Quality of life among frail older people Background: Frailty has a great impact in the wellbeing of older people. Aim: To evaluate the quality of life of older people with and without frailty. Material and Methods: We assessed sociodemographic variables, health, integral geriatric assessment, quality of life using the WHOQoL-BREF questionnaire and the level of fragility using the Tilburg Frailty Indicator (TFI) in 538 participants. Results: Three hundred and five participants aged 73 ± 7 years (229 women) were classified as fragile and 233 aged 72 ± 6 years (125 women) as not having frailty. Compared with their non-fragile counterparts, frail participants had a lower number of years attending school (5.9 and 7.4 respectively), a lower Barther index (93.6 and 98.3 respectively), a lower mini mental score (21.9 and 22.8 respectively) and a higher Yessavage depression score (2.0 and 0.8 respectively). Also, frail participants had a significantly lower total quality of life score and significantly lower scores in the physical and psychological domains. No differences were observed for the social and environmental domains. Older frail participants used health services more frequently than their non-fragile counterparts. Conclusions: In this sample, frailty was associated with a lower quality of life and worse scores in several geriatric assessment tools.
<p>La construcción de una gobernanza ambiental, en términos del diseño e implementación de una institucionalidad ad hoc, ha estado atravesada por la tensión entre una perspectiva orientada al resguardo de las inversiones y el crecimiento económico, versus los objetivos del desarrollo sustentable suscritos por los Estados nacionales. En Chile, esta tensión se expresa en el debate público como un conflicto entre los fundamentos técnicos y políticos a la base de la toma de decisiones y del diseño de normativas, especialmente en el ámbito de la evaluación de impactos ambientales. Sin embargo, al observar en profundidad esta controversia, es posible advertir que los usos de los conceptos técnico y político están lejos de ser unívocos. La multiplicidad epistemológica de estas definiciones resulta particularmente interesante en el relato de la élite burocrática de la institucionalidad, particularmente, funcionarios y funcionarias que participan activamente de la dirigencia sindical en el Servicio de Evaluación Ambiental (SEA) y la Federación Nacional de Trabajadores del Medio Ambiente (FENATRAMA). La dirigencia ha realizado acciones de interpelación a la autoridad política a partir de una defensa de la democracia y de lo técnico como expresión de “lo público”, incluso en directa confrontación con las autoridades gubernamentales. Esta investigación indaga las premisas que sostienen las acciones de incidencia política que han venido desarrollando las asociaciones de funcionarios ambientales en Chile, considerando que su posicionamiento devela la heterogeneidad de actores que constituyen el aparato público y la complejidad del debate sobre gobernanza ambiental.</p>
Rhodococcus equi is responsible for foal pneumonia worldwide, with a significant economic impact on the production and breeding of horses. In Chile, the first case was reported in 2000, and since then, its incidence has been increasing. Distinctive characteristics of R. equi as an intracellular pathogen in macrophages, emergence of virulence plasmids encoding surface lipoprotein antigens, and appearance of antibiotic resistance against macrolides and rifampicin have significantly complicated the treatment of R. equi pneumonia in foals. Therefore, in vitro susceptibility studies of first-line and newer antibiotics against R. equi are the first step to establishing effective treatments and optimizing new therapeutic options. The aim of the present study is to determine the susceptibility profile of fourteen strains of R. equi isolated from foals in Chile to several antibiotics of the macrolide group including azithromycin, amikacin, tildipirosin and gamithromycin as well as others such as rifampicin, doxycycline and ceftiofur. Identification of R. equi in collected isolates from foals in Chile has been performed by CAMP test and PCR based on detecting of the gene encoding the 16 S rRNA. The presence of genes encoding virulence plasmids was also determined using PCR. Results obtained have demonstrated presence of virulent R. equi strains in Chile. In vitro susceptibility pattern to different antibiotics has shown better results for doxycycline and rifampicin similar to previous studies performed. Current macrolides have been evaluated in order to consider alternative treatment options in a context of emerging resistance to classic macrolides and rifampicin, obtaining better results with gamithromycin (MIC range of 0.125 to 128 mg/ml) than with tildipirosin (MIC range of 16 to 128 mg/ml). An adequate diagnosis of bacterial susceptibility based on antibiograms is necessary to treat the Rhodococcus equi infection in foals.
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