Intervenciones para adultos con dependencia funcional y sus cuidadores durante la pandemia de COVID-19 / Interventions for functionally dependent adults and their caregivers during the COVID-19 pandemic

La pandemia de COVID-19 ha afectado a la población, perjudicando especialmente a los miembros de aquellos grupos sociales en situación de mayor vulnerabilidad. Estas poblaciones específicas, como aquellas con alguna dependencia funcional, podrían verse más afectadas por los efectos de la pandemia del COVID-19. Por lo tanto, el objetivo de este artículo fue describir las intervenciones para preservar la salud general, mantener la función y la independencia y prevenir la infección por COVID-19 para los adultos con dependencia funcional (ADF). Se realizó una búsqueda sistemática en bases de datos. Se revisaron los títulos y los resúmenes de cada publicación para determinar su relevancia. Dos revisores independientes accedieron a los artículos de texto completo para determinar su elegibilidad después de la selección inicial. Las búsquedas se realizaron en septiembre de 2021 y se actualizaron en enero y julio de 2022. La información encontrada se clasificó en 3 categorías: 1) ADF durante la pandemia de COVID-19; 2) ADF durante la pandemia de COVID-19 según una condición específica (condiciones neurológicas, discapacidades/deficiencias sensoriales y deterioro cognitivo), y 3) Adultos mayores con dependencia funcional. Los adultos con dependencia enfrentaron dificultades y barreras durante la pandemia por COVID-19. Las autoridades de cada país deben garantizar que los ADF tengan acceso a los servicios de rehabilitación en tiempos de crisis sanitaria. Además, es necesario aumentar la capacidad de los servicios de rehabilitación en tiempos de crisis como pandemias. De igual manera, se sugiere el fortalecimiento de estrategias como la telerehabilitación para evitar el deterioro o agravamiento de la funcionalidad de las personas dependientes. (AU)

The COVID-19 pandemic has affected the world population, especially people from social groups in a situation of greater vulnerability among people with some functional dependency. Therefore, the aim of this review was to describe interventions during the pandemic to preserve general health, maintain function and independence, and prevent COVID-19 infection for functionally dependent adults (FDA). A systematic search in databases was carried out. Titles and abstracts of each publication were reviewed for relevance. Full-text articles were accessed by two independent reviewers. The information found was classified into three categories: 1) FDA during the COVID-19 pandemic, 2) FDA during the COVID-19 pandemic according to a specific condition (neurological conditions, sensory disabilities/impairments, and cognitive impairment), and 3) Older adults with functional dependence. The FDAs have faced difficulties and barriers during the COVID-19 pandemic. Strengthening strategies such as telerehabilitation is suggested to avoid deterioration or aggravation of the functionality of dependent people. (AU)

"Nenhuma Pessoa Idosa Merece Passar por Isso": Compreensão da Violência para Mulheres Gerontes / "Ninguna Persona Adulta Mayor Merece Pasar Por Esto": Comprensión de la Violencia para las Mujeres Adultas Mayores / "No Elderly Person Deserves to Go Through This": Understanding Violence Towards Elderly Women

Resumo Introdução: A violência contra idosos é um fenômeno crescente, ocasionando prejuízos à saúde, com diferentes desfechos e consequências às vítimas. A chance de idosas sofrerem-na no âmbito familiar supera a dos homens, sendo o gênero um fator de risco considerável. Objetivo: Analisar a compreensão da violência contra pessoas idosas segundo mulheres gerontes. Metodologia: Pesquisa descritiva com abordagem qualitativa desenvolvida com 22 idosas de uma comunidade no estado da Paraíba, Brasil, escolhidas por conveniência. Utilizou-se para coleta de dados entrevistas semiestruturadas, processadas pelo software Iramuteq, com posterior Análise de Conteúdo. Resultados: Foram evidenciadas cinco classes: ciclo de violência; rede de apoio ao idoso vítima de violência; Vivência de situações violentas; violência financeira; e simbologia da violência na sociedade, as quais denotam compreensão da violência envolvendo os diferentes tipos. Apoiam-se nos fatores da vivência familiar, cultura e outros, consubstanciando o profissional de saúde como fundamental para o desfecho. O gênero influenciou no que concerne ao olhar lançado sobre a violência física e psicológica, bem como na relevância dada às equipes de saúde para identificação de ocorrências e prevenção de possíveis danos. Conclusão: Os diversos tipos de violência contra a pessoa idosa foram reconhecidos, incluindo fatores individuais, comunitários e sociais no ciclo violento. Além disso, associaram o envelhecimento a maior suscetibilidade para sofrer violência, independente da tipologia. Destaca-se a potencialidade do serviço de saúde na assistência à pessoa idosa vítima de violência, elucidando casos e atuando precocemente para interrupção dos ciclos perpetrados, exigindo a necessidade constante de atualização profissional para lidar com situações detectadas.

Resumen Introducción: La violencia contra las personas adultas mayores es un fenómeno creciente, que causa daños a la salud, con diferentes desenlaces y consecuencias para las víctimas. La posibilidad de que las mujeres adultas mayores la sufran en el ámbito familiar supera la de los hombres, siendo el género un factor de riesgo considerable. Objetivo: Analizar la comprensión de la violencia contra las personas mayores según las mujeres adultas mayores. Metodología: Investigación descriptiva con enfoque cualitativo desarrollada con 22 mujeres adultas mayores de una comunidad en el estado de Paraíba, Brasil, elegidas por conveniencia. Para la recolección de datos, se utilizaron entrevistas semiestructuradas, procesadas por el software Iramuteq, con posterior análisis de contenido. Resultados: Se evidenciaron cinco tipos de violencia: ciclo de la violencia, red de apoyo población adulta mayor víctima de violencia, experimentar situaciones violentas, violencia financiera y simbología de la violencia en la sociedad, que denotan la comprensión de la violencia de diferentes tipos. Estas ideas están respaldadas en los factores de la experiencia familiar, la cultura y otros, donde la persona profesional de la salud se identifica como fundamental para el cuidado y apoyo. El género influyó en la mirada lanzada sobre la violencia física y psicológica, así como en la relevancia dada a los equipos de salud para la identificación de sucesos y la prevención de posibles daños. Conclusión: Se han reconocido los diversos tipos de violencia contra las personas mayores, incluidos los factores individuales, comunitarios y sociales en el ciclo de violencia. Además, asociaron el envejecimiento con una mayor susceptibilidad a sufrir violencia, independientemente de la tipología. Destaca la potencialidad del servicio de salud en la asistencia a la persona mayor víctima de violencia, mediante la identificación de casos y la actuación temprana para la interrupción de los ciclos perpetrados. De manera que, se evidencia la necesidad constante de actualización profesional para hacer frente a situaciones detectadas.

Abstract Introduction: Violence against the elderly is a growing phenomenon, causing damage to health, with different outcomes and consequences to the victims. The possibility of elderly women suffering it in the family context surpasses that of men, with gender being a considerable risk factor. Objective: To analyze the understanding of violence against the elderly according to elderly women. Method: Descriptive research with a qualitative approach developed with 22 elderly women from a community in the state of Paraíba, Brazil, chosen for convenience. The data collection was based on semi-structured interviews, processed by the Iramuteq software, with subsequent Content Analysis. Results: Five classes of violence against the elderly were evidenced: cycle of violence; support network for the elderly victims of violence; experience of violent situations; financial violence; and symbolism of violence in society, which denote an understanding of violence involving the different types. They are based on the factors of family experience, culture, and others, placing the health professional as a fundamental element for care and support. Gender influenced the perspective on physical and psychological violence, as well as the relevance given to health teams for the identification of occurrences and the prevention of possible damage. Conclusion: The various types of violence against the elderly have been recognized, including individual, community, and social factors in the violent cycle. In addition, they associated aging with greater susceptibility to suffering violence, regardless of the typology. It highlights the potential of the health service in assisting the elderly victim of violence, elucidating cases, and acting early to interrupt the cycles perpetrated, requiring the constant need for professional updating to deal with detected situations.

Understanding the implementation and sustainability needs of evidence-based programs for racial and ethnic minoritized older adults in under-resourced communities with limited aging services.

BACKGROUND: Evidence-based programs (EBPs) for older adults effectively improve health outcomes. However, there is a limited understanding of the unique needs of service providers as they consider adopting, implementing, and maintaining programs for older minority adults in low-income communities with limited aging services. METHODS: We conducted semi-structured interviews with key informants of community-based organizations (CBOs) to understand implementation and sustainability needs of CBOs within four racial and ethnically diverse Los Angeles County geographic areas. We performed thematic analysis of interview transcripts. RESULTS: Interviews were conducted with representatives from 25 senior-serving agencies providing aging-related EBPs. CBO representatives reported implementing EBPs in 8 domains: Falls Prevention (68%), Mental Health (64%), Caregiver Health (48%), Chronic Disease Management (48%), Diabetes Management (36%), Arthritis Management (28%), Physical Activity (24%), and Multiple Conditions Management (8%). Themes are presented using the six domains of the Bass and Judge framework for factors impacting successful and sustained EBP implementation. CBOs in low-income and diverse communities described unique challenges with tailoring interventions based on local community context (literacy, language), cultural context, and locally available resources (technology, safe community spaces, transportation) and faced resource-intensive administrative burdens through staff turnover, data collection, sustainable funding, and networking. CONCLUSIONS: Serving racial and ethnic communities has unique challenges that require tailored approaches and additional resources to ensure equitable access to EBPs for all communities. We describe suggestions for enhancing the effective adoption of EBPs among service agencies in under-resourced and diverse aging communities serving populations with aging-related health disparities.

Population dynamics and seasonal migration patterns of Spodoptera exigua in northern China based on 11 years of monitoring data.

Background: The beet armyworm, Spodoptera exigua (Hübner), is an important agricultural pest worldwide that has caused serious economic losses in the main crop-producing areas of China. To effectively monitor and control this pest, it is crucial to investigate its population dynamics and seasonal migration patterns in northern China. Methods: In this study, we monitored the population dynamics of S. exigua using sex pheromone traps in Shenyang, Liaoning Province from 2012 to 2022, combining these data with amigration trajectory simulation approach and synoptic weather analysis. Results: There were significant interannual and seasonal variations in the capture number of S. exigua, and the total number of S. exigua exceeded 2,000 individuals in 2018 and 2020. The highest and lowest numbers of S. exigua were trapped in September and May, accounting for 34.65% ± 6.81% and 0.11% ± 0.04% of the annual totals, respectively. The average occurrence period was 140.9 ± 9.34 days during 2012-2022. In addition, the biomass of S. exigua also increased significantly during these years. The simulated seasonal migration trajectories also revealed varying source regions in different months, primarily originated from Northeast China and East China. These unique insights into the migration patterns of S. exigua will contribute to a deeper understanding of its occurrence in northern China and provide a theoretical basis for regional monitoring, early warning, and the development of effective management strategies for long-range migratory pests.

Association of 8-hydroxy-2'-deoxyguanosine with motoric cognitive risk in elderly Chinese people: RUGAO longevity and aging cross-sectional study.

BACKGROUND: Motor cognitive risk syndrome (MCR) represents a critical pre-dementia and disability state characterized by a combination of objectively measured slow walking speed and subjective memory complaints (SMCs). This study aims to identify risk factors for MCR and investigate the relationship between plasma levels of 8-hydroxy-2'-deoxyguanosine (8-OHdG) and MCR among Chinese community-dwelling elderly populations. METHODS: A total of 1312 participants were involved in this study based on the data of the Rugao Longevity and Aging Study (RuLAS). The MCR was characterized by SMCs and slow walking speed. The SCCs were defined as a positive answer to the question 'Do you feel you have more problems with memory than most?' in a 15-item Geriatric Depression Scale. Slow walking speed was determined by one standard deviation or more below the mean value of the patient's age and gender group. The plasma of 8-OHdG were measured by a technician in the biochemistry laboratory of the Rugao People's Hospital during the morning of the survey. RESULTS: The prevalence of MCR was found to be 7.9%. After adjusting for covariates, significant associations with MCR were observed in older age (OR 1.057; p = 0.018), history of cerebrovascular disease (OR 2.155; p = 0.010), and elevated 8-OHdG levels (OR 1.007; p = 0.003). CONCLUSIONS: This study indicated the elevated plasma 8-OHdG is significantly associated with increased MCR risk in the elderly, suggesting its potential as a biomarker for early detection and intervention in MCR. This finding underscores the importance of monitoring oxidative DNA damage markers in predicting cognitive and motor function declines, offering new avenues for research and preventive strategies in aging populations.

Financial-related discrimination and socioeconomic inequalities in psychological well-being related measures: a longitudinal study.

BACKGROUND: This study examined the prospective association between financial-related discrimination and psychological well-being related measures and assessed the role of financial-related discrimination in explaining socioeconomic inequalities in psychological well-being related measures. METHODS: Data of UK older adults (≥ 50 years) from the English Longitudinal Study of Ageing were used (baseline: Wave 5, 2010/2011; n = 8,988). The baseline total non-pension wealth (in tertiles: poorest, middle, richest) was used as a socioeconomic status (SES) measure. Financial-related discrimination at baseline was defined as participants who reported they had been discriminated against due to their financial status. Five psychological well-being related measures (depressive symptoms, enjoyment of life, eudemonic well-being, life satisfaction and loneliness) were examined prospectively across different follow-up periods (Waves 6, 2012/2013, 2-year follow-up; and 7, 2014/2015, 4-year follow-up). Regression models assessed associations between wealth, financial-related discrimination, and follow-up psychological measures, controlling for sociodemographic covariates and baseline psychological measures (for longitudinal associations). Mediation analysis informed how much (%) the association between wealth and psychological well-being related measures was explained by financial-related discrimination. RESULTS: Participants from the poorest, but not middle, (vs. richest) wealth groups were more likely to experience financial-related discrimination (OR = 1.97; 95%CI = 1.49, 2.59). The poorest (vs. richest) wealth was also longitudinally associated with increased depressive symptoms and decreased enjoyment of life, eudemonic well-being and life satisfaction in both 2-year and 4-year follow-ups, and increased loneliness at 4-year follow-up. Experiencing financial-related discrimination was longitudinally associated with greater depressive symptoms and loneliness, and lower enjoyment of life across follow-up periods. Findings from mediation analysis indicated that financial-related discrimination explained 3-8% of the longitudinal associations between wealth (poorest vs. richest) and psychological well-being related measures. CONCLUSIONS: Financial-related discrimination is associated with worse psychological well-being and explains a small proportion of socioeconomic inequalities in psychological well-being.

Optimizing strategies for slowing the spread of invasive species.

Invasive species are spreading worldwide, causing damage to ecosystems, biodiversity, agriculture, and human health. A major question is, therefore, how to distribute treatment efforts cost-effectively across space and time to prevent or slow the spread of invasive species. However, finding optimal control strategies for the complex spatial-temporal dynamics of populations is complicated and requires novel methodologies. Here, we develop a novel algorithm that can be applied to various population models. The algorithm finds the optimal spatial distribution of treatment efforts and the optimal propagation speed of the target species. We apply the algorithm to examine how the results depend on the species' demography and response to the treatment method. In particular, we analyze (1) a generic model and (2) a detailed model for the management of the spongy moth in North America to slow its spread via mating disruption. We show that, when utilizing optimization approaches to contain invasive species, significant improvements can be made in terms of cost-efficiency. The methodology developed here offers a much-needed tool for further examination of optimal strategies for additional cases of interest.

Additive interaction of family medical history of diabetes with hypertension on the diagnosis of diabetes among older adults in India: longitudinal ageing study in India.

BACKGROUND: The present study aimed to estimate the additive interaction of family history of diabetes and hypertension on the diagnosis of diabetes among individuals aged 45 years and above in India. The coexistence of these two exposures may act synergistically on the risk of diabetes, leading to adverse health outcomes. METHODS: The study utilized the data from the Longitudinal Ageing Study in India (LASI) Wave 1 (2017-2018). The total sample size for the current study was 58,612 individuals aged 45 years and above. Multivariable logistic regression models were employed to determine the individual and joint effect of a family history of diabetes with hypertension on diabetes. An additive model was applied to assess the interaction effect of the family medical history of diabetes with hypertension on the diagnosis of diabetes by calculating three different measures of additive interaction such as the relative excess risk ratio (RERI), attribution proportion due to interaction (AP), and synergy index (S). RESULTS: The prevalence of diabetes was three times higher among individuals with family history of diabetes (27.8% vs. 9.2%) than those without family history. Individuals with family history of diabetes (AOR: 2.47, CI: 2.11 2.89) had 2.47 times higher odds of having diabetes than those without family history. The prevalence of diabetes was significantly higher among individuals with hypertension and family history of diabetes (46.6%, 95% CI: 39.7-53.6) than those without the coexistence of family history of diabetes and hypertension (9.9%, 95% CI: 9.5-10.4), individuals with hypertension and without a family history of diabetes (22.7%, 95% CI: 21.2-24.2), and individuals with family history of diabetes and without hypertension (16.5%, 95% CI: 14.5-18.7). Moreover, the adjusted odds ratio (AOR) of the joint effect between family medical history of diabetes and hypertension on diabetes was 9.28 (95% CI: 7.51-11.46). In the adjusted model, the RERI, AP, and S for diabetes were 3.5 (95% CI: 1.52-5.47), 37% (0.37; 95% CI: 0.22-0.51), and 1.69 (95% CI: 1.31-2.18) respectively, which indicates that there is a significant positive interaction between family history of diabetes and hypertension on the diagnosis of diabetes. The study findings on interaction effects further demonstrate consistent results for two models of hypertension (self-reported hypertension and hypertensive individuals receiving medication) even after adjustment with potential confounding factors on diabetes (self-reported diabetes and individuals with diabetes receiving medication). CONCLUSIONS: The study findings strongly suggest that the interaction of family history of diabetes with hypertension has a positive and significant effect on the risk of diabetes even after adjustment with potential confounding factors. Furthermore, the findings indicate a synergistic effect, emphasizing the importance of considering both family medical history of diabetes and hypertension when assessing diabetes risk and designing preventive strategies or interventions.

Boom-bust population dynamics drive rapid genetic change.

Increasing environmental threats and more extreme environmental perturbations place species at risk of population declines, with associated loss of genetic diversity and evolutionary potential. While theory shows that rapid population declines can cause loss of genetic diversity, populations in some environments, like Australia's arid zone, are repeatedly subject to major population fluctuations yet persist and appear able to maintain genetic diversity. Here, we use repeated population sampling over 13 y and genotype-by-sequencing of 1903 individuals to investigate the genetic consequences of repeated population fluctuations in two small mammals in the Australian arid zone. The sandy inland mouse (Pseudomys hermannsburgensis) experiences marked boom-bust population dynamics in response to the highly variable desert environment. We show that heterozygosity levels declined, and population differentiation (FST) increased, during bust periods when populations became small and isolated, but that heterozygosity was rapidly restored during episodic population booms. In contrast, the lesser hairy-footed dunnart (Sminthopsis youngsoni), a desert marsupial that maintains relatively stable population sizes, showed no linear declines in heterozygosity. These results reveal two contrasting ways in which genetic diversity is maintained in highly variable environments. In one species, diversity is conserved through the maintenance of stable population sizes across time. In the other species, diversity is conserved through rapid genetic mixing during population booms that restores heterozygosity lost during population busts.

Decadal changes in biomass and distribution of key fisheries species on Newfoundland's Grand Banks.

Canadian fisheries management has embraced the precautionary approach and the incorporation of ecosystem information into decision-making processes. Accurate estimation of fish stock biomass is crucial for ensuring sustainable exploitation of marine resources. Spatio-temporal models can provide improved indices of biomass as they capture spatial and temporal correlations in data and can account for environmental factors influencing biomass distributions. In this study, we developed a spatio-temporal generalized additive model (st-GAM) to investigate the relationships between bottom temperature, depth, and the biomass of three key fished species on The Grand Banks: snow crab (Chionoecetes opilio), yellowtail flounder (Limanda ferruginea), and Atlantic cod (Gadus morhua). Our findings revealed changes in the centre of gravity of Atlantic cod that could be related to a northern shift of the species within the Grand Banks or to a faster recovery of the 2J3KL stock. Atlantic cod also displayed hyperaggregation behaviour with the species showing a continuous distribution over the Grand Banks when biomass is high. These findings suggest a joint stock assessment between the 2J3KL and 3NO stocks would be advisable. However, barriers may need to be addressed to achieve collaboration between the two distinct regulatory bodies (i.e., DFO and NAFO) in charge of managing the stocks. Snow crab and yellowtail flounder centres of gravity have remained relatively constant over time. We also estimated novel indices of biomass, informed by environmental factors. Our study represents a step towards ecosystem-based fisheries management for the highly dynamic Grand Banks.

Priorities and barriers for ageing well; results from stakeholder workshops in rural and urban Rwanda.

BACKGROUND: The National Older Person's Policy of 2021 in Rwanda highlights the need for social protection of older populations. However, there is a lack of local knowledge regarding the priorities and challenges to healthy aging faced by older people and their caregivers. OBJECTIVES: This study aimed to identify and compare the needs and priorities of older people and other stakeholders involved in caring for them in rural and urban areas of Rwanda. METHODS: The study was conducted in two locations, Kigali (urban) and Burera district (rural). Each site hosted two separate one-day workshops with older people (≥60 years) and stakeholders (all ages). Discussions were held in plenary and roundtable-groups to generate a list of the top 4 prioritized responses on areas of importance, priorities/enablers to be addressed, and obstacles to living a healthy and active life for older people. The research team identified similarities between stakeholder and older people's responses in each area and a socio-ecological model was used to categorize findings. RESULTS: There were substantial differences in responses between rural and urban areas and between older people and stakeholders. For each question posed, in each rural or urban area, there was only agreement between stakeholders and older people for a maximum of one response. Whereas, when comparing responses from the same participant groups in urban or rural settings, there was a maximum agreement of two responses, with two questions having no agreement in responses at all. Responses across all discussion-areas were mostly categorized within the Societal level, with Individual, Relationship, and Environment featuring less frequently. CONCLUSION: This study highlights the need for contextually curated interventions to address the concerns of older adults and their caregivers in rural and urban settings. An inclusive and multidimensional approach is needed to conquer the barriers that impede healthy aging, with input from various stakeholders.

The Demographic-Wealth model for cliodynamics.

Cliodynamics is a still a relatively new research area with the purpose of investigating and modelling historical processes. One of its first important mathematical models was proposed by Turchin and called "Demographic-Fiscal Model" (DFM). This DFM was one of the first and is one of a few models that link population with state dynamics. In this work, we propose a possible alternative to the classical Turchin DFM, which contributes to further model development and comparison essential for the field of cliodynamics. Our "Demographic-Wealth Model" (DWM) aims to also model link between population and state dynamics but makes different modelling assumptions, particularly about the type of possible taxation. As an important contribution, we employ tools from nonlinear dynamics, e.g., existence theory for periodic orbits as well as analytical and numerical bifurcation analysis, to analyze the DWM. We believe that these tools can also be helpful for many other current and future models in cliodynamics. One particular focus of our analysis is the occurrence of Hopf bifurcations. Therefore, a detailed analysis is developed regarding equilibria and their possible bifurcations. Especially noticeable is the behavior of the so-called coexistence point. While changing different parameters, a variety of Hopf bifurcations occur. In addition, it is indicated, what role Hopf bifurcations may play in the interplay between population and state dynamics. There are critical values of different parameters that yield periodic behavior and limit cycles when exceeded, similar to the "paradox of enrichment" known in ecology. This means that the DWM provides one possible avenue setup to explain in a simple format the existence of secular cycles, which have been observed in historical data. In summary, our model aims to balance simplicity, linking to the underlying processes and the goal to represent secular cycles.

Asociación de fuerza prensil y extensores de rodilla con estado nutricional de adultos mayores pertenecientes a la comunidad / Association of grip strength and knee extensors with nutritional status of community-dwelling older adults

Antecedentes y objetivo: Determinar la asociación de fuerza prensil de mano y extensores de rodilla con el estado nutricional de adultos mayores de la comunidad. Material y métodos: Estudio observacional transversal. Se analizó peso y talla de 847 adultos mayores según índice de masa corporal y se clasificaron en cuatro categorías nutricionales según el Ministerio de Salud de Chile. Se evaluó la fuerza prensil de mano y extensores de rodilla para ambas extremidades. La fuerza fue normalizada por masa corporal y se utilizó la correlación de Spearman entre índice de masa corporal y fuerza muscular. Resultados: La muestra fue de 582 mujeres y 265 hombres con edad promedio de 71,72±7,09. Las mujeres presentaron un índice de masa corporal de 30,03±5,48 y los hombres 27,64±4,05, la categoría más numerosa fue normopeso (n = 288) y la menor bajo peso (n = 74). La fuerza prensil de mano presentó mayor correlación que extensores de rodilla, específicamente, fuerza prensil de mano derecha (r: -0,40). La mayor correlación y significancia la presentó la categoría obesa para todas las mediciones de fuerza, resultando la fuerza prensil de mano derecha como la más alta (r: -0,29). Conclusiones: El aumento del estado nutricional de los adultos mayores influye negativamente sobre la fuerza muscular. La mejor asociación entre índice de masa corporal y fuerza muscular fue la prensión de mano derecha. Resalta el hallazgo del aumento de la esperanza de vida a medida que disminuye el IMC de la muestra. Futuros estudios deberían generar percentiles y valores normalizados en población chilena.(AU)

Aim: To determine the association of hand grip strength and knee extensor strength with the nutritional status of community-dwelling older adults. Material and methods: Observational cross-sectional study. Weight and height of 847 older adults were analyzed according to body mass index and classified into four nutritional categories according to the Chilean Ministry of Health. Hand grip and knee extensors strength for both extremities were evaluated. Strength was normalized by body mass. Spearman's correlation between body mass index and muscle strength was used. Results: The sample was 582 women, 265 men and an average age of 71.72±7.09. The women had a BMI of 30.03±5.48 and the men of 27.64 ± 4.05, the most numerous category was normal weight (n = 288) and the lowest low weight (n = 74). Hand grip strength presented a higher correlation than knee extensors, specifically, right hand grip strength (r: −0.40). The highest correlation and significance were presented by the obese category for all strength measurements, with right hand grip strength being the highest (r: −0.29). Conclusions: The increase in the nutritional status of older adults has a negative influence on muscle strength. The best association between body mass index and muscle strength was the right hand grip. The finding of the increase in life expectancy as the nutritional status of the sample decreases stands out. Future studies are needed to generate percentiles and normalized values in the Chilean population.(AU)

Condición física, clínica y fragilidad de adultos mayores en Cali, Colombia / Physical and clinical condition and fragility of older adults in Cali, Colombia

Introducción: A nivel mundial el envejecimiento de la población ha sido un tema de interés a investigar, debido a la carga de morbimortalidad y los costos en salud que ocasiona. Así, resulta relevante indagar sobre aquellos aspectos que hacen más vulnerables a los adultos mayores. Objetivo: Comparar la condición física y clínica según la fragilidad en adultos mayores de Cali, Colombia. Materiales y métodos: Estudio descriptivo transversal en adultos mayores de la ciudad de Cali, Colombia. El estudio tuvo aval ético institucional y todos los adultos mayores aceptaron participar firmando el consentimiento informado. Se usó la batería corta de desempeño físico (SPPB), y se compararon variables sociodemográficas, físicas y clínicas. y por nivel de fragilidad en vigoroso, prefrágil y frágil. Resultados: Se vincularon 470 adultos mayores con una edad promedio de 71,15±7,50 años, y en su mayoría del género femenino. Se presentaron diferencias estadísticamente significativas con un valor de p≤0,05 en la edad, estado socioeconómico, comuna, enfermedad, índice de masa corporal, actividad física, desempeño físico y riesgo de caídas; presentando mayor compromiso el grupo de fragilidad. Conclusión: El grupo de adultos mayores clasificados como frágiles presentaban menor condición física y clínica comparado con los grupos pre-frágiles y vigorosos. (AU)

Introduction: Worldwide, the aging of the population has been a topic of interest to investigate, due to the burden of morbidity and mortality and the health costs it causes. Thus, it is relevant to investigate those aspects that make older adults more vulnerable. Objective: To compare the physical and clinical condition according to frailty in older adults from Cali, Colombia. Materials and methods: Cross-sectional descriptive study in older adults from the city of Cali, Colombia. The study had institutional ethical endorsement and all the older adults agreed to participate by signing the informed consent. The short physical performance battery (SPPB) was used, and sociodemographic, physical and clinical variables and by level of frailty were compared in vigorous, pre-frail and frail. Results: Four hundred and seventy older adults with an average age of 71.15±7.50 years and mostly female were enrolled. There were statistically significant differences, P≤0.05 in age, socioeconomic status, commune, disease, body mass index, physical activity, physical performance, and risk of falls. The fragility group presented greater compromise. Conclusion: The group of older adults classified as frail had a lower physical and clinical condition compared to the pre-frail and vigorous groups. (AU)

Variaciones de las células de cuadrícula y de posicionamiento de la corteza entorrinal y del giro dentado de 6 humanos de 56 a 87 años / Variations of the grid and place cells in the entorhinal cortex and dentate gyrus of 6 individuals aged 56 to 87 years

Introducción: La relación entre la corteza entorrinal y el hipocampo ha sido estudiada por diferentes autores, que han destacado la importancia de las células de cuadrícula, las células de posicionamiento y la conexión trisináptica en los procesos que regulan: la persistencia de la memoria espacial, explícita y reciente, y su posible afección con el envejecimiento. Objetivo: Observar si existen diferencias en el tamaño y número de células de cuadrícula contenidas en la lámina iii de la corteza entorrinal y en la capa granular del giro dentado del hipocampo de pacientes mayores. Métodos: Realizamos estudios posmortem del cerebro de 6 sujetos de edades comprendidas entre los 56 y 87 años. Los cortes de cerebros que contenían el giro dentado del hipocampo y la corteza entorrinal adyacente se tiñeron con el método de Klüver-Barrera, después se midió, mediante el programa Image J, el área neuronal individual, el área neuronal total, así como el número de neuronas, contenidas en cuadrículas rectangulares a nivel de la lámina iii de la corteza entorrinal y la lámina ii del giro dentado y se llevó a cabo un análisis estadístico. Resultados: Se ha observado una reducción de la población celular de la capa piramidal externa de la corteza entorrinal, así como de las neuronas de la capa granular del giro dentado relacionada con el envejecimiento. Conclusión: Nuestros resultados indican que el envejecimiento produce una disminución en el tamaño y la densidad neuronal en las células de cuadrícula de la corteza entorrinal y de posicionamiento del giro dentado.(AU)

Introduction: The relationship between the entorhinal cortex and the hippocampus has been studied by different authors, who have highlighted the importance of grid cells, place cells, and the trisynaptic circuit in the processes that they regulate: the persistence of spatial, explicit, and recent memory and their possible impairment with ageing. Objective: We aimed to determine whether older age causes changes in the size and number of grid cells contained in layer III of the entorhinal cortex and in the granular layer of the dentate gyrus of the hippocampus. Methods: We conducted post-mortem studies of the brains of 6 individuals aged 56-87 years. The brain sections containing the dentate gyrus and the adjacent entorhinal cortex were stained according to the Klüver-Barrera method, then the Image J software was used to measure the individual neuronal area, the total neuronal area, and the number of neurons contained in rectangular areas in layer III of the entorhinal cortex and layer II of the dentate gyrus. Statistical analysis was subsequently performed. Results: We observed an age-related reduction in the cell population of the external pyramidal layer of the entorhinal cortex, and in the number of neurons in the granular layer of the dentate gyrus. Conclusion: Our results indicate that ageing causes a decrease in the size and density of grid cells of the entorhinal cortex and place cells of the dentate gyrus.(AU)

Functionality and loneliness in older people: Model of mediation by positive affect / Funcionalidad y soledad en personas mayores: Modelo de mediación por el afecto positivo

Objetivo: La soledad se asocia a la discapacidad funcional en la población mayor, aunque se sabe poco sobre el papel de la afectividad en esta relación. Nos proponemos explorar el efecto mediador de la afectividad en la relación entre funcionalidad y soledad, controlando el efecto de las variables relevantes. Métodos: Se administró la Escala de Soledad de la Universidad de California-16, la Escala de Funcionalidad Geriátrica, las Escalas de Afecto Positivo y Negativo-14 y la Escala de Depresión Geriátrica-8 a 489 adultos mayores (65–100 años), 428 de residencias geriátricas y 61 de la comunidad. Resultados: Los residentes en una institución, mujeres, viudos, con baja educación, más discapacidad funcional, más afecto negativo, menos afecto positivo y más síntomas depresivos reportaron más soledad. Controlando el efecto de los síntomas depresivos, género, situación residencial, estado civil y educación, solo el afecto positivo medió, parcialmente, la relación entre funcionalidad y soledad. Conclusión: Se sugieren intervenciones para aumentar la concienciación por parte de los adultos mayores en los perfiles personalizados de afecto positivo, aliviando así los sentimientos de soledad en los que sufren limitaciones funcionales (especialmente mujeres, con síntomas depresivos, viudos, residiendo en una institución y con bajo nivel educativo).(AU)

Objective: Research has shown that loneliness is associated with functional disability in the older population. However, little is known about the role of affectivity in this relationship. The present study explored a mediation model in which affectivity was hypothesized to mediate the re-lationship between functionality and loneliness, controlling for the effect of relevant variables.Methods:The University of California Loneliness Scale-16 items, Geriatric Functionality Scale, Positive and Negative AffectSchedule-14, and Geriatric Depression Scale-8 were administered to 489 old adults (65–100 years old), 428 from social care homes (SCH), and 61 from the community.Results:Those from SCH, women, widowed, withlow education, more functional disability, more negative affect, less posi-tive affect, and more depressive symptoms reported more loneliness. Con-trolling for the effect of depressive symptoms, gender, residential status, marital status, and education, only positive affect mediated, partially, the relationship between functionality and loneliness.Conclusion:We suggest implementing interventions that increase older adults' insights in personal-ized patterns of positive affect and, consequently, ease feelings of loneli-ness in older people suffering from functional limitations (especially wom-en, with depressive symptoms, widowed, residing in an institution, and with low educational level).(AU)

EXECUTIVE FUNCTIONS IN YOUNG ADULTS AGED 19 TO 24 YEARS WITH BREAST CANCER: AN EXPLORATORY REVIEW OF THE LITERATURE BETWEEN 2015 AND 2020 / FUNCIONES EJECUTIVAS EN ADULTOS JÓVENES DE 19 A 24 AÑOS CON CÁNCER DE MAMA: REVISIÓN EXPLORATORIA DE LITERATURA ENTRE 2015 Y 2020

With the growth and aging of the population, along with economic growth and changes in lifestyles associated with increased quality of life, the main burden of disease shifted from infectious diseases to noncommunicable and complex diseases. However, it is cancer that has increased its incidence in the world population, especially in low- and middle-income countries, where 70% of cancer deaths occur.  The research is articulated to sustainable development goal three, in particular on the effect of cancer on cognitive functioning, because cancer pain impairs cognitive functioning. A simple review for executive functions and breast cancer in PROSPERO indicated an absence of reviews on this topic. Reason why, our aim is to describe executive functions and treatment effect by chemotherapy/radiotherapy in young adult breast cancer patients between 2015 and 2020 in the scientific literature. Materials and methods: exploratory literature review according to PRISMA protocol for exploratory reviews. Articles published in Scopus, PubMed, ScienceDirect, scielo, google academic, in Spanish, English, French. With the keywords: ("Executive Function") AND ("Neoplasms") OR "breast cancer" OR "Drug Therapy," AND ("Young Adult"), searches were performed until February 4, 2020. Results: 16 articles included in the review. Clinical and methodological heterogeneity was found on patients' executive functions and treatment. However, we did find executive function impairment among patients assessed by both treatment and cancer. Conclusions: A systematic review on the subject and meta-analysis are suggested to identify the effect size, accompanied by the statistical evidence identified in the studies. Colombia could investigate this topic because there is no Colombian research.

Con el crecimiento y envejecimiento de la población, junto al crecimiento económico y los cambios en los estilos de vida asociados al incremento en la calidad de vida, la principal carga de morbilidad pasó de las enfermedades infecciosas a las no transmisibles y complejas. Sin embargo, es el cáncer incrementó su incidencia en la población mundial, especialmente en países de ingresos bajos y medios, dónde el 70% de las muertes por cáncer se presentan.  La investigación se articula al objetivo de desarrollo sostenible tres, en particular sobre el efecto del cáncer sobre el funcionamiento cognitivo, debido a que el dolor por cáncer deteriora el funcionamiento cognitivo. Una revisión sencilla por funciones ejecutivas y cáncer de mama en PROSPERO indicó una ausencia de revisiones en este tema. Razón por la cual, nuestro objetivo es describir las funciones ejecutivas y el efecto del tratamiento por quimioterapia/radioterapia en pacientes con cáncer de mama en adultos jóvenes entre 2015 y 2020 en la literatura científica. Materiales y métodos: Revisión exploratoria de literatura según protocolo PRISMA para revisiones exploratorias. Artículos publicados en Scopus, PubMed, ScienceDirect, scielo, google académico, en idioma español, inglés, francés. Con las palabras clave: ("Executive Function") AND ("Neoplasms") OR "breast cancer" OR "Drug Therapy," AND ("Young Adult"), las búsquedas se realizaron hasta el 4 de febrero de 2020. Resultados: 16 artículos incluidos en la revisión. Se encontró heterogeneidad clínica y metodológica sobre las funciones ejecutivas de los pacientes y el tratamiento. Sin embargo, sí se encontró afectación de funciones ejecutivas entre los pacientes evaluados tanto por el tratamiento cómo por el cáncer. Conclusiones: Se sugiere una revisión sistemática sobre el tema y meta-análisis para identificar el tamaño del efecto, acompañado de la evidencia estadística identificada en los estudios. Colombia podría investigar sobre esta temática debido a que no hay investigaciones colombianas.

Com o crescimento e o envelhecimento da população, juntamente com o desenvolvimento económico e as mudanças nos estilos de vida associadas ao aumento da qualidade de vida, o principal fardo da doença mudou de doenças infecciosas para doenças não transmissíveis e complexas. No entanto, é o câncer que aumentou a sua incidência na população mundial, especialmente nos países de baixa e média renda, onde 70% das mortes por câncer ocorrem. A pesquisa está articulada com o Objectivo de Desenvolvimento Sustentável 3, em particular sobre o efeito do câncer sobre o funcionamento cognitivo, porque a dor do cancro prejudica a função cognitiva. Uma simples revisão para funções executivas e câncer de mama em PROSPERO indicou uma ausência de comentários sobre este tópico. A razão pela qual, nosso objetivo é descrever as funções executivas e o efeito do tratamento por quimioterapia/radioterapia em pacientes jovens adultos com câncer de mama entre 2015 e 2020 na literatura científica. Materiais e métodos: revisão da literatura exploratória de acordo com o protocolo PRISMA para revisões exploratórias. Artigos publicados em Scopus, PubMed, ScienceDirect, scielo, google academic, em espanhol, inglês, francês. Com as palavras-chave: ("Função Executiva") E ("Neoplasmas") OU "câncer de mama" OU" Terapia de drogas," E ("Jovem Adulto"), as pesquisas foram realizadas até 4 de fevereiro de 2020. Resultados: 16 artigos incluídos na revisão. Foi encontrada heterogeneidade clínica e metodológica nas funções executivas e no tratamento dos pacientes. No entanto, descobrimos que a função executiva foi prejudicada entre os pacientes avaliados tanto pelo tratamento como pelo câncer. Conclusões: Sugere-se uma revisão sistemática do assunto e meta-análise para identificar o tamanho do efeito, acompanhada das provas estatísticas identificadas nos estudos. A Colômbia poderia investigar este assunto porque não há pesquisa colombiana.

Theoretical considerations and empirical predictions of the pharmaco- and population dynamics of heteroresistance.

Antibiotics are considered one of the most important contributions to clinical medicine in the last century. Due to the use and overuse of these drugs, there have been increasing frequencies of infections with resistant pathogens. One form of resistance, heteroresistance, is particularly problematic; pathogens appear sensitive to a drug by common susceptibility tests. However, upon exposure to the antibiotic, resistance rapidly ascends, and treatment fails. To quantitatively explore the processes contributing to the emergence and ascent of resistance during treatment and the waning of resistance following cessation of treatment, we develop two distinct mathematical and computer-simulation models of heteroresistance. In our analysis of the properties of these models, we consider the factors that determine the response to antibiotic-mediated selection. In one model, heteroresistance is progressive, with each resistant state sequentially generating a higher resistance level. In the other model, heteroresistance is non-progressive, with a susceptible population directly generating populations with different resistance levels. The conditions where resistance will ascend in the progressive model are narrower than those of the non-progressive model. The rates of reversion from the resistant to the sensitive states are critically dependent on the transition rates and the fitness cost of resistance. Our results demonstrate that the standard test used to identify heteroresistance is insufficient. The predictions of our models are consistent with empirical results. Our results demand a reevaluation of the definition and criteria employed to identify heteroresistance. We recommend that the definition of heteroresistance should include a consideration of the rate of return to susceptibility.

Stage-Specific Demographic Effects of Hydrologic Variation in a Stream Salamander.

AbstractWe lack a strong understanding of how organisms with complex life histories respond to climate variation. Many stream-associated species have multistage life histories that are likely to influence the demographic consequences of floods and droughts. However, tracking stage-specific demographic responses requires high-resolution, long-term data that are rare. We used 8 years of capture-recapture data for the headwater stream salamander Gyrinophilus porphyriticus to quantify the effects of flooding and drying magnitude on stage-specific vital rates and population growth. Drying reduced larval recruitment but increased the probability of metamorphosis (i.e., adult recruitment). Flooding reduced adult recruitment but had no effect on larval recruitment. Larval and adult survival declined with flooding but were unaffected by drying. Annual population growth rates (λ) declined with flooding and drying. Lambda also declined over the study period (2012-2021), although mean λ was 1.0 over this period. Our results indicate that G. porphyriticus populations are resilient to hydrologic variation because of compensatory effects on recruitment of larvae versus adults (i.e., reproduction vs. metamorphosis). Complex life cycles may enable this resilience to climate variation by creating opportunities for compensatory demographic responses across stages. However, more frequent and intense hydrologic variation in the latter half of this study contributed to a decline in λ over time, suggesting that increasing environmental variability poses a threat even when demographic compensation occurs.