We aimed to investigate the prevalence rate of abuse (psychological, physical, sexual, financial, neglect) of older persons (AO) in seven cities from seven countries in Europe (Germany, Greece, Italy, Lithuania, Portugal, Spain, Sweden), and to assess factors potentially associated with AO.
A cross-sectional study was conducted in 2009 (n = 4,467, aged 60-84). Potentially associated factors were grouped into domains (domain 1: age, gender, migration history; domain 2: education, occupation; domain 3: marital status, living situation; domain 4: habitation, income, financial strain). We calculated odds ratios (OR) with their respective 95 % confidence intervals (CI).
Psychological AO was the most common form of AO, ranging from 10.4 % (95 % CI 8.1-13.0) in Italy to 29.7 % (95 % CI 26.2-33.5) in Sweden. Second most common form was financial AO, ranging from 1.8 % (95 % CI 0.9-3.2) in Sweden to 7.8 % (95 % CI 5.8-10.1) in Portugal. Less common was physical AO, ranging from 1.0 % (95 % CI 0.4-2.1) in Italy to 4.0 % (95 % CI 2.6-5.8 %) in Sweden. Sexual AO was least common, ranging from 0.3 (95 % CI 0.0-1.1) in Italy and Spain to 1.5 % (95 % CI 0.7-2.8) in Greece. Being from Germany (AOR 3.25, 95 % CI 2.34-4.51), Sweden (OR 3.16, 95 % CI 2.28-4.39) or Lithuania (AOR 2.45, 95 % CI 1.75-3.43) was associated with increased prevalence rates of AO.
Country of residence of older people is independent from the four assessed domains associated with AO. Life course perspectives on AO are highly needed to get better insight, and to develop and implement prevention strategies targeted at decreasing prevalence rates of AO.
Data from 12 different European countries show a rapid increase in HIV antibody positivity among drug users or a high degree of contamination already reached wherever studies have been made. Until 31 December 1986, 698 (18%) of AIDS cases were among drug users, of which 600 (15%) of AIDS cases were solely drug users, and 98 (3%) were in addition homosexual or bisexual. A further increase is expected. Because of the epidemiological importance for transmission to the heterosexual population, this problem has become a focus of attention. Drug abusing prostitutes constitute a major source of infection for the heterosexual population and newborns. The increase in the number of AIDS cases in 1986 among male drug abusers was 98 - that is up 61% compared to previous years; among women, the increase was 56%. The 3 main approaches to solution of this problem, i.e. interdiction of the drug trade, availability of sterile needles, and an education program have not proven as successful as anticipated. Relevant indications of the progress of infection in society can only be obtained by systematic observation of conversion rates in differential subgroups, i.e. drug abusers, newly incarcerated drug abusers, male and female prostitutes who use drugs, and individuals newly reporting for treatment. Separation of HIV antibody positives and negatives in therapeutic communities which are not drug free is recommended for epidemiological purposes in view of the developments to date. Nor should forced segregation of the infected from noninfected be dismissed out of hand.
An analysis of regional (18 regions) and temporal (1931-89) covariation of suicide rates and indicators of alcohol use and abuse in Portugal is reported. In the time series analysis, a positive relationship was found. An increase in per capita alcohol consumption of one litre is accompanied by a simultaneous increase in the male suicide rate of 1.9 per cent. This is comparable to what has been reported for France and Denmark, but considerably less than that found in Norway, Sweden and Hungary. In the regional data, there was a substantial negative correlation between the variables. However, after controlling for religious and family integration, the latter correlation became small and insignificant but still negative. A possible explanation is suggested for the different outcomes of the two analyses.
It is possible to determine alpha1-antitrypsin Pi types from serum obtained at necropsy. The Pi types were identical in 37 paired antemortem and postmortem samples. Blood transfusion in the 72 hours preceeding death may produce serum that cannot be typed. The frequency of the Pis allele was high in this study (0.074) and may reflect terminal alterations in alpha1-antitrypsin mobility and thus Pi typing, or a higher frequency in the population studied. The Pis allele was particularly frequent among Canadians with French names and Canadians born in Italy, Greece, and Portugal. The prevalence and severity of emphysema were not increased in PiA and Pis heterozygotes, but the groups studied were small and the variable, smoking, could not be adequately controlled. Studies of larger groups are recommended.
Food Research Division, Food Directorate, Health Products and Food Branch, Health Canada, 2203D, 251 Sir Frederick Banting Driveway, Tunney's Pasture, Ottawa, Ontario, Canada K1A 0K9. email@example.com
Blue-green algae and spirulina are marketed in health food stores and over the Internet as food supplements in Canada, the United States, and Europe. The reported benefits of consuming these products include improved digestion, strengthening of the immune system, and relief from the symptoms of attention deficit disorder. Some of these products have been found to contain elevated concentrations of microcystins, which are known hepatotoxins. In addition to producing microcystins, Anabaena sp. and Aphanizomenon sp. also produce the potent neurotoxin anatoxin-a. Samples of food supplements containing blue-green algae and spirulina were collected in Portugal and from urban centers across Canada in 2005. Extracts of these supplements were analyzed to determine the presence and concentrations of anatoxin-a and its two main metabolites, dihydroanatoxin-a and epoxyanatoxin-a. Initial analyses were performed using high-performance liquid chromatography (HPLC) with fluorescence detection, and confirmation required the use of LC with tandem mass spectrometry (LC-MS-MS). The HPLC with fluorescence detection indicated no anatoxin-a, but four samples were suspected to contain either dihydroanatoxin-a or epoxyanatoxin-a at 0.1 to 0.2 microg/g. LC-MS-MS results, however, indicated no trace of either transformation product in any sample analyzed. The detection limits for anatoxin-a, dihydroanatoxin-a, and epoxyanatoxin-a were similar for both fluorescence detection (0.2 to 0.3, 0.4 to 1.4, and 0.2 to 1.5 pg on the column, respectively) and mass spectrometry (0.3 to 1.5, 0.3 to 0.8, and 0.5 to 0.8 pg on the column, respectively). Because of the higher specificity of the LC-MS-MS analysis, all tested food supplement samples were considered free of anatoxin-a and its transformation products.
Because of the beneficial effect of estrogens on the risk of cardiovascular disease and osteoporosis in postmenopausal women, the factors which influence endogenous postmenopausal estrogen levels are of substantial importance. The major source of postmenopausal estrogen is the aromatization of androgens to estrogens. Because alcohol is reported to increase aromatization rates, the relationship between serum estradiol and moderate alcohol consumption was examined in a group of 128 healthy Pittsburgh postmenopausal women, and a significant direct association was found. In order to address the generalizability of this finding, 3 comparable study populations of healthy postmenopausal women were recruited: 62 in Copenhagen, 34 in Lisbon and 20 in Madrid. Although no association was detected in the Madrid study sample, in both the Copenhagen and Lisbon study populations, not only were estradiol levels significantly increased in alcohol users as compared to abstainers, but also estradiol levels were significantly correlated with total weekly drinks consumed. Based on these findings in study samples of healthy postmenopausal women from Pittsburgh, Copenhagen and Lisbon, we conclude that the increase in estradiol levels seen with moderate alcoholic beverage consumption is not an isolated finding and speculate that moderate alcohol consumption by healthy postmenopausal women may have beneficial effects.
Evidence from large cohort studies has established an increased risk of gastric cancer for individuals infected with Helicobacter pylori (HP). In low incidence countries, like the United Kingdom and Sweden, case-control studies suggested that the prevalence of anti-HP antibodies in gastric cancer patients (at the time of cancer diagnosis) is greater than in control populations. We present results from a case-control study of the prevalence of IgG anti-HP antibodies in gastric cancer patients and a control population in a country with a high incidence of gastric cancer. Sera were studied from 80 gastric cancer patients (GC group) admitted consecutively to our department in 1990/91, and from 80 controls (CT group) matched by age and sex. IgG anti-HP was determined by ELISA. Patients' files were reviewed for evidence of previous diagnosis of peptic ulcer, gastric surgery, tumor localization and histopathological classification. Controls were submitted to a questionnaire for past history of peptic ulcer and gastric surgery. Positive results for anti-HP were: gastric cancer patients, 70.0%; control group, 81.5% (NS). However, the median optical densities (OD, a measure of antibody concentration) were significantly lower in the gastric cancer group than in controls: gastric cancer patients, 0.720 +/- 0.424 OD; control group, 0.906 +/- 0.443 OD (P = 0.004). There were no differences concerning past history of peptic ulcer or surgery. The proportion of positives for cancer of the cardia (66.7%) was lower than for the other tumour localizations (70.4%) (NS). Anti-HP positivity was lower in patients with gastric cancer associated with intestinal metaplasia than in controls (P = 0.14).(ABSTRACT TRUNCATED AT 250 WORDS)
To examine the impact of two culturally competent diabetes education methods, individual counselling and individual counselling in conjunction with group education, on nutrition adherence and glycemic control in Portuguese Canadian adults with type 2 diabetes over a three-month period.
The Diabetes Education Centre is located in the urban multicultural city of Toronto, Ontario, Canada. We used a three-month randomized controlled trial design. Eligible Portuguese-speaking adults with type 2 diabetes were randomly assigned to receive either diabetes education counselling only (control group) or counselling in conjunction with group education (intervention group). Of the 61 patients who completed the study, 36 were in the counselling only and 25 in the counselling with group education intervention. We used a per-protocol analysis to examine the efficacy of the two educational approaches on nutrition adherence and glycemic control; paired t-tests to compare results within groups and analysis of covariance (ACOVA) to compare outcomes between groups adjusting for baseline measures. The Theory of Planned Behaviour was used to describe the behavioural mechanisms that influenced nutrition adherence.
Attitudes, subjective norms, perceived behaviour control, and intentions towards nutrition adherence, self-reported nutrition adherence and glycemic control significantly improved in both groups, over the three-month study period. Yet, those receiving individual counselling with group education showed greater improvement in all measures with the exception of glycemic control, where no significant difference was found between the two groups at three months.
Our study findings provide preliminary evidence that culturally competent group education in conjunction with individual counselling may be more efficacious in shaping eating behaviours than individual counselling alone for Canadian Portuguese adults with type 2 diabetes. However, larger longitudinal studies are needed to determine the most efficacious education method to sustain long-term nutrition adherence and glycemic control.