S1 Health literacy and health education in adolescence Catarina Cardoso Tomás S2 The effect of a walking program on the quality of life and well-being of people with schizophrenia Emanuel Oliveira, D. Sousa, M. Uba-Chupel, G. Furtado, C. Rocha, A. Teixeira, P. Ferreira S3 Diagnosis and innovative treatments - the way to a better medical practice Celeste Alves S4 Simulation-based learning and how it is a high contribution Stefan Gisin S5 Formative research about acceptability, utilization and promotion of a home fortification programme with micronutrient powders (MNP) in the Autonomous Region of Príncipe, São Tomé and Príncipe Elisabete Catarino, Nelma Carvalho, Tiago Coucelo, Luís Bonfim, Carina Silva S6 Safety culture of the patient: a reflexion about the therapeutic approach on the patient with vocal pathology Débora Franco S7 About wine, fortune cookies and patient experience Jesús Alcoba González O1 The psychological impact on the emergency crews after the disaster event on February 20, 2010 Helena G. Jardim, Rita Silva O2 Musculoskeletal disorders in midwives Cristina L. Baixinho, Mª Helena Presado, Mª Fátima Marques, Mário E. Cardoso O3 Negative childhood experiences and fears of compassion: Implications for psychological difficulties in adolescence Marina Cunha, Joana Mendes, Ana Xavier, Ana Galhardo, Margarida Couto O4 Optimal age to give the first dose of measles vaccine in Portugal João G. Frade, Carla Nunes, João R. Mesquita, Maria S. Nascimento, Guilherme Gonçalves O5 Functional assessment of elderly in primary care Conceição Castro, Alice Mártires, Mª João Monteiro, Conceição Rainho O6 Smoking and coronary events in a population of Spanish health-care centre: An observational study Francisco P. Caballero, Fatima M. Monago, Jose T. Guerrero, Rocio M. Monago, Africa P. Trigo, Milagros L. Gutierrez, Gemma M. Milanés, Mercedes G. Reina, Ana G. Villanueva, Ana S. Piñero, Isabel R. Aliseda, Francisco B. Ramirez O7 Prevalence of musculoskeletal injuries in Portuguese musicians Andrea Ribeiro, Ana Quelhas, Conceição Manso O8 Hip fractures, psychotropic drug consumption and comorbidity in patients of a primary care practice in Spain Francisco P. Caballero, Jose T. Guerrero, Fatima M. Monago, Rafael B. Santos, Nuria R. Jimenez, Cristina G. Nuñez, Inmaculada R. Gomez, Mª Jose L. Fernandez, Laura A. Marquez, Ana L. Moreno, Mª Jesus Tena Huertas, Francisco B. Ramirez O9 The role of self-criticism and shame in social anxiety in a clinical SAD sample Daniel Seabra, Mª Céu Salvador O10 Obstruction and infiltration: a proposal of a quality indicator Luciene Braga, Pedro Parreira, Anabela Salgueiro-Oliveira, Cristina Arreguy-Sena, Bibiana F. Oliveira, Mª Adriana Henriques O11 Balance and anxiety and depression symptoms in old age people Joana Santos, Sara Lebre, Alda Marques O12 Prevalence of postural changes and risk factors in school children and adolescents in a northern region (Porto) Clarinda Festas, Sandra Rodrigues, Andrea Ribeiro, José Lumini O13 Ischemic stroke vs. haemorrhagic stroke survival rate Ana G. Figueiredo O14 Chronobiological factors as responsible for the appearance of locomotor pathology in adolescents Francisco J. Hernandez-Martinez, Liliana Campi, Mª Pino Quintana-Montesdeoca, Juan F. Jimenez-Diaz, Bienvenida C. Rodriguez-De-Vera O15 Risk of malnutrition in the elderly of Bragança Alexandra Parente, Mª Augusta Mata, Ana Mª Pereira, Adília Fernandes, Manuel Brás O16 A Lifestyle Educational Programme for primary care diabetic patients: the design of a complex nursing intervention Mª Rosário Pinto, Pedro Parreira, Marta L. Basto, Ana C. Rei, Lisete M. Mónico O17 Medication adherence in elderly people Gilberta Sousa, Clementina Morna, Otília Freitas, Gregório Freitas, Ana Jardim, Rita Vasconcelos O18 Hospitalization for cervical cancer of residents in the metropolitan region of Porto Alegre, Southern Brazil, 2012 to 2014 Lina G. Horta, Roger S. Rosa, Luís F. Kranz, Rita C. Nugem, Mariana S. Siqueira, Ronaldo Bordin O19 Oncologic assistance of high complexity: evaluation of regulating accesses Rosiane Kniess, Josimari T. Lacerda O20 Perceived barriers for using health care services by the older population as seen by the social sector: findings from the Vila Nova de Gaia Gerontological Plan Joana Guedes, Idalina Machado, Sidalina Almeida, Adriano Zilhão, Helder Alves, Óscar Ribeiro O21 Sleep difficulties and depressive symptoms in college students Ana P. Amaral, Ana Santos, Joana Monteiro, Mª Clara Rocha, Rui Cruz O22 Psychopathological symptoms and medication use in higher education Ana P. Amaral, Marina Lourenço, Mª Clara Rocha, Rui Cruz O23 Sexually transmitted diseases in higher education institutions Sandra Antunes, Verónica Mendonça, Isabel Andrade, Nádia Osório, Ana Valado, Armando Caseiro, António Gabriel, Anabela C. Martins, Fernando Mendes O24 Alcohol consumption and suicide ideation in higher education students Lídia Cabral, Manuela Ferreira, Amadeu Gonçalves O25 Quality of life in university students Tatiana D. Luz, Leonardo Luz, Raul Martins O26 Male and female adolescent antisocial behaviour: characterizing vulnerabilities in a Portuguese sample Alice Morgado, Maria L. Vale-Dias O27 Risk factors for mental health in higher education students of health sciences Rui Porta-Nova O28 International classification of functioning disability and health as reflexive reasoning in primary attention in health Tânia C. Fleig, Éboni M. Reuter, Miriam B. Froemming, Sabrina L. Guerreiro, Lisiane L. Carvalho O29 Risk factors and cardiovascular disease in Portalegre Daniel Guedelha, P....

Frailty is a syndrome of growing importance given the global ageing population. While frailty is a multifactorial process, poor nutritional status is considered a key contributor to its pathophysiology. As nutrition is a modifiable risk factor for frailty, strategies to prevent and treat frailty should consider dietary change. Observational evidence linking nutrition with frailty appears most robust for dietary quality: for example, dietary patterns such as the Mediterranean diet appear to be protective. In addition, research on specific foods, such as a higher consumption of fruit and vegetables and lower consumption of ultra-processed foods are consistent, with healthier profiles linked to lower frailty risk. Few dietary intervention studies have been conducted to date, although a growing number of trials that combine supplementation with exercise training suggest a multi-domain approach may be more effective. This review is based on an interdisciplinary workshop, held in November 2020, and synthesises current understanding of dietary influences on frailty, focusing on opportunities for prevention and treatment. Longer term prospective studies and well-designed trials are needed to determine the causal effects of nutrition on frailty risk and progression and how dietary change can be used to prevent and/or treat frailty in the future.

Suppressor/Enhancer of Lin-12-like (Sel1L) is an adaptor protein for the E3 ligase hydroxymethylglutaryl reductase degradation protein 1 (Hrd1) involved in endoplasmic reticulum-associated degradation (ERAD). Sel1L’s physiological importance in mammalian ERAD, however, remains to be established. Here, using the inducible Sel1L knockout mouse and cell models, we show that Sel1L is indispensable for Hrd1 stability, ER homeostasis, and survival. Acute loss of Sel1L leads to premature death in adult mice within 3 wk with profound pancreatic atrophy. Contrary to current belief, our data show that mammalian Sel1L is required for Hrd1 stability and ERAD function both in vitro and in vivo. Sel1L deficiency disturbs ER homeostasis, activates ER stress, attenuates translation, and promotes cell death. Serendipitously, using a biochemical approach coupled with mass spectrometry, we found that Sel1L deficiency causes the aggregation of both small and large ribosomal subunits. Thus, Sel1L is an indispensable component of the mammalian Hrd1 ERAD complex and ER homeostasis, which is essential for protein translation, pancreatic function, and cellular and organismal survival. Significance This study provides insights into the physiological role of Sel1L, an adaptor protein for the ubiquitin ligase Hrd1 in endoplasmic reticulum-associated degradation (ERAD). Using both animal and cell models, this study provides unequivocal evidence for an indispensable role of Sel1L in Hrd1 stabilization, mammalian ERAD, endoplasmic reticulum homeostasis, protein translation, and cellular and organismal survival. Moreover, generation of inducible knockout mouse and cell models deficient in both Sel1L and Hrd1 provides an unprecedented opportunity to elucidate the functional importance of this key branch of ERAD in vivo and to identify its physiological substrates.

Background: Lower protein intake in older adults is associated with loss of muscle mass and strength. The present study aimed to provide a pooled estimate of the overall prevalence of protein intake below recommended (according to different cut‐off values) among community‐dwelling older adults, both within the general older population and within specific subgroups.Methods: As part of the PRevention Of Malnutrition In Senior Subjects in the EU (PROMISS) project, a meta‐analysis was performed using data from four cohorts (from the Netherlands, UK, Canada, and USA) and four national surveys [from the Netherlands, Finland (two), and Italy]. Within those studies, data on protein and energy intake of community‐dwelling men and women aged ≥55 years were obtained by either a food frequency questionnaire, 24 h recalls administered on 2 or 3 days, or food diaries administered on 3 days. Protein intake below recommended was based on the recommended dietary allowance of 0.8 g/kg body weight (BW)/d, by using adjusted BW (aBW) instead of actual BW. Cut‐off values of 1.0 and 1.2 were applied in additional analyses. Prevalences were also examined for subgroups according to sex, age, body mass index (BMI), education level, appetite, living status, and recent weight loss.Results: The study sample comprised 8107 older persons. Mean ± standard deviation protein intake ranged from 64.3 ± 22.3 (UK) to 80.6 ± 23.7 g/d [the Netherlands (cohort)] or from 0.94 ± 0.38 (USA) to 1.17z ± 0.30 g/kg aBW/d (Italy) when related to BW. The overall pooled prevalence of protein intake below recommended was 21.5% (95% confidence interval: 14.0–30.1), 46.7% (38.3–55.3), and 70.8% (65.1–76.3) using the 0.8, 1.0, and 1.2 cut‐off value, respectively. A higher prevalence was observed among women, individuals with higher BMI, and individuals with poor appetite. The prevalence differed only marginally by age, education level, living status, and recent weight loss.Conclusions: In community‐dwelling older adults, the prevalence of protein intake below the current recommendation of 0.8 g/kg aBW/d is substantial (14–30%) and increases to 65–76% according to a cut‐off value of 1.2 g/kg aBW/d. To what extent the protein intakes are below the requirements of these older people warrants further investigation.

Low protein intake has been linked to reduced muscle strength and physical performance in older adults but little is known about how it may affect muscle health and subsequent functional decline in the very old (aged 85+), who are at enhanced risk of malnutrition and loss of muscle mass and strength. To investigate the associations between low protein intake, defined as the intake of <1 g protein/kg adjusted body weight/day (<1 g/kg aBW/d) and decline in muscle strength and physical performance in the very old. The analytic sample consisted of 722 community-dwelling participants (60% women) from the Newcastle 85+ Study who had protein intake at baseline. Participants were followed-up for change in grip strength (GS) and Timed Up-and-Go (TUG) test over 5 years (baseline, 18, 36, and 60 months). We used mixed models to determine the effects of low protein intake on muscle strength and physical performance in all participants, and also stratified by sex. At baseline, 390 (54%) participants (261 women, p < 0.001) reported low protein intake, and these differed from participants with good intake (≥1 g/kg aBW/d) on several measures of health and function. In the model adjusted for protein intake, consuming <1 g/kg aBW/d of protein was associated with a 1.62 kg lower GS (p = 0.008) in all participants, and especially in women (β (SE) = -0.83 (0.41), p = 0.05) after adjusting for key baseline covariates (anthropometry, multimorbidity, arthritis in hands, cognitive status and physical activity). The rate of decline in GS over 5 years was not associated with protein intake. Women, but not men, with low protein intake had worse baseline TUG (β (SE) = 0.04 (0.02), p = 0.03) compared with those with good protein intake in the fully adjusted model, but the rate of decline in TUG was not affected by daily protein status. Intake of <1 g protein/kg aBW/d may negatively affect muscle strength and physical performance in late life, especially in older women, independently of important covariates. More research is needed in the very old to define the optimal protein intake for maintenance of muscle health and function.

Sarcopenia, a progressive age-related loss of skeletal muscle mass and strength, leads to disability, falls, and hospitalisation. Individual variation in sarcopenia onset may be partly explained by lifestyle factors such as physical activity and diet. Healthy dietary patterns (DPs) have been linked to better physical functioning in older adults, but their role in sarcopenia in the very old (aged ≥85) is unknown. To investigate the association between DPs and the risk of sarcopenia over 3 years, and to determine whether protein intake influences this relationship in community-dwelling older adults from the Newcastle 85 + Study. The analytic sample consisted of 757 participants (61.2% women) who had dietary assessment at baseline. After two-step clustering with 30 food groups to derive DPs, we used logistic regression to determine the risk of prevalent and incident sarcopenia across DPs in all participants, and in those with low (<1 g/kg adjusted body weight/day [g/kg aBW/d]) and good protein intake (≥1 g/kg aBW/d). We identified three DPs (DP1: 'Low Red Meat', DP2: 'Traditional British' and DP3: 'Low Butter') that varied by unsaturated fat spreads/oils, butter, red meat, gravy and potato consumption. Compared with participants in DP3, those in DP2 had an increased risk of prevalent (OR = 2.42, 95% CI: 1.15-5.09, p = 0.02) but not 3-year incident sarcopenia (OR = 1.67, 0.59-4.67, p = 0.33) adjusted for socio-demographic, anthropometry, health and lifestyle factors. Furthermore, DP2 was associated with an increased risk of prevalent sarcopenia at baseline (OR = 2.14, 1.01-4.53, p = 0.05) and 3-year follow-up (OR = 5.45, 1.81-16.39, p = 0.003) after adjustment for key covariates in participants with good protein intake. A DP high in foods characteristic of a traditional British diet (butter, red meat, gravy and potato) was associated with an increased risk of sarcopenia even when overall protein intake was good. The results need to be replicated in other cohorts of the very old to understand the role of DPs in sarcopenia onset and management.