Factors that cause women with osteoporosis to fall

ABSTRACT Objectives: To analyze and compare intrinsic and extrinsic factors that cause falls among women receiving treatment for osteoporosis. Subjects and methods: A cross-sectional study of women ≥50 years receiving treatment for osteoporosis. Participants filled out questionnaires (demographic characteristics), and researchers took anthropometric measurements of bone mineral density, handgrip strength (HGS), ankle range of motion (ROM), and gait speed (GS). We also evaluated the Timed Up and Go Test (TUGT), Five Times Sit-to-Stand Test (SST), and Falls Efficacy Scale-International (FES-I) and investigated the extrinsic factors for falls. Results: We included 144 participants (71.6 [8.3 years]), who reported 133 falls. We classified participants into a non-faller group (NFG; 0 falls, n = 71, 49.5%), a faller group (FG; 1 fall, n = 42, 28.9%), and a recurrent-faller group (RFG; more than 1 fall, n = 31, 21.5%). Most patients had an increased risk of falling according to the TUGT, SST, reduced ankle ROM, and GS (P < .005 for all). FES-I was associated with sporadic and recurrent falls. For the multivariate analysis, the number of falls was influenced by the presence of ramps (RR 0.48, 95% CI, 0.26-0.87, P = .015), uneven surfaces (RR 1.6, 95% CI. 1.05-2.43, P = .028), and antislippery adhesive on stairs (RR 2.75, 95% CI, 1.77-4.28, P < .001). Conclusion: Patients receiving treatment for osteoporosis are influenced by intrinsic and extrinsic factors that cause falls. Lower-limb strength and power-discriminated participants at a higher risk of falls, but extrinsic factors varied. Only uneven floors and antislippery adhesives on stairs were associated with increased frequency of falls.

Factores extrínsecos implicados en la pigmentación de las resinas compuestas dentales / Extrinsic factors involved in the pigmentation of dental composite resins

RESUMEN Las resinas compuestas dentales fueron introducidas en la primera mitad del siglo XX como una avance mecánico- estético en el campo de la odontología restauradora, en respuesta a los silicatos, que hasta aquel entonces era el material restaurador de primera elección, dentro de su composición, posee una matriz orgánica formada por Bis- GMA y otros monómeros de dimetacrilato (TEGMA, UDMA, siloranos), que son susceptibles a la pigmentación de sustancias extrínsecas, en diferente grado , las bebidas más comunes como vino tinto, té, café y bebidas azucaradas Objetivo: Revisar y analizar la literatura disponible que responda a la pregunta ¿Cuáles son los factores extrínsecos más comunes que causan pigmentación de las resinas compuestas?

ABSTRACT Dental composite resins were introduced in the first half of the 20th century as a mechanical-aesthetic advance in the field of restorative dentistry, as a response to silicates, which at that time was the first choice restorative material, composite resin contains a matrix of organic made up of Bis-GMA and other dimethacrylate monomers (TEGMA, UDMA, silorans) doing them susceptible to pigmentation with extrinsic substances, in this case drinks, such as red wine, tea and coffee are the main cause of the pigmentation of resins. Objective: To Review and analyze the available literature that answers the question: what are the most common extrinsic factors that cause pigmentation of composite resins?

Desorientación intrínseca y extrínseca en la atención nefrológica / Intrinsic and extrinsic disorientation in nephrological care

Resumen En este ensayo se muestra que el desarrollo de la nefrología en los últimos lustros ha sido básicamente en la diálisis y el trasplante renal, pero es insuficiente y limitado el acceso a toda la población que los requieren, lo cual es un fenómeno universal. Además, se ha generado la fragmentación de la especialidad en otras subespecialidades. Entre otros motivos que impiden que los tomadores de decisiones se decidan por ampliar la atención nefrológica terciaria a mayor población se identifican 12 factores intrínsecos y cuatro extrínsecos, aunado a limitados recursos destinados a la investigación, por lo que se invita a que las sociedades nacionales de nefrología actúen y traten de modificar esos factores que son obstáculos para el desarrollo de la especialidad y la ampliación de la atención nefrológica.

Abstract This essay shows that the development of nephrology in recent years has been basically in dialysis and kidney transplantation, but access to the entire population that requires it is insufficient and limited, which is a universal phenomenon. In addition, the fragmentation of the specialty into other subspecialities has been generated. Among other reasons that prevent decision makers from deciding to expand tertiary nephrology care to a larger population, 12 intrinsic factors and four extrinsic factors are identified, together with limited resources dedicated to research; therefore, national societies of nephrology are encouraged to act and try to modify those factors that are obstacles to the development of the specialty and the expansion of nephrological care.

El desarrollo de la autorregulación en la infancia temprana y sus factores moduladores / The Development of Self-Regulation in Early Childhood and its Modulating Factors

La autorregulación emocional refiere a la capacidad intrínseca de los niños y niñas de modular y modificar respuestas tanto emocionales como cognitivas, por demandas de situaciones específicas (Lewis & Todd, 2007; Vohs & Baumeister, 2004). Sin embargo, su definición no está exenta de ambigüedades (Gross, 2013). La siguiente revisión tiene como objetivo analizar el concepto y desarrollo ontogenético de la autorregulación, y describir los principales factores endógenos y exógenos que modulan esta habilidad cognitiva en los primeros años de vida. Específicamente se trabajará con el período que abarca del momento de nacimiento hasta los 3 años de vida, denominado infancia temprana. Se realizó una revisión narrativa para explicitar el estado de conocimiento hasta el momento, utilizando las bases de datos Scopus, Medline y Web of Science, recuperándose un total de 146 referencias, de las cuáles se seleccionaron 48 que eran acordes a los objetivos establecidos. Los principales factores intrínsecos recabados fueron la maduración de las redes atencionales y el temperamento, mientras que los factores exógenos fueron la sensibilidad materna, los estilos de crianza y los entornos socioeconómicos. Se concluye que esta habilidad debe ser diferenciada conceptualmente de la regulación emocional y las funciones ejecutivas, y que la misma es el resultado de determinantes bio-psico-sociales. En futuros trabajos deberían realizarse más investigaciones empíricas con infantes y en Latinoamérica, para lograr una comprensión más acabada sobre la variable y guiar las políticas públicas para optimizar su desarrollo

Emotional self-regulation refers to the child s intrinsic ability to modulate and modify emotional and cognitive responses, due to the demands of specific situations (Lewis & Todd, 2007; Vohs & Baumeister, 2004). However, its definition is not without ambiguities (Gross, 2013). The following review aims to analyze the ontogenetic concept and development of self-regulation, and describe the main endogenous and exogenous factors that modulate this cognitive ability in the first years of life. Specifically, it will work with the period from the moment of birth to 3 years of life, called early childhood. A narrative review was carried out to explain the state of knowledge, using the Scopus, Medline and Web of Science databases, recovering a total of 146 references, of which 48 were selected according to that were consistent with the established objectives. The main intrinsic factors collected were maturation of the attentional networks and temperament, while the exogenous factors were maternal sensitivity, parenting styles and socio-economic environments. It is concluded that this ability must be conceptually differentiated from emotional regulation and executive functions, and that it is the result of bio-psycho-social determinants. In future work, more empirical research with infants and in Latin America should be carried out to achieve a more complete understanding of the variable and guide public policies to optimize their development

Factors influencing nursing students’ decision to choose nursing

Background: Nurses are the “front line” staff in most health systems and their contribution is recognised as essential in meeting development goals and delivering safe and effective care (ICN, 2007). Nurses are in high demand not only in developed countries but also in developing countries like Malaysia. However, more than 70% of Malaysian hospitals currently do not have adequate nursing staff. At least 174,000 nurses need to be trained by 2020 to meet WHO’s nurse-to-patient ratio of 1:200. The purpose of this study is to identify the main factors that influence the nursing students’ decision to choose nursing as their career. Method: A descriptive study guided by Self Determination Theory was used for this study. A 29- item questionnaire adapted from McCabe, Nowak and Mullen (2005) was distributed to all students in a nursing college (n=117). Results: The five main reasons for choosing nursing as a career were “ability to help others”, “training was provided on the job”, “ability to work closely with people”, “parental advice”, and “accommodation was provided while training”. The top three main domains that influenced the nursing students’ decision to choose nursing as their career include “travel opportunities of nursing”, “intrinsic attraction of nursing” and “immediacy of support on entry to nursing”. A total of 19 (0.2%) will not choose nursing if given a chance. The main reasons were “want to take another course”, “no time to spend with family” and “nursing is a stressful job”. Conclusion: The findings of this study provided valuable information regarding motivating factors which attract the current generation to join nursing. It is of concern that items representing nurses’ image were not rated highly

Factores de riesgo asociados a infecciones en pacientes hospitalizados en la Unidad de Cuidados Intensivos (UCI) / Factors of risk associated with infections in the patients hospitalized in the Intensive Care Unit (UCI)

Este estudio de abordaje Cuantitativo Descriptivo Transversal busca determinar los factores de riesgos intrínsecos y extrínsecos, medios diagnósticos e incidencia; asociados a Infecciones en los pacientes hospitalizados en la Unidad de Cuidados Intensivos (UCI) de la Clínica San José en la ciudad de Cúcuta. La Edad, es un factor predisponente en el desarrollo de infecciones en los pacientes que ingresaron a la Unidad de Cuidados Intensivos (UCI) de la Clínica San José durante el periodo evaluado, se observó que la infección fue más frecuente en los adultos mayores de 41 años con un 86.5%. Las enfermedades de base relacionadas con la aparición de infecciones (Diabetes, Enfermedad Pulmonar Obstructiva Crónica (EPOC), Hepatopatía e Insuficiencia Renal), en el estudio no evidenció un comportamiento estadísticamente significativo, sin embargo, el 34.3% de los pacientes que presentaron insuficiencia renal, seguido del 29.9% que presentaron Enfermedad Pulmonar Obstructiva Crónica (EPOC) y Diabetes, tienen un mayor riesgo de desarrollar infecciones que los pacientes que carecen de este antecedente durante su tiempo de hospitalización en la Unidad de Cuidados Intensivos (UCI), siendo este un factor de riesgo predisponente en la aparición de las infecciones. Dentro de los procedimientos invasivos más usados están la sonda urinaria, la ventilación mecánica y el catéter venoso central. La incidencia de infección en la población objeto del presente estudio fue de 17,9%. Los agentes infecciosos que estuvieron presentes tanto en sangre, como en orina y secreción bronquial fueron Escherichia coli, Klebsiella y Staphylococcus Aureus, microorganismos altamente contagiosos y perjudiciales.

This study of Transverse Descriptive Quantitative collision thinks about how to determine the intrinsic and extrinsic, average(half) risk factors diagnoses and incidence; associated with Infections in the patients hospitalized in the Intensive care unit (UCI) of the Clinic San Jose in the city of Cúcuta. The Age, is a predisposing factor in the development of infections in patients who entered the Intensive Care Unit (ICU) for the Clinic San Jose during the period evaluated, noted that the infection was more frequent in adults older than 41 years with a 86.5%. The diseases as a basis related to the emergence of infections (Diabetes, pulmonary disease Obstructive Chronic (COPD, liver and kidney failure), in the study not showed a behavior statistically significant, however, the 34.3 per cent of the patients who had kidney failure, followed by 29.9% that presented Lung Disease Obstructive Chronic (COPD) and Diabetes, have An increased risk of developing infections that patients who lack of this background during his time of hospitalization in the Intensive Care Unit (ICU), this being a risk factor predisposing in the emergence of infections. Inside the most secondhand(worn) invasive procedures there are the urinal probe, the mechanical ventilation and the central venous catheter. The infection incidence in the population object of the present study was 17,9 %. The infectious agents that were present so much in blood, as in urine and bronchial secretion it was Escherichia coli, Klebsiella and Staphylococcus Aureus, highly contagious and harmful microorganisms.

Satisfacción laboral en enfermeras del hospital de oncología Centro Médico Nacional siglo XXI IMSS / Labor Satisfaction in the Oncology Hospital of the Social Security Mexican Institute’s National Medical Center Century XXI

Introducción. La andragogía está orientada hacia la educación de los adultos; los cuidadores como adulto responsables de un enfermo de Alzheimer deben contar con herramientas didácticas que mejoren su calidad de vida y desempeño. Objetivo. Determinar el enfoque para un modelo andragógico que incremente la capacidad del cuidador de un enfermo de Alzheimer basado en el significado de su experiencia. Metodología. Se trata un estudio observacional; descriptivo; exploratorio; la muestra fue de 29 cuidadores de enfermos de Alzheimer; siendo adultos; mujeres y familiares cercanos del paciente. A dichos cuidadores se le aplicó un cuestionario de 22 ítems de sobrecarga del cuidador propuesta por Zarit sobre la relación del cuidador con el enfermo; las relaciones sociales del cuidador; el efecto del cuidado en el estrés; capacidad y su salud; teniendo un alfa de Cronbach de .93. Resultados. Los resultados del estudio señalaron que el modelo andragógico debe orientarse de manera particular hacia conocimientos; habilidades e información que forme e instruya al cuidador sobre su capacidad para hacer frente al cuidado de un enfermo de Alzheimer; elementos como salud; relaciones con el paciente y con otras personas son afectados por razón del cuidado. De los resultados de otras investigaciones donde está presente un cuidador y un paciente; el presente documento coincide en señalar una incidencia sobre la vida cotidiana del cuidador por efecto de las relaciones y la gravedad de la enfermedad del paciente. Conclusiones: Es factible diseñar un modelo andragógico fundamentado en: conocimientos; habilidades e información que instruyan al cuidador sobre su capacidad para hacer frente al cuidado de un enfermo de Alzheimer.

IAndragogic learning models are oriented towards adults taking care of Alzheimer patients. This study has the objective of focusing on the improvement of an andragogic learning model so that it promotes and enhances the experience and capacity of professional taking care of Alzheimer patients. Methodology: Basic, observational, descriptive, and exploratory study. The sample was formed with 29 adults taking care of Alzheimer patients. These adults completed a 22 item questionnaire related to: work overload issves as viewed by zarit; social relations; stress impacts; and capacity. Cronbach alpha turned out to be .93 Results: Showed that this andragogic Learning model should be oriented towards knowledge, skills and information which prepare the professional to face the challenge of taking care of Alzheimer patients.Finding of this study were similar to those reported in other studies. Conclusions: It is possible to deseng on andragogic learning model gased on: knowledge, skills, and information which prepare the professional to face the challenge of taking care Alzheimer patients.

Study for Acromial Type, Acromial Tilt and Subacromial Distances in Subacromial Impingement Syndrome

OBJECTIVE: To study the acromial type, acromial angle, acromial tilt and subacromial distances which known as extrinsic factors of subacromial impingement syndrome in groups of subacromial impingement syndrome and normal control. METHOD: The radiography of shoulder named shoulder series composed of AP view, arch view and impingement view was performed in thirty patients with subacromial impingement syndrome and ninety persons with normal adult and we measured the acromial type, acromial angle, acromial tilt, subacromial distances and subacromial spur. RESULTS: Mean subacromial distances of impingement group were 11.3+/-2.4 mm in AP view, 11.1+/-2.5 mm in arch view and those of normal control group were 11.1+/-2.2 mm in AP view, 10.4+/-1.9 mm in arch view. Incidences of acromial type I,II,III in impingement group were 15 (50%), 10 (33.3%), 5 (16.7%) respectively and those in normal control group were 20 (22.2%), 46 (51.1%), 24 (26.7%) respectively. Incidence of subacromial spur was 19 (63.3%) in impingement group and 52 (57.8%) in normal control group. Mean subacromial spur size was 10.0+/-5.4 mm in impingement group and 12.4+/-4.5 mm in normal control group. Mean acromial angle was 27.1+/-8.3 degree in impingement group and 29.1+/-8.7 degree in normal control group. Mean acromial tilt was 28.0+/-6.39 degree in impingement group and 31.8+/-3.4 degree in normal control group. CONCLUSION: No significant statistical difference between subacromial impingement syndrome group and normal control group in acromial type, acromial angle, acromial tilt and subacromial distance known as extinsic factors of subacromial impingement syndrome.