Association of Serum 25-Hydroxyvitamin D Deficiency with Risk of Incidence of Disability in Basic Activities of Daily Living in Adults >50 Years of Age.

BACKGROUND: Vitamin D deficiency compromises muscle function and is related to the etiology of several clinical conditions that can contribute to the development of disability. However, there are few epidemiological studies investigating the association between vitamin D deficiency and the incidence of disability. OBJECTIVES: We aimed to assess whether vitamin D deficiency is associated with the incidence of disability in basic activities of daily living (BADL) and to verify whether there are sex differences in this association. METHODS: A 4-y follow-up study was conducted involving individuals aged 50 y or older who participated in ELSA (English Longitudinal Study of Ageing). The sample consisted of 4814 participants free of disability at baseline according to the modified Katz Index. Vitamin D was assessed by serum 25-hydroxyvitamin D [25(OH)D] concentrations and the participants were classified as sufficient (>50 nmol/L), insufficient (>30 to ≤50 nmol/L), or deficient (≤30 nmol/L). Sociodemographic, behavioral, and clinical characteristics were also investigated. BADL were re-evaluated after 2 and 4 y of follow-up. The report of any difficulty to perform ≥1 BADL was considered as an incident case of disability. Poisson models stratified by sex and controlled for sociodemographic, behavioral, and clinical characteristics were carried out. RESULTS: After 4-y follow-up, deficient serum 25(OH)D was a risk factor for the incidence of BADL disability in both women (IRR: 1.53; 95% CI: 1.16, 2.03) and men (IRR: 1.44; 95% CI: 1.02, 2.02). However, insufficient serum 25(OH)D was not a risk factor for the incidence of BADL disability in either men or women. CONCLUSIONS: Independently of sex, deficient serum 25(OH)D concentrations were associated with increased risk of incidence of BADL disability in adults >50 y old and should be an additional target of clinical strategies to prevent disability in these populations

Evaluation of the online management course from the perspective of former students

Objective To evaluate the online course from the perspective of e-learners as well as the relation between variables. Method A quantitative, descriptive and exploratory study. Results After three years, the satisfaction rates in the three listed categories presented an average rate higher than 75%. The coefficients indicated a high consistency of the questionnaire. Considering the overall rates in the three years period, the Instructor Performance category presented the highest rate. Strong associations between Self-Assessment and Instructor Performance, Self-Evaluation and Program of the Course and Instructor performance and Program of the course were identified. There was no association between the three categories mentioned with any other variables existing in the study. Conclusion E-learners expressed satisfaction with the course that means favored the interaction and the promotion of collective knowledge in nursing management. Also aspects need to be improved, especially the training of the instructor to mediate discussions and encourage student involvement throughout the course.info:eu-repo/semantics/publishedVersio

Is slowness a better discriminator of disability than frailty in older adults?

Background:The trajectory of incident disability that occurs simultaneously with changes in frailty status, as well as how much each frailty component contributes to this process in the different sexes, are unknown. The objective of this study is to analyse the trajectory of the incidence of disability on basic and instrumental activities of daily living (BADL and IADL) as a function of the frailty changes and their components by sex over time. // Methods: Longitudinal analyses of 1522 and 1548 of the English Longitudinal Study of Ageing study participants without BADL and IADL disability, respectively, and without frailty at baseline. BADL and IADL were assessed using the Katz and Lawton Scales and frailty by phenotype at 4, 8, and 12 years of follow-up. Generalized mixed linear models were calculated for the incidence of BADL and IADL disability, as an outcome, using changes in the state of frailty and its components, as the exposure, by sex in models fully adjusted for sociodemographic, behavioural, biochemical, and clinical characteristics. // Results: The mean age, at baseline, of the 1522 eligible individuals free of BADL and free of frailty was 68.1 ± 6.2 years (52.1% women) and of the 1548 individuals free IADL and free frailty was 68.1 ± 6.1 years (50.6% women). Women who became pre-frail had a higher risk of incidence of disability for BADL and IADL when compared with those who remained non-frail (P < 0.05). Men and women who became frail had a higher risk of incidence of disability regarding BADL and IADL when compared with those who remained non-frail (P < 0.05). Slowness was the only component capable of discriminating the incidence of disability regarding BADL and IADL when compared with those who remained without slowness (P < 0.05). Weakness and low physical activity level in men and exhaustion in women also discriminated the incidence of disability (P < 0.05). // Conclusions: Slowness is the main warning sign of functional decline in older adults. As its evaluation is easy, fast, and accessible, screening for this frailty component should be prioritized in different clinical contexts so that rehabilitation strategies can be developed to avoid the onset of disability

Trypanosoma cruzi high infectivity in vitro is related to cardiac lesions during long-term infection in Beagledogs

Trypanosoma cruzi is a hemoflagelate parasite associated with heart dysfunctions causing serious problems in Central and South America. Beagle dogs develop the symptoms of Chagas disease in humans, and could be an important experimental model for better understanding the immunopathogenic mechanisms involved in the chagasic infection. In the present study we investigated the relation among biological factors inherent to the parasite (trypomastigote polymorphism and in vitro infectivity) and immunoglobulin production, inflammation, and fibrosis in the heart of Beagle dogs infected with either T. cruzi Y or Berenice-78 strains. In vitro infectivity of Vero cells as well as the extension of cardiac lesions in infected Beagle was higher for Y strain when compared to Berenice-78 strain. These data suggested that in vitro infectivity assays may correlate with pathogenicity in vivo. In fact, animals infected with Y strain, which shows prevalence of slender forms and high infectivity in vitro, presented cardiomegaly, inflammation, and fibrosis in heart area. Concerning the immunoglobulin production, no statistically significant difference was observed for IgA, IgM or IgG levels among T. cruzi infected animals. However, IgA together IgM levels have shown to be a good marker for the acute phase of Chagas disease