Molecular and circuit mechanisms for balancing competing drives are not well understood. While circadian and homeostatic mechanisms generally ensure sufficient sleep at night, other pressing needs can overcome sleep drive. Here, we demonstrate that the balance between sleep and sex drives determines whether male flies sleep or court, and identify a subset of octopaminergic neurons (MS1) that regulate sleep specifically in males. When MS1 neurons are activated, isolated males sleep less, and when MS1 neurons are silenced, the normal male sleep suppression in female presence is attenuated and mating behavior is impaired. MS1 neurons do not express the sexually dimorphic FRUITLESS (FRU) transcription factor, but form male-specific contacts with FRU-expressing neurons; calcium imaging experiments reveal bidirectional functional connectivity between MS1 and FRU neurons. We propose octopaminergic MS1 neurons interact with the FRU network to mediate sleep suppression by male sex drive.DOI: http://dx.doi.org/10.7554/eLife.23130.001

Objective: to identify the perspective of elderly persons on healthy aging as described by scientific literature. Method: a descriptive integrative review type study was performed, guided by the question: what knowledge has been produced about healthy aging from the perspective of the elderly? It was carried out using the Scopus Info Site (SCOPUS), Cumulative Index to Nursing & Allied Health Literature (CINAHL), Medical Literature Analysis and Retrieval System Online (MEDLINE), Literature of Latin America and the Caribbean (LILACS), EMBASE and WEB OF SCIENCE databases and in the directory of the Scientific Electronic Library Online Journals (SciELO), for literature published in the period between 2005 and 2016. Result: Eleven papers were regarded as eligible for this review. These studies revealed that healthy aging is related to different health dimensions: biological (adoption of healthy habits and behaviors with self-responsibility), psychological (feelings of optimism and happiness), spiritual (faith and religiosity) and social (reciprocity in social support factors and the capacity to live autonomously and independently). Conclusion: the synthesis of knowledge on healthy aging from the perspective of the elderly can support the actions of professionals who work with this population group to encourage and value the social determinants involved, so overcoming the exclusive focusing on the adoption of habits and behaviors inherent to lifestyle to achieve aging in a healthy way.

Sleep is an essential and conserved behavior, whose regulation at the molecular and anatomical level remains to be elucidated. Here we identify TARANIS (TARA), a Drosophila homolog of the Trip-Br (SERTAD) family of transcriptional coregulators, as a molecule that is required for normal sleep patterns. Through a forward-genetic screen, we isolated tara as a novel sleep gene associated with a marked reduction in sleep amount. Targeted knockdown of tara suggests that it functions in cholinergic neurons to promote sleep. tara encodes a conserved cell cycle protein that contains a Cyclin A (CycA)-binding homology domain. TARA regulates CycA protein levels and genetically and physically interacts with CycA to promote sleep. Further, decreased levels of Cyclin-dependent kinase 1 (Cdk1), a kinase partner of CycA, rescue the short-sleeping phenotype of tara and CycA mutants, while increased Cdk1 activity mimics the tara and CycA phenotypes, suggesting that Cdk1 mediates the role of TARA and CycA in sleep regulation. Finally, we describe a novel wake-promoting role for a cluster of ~14 CycA-expressing neurons in the pars lateralis (PL), previously proposed to be analogous to the mammalian hypothalamus. We propose that TARANIS controls sleep amount by regulating CycA protein levels and inhibiting Cdk1 activity in a novel arousal center.

Qualidade de Vida Relacionada à Saúde (QVRS) tem sido considerada como importante medida de avaliação do estado de saúde e de predição de mortalidade em idosos. Diversos estudos detectaram fatores associados à QVRS de idosos, mas, poucos deles, até o momento, propuseram-se a analisar as associações entre violência e QVRS dessa população. Objetivos: identificar a prevalência e as características da violência contra idosos não institucionalizados, residentes no Município de São Paulo; comparar idosos expostos e não expostos à violência em relação a dados sociodemográficos, econômicos, de saúde, de funcionalidade familiar, de incapacidade funcional e dos componentes físico e mental da QVRS; verificar se a violência é um fator independente associado aos escores dos componentes físico e mental da QVRS de idosos. Método: esta pesquisa transversal é parte integrante do Estudo SABE (Saúde, Bem-Estar e Envelhecimento). Os dados foram coletados em 2010 e a amostra compôs-se de 1.147 idosos que responderam o Short-Form 12 Health Related Survey (SF-12), instrumento genérico que avalia a QVRS em seus Componentes Físico (CF) e Mental (CM). O CF e o CM do SF-12 foram as variáveis dependentes do estudo. Utilizou-se a regressão linear múltipla, método stepwise backward, para identificação dos fatores associados aos componentes da QVRS. Resultados: a prevalência da violência contra idosos foi de 10,1% (IC 95% 8,4-12), e o tipo mais comum foi a psicológica (9,3%). As variáveis idade e coabitação não diferenciaram significativamente os idosos expostos e não expostos à violência. Sexo feminino, insuficiência de renda, baixa escolaridade, família disfuncional, saúde percebida como ruim, multimorbidade, dor referida, sintomas depressivos, deterioração cognitiva e dificuldades para executar ABVD ou AIVD foram as características presentes em maior proporção no grupo de idosos expostos à violência, quando comparados ao grupo não exposto. Além disso, os idosos expostos à violência, em comparação aos não expostos, alcançaram menores médias nos escores no CF (44,4, DP=10,8 contra 49,1, DP=9,3) e no CM (50,1, DP=12 contra 55,8, DP=7,5) com p<0,001 em ambos os componentes. Na análise múltipla, a violência contra idosos permaneceu significativamente associada ao CM da QVRS (β=-2,69; p<0,001), independente de covariáveis demográficas, econômicas, de saúde, de apoio familiar e de incapacidade funcional. Conclusão: a prevalência da violência contra idosos detectada neste estudo foi elevada; os idosos expostos à violência, em comparação aos não expostos, apresentaram diferenças em relação às suas características demográficas, econômicas, de saúde, de funcionalidade familiar e de incapacidade funcional; e a exposição à violência comprometeu o CM da QVRS dos idosos. Medidas de prevenção e controle desse agravo à saúde devem ser tratadas como prioritárias à população idosa. PALAVRAS-CHAVE: Qualidade de vida. Idoso. Maus-tratos ao idoso.

Sleep is essential but incompatible with other behaviors, and thus sleep drive competes with other motivations. We previously showed Drosophila males balance sleep and courtship via octopaminergic neurons that act upstream of courtship-regulating P1 neurons (Machado et al., 2017). Here we show nutrition modulates the sleep-courtship balance and identify sleep-regulatory neurons downstream of P1 neurons. Yeast-deprived males exhibited attenuated female-induced nighttime sleep loss yet normal daytime courtship, which suggests male flies consider nutritional status in deciding whether the potential benefit of pursuing female partners outweighs the cost of losing sleep. Trans-synaptic tracing and calcium imaging identified dopaminergic neurons projecting to the protocerebral bridge (DA-PB) as postsynaptic partners of P1 neurons. Activation of DA-PB neurons led to reduced sleep in normally fed but not yeast-deprived males. Additional PB-projecting neurons regulated male sleep, suggesting several groups of PB-projecting neurons act downstream of P1 neurons to mediate nutritional modulation of the sleep-courtship balance.

Adolescents with complex chronic illnesses, such as cancer and blood disorders, must partner with family and clinical caregivers to navigate risky procedures with life-altering implications, burdensome symptoms and lifelong treatments. Yet, there has been little investigation into how technology can support these partnerships. We conducted 38 in-depth interviews (15 with teenage adolescents with chronic forms of cancer and blood disorders, 15 with their parents, and eight with clinical caregivers) along with nine non-participant observations of clinical consultations to better understand common challenges and needs that could be supported through design. Participants faced challenges primarily concerning: 1) teens' limited participation in their care, 2) communicating emotionally-sensitive information, and 3) managing physical and emotional responses. We draw on these findings to propose design goals for sociotechnical systems to support teens in partnering in their care, highlighting the need for design to support gradually evolving partnerships in care.

Objective: to understand the experiences and expectations of obese elderly people on the care they received in the primary health care network. Methods: phenomenological study, in which 16 obese elderly people living in a municipality in the state of Minas Gerais, Brazil, were interviewed. Their statements were organized into categories and analyzed according to Alfred Schütz’s social phenomenology and thematic literature. Results: the following categories emerged: “Care neglected to obese elderly people in the primary health care network”, “Group activities as a way to provide primary health care to obese elderly people: a present past”, and “Qualified longitudinal care, centered in the needs of obese elderly people”. Final considerations: offering comprehensive and longitudinal primary health care to obese older people was difficult, and there was instability in the consolidation of public policies, which pointed out the need for effective bonds between different healthcare network services and between professionals and users.

Resumo Objetivou-se identificar a prevalência da violência doméstica contra idosos não institucionalizados e verificar se esta é um fator independente associado aos Componentes Físico (CF) e Mental (CM) da Qualidade de Vida Relacionada à Saúde (QVRS) desses idosos. É um estudo epidemiológico transversal e de base populacional integrante do Estudo SABE (Saúde, Bem-Estar e Envelhecimento). A amostra foi de 1.126 idosos que responderam ao Short-Form 12 Health Related Survey (SF-12), instrumento genérico que avalia a QVRS em seus CF e CM. A prevalência da violência doméstica contra idosos foi de 10% (IC 95% 9,1 - 13,6). Na análise múltipla, a violência contra idosos permaneceu significativamente associada ao CM (β = -3,03; p = 0,000) e ao CF (β = -1,69; p = 0,017) da QVRS, independente de covariáveis sociodemográficas, de saúde, de apoio familiar e de incapacidade funcional. A prevalência da violência doméstica foi elevada e comprometeu a saúde física e mental dos idosos.