To send content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about sending content to .
To send content items to your Kindle, first ensure email@example.com
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about sending to your Kindle.
Note you can select to send to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
To describe the feasibility of a meaning-centered group psychotherapy (MCGP) adaptation in a sample of Portuguese cancer patients.
The study was carried out according to four steps: 1st — Transcultural adaptation and validation (focus groups); 2nd — Preliminary study with MCGP original version (to test its feasibility); 3rd — Adaptation of MCGP original version to a 4-session version (and internal pilot study); and 4th — Pilot exploratory trial (MCGP-4 session version), implemented between January 1, 2018 and December 31, 2019. Inclusion criteria were >18 years, psychological complaints, and difficulty to adapt to cancer. Allocation was according to participants’ preference: MCGP vs. care as usual (CAU). Primary outcomes were: MCGP adapted version improved quality of life (QoL) and spiritual well-being; secondary outcomes were improvement of depression, anxiety, and distress. Assessments were done at baseline (T1) and 1 month after (T2), with self-report socio-demographic and clinical questionnaires, Distress Thermometer (DT), McGill Quality of Life Questionnaire (MQOL), Functional Assessment of Chronic Illness Therapy — Spiritual Well-Being Scale (FACIT-Sp-12), Hospital Anxiety and Depression Scale, and its subscales (HADS — HADS-D, HADS-A).
In the 1st step, and through focus groups, the manual was reformulated and tested. The preliminary study (2nd step) with MCGP original version showed a high number of dropouts which could jeopardize the study and, after reframing the sessions content, MCGP was adapted to a 4-session version, and its feasibility was tested by an internal pilot study (3rd step). The pilot exploratory trial (4th step) had 91 participants. Most socio-demographic and clinical characteristics between the groups (51: MCGP; 40: CAU) had no statistically significant differences. A comparison between the two groups at T2 showed that the MCGP group scored significantly higher in the general (U = 552.00, P < 0.001), and existential (U = 727.50, P = 0.018) domains and total score (U = 717.50, P = 0.015) of QoL, and CAU presented statistical higher levels in DT (U = 608.50, P = 0.001). Comparing the groups between T1 and T2, the MCGP group had a statistically significant improvement in the general (Z = −3.67, P < 0.001) and psychosocial (Z = −2.89, P = 0.004) domains and total score (Z = −2.71, P = 0.007) of QoL, and a statistically significant decrease in DT (Z = −2.40, P = 0.016). In terms of group effects, the MCGP group presented increased general (b = 1.42, P < 0.001, η2p = 0.179), and support (b = 0.80, P = 0.045, η2p = 0.048) domains and total score (b = 0.81, P = 0.013, η2p = 0.073) of QoL (small to elevated dimensions), and decreased levels of depression (b = −1.14, P = 0.044, η2p = 0.048), and distress (b = −1.38, P = 0.001, η2p = 0.127) (small to medium dimensions), compared with CAU. At T2, participants who attended ≥3 sessions (n = 38) had a statistically significant higher score in the general domain (U = 130.50, P = 0.009) of QoL, comparing with those who attended 1 or 2 sessions (n = 13).
Significance of results
This study supports the benefits of an MCGP adapted version in improving QoL and psychologic well-being. More studies are necessary to address the limitations of this pilot exploratory trial, as its small sample size.
The increasing pressure of anthropogenic development in areas with high natural value poses a huge challenge for wildlife conservation worldwide. The Tagus estuary in southern Portugal is among the most important wetlands for migratory shorebirds in the East Atlantic Flyway (EAF). However, in 2020 the Portuguese government approved the construction of the new Lisbon international airport at the heart of the Tagus estuary. Intense aircraft traffic, flying at low altitudes during both approach and take-off, is expected to cross the estuary, overlapping to a great extent the important intertidal foraging areas. Here, we aim to quantify the potential loss of conservation value of the intertidal areas of the Tagus estuary for shorebirds resulting from the disturbance (noise) caused by overflying aircraft. Using a comprehensive dataset of wintering shorebird abundance and distribution in the whole intertidal estuarine area we first identified priority areas for conservation using a spatial prioritization approach. We then performed a replacement cost analysis by excluding the areas likely to become unsuitable or severely underused by birds due to intense air traffic noise. Our results suggest that the implementation of the new Lisbon airport may lead to a loss of up to 30% of the conservation value of the Tagus estuary in terms of intertidal feeding areas of wintering birds alone. The global impact will likely be greater when effects on supratidal roosts, as well as on passage birds, are also considered. The Tagus estuary, which is internationally important for six of the 10 species included in our analysis, is just one of a network of already depleted sites along the EAF. Thus, negative impacts on bird populations on the Tagus estuary will have repercussions and undermine conservation efforts elsewhere. The plight of shorebirds at the Tagus estuary is thus a matter of international conservation concern.
An outstanding cultural promoter, collector and patron of the arts in his native Spain, Gaspar de Haro y Guzmán (1629–87), 7th Marquess del Carpio, left his mark as ambassador in Rome (1677–82) and as viceroy in Naples (1682–7). In Italy, Carpio assembled forty-three volumes of drawings, of which only four, including SAL ms 879, have been spared dismemberment. Yet, lumping the ‘Carpio Album’ together with the nobleman’s collection of original drawings completely misses the point. Unlike the others, which were assembled to boost Carpio’s connoisseurship of Italian art, the Album was commissioned to showcase the collection of (largely antique) sculpture he had acquired in Rome and the series of modern fountains he commissioned, also in Rome. Like Vincenzo Giustiniani’s epoch-making Galleria Giustiniana of 1636–7, the Album was to be printed. The marquess’s departure for Naples cut short an ambitious publication project, the theoretical background and pedagogic scope of which have been largely overlooked. The attribution of drawings to artists Philipp Schor and Paolo De Matteis, amongst others, underlines the complex cultural agenda underpinning an Album conceived to reinstate the Roma antica myth by linking it to its Roma moderna counterpart. A new understanding of De Matteis’s artistry and objectives in configuring the Album is complemented with findings regarding Carpio’s commissioning or acquisition of antique, pseudo-antique and modern sculpture. The collection’s fateful dispersal helps unravel the Album’s most likely provenance.
Individuals with dementia usually have multiple chronic illnesses, most of whom are medicated with five or more medications. However, as dementia progresses and the goal of care moves from prolonging life to optimizing quality of life, the risk of taking certain medications may outweigh its benefit. Therefore, it is necessary to reassess the medication over time.
The objective of this work was to explore the barriers to optimising prescribing and deprescribing (withdrawing) of medications and the benefits of this procedure. Optimizing pharmacological treatment for people with dementia usually requires the prescription of inappropriate drugs and the initiation of other drugs. Several obstacles to the optimization of treatment have been identified in elderly people with multiple morbidities, related to the doctor, the health system, the patient and the caregiver, including: inadequate guidelines, incomplete medical history, prevention of negative consequences and established beliefs in the benefits and harms medication. Desprescribing older people with dementia is made even more difficult by the decrease in decision-making capacity, difficulties in understanding and communicating, increased involvement of caregivers and difficulties in setting goals.
Deprescribing, an integral component of a continuum of good prescribing practices, is the process of medication withdrawal or dose reduction to correct or prevent medication-related complications, improve outcomes, and reduce costs. Deprescribing can be a challenge in patients with dementia. In this narrative review we evaluate topics related with deprescribing: what constitutes deprescribing, the importance to deprescribing for patients with dementia, the potential benefits, barriers and enablers of deprescribing and the deprescribing process.
Patients with dementia often have multiple comorbidities and have complex medication regimens. Also, they face challenges with medication adherence because of the nature of the disease. Proper medication adherence is important to prevent progression of these comorbidities and decline in overall health. However, as dementia progresses, the risk of taking certain medications may outweigh the benefits. In addition, older people, especially those with physical and mental decline, tend to experience lower efficacy of these medications along with a higher risk of drug adverse effects. As with prescribing or continuing medications, deprescribing brings with it the potential for harm as well as benefit. Other barriers to deprescription include concerns from the patients or the family, worries and doubts from the physician and some issues related to each health system. Many challenges for its execution have been described.
Recent studies report benefits and safety in the prescription of patients with dementia, reinforcing the importance of considering prescription in the reevaluation of the patient. Advance care planning is the cornerstone of palliative care, and prescription should be considered in this process.
Evidence on how gender intersects with relevant social constructs in later phases of life is scarce. This investigation examined gender inequalities in perceived health status (self-perceived general health; SPGH) by Portuguese elderly community-dwellers while considering psycho-social and socio-demographic determinants. This study used data from a representative sample of community-dwellers aged ≥65 years (N = 920), who were enrolled in the Portuguese Elderly Nutritional Status Surveillance System (PEN-3S) project. Associations between SPGH and socio-demographic and psycho-social variables, functionality and self-reported morbidity were tested; indirect effects of relevant predictors on SPGH were also tested using a bootstrap method. Gender inequalities in health were found: women significantly rated their health worse than men; overall, participants rated their health as fair. Education, functional status, depression symptoms and self-reported morbidity significantly predicted SPGH among women, whereas only the latter two were associated with SPGH among men. For both genders, depression was the strongest predictor of SPGH. Mediation analyses detected indirect effects of cognitive function and loneliness feelings on SPGH among older adults. Results herein provide insights on the predictive role of psycho-social variables on SPGH and support the need for considering the context when addressing the correlates of SPGH among Portuguese older adults. Altogether, these findings might support cost-effective interventions targeting the most vulnerable groups of the population to inequalities in health and its predictors.
In 2012, a report drafted by the United Nations Human Settlements Programme (UN-Habitat) pointed out that Latin America was the most urbanised region of the world, with 23–75 per cent of its population living in cities. In 2010, the total population of the region totalled 588 million, with 468 million inhabitants living in cities. In Brazil alone, the largest country of the region, a third of the region's population is concentrated. The intense regional process of urbanisation occurred mostly in the second half of the 20th century, when in addition to intense rural– urban migration, most of the countries of the region went through a demographic transition process. With this, the cities of the region received 305 million new inhabitants in only a period of 40 years between 1970 and 2010 (UN-Habitat, 2012).
Beyond intense demographic growth, another characteristic common to Latin American countries is profound social inequality, with great income concentration and a significant portion of the population living below the poverty line. Within this scenario of demographic growth and deep social inequality, the formal real estate market is inaccessible to the low-income population, who have historically used informal practices to access housing. The intense urban growth of the last decades was based overall in the consolidation and densification of irregular and precarious settlements, whether irregular and clandestine peripheral allotments or favelas and invasions in central areas as well. What defines an irregular, clandestine or favela-like area varies in each one of the Latin American countries; however, all of those areas are characterised by housing precariousness, where buildings do not have licences, are not inspected by the authorities, have hazardous access to urban infrastructure (water supply, sanitary exhaustion, power, garbage removal) and are self-constructed. Pictures like those of the favelas in Rio de Janeiro, the irregular allotments in permanent protection areas on the borders of water supplies to Sao Paulo's dams, the comunas in Medellin's slopes or the villas alongside the railway tracks in Buenos Aires are paradigmatic examples of the day-to-day housing of the low-income population in Latin American cities (see Figures 2.1, 2.2 and 2.3).
There is growing literature regarding the controversial subject of the placement of early intervention in psychosis programs (EIP) in the psychiatric services network.
To review the literature concerning the different organizational models in early intervention in psychosis and their positioning with local psychiatric services.
To describe our community based early intervention program, integrated in a general adult psychiatry service. We intend to reflect about our experience, on the weaknesses and strengths of our service's model.
A non-systematic literature review about different models of service organization in early intervention in psychosis was performed, using Medline database and Google Scholar search-engine as well as reference textbooks.
The current debate is centered on whether EIP should be organized as autonomous services or integrated in broader psychiatric services.
The PSIC Programme is an assertive community-based programme for patients with a first psychotic episode. It was developed by the Psychiatric Department of Prof. Doutor Fernando Fonseca Hospital in 2001 through the cooperative use of the existing human and financial resources.
The integration of early intervention programs in general psychiatric services, allows for the delivery of specialized rehabilitative treatments while maintaining the continuity of care even after the critical period.
Early intervention programs encapsulate a new optimism within community mental health teams. Inevitably the high standards imported from early intervention, begin to be benchmarks for all services for psychotic individuals.
The aim was to understand the processes of therapeutic changes in Meaning-Centered Group Psychotherapy (MCGP) in a Portuguese sample.
Adult cancer patients with distress motivated to participate in MCGP were identified; descriptive and narrative analyses were performed on the session content.
The sample had 24 participants (mean age: 63.43 years); the majority were females (75%), with a median academic degree (54%). Breast cancer was most frequent (67%) at the localized stage (71%). The narrative analysis defined seven categories according to the MCGP themes. In “Moments with Meaning (MwM),” the most relevant dimensions were related to interpersonal relations, the moment of diagnosis, and personal achievements. This category established relations with almost all other categories, as did the category “historical sources of meaning (SoM).” The category “identity before and after cancer diagnosis” was only related to “attitudinal SoM” and “transitions.” Historical SoM had two dimensions, “past” and “present and future” legacies, in which prominent topics related to family, childhood, achieved goals, and values to pass to others explored. Attitudinal SoM established relations only with the category “creative SoM,” in which “courage” and “responsibility” were the main dimensions, which were also related to “MwM,” “historical,” and “attitudinal SoM.” Experiential SoM, with the main dimension “love,” was related to “MwM” and “historical SoM.” Transitions only established relations with “historical SoM” and “identity before and after cancer.”
Significance of results
The findings that “MwM” and “historical SoM” were the categories which established a solid pattern of relations suggest that these are the main psychotherapy topics that can have more influence for the participants; one explanation is that these categories imply a concrete way of thinking, which is easier to understand. This process of therapeutic changes must be integrated in a cultural context, as it is well known to have an impact upon the “meaning” of life.
Essential oils (EOs) are considered a new class of ecological products aimed at the control of insects for industrial and domestic use; however, there still is a lack of studies involving the control of fleas. Ctenocephalides felis felis, the most observed parasite in dogs and cats, is associated with several diseases. The aim of this study was to evaluate the in vitro activity, the establishment of LC50 and toxicity of EOs from Alpinia zerumbet (Pers.) B. L. Burtt & R. M. Sm, Cinnamomum spp., Laurus nobilis L., Mentha spicata L., Ocimum gratissimum L. and Cymbopogon nardus (L.) Rendle against immature stages and adults of C. felis felis. Bioassay results suggest that the method of evaluation was able to perform a pre-screening of the activity of several EOs, including the discriminatory evaluation of flea stages by their LC50. Ocimum gratissimum EO was the most effective in the in vitro assays against all flea stages, presenting adulticide (LC50 = 5.85 μg cm−2), ovicidal (LC50 = 1.79 μg cm−2) and larvicidal (LC50 = 1.21 μg cm−2) mortality at low doses. It also presented an excellent profile in a toxicological eukaryotic model. These findings may support studies involving the development of non-toxic products for the control of fleas in dogs and cats.
The second and final year of the Erasmus Plus programme ‘Innovative Education and Training in high power laser plasmas’, otherwise known as PowerLaPs, is described. The PowerLaPs programme employs an innovative paradigm in that it is a multi-centre programme, where teaching takes place in five separate institutes with a range of different aims and styles of delivery. The ‘in-class’ time is limited to 4 weeks a year, and the programme spans 2 years. PowerLaPs aims to train students from across Europe in theoretical, applied and laboratory skills relevant to the pursuit of research in laser plasma interaction physics and inertial confinement fusion. Lectures are intermingled with laboratory sessions and continuous assessment activities. The programme, which is led by workers from the Hellenic Mediterranean University and supported by co-workers from the Queen’s University Belfast, the University of Bordeaux, the Czech Technical University in Prague, Ecole Polytechnique, the University of Ioannina, the University of Salamanca and the University of York, has just finished its second and final year. Six Learning Teaching Training activities have been held at the Queen’s University Belfast, the University of Bordeaux, the Czech Technical University, the University of Salamanca and the Institute of Plasma Physics and Lasers of the Hellenic Mediterranean University. The last of these institutes hosted two 2-week-long Intensive Programmes, while the activities at the other four universities were each 5 days in length. In addition, a ‘Multiplier Event’ was held at the University of Ioannina, which will be briefly described. In this second year, the work has concentrated on training in both experimental diagnostics and simulation techniques appropriate to the study of plasma physics, high power laser matter interactions and high energy density physics. The nature of the programme will be described in detail, and some metrics relating to the activities carried out will be presented. In particular, this paper will focus on the overall assessment of the programme.
Both malnutrition (which here refers to undernutrition) and obesity are prevalent in older adults, but they are frequently seen as mutually exclusive. In fact, a low body mass index (BMI) is one of the aetiological diagnostic criteria for malnutrition. On the contrary, the concomitant presence of malnutrition and obesity has been less studied. The aim of this study was to characterise the nutritional status of community-dwelling older adults (≥ 65 years old) living in Portugal. The study included a nationally representative sample of randomly selected community-dwelling older adults. Trained nutritionists collected data through face-to-face structured interviews regarding sociodemographic characteristics, nutritional status and anthropometric measures (namely, weight and height), among other variables of the PEN-3S study. Nutritional status was assessed by the 18-item Mini Nutritional Assessment (full MNA®), in which a lower score indicates worse nutritional status. The World Health Organisation's (WHO) BMI cut-offs for adults were followed (obesity: BMI ≥ 30Kg/m2). MNA and BMI categories estimates (95% CI) were obtained using Complex Samples analysis (SPSS® 24.0). Non-difference between sexes was analysed with Chi-square tests. Complete information was available for 1110 community-dwelling participants (mean age: 75.9 ± 8.1 years; 48.9% women; 71.4% attended school for < 5 years). According to the MNA, 0.5% (95%CI: 0.2–1.7) were classified as malnourished and 16.0% (12.9–19.7) were at risk of malnutrition. Following WHO's BMI criteria, 0.6% (0.2–1.5) had a BMI ≤ 18.5Kg/m2, 41.9% (37.9–46.0) had a BMI between 25–30Kg/m2, and 36.7% (32.8–40.9) presented a BMI ≥ 30Kg/m2. The prevalence of risk of malnutrition was significantly higher for women (20.1%, 95%CI: 15.4–25.9) than men (10.4%, 7.6–14.1; p < 0.001). The prevalence of obesity was also significantly higher for women (42.2%, 35.9–48.7 versus 29.3%, 24.8–34.2; p = 0.007). Moreover, 13.9% (9.2–20.4) were simultaneously at risk of malnutrition and had a BMI ≥ 30Kg/m2, while no one in this BMI category was classified as malnourished. Although appropriate BMI cut-offs for older adults are still uncertain, these results highlight that a high BMI does not exclude the risk of malnutrition, particularly in women. Therefore, health professionals should routinely screen for malnutrition using multi-component, validated screening tools, irrespective of the BMI. In fact, malnutrition is preventable if detected on time and effective interventions exist. The concomitant presence of malnutrition and obesity may pose additional challenges to the treatment.
A commercial drinkable yogurt with and without 4% of added trehalose (as cell protectant) was spray-dried obtaining a powder with low water activity (aw). Total bacterial count in the powder was between 8.48–8.90 log cfu/g. The dried yogurt was stored: (i) at 38 °C and aw = 0.33; (ii) at 38 °C in hermetically sealed flasks (aw = 0.21/0.22); (iii) in a cyclic temperature chamber (10–20 °C) in hermetically sealed flasks (aw = 0.21/0.22). Whole milk was then fermented by adding an inoculum of spray-dried yogurt after storage under these different conditions. The kinetics of acidification showed the presence of a lag time which was strongly dependent on storage conditions. The data was fitted with a logistic type equation from which the lag time was calculated. To evaluate structural differences among samples, Fourier Transform Infrared spectra (FTIR) were recorded. Partial Least Squares (PLS) models enabled a good correlation between lag time of fermentation and FTIR spectra. The lag time for yogurt powder stored at aw about 0.21/0.22 and cyclic temperature 10–20 °C remained approximately constant over the 12 weeks of storage, while all the other conditions resulted in a dramatic increase. The addition of trehalose had a small influence on lag time and, therefore, as a protectant of lactobacilli.
Steep slope vineyards are a complex scenario for the development of ground robots. Planning a safe robot trajectory is one of the biggest challenges in this scenario, characterized by irregular surfaces and strong slopes (more than 35°). Moving the robot through a pile of stones, spots with high slope or/and with wrong robot yaw may result in an abrupt fall of the robot, damaging the equipment and centenary vines, and sometimes imposing injuries to humans. This paper presents a novel approach for path planning aware of center of mass of the robot for application in sloppy terrains. Agricultural robotic path planning (AgRobPP) is a framework that considers the A* algorithm by expanding inner functions to deal with three main inputs: multi-layer occupation grid map, altitude map and robot’s center of mass. This multi-layer grid map is updated by obstacles taking into account the terrain slope and maximum robot posture. AgRobPP is also extended with algorithms for local trajectory replanning during the execution of a trajectory that is blocked by the presence of an obstacle, always assuring the safety of the re-planned path. AgRobPP has a novel PointCloud translator algorithm called PointCloud to grid map and digital elevation model (PC2GD), which extracts the occupation grid map and digital elevation model from a PointCloud. This can be used in AgRobPP core algorithms and farm management intelligent systems as well. AgRobPP algorithms demonstrate a great performance with the real data acquired from AgRob V16, a robotic platform developed for autonomous navigation in steep slope vineyards.
There is a long history of exploitation of the South American river turtle Podocnemis expansa. Conservation efforts for this species started in the 1960s but best practices were not established, and population trends and the number of nesting females protected remained unknown. In 2014 we formed a working group to discuss conservation strategies and to compile population data across the species’ range. We analysed the spatial pattern of its abundance in relation to human and natural factors using multiple regression analyses. We found that > 85 conservation programmes are protecting 147,000 nesting females, primarily in Brazil. The top six sites harbour > 100,000 females and should be prioritized for conservation action. Abundance declines with latitude and we found no evidence of human pressure on current turtle abundance patterns. It is presently not possible to estimate the global population trend because the species is not monitored continuously across the Amazon basin. The number of females is increasing at some localities and decreasing at others. However, the current size of the protected population is well below the historical population size estimated from past levels of human consumption, which demonstrates the need for concerted global conservation action. The data and management recommendations compiled here provide the basis for a regional monitoring programme among South American countries.
The Erasmus Plus programme ‘Innovative Education and Training in high power laser plasmas’, otherwise known as PowerLaPs, is described. The PowerLaPs programme employs an innovative paradigm in that it is a multi-centre programme where teaching takes place in five separate institutes with a range of different aims and styles of delivery. The ‘in class’ time is limited to four weeks a year, and the programme spans two years. PowerLaPs aims to train students from across Europe in theoretical, applied and laboratory skills relevant to the pursuit of research in laser–plasma interaction physics and inertial confinement fusion (ICF). Lectures are intermingled with laboratory sessions and continuous assessment activities. The programme, which is led by workers from the Technological Educational Institute (TEI) of Crete, and supported by co-workers from the Queen’s University Belfast, the University of Bordeaux, the Czech Technical University in Prague, Ecole Polytechnique, the University of Ioannina, the University of Salamanca and the University of York, has just completed its first year. Thus far three Learning Teaching Training (LTT) activities have been held, at the Queen’s University Belfast, the University of Bordeaux and the Centre for Plasma Physics and Lasers (CPPL) of TEI Crete. The last of these was a two-week long Intensive Programme (IP), while the activities at the other two universities were each five days in length. Thus far work has concentrated upon training in both theoretical and experimental work in plasma physics, high power laser–matter interactions and high energy density physics. The nature of the programme will be described in detail and some metrics relating to the activities carried out to date will be presented.
To characterise the nutritional status and to identify malnutrition-associated variables of older adults living in Portuguese nursing homes.
Cross-sectional study. Data on demographic and socio-economic characteristics, self-reported morbidity, eating-related problems, nutritional status, cognitive function, depression symptoms, loneliness feelings and functional status were collected by trained nutritionists through a computer-assisted face-to-face structured interview followed by standardised anthropometric measurements. Logistic regression was used to identify factors associated with being at risk of malnutrition/malnourished.
Portuguese nursing homes.
Nationally representative sample of the Portuguese population aged 65 years or over living in nursing homes.
A total of 1186 individuals (mean age 83·4 years; 72·8 % women) accepted to participate. According to the Mini Nutritional Assessment, 4·8 (95 % CI 3·2, 7·3) % were identified as malnourished and 38·7 (95 % CI 33·5, 44·2) % were at risk of malnutrition. These percentages increased with age and were significantly higher for women. Logistic regression showed (OR; 95 % CI) that older adults reporting no or little appetite (6·5; 2·7, 15·3), those revealing symptoms of depression (2·6; 1·6, 4·2) and those who were more dependent in their daily living activities (4·7; 2·0, 11·1) were also at higher odds of being malnourished or at risk of malnutrition.
Malnutrition and risk of malnutrition are prevalent among nursing home residents in Portugal. It is crucial to routinely screen for nutritional disorders, as well as risk factors such as symptoms of depression and lower functional status, to prevent and treat malnutrition.
The main aim of the present study was to examine the association between the Dietary Inflammatory Index (DII®) and academic performance in children.
School-based cross-sectional study. The DII was calculated based on dietary information obtained from a single 24h dietary recall. Academic performance was assessed by school records provided by the administrative services (i.e. Maths and Language).
Porto area (Portugal).
A total of 524 children (277 girls) aged 11·56 (sd 0·86) years.
The DII was associated with academic indicators (standardized β values ranging from −0·121 to −0·087; all P<0·05). Significant differences were found between quartiles of the DII (P<0·05); children in the fourth quartile had significantly lower scores in all academic indicators compared with children in the first quartile (score differences ranging from −0·377 to −0·292) after adjustment for potential confounders.
The inflammatory potential of diet may negatively influence academic performance. Children should avoid the consumption of a pro-inflammatory diet and adhere to a more anti-inflammatory diet to achieve academic benefits.
This study assessed the anthelmintic activity of plant-derived compounds against gastrointestinal nematodes of goats using the egg hatch and larval motility assays. The compounds tested were saponins (digitonin and aescin) and their respective sapogenins (aglycones), hecogenin acetate and flavonoids (catechin, hesperidin, isocordoin and a mixture of isocordoin and cordoin). Additionally, cytotoxicity of active substances was analysed on Vero cell through 3-4,5-dimethylthiazol-2-yl,2,5diphenyltetrazolium bromide (MTT) and propidium iodide (PI) tests. Significant reduction on the egg hatching (P < 0.05) was seen only in the treatments with aescin (99%/EC50 = 0.67 mg mL−1) and digitonin (45%). The compounds that reduced the larval motility (P < 0.05) were digitonin (EC50 = 0.03 mg mL−1 and EC90 = 0.49 mg mL−1) and the hecogenin acetate (75%). The other sapogenins showed low anthelmintic activity. All the flavonoids showed low ovicidal (4–12%) and larvicidal (10–19%) effects. The aescin and digitonin showed low toxicity in PI test (viable cells >90%). Nevertheless, higher cytotoxicity was observed in the MTT assay, with IC50 of 0.20 mg mL−1 (aescin) and 0.0074 mg mL−1 (digitonin). Aescin and digitonin have a pronounced in vitro anthelmintic effect and the glycone portion of these saponins plays an important role in this activity.