Trajectories and food dynamics of Elderly People: food as life story

Argentina atraviesa un proceso de transición demográfica avanzada, ya que los/as Adultos Mayores (AM) alcanzan el 15,1% de la población. Ello pone en tensión el lugar de las/os AM en la sociedad, sus condiciones de acceso y resolución de necesidades, entre ellas la alimentación. En este trabajo se postula que hablar de la alimentación, de los alimentos, es hablar de los/as AM, de la historia de vida de estas personas que se va escribiendo entre sustancias y circunstancias que hacen a actividades tan cotidianas como el cocinar y el comer. Así, se planteó como objetivo, indagar acerca de la categoría trayectorias y dinámicas alimentarias (TyDA) de los/as AM de la Ciudad de Córdoba-Argentina, para establecer diálogo(s) posible(s) entre alimentación y curso de vida.Se realizó una investigación con posicionamiento epistemológico mixto entre paradigma interpretativista y crítico; con triangulación metodológica cuali-cuantitativa. Etapa cuantitativa: muestra no probabilística por cuotas según nivel de instrucción (n=384); incluyendo a AM de Córdoba y gran Córdoba que integran espacios participativos. Se implementó un cuestionario semiestructurado. Etapa cualitativa: muestra intencional (n=10) a partir del muestro anterior. Se realizaron observaciones participantes, bitácora de campo y entrevistas. Participaron 384 AM, edad promedio de 72 años (DE=7), 79% mujeres y 21% varones. Las TyDA, siguiendo una idea de proceso que se construye y reconstruye constantemente, fueron abordadas desde: a) Etapa de la vida b) Sistema Alimentario y c) Alimentos identificadores. Reconstruir la historia de la comida de los/as AM propicia el reencuentro con la propia historia (infancia, juventud, adultez, vejez). Esta matriz de sentido es una invitación a repensar los abordajes en materia de políticas públicas destinados a este grupo poblacional; que genera cambios demográficos tanto a nivel macrosocial (cultura, economía, mercado de trabajo, sistemas políticos) pero especialmente en la experiencia de vida de los y las AM.Argentina is going through an advanced demographic transition process, as the Elderly (E) reach 15.1% of the population. This puts in strain the place of the E in society, their conditions of access and resolution of needs, including food. In this work it is postulated that to talk about food is to talk about the E, about the life story of these people that is being written among substances and circumstances resulting from daily activities such as cooking and eating. Thus, the objective was to research on trajectories and food dynamics (T&FD) of the E living in Cordoba City, Argentina, to establish possible dialogue(s) between food and life course. An investigation with mixed epistemological positioning between interpretive and critical paradigm was carried out; with qualitative quantitative methodological triangulation. Quantitative stage: non-probabilistic sample according to level of instruction (n=384); including the E from Cordoba and great Cordoba that integrate participatory spaces. A semistructured questionnaire was implemented. Qualitative stage: intentional sample (n=10) resulting from the previous sample. Participant observations, field log and interviews were made. 384 participated, average age of 72 years old (SD=7), 79% women and 21% men. The T&FD, following a process idea that is constantly constructed and reconstructed, were approached from: a) Life stage b) Food System and c) Food identifiers. Reconstructing the history of the food of the E favors the connection with their own life story (childhood, youth, adulthood, old age). This matrix of meaning is an invitation to rethink public policy approaches for this population group, which generates demographic changes at a macrosocial level (culture, economy, labor market, political systems) but especially in the life experience of these E.Fil: Abraham, Maria Daniela. Universidad Nacional de Córdoba. Facultad de Medicina. Escuela de Nutrición; ArgentinaFil: Huergo, Juliana. Universidad Nacional de Córdoba. Facultad de Medicina. Escuela de Nutrición; Argentina. Universidad Nacional de Cordoba. Instituto de Estudios En Comunicacion, Expresion y Tecnologias. - Consejo Nacional de Investigaciones Cientificas y Tecnicas. Centro Cientifico Tecnologico Conicet - Cordoba. Instituto de Estudios En Comunicacion, Expresion y Tecnologias.; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Centro de Investigaciones y Estudios sobre Cultura y Sociedad. Universidad Nacional de Córdoba. Centro de Investigaciones y Estudios sobre Cultura y Sociedad; ArgentinaFil: Butinof, Mariana. Universidad Nacional de Córdoba. Facultad de Medicina. Escuela de Nutrición; Argentin

Tarjeta Alimentar: ¿qué define una mejor compra? ¿para quiénes? Operativo de implementación en la Provincia de Córdoba

Introducción:La Tarjeta Alimentar (TA) constituyó una estrategia del Plan Argentina contra el Hambre, direccionada a promover y fortalecer el acceso a la Canasta Básica de Alimentos de la población con pobreza de ingresos, en pos de mejorar la calidad nutricional de la alimentación. El operativo de entrega de la TA en la provincia de Córdoba, (27 febrero al 12 marzo de 2020), contó con la participación activa de la Escuela de Nutrición (UNC) en su planificación, ejecución y evaluación. Objetivos: Este trabajo se propone describir la población destinataria de la Tarjeta Alimentar en la provincia de Córdoba, y analizar los principales sentidos asociados a “la mejor compra de alimentos”. Métodos: abordaje cualitativo y cuantitativo (n=9571 mujeres). Técnicas: cuestionario semi-estructurado y talleres participativos. Análisis estadístico descriptivos, inferencial y de contenido de los principales sentidos sobre la “mejor compra de alimentos”. Resultados: marcada heterogeneidad en condiciones materiales de vida (necesidades básicas), servicios (red de agua instalada), equipamiento para cocinar (horno, heladera), sitios de compra (supermercados, comercios barriales, inaccesibilidad a alimentos variados), programas sociales estatales y comunitarios (comedores barriales, redes de apoyo). Sentidos que definen la “mejor compra”: adquisición de un alimento específico; buena relación costo/beneficio; cobertura de alimentación saludable; darse un gustito; alcanzar lo diario; alimentos inocuos; buen trato, elegir dónde comprar, cercanía. Conclusiones: esta política puede ser pensada como una “primera” compensación para achicar la brecha estructural alimentaria argentina. Nos interpela ¿qué implica “comer bien” para cada quién? Desde esta matriz de sentidos se define “la mejor compra”.  Palabras claves: políticas sociales, alimentación, sentidos, Córdob

Dietary practices linked to the occurrence of non-communicable diseases among older adults

Introducción: El proceso de envejecimiento poblacional argentino cursa una transición demográfica avanzada que transforma los perfiles de salud, prevaleciendo enfermedades no transmisibles. En tanto la alimentación en la vejez constituye un hecho social, cultural y ambiental, que incide en la calidad de vida y la salud. Objetivo: Identificar las condiciones de vida, potencialmente asociadas al desarrollo de enfermedades no transmisibles, que intervienen en el desarrollo de las prácticas alimentarias de personas adultas mayores de la ciudad de Córdoba y Gran Córdoba, en el periodo 2017-2019. Métodos: Estudio analítico de corte transversal, con triangulación metodológica cuali-cuantitativa. Se diseñó una muestra no probabilística de personas adultas mayores (≥ 60 a os de edad) por cuotas según nivel de instrucción, implementando cuestionarios semiestructurados (n = 384), entrevistas (n = 12) y observaciones participantes. Resultados: En el espacio singular, emerge la presencia de enfermedades asociadas a la vejez que traen cambios alimentarios y de salud. En la dimensión particular-colectiva, se reconocen variaciones de salud a nivel de grupos; la enfermedad que individualmente se vivencia como una preocupación pasa a ser parte de la trama de vinculación social. El análisis multivariado identifica dos modalidades con una mirada multidimensional de la salud y la alimentación contextualizadas. En el espacio general se plantea una tensión entre el nuevo paradigma sobre el envejecimiento y las condiciones materiales de vida para ello. Conclusiones: Analizar la salud y alimentación de personas adultas mayores en su contexto, permite reconocer puntos de encuentro entre modos predominantes de envejecer, visibilizando el principio de un cambio social.Introduction: The process of aging of the Argentine population is undergoing an advanced demographic transition that transforms health profiles, prevailing noncommunicable diseases. While food in old age is a social, cultural and environmental fact, which affects the quality of life and health. Objective: Identify the living conditions, potentially associated with the development of non-communicable diseases, that impact in the development of food practices of older adults in the city of Córdoba and Gran Córdoba, in the period 2017 – 2019. Methods: Cross-sectional analytical study, with qualitative-quantitative methodological triangulation. A non-probabilistic sample of older adults (≥ 60 years of age) was designed by quotes according to level of education, implementing semi-structured questionnaires (n = 384), interviews (n = 12) and participant observations. Results: In the solo space, the presence of diseases associated with old age that bring dietary and health changes emerges. In the particular-collective dimension, health variations are recognized at the group level; the disease that is individually experienced as a concern becomes part of the fabric of social bonding. The multivariate analysis identified two modalities with a contextualized multidimensional view of health and food. In the general space there is a tension between the new paradigm on aging and the material conditions of life for it. Conclusions: Analyzing the health and nutrition of older adults in their context, allows to recognize points of encounter between predominant ways of aging, and making visible the principle of a social change.Fil: Abraham, Maria Daniela. Universidad Nacional de Córdoba. Facultad de Medicina. Escuela de Nutrición; Argentina. Universidad Nacional de Córdoba. Instituto de Estudios en Comunicación, Expresión y Tecnologías. - Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Instituto de Estudios en Comunicación, Expresión y Tecnologías; ArgentinaFil: Huergo, Juliana. Universidad Nacional de Córdoba. Facultad de Medicina. Escuela de Nutrición; Argentina. Universidad Nacional de Córdoba. Instituto de Estudios en Comunicación, Expresión y Tecnologías. - Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Instituto de Estudios en Comunicación, Expresión y Tecnologías; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Centro de Investigaciones y Estudios sobre Cultura y Sociedad. Universidad Nacional de Córdoba. Centro de Investigaciones y Estudios sobre Cultura y Sociedad; ArgentinaFil: Díaz, Gustavo Tomas. Universidad Nacional de Córdoba. Facultad de Medicina; ArgentinaFil: Butinof, Mariana. Universidad Nacional de Córdoba. Facultad de Medicina. Escuela de Nutrición; Argentin

Exploración y descripción de experiencias de salud comunitaria en la provincia de Córdoba, como acciones transformadoras, desde la perspectiva de la Epidemiología Comunitaria

En el marco del Seminario Permanente de Epidemiología Comunitaria y el convenio EPICOM[1] surge la propuesta de realizar un relevamiento cuyos objetivos pretenden visibilizar y comprender el sentido de la participación en diferentes experiencias de salud de base comunitaria en la Provincia de Córdoba. Se pretende asimismo, desde una mirada colectiva, dar cuenta de diferentes escenarios de vulneración de derechos humanos, particularmente vinculados con la salud. La Epidemiología Comunitaria se reconoce como una herramienta de visibilización de las comunidades, posicionando las mismas como actores activos y críticos, desarrollando estrategias que les permitan lograr  una mayor equidad en salud. Al momento de dar cuenta del proceso de las experiencias en salud comunitaria desde el plano de lo singular, se enfatiza  en la idea de que los problemas de salud se corresponden con diferentes espacios de determinación y condicionamiento. Ante este complejo proceso se asume que con frecuencia se suelen producir vicios de reduccionismo en el plano de lo general[2]. Se pretende abordar las relaciones entre vida cotidiana, salud, derechos, así como también los niveles de participación, protagonismo e involucramiento por parte de las comunidades en las acciones relativas a las experiencias. La Epidemiología Comunitaria postula que la participación es una herramienta de democracia, de “toma de la palabra” de las comunidades[3], como protagonistas de su salud traducidos en proyectos de vida. Este trabajo pretende sumergirse en el análisis de los datos del Relevamiento desde un enfoque cualitativo, por ser un abordaje capaz de incorporar el significado y la intencionalidad de los actos, las relaciones y las estructuras sociales, apuntando a comprender la lógica interna de los actores sociales involucrados en las experiencias[4]. Poder pensar el andar institucional, en y junto a las comunidades, nos invita a posicionarnos en un lugar de diálogo, entendiendo que nos relacionamos con sujetos de derechos, con conciencia histórica, portadores de saberes. [1] Convenio firmado entre instituciones académicas y de atención a la salud de la Provincia de Córdoba en 2007, integrado actualmente por la Secretaría de Extensión Universitaria de la UNC, Departamento de Prestaciones Sociales, División de Promoción y Prevención, INSSJP-PAMI Córdoba y el Instituto Mario Negri de Italia. [2] CASTELLANOS P. L. Sobre el concepto de salud enfermedad. Descripción y explicación de la situación de salud. Bol. Epidemiológico OPS. 1990; vol. 10, Nº 4. [3] TOGNONI, Gianni (editor) (1997), Manual de Epidemiología Comunitaria. Ecuador: Edición CECOMET. A- [4] DE SOUZA MINAYO M. Cecilia. La Artesanía de la Investigación Cualitativa. Lugar Editorial, 2009.

Searching novel therapeutic targets for scleroderma: P2X7-receptor is UP-regulated and promotes a fibrogenic phenotype in systemic sclerosis fibroblasts

Objectives: Systemic sclerosis (SSc) is a connective tissue disorder presenting fibrosis of the skin and internal organs, for which no effective treatments are currently available. Increasing evidence indicates that the P2X7 receptor (P2X7R), a nucleotide-gated ionotropic channel primarily involved in the inflammatory response, may also have a key role in the development of tissue fibrosis in different body districts. This study was aimed at investigating P2X7R expression and function in promoting a fibrogenic phenotype in dermal fibroblasts from SSc patients, also analyzing putative underlying mechanistic pathways. Methods: Fibroblasts were isolated by skin biopsy from 9 SSc patients and 8 healthy controls. P2X7R expression, and function (cytosolic free Ca2+ fluxes, α-smooth muscle actin [α-SMA] expression, cell migration, and collagen release) were studied. Moreover, the role of cytokine (interleukin-1β, interleukin-6) and connective tissue growth factor (CTGF) production, and extracellular signal-regulated kinases (ERK) activation in mediating P2X7R-dependent pro-fibrotic effects in SSc fibroblasts was evaluated. Results: P2X7R expression and Ca2+ permeability induced by the selective P2X7R agonist 2'-3'-O-(4-benzoylbenzoyl)ATP (BzATP) weremarkedly higher in SSc than control fibroblasts. Moreover, increased aSMA expression, cell migration, CTGF, and collagen release were observed in lipopolysaccharides-primed SSc fibroblasts after BzATP stimulation. While P2X7-induced cytokine changes did not affect collagen production, it was completely abrogated by inhibition of the ERK pathway. Conclusion: In SSc fibroblasts, P2X7R is overexpressed and its stimulation induces Ca2+-signaling activation and a fibrogenic phenotype characterized by increased migration and collagen production. These data point to the P2X7R as a potential, novel therapeutic target for controlling exaggerated collagen deposition and tissue fibrosis in patients with SSc

Genetic risk and a primary role for cell-mediated immune mechanisms in multiple sclerosis.

Multiple sclerosis is a common disease of the central nervous system in which the interplay between inflammatory and neurodegenerative processes typically results in intermittent neurological disturbance followed by progressive accumulation of disability. Epidemiological studies have shown that genetic factors are primarily responsible for the substantially increased frequency of the disease seen in the relatives of affected individuals, and systematic attempts to identify linkage in multiplex families have confirmed that variation within the major histocompatibility complex (MHC) exerts the greatest individual effect on risk. Modestly powered genome-wide association studies (GWAS) have enabled more than 20 additional risk loci to be identified and have shown that multiple variants exerting modest individual effects have a key role in disease susceptibility. Most of the genetic architecture underlying susceptibility to the disease remains to be defined and is anticipated to require the analysis of sample sizes that are beyond the numbers currently available to individual research groups. In a collaborative GWAS involving 9,772 cases of European descent collected by 23 research groups working in 15 different countries, we have replicated almost all of the previously suggested associations and identified at least a further 29 novel susceptibility loci. Within the MHC we have refined the identity of the HLA-DRB1 risk alleles and confirmed that variation in the HLA-A gene underlies the independent protective effect attributable to the class I region. Immunologically relevant genes are significantly overrepresented among those mapping close to the identified loci and particularly implicate T-helper-cell differentiation in the pathogenesis of multiple sclerosis

Induction of Heme Oxygenase-1 Can Halt and Even Reverse Renal Tubule-Interstitial Fibrosis

Background: The tubule-interstitial fibrosis is the hallmark of progressive renal disease and is strongly associated with inflammation of this compartment. Heme-oxygenase-1 (HO-1) is a cytoprotective molecule that has been shown to be beneficial in various models of renal injury. However, the role of HO-1 in reversing an established renal scar has not yet been addressed. Aim: We explored the ability of HO-1 to halt and reverse the establishment of fibrosis in an experimental model of chronic renal disease. Methods: Sprague-Dawley male rats were subjected to unilateral ureteral obstruction (UUO) and divided into two groups: non-treated and Hemin-treated. To study the prevention of fibrosis, animals were pre-treated with Hemin at days -2 and -1 prior to UUO. To investigate whether HO-1 could reverse established fibrosis, Hemin therapy was given at days 6 and 7 post-surgery. After 7 and/or 14 days, animals were sacrificed and blood, urine and kidney tissue samples were collected for analyses. Renal function was determined by assessing the serum creatinine, inulin clearance, proteinuria/creatininuria ratio and extent of albuminuria. Arterial blood pressure was measured and fibrosis was quantified by Picrosirius staining. Gene and protein expression of pro-inflammatory and pro-fibrotic molecules, as well as HO-1 were performed. Results: Pre-treatment with Hemin upregulated HO-1 expression and significantly reduced proteinuria, albuminuria, inflammation and pro-fibrotic protein and gene expressions in animals subjected to UUO. Interestingly, the delayed treatment with Hemin was also able to reduce renal dysfunction and to decrease the expression of pro-inflammatory molecules, all in association with significantly reduced levels of fibrosis-related molecules and collagen deposition. Finally, TGF-beta protein production was significantly lower in Hemin-treated animals. Conclusion: Treatment with Hemin was able both to prevent the progression of fibrosis and to reverse an established renal scar. Modulation of inflammation appears to be the major mechanism behind HO-1 cytoprotection.Fundacao de Amparo Pesquisa do Estado de Sao Paulo-FAPESP[07/07139-3]Coordenaco de Aperfeioamento de Pessoal de Nivel Superior-CAPESInstituto Nacional de Ciencia e Tecnologia de Complexos Fluidos (INCT)Conselho Nacional de Desenvolvimento Cientifico e Tecnologico-CNP

Genotype-Phenotype Correlation in NF1: Evidence for a More Severe Phenotype Associated with Missense Mutations Affecting NF1 Codons 844–848

Neurofibromatosis type 1 (NF1), a common genetic disorder with a birth incidence of 1:2,000–3,000, is characterized by a highly variable clinical presentation. To date, only two clinically relevant intragenic genotype-phenotype correlations have been reported for NF1 missense mutations affecting p.Arg1809 and a single amino acid deletion p.Met922del. Both variants predispose to a distinct mild NF1 phenotype with neither externally visible cutaneous/plexiform neurofibromas nor other tumors. Here, we report 162 individuals (129 unrelated probands and 33 affected relatives) heterozygous for a constitutional missense mutation affecting one of five neighboring NF1 codons—Leu844, Cys845, Ala846, Leu847, and Gly848—located in the cysteine-serine-rich domain (CSRD). Collectively, these recurrent missense mutations affect ∼0.8% of unrelated NF1 mutation-positive probands in the University of Alabama at Birmingham (UAB) cohort. Major superficial plexiform neurofibromas and symptomatic spinal neurofibromas were more prevalent in these individuals compared with classic NF1-affected cohorts (both p < 0.0001). Nearly half of the individuals had symptomatic or asymptomatic optic pathway gliomas and/or skeletal abnormalities. Additionally, variants in this region seem to confer a high predisposition to develop malignancies compared with the general NF1-affected population (p = 0.0061). Our results demonstrate that these NF1 missense mutations, although located outside the GAP-related domain, may be an important risk factor for a severe presentation. A genotype-phenotype correlation at the NF1 region 844–848 exists and will be valuable in the management and genetic counseling of a significant number of individuals

Results of the COVID-19 mental health international for the general population (COMET-G) study.

INTRODUCTION: There are few published empirical data on the effects of COVID-19 on mental health, and until now, there is no large international study. MATERIAL AND METHODS: During the COVID-19 pandemic, an online questionnaire gathered data from 55,589 participants from 40 countries (64.85% females aged 35.80 ± 13.61; 34.05% males aged 34.90±13.29 and 1.10% other aged 31.64±13.15). Distress and probable depression were identified with the use of a previously developed cut-off and algorithm respectively. STATISTICAL ANALYSIS: Descriptive statistics were calculated. Chi-square tests, multiple forward stepwise linear regression analyses and Factorial Analysis of Variance (ANOVA) tested relations among variables. RESULTS: Probable depression was detected in 17.80% and distress in 16.71%. A significant percentage reported a deterioration in mental state, family dynamics and everyday lifestyle. Persons with a history of mental disorders had higher rates of current depression (31.82% vs. 13.07%). At least half of participants were accepting (at least to a moderate degree) a non-bizarre conspiracy. The highest Relative Risk (RR) to develop depression was associated with history of Bipolar disorder and self-harm/attempts (RR = 5.88). Suicidality was not increased in persons without a history of any mental disorder. Based on these results a model was developed. CONCLUSIONS: The final model revealed multiple vulnerabilities and an interplay leading from simple anxiety to probable depression and suicidality through distress. This could be of practical utility since many of these factors are modifiable. Future research and interventions should specifically focus on them