Poor sleep quality and oral health among older Brazilian adults

Objectives: This study evaluates the association between normative and subjective oral health measures and poor self‐reported sleep quality among community‐dwelling older adults in Brazil. / Methods: This was a cross‐sectional study with data from the Brazilian Longitudinal Study of Aging. The dependent variable was the poor sleep quality. Independent variables of interest included number of teeth and self‐reported impact of oral health on eating/chewing and on maintaining emotional stability. / Results: Poor sleep quality was reported by 17.8 (95% CI 16.6; 19.2) of the participants, 29% of the participants were edentulous, and 30% had 20 or more teeth. Impacts of oral health on eating and maintaining emotional stability was found among 33.3% and 20% of the older adults, respectively. After adjusting for all oral health measures and covariates, the magnitude of the associations between the number of teeth and sleep quality was attenuated. Sleep quality was related to oral health impacts on eating (OR 1.19 [95% CI 1.00; 1.41]) and on emotional stability (OR 1.51 [95% CI 1.21; 1.87]). / Conclusions: This study found an association between oral health and sleep quality emphasizing the importance of oral health to general health

Differences in the prevalence of prediabetes, undiagnosed diabetes and diagnosed diabetes and associated factors in cohorts of Brazilian and English older adults

OBJECTIVE: To analyse differences in the prevalence of prediabetes (PD), undiagnosed diabetes (UDD) and diagnosed diabetes (DD) and associated factors between Brazilian and English older adults. DESIGN: Cross-sectional study. SETTING: England and Brazil. PARTICIPANTS: 5301 participants of the English Longitudinal Study of Ageing study and 1947 participants of the Brazilian Longitudinal Study of Aging study classified as non-diabetics, PD, UDD and DD. RESULTS: The prevalence of PD, UDD and DD was 48·6, 3 and 9·6 % in England and 33, 6 and 20 % in Brazil. In England, the increase in age, non-white skin colour, smoking, general obesity and abdominal obesity were associated with PD, UDD and DD, whereas hypertriglyceridaemia, low HDL levels, hypertension and stroke were associated with UDD and DD. In Brazil, the increase in age was associated with DD and UDD, non-white skin colour and smoking were associated with UDD and abdominal obesity and hypertriglyceridaemia were associated with all three conditions. CVD in England and schooling in Brazil were associated with PD and DD. A sedentary lifestyle was associated with DD in both samples. CONCLUSIONS: The prevalence of diabetes was higher in the Brazilian sample. Different associated factors were found in the two samples, which may be related to differences in nutritional transition, access to healthcare services and the use of such services

Does undiagnosed diabetes mitigate the association between diabetes and cognitive impairment? Findings from the ELSI‐Brazil study

Background: Type 2 diabetes mellitus (T2DM) is associated with cognitive impairment. However, most of the evidence has been based on self‐reported T2DM, and undiagnosed diabetes has not been considered as a separate category. We aimed to examine the extent to which undiagnosed diabetes modifies the association between diabetes and cognitive impairment in a representative sample of Brazilian adults aged 50 years and older. / Methods: We analyzed baseline data from 1944 participants of the Brazilian Longitudinal Study of Aging (ELSI‐Brazil) conducted from 2015 to 2016. Diabetes was evaluated based on self‐reported doctor diagnosis and glycosylated hemoglobin levels. Participants were classified as diabetics (D), undiagnosed diabetics (UDD), or nondiabetics (ND). Cognitive function was assessed by word list learning and verbal fluency tests. Three multiple logistic regression models were used to evaluate the changes in the strength of the associations. / Results: Participants with diabetes had 49% greater odds of exhibiting impaired memory than nondiabetics (odds ratio [OR] = 1.49; 95% CI: 1.01‐2.20). By combining UDD and ND, the association between diabetes and impaired memory was attenuated by 2.0%, losing its statistical significance (OR = 1.46; 95% CI: 0.98‐2.17). By combining UDD and D, the association was attenuated by 7.4% (OR = 1.38; 95% CI: 1.01‐1.90). No significant association was found between T2DM and impaired verbal fluency. / Conclusion: This study found an association between T2DM and impaired memory but not with impaired verbal fluency. When UDD individuals are considered diabetics, this association is attenuated; when UDD individuals are considered as ND, this association is attenuated to the extent that it loses its statistical significance, affecting thus the clinical interpretation

Lean Principles in Vertical Farming: A Case Study

Vertical farming (VF) has been recognised as an important tool for managing future food security, yet economic viability poses a significant hurdle with the vast majority of farms closing within three years. The application of lean principles poses an opportunity to address inefficiencies, such as significant labour expenditure, but existing literature is yet to consider process improvement methodologies in VF. In this paper, an established framework for lean implementation is applied to an industry case study providing techniques for process improvement. This work is novel and crucial for workflow standardisation and higher profit margins in this emerging sector

Ponderomotive and resonant effects in the acceleration of particles by electromagnetic modes

Funding: U.K. Science and Engineering Research Council under Grant No. EP/N028694/1 (R.A.C.).In the present analysis, we study the dynamics of charged particles under the action of slowly modulated electromagnetic carrier waves. With the use of a high-frequency laser mode along with a modulated static magnetic wiggler, we show that the ensuing total field effectively acts as a slowly modulated high-frequency beat-wave field typical of inverse free-electron laser schemes. This effective resulting field is capable of accelerating particles in much the same way as space-charge wake fields do in plasma accelerators, with the advantage of being more stable than plasma related methods. Acceleration occurs as particles transition from ponderomotive to resonant regimes, so we develop the ponder- omotive formalism needed to examine this problem. The ponderomotive formalism includes terms that, although not discussed in the usual applications of the approximation, are nevertheless of crucial importance in the vicinity of resonant capture. The role of these terms is also briefly discussed in the context of generic laser-plasma interactions.PostprintPeer reviewe

Racial inequities in tooth loss among older Brazilian adults: A decomposition analysis

OBJECTIVE: To determine the extent to which racial inequities in tooth loss and functional dentition are explained by individual socioeconomic status, smoking status and frequency/reason for the use of dental services. METHODS: Data came from the Brazilian Longitudinal Study of Ageing, a nationally representative sample of community-dwelling people aged 50 years and over. Tooth loss and functional dentition (ie 20+ natural teeth) were the outcomes. The main explanatory variable was self-classified race. Covariates included dental visits in the past 12 months, dental visits for check-ups only, smoking status, self-reported chronic conditions, depression and cognitive function. Logistic regression and Blinder-Oaxaca decomposition analysis were used to estimate the share of each factor in race-related tooth loss inequities. RESULTS: The analytical sample comprised of 7126 respondents. While the prevalence of functional dentition in White Brazilians was 37% (95% CI: 33.5;40.9), it was 29% (95% CI: 26.4;31.6) among Browns and 30% (95% CI: 25.1;35.4) among Blacks. The average number of lost teeth among Whites, Browns and Blacks were 18.7 (95% CI: 17.8;19.6), 20.4 (95% CI: 19.7;21.1) and 20.8 (95% CI: 19.5;22.0), respectively. Decomposition analysis showed that the selected covariates explained 71% of the racial inequalities in tooth loss. Dental visits in the previous year and smoking status explained nearly half of race-related gaps. Other factors, such as per capita income, education and cognitive status, also had an important contribution to the examined inequalities. The proportion of racial inequities in tooth loss that was explained by dental visits (frequency and reason) and smoking status decreased from 40% for those 50-59 years of age to 22% among participants aged 70-79 years. CONCLUSIONS: Frequency and reason for dental visits and smoking status explained nearly half of the racial inequity in tooth loss among Brazilian older adults. The Brazilian Family Health Strategy Program should target older adults from racial groups living in deprived areas

The Brazilian Longitudinal Study of Aging (ELSI-Brazil): Objectives and Design

Brazil is experiencing among the world’s fastest demographic aging worldwide. This demographic transition is occurring in a context of few resources and great social inequalities. The Brazilian Longitudinal Study of Aging (ELSI-Brazil) is a nationally representative study of 9,412 people aged 50 years or older, residing in 70 municipalities across the 5 Brazilian regions. ELSI-Brazil allows investigations of the aging process, its health, psychosocial and economic determinants, and societal consequences. The baseline examination (2015–2016) included detailed household and individual interviews and physical measurements (blood pressure, anthropometry, grip strength, and timed walk and balance tests). Blood tests and sample storage were performed in a subsample of study participants. Subsequent waves are planned for every 3 years. The study adopts a conceptual framework common to other large-scale longitudinal studies of aging in the world, such as the Health and Retirement Study, allowing cross-national comparisons. The goal of ELSI-Brazil is not only to build an understanding of aging in a large, Western, middle-income country in a rapid demographic transition but also to provide scientific data to support and study policy changes that may affect older adults. We describe the methodology of the study and some descriptive results of the baseline survey

Savanna turning into forest: concerted vegetation change at the ecotone between the Amazon and “Cerrado” biomes

In the “Cerrado”–Amazon ecotone in central Brazil, recent studies suggest some encroachment of forest into savanna, but how, where, and why this might be occurring is unclear. To better understand this phenomenon, we assessed changes in the structure and dynamics of tree species in three vegetation types at the “Cerrado”–Amazon ecotone that are potentially susceptible to encroachment: open “cerrado” (OC), typical “cerrado” (TC) and dense woodland (DW). We estimated changes in density, basal area and aboveground biomass of trees with diameter ≥ 10 cm over four inventories carried out between 2008 and 2015 and classified the species according to their preferred habitat (savanna, generalist, or forest). There was an increase in all structural parameters assessed in all vegetation types, with recruitment and gains in basal area and biomass greater than mortality and losses. Thus, there were net gains between the first and final inventories in density (OC: 3.4–22.9%; TC: 1.8–12.6%; DW: 0.2–8.3%), in basal area (OC: 8.3–18.2%; TC: 2–12.7%; DW: 2.3–8.9%), and in biomass (OC: 10.6–16.4%; TC: 1–12%; DW: 5.2–18.7%). Furthermore, all vegetation types also experienced net gains in forest and generalist species relative to savanna species. A decline in recruitment of savanna species was a likely consequence of vegetation encroachment and environmental changes. Our results indicate, for the first time based on quantitative and standardized multi-site temporal data, that concerted structural changes caused by vegetation encroachment are occurring at the ecotone between the two largest biomes in Brazil