THE HIGH DIAGNOSTIC YIELD OF A GERIATRIC OUTPATIENT CLINIC

Objectives: To determine characteristics of older patients referred to a geriatric outpatient clinic; 2) to determine the prevalence of geriatric syndromes in this population; 3) to identify main recommendations made to referring primary care physicians. Design: Cross-sectional analysis Setting: Outpatient clinic of the service of geriatric medicine at the University of Lausanne Medical Center, Lausanne, Switzerland. Participants: Community-dwelling patients aged 65 and over referred to the clinic. Measurements: Demographics, social, functional and health status data, main diagnoses identified and recommendations made for primary care physicians were collected prospectively. Results: Subjects (N=206, mean age 79.7±7.6 years, 57.3% women, 48.5% living alone, 36.9% receiving formal home care) were referred by primary care physicians (76%), hospitalists (18%), or family members (7%). Main reasons for referral were request for comprehensive assessment, cognitive evaluation, and mobility assessment (45.2%, 26.2%, and 15.5%, respectively). 21.4% of patients are independent in Lawton's Instrumental ADL and 47.1% are independent in Katz's Basic ADL, and 57.3% of patients reported having fallen once or more over the last year. Overall, 76.2% of patients had gait and balance impairment, 72.8% cognitive impairment, 57.3% polypharmacy (≥6 drugs; median 6.5±3.9, IQR 4-8), 54.4% affective disorder, 48.3% osteoporosis, 45.1% urinary incontinence and 33.8% orthostatic hypotension. Polymorbidity (≥6 geriatric syndromes) was present in 58.3% of referred patients. On average, patients received 10.6±4.0 recommendations, including fall prevention interventions (85.2 % of patients: walking aid adaptation in 48.1%, vitamin D prescription in 59.7%, home hazards assessment in 59.2%, and exercise prescription in 53.4%), referral to a memory clinic (45.6%), and treatment modifications (69.9 % of all patients and 81.6% of patients with polypharmacy, mostly psychotropic drugs discontinuation). Conclusions: Polymorbidity was frequent in these older outpatients, with polypharmacy, mobility and cognitive impairments being most prevalent. Outpatient geriatric consultation is a good opportunity to identify geriatric syndromes and propose interventions to prevent or delay functional decline

Monitoramento eletrônico da atividade alimentar de percevejos pelo uso do EPG em soja Bt versus soja convencional.

Orientador: Antônio Ricardo Panizzi

Accounting Profession in the Netherlands, Second Edition Revised; Professional Accounting in Foreign Country Series

https://egrove.olemiss.edu/aicpa_guides/1688/thumbnail.jp

Determination of brazed joint constitutive law by inverse method

An important parameter often neglected for the calculation of residual stresses in brazed ceramic/metal assemblies is the joint constitutive law. In situ camber measurements on a model system (axisymmetric TZM/InCuSil ABA/316L samples) performed using a special vertical dilatometer during the whole brazing thermal cycle are compared with results of FEM calculations based on published filler metal constitutive laws. A strong disagreement is observed. Actual constitutive law of the joint is determined from these measurements using a numerical inverse method. Calculated displacements are fully consistent with experimental ones. True solidification temperature of the joint is determined. The identified constitutive law of the joint exhibits a low flow stress from solidification temperature to 320°C

Coprological study on intestinal helminths in Swiss dogs: temporal aspects of anthelminthic treatment

Coproscopic examination of 505 dogs originating from the western or central part of Switzerland revealed the presence (prevalence data) of the following helminthes: Toxocara canis (7.1%), hookworms (6.9%), Trichuris vulpis (5.5%), Toxascaris leonina (1.3%), Taeniidae (1.3%), Capillaria spp. (0.8%), and Diphyllobothrium latum (0.4%). Potential risk factors for infection were identified by a questionnaire: dogs from rural areas significantly more often had hookworms and taeniid eggs in their feces when compared to urban family dogs. Access to small rodents, offal, and carrion was identified as risk factor for hookworm and Taeniidae, while feeding of fresh and uncooked meat did not result in higher prevalences for these helminths. A group of 111 dogs was treated every 3months with a combined medication of pyrantel embonate, praziquantel, and febantel, and fecal samples were collected for coproscopy in monthly intervals. Despite treatment, the yearly incidence of T. canis was 32%, while hookworms, T. vulpis, Capillaria spp., and Taeniidae reached incidences ranging from 11 to 22%. Fifty-seven percent of the 111 dogs had helminth eggs in their feces at least once during the 1-year study period. This finding implicates that an infection risk with potential zoonotic pathogens cannot be ruled out for the dog owner despite regular deworming four times a yea

Enhancement of the Binding Energy of Charged Excitons in Disordered Quantum Wires

Negatively and positively charged excitons are identified in the spatially-resolved photoluminescence spectra of quantum wires. We demonstrate that charged excitons are weakly localized in disordered quantum wires. As a consequence, the enhancement of the "binding energy" of a charged exciton is caused, for a significant part, by the recoil energy transferred to the remaining charged carrier during its radiative recombination. We discover that the Coulomb correlation energy is not the sole origin of the "binding energy", in contrast to charged excitons confined in quantum dots.Comment: 4 Fig

Characterizing extremal digraphs for identifying codes and extremal cases of Bondy's theorem on induced subsets

An identifying code of a (di)graph $G$ is a dominating subset $C$ of the vertices of $G$ such that all distinct vertices of $G$ have distinct (in)neighbourhoods within $C$. In this paper, we classify all finite digraphs which only admit their whole vertex set in any identifying code. We also classify all such infinite oriented graphs. Furthermore, by relating this concept to a well known theorem of A. Bondy on set systems we classify the extremal cases for this theorem

Two-Stage Rotational Disordering of a Molecular Crystal Surface: C60

We propose a two-stage mechanism for the rotational surface disordering phase transition of a molecular crystal, as realized in C$_{60}$ fullerite. Our study, based on Monte Carlo simulations, uncovers the existence of a new intermediate regime, between a low temperature ordered $(2 \times 2)$ state, and a high temperature $(1 \times 1)$ disordered phase. In the intermediate regime there is partial disorder, strongest for a subset of particularly frustrated surface molecules. These concepts and calculations provide a coherent understanding of experimental observations, with possible extension to other molecular crystal surfaces.Comment: 4 pages, 2 figure

Evidence for distinct polymer chain orientations in KC60 and RbC60

The KC60 and RbC60 polymer phases exhibit contrasting electronic properties while powder diffraction studies have revealed no definite structural difference. We have performed single crystal X-ray diffraction and diffuse scattering studies of these compounds. It is found that KC60 and RbC60 possess different chain orientations about their axes, which are described by distinct space groups Pmnn and I2/m, respectively. Such a structural difference will be of great importance to a complete understanding of the physical properties.Comment: To be published in Phys. Rev. Let