Interventions to prevent or reduce linear growth failure may be perceived to have limited value where appropriate linear growth in children is determined by comparison to peers and siblings. Such perceptions may be significant barriers to programmes addressing stunting prevention in settings where many children are stunted. Efforts to raise awareness about the risks of linear growth faltering may need to consider delivering messages to caregivers that emphasize the social and economic consequences of stunting.
Since its “depenalization” in 1993, the U.S. dollar has become possibly a more significant component of Cuba's money supply than the old peso. What are the alternatives? The euro seems inappropriate, given the inevitability of eventual normalization of relations with the United States. More advantageous would be to restore the Cuban peso, though this would involve unifying the bifurcated economic structure and the dual monetary and exchange rate systems. The Cuban government has yet to announce its plans. This study argues that an appropriate mix of exchange rate, monetary, fiscal, and income or wage and salary policies should support a rehabilitation of the Cuban peso.
In field experiments in 1981, 36 g ai/ha of chlorsulfuron {2-chloro-N-[[(4-methoxy-6-methyl-1,3,5-triazin-2-yl)amino] carbonyl] benzenesulfonamide} applied to winter wheat (Triticum aestivum L. ‘Arthur’) in early spring reduced seed yield in conventional and no-till plantings of double-cropped soybeans [Glycine max (L.) ‘Essex’]. From 1982 to 1984, three rates of chlorsulfuron (9, 18, and 36 g/ha) were applied at three different times (preemergence, early winter, and early spring) to study their residual effects on double-cropped soybeans. Chlorsulfuron at 36 g/ha applied preemergence or early spring reduced soybean seed yields when averaged over the 3-yr period. Metsulfuron {2-[[[[(4-methoxy-6-methyl-1,3,5-triazine-2-yl)amino] carbonyl] amino] sulfonyl] benzoic acid} was tested at three rates (4.5, 9, and 18 g/ha) applied at three times (same as chlorsulfuron) in field studies in 1983 and 1984. Metsulfuron did not injure subsequently planted no-till soybeans.
The influence of common ragweed (Ambrosia artemisiifolia L.) interference on soybean [Glycine max (L.) Merr. ‘Ransom’] yield was studied in the field utilizing naturally occurring weed populations. The damage-threshold population for a full-season, in-row common ragweed infestation was four weeds/10 m of row, which resulted in an 8% yield loss. Soybeans kept weed-free for 2 weeks or longer after emergence in a dry year produced normal yields, but 4 weeks of weed-free maintenance was required when adequate moisture was available early in the growing season. Soybean yield was not reduced by a natural population of common ragweed if the period of interference was limited to 6 weeks or less after crop emergence. By 8 weeks after emergence, common ragweed height averaged 25 cm taller than soybeans, and the weed canopy intercepted 24% of the photosynthetically active radiation.