Background and purpose
The Movement Disorder Society sponsored version of the Unified Parkinson's Disease Rating Scale (MDS‐UPDRS) is a comprehensive instrument for assessing Parkinson's disease ...(PD). The present study was aimed at determining the relationships between MDS‐UPDRS components and health‐related quality of life (HRQoL) evaluations in PD patients.
Methods
An international, multicenter, cross‐sectional study was carried out of 435 PD patients assessed with the MDS‐UPDRS, Hoehn and Yahr (HY), Clinical Impression Severity for PD, EQ‐5D and PD Questionnaire − eight items (PDQ‐8). Spearman's rank correlation coefficients, exploratory factor analysis and multiple linear regression models (dependent variables EQ‐5D and PDQ‐8) were performed.
Results
The participants’ age was 66.71 ± 10.32 years (51.5% men). PD duration was 8.52 ± 6.14, and median HY was 2 (range 1–5). The correlation between the EQ‐5D index and the MDS‐UPDRS ranged from −0.46 (Part IV) to −0.72 (Part II) and for the PDQ‐8 index from 0.47 (Part III) to 0.74 (Part II). In multiple regression models with the MDS‐UPDRS domains as independent variables, the main determinant for both the EQ‐5D index and the PDQ‐8 was Part II followed by Part I. After factorial grouping of the cardinal PD manifestations embedded in the MDS‐UPDRS Parts III and IV for inclusion into multiple regression models, a factor formed by M‐EDL, nM‐EDL and fluctuations was the main determinant for both the EQ‐5D and PDQ‐8 indexes.
Conclusions
The MDS‐UPDRS component most tightly related with the HRQoL measures was a combination of motor and non‐motor experiences of daily living.
The Global Activity Limitation Indicator (GALI) is an instrument that measures long-term overall disability. The objective of this study was to evaluate GALI's predictive value on mortality while ...examining variations according to sex, age, and educational level.
Longitudinal study.
This longitudinal study was based on 42,991 individuals aged ≥15 years who participated in the 2011–2012 National Health Survey and the 2014 European Health Survey in Spain. These records were linked to mortality data up to December 2021. GALI assessed self-reported functional limitation in the past 6 months and classified individuals into three categories: severely limited, limited but not severely, and not limited. Incidence rate ratios (IRR) were calculated using Poisson regression models, adjusting for sociodemographic, lifestyle, and health status variables.
Compared to individuals with no limitations, those with non-severe limitations had an IRR for mortality of 1.27 (95% CI: 1.16–1.38), and 2.04 (95% CI: 1.81–2.31) in those with severe limitations. Women with severe limitations exhibited a higher IRR (2.32; 95% CI: 1.98–2.71) compared to men (1.73; 95% CI: 1.45–2.08) (P for interaction = 0.005). Individuals <65 years with severe limitations showed a greater association (2.22; 95% CI: 1.58–3.10) than those ≥65 (1.49; 95% CI: 1.32–1.69) (P for interaction <0.001). Among individuals with lower educational attainment, the IRR was 2.08 (95% CI: 1.83–2.37), and 1.87 (95% CI: 1.37–2.56) for the higher education group (P for interaction = 0.017).
GALI is a robust predictor of all-cause mortality in the general population and subgroups. The association is stronger in women, individuals <65 years, and those with lower educational levels.
Despite the biological plausibility of the association between heavy metal exposure and mental health disorders, epidemiological evidence remains scarce. The objective was to estimate the association ...between heavy metals and metalloids in soil and the prevalence of mental disorders in the adult population of Spain.
Individual data came from the Spanish National Health Survey 2011–2012, 18,073 individuals residing in 1772 census sections. Mental health was measured with the 12-item General Health Questionnaire. The concentration estimates of heavy metal and metalloid levels in topsoil (upper soil horizon) came from the Geochemical Atlas of Spain based on 13,317 soil samples. Levels of lead (Pb), arsenic (As), cadmium (Cd) and manganese (Mn) were estimated in each census section by “ordinary Kriging”. Odds ratios (OR) were calculated by multilevel logistic regression models.
Compared with the lowest Pb concentration levels quartile, the OR for the second quartile was 1.29 (95%CI: 1.11–1.50), increasing progressively to 1.37 (95%CI: 1.17–1.60) and 1.51 (95%CI: 1.27–1.79) in the third and fourth quartiles, respectively. For As, the association was observed in the third and fourth quartiles: 1.21 (95%CI: 1.04–1.41) and 1.42 (95% CI: 1.21–1.65), respectively. Cd was associated also following a gradient from the second quartile: 1.34 (95%CI: 1.15–1.57) through the fourth: 1.84 (95%CI: 1.56–2.15). In contrast, Mn only showed a positive association at the second quartile. Additionally, individuals consuming vegetables > once a day the OR for the fourth quartile of Pb concentration, vs. the first, increased to 2.93 (95%CI: 1.97–4.36); similarly for As: 3.00 (95%CI: 2.08–4.31), and for Cd: 3.49 (95%CI: 2.33–5.22).
Living in areas with a higher concentration of heavy metals and metalloids in soil was associated with an increased probability of having a mental disorder. These relationships were strengthened in individuals reporting consuming vegetables > once a day.
•Higher concentration of heavy metals in soil was associated with mental disorders.•We observed a gradient effect for Pb, As, and Cd.•Stronger association was found in people consuming >1 daily serving of vegetables.
•Active ageing is multidimensional: health-participation-lifelong learning-security.•There is no consensus on how to measure the construct and its different components.•Little care is paid to the ...role of active ageing in reducing mortality as people age.•We identified the factor structure of each active ageing domain using principal component analysis.•Promoting the physical health component of active ageing is key to enhance survival.
The World Health Organization’s active ageing model is based on the optimisation of four key “pillars”: health, lifelong learning, participation and security. It provides older people with a policy framework to develop their potential for well-being, which in turn, may facilitate longevity. We sought to assess the effect of active ageing on longer life expectancy by: i) operationalising the WHO active ageing framework, ii) testing the validity of the factors obtained by analysing the relationships between the pillars, and iii) exploring the impact of active ageing on survival through the health pillar.
Based on data from a sample of 801 community-dwelling older adults, we operationalised the active ageing model by taking each pillar as an individual construct using principal component analysis. The interrelationship between components and their association with survival was analysed using multiple regression models.
A three-factor structure was obtained for each pillar, except for lifelong learning with a single component. After adjustment for age, gender and marital status, survival was only significantly associated with the physical component of health (HR = 0.66; 95% CI = 0.47−0.93; p = 0.018). In turn, this component was loaded with representative variables of comorbidity and functionality, cognitive status and lifestyles, and correlated with components of lifelong learning, social activities and institutional support.
According to how the variables clustered into the components and how the components intertwined, results suggest that the variables loading on the biomedical component of the health pillar (e.g. cognitive function, health conditions or pain), may play a part on survival chances.
The assessment of the acquisition of clinical competencies is a critical issue for nursing students. 360-degree evaluations are a widespread practice in professional competency assessment and can be ...applied to the learning/teaching process of future nurses.
To determine the effectiveness of the implementation of a 360-degree evaluation proposal for assessing the competencies acquired by third-year nursing students during their clinical placements.
A mixed-methods design was used with a primary component (a cross-sectional descriptive observational design) and a parallel qualitative component.
Sixty-seven third-year nursing students from a public university in Madrid, Spain, who were undertaking their clinical placements during seven weeks in medical/surgical units in hospital settings.
This study was conducted between September 2017 and May 2018. Quantitative data were obtained using assessment tools specifically developed for this 360-degree evaluation proposal. Qualitative information was collected from two focus groups, one with students and one with teaching staff. A descriptive analysis of the quantitative data was conducted. Qualitative data were studied using a thematic analysis.
The mean scores for each of the items in the 360-degree evaluation were high, with the highest grades being observed in the evaluations made by peers and patients (a mean of 9.1 out of 10.0). On average, the 360-degree evaluation method yielded grades 0.067 percentage points higher than did the previous evaluation method (p ≤ 0.001). Students and teaching staff encountered difficulties in the evaluations made by users/families and other members of the healthcare team (nursing assistants and physicians), although they rated the overall proposal as being very powerful in terms of educational value.
The 360-degree evaluation method is an innovative, motivating, and integrating approach to the acquisition of competencies with a focus on excellence.
•360 Degree Evaluation sets up an integral an integrative students´ traineeship monitoring.•Further than an evaluation proposal, 360 Degree Evaluation constitutes a learning framework itself.•Health team evaluation promotes team-working and collaborative leadership skills.•Peers evaluation encourages students to gain responsibility of their own learning process.•Patient participation in student's evaluation sets the focus on patient centred care philosophy.
Glucagon-like peptide 1 (GLP-1) functions as an incretin hormone with antidiabetogenic properties. However, the role of GLP-1 in human bone marrow-derived mesenchymal stem cells (hMSCs), if any, ...remains unknown. The effects of GLP-1 on hMSCs were tested with regard to cell proliferation, cytoprotection, and cell differentiation into adipocytes. The signaling pathways involved in these processes were also analyzed. Cells were characterized with biochemical and morphological approaches before and after being induced to differentiate into adipocytes. PCNA protein levels were used as a proliferation index, whereas cell apoptosis was studied by deprivation of fetal bovine serum. Isolated hMSCs expressed stem cell markers as well as mRNA and GLP-1 receptor protein. GLP-1 increased the proliferation of hMSCs, which decreased when they were induced to differentiate into adipocytes. This process produced biochemical and morphological changes in cells expressing PPARgamma, C/EBPbeta, AP2, and LPL in a time-dependent pattern. Notably, GLP-1 significantly reduced the expression of PPARgamma, C/EBPbeta, and LPL. These effects were exerted at least through the MEK and PKC signaling pathways. In addition, GLP-1 significantly reduced cell apoptosis. Our data indicate that, in hMSCs, GLP-1 promotes cellular proliferation and cytoprotection and prevents cell differentiation into adipocytes. These latter findings underscore the potential therapeutic role of GLP-1 in preventing the adipocyte hyperplasia associated with obesity and, additionally, could bolster the maintenance of hMSC stores by promoting the proliferation and cytoprotection of undifferentiated hMSC.
The CB1 cannabinoid receptor, the main molecular target of endocannabinoids and cannabis active components, is the most abundant G protein-coupled receptor in the mammalian brain. In particular, the ...CB1 receptor is highly expressed in the basal ganglia, mostly on terminals of medium-sized spiny neurons, where it plays a key neuromodulatory function. The CB1 receptor also confers neuroprotection in various experimental models of striatal damage. However, the assessment of the physiological relevance and therapeutic potential of the CB1 receptor in basal ganglia-related diseases is hampered, at least in part, by the lack of knowledge of the precise mechanism of CB1 receptor neuroprotective activity. Here, by using an array of pharmacological, genetic and pharmacogenetic (designer receptor exclusively activated by designer drug) approaches, we show that (1) CB1 receptor engagement protects striatal cells from excitotoxic death via the phosphatidylinositol 3-kinase/Akt/mammalian target of rapamycin complex 1 pathway, which, in turn, (2) induces brain-derived neurotrophic factor (BDNF) expression through the selective activation of BDNF gene promoter IV, an effect that is mediated by multiple transcription factors. To assess the possible functional impact of the CB1/BDNF axis in a neurodegenerative-disease context in vivo, we conducted experiments in the R6/2 mouse, a well-established model of Huntington's disease, in which the CB1 receptor and BDNF are known to be severely downregulated in the dorsolateral striatum. Adeno-associated viral vector-enforced re-expression of the CB1 receptor in the dorsolateral striatum of R6/2 mice allowed the re-expression of BDNF and the concerted rescue of the neuropathological deficits in these animals. Collectively, these findings unravel a molecular link between CB1 receptor activation and BDNF expression, and support the relevance of the CB1/BDNF axis in promoting striatal neuron survival.
The VETTONIA project aims to disseminate the rich heritage from the Iron Age of the western Iberian Peninsula and the archaeological investigations carried out on this topic in recent years. The ...project utilizes new technologies such as virtual tours, 3D models, and impressions to create interactive and stimulating ways to access the results of the most recent archaeological research. Using these resources, lectures and seminars are being given in various forums with diverse types of audiences to present the virtual tours and the rest of the dissemination initiatives. In addition, the project presents its different initiatives during the annual archaeological interventions developed in the oppidum of Ulaca (Solosancho, Ávila, Spain), with good reception by the attending public. The VETTONIA project represents a pioneering dissemination experience that takes advantage of the educational opportunities offered by new technologies. In the future, tools such as virtual tours to archaeological sites may prove essential in classroom teaching at different levels and could promote sustainable tourism in fragile natural environments such as those that constitute the major settlements of the Late Iron Age (ca. 400–50 BC).
Background
The COVID-19 pandemic, and its consequences in terms of control measures and restrictions to normal life, has affected the population mental health. One of the four case studies from the ...Population Health Information Research Infrastructure (PHIRI) for COVID-19 is focused on mental health with the objective to measure changes in incidence of mental health problems associated with the COVID-19 pandemic in several European countries.
Methods
Using electronic health records (EHR), data on new episodes of depression or anxiety, prescription of antidepressants and anxiolytics, and visits to primary care, specialized care or emergency units with an episode of depression/anxiety, were collected by participant data hubs at national/regional level for the period 2017-2021. A common data model to collect the data was defined for all participating data hubs and analysis of status prior and during the COVID-19 pandemic was performed using R.
Results
Data hubs from Austria, Finland, Spain (Aragon), and United Kingdom (Wales) were able to provide aggregated results from raw individual-level data. Preliminary analysis of trends suggests a decrease in new cases of depression and anxiety in the pandemic period (2020-2021) in comparison with previous years. Different trends were observed between data hubs regarding prescription of drugs and the number of primary/specialized care visits due to depression or anxiety. Issues in the access to data in some of the participating data hubs were observed, related to ethical and legal matters, and the lack of centralized registers and of private consultations statistics.
Conclusions
The results of this use case show that EHR for the secondary use can be retrieved in a common way across Europe to analyse and compare the impact of COVID-19 in population mental health in European countries. However, the process is more complicated and time consuming than expected.
Ketone bodies can replace glucose as the major source of brain energy when glucose becomes scarce. Although it is generally assumed that the liver supplies extrahepatic tissues with ketone bodies, ...recent evidence shows that astrocytes are also ketogenic cells. Moreover, the partitioning of fatty acids between ketogenesis and ceramide synthesis
de novo might control the survival/death decision of neural cells. These findings support the notion that astrocytes might supply neurons with ketone bodies
in situ, and raise the possibility that astrocyte ketogenesis is a cytoprotective pathway.
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