The evolution of universities of the third age around the world: A historical review.

Universities of the Third Age (U3A), lifelong learning institutes, and "senior universities" are terms used to describe organizations that provide education for older adults, specifically for those who are retired or in the "third age" of life. The purpose of this article is to provide a comprehensive, historical overview of the evolution of these organizations across global settings. This article highlights the importance of older adult education while discussing U3A's structure and models. The article explores the origins and historical development of the U3A model and its influence on recent initiatives like the Age-Friendly Universities movement. It then focuses on the impact of French and British Models of U3A on providing older adult education. There is a general discussion of the expansion of these organizations in several countries and a comparison of each's curricular structure and approach. The article concludes with suggested future directions and potential areas of improvement (e.g. technology access, accessibility, and inclusion of older adult learners; diverse needs and interests) and ways these models can remain relevant to the ever-changing older adult learner population. Through this analysis, the article contributes to the understanding of U3A organizations and their role in promoting lifelong learning for older adults.

Sexual expression involving people with dementia living in long-term care facilities: Staff's reactions.

This study aims to explore and compare the reaction of long-term care staff towards situations of sexual intercourse in which one or both partners have dementia. Participants were 538 staff members at 28 Portuguese long-term care facilities. Data were collected using a printed questionnaire with seven vignettes with situations related to the sexuality of LTCF residents. In this study, three of these vignettes were analysed with situations in which residents were having relationships in their bedrooms: (1) one male resident and one female resident; (2) two residents with dementia; (3) two residents, one of them with dementia. For each of the vignettes, participants are asked what they think their 'colleagues' would do in each vignette, i.e. 'What do you think most of your colleagues would do?' The results revealed that when sexual relationships involved both partners living with dementia, the most selected reaction was 'Comment on what happened with supervision or direction', which may suggest that the situation was perceived as difficult or problematic. The most restrictive reactions were most often chosen when only one partner had dementia. This study suggests the need to improve and provide training, so that staff have knowledge and strategies that allow people living with dementia to preserve their sexual rights in long-term care facilities.

Linfoma de Burkitt como adenopatía axilar en un paciente inmunosuprimido / Burkitt lymphoma as an axillary adenopathy in an immunosuppressed patient

Burkitt lymphoma is derived from germinal or post-germinal center B cells and is a highly aggressive B cell non-Hodgkin lymphoma that represents <1 percent of adult non-Hodgkin lymphomas. The authors describe the case of a 63 years old Caucasian male, with history of human immunodeficiency virus infection, latent syphilis and varicella zoster infection on the left limb (L3 dermatome) who came to the emergency department with a palpable left axillary mass with three weeks evolution accompanied with vesicles 48 hours after. He reported a history of anorexia and weight loss on the past 3 months. Complete blood count was within normal range but was observed a fivefold elevation of lactate dehydrogenase and a CD4 count <200cells/microL. The histology of the adenopathic axillar conglomerate made the diagnosis of Burkitt lymphoma but, besides all efforts, the patient ended to die before starting a regimen of chemotherapy. (AU)

The Role of Operative Vaginal Delivery in Postpartum Sexual Dysfunction: MOODS - A Prospective Study.

BACKGROUND: Childbirth brings many changes to women's life and sexual health. The influence of operative vaginal delivery on sexual function has produced inconsistent results. AIM: To evaluate the effects of mode of vaginal delivery (spontaneous or operative) in postpartum sexual function. METHODS: Descriptive prospective study (MOODS- Maternal-neonatal Outcomes in Operative Vaginal Delivery) including 304 women who had a singleton term vaginal delivery (operative or spontaneous in a relation 2:1). Women were invited to answer a questionnaire at 3, 6 months and 1 year postpartum. OUTCOMES MEASUREMENT: A validated questionnaire was applied, the Female Sexual Function Index (FSFI) Score, to evaluate effects of operative delivery on sexual health. Sexual dysfunction was defined by FSFI score <26.55. RESULTS: 211 women answered at least one questionnaire. Overall rate of sexual dysfunction was 62%, 43% and 48% at 3, 6 and 12 months respectively. At 3 months, total FSFI score was significantly lower in operative vaginal delivery group (mean±SD, 21.3±8.6 vs 24.9±7.9, P = 0.015). Arousal (P = 0.028), orgasm (P = 0.029), satisfaction (P = 0.015) and pain (P = 0.007) FSFI domains were also significantly inferior. At this time, 44% women in spontaneous delivery group and 70% in operative delivery group had sexual dysfunction (P = 0.0002). At 6 months, there were no differences in FSFI scores according the type of delivery. At 12 months, total FSFI score was similar in both groups, but pain domain was significantly lower in operative delivery (P = 0.004). Considering type of instrument (Thierry's Spatulas or Kiwi Vacuum), no differences were found regarding episiotomy, perineal trauma, obstetric anal sphincter injury or postpartum complications. FSFI scores did not differ between the two instruments at any time point. A logistic regression showed that, when controlled for perineal trauma, mode of delivery was independently associated with sexual dysfunction at 3 months (P = 0.02). CLINICAL IMPLICATIONS: Clinicians should assess women's sexual health during pregnancy and postpartum period in order to enhance their wellbeing. STRENGTHS/LIMITATIONS: Strengths include its prospective design, standardized questionnaire and the new perspectives about a different obstetrical instrument (Thierry's spatulas). Limitations include the absence of pre-pregnancy sexual function data and considerable drop-out rate. CONCLUSION: Sexual dysfunction affects a great proportion of newly mothers and in postpartum period mode of delivery and perineal trauma seem to play an important role. Although there was a progressive reduction over time, prevalence of sexual dysfunction at 6 months and 1 year postpartum was still considerable. The type of obstetrical instrument does not seem to influence short or long-term sexual function. de Sousa NQ, Borges AC, Sarabando R, et al. The Role of Operative Vaginal Delivery in Postpartum Sexual Dysfunction: MOODS - A Prospective Study. J Sex Med 2021;18:1075-1082.

Test-Retest Reliability of Pain Measures in Institutionalized Older Adults: Number of Painful Body Sites, Pain Intensity, and Pain Extent.

OBJECTIVE: The reliability of pain assessment in frail and older adults has seldom been assessed. This study aims to assess the test-retest reliability of (1) the number of painful body sites, (2) pain intensity, and (3) pain extent in institutionalized older adults. METHODS: Seventy-four older adults who were institutionalized were assessed in 2 separate sessions, 2 days to 1 week apart, for pain intensity, number of painful body sites, and pain extent (in pixels) using a vertical pain numeric scale (0 to 10), a body chart divided into 50 body regions, and ImageJ, respectively. Intraclass correlation coefficients (ICCs), standard error of measurement (SEM), and minimal detectable differences (MDDs) were calculated. RESULTS: In session 1, the mean values (± standard deviation) were 5.54 ± 2.12 points for pain intensity, 4.47 ± 3.27 for number of painful body sites, and 2,726.00 ± 2,322.09 for pain extent. ICCs were 0.82 (95% confidence interval [CI] = 0.72 to 0.89) for pain intensity, 0.89 (95% CI = 0.83 to 0.93) for number of painful body sites, and 0.74 (95% CI = -0.07 to 0.91) for pain area. The MDDs were 2.46 for pain intensity, 3.14 for number of painful body sites, and 4,997.60 for pain extent. CONCLUSIONS: The vertical pain rating scale and the body chart seem reliable to assess pain intensity and number of pain sites, respectively. The wide CI for the ICC found for pain area and the high measurement error compromise its potential clinical relevance.

A Rare Cause of Dyspnoea: Right-sided Bochdalek Hernia in an Adult.

Right-sided Bochdalek hernia (BH) is very rarely diagnosed in adults. It commonly presents with gastrointestinal symptoms (pain, abdominal distension and vomiting). Breathlessness, recurrent chest infections and other pulmonary sequelae can also be present. We report the case of a 92-year-old man with a 3-day history of dyspnoea, fever and thoracic pain and multiple episodes of vomiting. An x-ray was performed, and the diagnosis of a large BH hernia was confirmed by computed tomography of the thorax. The condition may be fatal in cases where the small bowel undergoes necrosis or perforation. An emergent laparotomy was performed, but the patient did not improve clinically and died immediately after the procedure. LEARNING POINTS: Right-sided Bochdalek hernia (BH) is very rarely diagnosed in adults.Misdiagnosis of BH as a tension pneumothorax (which has a similar clinical presentation) can delay treatment and put patients at risk.The outcome of BH depends on the presentation, early diagnosis and emergent intervention.

Inter-rater reliability, standard error of measurement and minimal detectable change of the 12-item WHODAS 2.0 and four performance tests in institutionalized ambulatory older adults.

PURPOSE: Self-reported and performance-based instruments are both necessary for a comprehensive view of the functioning of institutionalized older adults. Our aim was to assess the reliability and measurement error of the 12-item World Health Organization Disability assessment Schedule and compare these indexes against performance-based tests. MATERIALS AND METHODS: One hundred participants from Nursing Homes and Day Care Centers were assessed twice (two days to one week apart) by two independent assessors. Reliability and measurement error indexes were calculated. RESULTS: Reliability of the World Health Organization Disability assessment Schedule total score, and of three performance tests was appropriate for individual comparisons (ICC ≥ 0.92). Reliability for the five times seat to stand test was appropriate for group comparisons only (ICC = 0.84). The high measurement error of the timed up and go test (SEM = 4.25; MDC = 11.78) and of the five times seat to stand test (SEM = 3.47; MDC = 9.62) and the number of participants unable to perform them (TUG: n = 11; FTSST: n = 41) suggest that these tests are less suitable to monitor individual changes. CONCLUSIONS: The 12-item World Health Organization Disability Assessment Schedule total score, the gait speed and hand grip tests could be used to monitor changes at both the individual and group level in a population with decreased functioning. Implications for Rehabilitation The 12-item World Health Organization Disability assessment Schedule, could be used to monitor changes in perceived functioning both at the individual and group level in institutionalized ambulatory older adults. The gait speed and hand grip tests could be used to monitor changes in performance both at the individual and group level in institutionalized ambulatory older adults' functioning. The utility of the time up and go and of the five times seat to stand test might be of limited value when aiming to monitor changes in institutionalized older adults' functioning.

Living Too Long? Exploring Attitudes Toward Reaching 100 Years Old.

Objective This study analyses the relationship between pro- and anti-longevity attitudes, attitudes toward centenarians, and the wish to reach 100 years of age in a sample of community dwelling older adults. Methods Participants ( N = 137) completed a questionnaire on attitudes toward life-extension and an aging semantic differential using centenarians as an attitudinal target. Sociodemographic information, perceived health status, and information on knowing a centenarian were also obtained. A cluster analysis was used to identify subgroups (leaning anti-longevity group vs. leaning prolongevity group), and their associations with personal attributes were tested using logistic regression models. Results Most respondents said they would wish to reach 100 years old (54.7%) and presented a leaning positive attitude toward centenarians (52.6%). Holding a negative attitude toward centenarians rather than any other attribute increases the odds of having more negative attitudes toward life extension. Conclusion Results stress the importance of social views on extreme longevity in shaping life extension attitudes.

Remote Care Technology: A Systematic Overview.

The present study was based on a systematic review of reviews and meta-analyses and aimed to identify technologies being used to provide home monitoring to support older adults with chronic diseases and to promote their empowerment, as well as to identify how these technologies impact health related outcomes.

Validation of European Portuguese Version of the Kwazo Instrument.

Kwazo instrument was designed to assess the customer's satisfaction with prescription and attribution services of assistive technology. This paper presents the cross-cultural translation and validation of the European Portuguese version of the Kwazo, whose psychometric proprieties were assessed by customers of rehabilitation facilities of North and Centre of Portugal.

Pain intensity is associated with both performance-based disability and self-reported disability in a sample of older adults attending primary health care centers.

BACKGROUND: Older adults' function level can be used as a predictor of future detrimental events, such as disability, reliance on others, risk of institutionalization and likelihood of death. The assessment of function at the primary health care centers using self-reported and/or performance based measures is of prime importance. OBJECTIVE: To determine whether personal factors, pain, depression and physical activity are associated with self-reported and performance based disability for older adults aged ≥ 60 years attending primary health care centers, as measured by the WHO Disability Assessment Schedule 2.0 (WHODAS 2.0) and Short Physical Performance Battery (SPPB), respectively. METHODS: Participants (196 females and 55 males; mean age ± SD = 70.87 ± 7.76) had their pain, self-reported disability, performance, physical activity levels and depressive symptoms assessed. Regression analyses were performed with self-reported and performance-based disability as the dependent variable and age, sex, education, chronic conditions, depression, physical activity and pain characteristics as dependent variables. RESULTS: Mean (SD) results for SPPB were 8.45 (2.86) and 20.06 (8.21) for WHODAS. Pain intensity, depression, pain frequency, number of chronic conditions and level of physical activity explained 44% of the self-reported disability variance. Pain intensity, age, level of physical activity, years of formal education and chronic conditions explained 37% of the performance variance. Pain intensity alone explained 27% and 18% of the self-reported and performance based disability, respectively. CONCLUSION: Findings indicate that primary health care interventions should target pain intensity, depressive symptoms and physical activity as a means to preventing or decreasing both self-reported and performance based disability.

Influência do género nas imagens da velhice: um estudo exploratório na população portuguesa / The influence of gender in the images of old age: an exploratory study in the Portuguese population

Este estudo exploratório pretende contribuir para um melhor conhecimento das imagens da velhice considerando o género. Para isso administrou-se um questionário a 100 sujeitos. Os principais resultados indicam que: 'desânimo e vulnerabilidade' é uma imagem partilhada por homens e mulheres em relação a homens e mulheres velhos, enquanto 'incapacitado e dependente' é associado por homens e mulheres a um homem velho, mas apenas pelas mulheres a uma mulher velha (AU)

As imagens da velhice em diferentes grupos etários: um estudo exploratório na população portuguesa / Images of aging in different age groups: an exploratory study in the Portuguese population

Este estudo exploratório procura evidenciar as imagens da velhice em diferentes faixas etárias. A amostra envolve 120 sujeitos de quatro grupos etários: muito-idosos, idosos-jovens adultos e jovens. Solicitou-se aos inquiridos que completassem três frases: uma pessoa velha é; a velhice é; sabemos que alguém está velho quando. Os resultados indicam que as imagens tendem a ser mais negativas entre os de idosos, as imagens comuns são uma 'fase normal da vida', 'desânimo e vulnerabilidade' e 'incapacidade'