Quality Control in RT-PCR Viral Load Assays: Evaluation of Analytical Performance for HIV, HBV, and HCV.

Introduction: Quality Control Management (QCM) in clinical laboratories is crucial for ensuring reliable results in analytical measurements, with biological variation being a key factor. The study focuses on assessing the analytical performance of the Reverse Transcription Polymerase Chain Reaction (RT-PCR) system for Human Immunodeficiency Virus (HIV), Hepatitis B (HBV), and Hepatitis C (HCV). Five models proposed between 1999 and 2014 offer different approaches to evaluating analytical quality, with Model 2 based on biological variation and Model 5 considering the current state of the art. The study evaluates the RT-PCR system's analytical performance through Internal Quality Control (IQC) and External Quality Control (EQC). Materials and Methods: The Laboratório Central de Saúde Pública do Estado do Ceará (LACEN-CE) conducted daily IQC using commercial kits, and EQC was performed through proficiency testing rounds. Random error, systematic error, and total error were determined for each analyte. Results: Analytical performance, assessed through CV and random error, met specifications, with HIV and HBV classified as "desirable" and "optimal." EQC results indicated low systematic error, contributing to total errors considered clinically insignificant. Conclusion: The study highlights the challenge of defining analytical specifications without sufficient biological variability data. Model 5 is deemed the most suitable. The analytical performance of the RT-PCR system for HIV, HBV, and HCV at LACEN-CE demonstrated satisfactory, emphasizing the importance of continuous quality control in molecular biology methodologies.

How to Promote Gerotranscendence in Older Adults? A Scoping Review of Interventions.

Gerotranscendence is a psychosocial theory that proposes older adults experience a mindset shift in multiple dimensions (cosmic, coherence, solitude), associated with different constructs, such as life satisfaction and well-being. Increasing studies are employing gerotranscendence, but the practical aspects of how gerotranscendence can be developed are still underexplored. This review involved an assessment of the size and scope of the existing literature on interventions related to gerotranscendence and their effect on participants' well-being. Six databases were searched, and eight studies were selected: five were observational, while three were randomized control trials. Findings showed that gerotranscendence can be developed through weekly thematic encounters. Moreover, the interventions examined in the selected studies were described as having positively impacted participants' mental health and life satisfaction. Future studies should explore gerotranscendence interventions using a rigorous methodology and long-term follow-up data to add consistency to these findings.

Gerontological social workers' perspectives about the future at the start of a COVID-19 vaccination program: A photovoice study.

Summary: The COVID-19 pandemic is a continuing public health crisis, although it has lessened in its intensity since the start of worldwide vaccination programs. In aged care facilities, gerontological social workers have become frontline professionals facing multiple challenges and demands. One year after the first COVID-19 case in Portugal, during the second major lockdown in the country, and with vaccination starting in these facilities, a photovoice program to identify the experiences of these professionals was developed. This study aimed to understand how gerontological social workers foresee the future of practice and intervention with older adults. A thematic analysis was conducted based on the photographs and associated narratives from 10 participants, all female, aged between 22 and 35 years, who attended a program's session. Findings: Three themes were identified with the thematic analysis: (1) personal and professional growth (with renewed life perspectives and increased resilience), (2) reinvention of intervention (with improved management of emotions, teamwork, and alternative ways of intervening), and (3) hope to use the lessons learned (hope that vaccination will bring conditions to recover the older adults' well-being and opportunities to use the good lessons learned). Applications: These findings are relevant to inform policymakers and governments about practices in aged care facilities and to improve the training of gerontological social workers in acute action management and intervention. We stress alternative ways of intervening that came up in the response to the pandemic such as emotional management, digital technology, communication strategies, self-care, or the families' involvement.

Saúde mental em estudantes do ensino superior politécnico na pandemia COVID-19 / The mental health of polytechnic higher education students in the COVID-19 pandemic / Salud mental de los estudiantes de educación superior politécnica en la pandemia COVID-19

Resumo Enquadramento: A pandemia mudou significativamente as rotinas sociais e académicas dos estudantes do ensino superior. Objetivo: Identificar os níveis de saúde mental de estudantes do ensino superior e fatores associados. Metodologia: Estudo transversal com amostra de conveniência de 567 estudantes (idade média 23,92, ± 8,36; 63,8% feminino), que responderam a um questionário online no início do segundo confinamento, que incluiu o General Health Questionnaire (GHQ-28), aspetos sociodemográficos, académicos e as principais mudanças ocorridas durante a pandemia. Resultados: A pontuação média do GHQ foi 29,18 (± 12,99) e as menores e as maiores pontuações médias foram obtidas nas subescalas depressão grave (3,55 ± 4,46) e disfunção social (11,44 ± 3,81), respetivamente. 60,5% registou risco para problemas mentais. Os participantes que identificam alterações laborais têm melhor saúde mental. Quem identifica alterações nas rotinas familiares tem maior sintomatologia depressiva e quem identifica alterações nas relações familiares maior sintomatologia ansiógena e insónia. Conclusão: Urge considerar a saúde mental dos estudantes, promovendo estratégias para minimizar o impacto da pandemia, nomeadamente na disfunção social.

Abstract Background: The pandemic significantly changed social and academic routines of higher education students. Objective: Identify the mental health levels of higher education students and the associated factors. Methods: Cross-sectional study with a convenience sample of 567 students (mean age 23.92, ± 8.36; 63.8% female), that answered an online survey at the beginning of the second lockdown, which included the General Health Questionnaire (GHQ-28), sociodemographic and academic aspects, and main changes that occurred during the pandemic. Results: The mean score of the GHQ was 29.18 (±12.99) and the lowest and highest scores were obtained in severe depression (3.55±4.46) and social dysfunction (11.44±3.81). 60.5% indicated risk for mental problems. Participants identifying changes at labor level had better mental health. The ones identifying changes at familiar routines had higher depressive symptomatology and changes in familiar relationships had higher anxiety symptomatology and insomnia. Conclusion: It is urgent to consider the mental health of students, promoting strategies to minimize the impact of the pandemic, namely in social dysfunction.

Resumen Marco contextual: La pandemia ha cambiado significativamente las rutinas sociales y académicas de los estudiantes de educación superior. Objetivo: Identificar los niveles de salud mental de los estudiantes de educación superior y los factores asociados. Metodología: Estudio transversal con una muestra de conveniencia de 567 estudiantes (edad media de 23,92, ± 8,36; 63,8% mujeres), que completaron un cuestionario en línea al inicio del segundo confinamiento, que incluía el Cuestionario de Salud General (GHQ-28), aspectos sociodemográficos y académicos, y los principales cambios ocurridos durante la pandemia. Resultados: La puntuación media del GHQ fue de 29,18 (± 12,99) y las puntuaciones medias más bajas y más altas se obtuvieron en las subescalas depresión grave (3,55 ± 4,46) y disfunción social (11,44 ± 3,81), respectivamente. El 60,5% registró riesgo de problemas mentales. Los participantes que identifican cambios en el trabajo tienen una mejor salud mental. Los que identifican cambios en las rutinas familiares tienen más síntomas depresivos y los que identifican cambios en las relaciones familiares tienen más síntomas de ansiedad e insomnio. Conclusión: Se debe considerar urgentemente la salud mental de los estudiantes, así como promover estrategias para minimizar el impacto de la pandemia, especialmente en la disfunción social.

Post-Mortem Diagnosis of Pediatric Dengue Using Minimally Invasive Autopsy during the COVID-19 Pandemic in Brazil.

We report the first pediatric disease in which the use of minimally invasive autopsy (MIA) confirmed severe dengue as the cause of death. During the COVID-19 pandemic, a previously healthy 10-year-old girl living in north-eastern Brazil presented fever, headache, diffuse abdominal pain, diarrhoea, and vomiting. On the fourth day, the clinical symptoms worsened and the patient died. An MIA was performed, and cores of brain, lungs, heart, liver, kidneys, and spleen were collected with 14G biopsy needles. Microscopic examination showed diffuse oedema and congestion, pulmonary intra-alveolar haemorrhage, small foci of midzonal necrosis in the liver, and tubular cell necrosis in the kidneys. Dengue virus RNA and NS1 antigen were detected in blood and cerebrospinal fluid samples. Clinical, pathological, and laboratory findings, in combination with the absence of other lesions and microorganisms, allowed concluding that the patient had died from complications of severe dengue.

To Live or Die: What to Wish at 100 Years and Older.

Previous research has shown that will to live is a strong predictor for survival among older people, irrespective of age, gender, and comorbidities. However, research on whether life at age 100 is perceived as worth living is limited. The available literature has presented evidence for good levels of positive attitudes and life satisfaction at such an advanced age, but it has also suggested that a longing for death is common. This study aimed to add to the existing data on this matter by exploring centenarians' will to live and the associated factors. The sample comprised 121 centenarians (mean age, 101 years; SD, 1.63 years), 19 (15.7%) of whom were males, from two centenarian studies (PT100). Answers to open questions were analyzed to identify the centenarians' will to live and the reasons behind it. Three groups were created (willing to live longer, not willing to live longer, no clear positioning) and further analyzed in terms of sociodemographic characteristics, health status, social functioning, and well-being. Of the total sample, 31.4% expressed willingness to live longer, 30.6% did not, and 38% presented no clear positioning. The presence of the Catholic religion (God) was referred for centenarians in all three groups. Annoyance, uselessness, loss of meaning, disconnection, and loneliness were the most common justifications for being reluctant to live longer. Positive valuation of life and good self-rated health, followed by having a confidant and reduced pain frequency, were the factors associated with being willing to live longer. The results of the study contribute to the understanding of the psychological functioning of individuals with exceptional longevity, particularly concerning the factors behind willingness to live at such an advanced age.

Influence of Active and Healthy Ageing on Quality of Life Changes: Insights from the Comparison of Three European Countries.

This study aimed to analyze the determinants of quality of life (QoL) in older people in three European countries (Portugal, Spain and Sweden). A sample of 7589 participants in waves 4 (2011) and 6 (2015) of the Survey on Health, Aging, and Retirement in Europe (SHARE) project, aged 50 and over and living in Portugal, Spain and Sweden, was included. The CASP-12 scale was used to measure QoL. A principal component analysis was performed to group preselected variables related to active and healthy ageing into the dimensions of health, social participation, and lifelong learning. A linear regression model was built using the change in CASP-12 scores over the 4-year follow-up as the dependent variable, including the interactions between country and each independent variable in the model. After four years, the average QoL increased in Portugal (difference = 0.8, p < 0.001), decreased in Spain (-0.8, p < 0.001), and remained constant in Sweden (0.1, p = 0.408). A significant country-participation component interaction (p = 0.039) was found. In Spain, a higher participation (ß = 0.031, p = 0.002) was related to a higher QoL improvement at 4 years, but not in Sweden or Portugal. Physical health and emotional components (ß = 0.099, p < 0.001), functional ability (ß = 0.044, p = 0.023), and cognitive and sensory ability (ß = 0.021, p = 0.026) were associated with QoL changes over time in all countries. The country-specific associations between health, social participation and QoL should be taken into account when developing public health policies to promote QoL among European older people.

The Caregiver Support Ratio in Europe: Estimating the Future of Potentially (Un)Available Caregivers.

The caregiver support ratio (CSR) is defined as the number of potential caregivers aged 45-64 years, the most common caregiving age range, for each person aged 80+, the subgroup of older adults most at risk of needing long-term services and support. This study uses data from the CENSUS HUB database and from the UN database to calculate the current (last year available: 2011) and projected (2020, 2030, 2040 and 2050) CSR for a group of European countries. Mediterranean countries, France, Belgium, and Sweden presented the lowest CSR (5:1) in 2011. The countries with the highest CSR were Slovakia (9:1) and Ireland, Poland, Cyprus, and Malta (8:1). The estimated CSR is expected to progressively decline from 6:1 (2011) to 2:1 (2050) for all countries. Although differences in the CSR exist between countries, the number of people aged 45-64 who are available to care for each person aged 80+ will decrease uniformly in the coming decades. Cross-national challenges for gerontological social policies and healthcare provision are expected due to the increasing demand for long-term care among the oldest population.

Anxiety, Depression and Quality of Life in Older Adults: Trajectories of Influence across Age.

This study focuses on the influence of anxiety and depression on individual trajectories of quality of life in old age through a longitudinal approach. A representative sample of adults aged 50+ living in Portugal and participating in wave 4 (W4) and wave 6 (W6) of the Survey of Health, Ageing and Retirement in Europe (SHARE) project was considered. Participants, 1765 at baseline (W4) and 1201 at follow up (W6), were asked about their quality of life (CASP-12) and emotional status (Euro-D scale; five items from the Beck Anxiety Inventory). Linear Mixed Effects models were performed to identify factors associated with changes in quality of life across age. Increasing age was found to have a significant negative effect on quality of life. Lower education and higher levels of depression and anxiety at baseline were also associated with worse quality of life; 42.1% of the variation of CASP-12 across age was explained by fixed and random effects, being depression followed by anxiety as the factors that presented with the highest relative importance. Both depression and anxiety play an important role in quality of life in older adults and must be acknowledged as important intervention domains to foster healthy and active aging.

Psychometric Properties of the CASP-12 Scale in Portugal: An Analysis Using SHARE Data.

The purpose of this study is to assess the psychometric properties of the Portuguese version of the Control, Autonomy, Self-realization, and Pleasure (CASP)-12 scale used in the Survey of Health, Aging and Retirement in Europe (SHARE) project. Data were obtained from a representative sample of 1666 people aged ≥50 years living in Portugal and participating in the SHARE wave 6. In addition to the CASP-12 scale, sociodemographic data and health status, activity limitation (GALI), depression (Euro-D) and satisfaction with life scores were collected. Data quality and acceptability, construct and structural validity and internal consistency of the CASP-12 scale were analyzed. A Rasch analysis was also performed. CASP-12 total score (mean: 33.3; standard deviation: 5.8, range: 12-48) correlated with Euro-D (-0.57) and with life satisfaction (0.52). Mean scores were significantly lower for women, people aged ≥75 years and those with activity limitations and worse health status (p < 0.001). The confirmatory factor analysis showed good fit to the 4-factor model (root mean squared error of approximation (RMSEA): 0.07; comparative fit index (CFI): 0.90, χ2 (48) = 444.59, p < 0.001), which was confirmed by Rasch analysis (χ2 (36) = 10.089, p = 0.745, person separation index (PSI) = 0.722 for the 4-factor model). For domains, person separation index ranged 0.31-0.79 and Cronbach's alpha, 0.37-0.73. In conclusion, the Portuguese version of the CASP-12 scale presents some inadequacies in acceptability, internal consistency and structural validity.

Gravidez tardia no último filho e o seu impacto em trajetórias desenvolvimentais / Late pregnancy in the last child and its impact on developmental trajectories / Embarazo tardío en el último hijo y su impacto en las trayectorias de desarrollo

Este estudo analisa a experiência da maternidade tardia (35+ anos) e as suas implicações na fase avançada de vida, nomeadamente nas trajetórias pessoais e familiares. Trata-se de um estudo qualitativo com 15 díades compostas por mães tardias, atualmente idosas, e seus últimos filhos. Os resultados remetem para os riscos de saúde, distress emocional e julgamentos sociais da gestação tardia. Ao nível familiar destaca-se a presença de desafios da sobreposição de etapas distintas do ciclo de vida (cuidar de filhos pequenos e adolescentes vs. gestão da meia-idade) e, hoje, da (in)capacidade de cuidar dos netos. Os filhos evidenciam preocupações com a prestação de cuidados dos pais, tarefa que por ocorrer precocemente nas suas trajetórias desenvolvimentais, se pauta por dificuldades acrescidas.

This study focuses on the experience of late motherhood (35+ years) and its implications in the phase of advanced age, particularly in personal and family trajectories. It is a qualitative study of 15 dyads composed by older women who were late mothers and their last children. Results highlight the presence of several health risks, emotional distress and social judgments of late pregnancy. About family dynamics, challenges were mentioned by the overlapping of distinct stages of the life cycle (caring for small and teenage children vs. demands of middle age), and, currently, by the (in)capacity to take care of grandchildren. Children experienced several concerns related to their parent's caregiving, a demanding task that is perceived as happening too early in their developmental trajectories.

Este estudio analiza la experiencia de la maternidad tardía (más de 35 años) y sus implicaciones en la etapa avanzada de la vida, es decir, en las trayectorias personales y familiares. Este es un estudio cualitativo con 15 díadas compuestas por madres tardías, actualmente ancianas, y sus últimos hijos. Los resultados se refieren a los riesgos para la salud, la angustia emocional y los juicios sociales del embarazo tardío. A nivel familiar, destacamos la presencia de desafíos de la superposición de diferentes etapas del ciclo de vida (cuidado de niños pequeños y adolescentes frente a la gestión de la mediana edad) y, hoy, de la (in)capacidad de cuidar a los nietos. Los niños muestran inquietudes acerca de la provisión de cuidado parental, una tarea que, debido a que ocurre temprano en sus trayectorias de desarrollo, está marcada por mayores dificultades.

Self-medication in older European adults: Prevalence and predictive factors.

BACKGROUND/OBJECTIVES: Self-medication, despite some benefits, carries many risks, especially when practiced by older adults who are polymedicated. Information addressing the prevalence and associated factors of self-medication in older age in a European context is scarce and sometimes contradictory. This paper aims to estimate the prevalence of self-medication among older adults across Europe and to identify its predictive factors. DESIGN: Cross-sectional study. SETTING: Micro-data from the European Health Interview Survey (2006-2009) was used. PARTICIPANTS: The sample comprised 31,672 community-dwelling individuals aged 65 and over living in private households in 14 European countries. MEASUREMENTS: The analyses explored the use, over the last two weeks, of any medicines, supplements, or vitamins that were not prescribed by a doctor. RESULTS: The mean self-medication prevalence was 26.3 %, being the highest in Poland (49.4 %) and the lowest in Spain (7.8 %). Greater odds of self-medication were found for women and for participants who were younger, divorced, or presented a higher educational degree. The presence of long-standing illness and physical pain or not using prescribed medication also significantly increased the possibility of self-medication. A wide variation in the odds of self-medication between countries was also observed (up to 8 times more for Poland, compared to Spain). CONCLUSION: Self-medication is a prevalent problem among older Europeans, and even though some think it is risk-free, dangers tend to be greater with advancing age. This study will help identify the groups most likely to have this behavior so that we can focus on targeted educative and preventive initiatives.

Further survival at age 100: Findings from the Oporto Centenarian study.

BACKGROUND: This paper aims to identify the health-related predictors of survival in centenarians. METHODS: A population-based study conducted in North Portugal (PT100) followed 140 individuals from the age of 100+ years. A detailed questionnaire at baseline was completed including information on sociodemographic characteristics, physical health, functional, cognitive, and nutritional status and life-style. Survival of study participants was checked every six months over the period of December 2013 until June 2019. RESULTS: In the univariate Cox proportional hazards model, longer survival was associated with the absence of acute disease, better functional status, absence of physical fatigue and better cognition. Multivariate analysis revealed that acute disease, functional status and physical fatigue remained significant. CONCLUSIONS: Acute disease, functional status and physical fatigue are predictors of survival in the PT100 centenarians.

Quando os cuidados continuados chegam ao fim: perspetivas de cuidadores informais sobre o momento da alta / When long-term care comes to an end: informal caregivers' perspectives on patient discharge / Cuando los cuidados de larga duración terminan: perspectivas de los cuidadores informales sobre el momento del alta

Enquadramento: As unidades de cuidados continuados integrados (UCCI) têm como princípio a readaptação e reinserção familiar e social. Objetivo: Conhecer as perspetivas de cuidadores informais sobre o momento da alta do internamento em cuidados continuados dos seus familiares com demência. Metodologia: Quinze cuidadores (média de idades 60 anos) foram entrevistados e os dados analisados qualitativamente com recurso ao NVivo. Resultados: Apesar da preocupação e medo relativamente ao momento de alta, a maioria dos participantes não tomou qualquer ação. Quando questionados sobre o que fariam se o seu familiar tivesse alta da UCCI, referem considerar o domicílio (n = 5) ou uma estrutura residencial para pessoas idosas (n = 10). Esta decisão tem em conta um ou mais motivos, nomeadamente fatores ambientais, indisponibilidade do cuidador, relação de proximidade, questões económicas e questões familiares. Conclusão: Os motivos que pesam na integração e prestação de cuidados ao paciente após a alta devem ser considerados pelos profissionais, no sentido de um melhor apoio, formação e capacitação dos cuidadores informais, medidas que devem ser partes constituintes de uma rotina de cuidados.

Background: The purpose of long-term integrated care units is the readaptation and reintegration into family and social life. Objective: To understand informal caregivers' perspectives on the discharge of their relatives with dementia from long-term care facilities. Methodology: Fifteen caregivers (mean age of 60 years) were interviewed, and data were qualitatively analyzed using NVivo. Results: Despite the concern and fear about discharge, most participants did not take any action. When questioned about what they would do if their family member was discharged from the unit, they mentioned that they would return home (n = 5) or go to a residential facility for older people (n = 10). This decision is justified by one or more reasons, namely environmental factors, caregiver unavailability, relationship of proximity, economic issues, and family issues. Conclusion: Healthcare professionals should consider the reasons influencing the integration and delivery of patient care after discharge to better support, train, and empower informal caregivers. These measures should be part of a care routine.

Marco contextual: El principio de las unidades de cuidados de larga duración integrados (unidades de cuidados integrados - UCCI) es la readaptación y reintegración familiar y social. Objetivo: Conocer las perspectivas de los cuidadores informales sobre el momento del alta hospitalaria en cuidados de larga duración de sus familiares con demencia. Metodología: Se entrevistó a 15 cuidadores (edad media de 60 años) y se analizaron los datos cualitativamente mediante NVivo. Resultados: A pesar de la preocupación y el temor al momento de recibir el alta, la mayoría de los participantes no tomaron ninguna medida. Cuando se les preguntó qué harían si su familiar recibiera el alta de la UCCI, respondieron que considerarían el domicilio (n = 5) o una residencia para personas mayores (n = 10). Esta decisión tiene en cuenta uno o más motivos, a saber, los factores ambientales, la falta de disponibilidad del cuidador, la relación de proximidad, las cuestiones económicas y las cuestiones familiares. Conclusión: Los motivos que influyen en la integración y la prestación de cuidados al paciente después del alta deben ser considerados por los profesionales, con el fin de apoyar, formar y capacitar mejor a los cuidadores informales, medidas que deberían formar parte de una atención rutinaria.

Falls and fear of falling in a sample of centenarians: the role of multimorbidity, pain and anxiety.

BACKGROUND: To explore the recent history of falls and the existence of fear of falling in a sample of centenarians, and to identify factors associated with both conditions. METHODS: The sample included 109 centenarians from two Portuguese studies. The two main outcomes of this study are fear of falling and history of fall(s). RESULTS: Results revealed that more than a half (51.4%) of the participants had fallen in the last 5 years and that the percentage of fear of falling was 78.9%. No association was found between the two conditions. The factors associated with each one were found to be different: number of health conditions for history of falls, and pain frequency and anxiety for fear of falling. CONCLUSIONS: The relationship between anxiety and fear of falling reinforces the importance of screening both conditions as it can improve their detection and treatment. The established relationship between a high number of health conditions (common at very advanced ages) and falls demands greater attention in fall prevention initiatives specifically targeted to the extremely elderly.

Thinking About the End of Life When It Is Near: A Comparison of German and Portuguese Centenarians.

This study examined how common thinking of and planning for the end of life (EOL) is among German and Portuguese centenarians, and whether patterns of EOL views are shaped by cultural and individual characteristics. A significant portion of centenarians in both countries reported not thinking about the EOL, not believing in the afterlife, and not having made EOL arrangements. Latent class analysis identified three EOL patterns: Class 1 (EOL thoughts with EOL arrangements and afterlife beliefs), Class 2 (EOL arrangements and afterlife beliefs without EOL thoughts), and Class 3 (Overall low endorsement of EOL items). The proportion of Portuguese centenarians was higher in Class 1 and of German centenarians higher in Classes 2 and 3. Centenarians' demographic, social, and health characteristics were significantly different across EOL patterns. As lack of EOL planning can result in poor EOL quality, enhancing communication among centenarians, family, and health-care professionals seems imperative.

Objective vs. Subjective Health in Very Advanced Ages: Looking for Discordance in Centenarians.

Background: Living beyond 100 years of age is associated with several functional and health constraints but their impact depends on one's perception of the situation. Associations between self-rated health (SRH) with sociodemographic and psychosocial variables have been explored in several studies, revealing that one's health appraisal depends of factors beyond the objective health condition. There is a large body of literature concerning SRH in later life but lack of evidence about centenarians' perception of health and its associated factors, which could increase the available knowledge on the strengths and resources individuals in very advanced ages have for facing daily life limitations. Objective and Methods: This study aims to analyse the relationship between subjective and objective health status in a sample of centenarians (n = 127). Subjective health was assessed by a single-item health measure, and objective health by considering the number of reported diseases and a functional capacity scale (BADL and IADL). Main health characteristics are described as well as examined the association between objective and subjective health. Results: 46.5% of the sample has a good, very good, or excellent appraisal of their own health. SRH was associated (p < 0.05) with BADL and IADL scores and with the total number of diagnosis; when analyzing SRH according to the level of functional capacity, results revealed that most individuals with severe and moderate dependence have a reasonable to excellent SRH (p > 0.05). Conclusion: Having diseases and functional dependence at 100 years old may not mean to have a bad SRH. The high variability in SRH and the discordance between objective and subjective measures are a proof of centenarian's capacity of adaptation and the existence of individual resources, which may be decisive for one' perception and handling of health situation at such an advanced age.

Patterns of Physical Activity and Screen Time Among Brazilian Children.

OBJECTIVE: To investigate the patterns of physical activity (PA) and screen time among children and adolescents attended by the Brazilian National Health System. METHODS: This cross-sectional study was conducted in the city of Bauru, São Paulo, Brazil. The sample was composed of 270 children and adolescents attending 5 basic health care units. PA and screen time were assessed through a questionnaire. Economic status, sex, and body composition variables were used as covariates. RESULTS: Boys were more likely to be active when compared with girls (odds ratio = 2.56; 95% confidence interval, 1.43-4.58). Children and adolescents who accumulated less screen time were more likely to be in the most active group (odds ratio = 0.41; 95% confidence interval, 0.24-0.72). When comparing data year on year, we found that the level of PA has not changed significantly among children aged 7-10 years; however, at the age of 10, we noticed a significant reduction in PA scores, which kept decreasing until the age of 12. Regarding screen time, the situation was the opposite, with the amount of time spent in this behavior increasing over the years. CONCLUSION: Our results showed an association between low PA levels and high amount of screen time among children and adolescents, showing that is necessary to encourage an active lifestyle, decreasing time spent on television, computers, cell phones, and video games.

Centenarians in Europe.

OBJECTIVES: The group of individuals aged 80 and over is growing faster than other segments of the population, and within this group the number of centenarians has risen exponentially worldwide. This paper reports the numbers of centenarians (total, and ratio relative to total population) in 32 European countries and their key characteristics: gender distribution, level of education, and type of residence. STUDY DESIGN: Population based study. MEASURES: We used national census data collected in 2011 for individuals aged 100 and over living in Austria, Belgium, Bulgaria, Croatia, Cyprus, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Iceland, Ireland, Italy, Latvia, Liechtenstein, Lithuania, Luxembourg, Malta, Netherlands, Norway, Poland, Portugal, Romania, Slovakia, Slovenia, Spain, Sweden, Switzerland and the UK. Data on gender, residence and education were used. RESULTS: The total number of centenarians was 89156, corresponding to 17.3 centenarians per 100000 inhabitants of the total population and 98.0 centenarians per 100000 individuals aged 65 and older. Centenarian ratios were highest in France, Italy and Greece, and lowest in Bulgaria, Romania, and Croatia. The percentage of men was 16.5% on average, and ranged from around 13% (Germany, Latvia, Belgium) to 37% (Hungary). Across Europe, 62.7% of the centenarians lived in private households, with a range from 10.9% (Iceland) to 90.0% (Romania). Education levels varied across countries, with an average of 13.6% having no formal education, ranging from 0.0% (the UK, Finland, Iceland) to 61.6% (Portugal). CONCLUSIONS: Centenarian numbers have increased substantially since last available data. The findings will inform specific health promotion policies, the strengthening of current services and the development of innovative care systems.