Frailty is recognized as one of the most important global health challenges as the population is aging. The aim of this study was to evaluate prevalence and incidence of frailty, and associated ...factors, among the population of older adults in Slovenia compared to other European countries.
The prevalence and 4-year incidence of frailty among older adults (≥65 years) were evaluated using data from the Survey of Health, Ageing and Retirement in Europe (SHARE). Frailty was defined by the SHARE operationalization of Frailty phenotype. Multiple logistic regression model was used to explore factors associated with frailty.
Age-standardized prevalence (95% CI) of frailty and pre-frailty in Slovenia were 14.9% (13.3-16.5) and 42.5% (39.8-45.2), respectively. Factors (OR, 95% CI) associated with increased frailty in Slovenia included age (7584 years: 5.03 (3.08-8.22); ≥85 years 21.7 (10.6-44.7) vs. 65-74 years), self-rated health (fair: 4.58 (2.75-7.61), poor: 54.6 (28.1-105.9) vs. excellent/very good/good), number of chronic diseases (1.20 (1.03-1.40)), and polypharmacy (yes: 3.25 (1.93-5.48) vs. no). Female gender and lower education were significantly associated with pre-frailty, but not frailty, in the adjusted model. Independently of these characteristics, age-standardized prevalence of frailty varied among geographical regions. Age-standardized 4-year incidence of frailty and pre-frailty in Slovenia were 6.6% (3.0-10.1) and 40.2% (32.7-47.6), respectively.
Among the Slovenian population of older adults aged 65 years and older, the age-standardized prevalence of frailty is 15% and 4-year incidence of frailty is 7%. Regional differences in Slovenia show the lowest prevalence in central Slovenian regions and the highest in northeastern Slovenian regions.
The increase in the elderly population is causing changes and challenges that demand a comprehensive public health response. A specific characteristic of the elderly is their frailty. Today's ...problems with identifying levels of frailty are being resolved by numerous tools in the form of frailty assessment scales. This systematic review establishes which frailty assessment scales for the elderly are being used and what their applicability in primary care is like in Slovenia and around the world.
Documents published after 2010 were searched for in the PubMed database using keywords and other specific criteria.
A total of 177 search hits were obtained based on various search strings. The final analysis included 28 articles, of which three were systematic literature reviews. These three covered quantitative studies, mainly consisting of observational cross-sectional surveys or cohort studies. Three other studies featured non-systematic literature reviews. Quantitative studies (mainly cross-sectional surveys or cohort studies) prevailed among the remaining 22 articles. One study had a qualitative design (Delphi method). The main outcome measures observed by all studies were frailty assessment scales for the elderly, the majority of which were evaluated on a sample of the elderly.
None of the assessment scales examined are used as the gold standard for primary care. A variety of tools are being used in clinical practice to assess frailty in elderly patients, highlighting the need for standardization and guidelines. This requires evaluating the current assessment scales in terms of validity and reliability, and suitably improving them.
This paper aimed to review the effect of physical activity and exercise in frail older persons. As the process which leads to frailty and disability can be slowed down or even completely reversed, it ...can be appropriate for early interventions.
A literature search was conducted in the following databases: PubMed, Cochrane, Embase, Cinahl and UpToDate. The criterion in selecting the literature was that articles were published from 2002 to 2017. From 620,043 initial hits, 25 publications were selected.
Physical activity and exercise in frail elderly are effective and relatively safe and may reverse frailty.
Different exercise interventions in frail elderly persons can increase strength and power, improve balance and reduce fall incidence resulting in greater quality of life. From this perspective, physical exercise interventions should become daily routine in frail elderly persons.
To deliver quality management of a frail individual, a clinician should understand the concept of frailty, be aware of its epidemiology and be able to screen for frailty and assess it when it is ...present, and, finally, to recommend successful interventions.
A systematic literature search was conducted in the following databases: PubMed, Cochrane, Embase, Cinahl and UpToDate. The criterion in selecting the literature was that articles were published in the period from 2002 to 2017. From 67432 initial hits, 27 publications were selected.
Useful interventions to address frailty are supplementation of vitamin D, proper nutrition, multicomponent training, home-based physiotherapy and comprehensive geriatric assessment, particularly when performed in geriatric wards.
Comprehensive geriatric assessment is an effective way to decrease frailty status especially when performed in geriatric wards. Multicomponent physical training and multidimensional interventions (physical training, nutrition, vitamin D supplementation and cognitive training) are effective measures to reduce frailty.
To help general practitioners (GPs) in early identification of patients with palliative care (PC) needs, this pilot study aimed to determine the potential of the combined original surprise question ...(SQ1) ('Would I be surprised if this patient died within the next 12 months?') and the second surprise question (SQ2) ('Would I be surprised if this patient was still alive after 12 months?'). We hypothesized that answering these SQs would trigger them to make a multidimensional care plan.
26 Slovenian GPs, randomized into 4 groups, were invited to write a care plan for each of the four patients described in case vignettes (2 oncologic, 1 organ failure and 1 frailty case). GPs in group 1 were only asked to write a care plan for each patient. GPs in group 2 answered SQ1 and GPs in groups 3 and 4 answered SQ1 and SQ2 before writing the care plan. The type and number of PC aspects mentioned in the respective care plans were quantified into a numeric RADboud ANTicipatory (RADIANT) score.
Mean RADIANT scores in groups 1-4 were 2.2, 3.6, 2.5 and 3.1, respectively. When comparing the different vignettes, vignette B (terminal oncologic patient) scored best (3.6). Mean RADIANT scores in groups 3 and 4 were slightly higher for GPs who would be surprised compared to GPs who would not be surprised if the patient was still alive in 12 months.
The combined SQs were considered helpful in the early identification of patients in need of PC in Slovenian general practice.
Tribološka ispitivanja mogu se provesti na nekoliko razina, od mikrorazine do nanorazine. Na toj osnovi mogu se istražiti korelacije između viskoelastičnosti, krhkosti i tribološkog ponašanja ...materijala na osnovi polimera koje odražavaju utjecaje sastava, orijentacije u magnetnom polju i obrade površine. Relacija između stupnja viskoelastičnog oporavka i krhkosti analizirana je u radu 2006. U raspravi su istaknuta znatna poboljšanja svojstava, uključivo i tribološka, dodatkom anorganskih mikročestica i nanočestica punila. Uočen je utjecaj površinske i međupovršinske napetosti u multifaznim sustavima na tribološka svojstva. Opisane su računalne simulacije tribološkog ponašanja kao dopuna eksperimentima. Predstavljene su osnovne razlike izme|u mikrotribologije i nanotribologije.
U radu je opisana primjena ispitivanja radi procjene upotrebljivosti starog cjevovoda vodika u rafineriji nafte Sisak koji se nakon dužeg razdoblja mirovanja stavlja u rad. Cjevovod je izgrađen i ...pušten u rad 1980. godine i kontinuirano se upotrebljavao do 1989. U navedenom razdoblju cjevovod se upotrebljavao za transport plinovitog vodika s postrojenja katalitičkog reformiranja KP-5 na ono za proizvodnju aromatskih ugljikovodika (benzena, o-ksilena i p-ksilena) KP-7. Osim prethodno navedenog razdoblja rada, cjevovod je stavljen u šestomjesečni rad s istom zadaćom tijekom 1996. godine. Nakon toga cjevovod vodika nije se do danas upotrebljavao za transport niti jedne vrste medija. Krajem 2010. cjevovod se ponovno stavlja u rad s istim zadatkom dobave plinovitog vodika kao sirovine za proizvodni proces izomerizacije na postrojenju KP-7. Zbog ponovne upotrebe i određivanja utjecaja vodika na mehanička svojstva materijala provedena su mehanička i tehnološka ispitivanja cjevovoda te je ispitana mikrostruktura materijala cjevovoda. Tlačnim ispitivanjem cjevovoda provedenim prema normi ASME B. 31.3 ispitano je stanje cjevovoda vodika na mogućnost propuštanja plinovitog medija koji će se transportirati kroz cjevovod. Metalografskim ispitivanjima ispitana je mikrostruktura materijala cjevovoda, prvenstveno na utjecaj vodika, a osim toga i na utjecaje erozije i korozije koji također mogu dovesti do oštećenja cjevovoda. Charpyevom metodom ispitana je žilavost koja pokazuje kolika je otpornost materijala cjevovoda na krhki lom. Metodom po Vickersu ispitana je tvrdoća koja pokazuje otpornost materijala na unutrašnje naprezanje i plastičnu deformaciju koja se može pojaviti kod djelovanja vanjskog opterećenja na materijal cjevovoda. Cilj ispitivanja bio je utvrditi postojeće stanje mehaničkih i tehnoloških svojstva materijala cjevovoda u svrhu njegove ponovne pouzdane i kvalitetne upotrebe.
Mehaničkim, metalografskim i SEM ispitivanjima proučavan je utjecaj vodika na krhkost modernih visokočvrstih dvofaznih DP- i višefaznih TRIP-čelika. Rezultati proučavanja mikrostrukturnih i ...mehaničkih svojstava termomehanički obrađenih TMCP-čelika prije i nakon navodičenja ukazali su na činjenicu da je TRIP-čelik otporniji na vodikovu krhkost, o čemu svjedoči njegova sitnozrnata mikrostruktura bez pukotina te nepromijenjene vrijednosti za mehanička svojstva nakon navodičenja.
Postojanje, funkcionalnost i održivost međubankarskog tržišta značajno određuju potencijale procesa upravljanja imovinama i obvezama banke kao i razinu ostvarenih performansi bankarskog sektora. Uz ...ostale brojne čimbenike bankarskog poslovanja, ključne uloge međubankarskog tržišta poput pristupa kratkoročnoj likvidnosti sustava, omogućavanja procesa posuđivanja i zaduživanja te pružanja mogućnosti zaštite značajno pridonose oblikovanju rizičnog profila i profitabilnosti banke. Stoga su ciljevi istraživanja dvostruki i uključuju teorijsko tumačenje i empirijsku provjeru utjecaja razvitka međubankarskog tržišta na financijski uspjeh bankovnog sustava u Republici Hrvatskoj. Nadalje, ključni odnosi između međubankarskog tržišta i povezanih rizika su uključeni u razvijenom modelu. Izravna ovisnost održivog razvoja bankovnog sektora u Republici Hrvatskoj o stabilnosti međubankarskog tržišta dokazana je na empirijskim podacima iz razdoblja 2002.-2009., s napomenom da je prisutnost prvoklasnih banaka u stranom vlasništvu značajno smanjila povezane rizike. Čak i u odsutnosti ekstremnih događaja na međubankarskom tržištu, hrvatski bankovni sustav je kontinuirano osjetljiv na sistemski rizik u obliku uvećanja troškova eksternog financiranja. Stoga bi empirijski rezultati istraživanja i izneseni zaključci mogli biti korisni za upravljačke strukture komercijalnih banaka kao i za nacionalne bankarske autoritete.
Istražen je učinak dvaju naširoko rabljenih antikoagulanata i pohrana eritrocita na njihovu in vitro osmotsku krhkost, hematokrit i osmolalnost plazme u nojeva. Krv je bila uzeta iz vene osam nojeva ...(90-110 kg) u epruvetu s vakuumom koja je sadržavala ili EDTA (k3) ili litij-heparin. Osmotska krhkost eritrocita bila je određena mjerenjem oslobođenoga hemoglobina iz krvi dodane u epruvete sa serijski razrijeđenom fosfat-puferiranom fiziološkom otopinom (PBS, pH 7,4). Hematokrit je bio određen mikrocentrifugiranjem, a osmolalnost krioskopskim osmometrom. Uzorci krvi bili su analizirani 0,5, 6 i 12 sati nakon uzimanja. EDTA je povećala osmotsku krhkost eritrocita u usporedbi s heparinom (P<0,01). Početna hemoliza (>5%) pojavila se između 0,50 i 0,55% PBS-a u heparinu. U 0,85% PBS-u hemoliza uzoraka uzetih u EDTA bila je veća od 30%, dok je u heparinu bila <5%. Srednja korpuskularna krhkost bila je između 0,35 i 0,45% PBS-a u heparinu i 0,85% PBS-a u EDTA. Najjača hemoliza pojavila se u 0,35% PBS-u s EDTA i u 0,20% PBS-u s heparinom. Hematokrit nije bio značajno promijenjen pri pohrani (P>0,05). Vrijednosti hematokrita bile su međutim značajno manje u heparinu u usporedbi s EDTA (P<0,05). Osmolalnost s EDTA i heparinom bila je 30 minuta nakon uzimanja značajno manja (P<0,05) nego nakon šest i 12 sati. Nije bilo značajne razlike u osmolalnosti plazme šest sati nakon uzimanja u usporedbi s vrijednostima nakon 12 sati. Plazma u EDTA imala je značajno veću (P<0,05) osmolalnost nego ona u heparinu.
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