"Older people are weak": perceptions and meanings of ageing and abuse against older people

Introduction

This paper addresses the broader issue of elder abuse and seeks to analyse how victims and non-victims of abuse connect and explain the perception of ageing and the phenomenon of violence against older people.

Methods

A qualitative study was conducted based on evidence gathered through 45 semi-structured interviews with people aged 60 or above who are part of the Portuguese EPIPorto population cohort. The interviews were analysed using grounded theory.

Results/discussion

The results show that respondents link the ageist narratives that exist in our societies to the prevalence and naturalisation of violence against older people, that the risk of abuse increases with the weakening of family support networks, and that abuse is both a manifestation of asymmetrical power relations between victims and perpetrators and a severe violation of human rights. The findings also highlight the need to broaden the concept of violence against older people to include offences in the public sphere and not just in the context of the family and institutions.

Genomic Medicine in Canine Periodontal Disease: A Systematic Review

Genomic medicine has become a growing reality; however, it is still taking its first steps in veterinary medicine. Through this approach, it will be possible to trace the genetic profile of a given individual and thus know their susceptibility to certain diseases, namely periodontal disease. This condition is one of the most frequently diagnosed in companion animal clinics, especially in dogs. Due to the limited existing information and the lack of comprehensive studies, the objective of the present study was to systematically review the existing scientific literature regarding genomic medicine in canine periodontal disease and determine which genes have already been studied and their probable potential. This study followed the recommendations of the PRISMA 2020 methodology. Canine periodontal disease allied to genomic medicine were the subjects of this systematic review. Only six articles met all of the inclusion criteria, and these were analyzed in detail. These studies described genetic variations in the following genes: interleukin-6, interleukin-10, interleukin-1, lactotransferrin, toll-like receptor 9, and receptor activator of nuclear factor-kappa B. Only in two of them, namely interleukin-1 and toll-like receptor 9 genes, may the identified genetic variations explain the susceptibility that certain individuals have to the development of periodontal disease. It is necessary to expand the studies on the existing polymorphic variations in genes and their relationship with the development of periodontal disease. Only then will it be possible to fully understand the biological mechanisms that are involved in this disease and that determine the susceptibility to its development.

Portuguese Older Persons' Views about Living in a Nursing Home: Challenges to the Rehabilitation of the Image of LTC in Post-Pandemic Times

This paper addresses the broad topic of what older people think about nursing homes in Portugal. In the aftermath of the COVID-19 pandemic and considering the tragic events taking place in nursing homes, the challenge of reimagining the sector involves not only improving procedures and models of care, making sure they meet what citizens consider adequate, but also rehabilitating the image people have about nursing homes and rebuilding trust. Current and future decisions about how one meets LTC needs is influenced by the extent to which individuals see the alternatives as adequate. The paper presents evidence collected from a qualitative study run just before the COVID-19 pandemic began, with a sample of 45 community-dwelling individuals aged 60 plus, in Portugal. Opinions and views about nursing homes were collected and the results point to enduring negative aspects that are considered at odds with what constitutes adequate care. The paper discusses in length what those aspects are and concludes that future reforms of the nursing homes sector in Portugal need to consider what current and future users think and feel about that specific type of service. Debates in Portugal tend to be more focused on discussions about expanding the sector and less on aspects of quality of care. Views and opinions of interviewed participants, however, suggest that people may be more worried about quality of care.

A multidimensional perspective of the relation between social isolation and depression among Portuguese older adults

We aimed to explore how different social isolation components were associated with depression among older adults in Portugal. We analysed data collected through structured questionnaires in 2017 from 643 Portuguese adults aged 60 and over. Depression was assessed using the Geriatric Depression Scale (Short-Form). Social isolation was operationalised using objective indicators - living alone, marital status, leisure activities - and subjective indicator - perceived social support. Because social isolation is a multidimensional construct that is likely to be more than the sum of its components, cluster analysis was conducted to group individuals into social isolation profiles. Associations were estimated using adjusted odds ratios (ORs) and 95% confidence intervals (CIs). Five profiles were identified: Cluster 1 (partnered; high social support; high variety of leisure activities); Cluster 2 (partnered; high social support; few leisure activities); Cluster 3 (not partnered; low social support; few leisure activities); Cluster 4 (living alone; high social support; high variety of leisure activities); Cluster 5 (partnered; high social support; limited variety of leisure activities). Compared with Cluster 1, participants in Cluster 2 were three times more likely to have depression, independent of age, gender, education, comorbidities and self-rated health (OR = 3.04; 95% CI: 1.38-6.71). Participants in Cluster 3 presented the highest probability of depression that was not explained by any of the confounders (OR = 4.74; 95% CI: 2.15-10.44). Older adults living alone are not necessarily more prone to depression, with social support and leisure activities playing an important role. To disentangle how social isolation affects health, objective and subjective isolation measures should be considered.

Genomic Medicine in Periodontal Disease: Old Issue, New Insights

Genetic variability is the main cause of phenotypic variation. Some variants may be associated with several diseases and can be used as risk biomarkers, identifying animals with higher susceptibility to develop the pathology. Genomic medicine uses this genetic information for risk calculation, clinical diagnosis and prognosis, allowing the implementation of more effective preventive strategies and/or personalized therapies. Periodontal disease (PD) is the inflammation of the periodontium induced mainly by bacterial plaque and is the leading cause of tooth loss. Microbial factors are responsible for the PD initiation; however, several studies support the genetic influence on the PD progression. The main purpose of the present publication is to highlight the main steps involved in the genomic medicine applied to veterinary patients, describing the flowchart from the characterization of the genetic variants to the identification of potential associations with specific clinical data. After investigating which genes might potentially be implicated in canine PD, the RANK gene, involved in the regulation of osteoclastogenesis, was selected to illustrate this approach. A case-control study was performed using DNA samples from a population of 90 dogs – 50 being healthy and 40 with PD. This analysis allowed for the discovery of four new intronic variations that were banked in GenBank (g.85A>G, g.151G>T, g.268A>G and g.492T>C). The results of this study are not intended to be applied exclusively to PD. On the contrary, this genetic information is intended to be used by other researchers as a foundation for the development of multiple applications in the veterinary clinical field.

Abuse among Portuguese older people at a time of economic crisis recovery: findings from the Harmed study

This study aimed to assess the prevalence of abuse against Portuguese older people after an economic crisis and to assess how it has influenced health. A cross-sectional study was carried out including 677 older adults (≥60 years) during 2017. Results show that overall, 23.9% of older people reported being a victim of abuse in the last 12 months. The prevalence of psychological abuse was 19.9%, financial abuse 5.8%, physical abuse 2.5% and sexual abuse 1.9%. Older people who report abuse were more likely to have perceived insufficient income and low social support. The abuse was also significantly associated with poor health status and depressive symptoms. Even in an auspicious period, more than a fifth of older people experiences abuse which is associated with social and health vulnerabilities. These results support that an investment should be made in terms of policies toward an age-friendly environment.

Hyperbaric Oxygen Therapy in Systemic Inflammatory Response Syndrome

(1) Background: Systemic inflammatory response syndrome (SIRS) can occur due to a large number of traumatic or non-traumatic diseases. Hyperbaric oxygen therapy (HBOT) may be used as a main or adjuvant treatment for inflammation, leading to the main aim of this study, which was to verify the applicability of HBOT as a safe and tolerable tool in SIRS-positive dogs. (2) Methods: This prospective cohort study included 49 dogs who showed two or more parameters of SIRS, divided into the Traumatic Study Group (n = 32) and the Non-Traumatic Study Group (n = 17). All dogs were submitted to HBOT for 60–90 min sessions, with 2.4–2.8 ATA. (3) Results: This study revealed that 73.5% (36/49) of dogs showed improvement, and the minimum number of HBOT sessions was two, with a mean of 12.73. The number of days between diagnosis and the beginning of HBOT showed statistical significance (p = 0.031) relative to the clinical outcome. No dogs showed any major side effects. (4) Conclusions: We concluded that HBOT may be safe and tolerable for SIRS-positive dogs, and that it should be applied as early as possible.

Engagement in civic organisations in old age: Motivations for participation and retention

Although the importance of older citizens' civic engagement has been highlighted in research and policy, the topic remains underexplored. In this study, we discuss older Portuguese citizens' motivations for civic engagement. The research is based on interviews with eighteen participants aged over 60, who are retired but active in civic organisations, in which they hold or have held leadership positions. We employed thematic analysis to examine the qualitative data. The findings suggest a range of motivations for participation, with personal and ideological/political motives emerging as relevant for involvement, retention and leaving, and interpersonal relationships motivating involvement and retention. However, the specific motivations differ as a function of not only the stages of involvement/retention/leaving, but also the type of organisation and the participants' life experiences. There are notable differences between the motivations for involvement in cultural and recreational organisations, neighbourhood organisations and volunteer programmes, where the emphasis is on fostering interpersonal relationships, and the more ideological/political motivations that appear as determinant within political and activist organisations. As such, this study brings a more complex understanding of the range of motivations for civic engagement in later life, with significant implications for fostering older citizens' mobilisation and sustained engagement.

“How many likes?”: The use of social media, body image insatisfaction and disordered eating

Introduction

Social media use has grown exponentially over the past few years, having a key role in communication among our youngsters. The impact of social media in mental health is still unclear. While some studies advocate that it increases social support and general satisfaction, others associate social media with the development of mental health issues. Social media can also perform some pressure regarding body image and eating behavior, caused by the idealistic appearance shown there in a very visual way.

Objectives

This review intends to identify the existing evidence regarding social media use, its impact on body image and eating behavior.

Methods

Search performed on May 11, 2020, including articles published since January 1st, 2006, written in Portuguese, English, Spanish and French. We used the MeSH terms ‘Body dissatisfaction’, ‘Body image’, ‘Feeding and eating disorders’, ‘Eating behaviors’ and ‘Social media’. The quality and strength of recommendation of the articles were evaluated using the Strength of Recommendation Taxonomy (SORT) scale from the American Academy of Family Physicians.

Results

716 articles were initially found. Eight were selected: two systematic reviews, three cohort studies, two cross-sectional studies and one observational study.

Conclusions

This review presents studies that establish a correlation between social media use, body image dissatisfaction and disordered eating. However, methodological and population heterogeneity can compromise the conclusions observed. With the current evidence, we can conclude that there is a relationship between the use of social media and changes in body image and/or eating behaviors in adolescents and young adults (SORT B).

Disclosure

No significant relationships.

The impact of the winery's wastewater treatment system on the winery water footprint

In the Mediterranean region, water scarcity has already prompted concern in the wine sector due to the strong impact it has on vineyard productivity and wine quality. Water footprint is an indicator that takes account of all the water involved in the creation of a product and may help producers to identify hotspots, and reduce water consumption and the corresponding production costs. In recent years several studies have been reported on wine water footprint determination, but mostly focused on the viticulture phase or assuming no grey water footprint at the winery since it has a treatment system. In the framework of the WineWaterFootprint project a medium-size winery was monitored, with direct measurements, regarding determination of the blue and grey components of water footprint. The determined winery water footprint ranged from 9.6 to 12.7 L of water per wine bottle of 0.75 L, the wastewater produced being responsible for about 98%, which means that the grey component cannot be disregarded. The developed scenarios show that a potential reduction of 87% in winery water footprint can be obtained with almost no investment. The challenge of reducing the grey footprint is not in technology development, but rather in the proper maintenance and monitoring of treatment systems.

Toll-like receptor 9 gene in Periodontal Disease - A promising biomarker

Periodontal Disease is an infectious and inflammatory disorder triggered mainly by periodontopathogenic bacteria, however, as a multifactorial disease, several factors modulate its progression, namely, genetic factors. Toll-like receptors (TLR) recognize molecular patterns present in pathogens and trigger an immune response against them. Thus, sequences variants in TLR genes seem to have the potential to modify the predisposition to Periodontal Disease and its progression. Based on this fact, TLR9 gene were analysed in a case-control study. DNA was obtained from 90 dogs (50 control and 40 cases) and a fragment of TLR9 gene was amplified by PCR and sequenced. The variants were identified by comparison with the dog wild type sequences. Our results suggest that rs375556098 and rs201959275 polymorphisms in the TLR9 gene are good candidates to become biomarkers of the canine predisposition to Periodontal Disease. It's important to notice that these polymorphic sites exist in Human exactly in the same codon. Since the dog is the best animal model to replicate the pathophysiological mechanisms of human Periodontal Disease, these results can potentially be extrapolated to humans.

Efecto de los cultivos autóctonos en la producción de Paio, un embutido curado tradicional portugués

En los países mediterráneos, como Portugal, los embutidos curados tradicionales son muy apreciados. A menudo se siguen fabricando en pequeñas unidades de procesamiento, de acuerdo con los procedimientos tradicionales. Los objetivos del presente estudio fueron evaluar el efecto de diferentes cultivos iniciadores y su concentración óptima, para reducir la carga microbiana y las aminas biogénicas en productos finales, con el objetivo de mejorar la seguridad de los embutidos sin deteriorar la aceptación sensorial. pH, aw, perfil microbiológico, aminas biogénicas, análisis del perfil de color y textura fueron evaluados. Las cepas y las concentraciones a utilizar, se seleccionaron en base a resultados previos: Staphylococcus xylosus, Lactobacillus sakei y una cepa de levadura a una concentración de 106 ufc / g de masa de carne cada una, se añadió 0,25% de dextrosa. Siempre se utilizó un lote control sin cultivos iniciadores. Los valores de aw fueron menores en los embutidos inoculados. En general, los valores de pH fueron ligeramente superiores en los embutidos inoculados. El tratamiento con L. sakei solo fue el más efectivo en la reducción del nivel de contaminación con L. monocytogenes, sin embargo este efecto parece perderse en cultivos mixtas. La inoculación, disminuyó generalmente el contenido de putrescina, de cadaverina y de tiramina. La inoculación de levadura parece contribuir al color más oscuro de los Paios. Con respecto a la textura, el Paio control demostró valores más altos de la dureza.

Creation of a Neovagina by Laparoscopic Modified Vecchietti Technique: Anatomic and Functional Results

Purpose To evaluate the anatomic and functional results of a laparoscopic modified Vecchietti technique for the creation of a neovagina in patients with congenital vaginal aplasia. Methods Retrospective study of nine patients with congenital vaginal aplasia submitted to the laparoscopic Vecchietti procedure, in our department, between 2006 and 2013. The anatomical results were evaluated by assessing the length, width and epithelialization of the neovagina at the postoperative visits. The functional outcome was evaluated using the Rosen Female Sexual Function Index (FSFI) questionnaire and comparing the patients' results to those of a control group of 20 healthy women. The statistical analysis was performed using SPSS Statistics version 19.0 (IBM, Armonk, NY, USA), Student t-test, Mann-Whitney U test and Fisher exact test. Results The condition underlying the vaginal aplasia was Mayer-Rokitansky-Küster-Hauser syndrome in eight cases, and androgen insensitivity syndrome in one case. The average preoperative vaginal length was 2.9 cm. At surgery, the mean age of the patients was 22.2 years. The surgery was performed successfully in all patients and no intra or postoperative complications were recorded. At the first postoperative visit (6 to 8 weeks after surgery), the mean vaginal length was 8.1 cm. In all cases, the neovagina was epithelialized and had an appropriate width. The mean FSFI total and single domain scores did not differ significantly from those of the control group: 27.5 vs. 30.6 (total); 4.0 vs. 4.2 (desire); 4.4 vs. 5.2 (arousal); 5.2 vs. 5.3 (lubrication); 4.2 vs. 5.0 (orgasm); 5.3 vs. 5.5 (satisfaction) and 4.4 vs. 5.4 (comfort). Conclusions This modified laparoscopic Vecchietti technique is a simple, safe and effective procedure, which allows patients with congenital vaginal aplasia to have a satisfactory sexual activity, comparable to that of normal controls.

Tongue nodules in canine leishmaniosis--a case report

BACKGROUND

Canine leishmaniosis (CanL) caused by Leishmania infantum is an endemic zoonosis in southern European countries. Infected dogs can present rare or atypical forms of the disease and diagnosis can be challenging. The present report describes a case of tongue nodules in a 3-year-old neutered female Labrador Retriever dog with leishmaniosis.

FINDINGS

A fine needle aspiration of the lingual nodules revealed amastigote forms of Leishmania inside macrophages. Differential diagnosis ruled out neoplasia, calcinosis circumscripta, solar glossitis, vasculitis, amyloidosis, eosinophilic granulomas, chemical and electrical burns, uremic glossitis and autoimmune diseases. Combined therapy with antimoniate meglumine and allopurinol for 30 days resulted in the normalization of hematological and biochemical parameters. Two months after diagnosis and the beginning of treatment, a mild inflammatory infiltrate was observed by histopathology, but an anti-Leishmania immunofluorescence antibody test (IFAT) was negative as well as a PCR on both tongue lesions and a bone marrow aspirate. Seven months after diagnosis, the dog's general condition appeared good, there were no tongue lesions and a new IFAT was negative. Fifteen months after diagnosis this clinically favourable outcome continued.

CONCLUSIONS

The dog could have suffered a relapsing episode of CanL, but a new systemic or local infection cannot be excluded. Regular clinical re-evaluation should be maintained, as a future relapse can potentially occur. In conclusion, CanL should be considered in the differential diagnosis of nodular glossitis in dogs.

Analysis of new lactotransferrin gene variants in a case-control study related to periodontal disease in dog

The molecular and genetic research has contributed to a better understanding of the periodontal disease (PD) in humans and has shown that many genes play a role in the predisposition and progression of this complex disease. Variations in human lactotransferrin (LTF) gene appear to affect anti-microbial functions of this molecule, influencing the PD susceptibility. PD is also a major health problem in small animal practice, being the most common inflammatory disease found in dogs. Nevertheless, the research in genetic predisposition to PD is an unexplored subject in this species. This work aims to contribute to the characterization of the genetic basis of canine PD. In order to identify genetic variations and verify its association with PD, was performed a molecular analysis of LTF gene in a case-control approach, including 40 dogs in the PD cases group and 50 dogs in the control group. In this study were detected and characterized eight new single nucleotide variations in the dog LTF gene. Genotype and allele frequencies of these variations showed no statistically significant differences between the control and PD cases groups. Our data do not give evidence for the contribution of these LTF variations to the genetic background of canine PD. Nevertheless, the sequence variant L/15_g.411C > T leads to an aminoacid change (Proline to Leucine) and was predicted to be possibly damaging to the LTF protein. Further investigations would be of extreme value to clarify the biological importance of these new findings.

Social representations of smoking behaviour in 13-year-old adolescents

OBJECTIVE

The purpose of this study was to identify adolescents' social representations on smoking using a qualitative approach.

METHODS

Thirty semi-structured interviews were conducted by trained interviewers. The interviews were recorded with participant's permission after our comprehensive explanation of the interview process. After transcript the content of each interview, information was synthesised under each of main question, and a conceptual content analysis was undertaken. The analysis was performed by two of the authors, and the conflicts were resolved by a third person.

RESULTS

Adolescents suggested different explanations for general people and adolescent smoking behaviour. While in general people smoking behaviour was mostly related to dependence, in adolescence it is referred to be associated with status improving among peers and to keep up social relations. We realised that adolescents are aware of the serious health implications of smoking, but they only referred it as a long-term effect in adulthood and no consequences during adolescence were for seen. We also noted the difficulties in giving preventive measures targeted on adolescents.

CONCLUSION

This study points out the importance of peers as agents of socialization in tobacco consumption, and shows the importance of anti-smoking campaigns among this age group with emphasis on smoking consequences in adolescence.

Effects of resistance training on cytokines

It is speculated that exercise training decreases resting levels of tumor necrosis factor alpha (TNF-alpha) and C-reactive protein (CRP); reduces body mass and leptin (LP); and increases adiponectin (AD) and insulin sensitivity. This systematic review analyzed the effectiveness of resistance training (RT) longitudinal clinical studies on AD, LP, CRP and TNF-alpha. Seventeen studies were included and the majority of randomized controlled trials support that RT produces increases in AD, and decreases in both LP and CRP. Greater responses in AD and LP were evident in overweight and obese individuals; while RT appeared to be effective in reducing CRP in obese individuals, and older adults. Additionally, women may be more responsive to RT effects on AD, LP and CRP. Training duration and intensity may affect the response of AD and CRP with greater responses shown with 16 weeks or more of training and/or with intensities greater than 80% of one repetition maximum. No response to RT of TNF-alpha levels was apparent. Although based on a limited number of studies, some of which are uncontrolled non-randomized in design, our review suggests some positive effects of RT programs on cytokine levels, but specifics of the responses in different populations need further elucidation.

Paraovarian tumor of borderline malignancy - a case report

A case of a 23-year-old woman with a paraovarian tumor is presented. The patient complained of pelvic pain and abdominal swelling. Cystectomy was the initial surgical treatment, but after the histological diagnosis, a staging surgery was carried out. The clinical aspects and subsequent management of related cases are discussed, and a literature review is made.

Endometrioid adenocarcinoma arising in endometriosis foci six years after estrogen replacement therapy: a case report

We present a case of a 53-year-old woman who developed an endometrioid adenocarcinoma six years after total abdominal hysterectomy (TAH) and bilateral salpingo-oophorectomy (BSO), who was on estrogenic-only hormone replacement therapy (HRT).

Paraovarian tumor of borderline malignancy – a case report

A case of a 23-year-old woman with a paraovarian tumor is presented. The patient complained of pelvic pain and abdominal swelling. Cystectomy was the initial surgical treatment, but after the histological diagnosis, a staging surgery was carried out. The clinical aspects and subsequent management of related cases are discussed, and a literature review is made.

Transvaginal ultrasonography and hysteroscopy in postmenopausal bleeding: a prospective study

OBJECTIVE

To determine the diagnostic value of transvaginal ultrasonography and hysteroscopy in patients with postmenopausal bleeding.

MATERIAL AND METHODS

Between January 1, 1998 and June 30, 1999, 88 outpatient women with postmenopausal bleeding were enrolled in a prospective study. They underwent transvaginal ultrasonography and hysteroscopy, and were submitted to directed biopsy during hysteroscopy. Findings were classified as normal endometrium, suggestive of atrophy, focal abnormality (benign or suspicious), and diffuse thickness (benign or suspicious). Data was compared with the final diagnosis, established by histological examination, as atrophy, benign pathology, atypical hyperplasia and endometrial carcinoma.

RESULTS

Among 88 women enrolled, 15 were excluded because hysteroscopy was impossible, and four had abandoned the study. The histological findings were scanty material in 12 (17.4%), atrophy in 24 (34.8%), cystic atrophy in one (1.4%), normal endometrium in five (7.2%), tuberculous endometritis in one (1.4%), polyps in 12 (17.4%), leiomyoma in one (1.4%), non-atypical hyperplasia in three (4.3%), atypical hyperplasia in one (1.4%) and endometrial carcinoma in nine cases (13.0%). For the assessment of endometrial carcinoma, ultrasonography revealed sensitivity 77.8%, specificity 93.3%, positive predictive value 63.6%, negative predictive value 96.6%; and hysteroscopy revealed sensitivity of 88.9%, specificity 98.3%, positive predictive value 88.9%, negative predictive value 98.3%. The combined use of both methods revealed sensitivity 100%, specificity 91.7%, positive predictive value 64.3%, negative predictive value 100%.

CONCLUSIONS

Both imagiological methods were found to be useful screening tests for endometrial carcinoma. Hysteroscopy was a superior diagnostic procedure.

[Comparison of coronary arteriosclerosis in patients with myocardial infarction and angina pectoris]

PURPOSE

To compare the severity of the coronary heart disease and the presence of coronary risk factors between angina and myocardial infarction (MI) patients.

METHODS

We studied 62 patients with MI and 129 with angina through coronary angiography to evaluate occlusion (lesion of 99% or 100%), extent (with a score of 0-5 derived by the number of vessels affected) and severity (3 groups of different stenosis degrees). Two experiment observers blindly interpreted the angiograms.

RESULTS

Patients with MI had more occlusions (50% vs 13.2% [p < 0.01]), more severity (79% vs 54.3% with > 90% stenosis [p < 0.02]) and more extent (2.0 vs 0.87; [p < 0.001]), even when controlled for current coronary risk factors and disease duration. Smoking was the only independent risk factor related to MI (p < 0.001).

CONCLUSION

Among the studied patients, coronary heart disease extent and severity was greater in the MI group, as well as the prevalence smoking.

Acromesomelic dwarfism: a new variation

The rate skeletal disorder, acromesomelic dwarfism, is characterized by short stature and short limbs. Bone dysplasia is evident. We report two cases of a variation of this disorder in a Portuguese woman and her son. The clinical features of these two cases differ from those of cases previously reported in the literature.