Risk Factors Associated with Falls among Nursing Home Residents: A Case-Control Study

Introduction: To identify factors predictive of falls and enable appropriate management of fall risk it is necessary to understand the behaviour and health conditions of older adults living in nursing homes. Objective: This study had two main objectives. The first was to find significant predictors for falls in older adults living in nursing homes. The second main goal was to build a predictive model to find the best predictors for falls. Methods: Out of 56 nursing homes with the same legal statute, 25 agreed to participate. The sample was randomly selected and only the independent or slight/ moderately dependent participants were included in the study (n = 325). Results: There was a mean of 1.47 ± 0.99 falls (range from 1 to 7) per resident in nursing homes. By using the t test and odds ratio analysis, ten factors related to falls were identified. Through the binary logistic regression, a model was tested identifying four robust predictors: static balance, resorting to emergency services, polypharmacy, and an independent self-care profile. Conclusions: The present study replicated the main results of contemporary research on the risk factors of falls. More importantly, it suggests that the self-care profile model should be taken into account in future studies and early interventions. It is crucial to implement preventive measures consistent with safer environments and to establish an individual plan for integrated activities according to older adults’ health needs.Para identificar os fatores preditivos de quedas e permitir a gestão adequada do seu risco, é necessário compreender o comportamento e as condições clínicas dos idosos. Objetivos: Este estudo teve dois objetivos principais. O primeiro foi encontrar preditores para quedas em idosos que vivem em estruturas residenciais para idosos. O segundo objetivo principal foi construir um modelo preditivo para encontrar os melhores preditores de quedas. Métodos: De um total de 56 estruturas residenciais para idosos contactados, com o mesmo enquadramento legal, 25 aceitaram participar. A amostra foi selecionada aleatoriamente e apenas os participantes independentes ou com um compromisso leve/moderado foram incluídos no estudo (n = 325). Resultados: Registou- se uma média de 1.47 ± 0.99 quedas (variando entre 1 a 7) por participante. Por meio do teste t e da análise de odds ratio, foram identificados dez fatores relacionados com as quedas. Através da regressão logística binária, foi testado um modelo identificando quatro preditores robustos: equilíbrio estatístico, recurso a serviços de emergência, polifarmácia e perfil de autocuidado independente. Conclusões: O presente estudo replicou os principais resultados de pesquisas contemporâneas sobre os fatores de risco para quedas. Mais importante ainda, sugere que o modelo de perfil de autocuidado deve ser levado em consideração em estudos futuros e intervenções precoces. É fundamental implementar medidas preventivas condizentes com ambientes mais seguros e estabelecer um plano individual de atividades integradas de acordo com as necessidades de saúde dos idosos.info:eu-repo/semantics/publishedVersio

Aerobic exercise training induces metabolic benefits in rats with metabolic syndrome independent of dietary changes

OBJECTIVES: We evaluated the effects of aerobic exercise training without dietary changes on cardiovascular and metabolic variables and on the expression of glucose transporter Type 4 in rats with metabolic syndrome. METHODS: Twenty male spontaneously hypertensive rats received monosodium glutamate during the neonatal period. The animals were allocated to the following groups: MS (sedentary metabolic syndrome), MS-T (trained on a treadmill for 1 hour/day, 5 days/week for 10 weeks), H (sedentary spontaneously hypertensive rats) and H-T (trained spontaneously hypertensive rats). The Lee index, blood pressure (tail-cuff system), insulin sensitivity (insulin tolerance test) and functional capacity were evaluated before and after 10 weeks of training. Glucose transporter Type 4 expression was analyzed using Western blotting. The data were compared using analysis of variance (ANOVA) (

Compensatory postural adjustments in na oculus virtual reality environment and the risk of falling in Alzheimer’s disease

Background/Aims Alzheimer's disease (AD) patients have an impaired ability to quickly reweight central sensory dependence in response to unexpected body perturbations. Herein, we aim to study provoked compensatory postural adjustments (CPAs) in a conflicting sensory paradigm with unpredictable visual displacements using virtual reality goggles. Methods We used kinematic time-frequency analyses of two frequency bands: a low-frequency band (LB; 0.3-1.5 Hz; mechanical strategy) and a high-frequency band (HB; 1.5-3.5 Hz; cognitive strategy). We enrolled 19 healthy subjects (controls) and 21 AD patients, divided according to their previous history of falls. Results The AD faller group presented higher-power LB CPAs, reflecting their worse inherent postural stability. The AD patients had a time lag in their HB CPA reaction. Conclusion The slower reaction by CPA in AD may be a reflection of different cognitive resources including body schema self-perception, visual motion, depth perception, or a different state of fear and/or anxiety.The Centro ALGORITMI was funded by the FP7 Marie Curie ITN Neural Engineering Transformative Technologies (NETT) project. The authors have no conflicts of interest to report.info:eu-repo/semantics/publishedVersio

The beneficial effects of exercise in rodents are preserved after detraining: a phenomenon unrelated to GLUT4 expression

<p>Abstract</p> <p>Background</p> <p>Although exercise training has well-known cardiorespiratory and metabolic benefits, low compliance with exercise training programs is a fact, and the harmful effects of physical detraining regarding these adaptations usually go unnoticed. We investigated the effects of exercise detraining on blood pressure, insulin sensitivity, and GLUT4 expression in spontaneously hypertensive rats (SHR) and normotensive Wistar Kyoto rats (WKY).</p> <p>Methods</p> <p>Studied animals were randomized into sedentary, trained (treadmill running/5 days a week, 60 min/day for 10 weeks), 1 week of detraining, and 2 weeks of detraining. Blood pressure (tail-cuff system), insulin sensitivity (kITT), and GLUT4 (Western blot) in heart, gastrocnemius and white fat tissue were measured.</p> <p>Results</p> <p>Exercise training reduced blood pressure (19%), improved insulin sensitivity (24%), and increased GLUT4 in the heart (+34%); gastrocnemius (+36%) and fat (+22%) in SHR. In WKY no change in either blood pressure or insulin sensitivity were observed, but there was an increase in GLUT4 in the heart (+25%), gastrocnemius (+45%) and fat (+36%) induced by training. Both periods of detraining did not induce any change in neither blood pressure nor insulin sensitivity in SHR and WKY. One-week detraining reduced GLUT4 in SHR (heart: -28%; fat: -23%) and WKY (heart: -19%; fat: -22%); GLUT4 in the gastrocnemius was reduced after a 2-week detraining (SHR: -35%; WKY: -25%). There was a positive correlation between GLUT4 (gastrocnemius) and the maximal velocity in the exercise test (r = 0.60, p = 0.004).</p> <p>Conclusions</p> <p>The study findings show that in detraining, despite reversion of the enhanced GLUT4 expression, cardiorespiratory and metabolic beneficial effects of exercise are preserved.</p

Clean-Room lithographical processes for the fabrication of Graphene biosensors

This work is on developing clean-room processes for the fabrication of electrolyte-gate graphene field-effect transistors at the wafer scale for biosensing applications. Our fabrication process overcomes two main issues: removing surface residues after graphene patterning and the dielectric passivation of metallic contacts. A graphene residue-free transfer process is achieved by using a pre-transfer, sacrificial metallic mask that protects the entire wafer except the areas around the channel, source, and drain, onto which the graphene film is transferred and later patterned. After the dissolution of the mask, clean gate electrodes are obtained. The multilayer SiO2/SiNx dielectric passivation takes advantage of the excellent adhesion of SiO2 to graphene and the substrate materials and the superior impermeability of SiNx. It hinders native nucleation centers and breaks the propagation of defects through the layers, protecting from prolonged exposition to all common solvents found in biochemistry work, contrary to commonly used polymeric passivation. Since wet etch does not allow the required level of control over the lithographic process, a reactive ion etching process using a sacrificial metallic stopping layer is developed and used for patterning the passivation layer. The process achieves devices with high reproducibility at the wafer scale.Portuguese Foundation for Science and Technology (FCT) in the framework of the Strategic Funding UIDB/04650/2020, UIDP/00013/2020, and Operational Program Competitiveness and Internationalization (POCI) under project POCI-01-0145-FEDER-031069 (PORTGRAPHE). This work was partially supported by E.U. Horizon 2020 Research and Innovation Programme, under project MULTIMAL (grant #777222). P.D. Cabral acknowledges the Ph.D. grant (SFRH/BD/128579/2017) from the FC

Gestão da pandemia COVID-19 numa Escola de Enfermagem Portuguesa: um relato de experiencia

Introdução: A pandemia COVID-19, decretada pela OMS em março de 2020, originou enormes desafios. As instituições de ensino viram-se confrontadas com a necessidade de tomar medidas para controlar a disseminação da doença. Para manter a comunidade escolar segura, desenvolveu- se um plano de contingência abrangente para que toda a comunidade educativa se sentisse envolvida e apta a seguir as medidas propostas. Objetivos: (I) Descrever o processo de construção de um plano de contingência para responder à situação de pandemia COVID-19, numa Escola Superior de Enfermagem; (II) Descrever a implementação do plano de contingência e sua adequação, em função da evolução da situação pandémica e (III) Descrever os principais desafios encontrados e as estratégias corretivas adotadas. Metodologia: Relato de experiência da construção e implementação do plano de contingência da Instituição. Foi nomeada uma Equipa de Plano de Contingência que elaborou um plano em conformidade com as orientações das diversas entidades reguladoras da saúde, estruturado em quatro tópicos: 1) organização de estruturas; 2) formação; 3) organização das atividades letivas e laborais; 4) acompanhamento e monitorização. Foram, ainda, elaborados vários documentos orientadores de práticas seguras, destinados à readequação do processo ensino-aprendizagem e à segurança dos colaboradores e estudantes. Resultados: Foi instituída uma sala de isolamento para apoio às situações de casos suspeitos, em cada edifício. Reorganizaram-se os espaços para garantir distâncias de segurança; disponibilizaram-se antisséticos em pontos estratégicos para promover a higienização das mãos; adotou-se sinalética para facilitar a circulação das pessoas; alteraram-se dinâmicas internas e procedimentos específicos; organizaram-se sessões de esclarecimento dirigidas aos professores e formação online, para estudantes e funcionários não docentes, e formação presencial para as equipas de limpeza e de apoio e vigilância. Para monitorizar a evolução da pandemia na comunidade escolar, foi criado um processo de notificação/registo de casos. Conclusões: O plano de contingência tem respondido às necessidades da instituição. Mostrou-se dinâmico e flexível, sendo sempre ajustado de acordo com as normas/orientações nacionais e em parceria com as Autoridades de Saúde Locais. As mudanças implementadas mostraram-se eficazes e tiveram a adesão da comunidade escolar, que passou a integrar as novas regras no seu dia a dia. O número muito reduzido de casos com origem na instituição parece ser revelador do sucesso das medidas implementadas.Introduction: The COVID-19 pandemic, decreed by the WHO in March 2020, created enormous challenges. Our Institution was faced with the need to take measures to control the spread of the disease and keep the academic community safe, for which a comprehensive contingency plan was created so that the entire community felt involved and able to follow the proposed measures. Objectives: (I) Describe the process of building a contingency plan to respond to the COVID-19 pandemic situation in a Nursing School; (II) Describe the implementation of the contingency plan and its adequacy, depending on the evolution of the pandemic situation and (III) Describe the main challenges encountered and the corrective strategies adopted. Methodology: Experience report of the construction and implementation of the Institution’s contingency plan. A Contingency Plan Team was appointed that created a plan following the guidelines of the various health regulatory authorities, structured in four topics: 1) organization of structures; 2) training; 3) organization of academic and work activities; 4) follow-up and monitoring. In addition, several guiding documents for safe practices were also prepared, aimed at readjusting the teaching-learning process and the safety of employees. Results: 1) organization of structures: An isolation room was established in each building, Spaces were reorganized to ensure safe distances; antiseptics were distributed; Signals was adopted to make the path; internal dynamics and specific procedures changed. 2) training: Clarification sessions were organized with teachers and online training for students and non-teaching staff, and face-to-face training for cleaning staff and support teams. 3) organization of academic and work activities: plan the beginning and breaks according to the maximum amount of people in the same room, fixed the capacity of each classroom. 4) follow-up and monitoring: a case notification/registration process was created and spread the message for all community on the website and by email. Conclusions: The contingency plan has responded to the Institution› s needs. It was dynamic and flexible, always be adjusted according to national norms/guidelines and in partnership with Local Health Authorities. The implemented changes proved to be effective and supported the entire school community, which started to integrate the new rules into their daily lives. The very low cases report of covid-19 with the beginning in our institution, seems to reveal the success of the implemented measures.info:eu-repo/semantics/publishedVersio

Alternative transmission routes in the malaria elimination era: an overview of transfusion-transmitted malaria in the Americas

Submitted by Janaína Nascimento ([email protected]) on 2019-02-21T11:59:00Z No. of bitstreams: 1 ve_Alho_Regina_etal_INI_2017.pdf: 1190158 bytes, checksum: 8937322faefa31c89eb1bbd2f7d134a3 (MD5)Approved for entry into archive by Janaína Nascimento ([email protected]) on 2019-02-25T11:34:33Z (GMT) No. of bitstreams: 1 ve_Alho_Regina_etal_INI_2017.pdf: 1190158 bytes, checksum: 8937322faefa31c89eb1bbd2f7d134a3 (MD5)Made available in DSpace on 2019-02-25T11:34:33Z (GMT). No. of bitstreams: 1 ve_Alho_Regina_etal_INI_2017.pdf: 1190158 bytes, checksum: 8937322faefa31c89eb1bbd2f7d134a3 (MD5) Previous issue date: 2017Universidade do Estado do Amazonas. Manaus, AM, Brasil / Fundação de Hematologia e Hemoterapia do Amazonas. Manaus, AM, Brasil.Fundação de Medicina Tropical Dr. Heitor Vieira Dourado. Manaus, AM, Brasil.Universidade do Estado do Amazonas. Manaus, AM, Brasil / Fundação de Medicina Tropical Dr. Heitor Vieira Dourado. Manaus, AM, Brasil.Fundação de Hematologia e Hemoterapia do Amazonas. Manaus, AM, Brasil.Universidade do Estado do Amazonas. Manaus, AM, Brasil.Universidade do Estado do Amazonas. Manaus, AM, Brasil / Fundação de Medicina Tropical Dr. Heitor Vieira Dourado. Manaus, AM, Brasil.Sem afiliação.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil / Fundação Oswaldo Cruz. Instituto de Pesquisas Leônidas e Maria Deane. Manaus, AM, Brasil.Universidade do Estado do Amazonas. Manaus, AM, Brasil / Fundação de Medicina Tropical Dr. Heitor Vieira Dourado. Manaus, AM, Brasil.Universidade do Estado do Amazonas. Manaus, AM, Brasil / Fundação de Medicina Tropical Dr. Heitor Vieira Dourado. Manaus, AM, Brasil / Fundação Oswaldo Cruz. Instituto de Pesquisas Leônidas e Maria Deane. Manaus, AM, Brasil.Background: Transfusion-transmitted (TT) malaria is an alternative infection route that has gained little attention from authorities, despite representing a life-threatening condition. There has been no systematic review of this health problem in American countries. The aim of this study was to describe the clinical and epidemiological characteristics of TT malaria in the Americas and identify factors associated with lethality based on the studies published in the literature. Methods: Potentially relevant papers in all languages were retrieved from MEDLINE and LILACS. Additional articles were obtained from reviews and original papers. Publications on screening of candidate blood donors and on surveillance of TT malaria cases were included. Odds ratios with respective 95% confidence intervals (95% CI) were calculated. Epidemiological characteristics of blood donors of TT malaria cases, including a pooled positivity of different tests for malaria diagnosis, were retrieved. Results: A total of 63 publications regarding TT malaria from seven countries were included, from 1971 to 2016. A total of 422 cases of TT malaria were recorded. Most TT malaria cases were in females (62.0%) and 39.5% were in the ≥61 years-old age group. About half of all cases were from Mexico (50.7%), 40.3% from the United States of America (USA) and 6.6% from Brazil. Gyneco-obstetrical conditions (67.3%), surgical procedures (20.6%) and complications from neoplasias (6.1%) were the most common indications of transfusion. Packed red blood cells (RBCs) (50.7%) and whole blood (43.3%) were the blood products mostly associated with TT malaria. Cases were mostly caused by Plasmodium malariae (58.4%), followed by Plasmodium vivax (20.7%) and Plasmodium falciparum (17.9%). A total of 66.6% of cases were diagnosed by microscopy. Incubation period of 2–3 weeks was the most commonly observed (28.6%). Lethality was seen in 5.3% of cases and was associated with living in non-endemic countries, P. falciparum infection and concomitant neoplastic diseases. Conclusion: There is an important research and knowledge gap regarding the TT malaria burden in Latin American countries where malaria remains endemic. No screening method that is practical, affordable and suitably sensitive is available at blood banks in Latin American countries, where infections with low parasitaemia contribute greatly to transmission. Lethality from TT malaria was not negligible. TT malaria needs to be acknowledged and addressed in areas moving toward elimination