Functional differences found in the elderly living in the community

Introduction: Successful aging lies in cognitive and functional maintenance, and in the optimal performance of daily tasks that keep the elderly free of disability and dependence. However, there is little evidence for functional differences for gender and age, and how cognitive and physical demands in past working lives can affect them, to design more personalized occupational therapy interventions to prevent functional and cognitive impairment. Method: This observational descrip-tive study evaluated 367 older adults living in a community with subjective memory complaints and scored between 24 and 35 with the Spanish version of the “Mini-Mental State Examination (MEC-35)”. Basic activities of daily living (BADL) were studied with the Barthel Index, while instrumental ADL (IADL) were examined with the Lawton–Brody scale. Functional differences for gender, age, and physico-mental occupation were examined. Results: The significant differences found for gender indicated that men did better in BADL (p = 0.026) and women better performed IADL (p < 0.001). Differences between age groups suggest that the younger group (aged 64–75) obtained better results for BADL (p = 0.001) and IADL (p < 0.001). For physico-mental occupation, statistically significant differences were found only in IADL for mental (p = 0.034) and physical occupation (p = 0.005). Conclusions: Gender, age, and the cognitive and physical demands of occupational stages, can be important predictors of cognitive and functional impairment. These results can be generalized to other health centers in the province and to other Spanish Autonomous Communities because their socio-demographic variables are similar. It would be interesting to carry out multimodal personalized interventions that consider the factors that might affect functional impairment to preserve personal autonomy. © 2021 by the authors. Licensee MDPI, Basel, Switzerland

An evaluation of undergraduate student nurses' gameful experience whilst playing a digital escape room as part of a FIRST year module: a cross-sectional study

The circumstances arising from the COVID-19 pandemic have accelerated the use of digital teaching and learning in health professions education. Digital gamification-based teaching and learning activities are innovative and versatile tools for the acquisition of professional competencies in higher education, which can be used on a range of topics and can be supplemental to other teaching methods

Determination of the high-pressure crystal structure of BaWO4 and PbWO4

We report the results of both angle-dispersive x-ray diffraction and x-ray absorption near-edge structure studies in BaWO4 and PbWO4 at pressures of up to 56 GPa and 24 GPa, respectively. BaWO4 is found to undergo a pressure-driven phase transition at 7.1 GPa from the tetragonal scheelite structure (which is stable under normal conditions) to the monoclinic fergusonite structure whereas the same transition takes place in PbWO4 at 9 GPa. We observe a second transition to another monoclinic structure which we identify as that of the isostructural phases BaWO4-II and PbWO4-III (space group P21/n). We have also performed ab initio total energy calculations which support the stability of this structure at high pressures in both compounds. The theoretical calculations further find that upon increase of pressure the scheelite phases become locally unstable and transform displacively into the fergusonite structure. The fergusonite structure is however metastable and can only occur if the transition to the P21/n phases were kinetically inhibited. Our experiments in BaWO4 indicate that it becomes amorphous beyond 47 GPa.Comment: 46 pages, 11 figures, 3 table

La medicina rural: una visión mirando al futuro

The management of any large building stock with limited resources poses a problem of prioritization of refurbishment actions. Also, available technical information about the building stock is often incomplete and the process of standardization and updating is expensive and time consuming. Some public owners are developing preliminary BIM models of their stock, but they are willing to limit the complexity of the models within the lowest amount of information required for management and maintenance, so as to make that process affordable. Indeed, administrations are challenged by their duty relative to planning regular maintenance and operation of buildings, because of the legislation in force, which requires monitoring of their facilities. For the reasons stated above, this paper presents a decision support tool that can help prioritize refurbishment actions on large building assets. To this purpose, many requirements must be jointly considered in this examination, each requirement being assessed by means of one or several indicators. Then the indicators are compared one another, according to a multi-criteria approach, that weighs the several criteria and rank the assets. In order to deal with the extensive and uncertain information that must be managed in this process, indicators are estimated by means of Bayesian Networks. This tool is used first to assess the technical indicators and rank the assets, while marking any facilities not complying with regulations. Then, additional Bayesian Networks are in charge of estimating the budget needed to upgrade non-compliant facilities with minimum legislation requirements. The outcomes of this research can be used even to assess the level of detail of the information that must be included in BIM models of the stock, in fact acting as guidelines for their development. Finally, the application of the decision tool on a real test case will be presented

Association of self-reported and device-measured sedentary behaviour and physical activity with health-related quality of life among european older adults

Human movement behaviours such as physical activity (PA) and sedentary behaviour (SB) during waking time have a significant impact on health-related quality of life (HRQoL) in older adults. In this study, we aimed to analyse the association between self-reported and device-measured SB and PA with HRQoL in a cohort of community-dwelling older adults from four European countries. A subsample of 1193 participants from the SITLESS trial (61% women and 75.1 ± 6.2 years old) were included in the analysis. The association between self-reported and objective measures of SB and PA with HRQoL were quantified using Spearman’s Rho coefficients. The strength of the associations between self-reported and device-measured PA and SB with self-rated HRQoL (mental composite score, MCS; physical composite score, PCS) were assessed through multivariate multiple regression analysis. Self-reported and device-measured PA and SB levels showed significant but poor associations with PCS (p < 0.05). The association with MCS was only significant but poor with self-reported light PA (LPA) and moderate-to-vigorous PA (MVPA). In conclusion, the findings of this study suggest that both self-reported and device-measured PA of all intensities were positively and significantly associated, while SB was negatively and significantly associated with the PCS of the SF-12. © 2021 by the authors. Licensee MDPI, Basel, Switzerland

A search for point sources of EeV photons

Measurements of air showers made using the hybrid technique developed with the fluorescence and surface detectors of the Pierre Auger Observatory allow a sensitive search for point sources of EeV photons anywhere in the exposed sky. A multivariate analysis reduces the background of hadronic cosmic rays. The search is sensitive to a declination band from -85{\deg} to +20{\deg}, in an energy range from 10^17.3 eV to 10^18.5 eV. No photon point source has been detected. An upper limit on the photon flux has been derived for every direction. The mean value of the energy flux limit that results from this, assuming a photon spectral index of -2, is 0.06 eV cm^-2 s^-1, and no celestial direction exceeds 0.25 eV cm^-2 s^-1. These upper limits constrain scenarios in which EeV cosmic ray protons are emitted by non-transient sources in the Galaxy.Comment: 28 pages, 10 figures, accepted for publication in The Astrophysical Journa

Reconstruction of inclined air showers detected with the Pierre Auger Observatory

We describe the method devised to reconstruct inclined cosmic-ray air showers with zenith angles greater than $60^\circ$ detected with the surface array of the Pierre Auger Observatory. The measured signals at the ground level are fitted to muon density distributions predicted with atmospheric cascade models to obtain the relative shower size as an overall normalization parameter. The method is evaluated using simulated showers to test its performance. The energy of the cosmic rays is calibrated using a sub-sample of events reconstructed with both the fluorescence and surface array techniques. The reconstruction method described here provides the basis of complementary analyses including an independent measurement of the energy spectrum of ultra-high energy cosmic rays using very inclined events collected by the Pierre Auger Observatory.Comment: 27 pages, 19 figures, accepted for publication in Journal of Cosmology and Astroparticle Physics (JCAP