Life-course socio-economic status and its impact on functional health of Portuguese older adults.

Functional health is arguably one of the most important health indicators for older adults, because it assesses physical, cognitive and social functions in combination. However, life-course circumstances may impact this multidimensional construct. The aim of the present study was to assess the relationship between life-course socio-economic status (SES) and different dimensions of functional health in older adults. Data on 821 Portuguese adults aged 50 years and over in 2013-2015 were analysed. Life-course SES was computed using participants' paternal occupation (non-manual (nm); manual (m)) and own occupation (nm; m), resulting in four patterns: stable high (nm + nm), upward (m + nm), downward (nm + m) and stable low (m + m). Functional health included physical and mental functioning, cognitive function, handgrip strength, and walking speed. Linear (beta coefficients) and logistic regressions (odds ratios) were used to estimate the association between life-course SES and functional health.Overall, those who accumulated social disadvantage during life-course presented worse functional health than those with stable high SES (stable low - SF-36 physical functioning: ß = -9.75; 95% CI: -14.34; -5.15; SF-36 mental health: ß = -7.33; 95% CI: -11.55; -3.11; handgrip strength: ß = -1.60; 95% CI: -2.86; -0.35; walking time, highest tertile: OR = 5.28; 95% CI: 3.07; 9.09). Those with an upward SES were not statistically different from those in the stable high SES for most of the health outcomes; however, those with an upward SES trajectory tended to have higher odds of cognitive impairment (OR = 1.75; 95% CI: 0.96; 3.19). A downward SES trajectory increased the odds of slower walking speed (OR = 4.62; 95% CI: 1.78; 11.95). A disadvantaged life-course SES impacts older adults' physical and mental functioning. For some outcomes, this was attenuated by a favourable adulthood SES but those with a stable low SES consistently presented worse functional health.

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.

Trajectories of depressive symptoms through adolescence and young adulthood: social and health outcomes.

Depressive symptoms display heterogeneous trajectories across adolescence, which can lead to different consequences. This study aimed to identify trajectories of depressive symptoms from adolescence to young adulthood, assessing the association with social and health outcomes at young adulthood. Adolescents born in 1990, enrolled in schools of Porto, Portugal, in 2003-2004 (EPITeen study) completed the Beck Depression Inventory II (BDI-II) at 13, 17 and 21 years. Mixed models and model-based clustering were used to describe the trajectories in the BDI-II score (n = 2010). Outcomes were assessed at age 21 years with self-administered questionnaires and face-to-face interviews (n = 1594). Odds ratios or regression coefficients, with 95% confidence intervals, were estimated using logistic and linear regression. Three trajectory classes of depressive symptoms were identified, similar in shape in both sexes: High (8.4%), Moderate (31.3%) and Low (60.2%). Participants in High or Moderate classes were more likely to describe lower scores of community involvement, more medical appointments during the last year, higher levels of pain and had higher probability of self-rating health as "good" or "fair or poor". Females in the High and Moderate classes were more likely to be current smokers, to describe ever using drugs and to report more sexual partners, emergency room visits and the use of antidepressants. The risk of depressive symptoms in adulthood is likely to be early determined in adolescence. The trajectory classes with higher levels of symptoms were associated with worse social and health outcomes.

Socioeconomic position and quality of life among older people: The mediating role of social support.

Social support can obscure social gradients in health, but its role as a mediator between socioeconomic position (SEP) and quality of life (QoL) in older populations remains unknown. We aimed to examine to what extent social support mediates the association between SEP and overall QoL among older adults (aged 60-84 years). We studied a population-based cohort of 585 noninstitutionalized adults in Porto, Portugal, who were evaluated in 2009. Education, occupation, and perceived income adequacy were used as SEP indicators. The WHOQOL-OLD was used to determine overall QoL. Social support was assessed using the Multidimensional Scale of Perceived Social Support. Path analysis was conducted to quantify direct, indirect, and total effects of SEP on QoL. There was a positive total effect of education on QoL (ß = 0.28; 95% CI: 0.05-0.48). In this model, we found an indirect effect through social support (ß = 0.15; 95% CI: 0.05-0.26), explaining 54% of the pathway between education and QoL. A similar pattern was identified for the association between occupation and QoL. Perceived income adequacy had a total effect of 2.74 (95% CI: 1.68-3.93) on QoL. Although an indirect effect through social support was found (ß = 0.98; 95% CI: 0.42-1.55), a direct effect from this variable remained (ß = 1.76; 95% CI: 0.65-2.90). Social support can be a mechanism through which SEP impacts the QoL of older people. Strengthening social support ties may attenuate the impact of social inequalities and improve the QoL of this population.

Impact of maternal body mass index and gestational weight gain on pregnancy complications: an individual participant data meta-analysis of European, North American and Australian cohorts.

OBJECTIVE: To assess the separate and combined associations of maternal pre-pregnancy body mass index (BMI) and gestational weight gain with the risks of pregnancy complications and their population impact. DESIGN: Individual participant data meta-analysis of 39 cohorts. SETTING: Europe, North America, and Oceania. POPULATION: 265 270 births. METHODS: Information on maternal pre-pregnancy BMI, gestational weight gain, and pregnancy complications was obtained. Multilevel binary logistic regression models were used. MAIN OUTCOME MEASURES: Gestational hypertension, pre-eclampsia, gestational diabetes, preterm birth, small and large for gestational age at birth. RESULTS: Higher maternal pre-pregnancy BMI and gestational weight gain were, across their full ranges, associated with higher risks of gestational hypertensive disorders, gestational diabetes, and large for gestational age at birth. Preterm birth risk was higher at lower and higher BMI and weight gain. Compared with normal weight mothers with medium gestational weight gain, obese mothers with high gestational weight gain had the highest risk of any pregnancy complication (odds ratio 2.51, 95% CI 2.31- 2.74). We estimated that 23.9% of any pregnancy complication was attributable to maternal overweight/obesity and 31.6% of large for gestational age infants was attributable to excessive gestational weight gain. CONCLUSIONS: Maternal pre-pregnancy BMI and gestational weight gain are, across their full ranges, associated with risks of pregnancy complications. Obese mothers with high gestational weight gain are at the highest risk of pregnancy complications. Promoting a healthy pre-pregnancy BMI and gestational weight gain may reduce the burden of pregnancy complications and ultimately the risk of maternal and neonatal morbidity. TWEETABLE ABSTRACT: Promoting a healthy body mass index and gestational weight gain might reduce the population burden of pregnancy complications.

Longitudinal association of adiposity and high-sensitivity C-reactive protein from adolescence into early adulthood.

BACKGROUND AND AIMS: Longitudinal studies relating adiposity with low-grade inflammation are scarce. We aimed to examine the longitudinal association between the cumulative exposure to adiposity and low-grade inflammation from adolescence into early adulthood. METHODS AND RESULTS: Data from a population-based cohort (EPITeen) (n = 1147) was analyzed. Body mass index (BMI), body fat percentage (BF%), waist circumference (WC), and waist-to-height ratio (WHtR) and high-sensitivity C-reactive protein (hsCRP) were ascertained at 13, 17 and 21 years of age and standardized for each wave. Generalized least squares models with a compound symmetry correlation structure were fitted to estimate the longitudinal effect of adiposity on hsCRP and results were presented as linear regression coefficients and 95% confidence intervals [ß (95%CI)].The final model estimated the association between the difference in adiposity between two consecutive evaluations (13-17 and 17 to 21-years-old), adjusted for previous adiposity and hsCRP levels, sex, parental education, leisure-time physical activity and fruits and vegetables intake. A positive association between the cumulative exposure to adiposity and final hsCRP was observed, in which the difference between adiposity indicators of two consecutive study waves was independently associated with hsCRP: 0.382 (0.299; 0.465) for BMI, 0.234 (0.164; 0.304) for WC, 0.395 (0.314; 0.477) for BF% and 0.195 (0.133; 0.258) for WHtR. CONCLUSION: A significant longitudinal effect of the accumulation of adiposity on low-grade inflammation was observed. The change in adiposity from consecutive study waves was shown to have a stronger effect on final hsCRP concentrations than both previous adiposity and hsCRP levels.

Depressive symptoms at 13 years as predictors of depression in older adolescents: a prospective 4-year follow-up study in a nonclinical population.

Depression is the most important source of disability in adolescents, partially due to its recurrence. There is a lack of studies on population-based samples investigating the continuity of depressive symptoms during adolescence. This study evaluates depressive symptoms at early adolescence as predictors of depressive symptoms later in adolescence. Urban adolescents born in 1990 and enrolled in schools of Porto, Portugal, in 2003-2004 (EPITeen study) were evaluated at 13 and 17 years (n = 1106, 55.9% females), and completed a questionnaire comprising health behaviors and Beck Depression Inventory II (BDI-II) to assess depressive symptoms. A questionnaire on socio-demographic and clinical characteristics was self-reported. Regression coefficients (ß) and 95% confidence intervals (CI) were estimated using simple linear regression. The prevalence of adolescents with depressive symptoms above the cut-off (BDI-II > 13) was 11.9% at 13 years (girls: 17.1%; boys: 5.3%) and 10.8% at 17 years (girls: 14.7%; boys: 5.7%). Almost 6% of girls and 2% of boys had BDI-II > 13 at both assessments, and 35% of girls and boys with BDI-II > 13 at baseline also had BDI-II > 13 at follow-up. For both genders, depressive symptoms at age 13 were independently associated with depressive symptoms at age 17 (girls: ß = 0.35, 95% CI 0.28-0.42; boys: ß = 0.37, 95% CI 0.30-0.44). Depressive symptoms at age 13 were an independent predictive factor for adolescents' depressive symptoms at age 17. The prevalence of adolescents with BDI-II > 13 was higher in females, but the strength of this association was similar in both genders, highlighting the heavy burden of depressive symptoms already at an early age, among girls and boys.

Duration and degree of adiposity: effect on cardiovascular risk factors at early adulthood.

BACKGROUND/OBJECTIVES: The effect of adiposity dynamics throughout adolescence on adult cardiometabolic outcomes is not well known. We aimed to assess the effect of duration and degree of adiposity from adolescence to early adulthood on blood pressure and insulin resistance at 24 years. SUBJECTS/METHODS: We used data from 2253 participants evaluated at 13, 17, 21 and 24 years of age in the EPITeen cohort, Porto, Portugal. The area under the curve of body mass index (BMIAUC) was computed to summarize duration and degree of BMI for the 11-year period. Outcomes were systolic blood pressure (SBP) and insulin resistance at 24 years. The homeostasis model assessment of insulin resistance (HOMA-IR) was used as an indicator of insulin resistance and the variable was log-transformed. Associations between BMIAUC and each outcome were estimated by linear regression models. RESULTS: The median BMIAUC was 243.1 (223.9-268.6) kg m-2 in 11 years, corresponding to 22.1 kg m-2 on average per year. In crude analyses, both BMIAUC and BMI at 24 years were positively associated with SBP (ß=0.096 mm Hg, 95% confidence interval (CI) 0.077; 0.115 for BMIAUC; ß=4.616 mm Hg, 95% CI 3.082; 6.151 for BMI at 24 years) and ln HOMA-IR (ß=0.004, 95% CI 0.003; 0.005 for BMIAUC; ß=0.047, 95% CI 0.036; 0.057 for BMI at 24 years). After adjustment for confounders and for BMI at 24 years, the magnitude of the association of BMIAUC attenuated for both outcomes, mostly for SBP, but the association remained statistically significant. Results using standardized variables confirmed that both outcomes were more strongly associated with BMI at 24 years than with BMIAUC. CONCLUSIONS: In addition to the effect of adult attained BMI, cumulative exposure to higher BMI throughout adolescence, taking into account duration and degree, was also relevant for adult cardiovascular risk factors, mainly for insulin resistance.

Protein intake and dietary glycemic load of 4-year-olds and association with adiposity and serum insulin at 7 years of age: sex-nutrient and nutrient-nutrient interactions.

BACKGROUND/OBJECTIVES: The role of Protein Intake (PI) at preschool age on later adiposity is understudied, and prospective studies also examining Dietary Glycemic Load (GL) are lacking. The current study evaluated the association of PI and GL at 4 years with adiposity and Fasting Serum Insulin (FSI) 3 years later, and examined the possible interaction between PI and GL on these associations, by sex. DESIGN: This prospective study included 1999 singleton children enrolled in the population-based birth cohort, Generation XXI (Porto, Portugal, 2005-2006). Diet at 4 years was assessed by 3-days food diaries. Energy-adjusted PI and GL (g per day) were converted into sex-specific tertiles (T). At 7 years, Body Mass Index (BMI) z-scores were defined according to the World Health Organization. Sample's sex-specific z-scores were computed for Fat Mass Index (FMI), Waist-to-Height ratio (W/Ht) and FSI. Associations were estimated by linear regression coefficients (ß) and 95% confidence intervals (95% CI). RESULTS: After adjustment for confounders, PI was positively associated with BMI in girls (T2 vs T1: ß=0.187; 95% CI: 0.015, 0.359) and boys (T3 vs T1: ß=0.205; 95% CI: 0.003, 0.406), being associated with FSI only in boys (T3 vs T1: ß=0.207; 95% CI: 0.011, 0.404; P-interaction=0.026). Also, GL was associated with BMI only in boys (T3 vs T1: ß=0.362; 95% CI: 0.031, 0.693; P-interaction=0.006), in whom significant interactions between PI and GL were found on the association with FMI (P=0.019) and W/Ht (P=0.039). Boys within the third T of both PI and GL at 4 years had higher FMI (ß=0.505; 95% CI: 0.085, 0.925) and W/Ht (ß=0.428; 95% CI: 0.022, 0.834) at 7 years. CONCLUSIONS: In both girls and boys, PI at preschool age is positively associated with later BMI, being positively associated with FSI only in boys. Dietary GL is associated with adiposity only in boys, in whom it seems to interact with PI enhancing increased adiposity.

Changes in management policies for extremely preterm births and neonatal outcomes from 2003 to 2012: two population-based studies in ten European regions.

OBJECTIVE: To investigate changes in maternity and neonatal unit policies towards extremely preterm infants (EPTIs) between 2003 and 2012, and concurrent trends in their mortality and morbidity in ten European regions. DESIGN: Population-based cohort studies in 2003 (MOSAIC study) and 2011/2012 (EPICE study) and questionnaires from hospitals. SETTING: 70 hospitals in ten European regions. POPULATION: Infants born at <27 weeks of gestational age (GA) in hospitals participating in both the MOSAIC and EPICE studies (1240 in 2003, 1293 in 2011/2012). METHODS: We used McNemar's Chi2 test, paired t-tests and conditional logistic regression for comparisons over time. MAIN OUTCOMES MEASURES: Reported policies, mortality and morbidity of EPTIs. RESULTS: The lowest GA at which maternity units reported performing a caesarean section for acute distress of a singleton non-malformed fetus decreased from an average of 24.7 to 24.1 weeks (P < 0.01) when parents were in favour of active management, and 26.1 to 25.2 weeks (P = 0.01) when parents were against. Units reported that neonatologists were called more often for spontaneous deliveries starting at 22 weeks GA in 2012 and more often made decisions about active resuscitation alone, rather than in multidisciplinary teams. In-hospital mortality after live birth for EPTIs decreased from 50% to 42% (P < 0.01). Units reporting more active management in 2012 than 2003 had higher mortality in 2003 (55% versus 43%; P < 0.01) and experienced larger declines (55 to 44%; P < 0.001) than units where policies stayed the same (43 to 37%; P = 0.1). CONCLUSIONS: European hospitals reporting changes in management policies experienced larger survival gains for EPTIs. TWEETABLE ABSTRACT: Changes in reported policies for management of extremely preterm births were related to mortality declines.

Trajectories of total and central adiposity throughout adolescence and cardiometabolic factors in early adulthood.

BACKGROUND/OBJECTIVES: Our aim was to identify trajectories of total and central adiposity from 13 to 21 years, and to investigate how adiposity changes at different phases of adolescence relate to adulthood cardiovascular risk factors. SUBJECTS/METHODS: This study included participants from a population-based cohort (EPITeen), Portugal. Body mass index (BMI) and waist circumference (WC) were measured at 13, 17 and 21 years, and sex- and age-specific z-scores were calculated. Adiposity trajectories were identified using mixture growth models (BMI, n=2901; WC, n=2898). Cardiovascular risk factors were evaluated at 21 years (n=1763): systolic (SBP) and diastolic blood pressure (DBP), insulin resistance (HOMA-IR), triglycerides and cholesterol. Association of trajectory, and changes in adiposity z-scores with each cardiovascular risk factor was estimated by linear regression models. RESULTS: 'Normal', 'high, declining' and 'high, increasing' trajectories were identified in both sexes. 'High, increasing' BMI trajectory was associated with less favorable cardiovascular risk profile at 21 years in both sexes, whereas 'high, declining' presented a more favorable profile, similar to 'normal' trajectory in females. In addition, BMI increases between 13-17 years and 17-21 years were associated with increases in systolic and diastolic blood pressure, and insulin resistance, but more strongly for the later period. For every standard deviation (s.d.) increase in BMI between 17-21 years, mean SBP increased by 1.99 mmHg (95% confidence interval (CI): 1.01; 2.97) for females and 3.83 mmHg (2.67; 4.98) for males; the respective increase was 1.56 mmHg (0.72; 2.40) and 2.80 mmHg (1.97; 3.64) for DBP and 0.27 (0.21; 0.32) and 0.30 (0.24; 0.36) for HOMA-IR (log-transformed). Similar results were found for WC. CONCLUSIONS: Increases in adiposity, particularly from late adolescence-to-young adulthood, were associated with unfavorable cardiovascular profile in early adulthood. A benefit on the cardiovascular risk profile for participants in the declining adiposity trajectory was observed.

The role of prenatal exposures on body fat patterns at 7 years: Intrauterine programming or birthweight effects?

BACKGROUND AND AIMS: It remains unknown whether the effects of prenatal exposures on child's adiposity reflect entirely intrauterine programming. We aimed to assess the effects of maternal gestational weight gain, diabetes and smoking on the child's body fat patterns, disentangling the direct (through intrauterine programming) and indirect (through birthweight) effects. METHODS AND RESULTS: We included 4747 singleton 7-year-old children from the Generation XXI birth cohort (Porto, Portugal). At birth, maternal and newborn's characteristics were obtained. Anthropometrics were measured at age 7 years and body fat patterns were identified by principal component analysis. Path analysis was used to quantify direct, indirect and total effects of gestational weight gain, diabetes and smoking on body fat patterns. Pattern 1 was characterized by strong factor loadings with body mass index, fat mass index and waist-to-height ratio (fat quantity) and pattern 2 with waist-to-hip ratio, waist-to-thigh ratio, and waist-to-weight ratio (fat distribution). The positive total effect of maternal gestational weight gain and diabetes on the child's fat quantity was mainly through a direct pathway, responsible for 91.7% and 83.7% of total effects, respectively (ß = 0.022; 95% Confidence Interval (CI): 0.017, 0.027; ß = 0.041; 95% CI: -0.011, 0.093). No effects on fat distribution were found. Maternal prenatal smoking had a positive direct effect on patterns 1 and 2, explaining 94.9% and 76.1% of total effects, respectively. CONCLUSION: The effects of maternal gestational weight gain, diabetes and smoking on a child's fat quantity seem to be mainly through intrauterine programming. Maternal smoking also showed a positive direct effect on child's fat distribution.

Male and female physical intimate partner violence and socio-economic position: a cross-sectional international multicentre study in Europe.

OBJECTIVES: This work explores the association between socio-economic position (SEP) and intimate partner violence (IPV) considering the perspectives of men and women as victims, perpetrators and as both (bidirectional). STUDY DESIGN: Cross-sectional international multicentre study. METHODS: A sample of 3496 men and women, (aged 18-64 years), randomly selected from the general population of residents from six European cities was assessed: Athens; Budapest; London; Östersund; Porto; and Stuttgart. Their education (primary, secondary and university), occupation (upper white collar, lower white collar and blue collar) and unemployment duration (never, ≤12 months and >12 months) were considered as SEP indicators and physical IPV was measured with the Revised Conflict Tactics Scales. RESULTS: Past year physical IPV was declared by 17.7% of women (3.5% victims, 4.2% perpetrators and 10.0% bidirectional) and 19.8% of men (4.1% victims, 3.8% perpetrators and 11.9% bidirectional). Low educational level (primary vs university) was associated with female victimisation (adjusted odds ratio, 95% confidence interval: 3.2; 1.3-8.0) and with female bidirectional IPV (4.1, 2.4-7.1). Blue collar occupation (vs upper white) was associated with female victimisation (2.1, 1.1-4.0), female perpetration (3.0, 1.3-6.8) and female bidirectional IPV (4.0, 2.3-7.0). Unemployment duration was associated with male perpetration (>12 months of unemployment vs never unemployed: 3.8; 1.7-8.7) and with bidirectional IPV in both sex (women: 1.8, 1.2-2.7; men: 1.7, 1.0-2.8). CONCLUSIONS: In these European centres, physical IPV was associated with a disadvantaged SEP. A consistent socio-economic gradient was observed in female bidirectional involvement, but victims or perpetrators-only presented gender specificities according to levels of education, occupation differentiation and unemployment duration potentially useful for designing interventions.

Developmental trajectories of adiposity from birth until early adulthood and association with cardiometabolic risk factors.

OBJECTIVE: To identify developmental trajectories of adiposity from birth until early adulthood, and to investigate how they relate with cardiometabolic risk factors at 21 years of age. METHODS: Participants' weight and height measurements were obtained using the EPITeen cohort protocol at 13, 17 and 21 years of age, and extracted from child health books as recorded during health routine evaluations since birth. Blood pressure, triglycerides, cholesterol and insulin resistance (HOMA-IR) were assessed at 21 years. Trajectories were defined using 719 participants contributing 11 459 measurements. The individual growth curves were modelled using mixed-effects fractional polynomial, and the trajectories were estimated using normal mixture modelling for model-based clustering. Differences in cardiometabolic risk factors at 21 years according to adiposity trajectories were estimated through analysis of covariance (ANCOVA), and adjusted means are presented. RESULTS: Two trajectories-'Average body mass index (BMI) growth' (80.7%) and 'Higher BMI growth' (19.3%)-were identified. Compared with those in 'Average BMI growth', 'Higher BMI growth' participants were more frequently delivered by caesarean section, mothers were younger and had higher BMI, and parental education was lower; and at 21 years showed higher adjusted mean systolic (111.6 vs 108.3 mm Hg, P<0.001) and diastolic blood pressure (71.9 vs 68.4 mm Hg, P<0.001), and lower high-density lipoprotein cholesterol (53.3 vs 57.0 mg dl(-1), P=0.001). As there was a significant interaction between trajectories and sex, triglycerides and HOMA-IR were stratified by sex and we found significantly higher triglycerides, in males, and higher HOMA-IR in both sexes in 'Higher BMI growth' trajectory. All the differences were attenuated after adjustment for BMI at 21 years. CONCLUSIONS: In this long-term follow-up, we were able to identify two adiposity trajectories, statistically related to the BMI and cardiometabolic profile in adulthood. Our results also suggest that the impact of the adiposity trajectory on cardiometabolic profile is mediated by current BMI.

Fiber-coupled high-speed asynchronous optical sampling with sub-50 fs time resolution.

We present a fiber-coupled pump-probe system with a sub-50 fs time resolution and a nanosecond time window, based on high-speed asynchronous optical sampling. By use of a transmission grism pulse compressor, we achieve pump pulses with a pulse duration of 42 fs, an average power of 300 mW and a peak power exceeding 5 kW at a pulse repetition rate of 1 GHz after 6 m of optical fiber. With this system we demonstrate thickness mapping of soft X-ray mirrors at a sub-nm thickness resolution on a cm(2) scan area. In addition, terahertz field generation with resolved spectral components of up to 3.5 THz at a GHz frequency resolution is demonstrated.

Two-colour high-speed asynchronous optical sampling based on offset-stabilized Yb:KYW and Ti:sapphire oscillators.

We present a high-speed asynchronous optical sampling system, based on two different Kerr-lens mode-locked lasers with a GHz repetition rate: An Yb:KYW oscillator and a Ti:sapphire oscillator are synchronized in a master-slave configuration at a repetition rate offset of a few kHz. This system enables two-colour pump-probe measurements with resulting noise floors below 10⁻6 at a data aquisition time of 5 seconds. The measured temporal resolution within the 1 ns time window is below 350 fs, including a timing jitter of less than 50 fs. The system is applied to investigate zone-folded coherent acoustic phonons in two different semiconductor superlattices in transmission geometry at a probe wavelength far below the bandgap of the superlattice constituents. The lifetime of the phonon modes with a zero wave vector and frequencies in the range from 100 GHz to 500 GHz are measured at room temperature and compared with previous work.

Incident risk factors as predictors of HIV seroconversion in the Lisbon cohort of men who have sex with men: first results, 2011-2014.

HIV incidence in men who have sex with men (MSM) is increasing in western countries, including Portugal. We aimed to estimate HIV incidence and to assess how individual short-term changes in exposures over time predict seroconversion. We evaluated participants of an open cohort of HIV-negative MSM enrolled after testing at a community-based voluntary HIV counselling and testing centre in Lisbon. At each evaluation a structured questionnaire was completed and HIV status was ascertained using rapid followed by confirmatory testing. Between April 2011 and February 2014, 804 MSM were followed for a total of 893 person-years. Predictors of HIV seroconversion were identified using Poisson generalised linear regression. The overall seroincidence was 2.80/100 person-years (95% confidence interval: 1.89-4.14). Men who seroconverted had a higher mean number of tests per year. Seroconversions were significantly associated with partner disclosure of HIV status during follow-up, newly-adopted unprotected anal intercourse (UAI) with a steady partner and being newly-diagnosed with syphilis during follow-up. Likewise, sexual intercourse with HIV-positive men, having an HIV-positive steady partner at least once during follow-up and persistent UAI with occasional partners were predictors of seroconversion. High HIV incidence in this cohort is likely driven by short-term contextual and behavioural changes during follow-up.

HIV testing among Portuguese men who have sex with men--results from the European MSM Internet Survey (EMIS).

OBJECTIVES: To describe HIV testing behaviour and context of MSM in Portugal participating in the European MSM Internet Survey (EMIS). METHODS: Data for the Portuguese sample were extracted and those for 5187 participants were analysed. Multivariate logistic regression models were fitted to quantify the association between participants' characteristics and HIV testing behaviour and context. RESULTS: Seventy-two percent of the participants had ever been tested for HIV and among those ever tested, 11% were diagnosed with HIV. Primary care was the most common testing setting for HIV-negative men (37%). Compared to those never tested, men who had ever taken an HIV test had higher educational level (aOR 1.89, 95% CI 1.67-2.14) and identified themselves as gay/homosexual more frequently (aOR 1.94 , 95% CI 1.70-2.20). HIV testing odds significantly increased with the number of sexual partners in the previous 12 months. Those who reported unprotected anal intercourse (UAI) with a partner of unknown or serodiscordant HIV status in the previous 12 months were less likely to report an HIV test (aOR 0.38, 95% CI 0.33-0.44). Among those never tested or who tested negative, 41% and 22% reported UAI with a partner of unknown or serodiscordant status in the previous 12 months, respectively. Among men with diagnosed HIV, 72% were currently on antiretroviral therapy and 58% reported an undetectable viral load. More than one third (38%) of those who had detectable or unknown/undisclosed viral load reported at least one episode of UAI with a partner of unknown or serodiscordant HIV status in the last 12 months. CONCLUSIONS: Actual interventions should focus on: improving testing uptake and counselling; increasing treatment coverage; achieving and maintaining an undetectable viral load; and intensifying prevention efforts focused on consistent condom use.

Population mobility and the changing epidemics of HIV-2 in Portugal.

INTRODUCTION: Portugal is the European country with the highest frequency of HIV-2 infection, which is mainly concentrated in West Africa. The cumulative number of notified HIV-2 infections in Portugal was 1813 by the end of December 2008. To better characterize the dynamics of HIV-2 infection in the country and to obtain data that may be of use in the prevention of the spread of HIV-2, we evaluated a large pooled sample of patients. PATIENTS AND METHODS: Five Portuguese hospitals provided data on HIV-2-infected patients from 1984 to the end of 2007. Data concerning demographic characteristics and clinical variables were extracted. Patients were stratified according to date of diagnosis in approximately 5-year categories. RESULTS: The sample included 442 patients, accounting for 37% of all HIV-2 infections notified in Portugal during that period. HIV-2-infected patients showed clearly different characteristics according to the period of diagnosis. Until 2000, the majority of HIV-2-infected patients were Portuguese-born males living in the north of the country. From 2000 to 2007, most of the patients diagnosed with HIV-2 infection had a West African origin, were predominantly female and were living in the capital, Lisbon. The average age at diagnosis and loss to follow-up significantly increased over time. CONCLUSION: HIV-2 infection has been documented in Portugal since the early 1980s and its epidemiology appears to reflect changes in population movement. These include the movements of soldiers and repatriates from African territories during the independence wars and, later, migration and mobility from high-endemicity areas. The findings of this study stress the importance of promoting migrant-sensitive health care.