El perfil biológico del adulto mayor / The biological profile of the elderly

Actualmente en España estamos ante un cambio progresivo en la pirámide poblacional. La que debería tener forma triangular, está siendo invertida dado el aumento de la esperanza de vida de las personas mayores y las bajas tasas de natalidad del país. Este proceso se denomina “Envejecimiento demográfico” y se acompaña de importantes consecuencias a largo y corto plazo como es el problema de las pensiones.La vejez se trata de una época de cambios, tanto físicos como psicológicos y sociales que confluyen negativamente en una mayor vulnerabilidad a padecer ciertas patologías características de la edad como las enfermedades cerebrovasculares o del corazón. Esto es lo que se conoce como “fragilidad”, una cualidad descriptiva del adulto mayor que se caracteriza por la predisposición del mismo a perder progresivamente su autonomía, convirtiéndose en una persona dependiente de cuidadores para poder llevar a cabo las actividades básicas de la vida diaria. Es por ello, que en numerosas ocasiones acaban ocupando una plaza en las residencias de mayores, las cuales son consideradas ”pequeños hospitales” por disponer de todos los cuidados y atención sanitaria necesaria.Sin embargo, existe un malestar manifiesto entre los profesionales del sector debido a la precariedad a la que se enfrentan. La falta de recursos materiales y los sueldos infravalorados pueden llegar a repercutir en la calidad de la asistencia sanitaria que les prestan a los mayores.Pero en contraposición a los aspectos negativos asociados al envejecimiento, también contiene cuestiones positivas, teniendo en cuenta la amplísima madurez y experiencia con la que se enfrentan y superan las barreras que se les presentan. (AU)

Currently in Spain we are facing a progressive change in the population pyramid. The one that should have a triangular shape, is increasingly inverted given the increase in life expectancy of the elderly and the country’s low birth rates. This process is called “demographic aging” and is accompanied by important consequences in the long and short term, such as the problem of pensions.Old age is associated with a time of changes, both physical and psychologicaland social, which negatively converge in a greater vulnerability to certain pathologies characteristic of age, such as cerebrovascular or heart diseases.This is what is known as “fragility”’, a descriptive quality of the elderly that is characterized by their predisposition to progressively lose their autonomy, becoming a person dependent on caregivers to be able to carry out the basic activities of the daily life. That is why, on numerous occasions, they end up occupying a place in nursing homes, which are considered “small hospitals” because they have all the necessary care and health care. However, there is a clear discomfort among professionals in the sector due to the precariousness they face. The lack of material resources and undervalued salaries can have animpact on the quality of health care provided to the elderly.But in contrast to the negative aspects associated with aging, it also containspositive issues, taking into account the vast maturity and experience with which they face and overcome the barriers that are presented to them. (AU)

Condiciones sociodemográficas ambientales asociadas a perfiles de salud-alimentación entre personas adultas mayores, Córdoba-Argentina / Environmental sociodemographic conditions associated with health-nutrition profiles among elderly people, Córdoba-Argentina

Introducción: Las tendencias demográficas indican que el envejecimiento poblacional no es exclusivo de los países desarrollados. Argentina alcanza el 15,5% de la población adulta mayor. La pandemia por COVID-19 puso en escena la situación de salud pública de esta población, desafiando los sistemas de salud, con impactos desproporcionados en este grupo que sufrió más del 80% de los decesos ocurridos en el país, principalmente en quienes presentaban comorbilidades. Objetivo: Analizar las condiciones sociodemográficas y ambientales que intervienen en el proceso de desarrollo de perfiles de salud y alimentación de la población adulta mayor de Córdoba, Argentina 2020. Metodología: Estudio epidemiológico de corte transversal, de base poblacional, que incluyó 221 personas adultas mayores (≥60 años) mediante muestreo aleatorizado. A través de entrevista estructurada se indagaron datos sobre condiciones sociodemográficas, ambientales, perfiles de salud y alimentación. Resultados: La edad promedio de los participantes fue de 68 años. Un 85% reconoció contaminación barrial, siendo el 38% basurales cercanos al domicilio. El 89% manifestaron al menos una enfermedad no transmisible (ENT) o factor de riesgo asociado y el 66% presentó exceso de peso (IMC≥25kg/m2). La presencia de obesidad (IMC≥30kg/m2) se asoció (OR: 2,05; IC: 1,007-3,922) con el desarrollo de ENT. Solo el 4% de la población cumplió con la recomendación de consumo diario de frutas y verduras. Conclusión: Las características predominantes de perfiles de salud y alimentación asociadas a ENT identificadas, plantean la necesidad de profundizar sobre los determinantes sociales que condicionan el proceso de envejecimiento. (AU)

Introduction: Demographic trends indicate that population aging is not exclusive to developed countries. Argentina reaches 15.5% of the elderly population. The Covid-19 pandemic has brought to the forefront the public health situation of this population, challenging health systems, with disproportionate impacts on this group, which has suffered more than 80% of the deaths in the country, mainly in those with comorbidities. Objective: To analyze the sociodemographic and environmental conditions involved in the process of development of health and nutrition profiles of the elderly people of Córdoba, Argentina 2020. Methodology: Epidemiological, cross-sectional, population-based study that included 221 elderly people (≥60 years old), through random sampling. Data on sociodemographic and environmental conditions, health and dietary profiles were collected through structured interviews. Results: The average age of the participants was 68 years. Eighty-five percent recognized neighborhood contamination, 38% of them being garbage dumps close to their homes. Eighty-nine percent reported at least one non-communicable disease (NCD) or associated risk factor and 66% were overweight (BMI≥25kg/m2). The presence of obesity (BMI≥30kg/m2) was associated (OR=2.05; CI 1.007–3.922) with the development of NCDs. Only 4% of the population complied with the daily fruit and vegetable consumption recommendation. Conclusion: The predominant characteristics of the health and dietary profiles associated with NCDs identified suggest the need to study in depth the social determinants that condition the aging process. (AU)

Modeling potential distribution of newly recorded ant, Brachyponera nigrita using Maxent under climate change in Pothwar region, Pakistan.

Climate change has been discussed as to exert shifts in geographical range of plants, animals or insect species by increasing, reducing or shifting its appropriate climatic habitat. Globally, Pakistan has been ranked at 5th position on the list of countries most vulnerable to climate change in 2020. Climate change has resulted in the losses of biodiversity and alteration in ecosystem as a result of depletion of natural habitats of species in Pakistan as well as in the world. Ants have been regarded as indicators of environmental change and ecosystem processes. Brachyponera nigrita (Emery, 1895) was reported for the first time from Pakistan (Pothwar region). Objective of our studies was to model geographic distribution of newly recorded ant species, B. nigrita based on two representative concentration pathways (RCP) (RCP4.5 and RCP8.5) for 2050s using maximum entropy model (Maxent) in Pakistan. In modeling procedure, 21occurrence records and 8 variables namely Bio4 (Temperature seasonality), Bio8 (Mean temperature of wettest quarter), Bio10 (Mean temperature of warmest quarter), Bio12 (Annual precipitation), Bio13 (Precipitation of wettest month), Bio15 (Precipitation seasonality), Bio17 (Precipitation of driest quarter) and Bio18 (Precipitation of warmest quarter) were used to determine the current and future distributions. Performance of the model was evaluated using AUC (area under curves) values, partial ROC, omission rates (E = 5%) and AICc (Model complexity).The results showed the average AUC value of the model was 0.930, which indicated that the accuracy of the model was excellent. The jackknife test also showed that Bio4, Bio18, Bio17 and Bio15 contributed 98% for the prediction of potential distribution of the species as compared to all other variables. Maxent results indicated that distribution area of B. nigrita under future predicted bioclimatics 2050 (RCP 4.5 and RCP8.5) would be increased in various localities of Pakistan as compared to its current distribution. In Pothwar region, moderately suitable and highly suitable areas of this species would increase by 505.932321km2and 572.118421km2as compared to current distribution under 2050 (RCP 4.5), while under 2050 (RCP 8.5), there would be an increase of 6427.2576km2and 3765.140493km2 respectively in moderately suitable and highly suitable areas of B. nigrita. This species was associated with termites, collembolans and larval stages of different insects. White eggs, creamy white pupae and many workers of this species were observed in a variety of habitats. Unknown nesting ecology, species identification characters supported with micrographs has been given which will help researchers for further ecological studies.

The health and well-being of older women living alone in the United Kingdom and beyond: a scoping review.

In the United Kingdom (UK), women are more likely to live alone in later life. Social factors such as household composition have been shown to affect health and wellbeing as we age. The health and well-being of older women who live alone are of interest to researchers, care providers, health organizations, and policymakers. This article contributes to the literature by detailing a scoping review, establishing the current evidence in this field. The purpose and context of the review are given. The methodology and resulting data are described. Gaps in the literature and implications for practice and research are given.

Encuesta Anual de Hogares 2020: Estructura de la población. Ciudad de Buenos Aires (Informe de resultados, 1604)

El presente informe tiene como objetivo describir la composición de la población que reside en la Ciudad de Buenos Aires (CABA) en base a las variables sexo,edad y lugar de nacimiento. La Ciudad muestra una composición de su población feminizada y envejecida, sin embargo no es homogénea en su interior. Las comunas de la zona Norte son las más envejecidas y por ende las que muestran mayor presencia femenina en su interior, debido a la mayor longevidad de las mujeres. En cambio, las de zona Sur cuentan con mayor cantidad de niñas/os y en conjunto, su índice de masculinidad es más alto que la media de la Ciudad. En las de zona Centro, la estructura de la población se asemeja al total de la Ciudad. Estas diferencias según las distintas divisiones político administrativas y socioespaciales impactan en el nivel de crecimiento de la Ciudad y exponen necesidades específicas relacionadas con la vivienda, salud, seguridad social, mercado de trabajo y educación, entre otras, para cada zona de la Ciudad. En este informe de resultados se difunden las particularidades de la estructura poblacional de la Ciudad de Buenos Aires que surgen de la información obtenida con la Encuesta Anual de Hogares 2020 y se analizan sus características más destacadas. Se incorpora también el análisis de la estructura por zona y condición migratoria. (AU)

La inmigración en la Ciudad de Buenos Aires: Año 2020 (Informe de resultados, 1596)

En este informe de resultados se presenta la composición y características migratorias de la población de la Ciudad de Buenos Aires derivadas de la Encuesta Anual de Hogares 2020 y se analizan los rasgos más destacados del stock de migrantes examinando su aporte a la población de la ciudad por origen migratorio, edad y sexo así como su distribución espacial. El análisis por país de nacimiento pone de manifiesto la importancia de los flujos tradicionales internacionales procedentes de países limítrofes y Perú, junto al dinamismo que adquieren en los últimos años la población oriunda de otros países como es el caso de Venezuela y Colombia. (AU)

Demographic Disparities in Proximity to Certified Stroke Care in the United States.

Background and Purpose: Demographic disparities in proximity to stroke care influence time to treatment and clinical outcome but remain understudied at the national level. This study quantifies the relationship between distance to the nearest certified stroke hospital and census-derived demographics. Methods: This cross-sectional study included population data by census tract from the United States Census Bureau's 2014­2018 American Community Survey, stroke hospitals certified by a state or national body and providing intravenous thrombolysis, and geographic data from a public mapping service. Data were retrieved from March to November 2020. Quantile regression analysis was used to compare relationships between road distance to the nearest stroke center for each census tract and tract-level demographics of age, race, ethnicity, medical insurance status, median annual income, and population density. Results: Two thousand three hundred eighty-eight stroke centers and 71 929 census tracts including 316 995 649 individuals were included. Forty-nine thousand nine hundred eighteen (69%) tracts were urban. Demographic disparities in proximity to certified stroke care were greater in nonurban areas than urban areas. Higher representation of individuals with age ≥65 years was associated with increased median distance to a certified stroke center in nonurban areas (0.51 km per 1% increase [99.9% CI, 0.42­0.59]) but not in urban areas (0.00 km [−0.01 to 0.01]). In urban and nonurban tracts, median distance was greater with higher representation of American Indian (urban: 0.10 km per 1% increase [0.06­0.14]; nonurban: 1.06 km [0.98­1.13]) or uninsured populations (0.02 km [0.00­0.03]; 0.27 km [0.15­0.38]). Each $10 000 increase in median income was associated with a decrease in median distance of 5.04 km [4.31­5.78] in nonurban tracts, and an increase of 0.17 km [0.10­0.23] in urban tracts. Conclusions: Disparities were greater in nonurban areas than in urban areas. Nonurban census tracts with greater representation of elderly, American Indian, or uninsured people, or low median income were substantially more distant from certified stroke care.

The changing health needs of the UK population.

The demographics of the UK population are changing and so is the need for health care. In this Health Policy, we explore the current health of the population, the changing health needs, and future threats to health. Relative to other high-income countries, the UK is lagging on many health outcomes, such as life expectancy and infant mortality, and there is a growing burden of mental illness. Successes exist, such as the striking improvements in oral health, but inequalities in health persist as well. The growth of the ageing population relative to the working-age population, the rise of multimorbidity, and persistent health inequalities, particularly for preventable illness, are all issues that the National Health Service (NHS) will face in the years to come. Meeting the challenges of the future will require an increased focus on health promotion and disease prevention, involving a more concerted effort to understand and tackle the multiple social, environmental, and economic factors that lie at the heart of health inequalities. The immediate priority of the NHS will be to mitigate the wider and long-term health consequences of the COVID-19 pandemic, but it must also strengthen its resilience to reduce the impact of other threats to health, such as the UK leaving the EU, climate change, and antimicrobial resistance.

Estimated Projection of US Cancer Incidence and Death to 2040.

Importance: Coping with the current and future burden of cancer requires an in-depth understanding of trends in cancer incidences and deaths. Estimated projections of cancer incidences and deaths will be important to guide future research funding allocations, health care planning, and health policy efforts. Objective: To estimate cancer incidences and deaths in the United States to the year 2040. Design and Setting: This cross-sectional study's estimated projection analysis used population growth projections and current population-based cancer incidence and death rates to calculate the changes in incidences and deaths to the year 2040. Cancer-specific incidences and deaths in the US were estimated for the most common cancer types. Demographic cancer-specific delay-adjusted incidence rates from the Surveillance, Epidemiology, and End Results Program were combined with US Census Bureau population growth projections (2016) and average annual percentage changes in incidence and death rates. Statistical analyses were performed from July 2020 to February 2021. Main Outcomes and Measures: Total cancer incidences and deaths to the year 2040. Results: This study estimated that the most common cancers in 2040 will be breast (364 000 cases) with melanoma (219 000 cases) becoming the second most common cancer; lung, third (208 000 cases); colorectal remaining fourth (147 000 cases); and prostate cancer dropping to the fourteenth most common cancer (66 000 cases). Lung cancer (63 000 deaths) was estimated to continue as the leading cause of cancer-related death in 2040, with pancreatic cancer (46 000 deaths) and liver and intrahepatic bile duct cancer (41 000 deaths) surpassing colorectal cancer (34 000 deaths) to become the second and third most common causes of cancer-related death, respectively. Breast cancer (30 000 deaths) was estimated to decrease to the fifth most common cause of cancer death. Conclusions and Relevance: These findings suggest that there will be marked changes in the landscape of cancer incidence and deaths by 2040.

Climate change and anthropogenic food manipulation interact in shifting the distribution of a large herbivore at its altitudinal range limit.

Ungulates in alpine ecosystems are constrained by winter harshness through resource limitation and direct mortality from weather extremes. However, little empirical evidence has definitively established how current climate change and other anthropogenic modifications of resource availability affect ungulate winter distribution, especially at their range limits. Here, we used a combination of historical (1997-2002) and contemporary (2012-2015) Eurasian roe deer (Capreolus capreolus) relocation datasets that span changes in snowpack characteristics and two levels of supplemental feeding to compare and forecast probability of space use at the species' altitudinal range limit. Scarcer snow cover in the contemporary period interacted with the augmented feeding site distribution to increase the elevation of winter range limits, and we predict this trend will continue under climate change. Moreover, roe deer have shifted from historically using feeding sites primarily under deep snow conditions to contemporarily using them under a wider range of snow conditions as their availability has increased. Combined with scarcer snow cover during December, January, and April, this trend has reduced inter-annual variability in space use patterns in these months. These spatial responses to climate- and artificial resource-provisioning shifts evidence the importance of these changing factors in shaping large herbivore spatial distribution and, consequently, ecosystem dynamics.

Trends in the epidemiology of inflammatory bowel disease in Colombia by demographics and region using a nationally representative claims database and characterization of inflammatory bowel disease phenotype in a case series of Colombian patients.

ABSTRACT: The incidence of inflammatory bowel disease (IBD) is on the rise in Latin America. The aims of this study were to examine epidemiologic trends of IBD in Colombia by demographics, region, urbanicity, and to describe the IBD phenotype in a large well-characterized Colombian cohort.We used a national database of 33 million adults encompassing 97.6% of the Colombian population in order to obtain epidemiologic trends of IBD using International Classification of Diseases 10codes for adults with ulcerative colitis (UC) and Crohn disease (CD). We calculated the incidence and prevalence of UC and CD from 2010-2017 and examined epidemiologic trends by urbanicity, demographics, and region. We then examined the IBD phenotype (using Montreal Classification), prevalence of IBD-related surgeries, and types of IBD-medications prescribed to adult patients attending a regional IBD clinic in Medellin, Colombia between 2001 and 2017.The incidence of UC increased from 5.59/100,000 in 2010 to 6.3/100,000 in 2017 (relative risk [RR] 1.12, confidence interval (CI) (1.09-1.18), P < .0001). While CD incidence did not increase, the prevalence increased within this period. The Andes region had the highest incidence of IBD (5.56/100,000 in 2017). IBD was seen less in rural regions in Colombia (RR=.95, CI (0.92-0.97), p < .01). An increased risk of IBD was present in women, even after adjusting for age and diagnosis year (RR 1.06 (1.02-1.08), P = .0003). The highest IBD risk occurred in patients 40 to 59 years of age. In the clinic cohort, there were 649 IBD patients: 73.7% UC and 24.5% CD. Mean age of diagnosis in CD was 41.0 years and 39.9 years in UC. UC patients developed mostly pancolitis (43%). CD patients developed mostly ileocolonic disease and greater than a third of patients had an inflammatory, non-fistulizing phenotype (37.7%). A total of 16.7% of CD patients had perianal disease. CD patients received more biologics than UC patients (odds ratio: 3.20, 95% CI 2.19-4.69 P < .001).Using both a national representative sample and a regional clinic cohort, we find that UC is more common in Colombia and is on the rise in urban regions; especially occurring in an older age cohort when compared to Western countries. Future studies are warranted to understand evolving environmental factors explaining this rise.

Past and future potential range changes in one of the last large vertebrates of the Australian continent, the emu Dromaius novaehollandiae.

In Australia, significant shifts in species distribution have occurred with the loss of megafauna, changes in indigenous Australian fire regime and land-use changes with European settlement. The emu, one of the last megafaunal species in Australia, has likely undergone substantial distribution changes, particularly near the east coast of Australia where urbanisation is extensive and some populations have declined. We modelled emu distribution across the continental mainland and across the Great Dividing Range region (GDR) of eastern Australia, under historical, present and future climates. We predicted shifts in emu distribution using ensemble modelling, hindcasting and forecasting distribution from current emu occurrence data. Emus have expanded their range northward into central Australia over the 6000 years modelled here. Areas west of the GDR have become more suitable since the mid-Holocene, which was unsuitable then due to high precipitation seasonality. However, the east coast of Australia has become climatically sub-optimal and will remain so for at least 50 years. The north east of NSW encompasses the range of the only listed endangered population, which now occurs at the margins of optimal climatic conditions for emus. Being at the fringe of suitable climatic conditions may put this population at higher risk of further decline from non-climatic anthropogenic disturbances e.g. depredation by introduced foxes and pigs. The limited scientific knowledge about wild emu ecology and biology currently available limits our ability to quantify these risks.

The historical range and drivers of decline of the Tapanuli orangutan.

The Tapanuli Orangutan (Pongo tapanuliensis) is the most threatened great ape species in the world. It is restricted to an area of about 1,000 km2 of upland forest where fewer than 800 animals survive in three declining subpopulations. Through a historical ecology approach involving analysis of newspaper, journals, books and museum records from the early 1800s to 2009, we demonstrate that historically Pongo tapanuliensis inhabited a much larger area, and occurred across a much wider range of habitat types and at lower elevations than now. Its current Extent of Occurrence is 2.5% and 5.0% of the historical range in the 1890s and 1940s respectively. A combination of historical fragmentation of forest habitats, mostly for small-scale agriculture, and unsustainable hunting likely drove various populations to the south, east and west of the current population to extinction. This happened prior to the industrial-scale forest conversion that started in the 1970s. Our findings indicate how sensitive P. tapanuliensis is to the combined effects of habitat fragmentation and unsustainable take-off rates. Saving this species will require prevention of any further fragmentation and killings or other removal of animals from the remaining population. Without concerted action to achieve this, the remaining populations of P. tapanuliensis are doomed to become extinct within several orangutan generations.

Disruptive Demographics: Their Effects on Nursing Demand, Supply and Academic Preparation.

The nursing profession faces both a labor shortage and a diversity problem. Nine proactive strategies-rooted in the disruptive demographic trends that are transforming our nation-are advanced to address these 2 critical issues.

Yateras frente a la COVID-19: 386 días de silencio epidemiológico / Yateras versus COVID-19: 386 days of epidemiological silence

Introducción: No hay un reporte en la literatura científica que analice las causas que permitieron al municipio Yateras ser el único en Cuba en no tener pacientes diagnosticados con COVID-19 entre el 11 de marzo de 2020, fecha del primer reporte en el país, y el 2 de abril de 2021 en que se diagnosticó el primer paciente con la enfermedad. Objetivo: Caracterizar aspectos sociodemográficos de la población del municipio Yateras de la provincia de Guantánamo, en Cuba, durante este período en el cual no se diagnosticaron casos confirmados de la COVID-19. Métodos: Se realizó un estudio descriptivo, retrospectivo y transversal en el período comprendido entre el 11 de marzo de 2020 y el 2 de abril de 2021. El universo lo constituyó la población censada en ese período. Se estudiaron la edad, sexo, características de las viviendas, clasificación de la población según grupos dispensariales y otras condiciones que determinan la vulnerabilidad de los pobladores. Resultados: El 47,1 por ciento de la población fue vulnerable a la pandemia. El 98,8 por ciento presentó alguna comorbilidad o factor de riesgo, sobre todo el antecedente de hipertensión arterial sistémica en 2192 pobladores. El 10,7 por ciento de las viviendas se calificaron como hacinadas y 54,2 por ciento presentaba condiciones inadecuadas. Conclusiones: La mayor proporción de los pobladores de Yateras es vulnerable a la COVID-19, pero las particularidades sociodemográficas de esta población no determinaron el período de silencio epidemiológico que caracterizó al territorio, lo que se supone se debió al control y cumplimiento estricto de un sistema de medidas dirigidas al enfrentamiento de esta enfermedad, mediatizado por la actitud responsable y solidaria de la comunidad yaterana en el logro de esta finalidad(AU)

ABSTRACT Introduction: No report is available in the scientific literature analyzing the reasons why Yateras is the only municipality in Cuba without any COVID-19 patient from 11 March 2020, when the first case was reported in the country, until 2 April 2021, when the first case was diagnosed in the municipality. Objective: Characterize sociodemographic features of the population of the municipality of Yateras, province of Guantánamo, Cuba, during the period when no confirmed COVID-19 cases were diagnosed. Methods: A descriptive cross-sectional retrospective study was conducted in the period extending from 11 March 2020 to 2 April 2021. The study universe was the census-registered population in that period. The variables analyzed were age, sex, household conditions, population classification according to dispensary groups, and other conditions determining the vulnerability of the population. Results: Of the population studied, 47.1 percent was vulnerable to the pandemic. 98.8 percent had some sort of comorbidity or risk factor, mainly an antecedent of systemic arterial hypertension in 2192 inhabitants. 10.7 percent of the households were classified as overcrowded and 54.2 percent had inadequate conditions. Conclusions: A large number of Yateras residents are vulnerable to COVID-19. However, the sociodemographic features of this population did not determine the period of epidemiological silence characterizing the territory, which is thought to have been due to the control and strict compliance with a system of measures aimed at facing the disease, alongside the responsible, supportive attitude of the community toward the achievement of this goal(AU)