Understanding and Preventing Falls: Perspectives of First Responders and Older Adults

OBJECTIVE. The objectives of this study were to identify characteristics of older adult fallers in a local community in Marin County, California, examine the perceptions of older adults who contacted a local fire district after a fall, examine the perceptions of first responders from a local fire district regarding falls and fall prevention, explore the degree of depression in older adult fallers, and identify strategies to prevent falls in older adults. METHODS. This research study was an exploratory and retrospective descriptive study that utilized a mixed-method design. The researchers coded narratives from Patient Care Report (PCRs) provided by the fire district and also quantitatively analyzed PCRs to identify characteristics of older adult fallers. Researchers also qualitatively analyzed data gathered from focus groups with older adults and first responders and from phone interviews with community-dwelling older adults to understand their experiences regarding falls and fall prevention. RESULTS. Findings revealed that the majority of fallers were female, at an average age of 81 years old, living at home and alone during the fall. Older adult participants associated falls with negative emotions and expressed a strong desire to maintain their independence despite experiencing falls and fall injuries. First responder participants experienced challenges when communicating with older adult fallers due to cognitive and psychosocial factors. The lack of coordination of services with care facility staff also posed a challenge for first responder participants. CONCLUSION. As the older adult population increases, more older adults will fall and require emergency care from first responders. A collaboration between first responders and occupational therapists to develop and implement effective fall prevention programs for the community can potentially reduce falls and fall-related injuries and costs and improve the health and well-being of older adults

Engaging with First Responders to Prevent Falls in Older Adults

In order to further explore the circumstances of falls in the City of Novato’s older adults age 60 and over Novato Fire Protection District (NFPD) partnered with Dominican University Occupational Therapy Department to conduct a study with the support of County of Marin Mental Health Services Act funds. The following were the goals of this study: Identify fall risk factors in community-dwelling older adults. Understand the experiences of older adults who have fallen. Determine whether there is a relationship between falls and depression in older adults. Examine first responder experiences with fall-related calls in older adults. Identify approaches to prevent falls in older adults. Data sources included Patient Care Reports (PCRs) completed by EMS first responders with narratives coded by the researchers, two focus groups conducted with older adults living in adult care facilities, telephone interviews with four older adults residing at home in the community and a focus group with NFPD first responders

Phosphate, microbiota and ckd

Phosphate is a key uremic toxin associated with adverse outcomes. As chronic kidney disease (CKD) progresses, the kidney capacity to excrete excess dietary phosphate decreases, triggering compensatory endocrine responses that drive CKD-mineral and bone disorder (CKD-MBD). Eventu-ally, hyperphosphatemia develops, and low phosphate diet and phosphate binders are prescribed. Recent data have identified a potential role of the gut microbiota in mineral bone disorders. Thus, parathyroid hormone (PTH) only caused bone loss in mice whose microbiota was enriched in the Th17 cell-inducing taxa segmented filamentous bacteria. Furthermore, the microbiota was required for PTH to stimulate bone formation and increase bone mass, and this was dependent on bacterial production of the short-chain fatty acid butyrate. We review current knowledge on the relationship between phosphate, microbiota and CKD-MBD. Topics include microbial bioactive compounds of special interest in CKD, the impact of dietary phosphate and phosphate binders on the gut microbiota, the modulation of CKD-MBD by the microbiota and the potential therapeutic use of microbiota to treat CKD-MBD through the clinical translation of concepts from other fields of science such as the optimization of phosphorus utilization and the use of phosphate-accumulating organisms.This project has received funding from the European Union’s Horizon 2020 research and innovation programme under grant agreement No 860329, FIS/Fondos FEDER (PI18/01366, PI20/00744, PI19/00815, DTS18/00032, ERA-PerMed-JTC2018 (KIDNEY ATTACK AC18/00064 and PERSTIGAN AC18/00071, ISCIII-RETIC REDinREN RD016/0009), Sociedad Española de Nefrología, FRIAT, Comunidad de Madrid en Biomedicina B2017/BMD-3686 CIFRA2-C

Canagliflozin and Renal Events in Diabetes with Established Nephropathy Clinical Evaluation and Study of Diabetic Nephropathy with Atrasentan: what was learned about the treatment of diabetic kidney disease with canagliflozin and atrasentan?

Albuminuria; Atrasentan; CanagliflozinAlbuminuria; Atrasentan; CanagliflozinaAlbuminúria; Atrasentan; CanagliflozinaIn April 2019, two major Phase 3 randomized clinical trials were published that assessed primary renal outcomes in diabetic kidney disease (DKD) in type 2 diabetes mellitus (T2DM). The Canagliflozin and Renal Events in Diabetes with Established Nephropathy Clinical Evaluation (CREDENCE) tested an already available antidiabetic drug, canagliflozin, and the Study of Diabetic Nephropathy with Atrasentan (SONAR) tested a novel molecule, the endothelin-1 receptor blocker atrasentan, both on top of renin-angiotensin system blockade. Both trials demonstrated significant nephroprotection in patients with overt DKD (albuminuria >300 mg/g urinary creatinine) for combined primary endpoints of end-stage kidney disease (ESKD), doubling of serum creatinine or death from renal or cardiovascular causes in CREDENCE {hazard ratio [HR] 0.70 [95% confidence interval (CI) 0.59-0.82]} and ESKD and doubling of serum creatinine in SONAR [HR 0.65 (95% CI 0.49-0.88)]. Canagliflozin also decreased the secondary renal endpoint ESKD, doubling of serum creatinine or renal death [HR 0.66 (95% CI 0.53-0.81)], which was similar in nature and impact to the primary endpoint in SONAR. In addition, canagliflozin decreased a secondary endpoint of cardiovascular death or hospitalization for heart failure [HR 0.69 (95% CI 0.57-0.83)], whereas atrasentan had no significant impact on a secondary cardiovascular composite endpoint or on hospital admissions for heart failure and, despite restrictive exclusion criteria, there was a non-significant trend towards more frequent episodes of heart failure. Based on these results, canagliflozin will likely be approved for the indication of treating DKD in T2DM and the estimated glomerular filtration rate threshold for prescribing it will be lifted, whereas the future and place of atrasentan in the treatment of DKD remain unclear.Funded by FIS/Fondos FEDER (PI16/02057, PI16/01814. PI17/00257, ISCIII-RETIC REDinREN RD016/0009), Sociedad Espanola de Nefrología, FRIAT, Comunidad de Madrid en Biomedicina B2017/BMD-3686 CIFRA2-CM. E.P. is a researcher in the Ramón y Cajal Program

Canagliflozin and Renal Events in Diabetes with Established Nephropathy Clinical Evaluation and Study of Diabetic Nephropathy with Atrasentan : what was learned about the treatment of diabetic kidney disease with canagliflozin and atrasentan?

In April 2019, two major Phase 3 randomized clinical trials were published that assessed primary renal outcomes in diabetic kidney disease (DKD) in type 2 diabetes mellitus (T2DM). The Canagliflozin and Renal Events in Diabetes with Established Nephropathy Clinical Evaluation (CREDENCE) tested an already available antidiabetic drug, canagliflozin, and the Study of Diabetic Nephropathy with Atrasentan (SONAR) tested a novel molecule, the endothelin-1 receptor blocker atrasentan, both on top of renin-angiotensin system blockade. Both trials demonstrated significant nephroprotection in patients with overt DKD (albuminuria >300 mg/g urinary creatinine) for combined primary endpoints of end-stage kidney disease (ESKD), doubling of serum creatinine or death from renal or cardiovascular causes in CREDENCE {hazard ratio [HR] 0.70 [95% confidence interval (CI) 0.59-0.82]} and ESKD and doubling of serum creatinine in SONAR [HR 0.65 (95% CI 0.49-0.88)]. Canagliflozin also decreased the secondary renal endpoint ESKD, doubling of serum creatinine or renal death [HR 0.66 (95% CI 0.53-0.81)], which was similar in nature and impact to the primary endpoint in SONAR. In addition, canagliflozin decreased a secondary endpoint of cardiovascular death or hospitalization for heart failure [HR 0.69 (95% CI 0.57-0.83)], whereas atrasentan had no significant impact on a secondary cardiovascular composite endpoint or on hospital admissions for heart failure and, despite restrictive exclusion criteria, there was a non-significant trend towards more frequent episodes of heart failure. Based on these results, canagliflozin will likely be approved for the indication of treating DKD in T2DM and the estimated glomerular filtration rate threshold for prescribing it will be lifted, whereas the future and place of atrasentan in the treatment of DKD remain unclear

Sectorización de la red de agua potable para mejorar la eficiencia del sistema en los distritos de Castilla y Piura

La presente investigación se realizó con el objetivo de sectorizar la red de agua potable para mejorar la eficiencia en los distritos de Castilla y Piura. Para el análisis del sistema se caracterizó la topografía y geología de la zona de estudio a partir del AutoCAD. Se definió la fuente de abastecimiento y la demanda máxima de agua mediante bases de datos de información de pozos, ríos y canales con estudios de calidad de agua mediante el análisis fisicoquímico y microbiológico, así como el censo poblacional y vivienda del año 2018. Para la sectorización de la red de agua potable se aplicó el modelo numérico WaterGEMS versión v8i. Además, se utilizó para el análisis de la serie de datos programas estadísticos SPSS Statistics versión 25. Los principales resultados obtenidos fueron que el relieve es relativamente llano, oscilando los valores de las curvas de nivel desde 27 m.s.n.m. hasta 64 m.s.n.m. y presenta una litología que se clasifica como depósitos aluviales con descripciones de arenas sueltas de origen marino. La fuente de abastecimiento es el canal Daniel Escobar que circula un caudal de 70 m3/s, derivando el agua a la Planta de Tratamiento de Agua Potable Curumuy. El sistema de abastecimiento de agua se proyectó desde el año 2021 hasta el año 2041, generando una demanda máxima de agua potable para el sector I con un caudal máximo horario de 249.19 l/s. En el periodo estático de las dos alternativas de sectorización se seleccionó la más eficaz cuyos parámetros hidráulicos oscilan con presiones entre 10.31 m.c.a. y 32.64 m.c.a. La eficiencia del sistema para los distritos de Castilla, Piura y 26 de octubre, son superiores al 12% hasta el 20.83%. Existiendo mejor indicador de porcentaje de horas en presión inferior al umbral mínimo (I5) para el distrito de Castilla.Tesi

Upravljačko-nastavna iskustva u kontekstu španjolske krize: novi centar stručnog osposobljavanja u području audiovizualne k

One of the European guidelines in the field of education focuses on the efficiency of vocational training as a way to provide solutions for the current international crisis. This paper reports on the analysis of the efficient implementation of a new vocational centre in a special context of social and economic crisis in the north of Spain. As we are dealing with the Vocational Centre of Communication, we have had the opportunity to study the strategies used by media and include them in the new model of education. Some of these features have been described as opposed to traditional methodologies: entertainment, closeness, content repetition, iconic narrative, dramatization, dynamism and simplicity, among others. This experience was organised according to the new legislation that relies on the following new features: links with the production system, a flexible training offer, and the acknowledgment of the right to receive lifelong and permanent learning.U središtu jedne od europskih smjernica u području obrazovanja nalazi se učinkovitost stručnog usavršavanja kao načina rješavanja trenutne međunarodne krize. U ovom radu analizira se učinkoviti rad novog stručnog centra u posebnom kontekstu društvene i ekonomske krize na sjeveru Španjolske. Budući da predstavljamo Stručni centar za komunikaciju, imali smo mogućnost proučiti strategije kojima se koriste mediji i uključiti ih u novi obrazovni model. Opisana su neka od tih obilježja kao suprotnost tradicionalnim metodologijama: zabava, zatvorenost, ponavljanje sadržaja, ikonička naracija, dramatizacija, dinamika i jednostavnost. To je iskustvo organizirano u skladu s novim pravnim propisima koji počivaju na ovim karakteristikama: povezanost sa sustavom proizvodnje, fleksibilna programska ponuda i priznavanje prava na trajno, cjeloživotno učenje

CHK1 expression in gastric cancer is modulated by p53 and RB1/E2F1: Implications in chemo/radiotherapy response

Radiation has a limited but relevant role in the adjuvant therapy of gastric cancer (GC) patients. Since Chk1 plays a critical function in cellular response to genotoxic agents, we aimed to analyze the role of Chk1 in GC as a biomarker for radiotherapy resistance. We analyzed Chk1 expression in AGS and MKN45 human GC cell lines by RT-QPCR and WB and in a small cohort of human patient’s samples. We demonstrated that Chk1 overexpression specifically increases resistance to radiation in GC cells. Accordingly, abrogation of Chk1 activity with UCN-01 and its expression with shChk1 increased sensitivity to bleomycin and radiation. Furthermore, when we assessed Chk1 expression in human samples, we found a correlation between nuclear Chk1 accumulation and a decrease in progression free survival. Moreover, using a luciferase assay we found that Chk1’s expression is controlled by p53 and RB/E2F1 at the transcriptional level. Additionally, we present preliminary data suggesting a posttranscriptional regulation mechanism, involving miR-195 and miR-503, which are inversely correlated with expression of Chk1 in radioresistant cells. In conclusion, Chk1/microRNA axis is involved in resistance to radiation in GC, and suggests Chk1 as a potential tool for optimal stratification of patients susceptible to receive adjuvant radiotherapy after surgeryThis work was supported by Instituto de Salud Carlos III–Fondo de Investigación Sanitaria (PS09/1988 to ISP; PI11-00949, pI014-1495 and Feder Funds to RP); Comunidad Autónoma de Madrid-Universidad Autónoma de Madrid (CCG10-UAM/BIO-5871 to ISP); Fundación Leticia Castillejo Castillo and Ministerio de Ciencia e Innovación (SAF2012-30862 to RSP), Spain

Technological Forecasting of Traditional Knowledge Associated with Babassu

Babassu is a native palm tree from Brazil traditionally used by Indigenous Peoples (IP) and Traditional Communities (TC), in order to produce medicines applied in different treatments. Some of these medicinal applications have been scientifically analyzed in order to prove their pharmacological potentialities and have also been an object of interest for the protection of Intellectual Property Rights. The objective of this work was to carry out the technological forecasting of traditional knowledge associated with babassu related to the treatments applied by traditional medicine and to analyze the indicators connected with to the protection of Intellectual Property Rights. Initially, we conducted a survey of ethnobotanical and ethnopharmacological studies, presenting applications of babassu performed by traditional medicine. Subsequently, we presented a literature review, focused on analyzing the effects of babassu according to the practices of traditional medicine. Finally, we analyzed the records of filed patents made in World Intellectual Property Organization (WIPO), European Patent Office (EPO) and Latin American Base of the European Patent Office (LATIPAT) in relation to previously identified Traditional Knowledge Associated (TKA). There were different types of babassu applications used by traditional medicine, according to the results of the ethnobotanical and ethnopharmacological studies carried out in Brazil. The applications that stood out were related to anti-inflammatory and cicatrizant treatments. Most of the pharmacological research that focused on proving the medicinal potential associated with the use of babassu, analyzed applications in anti-inflammatory and cicatrizant treatments, which mostly demonstrated these potentialities. It was verified that the interests for the protection of Intellectual Property Rights of the TKA with babassu, and the anti-inflammatory and cicatrizant treatments, presented a growth. This study contributes with positive evidence for the medicinal and cosmetic potentialities of babassu presented by traditional medicine. However, it also shows that holders of TKA have not been involved in the processes of protection of Intellectual Property Rights of inventions that apply TKA with babassu. In view of the related conflicts, it is suggested that TKA be valued in management and conservation practices

Título: Arte nuevo de leer, escribir y contar

Autor consta en prelimSign.: [calderon]-3[calderon]4, A-I4, []4, K3-K4, L-M4, []2, N-Q4Las 5 h. de grab. calc.: "Las escribio Gabriel Fdez. Patiño, Cadenas fct.