The relationship between fear of falling and foot clearance in older people

Introduction : Fear of falling (FOF) is associated with falls and modifications in gait parameters. Foot clearance during walking is directly linked to tripping and falling. The relationship between FOF and foot Downloaded from http://gerontologist.oxfordjournals.org/ at Université & EPFL Lausanne on January 23, 2013 436 The Gerontological Society of America clearance has never been evaluated. Methods : Participants (N=568, aged 66 to 71 years, 57.2% women) underwent gait parameters measurements using footworn sensors. Specific foot clearance parameters evaluated included maximal and minimal heel and toe clearances and their variability. FOF was assessed using a single question. Results : Overall, 27.4% of the participants reported FOF. Compared to the others, participants with FOF had decreased maximal heel (28.9 vs 30.4 cm, p<.001) and toe clearance (12.5 vs 13.8 cm, p<.001), and decreased minimal toe clearance variability (SD 3.7 vs 4.0 cm, p<.001). Conclusion : These preliminary results suggest a relationship between FOF and foot clearance parameters. Multivariate analyses are underway.

Meal-induced thermogenesis and obesity: is a fat meal a risk factor for fat gain in children?

Diet composition, in particular fat intake, has been suggested to be a risk factor for obesity in humans. Several mechanisms may contribute to explain the impact of fat intake on fat gain. One factor may be the low thermogenesis induced by a mixed meal rich in fat. In a group of 11 girls (10.1 +/- 0.3 yr), 6 obese (body mass index, 25.6 +/- 0.6 kg/m(2)), and 5 nonobese (body mass index, 19 +/- 1.6 kg/m(2)), we tested the hypothesis that a mixed meal rich in fat can elicit energy saving compared with an isocaloric and isoproteic meal rich in carbohydrate. The postabsorptive resting energy expenditure and the thermic effect of a meal (TEM) after a low fat (LF; 20% fat, 68% carbohydrate, and 12% protein) or an isocaloric (2500 kJ or 600 Cal) and isoproteic high fat (HF; 48% fat, 40% carbohydrate, and 12% protein) meal were measured by indirect calorimetry. Each girl repeated the test with a different, randomly assigned menu (HF or LF) 1 week after the first test. TEM, expressed as a percentage of energy intake was significantly higher after a LF meal than after a HF meal (6.5 +/- 0.7% vs. 4.3 +/- 0.4%; P < 0.01). The postprandial respiratory quotient (RQ) was significantly higher after a LF meal than after a HF meal (0.86 +/- 0.013 vs. 0.83 +/- 0.014; P < 0.001). The HF low carbohydrate meal induced a significantly lower increase in carbohydrate oxidation than the LF meal (20.3 +/- 6.2 vs. 61.3 +/- 7.8 mg/min; P < 0.001). On the contrary, fat oxidation was significantly higher after a HF meal than after a LF meal (-1.3 +/- 2.4 vs. -15.1 +/- 3.6 mg/min; P < 0.01). However, the postprandial fat storage was 8-fold higher after a HF meal than after a LF meal (17.2 +/- 1.7 vs. 1.9 +/- 1.8 g; P < 0.001). These results suggest that a high fat meal is able to induce lower thermogenesis and a higher positive fat balance than an isocaloric and isoproteic low fat meal. Therefore, diet composition per se must be taken into account among the various risk factors that induce obesity in children.

El problema de la corriente de Humboldt (I)

Aborda el fenómeno de la corriente de Humboldt y los cambios climatológicos que se desarrollan durante las estaciones en el litoral peruano.

Thyroid hormone reduces the loss of axotomized sensory neurons in dorsal root ganglia after sciatic nerve transection in adult rat.

We have shown that a local administration of thyroid hormones (T3) at the level of transected rat sciatic nerve induced a significant increase in the number of regenerated axons. To address the question of whether local administration of T3 rescues the axotomized sensory neurons from death, in the present study we estimated the total number of surviving neurons per dorsal root ganglion (DRG) in three experimental group animals. Forty-five days following rat sciatic nerve transection, the lumbar (L4 and L5) DRG were removed from PBS-control, T3-treated as well as from unoperated rats, and serial sections (1 microm) were cut. The physical dissector method was used to estimate the total number of sensory neurons in the DRGs. Our results revealed that in PBS-control rats transection of sciatic nerve leads to a significant (P < 0.001) decrease in the mean number of sensory neurons (8743.8 +/- 748.6) compared with the number of neurons in nontransected ganglion (mean 13,293.7 +/- 1368.4). However, administration of T3 immediately after sciatic nerve transection rescues a great number of axotomized neurons so that their mean neuron number (12,045.8 +/- 929.8) is not significantly different from the mean number of neurons in the nontransected ganglion. In addition, the volume of ganglia showed a similar tendency. These results suggest that T3 rescues a high number of axotomized sensory neurons from death and allows these cells to grow new axons. We believe that the relative preservation of neurons is important in considering future therapeutic approaches of human peripheral nerve lesion and sensory neuropathy.

Distribuição de potássio, magnésio e outros metais em minerais de sedimentos do grupo barreiras no município de Aracruz, estado do Espírito Santo

Os sedimentos do Grupo Barreiras são muito pobres em minerais primários fontes de nutrientes. Para estudar a distribuição de K, Mg e outros metais em minerais das frações argila, silte e areia, coletaram-se 11amostras nas profundidades de 0,7; 1,4; 2,1; 2,8; 3,5; 4,2; 4,9; 5,6; 7,7; 10,5 e 14,0m, em um pacote de sedimentos do Grupo Barreiras, no município de Aracruz (ES) (19º49'13"S 40º16'24"O). Os teores totais de K, Mg, Ca, Al, Fe, Ti, Mn, Cu, Zn, Ni, Pb, Cr, Sr e Ga na terra fina seca em estufa e nas frações argila, silte e areia foram determinados por espectrômetria de emissão por plasma, após digestão completa da amostra com ácido fluorídrico concentrado. Para avaliar a contribuição de cada espécie mineral nos teores totais de K e de Mg, amostras da fração argila foram submetidas a extrações seqüenciais e seletivas de minerais. Em virtude da presença de camadas enriquecidas com concreções ferruginosas (principalmente do tamanho silte), ao longo do pacote de sedimentos, obtiveram-se os maiores teores totais de Fe2O3, nas profundidades de 2,1; 4,2 e 7,7m. Os sedimentos do Grupo Barreiras apresentaram limitada reserva de nutrientes, com baixos teores totais de K, Mg e Ca. Verificou-se aumento nos teores de K na fração argila com a profundidade, atingindo 618,2mgkg-1 a 14m. Na fração areia, os teores de K e de Mg foram maiores nas amostras com maior impureza de quartzo. A reserva em K e Mg na fração argila foi associada com a presença de mica e caulinita. A contribuição dos óxidos de Fe e de Al, dos aluminossilicatos de baixa cristalinidade e dos óxidos de Fe mais cristalinos, nos teores totais de K e de Mg, foi inexpressiva. As frações argila e silte foram as principais fontes de metais pesados nas amostras estudadas.

Propriedades químicas e cristalográficas da caulinita e dos óxidos de ferro em sedimentos do grupo barreiras no município de Aracruz, estado do Espírito Santo

As propriedades químicas e cristalográficas detalhadas da caulinita (Ct) e dos óxidos de ferro do solo e dos sedimentos do Grupo Barreiras são pouco conhecidas. Para estudar as características desses minerais em profundidade, coletaram-se 11 amostras (0,7; 1,4; 2,1; 2,8; 3,5; 4,2; 4,9; 5,6; 7,7; 10,5 e 14m) nos horizontes Bt, BC e C de um Argissolo Amarelo no município de Aracruz (ES). As frações argila e silte foram estudadas por difração de raios-X (DRX), análise termo-diferencial (ATD) e microscopia eletrônica. Os teores totais de Fe e outros microelementos (Cr, Mn, Ni, Pb, Ti e Zn) da fração argila foram determinados por espectrometria por emissão por plasma, após digestão da amostra com HF concentrado. Nos extratos resultantes das extrações com oxalato de amônio (OA) e ditionito-citrato-bicarbonato (DCB), determinaram-se os teores de Fe, Al, Si, Cr, Mn, Ni, Pb, Ti e Zn. A composição química da Ct das frações argila (amostra desferrificada) e silte (amostra natural) foi determinada pelo tratamento com NaOH 5molL-1 e pela combinação de aquecimento e extração com NaOH 0,5molL-1 fervente, respectivamente. O teor médio de Fe2O3 da Ct da fração argila (20,7gkg-1) foi superior ao obtido para a fração silte (5,2gkg-1), verificando-se, na menor fração, aumento nos teores de Fe2O3 com a profundidade. Graças ao maior raio iônico, a presença do Fe3+ na estrutura promoveu aumento no espaço interplanar do mineral, sobretudo na direção b. O tamanho das partículas de Ct foi semelhante entre os horizontes amostrados. A Ct apresentou grau semelhante de cristalinidade com a profundidade do solo, com exceção dos horizontes mais superficiais, os quais apresentaram menores valores de índice de cristalinidade, provavelmente por interferências com compostos orgânicos. A redução dos teores de Fe2O3 extraídos pelo DCB e da participação dos teores de FeOA mais FeDCB no Fe total da fração argila com a profundidade foi atribuída à dissolução dos óxidos de ferro, provocada pela umidade nas camadas inferiores dos sedimentos. A substituição isomórfica (SI) de Fe por Al na goethita (Gt) foi cerca de três vezes superior à da hematita (Hm), com maiores valores nos horizontes mais superficiais. A Hm apresentou menor valor de superfície específica (SE) que a Gt, refletindo os maiores valores de diâmetro médio do cristal para a Hm. Baixos valores de cristalinidade e menor tamanho de partículas estão associados à maior atividade e à influência da Ct e dos óxidos de ferro sobre as propriedades físico-químicas do solo. Os óxidos de ferro apresentaram baixa associação com microelementos, sobretudo com Ni, Pb e Ti.

Lixiviação de potássio da palha de espécies de cobertura de solo de acordo com a quantidade de chuva aplicada

Os restos vegetais deixados na superfície do solo em sistemas de semeadura direta, além de proteger o solo da erosão, constituem considerável reserva de nutrientes que podem ser disponibilizados para a cultura principal, subseqüente. Avaliou-se a lixiviação de K da palha de seis espécies vegetais com potencial de uso como plantas para cobertura do solo de acordo com a quantidade de chuva recebida após o manejo. Milheto (Pennisetum americanum, var. BN-2), sorgo de guiné (Sorghum vulgare), aveia preta (Avena strigosa), triticale (Triticum secale), crotalária juncea (Crotalaria juncea) e braquiária (Brachiaria decumbens) foram cultivados em vasos com terra, em casa de vegetação, em Botucatu (SP). Aos 45 dias da emergência, as plantas foram cortadas na altura do colo, secas em estufa e submetidas a chuvas simuladas de 4,4, 8,7, 17,4, 34,9 e 69,8 mm, considerando uma quantidade de palha equivalente a 8,0 t ha-1. A máxima retenção de água pela palha corresponde a uma lâmina de até 3,0 mm, independentemente da espécie, praticamente não ocorrendo lixiviação do potássio com chuvas da ordem de 5 mm. A máxima liberação de K por unidade de chuva ocorre com lâminas de até 20 mm, decrescendo a partir deste ponto. A quantidade de K liberado da palha logo após o manejo depende da espécie vegetal, não ultrapassando, no entanto, 24 kg ha-1 com chuvas da ordem de 70 mm, apresentando correlação positiva com a concentração do nutriente no tecido vegetal. O triticale e a aveia são mais eficientes na ciclagem do potássio.

La cessation de la chimiothérapie pour le traitement de l'adénocarcinome pancréatique avancé : recherche de facteurs prédictifs de mort imminente

Dans cette étude rétrospective, nous reportons des données relatives à la chimiothérapie chez des patients atteints d'adénocarcinome pancréatique avancé, avec attention à la durée du temps qui passe entre le dernier traitement et la mort. En outre, nous analysons des paramètres cliniques et de laboratoire, enregistrés à la dernière chimiothérapie, avec le but d'identifier des facteurs de risque pour un décès proche. L'analyse rétrospective est effectuée sur des patients avec adénocarcinome pancréatique avancé, qui ont bénéficié au moins d'une ligne de chimiothérapie. Nous avons enregistré les données concernant la chimiothérapie (régimes, lignes et date de la dernière administration) et avons choisi et enregistré des facteurs cliniques et de laboratoire, qui étaient récoltés à la dernière chimiothérapie (performance status, présence d'ascite, hémoglobine, leucocytes, plaquettes, bilirubine totale, albumine, LDH, protéine C-réactive et Ca19-9). Des analyses statistiques (univariée et multivariée) sont effectuées pour étudier la relation entre ces facteurs et le temps de survie, à la recherche de facteurs prédictifs de mort imminente. Nous avons analysé les données de 231 patients: hommes/femmes, 53/47%; métastatique/localement avancé, 80/20%; âge médian 66 ans (gamme 32-85). Tous les patients sont décédés à cause de la progression de la maladie. La survie globale médiane est 6.1 mois (95% Cl 5.1-7.2). Lors de la dernière chimiothérapie, le performance status est 0-1 pour 37% et 2 pour 63% des patients. Cinquante-neuf pour cent des patients reçoivent une ligne de chimiothérapie, 32, 8 et 1% reçoivent des chimiothérapies de deuxième, troisième, quatrième ligne, respectivement. L'intervalle entre la dernière administration de chimiothérapie et le décès est <4 semaines pour 24%, 4-12 semaines pour 47% et >12 semaines pour 29% des patients. La survie médiane à partir de la dernière chimiothérapie jusqu'au décès est 7.5 semaines (95% Cl 6.7-8.4). L'ascite, la leucocytose, des valeurs élevées de bilirubine, LDH, protéine C- réactive et Ca19-9, et des valeurs abaissées d'albumine sont associés à une survie plus courte à l'analyse univariée; néanmoins, aucun de ces facteurs n'est corrélé à la survie de façon significative à l'analyse multivariée. Nous en concluons qu'une proportion significative de patients avec adénocarcinome pancréatique avancé reçoit la chimiothérapie dans le dernier mois de vie, et que les paramètres cliniques et de laboratoire enregistrés à la dernière chimiothérapie ne prédisent pas une survie plus courte.

Acknowledgment and health in police officers

The way colleagues and supervisors acknowledge specific contribution and efforts of individuals is crucial for occupational mental health and well being. It contributes to improve the self image of employees and it gives a sense to the activities performed. We carried out a study about occupational health in police officers with a special emphasis on acknowledgment and reward. A questionnaire was sent to 1000 police officers working for a cantonal administration in Switzerland. In total, 695 participants answered the questionnaire. We used the French version of the Langner's questionnaire on psychiatric symptoms to identify cases characterized by potential mental health problems. Multiple choice items (6 modalities ranging from "not at all" to "tremendously") to measure acknowledgment were used. Answers were later dichotomized (low annoyance- high annoyance). Questions we used are: "Do you feel annoyed due to a lack of support and attention from your supervisors?" "Do you feel annoyed because the authorities (politics, judges, etc.) have a low consideration of your occupation?" "Do you feel annoyed due to a low appreciation by the public?" and "Do you feel annoyed due to a lack of acknowledgment by the hierarchy?". The score for psychiatric symptoms was high for 86 police officers for whom health might be at risk. Acknowledgment aspects associated with a high score for psychiatric symptoms are : high annoyance due to a lack of support and attention from supervisors (odds ratio [OR] 3.2, 95% confidence interval [CI] 2.0 to 5.1), high annoyance because authorities seems to have a low consideration for police officers (OR 2.7, 95% CI 1.7 to 4.3), high annoyance due to a low appreciation by the public (OR 1.8, 95% CI 1.2 to 2.9), and high annoyance due to a lack of acknowledgment by the hierarchy (OR 3.0, 95% CI 1.9 to 4.8). Preserving mental health in occupations characterized by high emotional demand is challenging. The results from our study suggest that appropriate acknowledgment might contribute to the prevention of mental health problems. Further research should address a potential causal relation of acknowledgment on mental health.

Prenatal management of monoamniotic twin pregnancies.

OBJECTIVE: To evaluate antenatal surveillance strategies and the optimal timing of delivery for monoamniotic twin pregnancies. METHODS: Obstetric and perinatal outcomes were retrospectively retrieved for 193 monoamniotic twin pregnancies. Fetal and neonatal outcomes were compared between fetuses followed in an inpatient setting and those undergoing intensive outpatient follow-up from 26 to 28 weeks of gestation until planned cesarean delivery between 32 and 35 weeks of gestation. The risk of fetal death was compared with the risk of neonatal complications. RESULTS: Fetal deaths occurred in 18.1% of fetuses (70/386). Two hundred ninety-five neonates from 153 pregnancies were born alive after 23 weeks of gestation. There were 17 neonatal deaths (5.8%), five of whom had major congenital anomalies. The prospective risk of a nonrespiratory neonatal complication was lower than the prospective risk of fetal death after 32 4/7 weeks of gestation (95% confidence interval 32 0/7-33 4/7). The incidence of death or a nonrespiratory neonatal complication was not significantly different between fetuses managed as outpatients (14/106 [13.2%]) or inpatients (15/142 [10.5%]; P=.55). Our statistical power to detect a difference in outcomes between these groups was low. CONCLUSIONS: The in utero risk of a monoamniotic twin fetus exceeds the risk of a postnatal nonrespiratory complication at 32 4/7 weeks of gestation. If close fetal surveillance is instituted after 26-28 weeks of gestation and delivery takes place at approximately 33 weeks of gestation, the risk of fetal or neonatal death is low, no matter the surveillance setting. LEVEL OF EVIDENCE: : II.

Health-related quality of life in survivors of childhood cancer: the role of chronic health problems.

INTRODUCTION: The influence of specific health problems on health-related quality of life (HRQoL) in childhood cancer survivors is unknown. We compared HRQoL between survivors of childhood cancer and their siblings, determined factors associated with HRQoL, and investigated the influence of chronic health problems on HRQoL. METHODS: Within the Swiss Childhood Cancer Survivor Study, we sent a questionnaire to all survivors (≥16 years) registered in the Swiss Childhood Cancer Registry, who survived >5 years and were diagnosed 1976-2005 aged <16 years. Siblings received similar questionnaires. We assessed HRQoL using Short Form-36 (SF-36). Health problems from a standard questionnaire were classified into overweight, vision impairment, hearing, memory, digestive, musculoskeletal or neurological, and thyroid problems. RESULTS: The sample included 1,593 survivors and 695 siblings. Survivors scored significantly lower than siblings in physical function, role limitation, general health, and the Physical Component Summary (PCS). Lower score in PCS was associated with a diagnosis of central nervous system tumor, retinoblastoma or bone tumor, having had surgery, cranio-spinal irradiation, or bone marrow transplantation. Lower score in Mental Component Summary was associated with older age. All health problems decreased HRQoL in all scales. Most affected were survivors reporting memory problems and musculoskeletal or neurological problems. Health problems had the biggest impact on physical functioning, general health, and energy and vitality. CONCLUSIONS: In this study, we showed the negative impact of specific chronic health problems on survivors' HRQoL. IMPLICATIONS FOR CANCER SURVIVORS: Therapeutic preventive measures, risk-targeted follow-up, and interventions might help decrease health problems and, consequently, improve survivors' quality of life.

Whose DNA is this? How relevant a question? (a note for forensic scientists).

This communication seeks to draw the attention of researchers and practitioners dealing with forensic DNA profiling analyses to the following question: is a scientist's report, offering support to a hypothesis according to which a particular individual is the source of DNA detected during the analysis of a stain, relevant from the point of view of a Court of Justice? This question relates to skeptical views previously voiced by commentators mainly in the judicial area, but is avoided by a large majority of forensic scientists. Notwithstanding, the pivotal role of this question has recently been evoked during the international conference "The hidden side of DNA profiles. Artifacts, errors and uncertain evidence" held in Rome (April 27th to 28th, 2012). Indeed, despite the fact that this conference brought together some of the world's leading forensic DNA specialists, it appeared clearly that a huge gap still exists between questions lawyers are actually interested in, and the answers that scientists deliver to Courts in written reports or during oral testimony. Participants in the justice system, namely lawyers and jurors on the one hand and forensic geneticists on the other, unfortunately talk considerably different languages. It thus is fundamental to address this issue of communication about results of forensic DNA analyses, and open a dialogue with practicing non-scientists at large who need to make meaningful use of scientific results to approach and help solve judicial cases. This paper intends to emphasize the actuality of this topic and suggest beneficial ways ahead towards a more reasoned use of forensic DNA in criminal proceedings.

Evapotranspiração real de uma cultura de laranja em produção num Latossolo Vermelho-Amarelo

A disponibilidade de água e de nutrientes no solo em épocas e quantidades apropriadas, associada às condições edáficas e climáticas, é fator de indiscutível relevância à produção das culturas. O objetivo do presente trabalho foi avaliar a evapotranspiração real de uma cultura de laranja, analisar sua variabilidade e verificar a influência deste processo de saída de água do solo na produtividade da cultura. O experimento foi realizado no município de Piracicaba (SP), num Latossolo Vermelho-Amarelo distrófico argissólico, e a evapotranspiração real foi avaliada pelo método do balanço de água no solo em 40 pontos correspondentes a 40 plantas de duas linhas adjacentes com 20 plantas cada. A cultura de laranja, plantada num espaçamento de 7 x 4 m (7 m entre linhas por 4 m entre plantas na linha), tinha 11 anos de idade. Em cada ponto, localizado na projeção da copa (2 m do tronco) de cada uma das 40 plantas ao longo da linha, foram instalados um tubo de Al até à profundidade de 1,2 m para acesso de uma sonda de nêutrons e três tensiômetros às profundidades de 1,0, 1,1 e 1,2 m. A variação da armazenagem de água no solo foi determinada a partir de leituras semanais da sonda de nêutrons. A precipitação pluvial, medida por meio de um pluviômetro com aquisição automática de dados, foi considerada normal para o período monitorado. A drenagem interna e a ascensão capilar foram estimadas pela equação de Darcy-Buckingham, a partir de leituras diárias dos três tensiômetros e da condutividade hidráulica determinada na profundidade de controle (1,1 m) em função do potencial mátrico pelo método do perfil instantâneo. A irrigação e os deflúvios foram inexistentes e a evapotranspiração real da cultura foi calculada pela diferença entre a variação de armazenagem e a soma algébrica dos outros processos avaliados. O balanço foi efetuado durante um ciclo anual da cultura de laranja, dividido em 14 períodos. Nesses 14 períodos de monitoramento, a evapotranspiração real foi analisada com base nos métodos da estatística descritiva e exploratória de dados, obtendo-se um coeficiente de variação médio desses 14 períodos de 16 %. Foi de 1.271 mm a evapotranspiração real anual desta comunidade de plantas cujos valores diários variaram de 0,4 a 8,4 mm. A eficiência de utilização da água ou a razão entre a produtividade e a evapotranspiração real por planta durante o período monitorado variou de 1,57 a 4,52 kg m-3; verificou-se que as plantas com maior produção estavam entre aquelas com maior evapotranspiração real.