Patterns of psychotropic prescribing and polypharmacy in older hospitalized patients in Ireland: the influence of dementia on prescribing

Neuropsychiatric Symptoms (NPS) are ubiquitous in dementia and are often treated pharmacologically. The objectives of this study were to describe the use of psychotropic, anti-cholinergic, and deliriogenic medications and to identify the prevalence of polypharmacy and psychotropic polypharmacy, among older hospitalized patients in Ireland, with and without dementia. All older patients (≥ 70 years old) that had elective or emergency admissions to six Irish study hospitals were eligible for inclusion in a longitudinal observational study. Of 676 eligible patients, 598 patients were recruited and diagnosed as having dementia, or not, by medical experts. These 598 patients were assessed for delirium, medication use, co-morbidity, functional ability, and nutritional status. We conducted a retrospective cross-sectional analysis of medication data on admission for 583/598 patients with complete medication data, and controlled for age, sex, and co-morbidity. Of 149 patients diagnosed with dementia, only 53 had a previous diagnosis. At hospital admission, 458/583 patients experienced polypharmacy (≥ 5 medications). People with dementia (PwD) were significantly more likely to be prescribed at least one psychotropic medication than patients without dementia (99/147 vs. 182/436; p < 0.001). PwD were also more likely to experience psychotropic polypharmacy (≥ two psychotropics) than those without dementia (54/147 vs. 61/436; p < 0.001). There were no significant differences in the prescribing patterns of anti-cholinergics (23/147 vs. 42/436; p = 0.18) or deliriogenics (79/147 vs. 235/436; p = 0.62). Polypharmacy and psychotropic drug use is highly prevalent in older Irish hospitalized patients, especially in PwD. Hospital admission presents an ideal time for medication reviews in PwD.

Triceps and subscapular skinfold thicknesses percentiles and cut-offs for overweight and obesity in a population-based sample of schoolchildren in Bogota, Colombia

OBJECTIVES: The aims of this study were to establish a Colombian smoothed centile charts and LMS tables for tríceps, subscapular and sum tríceps+subscapular skinfolds; appropriate cut-offs were selected using receiver operating characteristic analysis based in a populationbased sample of schoolchildren in Bogota, Colombia and to compare them with international studies. METHODS: A total of 9 618 children and adolescents attending public schools in Bogota, Colombia (55.7% girls; age range of 9–17.9 years). Height, weight, body mass index (BMI), waist circumference, triceps and subscapular skinfold measurements were obtained using standardized methods. We have calculated tríceps+subscapular skinfold (T+SS) sum. Smoothed percentile curves for triceps and subscapular skinfold thickness were derived by the LMS method. Receiver operating characteristics curve (ROC) analyses were used to evaluate the optimal cut-off point of tríceps, subscapular and sum tríceps+subscapular skinfolds for overweight and obesity based on the International Obesity Task Force (IOTF) definitions. Data were compared with international studies. RESULTS: Subscapular, triceps skinfolds and T+SS were significantly higher in girls than in boys (P <0.001). The median values for triceps, subscapular as well as T+SS skinfold thickness increased in a sex-specific pattern with age. The ROC analysis showed that subscapular, triceps skinfolds and T+SS have a high discrimination power in the identification of overweight and obesity in the sample population in this study. Based on the raw non-adjusted data, we found that Colombian boys and girls had high triceps and subscapular skinfolds values than their counterparts from Spain, UK, German and US. CONCLUSIONS: Our results provide sex- and age-specific normative reference standards for the triceps and subscapular skinfold thickness values in a large, population-based sample of 3 schoolchildren and adolescents from an Latin-American population. By providing LMS tables for Latin-American people based on Colombian reference data, we hope to provide quantitative tools for the study of obesity and its complications.

Relación entre velocidad/agilidad con indicadores de desempeño muscular y estado nutricional en escolares de 9 a 17 años en Bogotá, D.C. Estudio Fuprecol.

Objetivo: Estimar la relación entre indicadores de desempeño muscular y estado nutricional con la velocidad/agilidad, en una muestra de escolares de instituciones educativas del Distrito de Bogotá, Colombia, perteneciente al estudio FUPRECOL. Materiales y Métodos: estudio transversal, en 2803 niños y 3952 niñas (58.5 %), entre 9 y 17 años de edad, pertenecientes a 24 instituciones educativas del sector oficial, en Bogotá, Colombia. La velocidad/agilidad se evaluó con la prueba de carrera de ida y vuelta 4x10 m y los indicadores de fuerza muscular fueron medidos por medio de fuerza prensil, salto longitudinal. Las asociaciones se estimaron por medio de regresión logística binaria. Resultados: el 74.6 % de las mujeres y el 68.6 % de los varones mostraron bajos niveles de velocidad/agilidad; en mujeres, el modelo de regresión logística binario se observa que aquellas que tener bajos niveles de velocidad/agilidad se asociaba con obesidad (OR 2.25 IC 95 % 1.53-3.11), sobrepeso (OR 1.43 IC 95 % 1.19-1.72), bajos niveles de salto longitudinal (OR 2.06 IC 95 % 1.73-2.44) y tener valores de fuerza prensi no saludable (OR 1.45 IC 95 % 1.25-1.88). En hombres, tener entre 9-12 años, (OR 1.89 IC 95% 1.53-2.53), padecer de sobrepeso (OR 2.11 IC 95% 1.63-2.74) u obesidad (OR 3.00 IC 95% 2.03-4.43), se asoció con bajos niveles de velocidad/agilidad. Conclusión: se encontró que un alto porcentaje de la muestra estudiada tiene bajos niveles de velocidad/agilidad; adicionalmente, se observó una fuerte relación entre los indicadores de adiposidad y desempeño muscular, con los niveles de velocidad/agilidad. Se sugiere la implementación de programas escolares, que contrarresten la aparición de manifestaciones de riesgo cardiometabólico.

Soil management systems for sustainable melon cropping in the Submedian of the São Francisco Valley.

Changes in soils management systems, including the application of green manure, are able to increase crop productivity. The aim of this study was to propose a soil management system with the use of green manure to improve the nutritional status and melon productivity in the submedian of the São Francisco Valley. The experiment was installed in Typic Plinthustalf and conducted in split plot. There were two soil tillage systems, tillage (T) and no tillage (NT), and three types of green manure (two vegetal cocktails: VC1- 75% legumes (L) + 25% non-legumes (NL); VC2- 25% L+ 75% NL and spontaneous vegetation (SV)). The experimental design was a randomised block with four replications. Fourteen species of legumes, grasses and oilseeds were used for the composition of the plant cocktails. We evaluated production of the dry shoot and root biomass and carbon and nutrient accumulation by green manures and melon plant. Data were subjected to analysis of variance and the treatment means were compared by Tukey´s test (P<0.05). Shoot biomass production and carbon and nutrient accumulation were higher in plant mixtures compared to spontaneous vegetation. The root system of the plant cocktails added larger quantities of biomass and nutrients to the soil to a depth of 0.60 m when compared to the spontaneous vegetation. The cultivation of plant cocktails with soil tillage, regardless of their composition, is a viable alternative for adding biomass and nutrients to the soil in melon crops in semi-arid conditions, providing productivity increases.

Adubação de capim-elefante com composto orgânico produzido com resíduos animais.

A utilização do composto orgânico proveniente de resíduos da criação e abate de pequenos ruminantes pode elevar a produção de matéria seca do capim-elefante, tendo em vista o teor de nutrientes contidos nesse fertilizante orgânico, diminuindo os impactos da produção animal sobre o ambiente e reduzindo os custos de produção na área de capineira de capim-elefante. Dada à escassez de informações na literatura e a importância do manejo adequado da adubação orgânica na agropecuária, objetivou-se avaliar os atributos químicos e físicos do solo, o estado nutricional e a produção do capim-elefante submetido à aplicação de doses do composto orgânico proveniente de resíduos da produção e abate de pequenos ruminantes. O delineamento experimental adotado foi em parcelas subdivididas, com medidas repetidas no tempo, sendo as parcelas as doses (0; 13,3; 26,6; 39,9; 52,3; 79,8 t ha-1) de composto orgânico e um tratamento adicional com adubos minerais e as subparcelas os ciclos (1, 2, 3 e 4) com 4 blocos, totalizando 28 parcelas. As variáveis mensuradas foram atributos físicos e químicos do solo, a diagnose foliar e a produtividade de capim-elefante. Para o fator ciclo, a adubação orgânica incrementou a umidade gravimétrica e umidade volumétrica e ainda houve diminuição da densidade de partículas em função dos ciclos. Com as doses do fertilizante orgânico houve aumento nas concentrações da matéria orgânica, amônio, nitrato, amônio + nitrato, fósforo e saturação por base; houve redução do valor da acidez potencial, além da elevação dos teores de nitrogênio e fósforo nas plantas. As doses de composto orgânico aumentaram a biomassa de forragem total de capimelefante. A adubação mineral proporcionou maior incremento da produção do capim em relação à adubação orgânica no decorrer dos ciclos. Abstract: The use of organic compost from residues of production and slaughter of small ruminants can increase dry matter production of elephant grass, in due function of quantity nutrients in this compost, thus reducing the animal production impacts in the environment and production costs in elephant grass fields. Due to the Lack of information in literature and the importance regarding organic fertilization in agriculture, the aim of this work was evaluate chemical and physical soil attributes, nutritional status in plants and production of elephant grass in function of doses of organic compound of residues of production and slaughter of small ruminants. The experimental design was in split-plot, with the main treatment the doses (0; 13,3; 26,6; 39,9; 52,3; 79,8 t ha-1 ) of organic compost and one additional treatment with mineral fertilization and secondary treatments was the cycles (1, 2, 3 and 4) with 4 blocks, and 28 plots. The measured variables were physical and chemical attributes in the soil, nutritional diagnosis in plants and production of elephant grass. For cycle factor the organic fertilization increased gravimetric and volumetric humidity, yet, occurred decrease of density in function of cycles. With the doses of organic compost increased organic matter, ammonium, nitrate, ammonium + nitrate, phosphor and base saturation; and decreased the value of potential acidity; and increased content of N and P in plants. The doses of organic compost increased the elephant grass production. The mineral fertilization increased the elephant grass production in relation of organic fertilization over the cycles.

Micronutrient contents in healthy and Crinipellis perniciosa infected tissues of Theobroma grandiflorum.

Micronutrient contents in leaf and branch tissues of cupuassu plants (Theobroma grand iflorum) infected by Crinipellis perniciosa, the causal agent of witches' broom disease, were determined to support further studies on the effect of nutritional status in the disease progress. Lower contents of boron and manganese and higher content of copper were found in infected leaf tissues. There was not any statistical difference in the copper content of branch tissues, even though higher copper content was found in healthy branches than in healthy leaf tissues. No changes in contents of iron and zinc in healthy of infected tissues were detected.

Growth, mineral composition, fruit yield, and mycorrhizal colonization of feijoa in response to lime and phosphorus application.

2016

Use of organic compost containing waste from small ruminants in corn production.

Composting is a useful way of transforming livestock waste into organic fertilizer, which is proven to increase soil nutrient levels, and thus crop yield. Remains from production and slaughter of small ruminants can become a source of important elements for plant growth, such as N, after microorganism-driven decomposition.The aim of this investigation was to evaluate the effects of this compost on soil fertility and on the nutritional status and yield of the corn crop. The experiment was conducted in a Haplic Luvisol in a randomized block design with six treatments and five application rates of the organic compound in Mg ha-1: 3 (half the standard rate), 6 (standard rate), 9 (one and a half times the standard rate), 12 (twice the standard rate), and 24 (four times the standard rate) and an additional treatment with mineral fertilizers (110, 50 e 30 kg ha-1 of N, P2O5 and K2O, respectively), with four blocks. Evaluations were performed for two harvests of rainfed crops, measuring soil fertility, nutritional status, and grain yield. The compost increased P, K, Na and Zn values in the 0.00-0.20 m layer in relation of mineral fertilization in 616, 21, 114 and 90 % with rate 24 Mg ha-1 in second crop. Leaf N, Mg, and S contents, relative chlorophyll content, and the productivity of corn kernels increased in 27, 32, 36, 20 e 85 %, respectively, of low rate (3 Mg ha-1) to high rate (24 Mg ha-1) with of application of the compost. Corn yield was higher with application of organic compost in rate of 24 Mg ha-1 than mineral fertilizer combination in second crop.