A inovação social nas políticas públicas de proximidade

Este trabalho aborda a inovação social ao nível das iniciativas desenvolvidas pelas Juntas de Freguesia. A inovação social procura encontrar soluções para as necessidades/problemas sociais que, não sendo asseguradas pelo Estado (Governo Central), nem pelo mercado, podem ser implementadas via políticas públicas de proximidade de uma autarquia (Câmara Municipal ou Junta de Freguesia). Com a presente investigação pretende-se, por um lado, conhecer os principais problemas que são colocados às Juntas de Freguesia na sua relação de proximidade com a população, e por outro, descrever e analisar alguns projetos desenvolvidos e os seus impactos na população alvo. Os resultados do estudo mostram que a sensibilidade social dos autarcas é uma condição determinante para o desenvolvimento de projetos sociais. A análise custobenefício simples permite concluir que os projetos sociais desenvolvidos recolhem da população uma apreciação bastante favorável, atendendo quer à importância que lhe atribuem, quer à predisposição para comparticipação; Social Innovation in the Local Public Policies ABSTRACT: This study is concerned with social innovation at the level of the initiatives developed by four town councils [translation of “Juntas de Freguesia”], and it aims to present a global vision on the initiatives of social nature developed by these town councils. The choice of this theme of social innovation is justified by: i) the interest in the new attributions and competences of the Town Councils and their increasing intervention in the social area and ii) to the need to know the process of intervention in the local community. The results of the study point out the social sensitivity of the local authorities as a determining condition for the development of social projects with effective impacts to the real needs and expectations of the population. Through the simple cost-benefit analysis we observe that the developed social projects collect from the population a very favorable appreciation considering both the importance they attribute to it and the predisposition that they demonstrate to share the costs

Nutritional status and structural brain changes in Alzheimer's disease: The NUDAD project

INTRODUCTION: Weight loss is associated with higher mortality and progression of cognitive decline, but its associations with magnetic resonance imaging (MRI) changes related to Alzheimer's disease (AD) are unknown. METHODS: We included 412 patients from the NUDAD project, comprising 129 with AD dementia, 107 with mild cognitive impairment (MCI), and 176 controls. Associations between nutritional status and MRI measures were analyzed using linear regression, adjusted for age, sex, education, cognitive functioning, and cardiovascular risk factors. RESULTS: Lower body mass index (BMI), fat mass (FM), and fat free mass index were associated with higher medial temporal atrophy (MTA) scores. Lower BMI, FM, and waist circumference were associated with more microbleeds. Stratification by diagnosis showed that the observed associations with microbleeds were only significant in MCI. DISCUSSION: Lower indicators of nutritional status were associated with more MTA and microbleeds, with largest effect sizes in MCI

The prevalence of malnutrition according to the new ESPEN definition in four diverse populations

© 2015 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism.Background & aims: Consensus on the definition of malnutrition has not yet been reached. Recently, The European Society for Clinical Nutrition and Metabolism (ESPEN) proposed a consensus definition of malnutrition. The aim of the present study was to describe the prevalence of malnutrition according to the ESPEN definition in four diverse populations. Methods: In total, 349 acutely ill middle-aged patients, 135 geriatric outpatients, 306 healthy old individuals and 179 healthy young individuals were included in the study. Subjects were screened for risk of malnutrition using the SNAQ. The ESPEN definition of malnutrition, i.e. low BMI (< 18.5 kg/m2) or a combination of unintentional weight loss and low FFMI or low BMI was applied to all subjects. Results: Screening identified 0, 0.5, 10 and 30% of the healthy young, the healthy old, the geriatric outpatients and the acutely ill middle-aged patients as being at risk of malnutrition. The prevalence of malnutrition ranged from 0% in the healthy young, 0.5% in healthy old individuals, 6% in the geriatric outpatients to 14% in the acutely ill middle-aged patients. Prevalence of low FFMI was observed in all four populations (14-33%), but concurred less frequently with weight loss (0-13%). Conclusions: Using the ESPEN definition, 0%-14% malnutrition was found in the diverse populations. Further work is needed to fully address the validity of a two-step approach, including risk assessment as an initial step in screening and defining malnutrition. Furthermore, assessing the predictive validity of the ESPEN definition is needed

Consensus over de criteria voor diagnose van ondervoeding en sarcopenie

Dit najaar zijn de langverwachte nieuwe consensuscriteria voor het vaststellen van ondervoeding en sarcopenie gepresenteerd. Het gaat om de internationale criteria voor de diagnose van ondervoeding en de herziene Europese consensus over de sarcopenie-definitie en de criteria voor diagnose. Beide worden internationaal gedragen en zullen wereldwijd worden aanbevolen als de nieuwe standaar

Is being malnourished according to the ESPEN definition for malnutrition associated with clinically relevant outcome measures in geriatric outpatients?

10.1007/S41999-018-0057-zEUROPEAN GERIATRIC MEDICINE93389-39