Prevalence and factors associated with frailty in an older population from the city of Rio de Janeiro, Brazil: the FIBRA-RJ Study

OBJECTIVE: Frailty syndrome can be defined as a state of vulnerability to stressors resulting from a decrease in functional reserve across multiple systems and compromising an individual's capacity to maintain homeostasis. The purpose of this study was to determine the prevalence of frailty and its association with social and demographic factors, functional capacity, cognitive status and self-reported comorbidities in a sample of community-dwelling older individuals who are clients of a healthcare plan. METHODS: We evaluated 847 individuals aged 65 years or older who lived in the northern area of the city of Rio de Janeiro, Brazil. The subjects were selected by inverse random sampling and stratified by gender and age. To diagnose frailty, we used the scale proposed by the Cardiovascular Health Study, which consisted of the following items: low gait speed, grip strength reduction, feeling of exhaustion, low physical activity and weight loss. The data were collected between 2009 and 2010, and the frailty prevalence was calculated as the proportion of individuals who scored positive for three or more of the five items listed above. To verify the association between frailty and risk factors, we applied a logistic regression analysis. RESULTS: The prevalence of frailty syndrome was 9.1% (95% confidence interval [CI], 7.3-11.3); 43.6% (95% CI, 40.3-47) of the individuals were considered robust, and 47.3% (95% CI 43.8-50.8) were considered pre-frail (

Engagement of the Type I Interferon Receptor on Dendritic Cells Inhibits T Helper 17 Cell Development: Role of Intracellular Osteopontin

SummaryMechanisms that prevent inappropriate or excessive interleukin-17-producing T helper (Th17) cell responses after microbial infection may be necessary to avoid autoimmunity. Here, we define a pathway initiated by engagement of type I IFN receptor (IFNAR) expressed by dendritic cells (DC) that culminated in suppression of Th17 cell differentiation. IFNAR-dependent inhibition of an intracellular translational isoform of Osteopontin, termed Opn-i, derepressed interleukin-27 (IL-27) secretion and prevented efficient Th17 responses. Moreover, Opn-i expression in DC and microglia regulated the type and intensity of experimental autoimmune encephalomyelitis (EAE). Mice containing DC deficient in Opn-i produced excessive amounts of IL-27 and developed a delayed disease characterized by an enhanced Th1 response compared with the dominant Th17 response of Opn-sufficient mice. Definition of the IFNAR-Opn-i axis that controls Th17 development provides insight into regulation of Th cell sublineage development and the molecular basis of type I interferon therapy for MS and other autoimmune diseases

A Computational Method based on Radio Frequency Technologies for the Analysis of Accessibility of Disabled People in Sustainable Cities

The sustainability strategy in urban spaces arises from reflecting on how to achieve a more habitable city and is materialized in a series of sustainable transformations aimed at humanizing different environments so that they can be used and enjoyed by everyone without exception and regardless of their ability. Modern communication technologies allow new opportunities to analyze efficiency in the use of urban spaces from several points of view: adequacy of facilities, usability, and social integration capabilities. The research presented in this paper proposes a method to perform an analysis of movement accessibility in sustainable cities based on radio frequency technologies and the ubiquitous computing possibilities of the new Internet of Things paradigm. The proposal can be deployed in both indoor and outdoor environments to check specific locations of a city. Finally, a case study in a controlled context has been simulated to validate the proposal as a pre-deployment step in urban environments

Expected effect of retinal thickness after focal photocoagulation in diabetic macular oedema

AbstractBackgroundMacular oedema is a form of diabetic retinopathy that can be treated with photocoagulation. The expected effect of treatment varies, and may depend on the previous characteristics of retinal thickening.ObjectiveTo determine whether the change in retinal thickness after focal photocoagulation for diabetic macular oedema varies due to the presence of anatomical features that may justify a separate assessment.Material and methodsNon-experimental, comparative, retrospective, longitudinal study. The mean percentage change in macular volume was compared in eyes with diabetic macular oedema, 3 weeks after focal photocoagulation. The analysis was stratified according to the presence of central and perifoveal temporal thickening (Mann–Whitney U). A regression analysis was performed to identify the contribution of the anatomical variables before photocoagulation to the change in macular volume.ResultsA total of 72 eyes were evaluated. The mean change of macular volume in the sample was −0.68±3.84%. In the multiple regression analysis, the changes of perifoveal temporal (beta 0.54, p<0.001) and central field thickness (beta 0.3, p=0.01) contributed to the change of macular volume (R=0.64). Macular volume decreased by a mean of −2.1±4.3% in eyes with temporal perifoveal thickening, and increased by 0.5±2.8% (p =0.007) in eyes with no thickening.ConclusionPerifoveal temporal thickening before photocoagulation changes the expected effect of this therapy on macular volume in eyes with focal diabetic macular oedema. It is recommended to evaluate the effect separately, and according to the perifoveal temporal thickness

Saúde da Pessoa Idosa

O objetivo geral deste módulo é fornecer ao profissional os conhecimentos necessários para executar ações de prevenção e promoção da saúde, hierarquização da demanda e do cuidado e abordagem dos principais problemas que afligem os idosos, considerando as ações da Atenção Básica. O módulo é composto por 4 unidades e aborda as seguintes temáticas: Promoção da Saúde no Envelhecimento; Prevenção de doenças no Envelhecimento; Nutrição, perda de peso Involuntária; Avaliação da estabilidade postural e prevenção de quedas; Avaliação Multidimensional da Pessoa Idosa I; Avaliação Multidimensional da Pessoa Idosa II; Farmacologia no Envelhecimento; Incontinência Urinária; Doença de Parkinson e Tremor; Osteoporose; Avaliação e manejo do declínio cognitivo 1; Avaliação e manejo do declínio cognitivo 2; Depressão; Desequilíbrio e Vertigem; Avaliação dos cuidadores e contexto familiar dos idosos; Violência e maus tratos contra idosos; Cuidados Paliativos.1.0Ministério da Saúd

Instituto SEQUOIA : Um serviço privado, multidisciplinar e de cuidado aos idosos

Population aging is a reality all over the world, requiring a change in the way care is perceived and resources are divided for different age groups. In Brazil, current indicators and projections place the country among those with the highest number of elderly people. By contrast, there is a shortage of action plans and inter- and multi-disciplinary teams, as well as public policies and professionals, focusing on the elderly, in part as a consequence of an accelerated aging process in developing countries. Within this context, the SEQUOIA Institute (IS) was created to attend to this process by monitoring the overall health of patients. The institute's routine work includes clinical actions, team meetings, socialization projects and lectures. The IS features a 10% yearly growth in medical assistance, a 20% rise in psychological treatments, and a 50% increase in lecture attendance.Le vieillissement de la population est un phénomène mondial qui exige de revoir la façon dont sont perçus les soins et dont sont divisées les ressources en fonction des différentes tranches d’âge. Les indicateurs et les projections actuels montrent que le Brésil est le pays qui compte la plus grande proportion de personnes âgées. Et pourtant, les plans d’action, les équipes inter- et pluridisciplinaires, mais aussi les politiques publiques et les professionnels spécialistes des questions liées aux personnes âgées sont en nombre insuffisant, notamment en raison d’un processus de vieillissement accéléré dans les pays en développement. C’est dans ce contexte qu’a été créé l’Institut SEQUOIA (IS), dont la mission consiste à gérer ce processus en effectuant un suivi de la santé générale des patients. Les principales tâches de l’institut incluent études cliniques, réunions d’équipes, projets impliquant des débats et conférences. L’IS affiche une croissance annuelle de 10 % dans le secteur de l’assistance médicale, de 20 % dans le nombre de traitements psychiques et de 50 % dans le taux de participation aux conférences.El envejecimiento de la población es una realidad en todo el mundo, que requiere reestructurar la forma de ver el cuidado y la división de recursos para las distintas franjas etarias. En Brasil, los indicadores actuales y las proyecciones colocan al país entre aquellos con el mayor número de ancianos. En contrapartida, existe una escasez de modelos de actuación, de equipos inter- y multidisciplinarios, así como de políticas públicas y de profesionales capacitados para tratar a los ancianos, en parte como consecuencia de un acelerado proceso de envejecimiento en los países en desarrollo. Dentro de este contexto fue creado el Instituto SEQUOIA (IS), con el objetivo de seguir este proceso a través de la supervisión global de los pacientes, y cuyo trabajo de rutina incluye acciones clínicas, reuniones de equipos, proyectos de socialización y conferencias. El IS presenta un crecimiento anual de un 10 % en la asistencia médica, un 20 % en los números de tratamientos psicológicos y un 50 % en tasas de participación en las conferencias.O envelhecimento populacional é uma realidade em todo o mundo, o que requer uma reestruturação na forma de olhar o cuidado e a divisão de recursos para as diferentes faixas etárias. No Brasil existem indicadores atuais e projeções que colocam o país em destaque em número de idosos. Em contrapartida existe uma escassez de modelos de atuação, equipes inter e multidisciplinares, além de políticas públicas e profisisonais capacitados para lidar com os idosos, em parte por consequencia de um acelerado processo de envelhecimento nos países em desenvolvimento. Dentro deste contexto foi criado o Instituto SEQUOIA (IS) com o objetivo de cuidar deste processo através do olhar para a saúde global dos pacientes, e que possuí em sua rotina a atuação clínica, reuniões de equipe, projetos de socialização e  palestras. O IS apresenta um crescimento de 10% ao ano na assistencia médica, 20% no números de atendimentos psicológicos, além de 50% a mais na participação em palestras

Improving Urban Accessibility: A Methodology for Urban Dynamics Analysis in Smart, Sustainable and Inclusive Cities

Despite the improvisations of current urban accessibility regulations and their application in urban systems, it is a fact that our cities are not accessible. Both, the assessment of the effectiveness of urban accessibility and its maintenance over time are issues that require a more consistent approach. In order to address these aspects, it is necessary to have an accurate awareness of the existing condition of urban accessibility. Therefore, the way this information is transformed into specific data, which must be collected, stored and assessed, is one of the main challenges that smart cities face. This research helps implement an integrated system for urban accessibility analysis, combining the latest advances in the Information and Communication Technologies, such as RF & GPS positioning, smart sensing and cloud computing. The main goal of this research is to develop a reliable and effective method to assess public space accessibility with special focus on people with disabilities, by eliciting from users personal experiences. Consequently, the data obtained will enable a better design for improving pedestrian mobility. As a result, a computational architecture for urban dynamics analysis has been designed. Finally, technology and data processing have been validated as an effective system for data collection, and, as a first approach to users’ real experience, it has been proposed to have a testing scenario at the University of Alicante

A mixed integer programming approach for multi-action planning for threat management

Planning for management actions that address threats to biodiversity is important for securing its long term persistence. However, systematic conservation planning (SCP) has traditionally overlooked this aspect and just focused on identiying priority areas without any recommendation on actions needed. This paper develops a mixed integer mathematical programming (MIP) approach for the multi-action management planning problem (MAMP), where the goal is to find an optimal combination of management actions that abate threats, in an efficent way while accounting for connectiivty. An extended version of the MAMP model (MAMP-E) is also proposed that adds an expression for minimizing fragmentation between different actions. To evaluate the efficiency of the two models, they were applied to a case study corresponding to a large area of the Mitchell River in Northern Asutralia, where 45 species of freshwater fish are exposed to the presence of four threats. The evaluation compares our exact MIP approach with the conservation planning software Marxan and the heuristic approach developed in Cattarino et al. (2015). The results obtained show that our MIP models have three advantages over their heuristic counterparts: shorter execution times, higher solutions quality, and a solution quality guarantee. Hence, the proposed MIP methodology provides a more effective framework for addressing the multi-action conservation problem.Peer ReviewedPostprint (published version

Arquitectura e Ciências Sociais: pontos de partida para uma reflexão e programa de trabalhos

Colóquio Internacional Espaço e Sociedade. Organização do CEAU Grupo Atlas da Casa e do Instituto de Sociologia, Porto, FAUP, 14 MarçoArchitecture et Sciences Sociales: points de départ pour une réflexion et un programme de travau

Synthesis of quinoxaline 1,4-di-N-oxide derivatives on solid support using room temperature and microwave-assisted solvent-free procedures

We describe the synthesis of 12 new ethyl and methyl quinoxaline-7-carboxylate 1,4-di-N-oxide derivatives on solid supports with room temperature and microwave-assisted solvent-free procedures. Results show that solid supports have good catalytic activity in the formation of quinoxaline 1,4-di-N-oxide derivatives. We found that florisil and montmorillonite KSF and K10 could be used as new, easily available, inexpensive alternatives of catalysts. Additionally, room temperature and microwave-irradiation solvent-free synthesis was more efficient than a conventional procedure (Beirut reaction), reducing reaction time and increasing yield