The prevalence of elder abuse in the Porto Alegre metropolitan area

Abuse of the elderly is a form of violence to come to the public's attention. Dental professionals are in an ideal position to identify physical abuse. The aim of this study was to assess the prevalence of elderly abuse and analyze the database of injury reports that can be identified by dental teams. A documentary analysis study developed by the Elderly Protection Police Station of Porto Alegre, Rio Grande do Sul, was carried out. The information used came from 2,304 complaints filed at the aforementioned institution between the years of 2004 and 2006. The records of abuse are categorized as injury, neglect, mistreatment, theft, financial abuse, threat, disturbing the peace, atypical fact, and others. The injuries that could be identified by the dental team were classified according to the injury's location in the area of the head, face, mouth and neck. Descriptive analysis was performed, and chi-square tests were used to evaluate the distributions of the types of elder abuse in relation to sex and age. The most frequent of the different types of abuse was theft, with a prevalence of 17.8%, followed by disturbing the peace at 11.8%. Disturbing the peace, threat, and bodily injury were significantly associated with women. Elder abuse among women and men declines with age. The prevalence of head injury was 25% of the total injuries, most often in females, and in those aged < 70 years. Based on these results, it is necessary that the dental team observe the elderly person's appearance for suspicious physical signs

Photovoltaic energy: a key player towards a sustainable energy mix

International audienceThe energetic issues are on the top of the political agenda in many countries, for environmental reasons, for its driving role in all the economic sectors, as well as for the energetic independency concerns. This problematic is stressed by the increasing weight of renewable intermittent power sources in the global mix. In particular, due to its high potential and the strong national policy support it beneficiated, solar photovoltaic energy is now a key player in the world energy mutation and the way it is integrated into the global mix should be carefully performed.To deeply understand the way the solar energy can penetrate and transform the forthcoming energy framework, we adopted a three-level strategy to provide some answers to the following questions: i/ how can we situate the photovoltaic power role in future energy mixes?; ii/due to its main drawback, intermittency, could we provide an optimal design of a system combining storage devices?; iii/ what is the efficiency of the incentive policies that are or have been implemented to accelerate its deployment?That is why, in a first part, the peculiar position of the solar photovoltaic energy in the energy mix is analyzed. After recalling the general issue of future global energetic mixes, we propose a brief description of the different photovoltaic technologies and their promising evolutions in terms of technical improvements and cost reductions. Then, we describe the fast growing photovoltaic market and its consequences both on the electricity mix and the industry sector.In the second part we investigate the problematic of integrating such intermittent energy in the electricity mix, by developing a multi-criteria optimization methodology which simulates a system composed of photovoltaic panels and storage devices. Applications on a real case in the Cirque de Mafate (L’île de la Réunion, France) are provided to illustrate the interest of our method.Finally, we question the efficiency of different public supports to the photovoltaic technologies in the most relevant countries. We focus on correlating the installed power capacity with the spent public money and the electricity prices.In these works, we put into relief the necessity to consider energy issues through the prism of technical basis. Indeed, solutions that cannot be efficient should not be implemented in the system. However, a solely technical treatment of energy challenges is obviously insufficient, since energy is core point for the economy, for the citizen and so for the politician. Such a combined approach needs to remain anchored on concrete data close to the reality of the technical devices and keeping in mind the financial feasibility of the proposed solutions, when designing a new energy landscape and thus a new societal model

Pancreatic surgery outcomes: multicentre prospective snapshot study in 67 countries

Background: Pancreatic surgery remains associated with high morbidity rates. Although postoperative mortality appears to have improved with specialization, the outcomes reported in the literature reflect the activity of highly specialized centres. The aim of this study was to evaluate the outcomes following pancreatic surgery worldwide.Methods: This was an international, prospective, multicentre, cross-sectional snapshot study of consecutive patients undergoing pancreatic operations worldwide in a 3-month interval in 2021. The primary outcome was postoperative mortality within 90 days of surgery. Multivariable logistic regression was used to explore relationships with Human Development Index (HDI) and other parameters.Results: A total of 4223 patients from 67 countries were analysed. A complication of any severity was detected in 68.7 percent of patients (2901 of 4223). Major complication rates (Clavien-Dindo grade at least IIIa) were 24, 18, and 27 percent, and mortality rates were 10, 5, and 5 per cent in low-to-middle-, high-, and very high-HDI countries respectively. The 90-day postoperative mortality rate was 5.4 per cent (229 of 4223) overall, but was significantly higher in the low-to-middle-HDI group (adjusted OR 2.88, 95 per cent c.i. 1.80 to 4.48). The overall failure-to-rescue rate was 21 percent; however, it was 41 per cent in low-to-middle-compared with 19 per cent in very high-HDI countries.Conclusion: Excess mortality in low-to-middle-HDI countries could be attributable to failure to rescue of patients from severe complications. The authors call for a collaborative response from international and regional associations of pancreatic surgeons to address management related to death from postoperative complications to tackle the global disparities in the outcomes of pancreatic surgery (NCT04652271; ISRCTN95140761)