Interinstitutional networks and democratization of services in social intervention with older people in Portugal

 This article presents an interinstitutional network supporting older people in Portugal and a policy document that institutionalized this type of interinstitutional practices. The data are part of a large corpus collected in the course of interdisciplinary research: “Aging, poverty and social exclusion: an interdisciplinary study on innovative support services.” (https://apseclunl.wordpress.com/). The documentation of good practices in intervention with older people at risk of exclusion were the aim of the research project. The data collected incudes: interviews, observation and recordings of inter-institutional meetings. In the light of the relevant literature, the study discusses the ethnographic account in relation to relevant policy documents (“Rede Social” Interinstitutional Network Program RCM no. 197/97, of 18 November). Describing the main aspects of the intervention strategies with the older population, the article documents the value of these experiences and the approach in policies for the democratization of services and the inclusion of citizens participating in decision making about delivery of services and the promotion of inclusive societies. 

Exploring terms used for the oldest old in the gerontological literature.

In response to the global increasing age of the population, there is general agreement on the need to define what is meant by 'old.' Yet there is no consensus on age groups within the definition of old, which makes comparative studies of people of differing ages in advancing years impossible. Attempts to sub-categorize the 'old' also show little consensus. This article serves to open a dialogue, as an illustrative example of these inconsistencies. Specifically, the aim of this research was to examine definitions of the 'oldest old' and 'fourth age', in order to highlight such inconsistencies and the need for consistent age stratifications. The authors conducted a literature search from January 2003 to April 2015 using the six most highly-rated non-medical journals in gerontology; the search was conducted again in 2018–2019 for currency. Forty-nine articles in total were reviewed. The findings show little consensus on the age stratifications used to define the 'oldest old' and 'fourth age,' which ranged from seventy-five plus to ninety-two plus years. Dividing the 'old' population into the oldest old and/or fourth age still shows a lack of consensus, with some authors suggesting that such divisions have only served to move ageism into very old age. There are terms for ten-year cohorts, which - if universally used - will mean that comparative ageing studies are possible. This in turn will inform international and national strategy documents, policy initiatives, clinical guidelines, and service provision and design. Given the growth in the numbers of people classed as old and the time span being 'old' covers, there is a real need for consensus. Definite age groupings that define people as cohorts, with existing and agreed words — such as sexagenarians (60–69,) septuagenarians (70–79), octogenarians (80–89), etc. - will completely remove the need for the value-laden term 'old' (and all its derivatives) for this poorly-defined population

Intervención sobre la Pobreza de la Población de Edad Avanzada en Tiempos de Crisis Económica. El Caso Portugués

In times of economic crisis, the distribution and impact of its effects vary greatly among social groups, due to the different level of exposure and availability of resources. This article conducts a policy analysis of the most important public policies and programmes fighting elderly poverty in Portugal, in the last two decades.It critically analyses the actual social and political situation, from three main perspectives: poverty approach; gender mainstream and public-private partnerships. The latest restriction measures have been jeopardizing the fight against poverty conducted in the last 15 years. Although poverty among the elderly is presently considered a political priority, no comprehensive policies are being developed. The policy interventions are directed towards extreme situations of poverty and dependency. Preventive measures are excluded from policies planning. The state is increasingly delegating to the social sector the social care responsibilities. Gender mainstream is still a rhetoric concept.En tiempos de crisis económica, la distribución y el impacto de sus efectos varían mucho entre sectores sociales, debido a sus diferentes niveles de exposición y disponibilidad de recursos. Este artículo propone un análisis de las principales políticas públicas y programas de lucha contra la pobreza entre las personas mayores en Portugal, en las últimas dos décadas. Se analiza críticamente la situación social y política actual a partir de tres perspectivas: pobreza, género y patrocinio público-privado. Las recientes medidas de restricción han comprometido la lucha contra la pobreza de personas mayores en los últimos 15 años. Aunque este tipo de pobreza es considerada actualmente una prioridad política, no se están desarrollando políticas adecuadas. Las intervenciones están dirigidas a situaciones extremas de pobreza y de dependencia. Las medidas preventivas son excluidas de los planes. El Estado delega cada vez más las responsabilidades de asistencia social en el sector privado no lucrativo. La perspectiva de género es todavía un concepto retórico

Epidermal growth factor receptor gene copy number in 101 advanced colorectal cancer patients treated with chemotherapy plus cetuximab

<p>Abstract</p> <p>Background</p> <p>Responsiveness to Cetuximab alone can be mediated by an increase of Epidermal Growth factor Receptor (EGFR) Gene Copy Number (GCN). Aim of this study was to assess the role of EGFR-GCN in advanced colorectal cancer (CRC) patients receiving chemotherapy plus Cetuximab.</p> <p>Methods</p> <p>One hundred and one advanced CRC patients (43 untreated- and 58 pre-treated) were retrospectively studied by fluorescence in situ hybridization (FISH) to assess EGFR-GCN and by immunohistochemistry (IHC) to determine EGFR expression. Sixty-one out of 101 patients were evaluated also for k-ras status by direct sequencing. Clinical end-points were response rate (RR), progression-free survival (PFS) and overall survival (OS).</p> <p>Results</p> <p>Increased EGFR-GCN was found in 60/101 (59%) tumor samples. There was no correlation between intensity of EGFR-IHC and EGFR-GCN (p = 0.43). Patients receiving chemotherapy plus Cetuximab as first line treatment had a RR of 70% (30/43) while it was 18% (10/56) in the group with previous lines of therapy (p < 0.0001). RR was observed in 29/60 (48%) of patients with increased EGFR-GCN and in 6/28 (21%) in those without (p = 0.02). At multivariate analyses, number of chemotherapy lines and increased EGFR-GCN were predictive of response; EGFR-IHC score, increased EGFR-GCN and number of chemotherapy lines were significantly associated with a significant better PFS. Response to therapy was the only prognostic predictive factor for OS. In the 60 patients analyzed for k-ras mutations, number of chemotherapy lines, increased EGFR-GCN and k-ras wild type status predicted a better PFS.</p> <p>Conclusion</p> <p>In metastatic CRC patients treated with chemotherapy plus Cetuximab number of chemotherapy lines and increased EGFR-GCN were significantly associated with a better clinical outcome, independent of k-ras status.</p

Contraception in chronic kidney disease: a best practice position statement by the Kidney and Pregnancy Group of the Italian Society of Nephrology

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Future talk in later life

This article focuses on the relevance that the dimension of the future has for promoting healthy and active aging. Older people generally have difficulties in talking about the future and when they do they generally express very negative perspectives on it. The data analyzed in this paper are part of an on-going interdisciplinary research project: "Aging, poverty and social exclusion: an interdisciplinary study on innovative support services" (https://apseclunl.wordpress.com/). The project aims at documenting good practices in social intervention with older people who are at risk of exclusion. This study describes and critically discusses an activity carried out in Portugal among older women in a poor area in the suburb of Lisbon entitled "self-awareness workshop on the future". Through a detailed discourse analysis within an ethnomethodological framework the study shows age membership categorizations in use and categorization processes, examining the workshop interaction. In particular, the article describes how the psychologist works at deconstructing and problematizing the negative connotations related to age membership categories. Taking into consideration the interactionally constructed nature of aging and the material consequences that different attitudes towards aging can imply is very important in particular in relation to the provision of services to older people

Improving social services for the elderly poor in Portugal

Intervenção social. - ISSN 0874-1611. - N. 37 (1.º semestre 2011). - p. 109-123.A literatura científica sobre o envelhecimento centra-se predominantemente sobre o aumento da população idosa na estrutura demográfica dos países e sobre i impacto dessas transformações na sustentabilidade do sistema de protecção social e de saúde, parecendo desprezar os estudos sobre a pobreza. Este artigo pretende relacionar o envelhecimento com a pobreza em idosos e com os serviços sociais, tendo presente a estratégia europeia de luta contra a pobreza e a sua transposição para o quadro normativo nacional. Nesta linha de análise destacamos a configuração dos serviços sociais em Portugal, tendo em conta o nível central, regional e local, ponderando a sua relevância para a protecção e inclusão social das pessoas idosas. Nestes últimos anos, os serviços sociais de apoio às camadas desfavorecidas da população, sobretudo no caso dos idosos pobres, têm merecido uma atenção particular. Contudo, em muitos países ocidentais, a recente crise económica e financeira tem levado os estados a retraírem o investimento, ponto em causa a qualidade dos serviços sociais. Terminamos com uma reflexão sobre o modo como as políticas públicas podem responder a uma população cada vez mais dependentes dos recursos formais e chamamos a atenção para a necessidade de mais estudos empíricos sobre este tema