Risk factors for falls in the community: based on self-report of elderly persons

Introduction: Several studies have shown independent risk factors for falling among community older people. However, there is few researches showing the importance of older person’s perception of their own fall risk. Aims: The study purpose was to identify independent risk factors for falls and to explore predictive factors related to the occurrence of falls in community-dwelling older people. Method: A cross-sectional study was conducted from January to April 2015. All data were based on self-report of older persons. An study-specific questionnaire was used. Univariate and logistic regression analyses were used. Results: The sample comprised 562 men and 760 women. Among the participants, 24.5% reported having had falls in the previous six months, scoring a total of 467 falling events. Of the individuals who had fallen, 36.8% had experienced recurrent falls. The risk of fall was nearly twice as high in women than in men (OR=1.85; 95% CI: 1.40-2.43). Being 75 years old or older was associated with an increased risk of falling compared with being 65-74 years old (OR=2.38; 95% CI:1.82-3.11). The elderly who had fallen reported injuries (48.3%) associated with falls, and 36% required health care. Conclusion: Six independent risk factors for falling into the community dwelling older people were identified, some of which are potentially modifiable.info:eu-repo/semantics/publishedVersio

El cuidado en el paradigma de desinstitucionalización: la sostenibilidad de las personas mayores dependientes en la família

Este estudo teve como objectivos caracterizar famílias com um idoso dependente em contexto familiar e identificar apoios sociais das famílias com um idoso dependente. Foi realizado um estudo exploratório descritivo de natureza qualitativa. Recorremos à entrevista semi-estruturada para colheita de informação (elaboração de genograma e ecomapa). Seleccionamos uma amostra intencional de 108 famílias de um concelho, de uma região Norte de Portugal. A colheita de dados ocorreu no período de Outubro 2007 a Junho de 2008. Os resultados mostraram que as famílias com idosos dependentes são predominantemente famílias nucleares e envelhecidas, com apoios formais e informais restritos. Nas fontes informais, a figura dos filhos foi a mais relatada seguindose os vizinhos e amigos, enquanto, nas formais foram referidas as unidades de saúde e profissionais de saúde: médico, enfermeiro, fisioterapeuta, farmacêutico e assistente social.This study main objectives were to describe families living with a dependent elder and to identify the social support of these families. We carried out a qualitative exploratory study using semi-structured data collection methods (development of eco-maps and genograms). We selected a sample of 108 families in a region of northern Portugal. Data collection took place from October 2007 to June 2008. The results showed that families with dependent elders are predominantly older nuclear families, with limited formal and informal support. With regard to informal sources, family relationships were the most reported, followed by neighbours and friends, while for formal sources the most mentioned were healthcare facilities and healthcare professionals: doctors, nurses, physiotherapists, pharmacists and social workers.Este estudio tiene como objetivo caracterizar a las familias con un anciano dependiente en contexto familiar e identificar los apoyos sociales de las familias con un anciano dependiente. Se realizó un estudio exploratorio descriptivo de naturaleza cualitativa. Hemos recurrido a la entrevista semi-estructurada para recopilar información (elaboración de genograma y ecomapa). Se seleccionó una muestra intencional de 108 familias de una región al norte de Portugal. Los datos fueron recolectados entre Octubre de 2007 y Junio de 2008. Los resultados mostraron que las familias con personas mayores con dependencia son en su mayoría familias nucleares y envejecidas, con un apoyo limitado formal e informal. En las fuentes informales, la figura de los hijos fue la más relatada, siguiéndose los vecinos y amigos, mientras que en las formales fueron referidas las unidades de salud y profesionales de la salud: médico, enfermero, fisioterapeuta, farmacéutico y asistente sociales.info:eu-repo/semantics/publishedVersio

Homecaring families of an dependent elderly by CVA (Cerebral vascular accident: From hospital to community - the Challenger

Com este estudo foi nossa intenção compreender e analisar o apoio fornecido pelos enfermeiros ao cuidador de indivíduos dependentes por AVC, na preparação e continuidade de cuidados e após a alta clínica. A sua finalidade é contribuir para a melhoria da assistência dos enfermeiros ao indivíduo dependente e sua família. Para tal, recorremos a um estudo de natureza qualitativa, utilizando a entrevista semi-estruturada para a colheita de dados. Entrevistamos 12 cuidadores informais de indivíduos idosos dependentes por AVC pertencentes a famílias de quatro regiões geográficas do distrito do Porto e Braga. Os achados revelaram que a educação para a saúde realizada junto dos cuidadores, foca essencialmente o cuidar instrumental, em que o enfermeiro de cuidados diferenciados identifica mais auto-cuidados não havendo continuidade da orientação, instrução por parte do enfermeiro dos cuidados de saúde primários. Cuidam só do indivíduo dependente descorando o cuidador principal e a família.The main aim of this study is understanding and analyse how nurses preparing the family members to take care their dependents individuals by CVA at home. With this work we want to contribute and prepare our nurses for a better help aid to the dependent individual and their family. We used a qualitative study and interviewed 12 carers belonging to families of the Porto and Braga regions. The results showed that education health with the family care is mostly technical and the nurses who work at the hospital just identify technical needs, however at the community there aren’t continuity on education health. So they care the dependent individual but they forget the homecaring and their family.info:eu-repo/semantics/publishedVersio

Cuidar de idosos dependentes no domicílio: desabafos de quem cuida

Com este estudo foi nossa intenção identificar quem é o cuidador principal de idosos dependentes no domicílio e que mudanças ocorrem na vida do cuidador e de sua família quando um elemento se torna dependente. Recorremos a um estudo de natureza qualitativa, utilizando a entrevista semiestruturada. Entrevistamos 12 cuidadores informais de indivíduos idosos dependentes por AVC, pertencentes a famílias dos distritos do Porto e Braga (Portugal). A finalidade deste trabalho é contribuir para a melhoria da assistência da enfermagem à família. Os achados revelaram que os cônjuges e filhas são os principais cuidadores dos idosos dependentes no domicílio. Ao assumirem o papel de cuidador suas vidas são transformadas, ocorrendo mudanças essencialmente no seu papel social, nas atividades de lazer e, em alguns casos, na atividade profissional. A maioria destes cuidadores tem apoio de filhos, de alguns amigos e vizinhos. Identificaram-se alterações e reorganizações na estrutura, função e processo da unidade familiar.info:eu-repo/semantics/publishedVersio

Ordering of binary colloidal crystals by random potentials

Structural defects are ubiquitous in condensed matter, and not always a nuisance. For example, they underlie phenomena such as Anderson localization and hyperuniformity, and they are now being exploited to engineer novel materials. Here, we show experimentally that the density of structural defects in a 2D binary colloidal crystal can be engineered with a random potential. We generate the random potential using an optical speckle pattern, whose induced forces act strongly on one species of particles (strong particles) and weakly on the other (weak particles). Thus, the strong particles are more attracted to the randomly distributed local minima of the optical potential, leaving a trail of defects in the crystalline structure of the colloidal crystal. While, as expected, the crystalline ordering initially decreases with an increasing fraction of strong particles, the crystalline order is surprisingly recovered for sufficiently large fractions. We confirm our experimental results with particle-based simulations, which permit us to elucidate how this non-monotonic behavior results from the competition between the particle-potential and particle-particle interactions

Epidemiology and natural history of central venous access device use and infusion pump function in the NO16966 trial

Background: Central venous access devices in fluoropyrimidine therapy are associated with complications; however, reliable data are lacking regarding their natural history, associated complications and infusion pump performance in patients with metastatic colorectal cancer.<p></p> Methods: We assessed device placement, use during treatment, associated clinical outcomes and infusion pump perfomance in the NO16966 trial.<p></p> Results: Device replacement was more common with FOLFOX-4 (5-fluorouracil (5-FU)+oxaliplatin) than XELOX (capecitabine+oxaliplatin) (14.1% vs 5.1%). Baseline device-associated events and post-baseline removal-/placement-related events occurred more frequently with FOLFOX-4 than XELOX (11.5% vs 2.4% and 8.5% vs 2.1%). Pump malfunctions, primarily infusion accelerations in 16% of patients, occurred within 1.6–4.3% of cycles. Fluoropyrimidine-associated grade 3/4 toxicity was increased in FOLFOX-4-treated patients experiencing a malfunction compared with those who did not (97 out of 155 vs 452 out of 825 patients), predominantly with increased grade 3/4 neutropenia (53.5% vs 39.8%). Febrile neutropenia rates were comparable between patient cohorts±malfunction. Efficacy outcomes were similar in patient cohorts±malfunction.<p></p> Conclusions: Central venous access device removal or replacement was common and more frequent in patients receiving FOLFOX-4. Pump malfunctions were also common and were associated with increased rates of grade 3/4 haematological adverse events. Oral fluoropyrimidine-based regimens may be preferable to infusional 5-FU based on these findings

CO2 Concentration in Day Care Centres is Related to Wheezing in Attending Children

Poor ventilation at day care centres (DCCs) was already reported, although its effects on attending children are not clear. This study aimed to evaluate the association between wheezing in children and indoor CO2 (a ventilation surrogate marker) in DCC and to identify behaviours and building characteristics potentially related to CO2. In phase I, 45 DCCs from Lisbon and Oporto (Portugal) were selected through a proportional stratified random sampling. In phase II, 3 months later, 19 DCCs were further reassessed after cluster analysis for the greatest difference comparison. In both phases, children’s respiratory health was assessed by ISAAC-derived questionnaires. Indoor CO2 concentrations and building characteristics of the DCC were evaluated in both phases, using complementary methods. Mixed effect models were used to analyze the data. In phase I, which included 3,186 children (mean age 3.1±1.5 years), indoor CO2 concentration in the DCC rooms was associated with reported wheezing in the past 12months (27.5 %) (adjusted odds ratio (OR) for each increase of 200 ppm 1.04, 95 % CI 1:01 to 1:07). In phase II, the association in the subsample of 1,196 children seen in 19 out of the initial 45 DCCs was not significant (adjusted OR 1.02, 95 % CI 0.96 to 1.08). Indoor CO2 concentration was inversely associated with the practices of opening Windows and internal doors and with higher wind velocity. A positive trend was observed between CO2 and prevalence of reported asthma (4.7 %). Conclusion: Improved ventilation is needed to achieve a healthier indoor environment in DCC