Epidemiology, diagnosis, and assessment of diabetes mellitus in the elderly population: a purposive review

The elderly population with diabetes mellitus is rapidly growing worldwide and has become a major social burden with significant impact on health and economics. This social category requires considerations that are not traditionally associated with diabetes mellitus management. Several epidemiological studies have shown that the prevalence of diabetes mellitus increases with advancing age. According to the recent International Diabetes Federation (IDF) published data, the number of people with diabetes mellitus among those 65 and over has reached 136 million (19.3%) with more frequent diabetes mellitus complications and co-morbidities compared to the young counterparts. Cardiovascular complications are the leading cause of death and the quality of life is strongly impacted by geriatric syndromes such as poor vision, dementia and functional dependence. The elderly diabetic population is classified into three categories; the robust, the fragile and the patient at the end of life. In practical terms, they can also be classified into two categories: the autonomous patients and the dependent patients, requiring support and assistance. Keywords: diabetes mellitus, elderly, epidemiology, geriatric syndromes, geriatric evaluation.

Optimization of international road transportation of cargoes in the management of enterprises of agricultural sector and road transport enterprises

To enhance the efficiency of management of enterprises in the agricultural sector, it is necessary to improve logistic processes of delivery of livestock and crop production in the implementation of international road transportation. Delivery of cargo "just in time" is very important, so transportation time planning is relevant and allows reducing costs. The process of planning the delivery of perishable goods was described. The spread of the required time is presented for transportation with a varied degree of stochasticity. It was found that the specifics of customs clearance affect the availability of a certain minimum time required for such a procedure. The time of customs clearance of cargo and delay time affect the deadline for cargo registration in international road transportation. The widest spread of time is observed by the procedure of customs clearance of cargoes that takes from 12 to 25 hours, and the probability of customs clearance is only 0.435. Accordingly, this affects a decrease in indicators of "just in time" delivery. The functional dependence of the probability of transit time not exceeding the planned time was compared, depending on the data of the specified route. Based on probabilistic analysis, the possibility of unplanned deviations from the estimated terms of each stage was taken into account and the optimal set of time intervals, which allow obtaining the optimal probability of "just in time" delivery, was proposed. The total cargo delivery time does not change. The recommendations on formulating the requirements for road transport enterprises were given. Namely, to strengthen the requirements for the time of cargo transit. These requirements include the average speed of motion, the choice of appropriate transport, planning the route in terms of the speed mode of highways, etc.

RESEARCH OF THE CUTTING MECHANISM AT ELECTRICAL DISCHARGE GRINDING

The paper presents the results of a study of the cutting mechanism during electrical discharge grinding of hard alloys. The cutting mechanism during electrical discharge grinding was studied using mathematical modeling. By means of geometric modeling, a method of grinding cup wear was developed. The functional dependence of the diamonds use factor in the Kw wheel on the technological parameters of processing, wear and tool characteristics were determined. Analysis of the results of the study shows that an increase in efficiency at electrical discharge grinding can be achieved by reducing the wear of S, and by corresponding variation in the concentration of diamonds and technological modes of processing.

Self-care deficit versus the potential to improve self-care: explanation of the nurse's clinical judgments

Background: people who become functionally dependent due to serious illness and/or the worsening of a chronic illness have different recovery paths. The attribution of the nursing diagnosis of self-care deficit versus potential to improve self-care requires, on the part of the nurse, a rigorous clinical judgment, for which a set of diagnostic activities is necessary. Objectives: the present study sought to identify the assumptions used by expert nurses when formulating the clinical judgment of self-care deficit versus the potential to improve self-care Methodology: qualitative design. Data were generated in two focus group meetings that included eleven nurses experienced in caring for persons with functional dependence and self-care defict. Previously prepared structured questions were used to facilitate discussion. The focus group meetings were recorded in audio and transcribed. Inductive content analysis was used to identify emerging themes. The checklist Consolidated Criteria for Reporting Qualitative Research (COREQ) was also used. Results: nurses` decision-making depends: the factors of influencing the potential to improve self-care abilities of a person with functional dependence, the domain of influence of these factors, and three fundamental aspects to consider when evaluating a person with functional dependence. Conclusions: the absence of recovery potential can rarely be deduced. People without cognitive impairment or with mild cognitive impairment present highest potential for recovery.

Risk factors for depression in older adults in Bogotá, Colombia

Purpose This paper aims to identify psychosocial, demographic and health risk factors associated with depression in older people. Design/methodology/approach A correlational study with 281 independent and autonomous persons of the community over 60 years old from Bogotá was conducted. The three instruments used to measure the variables included in the data analyses were Demographic and Health Data Questionnaire, Short version of 15 items of Geriatric Depression Scale (GDS) and Montreal Cognitive Assessment Test (MoCA). Findings Fifteen percent of the participants presented depression. Depression was associated with different demographic, low social support and health factors in this population group and was particularly high in women. Being a woman with poor social support networks and a previous history of depressive episodes should be considered as determining factors within a clinical risk profile for depression in older adulthood. It is essential to design prevention strategies focused on women and on the development of better social support in old age. Originality/value Depression is a prevalent and highly disabling disease, when it is suffered by an older person it is associated with higher mortality, functional dependence, poor physical health, worse quality of life indicators and psychological well-being. In the elderly, the clinical diagnosis of depression is difficult, as it has a high comorbidity and is often confused with other health conditions prevalent during older adulthood.

Dimensional effect when measuring Martens hardness

One of the most common methods of non-destructive testing, hardness testing, is used to evaluate the properties of materials. This is due to the ease of measurement and testing of the finished part, which will be used in the future, high productivity of the method, the ability to assess other mechanical properties of the material: elasticity, creep, tensile strength. An important aspect in the study of the hardness using in the range the Berkovich and Vickers indenters, which are more consistent with non-destructive testing, while the methods of Brinell and Rockwell leave quite large deformations, in our opinion, which further promote the development of structural defects and reduce the service life, which are not acceptable in critical products. Due to the improvement of product manufacturability, more and more manufacturers are trying to minimize the size of the part, while increasing their performance by applying a reinforced layer, which, in turn, should seek to reduce the thickness with increased service life. It is also impossible to study the hardness of very small products in the micro range due to the large mismatch between the dimensions of the product under test and the test method. In our opinion, the study of hardness by the Berkovich method in comparison with the Vickers method is more expedient for use with the same physicochemical properties of the material because of a larger scatter of hardness values between the compared methods, although they should be almost the same, with a small difference. An important omission to a certain year was the dimensional effect. Goal. The aim of the study is to assess the nature of the change in hardness with increasing load on the indenter, using the functional dependence of the hardness on the depth of the indenter. For this purpose, it is necessary to establish such connection for an indenter of various geometry. In this regard, we consider it appropriate to check the validity of the Meyer equation, which relates the load to the size of the imprint, for different indenters and materials. Results. When the hardness is calculated according to the Martens scales, the Vickers and Berkovich indenters are applied to the function of the surface area of the working part of the tip. An important factor of the consistency of the results in the increase in hardness is the small effect. The reasons for this can be very negligible. The sizeable effect is significantly infused into the results of increasing hardness, changing from 2,5 to 3,0 folds.

CONSTRUCTION OF MATHEMATICAL MODELS USING THE METHODS OF CORRELATION AND REGRESSION ANALYSIS

The article discusses the construction of a mathematical model using the methods of correlation and regression analysis in determining the functional relationship between the quantities. When conducting an experiment, it is often necessary to establish the interdependence between two or more quantities in order to obtain an empirical formula. In some cases, this is a simple task, because these connections are almost obvious or known in advance. As a rule, to establish the relationship between different indicators, factors and characteristics is not a trivial task. There is a need to use some hypothesis in the form of functional dependence. In other words, it is necessary to replace this functional dependence with a fairly simple mathematical expression. Such a mathematical expression can be a linear equation or a polynomial. In order to use such experimental data to determine such a mathematical or functional relationship between variables, the methods of correlation and regression analysis are used. Correlation analysis provides an answer to the statistical hypothesis of the absence or presence of a relationship between variables with some predetermined confidence probability. Determination of the functional dependence between different values on their experimental values is carried out using regression analysis. It is based on the well-known method of least squares. Proposing one or another regression equation, the researcher determines both the very existence of the relationship between variables and its mathematical form. Regression analysis considers the relationship between the dependent quantity and non-dependent variables. This relationship is represented using a mathematical model, that is, an equation that connects the dependent and independent variables. Processing of experimental data using correlation and regression analysis allows us to build a statistical mathematical model in the form of a regression equation. Thus, the methods of correlation and regression analysis are closely related.

THE INFLUENCE OF THE PREHOSPITAL PAUSE ON THE OUTCOMES OF EMERGENCY DECOMPRESSIVE-STABILIZING SURGERIES IN PATIENTS WITH TUMOR AND INFECTIOUS SPINE DISEASE

Resume. Purpose. To assess the relationship between the duration of pathological symptoms developed due to tumor or infectious destruction of the spine, and the medium-term (3 months after surgery) and long-term (1-year) outcomes of operations performed according to urgent indications. Study design: two-center cohort retrospective; level of evidence IIC [1]. Material and methods. 84 patients with tumor (group 1, n = 43) and infectious (group 2, n = 41) lesions of the spine underwent decompression and stabilization operations according to urgent indications in the period from 2016 to 2018. Neurological status (evaluation method -Frankel scale), pain intensity (evaluation method - visual analogue scale, VAS) and functional independence of patients (evaluation method - Karnofsky scale) were assessed before intervention, 3 months and 1 year after surgery. Statistical relationship between treatment outcomes and duration of the prehospital delay has been studied. Results. Only 11 out of 84 patients (13.1%), operated on for urgent indications, were hospitalized in the first 72 hours from the onset of vertebral syndrome; 6 (7.1%) of them had neurological disorders. At the time of surgery, 23 patients in each group had neurological disorders (53.5% and 56.1%, respectively), while the average duration of the prehospital period in both groups (Me) was 14.0 days. In patients without neurological disorders, the duration of the prehospital pause for the group of tumor lesions was 22.5 (14.0; 40; 0), for infectious - 14.5 (6.3; 30.0) days (data format - Me (Q25; Q75). After decompression and stabilization operations, positive neurological dynamics observed in patients with tumor lesions both in plegia and paresis (types B - D according to Frankel), while in infectious destruction - only in patients with mild paresis. An inverse correlation dependence of high strength between the duration of neurological disorders and the possibility of their improvement by 3 months after surgery was revealed in both groups (rs1 = -0.793 and rs2 = -0.828; p 0.001), as well as there was no connection between such outcomes and the duration of the hospital period (the urgency of the operation) (rs1 = -0.257; p = 0.283 and rs2 = -0.218; p = 0.330). When hospitalized for more than 14 days from the onset of pathological symptoms, the possibility of neurological improvement after surgery ceases to be statistically significant (p1 = 0.083, p2 = 0.157 for both groups, respectively), while the likelihood of a decrease in pain syndrome and functional dependence on others remains independent of the duration of the prehospital period. Conclusion. In case of tumor and infectious destruction of the vertebrae, urgent decompression and stabilization operations lead to a significant reduction in pain syndrome and an improvement in the functional independence of patients 3 and 12 months after the operation, regardless of the duration of the prehospital period. The duration of prehospital period of more than 2 weeks is critical for a reliable prognosis of improvement in neurological disorders after urgent surgeries in patients with neoplastic and infectious lesions of the spine.