Is urinary incontinence associated with sedentary behaviour in older women? Analysis of data from the National Health and Nutrition Examination Survey

BACKGROUND: Urinary incontinence (UI) is a common geriatric syndrome associated with physical and cognitive impairments. The association between type of UI and sedentary behaviour (SB) has not been explored. AIM: To determine association between moderate-severe UI, or any stress UI (SUI) or any urgency UI (UUI) and SB in community-dwelling older women. METHODS: Women aged 60 and over from the 2005-2006 cycle of the National Health and Nutrition Examination Survey (NHANES) with objectively measured (accelerometer) and self-reported SB and UI data were selected. Multivariate models exploring association between moderate-severe UI and SB, or SUI and SB, or UUI and SB were analysed using logistic regression adjusted for factors associated with UI. RESULTS: In the overall sample of 459 older women, 23.5% reported moderate-severe UI, 50.5% reported any SUI and 41.4% reported any UUI. In bivariate analysis objectively measured proportion of time in SB was associated with moderate-severe UI and UUI (p = 0.014 and p = 0.047) but not SUI. Average duration of SB bouts in those with moderate-severe UI or any SUI was no longer than older women reporting no continence issues, but it was significantly (19%) longer in older women with any UUI (mean difference 3.2 minutes; p = 0.001). Self-reported SB variables were not associated with any type of UI. Multivariate analysis showed an association between UUI and a longer average duration of SB bouts (OR = 1.05, 95% CI = 1.01-1.09, p = 0.006) but no association with moderate-severe UI or SUI. CONCLUSION: UUI was significantly associated with increased average duration of SB bouts in community-dwelling older women. The importance of objective measurement of SB is highlighted and suggests that decreasing time in prolonged sitting may be a target intervention to reduce UUI. Future studies are required to further explore the association between SB and incontinence

Regional differences in the profile of disabled community-dwelling older adults: a European population-based cross-sectional study

The main objective of this work was to estimate the prevalence of disability in European community-dwelling older adults, as well as to investigate differences in the profile of disabled older adults between European regions (Northern, Central, Eastern and Southern). A cross-sectional study based on wave 6 (2015) of the Survey of Health, Ageing and Retirement in Europe (SHARE) was conducted. Community-dwelling participants aged 65-84 were selected (n = 33,369). Disability was defined as presenting at least one functional limitation in basic activities of daily living (BADL). Sociodemographic, health services, lifestyle and health-related variables were analyzed. Statistical analysis was carried out through the Chi-square and ANOVA tests for bivariate analysis, and Poisson regression for multivariate analysis. Overall prevalence of disability was 13.8%: 9.4% in the Northern region, 13.1% in the Southern region, 13.6% in the Central region, and 16.6% in the Eastern region. Portugal, Poland, Estonia and Belgium showed the highest prevalence of BADL limitations, while Sweden, Denmark, Greece and Switzerland showed the lowest prevalence. Besides, disabled older adults from East Europe presented the most disadvantaged health profile, followed by the Southern region. On the other hand, disabled older adults living in the Northern region showed the most advantaged characteristics of most variables, except for smoking and polypharmacy

A pilot randomised clinical trial of a novel approach to reduce sedentary behaviour in care home residents: feasibility and preliminary effects of the GET READY study

Care-home residents are among the most sedentary and least active of the population. We aimed to assess the feasibility, acceptability, safety, and preliminary effects of an intervention to reduce sedentary behaviour (SB) co-created with care home residents, staff, family members, and policymakers within a pilot two-armed pragmatic cluster randomized clinical trial (RCT). Four care homes from two European countries participated, and were randomly assigned to control (usual care, CG) or the Get Ready intervention (GR), delivered by a staff champion one-to-one with the care home resident and a family member. A total of thirty-one residents participated (51.6% female, 82.9 (13.6) years old). GR involves six face to face sessions over a 12-week period with goal-oriented prompts for movement throughout. The feasibility and acceptability of the intervention were assessed and adverse events (AEs) were collected. The preliminary effects of the GR on SB, quality of life, fear of falling, and physical function were assessed. Means and standard deviations are presented, with the mean change from baseline to post-intervention calculated along with 95% confidence intervals. The CG smoked more, sat more, and had more functional movement difficulties than the GR at baseline. The GR intervention was feasible and acceptable to residents and staff. No AEs occurred during the intervention. GR participants showed a decrease in daily hours spent sitting/lying (Cohen's d = 0.36) and an increase in daily hours stepping, and improvements in health-related quality of life, fear of falling, and habitual gait speed compared to usual care, but these effects need confirmation in a definitive RCT. The co-created GR was shown to be feasible and acceptable, with no AEs

Análisis de escala de la riqueza de carábidos (Coleoptera: Carabidae) en América del Sur austral

The southern South America presents a complex history of geomorphological and climatic events, which have modulated and fragmented the southwestern part of the Andes mostly. Given the complexity of the southern landscape, the analysis of the hierarchical components alpha-?, beta-? and gamma-? on carabid diversity allows exploring the responses of species to spatial changes patterns according to the scales of the landscape. In order to understand how spatial scales influence the carabid diversity in southern South America, we used an approach at multiple spatial scales of multiplicative diversity partitioning. We included four spatial scales in our analysis: among 0.25° quadrats, 0.5° quadrats, provinces and biogeographic sub-regions. The results showed that the pattern of carabid distribution is not random, and varies according to the spatial scale. At larger scales ?-diversities are observed to be higher than expected, but lower than expected at smaller scales. This suggests that carabid ensembles are more homogenous than expected, particularly at the scale of 0.5° quadrats. As explanatory factors, glacial/post-glacial events and historical processes may have had an impact on the present species patterns. Furthermore, due to the importance of beta-? diversity on local and regional scales, a promising approach for future studies is to investigate which biogeographic mechanisms seem to determine the species distribution in different provinces.La compleja historia geomorfológica y climática de Sudamérica austral ha modulado y fragmentado particularmente el sector sur de los Andes. Dada la complejidad del paisaje austral, un análisis de los componentes de diversidad alfa-?, beta-? and gamma-? de carábidos, permite explorar los cambios de los patrones espaciales considerando las escalas de paisaje. Para analizar el efecto de la escala espacial sobre la diversidad de carábidos en Sudamérica austral, realizamos un particionamiento multiplicativo de diversidad. Para nuestro análisis incluimos cuatro escalas espaciales, cuadrículas de 0,25°, cuadrículas 0,5°, provincias biogeográficas y sub-regiones biogeográficas. Nuestros resultados muestran que el patrón de distribución de carábidos no es aleatorio. A gran escala se observa que las diversidades beta son mayores a lo esperado, mientras a baja escala son menores a lo esperado. Lo anterior sugiere que los ensambles de carábidos son más homogéneos, principalmente entre cuadrículas de 0,5°. Discutimos el efecto de procesos históricos en el patrón actual de especies. Debido a la importancia de la diversidad beta-? a escala local y regional, es que se da pie a una interesante línea de investigación para entender que mecanismos biogeográficos parecen determinar la distribución de especies en diferentes provincias

Validation of a dual-task exercise program to improve balance and gait speed in older people (DualPro): a Delphi study

Delphi method; Older adult; Therapeutic exerciseMétodo Delfos; Adulto mayor; Ejercicio terapéuticoMètode Delphi; Adult major; Exercici terapèuticBackground Most physical exercise programs for older people work the physical component in isolation, excluding cognitive aspects. Previous studies reported that both components (physical and cognitive) are necessary for correct functioning of older people in the society. Purpose To create and validate a dual-task exercise program (DualPro) to improve balance and gait speed in older people. Methods Expert consensus or the Delphi Method was used for validation. A group of 17 experts in neurorehabilitation and geriatrics was recruited to assess the proposed exercise program. They were selected taking into account their experience in clinical practice as well as their knowledge of the subject through the use of the expert competence coefficient (K). Online questionnaires were sent with a total of 11 exercises, which had to be rated using a “Likert” scale from 1 to 7. Results Two rounds were conducted to achieve 100% consensus in all exercises. The interquartile range of each exercise in both rounds was stable. During the second round, the relative interquartile range was less than 15% in all the questions, thus demonstrating consensus among the experts. Conclusion Experts in neurorehabilitation and geriatrics have concluded the validity of the progressive and systematized program of dual-task exercises focused on improving balance and gait speed for older people. This exercise program can help in the homogenization of the use of dual-task exercises in future studies and in professional practice.This work was supported by the Catalan Board of Physiotherapists, code 002/2019. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript

Is loneliness a predictor of the modern geriatric giants? Analysis from the survey of health, ageing, and retirement in Europe

Background: The modern Geriatric Giants have evolved to encompass four new syndromes, of frailty (linked to fatigue and physical inactivity), sarcopenia, anorexia of ageing, and cognitive impairment. In parallel, loneliness has been established as a risk factor for adverse mental and physical health outcomes among older adults. Objective: To analyse loneliness as a predictor of the modern Geriatric Giants in European older adults, using a longitudinal design of nationally representative data. Design: Longitudinal population-based cohort study. Subjects: Data from countries that participated in waves 5 and 6 of the Survey of Health, Ageing, and Retirement in Europe project. The sizes of the subsamples analysed ranged from 17,742 for physical inactivity to 24,524 for anorexia of ageing. Methods: Loneliness (measured from wave 5) was the independent variable of interest. The dependent variables were incidence of fatigue, physical inactivity, sarcopenia, anorexia of ageing, and cognitive impairment from wave 5 (baseline) to wave 6. Poisson regression models were used for multivariable analysis, obtaining Relative Risk (RR) and 95 % confidence intervals (CI). Results: The prevalence of loneliness ranged from 9.2%–12.4% at wave 5. The 2-year incidence of fatigue was 16 % (95 % CI: 15.5–16.5), physical inactivity 9.8 % (95 % CI: 9.4–10.3), sarcopenia 5.6 % (95 % CI: 5.3–5.9), anorexia of aging 5.4 % (95 % CI: 5.1–5.7), and cognitive impairment 10.3 % (95 % CI: 9.9–10.8). The multivariable analysis showed that loneliness was a predictive factor for fatigue (30 %, CI: 17–45 % higher risk), physical inactivity (24 %, CI: 7–43 % higher risk) and cognitive impairment (26 %, CI: 9–46 % higher risk), adjusted by age, sex, number of chronic diseases, education level, region and depression. Conclusions: Loneliness is an independent risk factor for fatigue, physical inactivity, and cognitive impairment in older adults. The incidence of anorexia of ageing and sarcopenia was not associated with loneliness over the 2- year observation period

Chitosan from Marine Amphipods Inhibits the Wilt Banana Pathogen Fusarium oxysporum f. sp. Cubense Tropical Race 4

In this work, we extracted chitosan from marine amphipods associated with aquaculture facilities and tested its use in crop protection. The obtained chitosan was 2.5 ± 0.3% of initial ground amphipod dry weight. The chemical nature of chitosan from amphipod extracts was confirmed via Raman scattering spectroscopy and Fourier transform infrared spectroscopy (FTIR). This chitosan showed an 85.7–84.3% deacetylation degree. Chitosan from biofouling amphipods at 1 mg·mL−1 virtually arrested conidia germination (ca. sixfold reduction from controls) of the banana wilt pathogenic fungus Fusarium oxysporum f. sp cubense Tropical Race 4 (FocTR4). This concentration reduced (ca. twofold) the conidia germination of the biocontrol fungus Pochonia chlamydosporia (Pc123). Chitosan from amphipods at low concentrations (0.01 mg·mL−1) still reduced FocTR4 germination but did not affect Pc123. This is the first time that chitosan is obtained from biofouling amphipods. This new chitosan valorizes aquaculture residues and has potential for biomanaging the diseases of food security crops such as bananas.This project was funded by PID2020-119734RB-I00 (Spanish Ministry of Science and Innovation), EU H2020 MUSA no. 727624, and AIRAM (Biodiversity Foundation, Spanish Ministry for Ecological Transition, and the Demographic Challenge) projects

Effectiveness of Interventions for Reducing Sedentary Behaviour in Older Adults Living in Long-Term Care Facilities: A Protocol for a Systematic Review

Background. Sedentary behaviour (SB) is an important risk factor for several health-related outcomes. The prevalence of SB is alarmingly high in older adults, who spend on average 9.4 h being sedentary each day, making them the most sedentary of all age groups. Objectives. The primary objective of this review is to assess the impact of interventions aimed at reducing SB in older adults (aged 60 years and older) living in long-term care facilities (LTCFs). The research question for this systematic review is as follows: in older people living in LTCFs, do interventions aimed at reducing SB, compared to usual care, result in a decrease in SB daily time or a reduction in the length of prolonged and uninterrupted sitting bouts? Data sources. Only peer-reviewed articles will be included in this systematic review, articles will be identified using the PICO method in seven different databases. Participants and interventions. Any primary intervention study (including randomized controlled trials, non-randomized controlled trials, and cohort studies) with the aim to reduce SB daily time or shorten the length of prolonged and uninterrupted sitting bouts in older adults living in LTCFs will be included. After searching databases, abstracts of the studies will be screened, and, after retrieving full text articles, data extraction will be conducted by two independent reviewers. Study appraisal and synthesis methods. The review will adhere to PRISMA reporting guidelines. Risk of bias (RoB) will be assessed using ROBINS-I or the RoB 2.0 tool and will be discussed with a third reviewer. The data will be grouped according to study design, with separate analysis for randomised and non-randomised designs. Results. The primary outcomes will be SB or time spent sedentary, assessed before and after the intervention. For the outcomes with the same measurement units, the pooled mean differences will be calculated. Standardised mean differences will be calculated for the outcomes with different measurement units. The data not suitable in numbers will be synthesised narratively. The strength of evidence of the outcomes will be assessed using GRADE assessment. If the data are suitable for quantitative analysis, we plan to use the Revman software to conduct a meta-analysis. Conclusions and implications of key findings. This protocol can serve as a valuable resource for other researchers interested in conducting similar systematic reviews or meta-analyses in the field of SB and older adult health

Incontinência urinária em idosos institucionalizados no Brasil: uma revisão integrativa

Este estudo teve como objetivo abordar os principais aspectos relacionados à incontinência urinária (IU) em idosos institucionalizados no Brasil, por meio de revisão integrativa de literatura. Em agosto de 2013, foram pesquisadas as bases de dados PubMed, Scopus, LILACS, SciELO, PAHO, MedCarib, CAPES e Google Acadêmico, utilizando combinações dos termos "incontinência urinária", "idosos", "institucionalizados" e "Brasil". Após aplicação dos critérios de elegibilidade, selecionaram-se 11 trabalhos: nove artigos científicos e duas dissertações de mestrado. A maior parte dos estudos foi do tipo seccional, realizado na Região Sul ou Sudeste, e com amostra menor que 100 indivíduos. A frequência da IU variou entre 22 e 100%, ultrapassando 50% na maior parte das pesquisas, com acometimento maior no sexo feminino. A forma clínica mais comum foi a IU de esforço, seguida pela IU de urgência, e o volume das perdas urinárias referido pelos residentes variou entre pequena e grande quantidade, sem predominância de nenhuma das categorias. O impacto da condição na qualidade de vida do indivíduo é diverso, entre leve e elevado, mas parece ser menor que em idosos não institucionalizados. Com base neste trabalho, conclui-se que a IU é um problema de saúde frequente no âmbito asilar, que pode afetar a qualidade de vida do residente e se associar ao declínio da mobilidade e à função cognitiva. As pesquisas no Brasil, contudo, são escassas e com amostra reduzida e, portanto, são necessários estudos com maior rigor metodológico que facilitem o planejamento de medidas adequadas de prevenção e tratamento, que visem reduzir os gastos sanitários, a sobrecarga dos cuidadores e profissionais de saúde e que permitam diminuir o impacto desta condição na saúde dos idosos institucionalizados

Effectiveness of the Validation Method in Work Satisfaction and Motivation of Nursing Home Care Professionals: A Literature Review

The purpose of this study was to carry out a literature review on the effectiveness of the validation method (VM) in job satisfaction and motivation of care professionals working with older people in nursing homes. The review was carried out in specialised databases: Scopus, PsychINFO, PubMed, Web of Science (WOS), Google Scholar, Scielo, and Cochrane Database of Systematic Reviews. 9046 results were obtained, out of which a total of 14 studies met the inclusion criteria: five quantitative, four qualitative, one single case series, two quasi-experimental and two mixed methods studies. The results of the analysed studies report that the VM can be an effective tool that facilitates communication and interaction in care, reducing levels of stress and job dissatisfaction among care professionals. The VM facilitates communication between professionals and older people with dementia, and improves the management of complex situations that may arise in care, directly influencing a reduction in work stress and increasing job satisfaction