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1.
Proc Natl Acad Sci U S A ; 120(3): e2216024120, 2023 01 17.
Artículo en Inglés | MEDLINE | ID: mdl-36623188

RESUMEN

Seagrasses provide multiple ecosystem services and act as intense carbon sinks in coastal regions around the globe but are threatened by multiple anthropogenic pressures, leading to enhanced seagrass mortality that reflects in the spatial self-organization of the meadows. Spontaneous spatial vegetation patterns appear in such different ecosystems as drylands, peatlands, salt marshes, or seagrass meadows, and the mechanisms behind this phenomenon are still an open question in many cases. Here, we report on the formation of vegetation traveling pulses creating complex spatiotemporal patterns and rings in Mediterranean seagrass meadows. We show that these structures emerge due to an excitable behavior resulting from the coupled dynamics of vegetation and porewater hydrogen sulfide, toxic to seagrass, in the sediment. The resulting spatiotemporal patterns resemble those formed in other physical, chemical, and biological excitable media, but on a much larger scale. Based on theory, we derive a model that reproduces the observed seascapes and predicts the annihilation of these circular structures as they collide, a distinctive feature of excitable pulses. We show also that the patterns in field images and the empirically resolved radial profiles of vegetation density and sediment sulfide concentration across the structures are consistent with predictions from the theoretical model, which shows these structures to have diagnostic value, acting as a harbinger of the terminal state of the seagrass meadows prior to their collapse.


Asunto(s)
Ecosistema , Modelos Teóricos , Humedales , Secuestro de Carbono , Sulfuros
2.
Glob Chang Biol ; 30(4): e17249, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38572713

RESUMEN

Warming as well as species introductions have increased over the past centuries, however a link between cause and effect of these two phenomena is still unclear. Here we use distribution records (1813-2023) to reconstruct the invasion histories of marine non-native macrophytes, macroalgae and seagrasses, in the Mediterranean Sea. We defined expansion as the maximum linear rate of spread (km year-1) and the accumulation of occupied grid cells (50 km2) over time and analyzed the relation between expansion rates and the species' thermal conditions at its native distribution range. Our database revealed a marked increase in the introductions and spread rates of non-native macrophytes in the Mediterranean Sea since the 1960s, notably intensifying after the 1990s. During the beginning of this century species velocity of invasion has increased to 26 ± 9 km2 year-1, with an acceleration in the velocity of invasion of tropical/subtropical species, exceeding those of temperate and cosmopolitan macrophytes. The highest spread rates since then were observed in macrophytes coming from native regions with minimum SSTs two to three degrees warmer than in the Mediterranean Sea. In addition, most non-native macrophytes in the Mediterranean (>80%) do not exceed the maximum temperature of their range of origin, whereas approximately half of the species are exposed to lower minimum SST in the Mediterranean than in their native range. This indicates that tropical/subtropical macrophytes might be able to expand as they are not limited by the colder Mediterranean SST due to the plasticity of their lower thermal limit. These results suggest that future warming will increase the thermal habitat available for thermophilic species in the Mediterranean Sea and continue to favor their expansion.


Asunto(s)
Especies Introducidas , Algas Marinas , Mar Mediterráneo , Ecosistema , Temperatura
3.
Glob Chang Biol ; 27(11): 2592-2607, 2021 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-33843114

RESUMEN

The introduction and establishment of exotic species often result in significant changes in recipient communities and their associated ecosystem services. However, usually the magnitude and direction of the changes are difficult to quantify because there is no pre-introduction data. Specifically, little is known about the effect of marine exotic macrophytes on organic carbon sequestration and storage. Here, we combine dating sediment cores (210 Pb) with sediment eDNA fingerprinting to reconstruct the chronology of pre- and post-arrival of the Red Sea seagrass Halophila stipulacea spreading into the Eastern Mediterranean native seagrass meadows. We then compare sediment organic carbon storage and burial rates before and after the arrival of H. stipulacea and between exotic (H. stipulacea) and native (C. nodosa and P. oceanica) meadows since the time of arrival following a Before-After-Control-Impact (BACI) approach. This analysis revealed that H. stipulacea arrived at the areas of study in Limassol (Cyprus) and West Crete (Greece) in the 1930s and 1970s, respectively. Average sediment organic carbon after the arrival of H. stipulacea to the sites increased in the exotic meadows twofold, from 8.4 ± 2.5 g Corg  m-2  year-1 to 14.7 ± 3.6 g Corg  m-2  year-1 , and, since then, burial rates in the exotic seagrass meadows were higher than in native ones of Cymodocea nodosa and Posidonia oceanica. Carbon isotopic data indicated a 50% increase of the seagrass contribution to the total sediment Corg pool since the arrival of H. stipulacea. Our results demonstrate that the invasion of H. stipulacea may play an important role in maintaining the blue carbon sink capacity in the future warmer Mediterranean Sea, by developing new carbon sinks in bare sediments and colonizing areas previously occupied by the colder thermal affinity P. oceanica.


Asunto(s)
Alismatales , Hydrocharitaceae , Carbono/análisis , Secuestro de Carbono , Ecosistema , Sedimentos Geológicos , Océano Índico , Mar Mediterráneo
4.
Aging Ment Health ; 25(1): 149-159, 2021 01.
Artículo en Inglés | MEDLINE | ID: mdl-31684754

RESUMEN

BACKGROUND: The Meeting Centres Support Programme (MCSP) offers a combined approach to providing practical, emotional and social support to people living with mild to moderately severe dementia and their family carers in the community. METHODS: A mixed methods explanatory design was used. The evaluation took place within the framework of the international Joint Programme - Neurodegenerative Disease Research (JPND) - MEETINGDEM study in nine Meeting Centres in Italy, Poland and the United Kingdom. Eighty-seven people with dementia and 81 family carers completed a user evaluation survey after three months and 83 people with dementia and 84 carers after 6 months of participation in MCSP. Thirty-two people with dementia and 30 carers took part in focus groups after nine months. RESULTS: The percentage of people with dementia who were very satisfied with the programme increased significantly over time (p = 0.05). The majority of carers reported that they felt less burdened after three months of participation in MCSP (48.1% much less; 35.4% a little less). After six months, this percentage increased significantly to 91% (p = 0.04, 57.7% much less; 33.3% little less). Focus group analysis showed that people with dementia and carers in all countries/centres improved their ability to maintain emotional balance. CONCLUSIONS: The MCSP is highly appreciated by people with dementia and carers in all countries and it confirms the results of previous research into MCSP in the Netherlands. Our findings indicate that MCSP is a model that can help its users to increase their capacity to deal with the challenges caused by dementia and can promote emotional balance.


Asunto(s)
Demencia , Enfermedades Neurodegenerativas , Cuidadores , Europa (Continente) , Humanos , Italia , Países Bajos , Polonia , Calidad de Vida , Apoyo Social , Reino Unido
5.
Proc Biol Sci ; 287(1922): 20193001, 2020 03 11.
Artículo en Inglés | MEDLINE | ID: mdl-32156215

RESUMEN

Exotic species often face new environmental conditions that are different from those that they are adapted to. The tropical seagrass Halophila stipulacea is a Lessepsian migrant that colonized the Mediterranean Sea around 100 years ago, where at present the minimum seawater temperature is cooler than in its native range in the Red Sea. Here, we tested if the temperature range in which H. stipulacea can exist is conserved within the species or if the exotic populations have shifted their thermal breadth and optimum due to the cooler conditions in the Mediterranean. We did so by comparing the thermal niche (e.g. optimal temperatures, and upper and lower thermal limits) of native (Saudi Arabia in the Red Sea) and exotic (Greece and Cyprus in the Mediterranean Sea) populations of H. stipulacea. We exposed plants to 12 temperature treatments ranging from 8 to 40°C for 7 days. At the end of the incubation period, we measured survival, rhizome elongation, shoot recruitment, net population growth and metabolic rates. Upper and lower lethal thermal thresholds (indicated by 50% plant mortality) were conserved across populations, but minimum and optimal temperatures for growth and oxygen production were lower for Mediterranean populations than for the Red Sea one. The displacement of the thermal niche of exotic populations towards the colder Mediterranean Sea regime could have occurred within 175 clonal generations.


Asunto(s)
Hydrocharitaceae/fisiología , Termotolerancia/fisiología , Especies Introducidas , Mar Mediterráneo , Rizoma , Agua de Mar , Temperatura
6.
BMC Med Educ ; 20(1): 16, 2020 Jan 15.
Artículo en Inglés | MEDLINE | ID: mdl-31941481

RESUMEN

BACKGROUND: Patient-centredness is considered a core competency for health professionals. To support faculty in designing courses focused on patient-centredness, an understanding of how educational interventions lead to patient-centredness is required. This study aims to show how learning mechanisms, which potentially contribute to patient-centredness, are triggered. METHODS: Thirty-five third-year medical students at the UMC Utrecht followed four different patients for two years. The intervention took place in an out-of-hospital setting. Students visited patients in their home circumstances and accompanied them to clinical events. Twelve students were interviewed. The realist approach was used to construct configurations which relate components of the intervention to the context and learning mechanisms. RESULTS: Following patients in their home circumstances for a prolonged period supported the development of meaningful relationships between students and patients and provided continuity. In the context of a meaningful relationship and continuity, mechanisms contributing to learning patient-centredness were triggered. The most important learning mechanisms found in this study were: reflecting, contextualising disease in a real persons' life, broadening perspectives and engaging with the patients. CONCLUSIONS: Learning mechanisms are triggered by continuity and by meaningful student-patient relationships. These can be enhanced by an out-of-hospital setting and longitudinal contact. Thus, a relationship between students and patients is an important enabler for the development of patient-centredness.


Asunto(s)
Prácticas Clínicas/métodos , Continuidad de la Atención al Paciente , Relaciones Interpersonales , Atención Dirigida al Paciente/métodos , Estudiantes de Medicina , Estudios de Seguimiento , Humanos , Aprendizaje , Atención Dirigida al Paciente/organización & administración , Proyectos Piloto , Evaluación de Programas y Proyectos de Salud , Investigación Cualitativa
7.
Int Psychogeriatr ; 31(3): 351-362, 2019 03.
Artículo en Inglés | MEDLINE | ID: mdl-30017013

RESUMEN

ABSTRACTBackground:Previous research shows that museum programs can be beneficial for the quality of life of people with dementia. This study evaluated the implementation of "Unforgettable," an interactive museum program for people with dementia and their caregivers in the Netherlands, and investigated the impact of the program's implementation on the museums as an organization and on the attitudes toward dementia of the museum staff. METHOD: Semi-structured interviews were held with 23 stakeholders to identify facilitators and barriers to the implementation of the Unforgettable program in 12 Dutch museums. Based on the model of Meiland et al. (2004), an overview is made of factors influencing the different levels and phases of the implementation process. The impact of Unforgettable on the attitudes of the museum staff was assessed using the Approaches to Dementia Questionnaire (n = 176). RESULTS: The training in the Unforgettable method, regular evaluation with the program guides and hosts, and cooperation with other organizations appeared essential for successful implementation of Unforgettable. A lack of promotional activities was an impeding factor. Compared to before the implementation, the museum employees' attitudes toward people with dementia became more positive. CONCLUSION: Both successful dissemination of the Unforgettable program and the more positive attitudes toward dementia of employees in museums implementing this program can contribute to the social participation of people with dementia and thereby to their quality of life.


Asunto(s)
Arteterapia , Cuidadores/psicología , Demencia/terapia , Museos , Calidad de Vida/psicología , Anciano , Demencia/psicología , Humanos , Entrevistas como Asunto , Masculino , Países Bajos , Evaluación de Resultado en la Atención de Salud , Evaluación de Programas y Proyectos de Salud
8.
Int J Geriatr Psychiatry ; 33(7): 883-892, 2018 07.
Artículo en Inglés | MEDLINE | ID: mdl-29513909

RESUMEN

OBJECTIVES: MEETINGDEM investigated whether the Dutch Meeting Centres Support Programme (MCSP) could be implemented in Italy, Poland, and the UK with comparable benefits. This paper reports on the impact on people living with dementia attending pilot Meeting Centres in the 3 countries. METHODS: Nine pilot Meeting Centres (MCs) participated (Italy-5, Poland-2, UK-2). Effectiveness of MCSP was compared with Usual Care (UC) on outcomes measuring behavioural and psychological symptoms (NPI), depression (CSDD), and quality of life (DQoL, QOL-AD), analysed by ANCOVAs in a 6-month pre-test/post-test controlled trial. RESULTS: Pre/post data were collected for 85 people with dementia and 93 carers (MCSP) and 74 people with dementia /carer dyads' receiving UC. MCSP showed significant positive effects for DQoL [Self-esteem (F = 4.8, P = 0.03); Positive Affect (F = 14.93, P < 0.00); Feelings of Belonging (F = 7.77, P = 0.01)] with medium and large effect sizes. Higher attendance levels correlated with greater neuropsychiatric symptom reduction (rho = 0.24, P = 0.03) and a greater increase in feelings of support (rho = 0.36, P = 0.001). CONCLUSIONS: MCSPs showed significant wellbeing and health benefits compared with UC, building on the evidence of effectiveness from the Netherlands. In addition to the previously reported successful implementation of MCSP in Italy, Poland, and the UK, these findings suggest that further international dissemination of MCSP is recommended.


Asunto(s)
Centros Comunitarios de Salud/organización & administración , Demencia/terapia , Trastornos Mentales/epidemiología , Anciano , Anciano de 80 o más Años , Demencia/psicología , Trastorno Depresivo/epidemiología , Femenino , Humanos , Italia/epidemiología , Masculino , Persona de Mediana Edad , Polonia/epidemiología , Calidad de Vida , Reino Unido/epidemiología
9.
Int Psychogeriatr ; 28(9): 1455-70, 2016 09.
Artículo en Inglés | MEDLINE | ID: mdl-27140909

RESUMEN

BACKGROUND: The aim of this study is to develop and try out an approach for personalized nature activities for people with dementia. METHODS: A qualitative descriptive study using focus group interviews with people with dementia was conducted. Based on the results of the focus groups and the relevant literature, the approach was developed. In a qualitative descriptive pilot study with a one-group design, we tried out the approach regarding acceptability and experience of the intervention among people with dementia, and satisfaction with the approach among healthcare professionals. Additionally, we investigated the organizational feasibility. RESULTS: From the focus groups, eight key aspects of experiencing nature were identified as being important for quality of life (e.g. relaxation, freedom), as well as six categories of preferred activities (e.g. active, passive, and social activities). Based on these themes and categories, an approach was developed to design nature activities according to the personal wishes, needs, and experiences of people with dementia. During the intervention, participants in the pilot study showed high levels of positive behaviors and low levels of negative behaviors. As regards, organizational feasibility, eight themes for successful implementation of nature activities were identified. CONCLUSIONS: This exploratory study contributes to the knowledge regarding the development and implementation of person-centered nature activities for people with dementia. The implementation of the activities could be improved by training professionals in person-centered care. The effect of the person-centered nature activities approach should be investigated.


Asunto(s)
Demencia/enfermería , Familia/psicología , Personal de Salud/educación , Aceptación de la Atención de Salud , Atención Dirigida al Paciente/normas , Calidad de Vida , Anciano , Anciano de 80 o más Años , Estudios de Factibilidad , Grupos Focales , Humanos , Entrevistas como Asunto , Persona de Mediana Edad , Educación del Paciente como Asunto , Investigación Cualitativa
10.
Adv Mar Biol ; 71: 109-60, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-26320617

RESUMEN

The pen shell Pinna nobilis (also known as the fan mussel) is an endemic bivalve of the Mediterranean Sea. Threatened by human activities, it has been listed as an endangered and protected species under the European Council Directive 92/43/EEC since 1992. The ecological role of this species is of importance because it filters and retains large amounts of organic matter from suspended detritus contributing to water clarity. In addition, as a hard substrate in the soft-bottom seafloor, it provides a surface that can be colonized by other (floral and faunal) benthic species. Here, we provide an overview of all available published studies on the pen shell, compiling available data and summarizing current knowledge on the conservation status and viability of populations over the full range of the Mediterranean Basin. Additionally, we discuss the different practices in applied methodology and identify gaps and new research areas in order to render conservation programmes of the species more effective.


Asunto(s)
Conservación de los Recursos Naturales , Moluscos/fisiología , Animales , Mar Mediterráneo , Especificidad de la Especie
11.
Acta Derm Venereol ; 95(2): 211-6, 2015 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-24806592

RESUMEN

Genital psoriasis is a neglected manifestation of psoriasis, although it affects numerous patients and has major effects on sexual quality of life (SQoL). We aimed to assess the value of specialised care for patients with genital psoriasis. Patients were treated for at least one year at a specialised research outpatient clinic with extensive attention for genital lesions and SQoL. The genital lesions were treated according to a stepwise algorithm. First follow-up was planned after 6 weeks; subsequent follow-up visits were scheduled every 3 months. At every visit, psoriasis severity and SQoL were measured with validated tools. Differences in scores between visits were analysed by a mixed model for repeated measures. Forty-two patients were included (M:F = 25:17). All objective and subjective genital psoriasis severity and QoL parameters improved significantly within the first follow-up period of approximately 6 weeks. In female patients, SQoL also significantly improved. In conclusion, genital psoriasis can relatively easy be treated within limited time exposure, resulting in significant improvement of QoL. Prompt and simple adjustments in the provided care are enough to accomplish this.


Asunto(s)
Fármacos Dermatológicos/administración & dosificación , Enfermedades de los Genitales Femeninos/tratamiento farmacológico , Enfermedades de los Genitales Masculinos/tratamiento farmacológico , Psoriasis/tratamiento farmacológico , Corticoesteroides/administración & dosificación , Algoritmos , Inhibidores de la Calcineurina/administración & dosificación , Estudios de Cohortes , Vías Clínicas , Esquema de Medicación , Quimioterapia Combinada , Femenino , Enfermedades de los Genitales Femeninos/diagnóstico , Enfermedades de los Genitales Femeninos/psicología , Enfermedades de los Genitales Masculinos/diagnóstico , Enfermedades de los Genitales Masculinos/psicología , Humanos , Masculino , Persona de Mediana Edad , Países Bajos , Servicio Ambulatorio en Hospital , Psoriasis/diagnóstico , Psoriasis/psicología , Calidad de Vida , Índice de Severidad de la Enfermedad , Conducta Sexual , Encuestas y Cuestionarios , Factores de Tiempo , Resultado del Tratamiento , Vitamina D/administración & dosificación , Vitamina D/análogos & derivados
12.
Sci Total Environ ; 942: 173805, 2024 Sep 10.
Artículo en Inglés | MEDLINE | ID: mdl-38848917

RESUMEN

BACKGROUND: Seagrass meadows are among the most abundant marine coastal ecosystems in the world. The wide variety of species, a worldwide distribution with overall high abundance, and especially their high productivity make them a plausible nature-based blue carbon solution to mitigate atmospheric CO2 levels. In the Mediterranean Basin, the endemic angiosperm Posidonia oceanica plays a remarkable role as a marine habitat provider in shallow waters through its vertical growth and as a carbon sink storing allochthonous carbon and biomass underneath the meadows. OBJECTIVES: Here, we assess the capacity of a pristine meadow to oxygenate the water column in the coastal area of the Balearic Islands through an evaluation of the metabolic rates in the benthic compartment as well as the resulting oxygen concentrations in the pelagic compartment. METHODS: Gross primary production (GPP), respiration (R), and net community production (NCP) are determined from dissolved oxygen (DO) measurements using two different calculation methods: a model developed for this purpose is used for data obtained from water column sensors and benthic multiparametric sensors, whereas the mass balance of measured DO is used to calculate the metabolic rates inside benthic chambers. RESULTS: The meadow at our study site was characterised as a net autotrophic ecosystem throughout the year. Oxygen productivity was significantly higher in the benthic compartment than in the water column and followed clear seasonal patterns, with enhanced productivity during spring. NOVELTY: This work shows the key role of a healthy Posidonia oceanica ecosystem as a water column oxygenator by comparing primary production using three different sampling strategies. The potential of the seagrass as climate change mitigator and its importance for the Mediterranean coasts should be considered in future coastal planning strategies.


Asunto(s)
Alismatales , Oxígeno , Oxígeno/análisis , Oxígeno/metabolismo , Ecosistema , España , Monitoreo del Ambiente , Biomasa , Agua de Mar/química
13.
Sci Total Environ ; 865: 161249, 2023 Mar 20.
Artículo en Inglés | MEDLINE | ID: mdl-36587676

RESUMEN

Methane (CH4) gas is the most important GHG after carbon dioxide, with open ocean areas acting as discreet CH4 sources and coastal regions as intense but variable CH4 sources to the atmosphere. Here, we report CH4 concentrations and air-sea fluxes in the coastal area of the Balearic Islands Archipelago (Western Mediterranean Basin). CH4 levels and related biogeochemical variables were measured in three coastal sampling sites between 2018 and 2021, with two located close to the densely populated island of Mallorca and one in a pristine area in the Cabrera Archipelago National Park. CH4 concentrations in seawater during the study period ranged from 2.7 to 10.9 nM, without significant differences between the sampling sites. Averaged estimated CH4 fluxes during the sampling period for the three stations oscillated between 0.2 and 9.7 µmol m-2 d-1 according to a seasonal pattern and in general all sites behaved as weak CH4 sources throughout the sampling period.

14.
Ambio ; 41(1): 44-55, 2012 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-22270704

RESUMEN

The Arctic marine ecosystem contains multiple elements that present alternative states. The most obvious of which is an Arctic Ocean largely covered by an ice sheet in summer versus one largely devoid of such cover. Ecosystems under pressure typically shift between such alternative states in an abrupt, rather than smooth manner, with the level of forcing required for shifting this status termed threshold or tipping point. Loss of Arctic ice due to anthropogenic climate change is accelerating, with the extent of Arctic sea ice displaying increased variance at present, a leading indicator of the proximity of a possible tipping point. Reduced ice extent is expected, in turn, to trigger a number of additional tipping elements, physical, chemical, and biological, in motion, with potentially large impacts on the Arctic marine ecosystem.


Asunto(s)
Cambio Climático , Ecosistema , Cubierta de Hielo , Regiones Árticas , Conservación de los Recursos Naturales , Monitoreo del Ambiente , Biología Marina , Modelos Teóricos , Océanos y Mares , Plancton/crecimiento & desarrollo , Estaciones del Año
15.
Sci Rep ; 12(1): 12956, 2022 07 28.
Artículo en Inglés | MEDLINE | ID: mdl-35902664

RESUMEN

The decreasing seawater pH trend associated with increasing atmospheric carbon dioxide levels is an issue of concern due to possible negative consequences for marine organisms, especially calcifiers. Globally, coastal areas represent important transitional land-ocean zones with complex interactions between biological, physical and chemical processes. Here, we evaluated the pH variability at two sites in the coastal area of the Balearic Sea (Western Mediterranean). High resolution pH data along with temperature, salinity, and also dissolved oxygen were obtained with autonomous sensors from 2018 to 2021 in order to determine the temporal pH variability and the principal drivers involved. By using environmental datasets of temperature, salinity and dissolved oxygen, Recurrent Neural Networks were trained to predict pH and fill data gaps. Longer environmental time series (2012-2021) were used to obtain the pH trend using reconstructed data. The best predictions show a rate of [Formula: see text] pH units year[Formula: see text], which is in good agreement with other observations of pH rates in coastal areas. The methodology presented here opens the possibility to obtain pH trends when only limited pH observations are available, if other variables are accessible. Potentially, this could be a way to reliably fill the unavoidable gaps present in time series data provided by sensors.


Asunto(s)
Oxígeno , Agua de Mar , Concentración de Iones de Hidrógeno , Aprendizaje Automático , Estaciones del Año , Agua de Mar/química
16.
Am J Alzheimers Dis Other Demen ; 36: 15333175211033721, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34424058

RESUMEN

Measuring Quality of Life (QOL) can be difficult due to its individual character. To explore the value of personalized QOL measurement for people with dementia, personalized versions of two dementia-specific QOL scales (Dementia quality of Life (DQoL) and Quaility of Life in Alzheimer's Disease (QoL-AD)) were constructed. This study investigated whether the personalized measures are more valid to detect variations in QOL than their standard versions for people with mild to moderate dementia, with sufficient internal consistency. Moreover, the relationship between the personalized QOL measures and severity of dementia was investigated. Finally, the study explored the differences between countries regarding the personalized overall QOL and differences in the importance of QOL domains. This explorative one-group design study used baseline data from the MEETINGDEM study into the implementation of the Meeting Centres Support Programme in Italy, Poland and the UK. The personalized versions of the DQoL and QoL-AD were reliable, but not more valid than their standard versions. No relationship between severity of dementia and personalized QOL was found. While no differences were found between countries for the overall QOL score, some QOL domains were valued differently: people with dementia from the UK rated self-esteem, mood, physical health, energy level and the ability to do chores around the house significantly less important than people from Italy and Poland. The personalized versions of the DQoL and QoL-AD may offer dementia care practice important insights into what domains contribute most to an individual's QOL.


Asunto(s)
Enfermedad de Alzheimer , Calidad de Vida , Cuidadores , Humanos , Italia , Polonia , Autoimagen
17.
J Cataract Refract Surg ; 46(1): 72-77, 2020 01.
Artículo en Inglés | MEDLINE | ID: mdl-32050235

RESUMEN

PURPOSE: To investigate the effect of 3 regimes on pain and wound healing after corneal crosslinking (CXL). SETTING: Tertiary academic referral center, Utrecht, the Netherlands. DESIGN: Prospective cohort study. METHODS: Consecutive progressive keratoconus patients who underwent 9 mW/cm epithelium-off CXL were included. Patients received a bandage contact lens (n = 20), occlusive patch (n = 20), or antibiotic ointment (n = 20) after treatment. Pain scores and quality of life, measured by the McGill Pain Questionnaire and Visual Analogue Scale (VAS), were analyzed. Epithelial healing after 2 days, correlations between pain and psychological factors that influence pain perception (depression anxiety stress score and pain catastrophizing score), and oral pain medication were evaluated. RESULTS: Sixty eyes of 52 patients were analyzed. On average, patients experienced considerable pain after CXL (median VAS score 6.2, range 0 to 10). The postoperative regimen did not significantly affect pain scores, although the antibiotic ointment group reported a higher VAS score (median VAS score 7.2 vs 6.7 and 6.0; P = .57). Occlusive patching showed a trend to quicker resolution of epithelial defects (85% completely healed vs 65% with lenses and 70% with antibiotic ointment; P = .43). Correlations with pain-modulating psychological factors were weak (R < 0.3) and not significant. The use of pain medication corresponded poorly to the prescribed use. CONCLUSION: This study demonstrated clinical equivalence of 3 regimes in combating postoperative pain after routine CXL. Wound healing appeared quicker in the occlusive patch group and therefore might be the best standard of care after CXL. The clinical tradition of using bandage contact lenses should be reevaluated.


Asunto(s)
Reactivos de Enlaces Cruzados , Epitelio Corneal/fisiología , Dolor Ocular/fisiopatología , Queratocono/tratamiento farmacológico , Fármacos Fotosensibilizantes/uso terapéutico , Cicatrización de Heridas/fisiología , Adolescente , Adulto , Antibacterianos/administración & dosificación , Vendajes , Colágeno/metabolismo , Lentes de Contacto , Sustancia Propia/metabolismo , Femenino , Humanos , Queratocono/metabolismo , Queratocono/fisiopatología , Masculino , Persona de Mediana Edad , Ofloxacino/administración & dosificación , Dimensión del Dolor , Fotoquimioterapia , Estudios Prospectivos , Riboflavina/uso terapéutico , Rayos Ultravioleta , Agudeza Visual/fisiología , Adulto Joven
18.
Front Microbiol ; 10: 494, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-30949141

RESUMEN

Ocean acidification and warming are two main consequences of climate change that can directly affect biological and ecosystem processes in marine habitats. The Arctic Ocean is the region of the world experiencing climate change at the steepest rate compared with other latitudes. Since marine planktonic microorganisms play a key role in the biogeochemical cycles in the ocean it is crucial to simultaneously evaluate the effect of warming and increasing CO2 on marine microbial communities. In 20 L experimental microcosms filled with water from a high-Arctic fjord (Svalbard), we examined changes in phototrophic and heterotrophic microbial abundances and processes [bacterial production (BP) and mortality], and viral activity (lytic and lysogenic) in relation to warming and elevated CO2. The summer microbial plankton community living at 1.4°C in situ temperature, was exposed to increased CO2 concentrations (135-2,318 µatm) in three controlled temperature treatments (1, 6, and 10°C) at the UNIS installations in Longyearbyen (Svalbard), in summer 2010. Results showed that chlorophyll a concentration decreased at increasing temperatures, while BP significantly increased with pCO2 at 6 and 10°C. Lytic viral production was not affected by changes in pCO2 and temperature, while lysogeny increased significantly at increasing levels of pCO2, especially at 10°C (R 2 = 0.858, p = 0.02). Moreover, protistan grazing rates showed a positive interaction between pCO2 and temperature. The averaged percentage of bacteria grazed per day was higher (19.56 ± 2.77% d-1) than the averaged percentage of lysed bacteria by virus (7.18 ± 1.50% d-1) for all treatments. Furthermore, the relationship among microbial abundances and processes showed that BP was significantly related to phototrophic pico/nanoflagellate abundance in the 1°C and the 6°C treatments, and BP triggered viral activity, mainly lysogeny at 6 and 10°C, while bacterial mortality rates was significantly related to bacterial abundances at 6°C. Consequently, our experimental results suggested that future increases in water temperature and pCO2 in Arctic waters will produce a decrease of phytoplankton biomass, enhancement of BP and changes in the carbon fluxes within the microbial food web. All these heterotrophic processes will contribute to weakening the CO2 sink capacity of the Arctic plankton community.

19.
Sci Rep ; 9(1): 13355, 2019 09 16.
Artículo en Inglés | MEDLINE | ID: mdl-31527825

RESUMEN

A mass mortality event is devastating the populations of the endemic bivalve Pinna nobilis in the Mediterranean Sea from early autumn 2016. A newly described Haplosporidian endoparasite (Haplosporidium pinnae) is the most probable cause of this ecological catastrophe placing one of the largest bivalves of the world on the brink of extinction. As a pivotal step towards Pinna nobilis conservation, this contribution combines scientists and citizens' data to address the fast- and vast-dispersion and prevalence outbreaks of the pathogen. Therefore, the potential role of currents on parasite expansion was addressed by means of drift simulations of virtual particles in a high-resolution regional currents model. A generalized additive model was implemented to test if environmental factors could modulate the infection of Pinna nobilis populations. The results strongly suggest that the parasite has probably dispersed regionally by surface currents, and that the disease expression seems to be closely related to temperatures above 13.5 °C and to a salinity range between 36.5-39.7 psu. The most likely spread of the disease along the Mediterranean basin associated with scattered survival spots and very few survivors (potentially resistant individuals), point to a challenging scenario for conservation of the emblematic Pinna nobilis, which will require fast and strategic management measures and should make use of the essential role citizen science projects can play.


Asunto(s)
Bivalvos/parasitología , Brotes de Enfermedades/veterinaria , Haplosporidios/crecimiento & desarrollo , Infecciones Protozoarias en Animales/epidemiología , Animales , Ecosistema , Ambiente , Haplosporidios/clasificación , Mar Mediterráneo/epidemiología , Filogenia , Infecciones Protozoarias en Animales/parasitología , Salinidad , Temperatura
20.
Nat Commun ; 10(1): 3998, 2019 09 05.
Artículo en Inglés | MEDLINE | ID: mdl-31488846

RESUMEN

The term Blue Carbon (BC) was first coined a decade ago to describe the disproportionately large contribution of coastal vegetated ecosystems to global carbon sequestration. The role of BC in climate change mitigation and adaptation has now reached international prominence. To help prioritise future research, we assembled leading experts in the field to agree upon the top-ten pending questions in BC science. Understanding how climate change affects carbon accumulation in mature BC ecosystems and during their restoration was a high priority. Controversial questions included the role of carbonate and macroalgae in BC cycling, and the degree to which greenhouse gases are released following disturbance of BC ecosystems. Scientists seek improved precision of the extent of BC ecosystems; techniques to determine BC provenance; understanding of the factors that influence sequestration in BC ecosystems, with the corresponding value of BC; and the management actions that are effective in enhancing this value. Overall this overview provides a comprehensive road map for the coming decades on future research in BC science.

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