Malnutrition, functional ability and mortality among older people aged ⩾60 years: a 7-year longitudinal study

BACKGROUND/OBJECTIVES: This study aimed to assess the association between risk of malnutrition and 7-year mortality, controlling for functional ability, socio-demographics, lifestyle behavior and diseases, and investigate the interaction between risk of malnutrition and functional ability on the risk of mortality. SUBJECTS/METHODS: A longitudinal study on home-living and special-housing residents aged [greater than or equal to] 60 years was conducted. Of 2312 randomly invited participants, 1402 responded and 1203 provided information on both nutritional status and functional ability. The risk of malnutrition was estimated by the occurrence of at least one anthropometric measure (BMI, MAC and CC) below cut-off in addition to the presence of at least one subjective measure (decreased food intake, weight loss and eating difficulty). RESULTS: At baseline, 8.6% of subjects were at risk of malnutrition and during the 7-year follow-up 34.6% subjects died. The risk of malnutrition was independently associated with 7-year mortality (hazard ratio (HR) 1.84, 95% confidence interval (CI) 1.28-2.65). Additional independent predictors were dementia (HR 2.76, 95% CI 1.85-4.10), activity of daily living (ADL) dependence (HR 2.08, 95% CI 1.62-2.67), heart disease (HR 1.44, 95% CI 1.16-1.78), diabetes (HR 1.41, 95% CI 1.03-1.93) and older age (HR 1.09, 95% CI 1.07-1.10). Moreover, the risk of malnutrition and ADL dependence in combination predicted the poorest survival rate (18.7%, P < 0.001). CONCLUSIONS: The risk of malnutrition significantly increases the risk of mortality in older people. Moreover, risk of malnutrition and ADL dependence together explain a significantly poorer survival rate; however, the importance of this interaction decreased in the multivariable model and risk of malnutrition and ADL dependence independently explained a significant risk of mortality

Occlusal adjustment using the bite plate-induced occlusal position as a reference position for temporomandibular disorders: a pilot study

<p>Abstract</p> <p>Background</p> <p>Many researchers have not accepted the use of occlusal treatments for temporomandibular disorders (TMDs). However, a recent report described a discrepancy between the habitual occlusal position (HOP) and the bite plate-induced occlusal position (BPOP) and discussed the relation of this discrepancy to TMD. Therefore, the treatment outcome of evidence-based occlusal adjustments using the bite plate-induced occlusal position (BPOP) as a muscular reference position should be evaluated in patients with TMD.</p> <p>Methods</p> <p>The BPOP was defined as the position at which a patient voluntarily closed his or her mouth while sitting in an upright posture after wearing an anterior flat bite plate for 5 minutes and then removing the plate. Twenty-one patients with TMDs underwent occlusal adjustment using the BPOP. The occlusal adjustments were continued until bilateral occlusal contacts were obtained in the BPOP. The treatment outcomes were evaluated using the subjective dysfunction index (SDI) and the Helkimo Clinical Dysfunction Index (CDI) before and after the occlusal adjustments; the changes in these two indices between the first examination and a one-year follow-up examination were then analyzed. In addition, the difference between the HOP and the BPOP was three-dimensionally measured before and after the treatment.</p> <p>Results</p> <p>The percentage of symptom-free patients after treatment was 86% according to the SDI and 76% according to the CDI. The changes in the two indices after treatment were significant (p < 0.001). The changes in the mean HOP-BPOP differences on the x-axis (mediolateral) and the y-axis (anteroposterior) were significant (p < 0.05), whereas the change on the z-axis (superoinferior) was not significant (p > 0.1).</p> <p>Conclusion</p> <p>Although the results of the present study should be confirmed in other studies, a randomized clinical trial examining occlusal adjustments using the BPOP as a reference position appears to be warranted.</p

Influence of citric acid and water on thermoplastic wheat flour/poly(lactic acid) blends. I: Thermal, mechanical and morphological properties

Wheat flour was plasticized with glycerol and compounded with poly(lactic acid) in a one-step twin-screw extrusion process in the presence of citric acid with or without extra water. The influence of these additives on process parameters and thermal, mechanical and morphological properties of injected samples from the prepared blends, was then studied. Citric acid acted as a compatibilizer by promoting depolymerization of both starch and PLA. For an extrusion without extra water, the amount of citric acid (2 parts for 75 parts of flour, 25 parts of PLA and 15 parts of glycerol) has to be limited to avoid mechanical properties degradation. Water, added during the extrusion, improved the whole process, minimizing PLA depolymerization, favoring starch plasticization by citric acid and thus improving phases repartition

Predictors of work-related cyberaggression in a random sample of the Swedish working population

Purpose With greater numbers of employees using computer-mediated communication, cyberaggression is becoming a more pressing problem for employees and their organizations. However, while a growing body of research illustrates its harmful effects, little is known about the factors that drive its occurrence. The authors therefore sought to identify factors that increase the risk of cyberaggression among employees. Design/methodology/approach A random sample of the Swedish working population (N = 11,556) was surveyed via Statistics Sweden (SCB), which produced a final sample of N = 2,847 (response rate = 24.6%). Findings Logistic regression analysis showed that emotionally demanding work, availability expectations, low perceived work quality, public sector work and being in a managerial position were related to higher levels of experienced cyberaggression. In addition, exploratory analyses indicated that some of these factors were more strongly related to cyberaggression enacted by organizational insiders compared to organizational outsiders. Originality/value Together, the authors' findings suggest that situational factors are stronger antecedents of cyberaggression victimization than personal factors. This has implications for organizations, as practical steps can be taken to reduce cyberaggression among employees