How to classify the Oldest Old according to Health Status: A study of 1160 subjects belonging to 552 90+ Italian sibships characterised by familial longevity recruited within the GeHA EU project

The health status of the oldest old, the fastest increasing population segment worldwide, progressively becomes more heterogeneous, and this peculiarity represents a major obstacle to their classification. We compared the effectiveness of four previously proposed criteria (Franceschi et al., 2000; Evert et al., 2003; Gondo et al., 2006; Andersen-Ranberg et al., 2001) in 1160 phenotypically fully characterized Italian siblings of 90 years of age and older (90+, mean age: 93 years; age range: 90–106 years) belonging to 552 sib-ships, recruited in Northern, Central and Southern Italy within the EU-funded project GEHA, followed for a six-year-survival. Main findings were: (i) ‘‘healthy’’ subjects varied within a large range, i.e. 5.2% (Gondo), 8.7% (Evert), 17.7% (Franceschi), and 28.5% (Andersen-Ranberg); (ii) Central Italy subjects showed better health than those from Northern and Southern Italy; (iii) mortality risk was correlated with health status independently of geographical areas; and (iv) 90+ males, although fewer in number, were healthier than females, but with no survival advantage. In conclusion, we identified a modified version of Andersen-Ranberg criteria, based on the concomitant assessment of two basic domains (cognitive, SMMSE; physical, ADL), called ‘‘Simple Model of Functional Status’’ (SMFS), as the most effective proxy to distinguish healthy from not-healthy subjects. This model showed that health status was correlated within sib-ships, suggesting a familial/genetic component.

Impact of nitrogen seeding on confinement and power load control of a high-triangularity JET ELMy H-mode plasma with a metal wall

This paper reports the impact on confinement and power load of the high-shape 2.5 MA ELMy H-mode scenario at JET of a change from all carbon plasma-facing components to an all metal wall. In preparation to this change, systematic studies of power load reduction and impact on confinement as a result of fuelling in combination with nitrogen seeding were carried out in JET-C and are compared with their counterpart in JET with a metallic wall. An unexpected and significant change is reported on the decrease in the pedestal confinement but is partially recovered with the injection of nitrogen.

Optical Coherence Tomography for the Monitoring of Neovascular Age-Related Macular Degeneration: A Systematic Review

Topic

To compare the accuracy of optical coherence tomography (OCT) with alternative tests for monitoring neovascular age-related macular degeneration (nAMD) and detecting disease activity among eyes previously treated for this condition.

Traditionally, fundus fluorescein angiography (FFA) has been considered the reference standard to detect nAMD activity, but FFA is costly and invasive. Replacement of FFA by OCT can be justified if there is a substantial agreement between tests.

Systematic review and meta-analysis. The index test was OCT. The comparator tests were visual acuity, clinical evaluation (slit lamp), Amsler chart, color fundus photographs, infrared reflectance, red-free images and blue reflectance, fundus autofluorescence imaging, indocyanine green angiography (ICGA), preferential hyperacuity perimetry, and microperimetry. We searched the following databases: MEDLINE, MEDLINE In-Process, EMBASE, Biosis, Science Citation Index, the Cochrane Library, Database of Abstracts of Reviews of Effects, MEDION, and the Health Technology Assessment database. The last literature search was conducted in March 2013. We used the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) to assess risk of bias.

We included 8 studies involving more than 400 participants. Seven reported the performance of OCT (3 time-domain [TD] OCT, 3 spectral-domain [SD] OCT, 1 both types) and 1 reported the performance of ICGA in the detection of nAMD activity. We did not find studies directly comparing tests in the same population. The pooled sensitivity and specificity of TD OCT and SD OCT for detecting active nAMD was 85% (95% confidence interval [CI], 72%–93%) and 48% (95% CI, 30%–67%), respectively. One study reported ICGA with sensitivity of 75.9% and specificity of 88.0% for the detection of active nAMD. Half of the studies were considered to have a high risk of bias.

There is substantial disagreement between OCT and FFA findings in detecting active disease in patients with nAMD who are being monitored. Both methods may be needed to monitor patients comprehensively with nAMD.

Optical coherence tomography for the diagnosis, monitoring and guiding of treatment for neovascular age-related macular degeneration:a systematic review and economic evaluation

BACKGROUND: Age-related macular degeneration is the most common cause of sight impairment in the UK. In neovascular age-related macular degeneration (nAMD), vision worsens rapidly (over weeks) due to abnormal blood vessels developing that leak fluid and blood at the macula.

OBJECTIVES: To determine the optimal role of optical coherence tomography (OCT) in diagnosing people newly presenting with suspected nAMD and monitoring those previously diagnosed with the disease.

DATA SOURCES: Databases searched: MEDLINE (1946 to March 2013), MEDLINE In-Process & Other Non-Indexed Citations (March 2013), EMBASE (1988 to March 2013), Biosciences Information Service (1995 to March 2013), Science Citation Index (1995 to March 2013), The Cochrane Library (Issue 2 2013), Database of Abstracts of Reviews of Effects (inception to March 2013), Medion (inception to March 2013), Health Technology Assessment database (inception to March 2013).

REVIEW METHODS: Types of studies: direct/indirect studies reporting diagnostic outcomes.

INDEX TEST: time domain optical coherence tomography (TD-OCT) or spectral domain optical coherence tomography (SD-OCT).

COMPARATORS: clinical evaluation, visual acuity, Amsler grid, colour fundus photographs, infrared reflectance, red-free images/blue reflectance, fundus autofluorescence imaging, indocyanine green angiography, preferential hyperacuity perimetry, microperimetry. Reference standard: fundus fluorescein angiography (FFA). Risk of bias was assessed using quality assessment of diagnostic accuracy studies, version 2. Meta-analysis models were fitted using hierarchical summary receiver operating characteristic curves. A Markov model was developed (65-year-old cohort, nAMD prevalence 70%), with nine strategies for diagnosis and/or monitoring, and cost-utility analysis conducted. NHS and Personal Social Services perspective was adopted. Costs (2011/12 prices) and quality-adjusted life-years (QALYs) were discounted (3.5%). Deterministic and probabilistic sensitivity analyses were performed.

RESULTS: In pooled estimates of diagnostic studies (all TD-OCT), sensitivity and specificity [95% confidence interval (CI)] was 88% (46% to 98%) and 78% (64% to 88%) respectively. For monitoring, the pooled sensitivity and specificity (95% CI) was 85% (72% to 93%) and 48% (30% to 67%) respectively. The FFA for diagnosis and nurse-technician-led monitoring strategy had the lowest cost (£39,769; QALYs 10.473) and dominated all others except FFA for diagnosis and ophthalmologist-led monitoring (£44,649; QALYs 10.575; incremental cost-effectiveness ratio £47,768). The least costly strategy had a 46.4% probability of being cost-effective at £30,000 willingness-to-pay threshold.

LIMITATIONS: Very few studies provided sufficient information for inclusion in meta-analyses. Only a few studies reported other tests; for some tests no studies were identified. The modelling was hampered by a lack of data on the diagnostic accuracy of strategies involving several tests.

CONCLUSIONS: Based on a small body of evidence of variable quality, OCT had high sensitivity and moderate specificity for diagnosis, and relatively high sensitivity but low specificity for monitoring. Strategies involving OCT alone for diagnosis and/or monitoring were unlikely to be cost-effective. Further research is required on (i) the performance of SD-OCT compared with FFA, especially for monitoring but also for diagnosis; (ii) the performance of strategies involving combinations/sequences of tests, for diagnosis and monitoring; (iii) the likelihood of active and inactive nAMD becoming inactive or active respectively; and (iv) assessment of treatment-associated utility weights (e.g. decrements), through a preference-based study.

STUDY REGISTRATION: This study is registered as PROSPERO CRD42012001930.

FUNDING: The National Institute for Health Research Health Technology Assessment programme.

Developing the clinical components of a complex intervention for a glaucoma screening trial:a mixed methods study

BACKGROUND: Glaucoma is a leading cause of avoidable blindness worldwide. Open angle glaucoma is the most common type of glaucoma. No randomised controlled trials have been conducted evaluating the effectiveness of glaucoma screening for reducing sight loss. It is unclear what the most appropriate intervention to be evaluated in any glaucoma screening trial would be. The purpose of this study was to develop the clinical components of an intervention for evaluation in a glaucoma (open angle) screening trial that would be feasible and acceptable in a UK eye-care service.

METHODS: A mixed-methods study, based on the Medical Research Council (MRC) framework for complex interventions, integrating qualitative (semi-structured interviews with 46 UK eye-care providers, policy makers and health service commissioners), and quantitative (economic modelling) methods. Interview data were synthesised and used to revise the screening interventions compared within an existing economic model.

RESULTS: The qualitative data indicated broad based support for a glaucoma screening trial to take place in primary care, using ophthalmic trained technical assistants supported by optometry input. The precise location should be tailored to local circumstances. There was variability in opinion around the choice of screening test and target population. Integrating the interview findings with cost-effectiveness criteria reduced 189 potential components to a two test intervention including either optic nerve photography or screening mode perimetry (a measure of visual field sensitivity) with or without tonometry (a measure of intraocular pressure). It would be more cost-effective, and thus acceptable in a policy context, to target screening for open angle glaucoma to those at highest risk but for both practicality and equity arguments the optimal strategy was screening a general population cohort beginning at age forty.

CONCLUSIONS: Interventions for screening for open angle glaucoma that would be feasible from a service delivery perspective were identified. Integration within an economic modelling framework explicitly highlighted the trade-off between cost-effectiveness, feasibility and equity. This study exemplifies the MRC recommendation to integrate qualitative and quantitative methods in developing complex interventions. The next step in the development pathway should encompass the views of service users.

Sustainable binders for concrete: a structured approach from waste screening to binder composition development

Worldwide, the building sector requires the production of 4 billion tonnes of cement annually, consuming more than 40% of global energy. Alkali activated “cementless” binders have recently emerged as a novel eco-friendly construction material with a promising potential to replace ordinary Portland cement. These binders consist of a class of inorganic polymer formed mainly by the reaction between an alkaline solution and an aluminosilicate source. Precursor materials for this reaction can be found in secondary material streams from different industrial sectors, from energy to agro-alimentary. However, the suitability of these materials in developing the polymerisation reaction must be assessed through a detailed chemical and physical characterisation, ensuring the availability of required chemical species in the appropriate quantity and physical state. Furthermore, the binder composition needs to be defined in terms of proper alkali activation dosages, water content in the mix, and curing conditions. The mix design must satisfy mechanical requirements and compliance to desired engineering properties (workability, setting time) for ensuring the suitability of the binder in replacing Portland cement in concrete applications. This paper offers a structured approach for the development of secondary material-based binders, from their identification to mix design and production procedure development. Essential features of precursor material can be determined through chemical and physical characterisation methods and advanced microscope techniques. Important mixing parameters and binder properties requirements are examined and some examples of developed binders are reported.

Genomic Resources Notes Accepted 1 June 2015 - 31 July 2015

This article documents the public availability of (i) microbiomes in diet and gut of larvae from the dipteran Dilophus febrilis using massive parallel sequencing, (ii) SNP and SSR discovery and characterization in the transcriptome of the Atlantic mackerel (Scomber scombrus, L) and (iii) assembled transcriptome for an endangered, endemic Iberian cyprinid fish (Squalius pyrenaicus).

Prática Pedagógica em Educação de Infância : consciência fonológica e desenvolvimento de competências orais e escritas

Relatório de estágio para a obtenção do grau de Mestre em Educação Pré-escolar e 1º Ciclo do Ensino Básico. Orientadora: Maria Leonor Simões dos Santos .Coorientadora: Marta Andreia de Sousa Jacinto Uva

A qualidade do serviço prestado pelos Serviços Académicos da Escola Superior ABC

A globalização dos mercados transformou a realidade em que vivem as nossas organizações criando a necessidade de, face à concorrência cada vez mais agressiva, lutar por uma posição de destaque no mercado onde se encontram, sendo a “qualidade” cada vez mais o fator de destaque. A qualidade vai muito além de um produto, hoje em dia a qualidade estende-se ao ensino passando pelos serviços. A qualidade preocupa não só a indústria como todas as atividades económicas, inclusive os serviços, quer estes sejam prestados por entidades privadas quer por entidades públicas. Dentro desta visão de “qualidade” de serviços, pretende este projeto de intervenção estudar a qualidade do serviço prestado, pelos serviços académicos de uma escola de ensino superior público e elaborar uma proposta de medidas de melhoria. Numa primeira fase estudámos a satisfação dos alunos face ao serviço prestado tendo sido recolhida a opinião de 120 alunos. De seguida analisámos os processos e procedimentos dos SAC e posteriormente elaborámos uma proposta de melhoria para obtermos um serviço que vá ao encontro das necessidades do seu público-alvo, correspondendo em tempo e formato às suas expectativas, por forma a obter qualidade contínua no serviço prestado. Durante a elaboração deste projeto conseguimos colocar em prática algumas das medidas propostas, sobre as quais obtivemos resultados e opiniões muito positivas.-Market globalization has transformed the reality in which our organizations live, thus creating an increasingly aggressive competition and the need to fight for a position in the market in which they are where "quality" has become an increasingly prominent factor. Quality goes far beyond a product. Nowadays, quality extends to education and even services. Quality concerns not only the industry and all economic activities including services, whether they are provided by private or by public entities. Within this vision of "quality" in services, this project aims to study the quality of the services provided by the academic department of a higher education school and develop a proposal for improvement measures. At the beginning we studied the extent to which students were satisfied with the service provided and we collected the opinions of 120 students. Then we examined the processes and procedures of SAC and subsequently drafted a proposal aiming to improve and to obtain a service which would meet the needs of our target audience, with time and format corresponding to their expectations, in order to achieve continuous quality in service. During the preparation of this project we were able to put some of the measures into practice, during obtained very positive results and opinions.

Resposta do Olival Intensivo e Super-Intensivo a Dois Regimes de Rega: Parâmetros Fisiológicos, Produção e Qualidade

O olival de regadio tem tido grande expansão nos últimos anos no Alentejo, sendo a administração da rega mais adequada às necessidades hídricas um dos fatores determinantes da sua boa gestão. No presente trabalho, avaliou-se a resposta de duas variedades de Olea europaea, Cobrançosa e Arbequina, em regime intensivo e super- intensivo, respetivamente, a duas dotações de rega, a normalmente utilizada pelo agricultor (RA) e outra experimental, com dotações acima (RA+) ou abaixo (RA−) das praticados em RA. Mediram-se os principais parâmetros hídricos das plantas e o teor em clorofilas, e registou-se a assinatura espectral em folhas adultas e jovens, ao meio- dia solar, em três épocas do ano, primavera, final do verão e inverno de 2011. Em Outubro foi feita a colheita, tendo-se quantificado a produção em termos de produção total e teor de óleo na matéria seca, e a qualidade do azeite em termos de acidez e oxidação. Face aos resultados, conclui-se que no olival intensivo de Cobrançosa, na rega experimental (RA+), acima da praticada pelo agricultor, não se verificou diferenças significativas na produção total nem no teor de óleo na matéria seca. Não se verificaram também diferenças significativas entre as regas nos parâmetros hídricos avaliados. Quanto ao olival super-intensivo de Arbequina, a rega experimental (RA−), deficitária relativamente à do agricultor (RA), acarretou menor produção, associada a menor teor relativo de água nas folhas, potenciais hídricos mais negativos e menor condutância estomática no final do verão e inverno, mantendo-se no entanto o teor de óleo nos frutos. O teor em clorofilas e alguns índices de vegetação foram influenciados pelo regime de rega apenas em algumas das datas. Nos dois olivais, as regas experimentais não influenciaram a qualidade do azeite, tendo-se obtido azeites extra virgem com propriedades semelhantes aos das modalidades RA. O estudo prossegue em 2012.

Pesquisa de Campylobacter fetus em amostras prepuciais de touros da região do Alentejo

A bactéria Campylobacter fetus divide-se em duas subespécies C. fetus fetus (Cff) e C. fetus venerealis (Cfv). Cfv é o agente patogénico responsável pela campilobacteriose genital bovina (CGB), uma doença que provoca infertilidade em vacas. Cff pode provocar abortos esporádicos, mas não provoca CGB. Neste trabalho procedeu-se à pesquisa de C. fetus por imunofluorescência direta (IFD) em 117 amostras prepuciais, recolhidas por raspagem, de touros pertencentes a 25 explorações na região do Alentejo. A prevalência real de CGB na amostra, considerando a sensibilidade e especificidade do teste, foi de 52,89% de animais e 80% de explorações. Foi também realizada uma comparação entre dois testes de diagnóstico de CGB, a IFD e o isolamento bacteriológico. O isolamento bacteriológico foi difícil de executar e a presença de bactérias contaminantes foi bastante problemática, levando a resultados falso-negativos. A sua correlação com a IFD foi muito baixa, tendo esta revelado ser muito mais sensível; #### Abstract Search for Campylobacter fetus in preputial samples of bulls from Alentejo region The bacteria Campylobacter fetus comprises two subspecies, C. fetus fetus (Cff) and C. fetus venerealis (Cfv). Cfv is the pathogen responsible for bovine genital campylobacteriosis (BGC), a disease that causes infertility in cows. Cff may lead to sporadic miscarriages, but does not cause BGC. In this work we searched for C. fetus by direct immunofluorescence (DIF) in 117 preputial samples, collected by scraping, from bulls from Alentejo region. The actual prevalence of BGC, considering the sensitivity and specificity of the test was 52.89% of animals and 80 % of farms. It was also performed a comparison between two BGC diagnostic tests, bacterial isolation and DIF. The bacterial isolation was difficult to perform and the presence of bacterial contaminants was very problematic, leading to false-negative results. The presence of bacterial contaminants in bacterial isolation was problematic, leading to false-negative results. Its correlation with DIF was quite low, and DIF proved to be much more sensitive.

SHORT-TERM EFFECTS OF SALINITY ON SOME PHYSIOLOGICAL PARAMETERS OF YOUNG OLIVE TREES OF ARBEQUINA, COBRANÇOSA AND GALEGA VARIETIES

SHORT-TERM EFFECTS OF SALINITY ON SOME PHYSIOLOGICAL PARAMETERS OF YOUNG OLIVE TREES OF ARBEQUINA, COBRANÇOSA AND GALEGA VARIETIES Ana Elisa Rato1,4, Renato Coelho1, Margarida Vaz1, Teresa Carola2, Dália Barbosa2, Nádia Silva1, José dos Santos2, Lourenço Machado2, João Godinho2, Luzia Ruas2, Margarida Barradas2, Hernani Pereira2, Sara Porfírio4 1 ICAAM, Universidade de Évora, Apartado 94, 7002-554 Évora, Portugal 2 Master students, Universidade de Évora, Apartado 94, 7002-554 Évora, Portugal 3 Ph.D. student, Universidade de Évora, Apartado 94, 7002-554 Évora, Portugal 4 aerato@uevora.pt Due to the desertification in some regions, the interest in plant’s tolerance to salinity has been increasing, as this response is determining for plant survival in stress conditions. This work reports the investigation of tolerance to salt in two year-old olive trees (Olea europaea L.) of three varieties, Arbequina, Cobrançosa and Galega vulgar. Plants were grown in 10 L plastic pots containing approximately 9 Kg of a sandy granitic soil, on a greenhouse. For 3 months (from the beginning of February to the end of April 2012), they were subjected to three levels of salinity in the irrigation water, 0 mM, 80 mM and 200 mM NaCl (6 plants per salinity level in a total of 18 plants of each variety),. Stomatal conductance (gs) and relative leaf chlorophyll content were assessed on each plant in February, March and April. Mid-day leaf water potential () and soil salinity were measured at the end of the experiment (April). On average, concerning all treatments and dates of determination, stomatal conductance of Arbequina and Galega vulgar was quite similar, around 40 mmol m-2 s-1, but Cobrançosa had a value of gs 36% higher, almost 50% higher (61 mmol m-2 s-1) when compared with the controls (0 mM salt) of the other two varieties. In percentage of controls, there was little difference in gs between varieties and between salinities during February and March. In contrast, in April, after about 90 days of exposure to salt, there was a clear decrease in gs with salt irrigation, proportional to salt concentration. Compared with controls, plants irrigated with 200 mM salt showed around 80% (Arbequina) or 85% (Cobrançosa and Galega vulgar) decrease in gs. Chlorophyll content of leaves showed less than 5% difference between varieties on the average of all treatments and dates of determination. During the course of this experiment, the salinity levels used did not show any relevant effect on chlorophyll content. Overall, at the end of the experimental period (April), leaf water potential () at midday was significantly higher in Cobrançosa (-1,4 MPa) than in Galega vulgar (-1,7 MPa) or Arbequina (-1,8 MPa), and salt decreased  of control plants (-1,25 MPa) by an average 30% (with 80 mM) and 65% (with 200 mM). At the end of the experiment, salinity in the soil irrigated with 0 mM, 80 mM or 200 mM NaCl was, on average of all varieties, 0,2 mS, 1,0 mS or 2,0 mS, respectively. Soil salinity was quite similar in Arbequina and Galega vulgar but about 35% lower in the pots of Cobrançosa, on average of all salt-irrigation levels. Plants of Cobrançosa had higher stomatal conductance, however they showed higher water potential and lower salinity in the soil. These apparently contradictory results seem to suggest that Cobrançosa responds to salt differently from the other two varieties. This issue needs further investigation.

Salinity-induced effects on transpiration rate, stomatal conductance and leaf area of three olive (Olea europaea L.) varieties

Transpiration of two year-old olive trees of three different varieties, Arbequina, Cobrançosa and Galega (18 trees per variety), irrigated with three levels of salt (0, 80 or 200 mM NaCl) for about 90 days, was measured by a gravimetric method. To determine leaf area, each tree was photographed from the side against a white background and the total area of each projected image was determined with ImageJ software. To calibrate these area determinations, one tree of each variety was subsequently stripped of all its leaves and its total leaf area was accurately measured. A correlation was then obtained between the area on the photograph of this particular tree and the total area of the detached leaves of the same tree. Using the leaf area determined by this procedure, transpiration rates of the trees could be calculated. Knowing leaf and air temperatures and RH, it was possible to determine the difference in molar fraction of water between the leaf and the air. Using this and the values of the transpiration rate, stomatal conductance could be calculated (gs calc) and compared with the conductance measured on the same trees with a porometer (gs). Actual leaf area of a plant was 1,40 (Arbequina), 1,42 (Cobrançosa) or 1,24 (Galega) times the area measured with ImageJ on the photograph of the same plant. Leaf area of the trees, on average of all salt irrigations, was significantly higher on Arbequina (0,187 m2) then on the other two varieties (0,138 m2 or 0,148 m2, for Cobrançosa or Galega, respectively), but did not differ significantly in percentage of controls (0 salt). On average of all three varieties, leaf area was also higher on plants irrigated without salt (0,181 m2) than on plants exposed to 80 or 200 mM NaCl (0,152 m2 or 0,140 m2, respectively), which did not differ between them. The same significant difference was observed when leaf area was expressed as percentage of controls. Transpiration rate was significantly higher on Cobrançosa (1,17 mmol m-2 s-1), on average of all treatments, but there were no significant differences between Arbequina (1,08 mmol m-2 s-1) and Galega (0,82 mmol m-2 s-1). In percentage of controls, there were no significant differences between varieties. Salt reduced significantly the transpiration rate in all varieties, both the actual and percentual values, to about 50% or 30% of controls when exposed to 80 mM or 200 mM NaCl, respectively. Stomatal conductance (gs), assessed by porometry, was significantly higher in control plants, mainly in Cobrançosa (102 mmol m-2 s-1), then in Arbequina (77 mmol m-2 s-1) and the lower values were found in Galega (51 mmol m-2 s-1). Salt reduced gs, on average of the three varieties to 30% or 10% of controls on exposure to 80 mM or 200 mM NaCl, respectively. Calculated (gs calc) and measured (gs) values of stomatal conductance showed a close relation between them (0,967, R2 = 0,837) which indicates this non-destructive method to determine whole-plant leaf area to be reasonably accurate.