Physical abuse against elderly persons in institutional settings

Introduction: People over 65 years old are expected to be an increasing group exposed to abuse. Despite the well-studied intra-familial abuse, institutional abuse still lacks a proper understanding about its determinants and characteristics. Aim: The general objective of this study is to provide a better knowledge about physical abuse against elderly people in institutional settings, in order to contribute to a timely detection, correct forensic diagnosis and prevention of these cases. Methods: A retrospective study was conducted through the analysis of forensic medical exams performed in the North Forensic Medical Services of Portugal, between 2004 and 2013, to elderly persons allegedly victims of physical abuse in an institutional setting by a caregiver (n = 59). Results: All the alleged cases occurred in nursing homes and in most of them (93.2%) the charges were against the institution and not focussing on a particular individual. The alleged victims were mainly female (79.7%), 75 years or older (75.9%), presenting a severe disability (55.9%) and 47.2% being unable to communicate. No injuries or post-traumatic pain were found in 55.9% of the cases to support the charge of physical abuse. Only in 6.8% of the cases were the forensic medical findings suggestive of physical abuse and, although this was not the object of the examination, 69.1% were considered suggestive or highly suggestive of neglect. A statistically significant association was found between the alleged victim's degree of disability and the occurrence of neglect (p = 0.003). Conclusion: The sample's size seems to be underestimated, probably due to lack of detection and/or reporting. The condition of these persons, mainly related with their inability to perceive abusive behaviours and/or to disclose them (mostly by physical and/or mental disability), as well as their reluctance to press charges due to fear of reprisal, affects significantly the detection and diagnosis of physical abuse, particularly in whom injuries are not obvious. In anticipation to the rapid ageing of the population, it is urgent to analyse and understand this emerging issue so that social policies and regulation may be developed, in an effort to protect the elderly, as well as to make improvements in the professionals' skills

Domestic violence against elderly with disability

Abuse against elders with disabilities is a growing problem as the world population ages. Though they require mandatory reporting, these cases are most frequently not detected or not reported by health professionals for a variety of reasons, including the difficulty of making an accurate diagnosis. By performing a retrospective analysis of alleged domestic violence cases against elders with moderate or severe disability, presented to medical forensic examination at the North Branch of the National Institute of Legal Medicine and Forensic Sciences of Portugal, in Porto, between 2005 and 2013 (n = 70), we aimed to improve our knowledge of some demographic and forensic characteristics of these cases as well as improve their detection and prevention. The most frequently reported type of abuse was physical (86%), allegedly perpetrated by male abusers (63%) living with their victims (90%), who were most commonly their children (47%) or partners (49%; when victims are married). The victims were most frequently female (63%) who had motor disabilities (49%) and presented a history of previous episodes of abuse in 74% of cases; however, only 28% were previously reported. The physical consequences were most frequently minor injuries (95%) with permanent consequences (scars) in only 6.8% of the cases. The injuries were multiple in the majority of the cases (64%), and the preferred locations were the head and neck (75%). Elderly females with motor disabilities appear to have a greatest risk of domestic violence, which translates, most frequently, into multiple injuries that are mainly in the head and neck

Adaptation of Scheffersomyces stipitis to hardwood spent sulfite liquor by evolutionary engineering

Hardwood spent sulfite liquor (HSSL) is a by-product of acid sulfite pulping process that is rich in xylose, a monosaccharide that can be fermented to ethanol by Scheffersomyces stipitis. However, HSSL also contains acetic acid and lignosulfonates that are inhibitory compounds of yeast growth. The main objective of this study was the use of an evolutionary engineering strategy to obtain variants of S. stipitis with increased tolerance to HSSL inhibitors while maintaining the ability to ferment xylose to ethanol

Association analysis of human leukocyte antigen class II (DRB1) alleles with leprosy in individuals from São Luís, state of Maranhão, Brazil

Epidemiological studies have demonstrated that the variability of the clinical response to infection caused by Mycobacterium leprae is associated with host genetic factors. The present study investigated the frequency of human leukocyte antigen (HLA) class II (DRB1) alleles in patients with leprosy from São Luís, Maranhão, Brazil. A case-control study was performed in 85 individuals with leprosy and 85 healthy subjects. All samples were analysed via polymerase chain reaction-sequence specific oligonucleotide probes. The HLA-DRB1*16 allele showed a higher frequency in the group with leprosy [(9.41% vs. 4.12%) odds ratio (OR) = 2.41 95% confidence interval (CI) (0.96-6.08) p = 0.05], whereas the HLA-DRB1*11 allele was less frequent in the group with leprosy [(6.47% vs. 11.76%) OR = 0.51 95% CI (0.23-1.12) p = 0.09]. The frequency of HLA-DRB1* alleles between the control group and leprosy patient subgroups presenting different forms of the disease showed that the HLA-DRB1*16 (16.13% vs. 8.24%, OR = 4.10, CI = 1.27-13.27, p = 0.010) and HLA-DRB1*14 (5% vs. 3.53%, OR = 4.63, CI = 1.00-21.08, p = 0.032) alleles were significantly more frequent in patients with different clinical subtypes of leprosy. The sample size was a limitation in this study. Nevertheless, the results demonstrated the existence of a genetic susceptibility associated with the clinical forms of leprosy. The low frequency of the HLA-DRB1*11 allele should be further studied to investigate the possible protective effect of this allele

Three-Dimensional Anisotropic Metamaterials as Triaxial Optical Inclinometers

Split-ring resonators (SRRs) present an attractive avenue for the development of micro/nano scale inclinometers for applications like medical microbots, military hardware, and nanosatellite systems. However, the 180 degrees isotropy of their two-dimensional structure presents a major hurdle. In this paper, we present the design of a three-dimensional (3D) anisotropic SRR functioning as a microscale inclinometer enabling it to remotely sense rotations from 0 degrees to 360 degrees along all three axes (X, Y, and Z), by employing the geometric property of a 3D structure. The completely polymeric composition of the cubic structure renders it transparent to the Terahertz (THz) light, providing a transmission response of the tilted SRRs patterned on its surface that is free of any distortion, coupling, and does not converge to a single point for two different angular positions. Fabrication, simulation, and measurement data have been presented to demonstrate the superior performance of the 3D micro devices