The Mini Nutritional Assessment of the elderly in the practice of a hospital geriatrics service: inception, validation and operational characteristics

The results of the administration of the Mini Nutritional Assessment (MNA) of the Elderly to 197 patients (Women: 62.5%; Ages between 60-75 years: 55.4%; Older than 85 years: 9.7%; Whites: 73.7%) consecutively admitted to the Geriatrics Service of the "Hermanos Ameijeiras" Hospital (La Habana, Cuba) are presented. Sixty-nine percent of the patients had between 2 - 7 concurrent health problems. Neoplasms and lymphoproliferative processes (22.8%), heart and blood vessels diseases (15.7%), and infections (12.2%) were prevalent. The state of nutritional anthropometric and biochemical markers was as follows: Body Mass Index < 21 kg x m(-2): 30.9%; Mid-arm Circumference <22 cm: 19.3%; Leg Circumference <31 cm: 42.6%; Serum Albumin <35 g x L(-1): 20.3%. Sixty-eight percent of the patients received scores <24 after administering the MNA. It is to be noticed that 19.3% of the patients was malnourished after receiving scores < 17. MNA scores <24 were concentrated in: Neurological disorders (80.0%), Neoplasms and lymphoproliferative processes (77.8%), heart and blood vessels diseases (74.2%), gastrointestinal disorders (70.6%), infections (69.7%), Diabetes mellitus (66.7%). Patients with the lowest scores also exhibited the lowest values of anthropometric and biochemical markers. MNA score was independent from the patient's sex, skin colour, or number of concurrent health problems. Age had not any influence upon MNA score, although lower scores were observed among the oldest patients. MNA scoring was 80.0% coincident with nutritional diagnosis independently done with anthropometric and biochemical markers used either separately or combined. Aging of the Cuban population, along with increased proportions of elder patients in hospital areas should lead to consider the nutritional status of patients older than 60 years as an important predictor of the success of medical interventions and the quality of medical assistance.     

Ready to Use Therapeutic Foods (RUTF) improves undernutrition among ART-treated, HIV-positive children in Dar es Salaam, Tanzania

ABSTRACT: BACKGROUND: HIV/AIDS is associated with an increased burden of undernutrition among children even under antiretroviral therapy (ART). To treat undernutrition, WHO endorsed the use of Ready to Use Therapeutic Foods (RUTF) that can reduce case fatality and undernutrition among ART-naive HIV-positive children. However, its effects are not studied among ART-treated, HIV-positive children. Therefore, we examined the association between RUTF use with underweight, wasting, and stunting statuses among ART-treated HIV-positive children in Dar es Salaam, Tanzania. METHODS: This cross-sectional study was conducted from September-October 2010. The target population was 219 ART-treated, HIV-positive children and the same number of their caregivers. We used questionnaires to measure socio-economic factors, food security, RUTF-use, and ART-duration. Our outcome variables were underweight, wasting, and stunting statuses. RESULTS: Of 219 ART-treated, HIV-positive children, 140 (63.9%) had received RUTF intervention prior to the interview. The percentages of underweight and wasting among non-RUTF-receivers were 12.4% and 16.5%; whereas those of RUTF-receivers were 3.0% (P = 0.006) and 2.8% (P = 0.001), respectively. RUTF-receivers were less likely to have underweight (Adjusted Odd Ratio (AOR) =0.19, CI: 0.04, 0.78), and wasting (AOR = 0.24, CI: 0.07, 0.81), compared to non RUTF-receivers. Among RUTF receivers, children treated for at least four months (n = 84) were less likely to have underweight (P = 0.049), wasting (P = 0.049) and stunting (P < 0.001). CONCLUSIONS: Among HIV-positive children under ART, the provision of RUTF for at least four months was associated with low proportions of undernutrition status. RUTF has a potential to improve undernutrition among HIV-positive children under ART in the clinical settings in Dar es Salaam, Tanzania.     

北京市朝阳区部分社区老年人的肺炎疫苗接种率及影响因素分析

目的分析北京市朝阳区部分社区老年人肺炎疫苗接种率及其影响因素,以提高老年人肺炎疫苗的接种率,降低社区老年人肺炎球菌感染的危害。方法通过整群抽样的方法,选取北京市朝阳区年龄≥60岁的部分社区老年人进行问卷调查,收集调查对象的基本信息、健康状况、就医行为及疫苗接种情况,分析社区老年人肺炎疫苗接种率的影响因素。结果调查数据显示社区老年人的肺炎疫苗接种率为2.1%,经多因素Logistic回归分析,年龄、受教育程度及健康状况是肺炎疫苗接种率的主要影响因素(P<0.05)。结论应通过多种措施提高老年人等优先人群肺炎疫苗的接种率;干预过程中应重视受教育程度较低、身体素质较好以及年龄相对较轻的老年人。     

Ozone-forming potential and fuel formulation from mobile sources in Mexico

Most major metropolitan areas in Mexico have continually violated government health standards for ozone. Throughout this period policy plans have been developed for lowering urban ozone, and bringing cities into compliance with the law, among them, fuel reformulation. In this work, 12 fuels were prepared in several sets, to study the ozone-forming potential effects of individual fuel properties of Tier 0 and Tier 1 in-use vehicles of the Metropolitan Area of Mexico City. The results indicate that the specific reactivities for Tier 1 vehicles are in general much higher than those reported in similar studies performed by other groups. An emission inventory for the 2010 year was calculated for each fuel in order to provide different scenarios for future formulations.     

Body iron reserves of rural and urban Guatemalan women of reproductive age

Body iron reserves (using serum ferritin as an index), hematological status, and other indicators of iron nutrition were evaluated in three groups of non-pregnant nulliparous women with ages comprised between 14 and 29 years (mean = 19 years). The first group (n = 33) included residents of the rural coastal area (less than 750 m above sea level) (group RCG); the second (n = 32) from the rural highlands (751-1,500 m) (group RHG); and the third group (n = 104) from urban Guatemala City (1,500 m) (group UG). The women in the UG group belonged to the middle or high socioeconomic stratum. Median values in serum ferritin levels (ng/ml) for each group were: RCG = 11.5 (undetectable 50.6); RHG = 17.2 (1.9-83.1) and UG = 20.2 (3.9-56.7). The difference between RCG and UG was statistically significant (P less than 0.05). The percentage of women with serum ferritin levels less than or equal to 9 ng/ml (iron deficiency) was 45 in the RCG, 25 in the RHG and 12 in the UG group. In addition, the prevalence of subnormal hemoglobin levels (below mean - 1 SD) was 46% in the RCG, 12% in the RHG and 8% in the UG. There were no cases of subnormal blood folate levels. As results indicate, the women studied had low iron reserves, the rural coastal group being the most affected. They also evidenced the high prevalence of iron deficiency in the region and the need for public health actions to overcome this nutrition problem.     

Food habits and caries experience in young adults from Rosario, Argentina

Odontological assistance in Rosary City is offered in private and public services. The public ones lack programs to avoid dental loss in adults. Our aim was to describe the caries experience and dietetic habits in three sub-populations of young adults. Applying a standardized anamnesis, 517 patients, both sexes, 15-45 years old, attending to a private service (19%) and two public ones (81%), were investigated. Studied variables: oral health, lacteal and sweet food consumed, and instruction level. Student t-test, ANOVA and chi-square tests were applied. Average decayed teeth were 1.7+/-2.0 in the private service, and 4.1+/-2.8 in the public ones (p<0.0001); missing teeth were 5.4+/-5.2 and 6.8+/-5.4 (p=0.04); and filled teeth were 4.4+/-4.2 and 1.3+/-2.2, respectively (p<0.0001). Dairy foods daily consumption was higher in the private service (p<0.001). Patients in the public services expressed to replace milk by mate, and to relate its consumption with pregnancy and lactation, or to leave it for children. Sweets delicacies consumed in the private sector -considered of risk- were sweet breads, cakes, cookies and sweets, and in the public ones were soft candies, "alfajores" and sweet made with milk. Minor risk sweets consumption in private patients were ice creams, sodas and chocolates, and in the public ones, hard candies and chewing gums, with and without sugar. Although a high number of patients consume delicacies and sweet foods at any hour, private patients were a minority; and they were a majority when considering its ingestion only after a food.     

Advances in the science and technology of paints, inks and related coatings: 2006

This review summarises the many developments reported inSurface Coatings International Part B: Coatings Transactions,89, 2006. Thus the advances in polymer synthesis and characterisation and synthetic latexes for use in coatings are reviewed Developments in RAFT agents, hyperbranched polymers, and coupling agents for adhesion are discussed. Novel hybrid, smart anticorrosive, optical thin-film and powder coatings are surveyed, and developments in the oxidative and UV curing of paints and coatings described. Adaptive speckle imaging interferometry, a new technique for characterising the curing of coatings, and an ultrathin film high-shear disperser used to produce nanoparticles are discussed. Studies on plasma treatments, weatherability, and scratch and mar resistance of coatings are reviewed. Developments in printing inks, printability and deinking technology are surveyed. The colour and constitution relationships in azonaphtharylamide pigments are discussed. The latest developments in digital image capture and filmless camera technology and techniques are summarised.     

Use of knee height to correct the body height of elderly Hispanics

Loss of stature in certain elderly subjects can be attributed to diseases such as osteoporosis, as well as to age and generational effects. In addition, many elders cannot stand straight for accurate measurement. For these cases, total height can be estimated with regression equations based on knee height. The aims of this study were, firstly, to evaluate the applicability of regression equations based on knee height for estimation of stature and, secondly, to document the differences between measured and estimated height in a group of elderly Hispanics with postural problems (n = 166) in comparison with a group of elderly Hispanic without postural problems (n = 270). Using both, estimated and measured height, we also calculated the body mass index (BMI) of both groups of elders. Statistical analyses were done with paired t-tests, within sex and study group. Within the group with postural problems, estimated height was higher than the measured height for both men (p < or = 0.001) and women (p < or = 0.001). There were no significant differences between measured and estimated height in the group without postural problems. Furthermore, in the group with postural problems, BMI values calculated with estimated height were lower than those estimated with the measured height, and these differences were also significant for both men (p < or = 0.001) and women (p < or = 0.001). With the aging of the Latin American population, there is a need for more nutrition and health research among elders. In order to do this we need to develop and use methods and criteria appropriate for each population.     

Scaling behavior in the scratching of automotive clearcoats

The scratch resistance of four clearcoat formulations was evaluated using a CSM nano-scratch tester, an AMTEC-Kistler simulated carwash tester, and a laboratory scale macro-scratching tester. Significant differences in the rank-order of all the clearcoats were found when comparing the scratch and mar behavior using macro-scratching, nano-scratching, and AMTEC-Kistler testing. Field vehicles were also examined where the mean and median widths of scratches found on vehicles were 237 and 141 μm, respectively. The range of loads associated with events with the potential to create real-world scratches was found to be significantly higher (5–35 N) than the forces needed to make scratches of the same mean size as those seen in the field (7–10 N). These results indicated that a significant improvement in the scratch resistance of these clearcoats would be needed before customers would notice improvements in their paint finish’s scratch resistance.     

The nutritional and health status of the Latin American woman

Latin America is a region where countries have various levels of socioeconomic development. Thus, the living standards and health status of its people differ significantly in the midst of a mosaic of social, ethnic, cultural and economic realities. Social inequalities and extreme poverty determine significant differences, not only in the magnitude of health indicators, but also in the type of pathology prevalent. People in the high socioeconomic levels are affected by nutritional diseases characterized by excessive food intake, while people from the low socioeconomic levels are affected by undernutrition and its associated pathology. Undernutrition occurs fundamentally among the age groups at higher risk in the population segments with low income, low food intake, illiteracy and poor access to the health care and preventive medicine centers. Among families exposed to undernutrition, women are usually in worse condition than men. This is due to the long working hours and the increased nutritional requirements caused by frequent gestations and prolonged lactation. It is estimated that one fourth of newborns in Latin America are affected by low birth weight, which has been associated to adolescent mothers, their excessive physical work, anemia, low maternal pregestational weight, low weight gain during gestation, and frequent maternal infections. Nutritional anemia due to iron deficiency is highly prevalent among pregnant women in Latin America. In some countries, the prevalence of folate deficiency during pregnancy appears to have increased significantly in the past 15 years and is becoming a nutritional problem that needs preferential attention. Diets generally are inadequate and, in the case of pregnant and lactating women, usually deficient in calories, protein, iron and folic acid. It is urgent that the health and nutritional status of Latin American women of low socioeconomic condition be given special attention, particularly mothers during gestation and lactation. Otherwise, women will not be able to altogether fulfill their important role in the home and within the family, nor will they successfully participate in the economic development of their countries.     

The impact of malnutrition on brain development, intelligence and school work performance

The findings from several authors confirm that undernutrition at an early age affects brain growth and intellectual quotient. Most part of students with the lowest scholastic achievement scores present suboptimal head circumference (anthropometric indicator of past nutrition and brain development) and brain size. On the other hand, intellectual quotient measured through intelligence tests (Weschler-R, or the Raven Progressives Matrices Test) has been described positively and significantly correlated with brain size measured by magnetic resonance imaging (MRI); in this respect, intellectual ability has been recognized as one of the best predictors of scholastic achievement. Considering that education is the change lever for the improvement of the quality of life and that the absolute numbers of undernourished children have been increasing in the world, is of major relevance to analyse the long-term effects of undernutrition at an early age. The investigations related to the interrelationships between nutritional status, brain development, intelligence and scholastic achievement are of greatest importance, since nutritional problems affect the lowest socioeconomic stratum with negative consequences manifested in school-age, in higher levels of school dropout, learning problems and a low percentage of students enrolling into higher education. This limits the development of people by which a clear economic benefit to increase adult productivity for government policies might be successful preventing childhood malnutrition.     

From controversy to consensus: The Redwood City recycled water experience

The Redwood City Recycled Water Project faced intense local opposition from a small but determined group of citizens who objected to the use of recycled water from a public health and safety perspective, particularly in areas where children play. In response to this opposition, the City Council eventually formed a community task force and empowered them to help develop a solution to the City's water supply problem. This paper presents the evolution of the project, from its impetus through the environmental review and project approval process; the task force operations and recommendations, which the Council enthusiastically endorsed, are described. The paper concludes with the current status of the project, and lessons the City learned through the process to create a community-based, consensus-driven solution.     

High prevalence of undernutrition in Spanish elders admitted to a general hospital and associated factors

The objective of the study was to evaluate the nutritional status of the hospitalised elderly patients using the Mini Nutritional Assessment (MNA) and nutritional classic parameters, to estimate the prevalence of undernutrition among them and to value the correlation of undernutrition with epidemiological characteristics of the sample for determine the highest risk's group among the malnourished patients. A cross sectional survey was done among a sample of 200 elderly patients admitted to the USP San Carlos Hospital (Murcia, Spain) during a period of 3 months. Patients answered a questionnaire including demographic data and the MNA clinical tool. Lymphocyte concentration and albumin and transferrin serum levels were also collected. Statistical analyses were performed with the Student t and chi 2 tests. For the MNA, the Spearman's coefficient was employed. Mean age of the 200 patients was 80.72 SD 7.43 years. Mean weight was 63.41 SD 19.57 kg and mean height was 160.93 SD 8.36 cm, with a mean Body Mass Index of 24.27 SD 7.31. The serum values of albumin and transferrin and total lymphocytes in blood were 3.09 SD 0.5 g/l, 1.69 SD 0.37 mg/dl and 1412 mm3 respectively. Average score of the MNA was 15.9 SD 6.21 and, according to this scale, 50% (n=100) of the patients were malnourished. Correlation analyses resulted in significant association (p < 0.001) between values of undernutrition in the MNA and measurements under normality of the biochemical and immunological parameters. The patients who presents chronic diseases, advanced physical or mental deterioration and minor self-sufficiency are either malnourished or at high risk of being. The individualized nutritional evaluation must be performed routinely when the patient is admitted to the hospital for detect and treat early signs of malnutrition.     

Survey of seed oils for use as diesel fuels

Fifty-one out of 364 plant seeds being surveyed had fatty acid contents greater than 15% (dry weight), and their methyl esters had cetane indices higher than 50. Rambutan seed was an exception, with a lipid content of only 14.7%, but a high cetane index (67.1); thus, it was included in this report. Twenty seed oil methyl esters had cetane indices greater than 60. Three seed oils from the Sapindaceae family not only had high cetane indices but also contained long-chain fatty acids of 20 carbon atoms. Gross heats of combustion of the fatty acid methyl esters were slightly higher than those of neat oil, ranging from 38.2 to 40.8 j/g, whereas the heating values of the oils ranged from 37.4 to 40.5 j/g. Thus, these plant seed oils have great potential for development as diesel fuel or diesel fuel extender.     

开封农村地区婴幼儿中肠道病毒71型和柯萨奇病毒A组16型中和抗体水平及流行趋势

目的了解开封农村地区婴幼儿中肠道病毒71型(EV71)和柯萨奇病毒A组16型(CA16)中和抗体水平及流行趋势。方法应用微量细胞病变法,对2004年开封农村地区采集的349名7～30月龄婴幼儿血清进行EV71和CA16中和抗体检测。结果7～30月龄婴幼儿EV71和CA16中和抗体阳性率分别为36.7%(128/349)和36.5%(123/337),但二者流行趋势不同。EV71抗体阳性率由10～12月龄组的18.2%上升至25～30月龄组的81.3%,上升约4.5倍,抗体几何平均滴度(GMTs)也缓慢上升;CA16抗体阳性率由13～15月龄组的23.0%上升至22～24月龄组的47.6%,上升约2.1倍,GMTs在125～338之间波动;不同月龄婴幼儿中存在EV71和CA16混合感染的情况,19～24和25～30月龄组的EV71和CA16混合感染率显著高于7～12和13～18月龄组。结论开封农村地区婴幼儿中EV71和CA16中和抗体阳性率高,但二者上升的趋势不同,18月龄后的婴幼儿中EV71和CA16混合感染的比例显著升高。     

Helicobacter pylori infection (13C-UBT), and its relationship with nutritional and socioeconomic factors in low income school children from Valencia, Venezuela

Helicobacter pylori infection (Hp) is widely spread around the world, and it is considered one of the main causes of chronic gastritis, peptic and duodenal ulcers, and gastric cancer. Recent research has shown that it can be associated with nutritional disorders, mainly with iron and other micronutrient deficiencies. The objective of this study was to assess the prevalence of Hp infection, and infection pattern according to age, sex, nutritional status, and socioeconomic conditions in children who attended the Unidad Educativa "Valentin Espinal" in the city of Valencia. 170 children, between 3 and 14 years of age were studied to assess Hpylori infection (13C-urea breath test), age, nutritional status according to BMI and Height for age, hemoglobin (cianometahemoglobin), serum ferritin (ELISA), socioeconomic status (Graffar-Méndez-Castellano), housing conditions, number of families and of people cohabitating in the same household, and quality of services. 78.8% of the children were infected with Hp, witch was significantly correlated with age but not gender. 25.9% of the sample had undernutrition, and 46.5% were stunted. 98.1% of the families lived in poverty, and 98% of the households showed sanitary deficiencies. A mean of 6.0 +/- 2.4 persons lived in each household (range: 2-15), and an average of 3.2 person shared bedrooms. The odds of being infected were higher in those children who were stunted. Also, socioeconomic status, mother's education level, and poor hosing conditions were significantly associated to being infected. Hpylori is highly prevalent among socially and economically deprived children, and age, overcrowding, and a low education level of the mother increases the risk of being infected.     

High-Molecular-Weight Polycyclic Aromatic Hydrocarbons in the Area and Vicinity of the Deza Chemical Plant,Czech Republic

Polycyclic aromatic hydrocarbons (PAHs) with molecular weight exceeding 278 amu were analyzed in air, water, and soils from the area and vicinity of the DEZA Chemical Plant (Vala w ské Mezi q í ) í, Czech Republic). Air and water were sampled using semipermeable membrane devices (SPMDs); grab sampling was applied for soils. Laser desorption/ionization-time-of-flight mass spectrometry (LDI-TOF MS) and liquid chromatography/ion trap mass spectrometry with atmospheric pressure chemical ionization (LC/APCI-ITMS) were employed for the quick assessment of PAH distribution and for the identification and quantification of some high-molecular-weight PAHs. Compounds with molecular mass up to 450 u were found. LDI-TOF mass spectra and selected LC/APCI-ITMS profiles (m/z 303, m/z 327, and m/z 351) were compared to identify potential source of contamination in this locality. High-molecular-weight PAHs were found in all environmental compartments in the area studied; their levels were quite high close to their source and decreased sharply with increasing distance from it.     

岳阳市献血者Rh血型系统表型的调查及Rh阴性献血者档案库的建立

目的调查岳阳市无偿献血人群Rh血型系统的表型,建立Rh阴性献血者档案库。方法使用Rh血型定型试剂,采用平板法进行初筛,结果可疑者用试管法确认。初筛阴性标本送血型参比室做确认试验,并进行Rh因子C、c、E、e和不规则抗体筛选。结果在183 596名无偿献血者中共筛出RhD阴性献血者404名(0.22%),弱D 5名(0.003%)。404名Rh阴性献血者中共检出A型112名(27.7%),B型112名(27.7%),O型128名(31.7%),AB型52名(12.9%)。表型共7种:ccdee 212名(52.5%),Ccdee 124名(30.7%),CCdee 30名(7.4%),ccdEe 18名(4.4%),ccdEE 8名(2.0%),CcdEe 8名(2.0%),CCdEe 4名(1.0%)。结论已建立了岳阳市Rh阴性献血者档案库。     

Variability for oil and fatty acid composition in castorbean varieties

Thirty-six castorbean varieties were surveyed for oil and fatty acid composition, in order to determine variability of these seed compounds. A large variability of seed oil percentage was observed, ranging from 39.6 to 59.5%. Concerning the fatty acids, little variability was observed for ricinoleic acid, which was the most abundant in the oil, ranging from 83.65 to 90.00%. The other fatty acids appeared in small concentrations and showed a small range: 0.87 to 2.35, 0.68 to 1.84, 2.96 to 5.64, 3.19 to 5.98, and 0.34 to 0.91%, for palmitic, stearic, oleic, linoleic, and linolenic acid, respectively. Non-significant correlations were observed between fatty acids and seed oil percentage. However, significant correlations were observed among fatty acid concentrations: positive and negative ones. These significant correlations could be associated with the biosynthetic pathways of the fatty acids, which are not fully elucidated. They suggest, however, that selection for a particular fatty acid will tend to increase those positively correlated, and decrease those negative ones. Selection and plant breeding techniques could then be applied to modify the oil content of the castorbean seeds, considering the variability observed. For the fatty acid composition, however, the variability was not large enough to make substantial changes in their concentrations by selection procedures. More varieties should be surveyed to find out if such variability is available.     

深圳市医疗卫生机构医疗废物产污现状调查与分析

为了解深圳市医疗卫生机构医疗废物产污现状,调查分析了30家医院、4家妇幼保健院和8家社康中心医疗废物产生情况。结果表明,医院、妇幼保健院和社康中心医疗废物平均产污系数分别为0.97 kg/床/d、1.64 kg/床/d和0.06 kg/人次,妇幼保健院产污系数要高于医院(P0.05);三级医院、二级医院和一级医院产污系数分别为0.89 kg/床/d、0.91 kg/床/d和1.10 kg/床/d,三者间无统计学差异(P0.05);医院医疗废物产生量与病床数呈极显著正相关关系(P0.01)。深圳市医疗卫生机构医疗废物产污系数在国内外均处于较高水平,其中妇幼保健院产污系数最大,三级医院、二级医院和一级医院相近。