Physical consequences of falls in the elderly: a literature review from 1995 to 2010

In the last decade, population ageing has been registered as a global phenomenon. A relation exists between falling and ageing, since falling frequency increases significantly with age. In fact, one in three older adult falls annually. Although ageing is generically associated with decrease and degeneration of psychological and physical functions, it is still not common for the correct identification of risk factors to lead to a clinical prognosis of the elder being in risk of falling. Therefore, the goal of this review article is to identify, categorise and analyse typical ageing and fall factors mentioned in the literature as well as to quantify the number of times they were referenced. The research considered hundreds of publications, but analysis was then restricted to the 87 most pertinent articles written in English and published in journals or scientific magazines between 1995 and 2010. We concluded that falls among older adults can be characterised by the following: anatomic characteristics and physiological consequences of ageing; the pathologies that induce falls, which can be neurological, musculoskeletal, cardiovascular and other diseases; causes and risk factors of falls that can be behavioural, biological, environmental or socio-economic; type of physical consequences of falls, including fractures, bruises, injuries or other physical consequences; and strategies to prevent, mitigate or rehabilitate, which can be of a physical, environmental or behavioural nature.

Carbon Nanofiber Type and Content Dependence of the Physical Properties of Carbon Nanofiber Reinforced Polypropylene Composites

The variation of the physical properties of four differ- ent carbon nanofibers (CNFs), based-polymer nano- composites incorporated in the same polypropylene (PP) matrix by twin-screw extrusion process was investigated. Nanocomposites fabricated with CNFs with highly graphitic outer layer revealed electrical isolation-to-conducting behaviors as function of CNF’s content. Nanocomposites fabricated with CNFs with an outer layer consisting on a disordered pyro- litically stripped layer, in contrast, revealed better mechanical performance and enhanced thermal sta- bility. Further, CNF’s incorporation into the polymer increased the thermal stability and the degree of crystallinity of the polymer, independently on the filler content and type. In addition, dispersion of the CNFs’ clusters in PP was analyzed by transmitted light opti- cal microscopy, and grayscale analysis (GSA). The results showed a correlation between the filler concentration and the variance, a parameter which measures quantitatively the dispersion, for all composites. This method indicated a value of 1.4 vol% above which large clusters of CNFs cannot be dispersed effectively and as a consequence only slight changes in mechanical performance are observed. Finally, this study establishes that for tailoring the physical properties of CNF based-polymer nanocomposites, both adequate CNFs structure and content have to be chosen.

Composite synthetic hydroxyapatite 30%, in two physical states, as dermal filler

The aim of this study was to evaluate the response to the implantation of synthetic hydroxyapatite 30% (HAP-91®) in different physical states as dermal filler. Eighteen New Zealand rabbits were used, distributed randomly into two equal groups and then divided into three groups according to the postoperative period at 8, 21 and 49 days. One mL of HAP-91®, fluid and viscous, was implanted in the subcutaneous tissue, 1 cm proximal to the cranial crest of the right scapula. The thickness of the skin was measured before and after implantation and for the following 15 days. Pain sensitivity assessment was conducted, assigning the following scores: 0 - when the animal allowed the touch of the implant area and expressed no signs of pain; 1 - when the animal allowed the touch, but pain reaction occurred, like increase of the respiratory rate or attempt to escape; 2 - when the animal did not allow the touch to the implanted area. At 8, 21 and 49 days, biopsy of the implanted area was performed. No difference was observed between the thickness of the skin (p>0.05) and all animals received a score 0 for soreness. Histological analysis did not reveal any obvious inflammatory process, showing a predominance of mononuclear cells in samples of eight days and tissue organization around the biomaterial with a tendency to encapsulation. The results indicate that HAP-91®, both viscous and fluid, is biocompatible and suitable for dermal filling.

Effect of filler content on morphology and physical-chemical characteristics of poly(vinylidene fluoride)/NaY-zeolite filled membranes

Poly(vinylidene fluoride) electrospun membranes have been prepared with different NaY zeolite contents up to 32%wt. Inclusion of zeolites induces an increase of average fiber size from ~200 nm in the pure polymer up to ~500 nm in the composite with 16%wt zeolite content. For higher filler contents, a wider distribution of fibers occurs leading to a broader size distributions between the previous fiber size values. Hydrophobicity of the membranes increases from ~115º water contact angle to ~128º with the addition of the filler and is independent on filler content, indicating a wrapping of the zeolite by the polymer. The water contact angle further increases with fiber alignment up to ~137º. Electrospun membranes are formed with ~80 % of the polymer crystalline phase in the electroactive  phase, independently on the electrospinning processing conditions or filler content. Viability of MC3T3-E1 cells on the composite membranes after 72 h of cell culture indicates the suitability of the membranes for tissue engineering applications.

Sugarcane productivity correlated with physical-chemical attributes to create soil management zone

The socioeconomic importance of sugar cane in Brazil is unquestionable because it is the raw material for the production of ethanol and sugar. The accurate spatial intervention in the management of the crop, resulting zones of soil management, increases productivity as well as its agricultural yields. The spatial and Person's correlations between sugarcane attributes and physico-chemical attributes of a Typic Tropustalf were studied in the growing season of 2009, in Suzanápolis, State of São Paulo, Brazil (20°28'10'' S lat.; 50°49'20'' W long.), in order to obtain the one that best correlates with agricultural productivity. Thus, the geostatistical grid with 120 sampling points was installed to soil and data collection in a plot of 14.6 ha with second crop sugarcane. Due to their substantial and excellent linear and spatial correlations with the productivity of the sugarcane, the population of plants and the organic matter content of the soil, by evidencing substantial correlations, linear and spatial, with the productivity of sugarcane, were indicators of management zones strongly attached to such productivity.

Evaluation of collaborative strategies for ecotourism and recreational activities in natural parks of Rio de Janeiro

In the city of Rio de Janeiro, the management agencies of environmental conservation units of the park type have been attempting to meet five primary objectives set by the National System for Conservation Units (NSCU), using participatory management guidelines for these units. Two of these objectives relate to the development of recreation activities that involve contact with nature and ecological tourism. This article presents the analyses and conclusions regarding the implementation of collaborative strategies with businesses to achieve such objectives; it is part of a series of research studies having a broader scope. Case studies were conducted in eight parks by means of dozens of interviews with managers and other interested social actors, as well as by documentary research and direct observation. The results suggest that the ecotourism objective is still far from being reached, and that the collaborative strategies used are not sufficient to compensate for the organizational, material and human limitations that encumber these agencies. It was also concluded for the sample that there lacks a strategic vision on the part of the three branches of government involved in the management of these parks in the sense of viewing ecotourism in the city's conservation units as a powerful means to foster local sustainable development.

O estresse ocupacional do professor do ensino superior: a relação entre os sintomas de estresse e a atividade docente em duas instituições de ensino superior da cidade de Teresina-pi

RESUMO: Com a globalização e as mudanças provenientes da mesma, o ser humano vem sofrendo com o estresse ao tentar se adaptar e acompanhar tais acontecimentos seja no âmbito familiar, social, afetivo e profissional. Para desempenhar as funções docentes do ensino superior, são exigidas diversas condições, e o professor sofre um desgaste físico e psicológico ao tentar suprir determinadas demandas, o que em muitos casos, ocasiona o estresse ocupacional. Com o propósito de aprofundar conhecimentos sobre a relação existente entre o estresse e a atividade docente, fizemos o seguinte questionamento: quais os sintomas de estresse apresentados em professores do ensino superior? Com Objetivo geral de estudar os sintomas e níveis de estresse, relacionando-os à carreira docente do ensino superior, com as variáveis: regime de trabalho, vínculo institucional, idade, sexo, tempo de trabalho, tipo de IES, em uma população específica pertencente a duas Instituições de Ensino Superior -IES da cidade de Teresina, Estado do Piauí- Brasil, sendo uma pública e uma privada. Visando atingir os objetivos propostos, utilizamos da metodologia de caráter exploratório e descritivo, com abordagem quantitativa dos dados recorrendo à estatística descritiva. O instrumento de coleta de dados utilizado foi o “Inventário de Sintomas de Stress Lipp – ISSL” da autora Marilda Lipp (2000), aplicado em uma amostra de cem (100) professores, com idade entre 22 e 55 anos de idade. Mediante a análise dos dados, pode-se verificar que apesar das diferenças existentes entre IES públicas e privadas, a maioria dos resultados foram semelhantes. Em ambas as IES houve presença de estresse nos docentes, prevalecendo a fase de alerta, logo após a fase de resistência, em seguida a fase de quase-exaustão,Houve um predomínio de sintomas psicológicos, onde na IES privada se destacam: aumento súbito de motivação e entusiasmo súbito. E como sintomas físicos: boca seca e nó no estômago. Na IES públicas os sintomas psicológicos foram: entusiasmo súbito e aumento súbito de motivação. E físicos: tensão muscular e nó no estômago. Em relação as co-variáveis que apresentaram maior relação com o estresse pode-se apresentar na IES privada o sexo masculino e feminino possuem a mesma representatividade, a faixa etária de 31 a 39 anos, estado civil casado, tempo de serviço de 7 a 13 anos, jornada de trabalho integral e vínculo efetivo. Já na IES pública verifica-se relação com o sexo feminino, idade variando de 31 a 39 anos, estado civil solteiro, tempo de serviço de 7 a 13 anos, jornada de trabalho parcial e vínculo substituto. De acordo com o que foi analisado, percebe-se que os docentes do ensino superior, independente do tipo de IES ao qual estão vinculados, estão sujeitos ao estresse e que estes não devem ser responsabilizados pelo mesmo, nem por adoção de medidas preventivas, visto que toda a IES sofre as conseqüências, e tem condições de auxiliar o professor com situações preventivas, de controle a partir do conhecimento, interpretação e mudança de hábitos do professor no ambiente universitário. ABSTRACT: With globalization and its changes, the human being has suffered from stress while trying to adapt and monitor such events, within family, social, emotional or professional scope. To play as teacher in higher education, they are required various conditions and the teacher suffers physical and psychological wear trying to meet certain demands, which in many cases leads to occupational stress.Aiming to deepen knowledge about the relationship between stress and teaching activities, we made the following question: what are the symptoms of stress presented by higher education teachers? With the general objective of study the symptoms and the stress levels, linking them to the teaching career in higher education, using the following variables: working regime, institutional link, age, sex, working time, type of HEI, in a specific population belongs to two Higher Education Institutions HEI - of Teresina, Piauí, Brazil, one public and one private. Aiming to achieve the proposed objectives, we used a exploratory - descriptive study, with quantitative approach of data using graphs and tables. The data collection instrument used was the "Lipp Stress Symptoms Inventory - ISSL" by the author Marilda Lipp (2000), applied to a sample of a hundred (100) teachers, between 22 and 55 years of age. Through data analysis, despite the differences between public and private HEIs, we can see that the most results were similar. In both HEIs, the results revealed that the alert phase of stress had prevailed, followed by resistance and almost-exhaustion phases. A small number presented stress in exhaustion phase and another group did not present stress. There was a predominance of psychological symptoms, which in private HEIs stands out: increase of motivation and enthusiasm suddenly. And as physical symptoms: dry mouth and stomached. In public HEI, psychological symptoms were sudden enthusiasm and increse of motivation. And physical symptoms: muscle tension and stomached. In relation to the co-variables that showed a greater relationship with stress, in private HEIs males and females have the same representation, between 31-39 years, married, working time of 7-13 years, full working day and effective link. Already in public HEIs, female, between 31-39 years, unmarried, working time of 7-13 years, partial working day and substitute link had prevailed. According to analysis, we find that teachers in higher education, regardless of the HEI to which they are linked, are subject to stress. And they should not be blamed for the onset of stress, neither by adopting preventive measures, since all the HEI suffers the consequences, and it is able to help teachers with preventive measures based on the knowledge, interpretation and change habits of the teacher in the university environment.

Chagas' disease and social security: a case-control study in an urban area, Goiás, Brazil

One hundred and twenty subjects with Chagas' cardiopathy and 120 non-infected subjects were randomly selected from first time claimants of sickness benefits in the National Institute of Social Security (INPS) in Goiás. Cases of Chagas' cardiopathy were defined based on serological test, history of residence in an endemic area and, clinical and/or electrocardiogram (ECG) alterations suggestive of Chagas' cardiomyopathy. Controls were defined as subjects with at least two negative serological tests. Case and controls were compared in the analysis for age, sex, place of birth, migration history, socio-economic level, occupation, physical exertion at work, age at affiliation and years of contribution to the social security scheme, clinical course of their disease and ECG abnormalities. Chagas' disease patients were younger than other subjects and predominantly of rural origin. Non-infected subjects presented a better socio-economic level, were performing more skilled activities and had less changes of job than cases. No important difference was observed in relation to age at affiliation to INPS. About 60% of cases have claimed for benefits within the first four years of contribution while among controls this proportion was 38.5%. Cases were involved, proportionally more than controls, in "heavy" activities. A risk of 2.3 (95%CL 1.5 - 4.6) and 1.8 (95%CL 1.2- 3.5) was obtained comparing respectively "heavy" and "moderate" physical activity against "light". A relative risk of 8.5 (95%CL 4.9 - 14.8) associated with the presence of cardiopathy was estimated comparing the initial sample of seropositive subjects and controls. A high relative risk was observed in relation to right bundle branch block (RR = 37.1 95%CL = 8.8 - 155.6) and left anterior hemiblock (RR = 4.4, 95%CL = 2.1 - 9.1).

Body composition, muscle strength, functional capacity, and physical disability risk in liver transplanted familial amyloidotic polyneuropathy patients

Abstract: Background: Familial amyloidotic polyneuropathy (FAP) is a neurodegenerative disease leading to sensory and motor polyneuropathies, and functional limitations. Liver transplantation is the only treatment for FAP, requiring medication that negatively affects bone and muscle metabolism. The aim of this study was to compare body composition, levels of specific strength, level of physical disability risk, and functional capacity of transplanted FAP patients (FAPTx) with a group of healthy individuals (CON). Methods: A group of patients with 48 FAPTx (28 men, 20 women) was compared with 24 CON individuals (14 men, 10 women). Body composition was assessed by dual-energy X-ray absorptiometry, and total skeletal muscle mass (TBSMM) and skeletal muscle index (SMI) were calculated. Handgrip strength was measured for both hands as was isometric strength of quadriceps. Muscle quality (MQ) was ascertained by the ratio of strength to muscle mass. Functional capacity was assessed by the six-minute walk test. Results: Patients with FAPTx had significantly lower functional capacity, weight, body mass index, total fat mass, TBSMM, SMI, lean mass, muscle strength, MQ, and bone mineral density. Conclusion: Patients with FAPTx appear to be at particularly high risk of functional disability, suggesting an important role for an early and appropriately designed rehabilitation program.

Effects of an exercise training program in physical condition after liver transplantation in familial amyloidotic polyneuropathy: a case report

Introduction: Familial amyloidotic polyneuropathy (FAP) is a neurodegenerative disease that leads to sensory and motor polyneuropathies as well as functional limitations. So far, liver transplantation is the only treatment for FAP because the mutated protein causing the disease is mainly produced in the liver. With the increasing survival of transplant recipients, functional and cardiovascular problems as consequences of immunosuppressant side effects are increasing associated with sedentary lifestyles and/or retransplantation status. We sought to analyze the impact of exercise training programs on 1 FAP patient’s course long-term after liver transplantation. Methodology. A FAP patient (female; 49 years of age; body mass index 18.8 kg/m2) underwent a liver transplantation 133 months before assessment. She was assessed for body composition, isometric quadriceps muscle strength, functional capacity, fatigue, and levels of physical activity before and after a 6-month period of combined exercise training. Results: After the exercise training program, almost all variables were improved, namely, total body skeletal muscle mass, proximal femoral bone mineral density, quadriceps strength, maximal oxygen consumption on 6 minutes walk test (6mwt) or VO2peak, total ventilation on 6mwt, and fatigue. The improvement in distance on 6mwt (69.2 m) was clinically significant. Preintervention the levels of physical activity were below international recommendations for health; after the program they achieved the recommendations. Conclusion: The results showed an improvement in functional capacity with a decrease in future disability risk associated with a better lifestyle with respect to physical activity levels in 1 patient.

Intermittent claudication and physical exercise: effectiveness of a home-based program

Peripheral arterial disease (PAD) as a high incidence in general population and 12% to 20% of population with more than 60 years has already clinical symptoms, such as intermittent claudication (IC), pain, loss of strength and functional incapacity. There are already some studies who refer the possible positive effects of physical exercise in functional consequences of PAD.

Knee muscle strength, balance and functional independence in persons with stroke

Purpose: to investigate the relationship between knee muscle strength, balance and functional independence within the first month after stroke. Relevance: cerebral vascular disease is one of the main causes of morbidity, disability and mortality in developed countries. Problems with movement control are frequent after stroke. Lower limb weakness and impaired balance are common problems that are related with the risk of falls and are likely to interfere with the ability to perform daily life activities. Physiotherapy intervention usually starts early after stroke and addresses impairments related to movement and posture in order to improve motor recovery and restore function.

Muscle strength, balance and functional independence in persons with stroke

Cerebral vascular disease is one of the main causes of morbidity, disability and mortality in developed countries. Problems with movement control are frequent after stroke. Lower limb weakness and impaired balance are common problems that are related with the risk of falls and are likely to interfere with the ability to perform daily life activities. Physiotherapy intervention usually starts early after stroke and addresses impairments related to movement and posture in order to improve motor recovery and restore function. Purpose: to investigate the relationship between knee muscle strength, balance and functional independence within the first month after stroke.