A monthly gridded burned area database of national wildland fire data.

We assembled the first gridded burned area (BA) database of national wildfire data (ONFIRE), a comprehensive and integrated resource for researchers, non-government organisations, and government agencies analysing wildfires in various regions of the Earth. We extracted and harmonised records from different regions and sources using open and reproducible methods, providing data in a common framework for the whole period available (starting from 1950 in Australia, 1959 in Canada, 1985 in Chile, 1980 in Europe, and 1984 in the United States) up to 2021 on a common 1° × 1° grid. The data originate from national agencies (often, ground mapping), thus representing the best local expert knowledge. Key opportunities and limits in using this dataset are discussed as well as possible future expansions of this open-source approach that should be explored. This dataset complements existing gridded BA data based on remote sensing and offers a valuable opportunity to better understand and assess fire regime changes, and their drivers, in these regions. The ONFIRE database can be freely accessed at https://zenodo.org/record/8289245 .

Dementia and comorbidities in primary care: a scoping review.

BACKGROUND: People with dementia (PwD) are known to have more chronic conditions compared to those without dementia, which can impact the clinical presentation of dementia, complicate clinical management and reduce overall quality of life. While primary care providers (PCPs) are integral to dementia care, it is currently unclear how PCPs adapt dementia care practices to account for comorbidities. This scoping review maps recent literature that describes the role for PCPs in the prevention, detection/diagnosis and management of dementia in the context of comorbidities, identifies critical knowledge gaps and proposes potential avenues for future research. METHODS: We searched for peer-reviewed literature published between 2017-2022 in MEDLINE, Cochrane Library, and Scopus using key terms related to dementia, primary care, and comorbidity. The literature was screened for relevance by title-abstract screening and subsequent full-text screening. The prioritized papers were categorized as either 'Risk Assessment and Prevention', 'Screening, Detection, and Diagnosis' or 'Management' and were further labelled as either 'Tools and Technologies', 'Recommendations for Clinical Practice' or 'Programs and Initiatives'. RESULTS: We identified 1,058 unique records in our search and respectively excluded 800 and 230 publications during title-abstract and full-text screening. Twenty-eight articles were included in our review, where ~ 50% describe the development and testing of tools and technologies that use pre-existing conditions to assess dementia risk. Only one publication provides official dementia screening guidelines for PCPs in people with pre-existing conditions. About 30% of the articles discuss managing the care of PwD, where most were anchored around models of multidisciplinary care and mitigating potentially inappropriate prescribing. CONCLUSION: To our knowledge, this is the first scoping review that examines the role for PCPs in the prevention, detection/diagnosis and management of dementia in the context of comorbidities. Given our findings, we recommend that future studies: 1) further validate tools for risk assessment, timely detection and diagnosis that incorporate other health conditions; 2) provide additional guidance into how comorbidities could impact dementia care (including prescribing medication) in primary care settings; 3) incorporate comorbidities into primary care quality indicators for dementia; and 4) explore how to best incorporate dementia and comorbidities into models/frameworks of holistic, person-centred care.

Characteristics and factors associated with mortality in tracheostomized patients with COVID-19: a retrospective cohort study in a hospital in Tacna, Peru. / Características y factores asociados a la mortalidad en pacientes con COVID-19 traqueostomizados: estudio de cohorte retrospectivo en un hospital de Tacna, Perú.

OBJECTIVE: We aimed to describe the main demographic, clinical, laboratory and therapeutic characteristics and to identify whether they are associated with mortality in tracheostomized patients. MATERIAL AND METHODS.: Retrospective cohort study in adult patients diagnosed with COVID-19, admitted to ICU (Intensive Care Unit) and requiring tracheostomy. Demographic, clinical, laboratory and treatment data were obtained from the medical records of patients admitted to Hospital III Daniel Alcides Carrión in Tacna. The Cox proportional hazards model was used for survival analysis and hazard ratios (HR) with their 95% confidence intervals (95%CI) were calculated. RESULTS.: We evaluated 73 patients, 72.6% were men, the most common comorbidities were obesity (68.5%), type 2 diabetes mellitus (35.6%), and arterial hypertension (34.2%). Thirty-seven percent of the participants died during their stay at the ICU. The median time from intubation to tracheostomy and the duration of tracheostomy was 17 (RIC: 15-21) and 21 (RIC: 3-39) days, respectively. Multivariate analysis showed that the factors associated with mortality were procalcitonin > 0.50 ng/dL at the time of tracheostomy (HRa: 2.40 95%CI: 1.03-5.59) and a PaO2/FiO2 ratio less than or equal to 150 mmHg (HRa: 4.44 95%CI: 1.56-12.60). CONCLUSIONS.: The factors associated with mortality at the time of tracheostomy were procalcitonin > 0.50 ng/dL and a PaO2/FiO2 ratio less than or equal to 150 mmHg.

OBJETIVO.: Describir las principales características demográficas, clínicas, laboratoriales y terapéuticas e identificar si están asociados con la mortalidad en pacientes traqueostomizados. MATERIAL Y MÉTODOS.: Estudio de cohorte retrospectiva en pacientes adultos con diagnóstico de COVID-19, ingresados a UCI (Unidad de Cuidados Intensivos) y que requirieron traqueostomía. Se extrajeron datos demográficos, clínicos, laboratoriales y de tratamiento de las historias clínicas de pacientes que ingresaron al Hospital III Daniel Alcides Carrión de Tacna. Para el análisis de supervivencia se empleó el modelo de riesgos proporcionales de Cox y se calcularon los cocientes de riesgo instantáneos (HR) con sus intervalos de confianza al 95% (IC95%). RESULTADOS.: Se evaluaron 73 pacientes, el 72,6% eran hombres, las comorbilidades más comunes fueron obesidad (68,5%), diabetes mellitus tipo 2 (35,6%) e hipertensión arterial (34,2%). El 37% de los participantes fallecieron durante la estancia en UCI. La mediana de tiempo desde la intubación hasta la traqueostomía y la duración de esta fue 17 (RIC: 15−21) y 21 (RIC: 3−39) días, respectivamente. El análisis multivariado mostró que los factores asociados a mortalidad, fueron presentar un valor de procalcitonina > 0,50 ng/dL en el momento de la traqueostomía (HRa: 2,40 IC95%: 1,03−5,59) y el nivel de PaO2/FiO2 menor o igual a 150 mmHg, (HRa: 4,44 IC95%: 1,56−12,60). CONCLUSIONES.: Los factores asociados a mortalidad al momento de realizar la traqueostomía fueron presentar un valor de procalcitonina > 0,50 ng/dL y un cociente PaO2/FiO2 menor o igual a 150 mmHg.

The Impact of an Authentic Sports Leadership Program for Coach.

Purpose: This paper studies the effects of authentic sports leadership training on coaches' self-perception of their own authentic leadership, perceived justice, competence, overall self-efficacy, and collective efficacy. Additionally, players' perceptions of their coaches with respect to their authentic leadership, perceived justice, competence, collective efficacy, satisfaction with the coach, and support for basic psychological needs were analyzed. Design: Twenty-five football and handball coaches were randomly assigned to two groups. Fifteen coaches made up the experimental group that carried out the training leadership program, while 10 coaches made up the control group, carrying out no training whatsoever. A total of 248 football and handball players participated in this study; 136 were led by coaches who participated in the training program, and 112 by coaches who did not participate in the program. Results: The results of this study indicate that coaches' self-perception is positively influenced after having received training in the variables of authentic leadership, perceived justice, competence, overall self-efficacy, and collective efficacy. Players whose coaches were part of the program perceive them as being more competent as coaches. Conclusions: The effects of an authentic sports leadership training program are effective for coaches and players alike.

Swine virome on rural backyard farms in Mexico: communities with different abundances of animal viruses and phages.

Domestic swine have been introduced by humans into a wide diversity of environments and have been bred in different production systems. This has resulted in an increased risk for the occurrence and spread of diseases. Although viromes of swine in intensive farms have been described, little is known about the virus communities in backyard production systems around the world. The aim of this study was to describe the viral diversity of 23 healthy domestic swine maintained in rural backyards in Morelos, Mexico, through collection and analysis of nasal and rectal samples. Next-generation sequencing was used to identify viruses that are present in swine. Through homology search and bioinformatic analysis of reads and their assemblies, we found that rural backyard swine have a high degree of viral diversity, different from those reported in intensive production systems or under experimental conditions. There was a higher frequency of bacteriophages and lower diversity of animal viruses than reported previously. In addition, sapoviruses, bocaparvoviruses, and mamastroviruses that had not been reported previously in our country were identified. These findings were correlated with the health status of animals, their social interactions, and the breeding/rearing environment (which differed from intensive systems), providing baseline information about viral communities in backyard swine.

Contributions to the study of spinocerebellar ataxia type 38 (SCA38).

OBJECTIVE: To report clinical and ancillary findings in a kindred with spinocerebellar ataxia 38 (SCA38). PATIENTS AND METHODS: Five family members spanning two generations developed gait ataxia and intermittent diplopia. On examination, a cerebellar syndrome accompanied by downbeat nystagmus and a saccadic head impulse test (HIT) were found. RESULTS: Whole-exome sequencing demonstrated a heterozygous variant in ELOVL5, c.779A > G (p.Tyr260Cys), in four tested patients. Intermittent concomitant esotropia and hypertropia caused transient diplopia in one individual each. Saccadic HIT responses were found in four subjects. Sensorineural hypoacusis was present in every case. Electrophysiological studies demonstrated a sensory neuronopathy in patients from the first generation, with prolonged disease duration. Baseline serum docosahexaenoic acid (DHA) percent was diminished in four individuals. Oral 26-week dietary DHA supplementation, 650 mg/day, raised serum DHA percent and induced a statistically significant reduction in Scale for the Assessment and Rating of Ataxia (SARA) total scores, and in stance and heel-shin slide item scores. CONCLUSION: The mentioned ELOVL5 variant segregated with disease in this kindred. Downbeat nystagmus, intermittent heterotropia causing transient diplopia, vestibular impairment demonstrated by abnormal HIT, and sensory neuronopathy were part of the clinical picture in this series. DHA supplementation raised serum DHA percent in cases with diminished levels, and induced a clinical amelioration and a statistically significant reduction in SARA scores in the study group. Further studies are needed to investigate the role of these findings in SCA38, and to determine the response to prolonged DHA supplementation.

Attitudes Toward Organ Donation: Differences Between Medical and Nursing Andalusian Students.

INTRODUCTION: A favorable attitude toward organ donation and transplantation (ODT) is fundamental among health professionals at the time of transplant promotion. In this sense, the training and awareness of professionals are fundamental. OBJECTIVE: To analyze the differences in the attitude toward ODT and the factors that condition it among Andalusian medical and nursing students. METHODS AND DESIGN: The study is a sociologic, multicenter, observational study. The population includes medical and nursing students in Andalusian universities. Database of the Collaborative International Donor Project is used and data are stratified by geographic area and academic course. The instrument of measurement was a validated questionnaire (PCID-DTO-RIOS) that was handed out to every student in a compulsory session. Completion of the questionnaire was anonymous and self-administered. The sample included Andalusian medical and nursing students (99% confidence and precision of ±1%) stratified by geographic area and year of study. RESULTS: There was a completion rate of 91%; 79% (n = 2879) of Andalusian students were in favor of donation and 21% were not in favor. The attitude toward ODT is more favorable in medical compared with nursing students (80% vs 77%; P = .021). The psychosocial profile toward donation is similar in both groups relating to the following variables (P < .05): knowing a transplant patient, having received information about the subject, attitude toward family donation, and having discussed transplantation with family and friends. CONCLUSION: Andalusian medical students favored organ donation more than Andalusian nursing students, and the favorable attitude is associated with having an awareness of the subject.

Flap bipedicular no tratamento de lesão cutânea traumática em membro torácico de gato: relato de caso / Bipedicular flap in the treatment of traumatic skin injury in cat thoracic member: case report

O objetivo do presente estudo é relatar a construção de um retalho direto de bolsa bipediculada com fixação apendicular à região torácica para o tratamento de lesões extensas no membro torácico direito de um gato. Foi tratado no Hospital Veterinário Unicesumar Maringá - Paraná, um felino de 1 ano de idade, apresentando lesão no membro torácico, após história de briga com outro animal da mesma espécie. Ao exame físico, apresentava fístula e edema no membro torácico direito. O paciente foi anestesiado e foi realizado o desbridamento das áreas desvitalizadas. Como terapia inicial, a lesão foi tratada como ferida aberta, até a formação de tecido de granulação, para posterior correção do defeito empregando retalho bipediculado em bolsa direta, com fixação temporária do membro à parede torácica. Após duas semanas, o membro foi desimplantado e os pontos foram removidos 21 dias após a aplicação do retalho. O uso do retalho permitiu completa cicatrização da ferida, sem ocorrência de hematomas, necrose ou deiscência de sutura. Conclui-se que a utilização do retalho bipedicular é aplicável ao tratamento de feridas traumáticas em membro torácico de felinos.

The aim of the present study is to report the construction of a direct bipedicled pouch flap with appendicular fixation to the thoracic region for the treatment of extensive lesions in the right thoracic limb of a cat. He was treated on Hospital Veterinário Unicesumar Maringá - Paraná, a 1-year-old feline, presenting injury to the thoracic limb after a history of fighting with another animal of the same species. On physical examination, he presented fistula and edema in the right thoracic limb. The patient was anesthetized and debridement of the devitalized areas was performed. As an initial therapy, the lesion was treated as an open wound until granulation tissue was formed for subsequent correction of the defect using a direct pouch bipedicled flap, with temporary fixation of the limb to the chest wall. After two weeks, the limb was unimplanted and the stitches were removed 21 days after flap application. The use of the flap allowed complete wound healing without bruising, necrosis or suture dehiscence. It is concluded that the use of bipedicular flap is applicable to the treatment of traumatic wounds in feline thoracic limb.

Tendências temporais da mortalidade no município de Lagarto, Nordeste do Brasil / Temporal trends of mortality in the city of Lagarto, Northeast of Brazil / Tendencias temporales de la mortalidad en el municipio de Lagarto, Nordeste de Brasil

Objetivo: Analisar as tendências temporais e o perfil epidemiológico das principais causas de mortalidade em residentes do município de Lagarto, Sergipe, entre 2006 a 2015. Métodos: Estudo epidemiológico, descritivo e de série histórica, através de dados secundários dos óbitos notificados no Sistema de Informação de Mortalidade (SIM). A análise das tendências temporais foi realizada pelo Programa Joinpoint Regression obtendo-se a variação percentual anual (APC) das taxas de mortalidade por meio da regressão Possion. Resultados: Foram notificados 5.586 óbitos, com predomínio do sexo masculino e idosos, 58% e 59,61% respectivamente. Observou-se um aumento da taxa de mortalidade geral de 1,58% ao ano (IC95%: 0,5 a 2,6; p=0,01). Somente as taxas de mortalidade infantil (TMI) e de seus componentes apresentaram tendências decrescentes. Conclusão: Apesar da tendência decrescente das TMI, as mesmas requerem ações especializada, bem como para a redução da mortalidade por doenças crônicas

Objective: The study's purpose has been to analyze the temporal trends and the epidemiological profile of the main causes of mortality in residents of the Lagarto City, Sergipe State, between 2006 and 2015. Methods: This is an epidemiological, descriptive and historical series study, through secondary data on deaths reported in Sistema de Informação de Mortalidade (SIM) [Mortality Information System]. The analysis of temporal trends was performed by the Joinpoint Regression Program, obtaining the Annual Percentage Change (APC) of mortality rates through Possion Regression. Results: 5,586 deaths were reported, with men predominating 58% and the elderly people 59.61%. There was an increase in the overall mortality rate of 1.58% per year (95% CI 0.5 to 2.6, p = 0.01). Only Infant Mortality Rates (IMR) and their components showed declining trends. Conclusion: Despite the decreasing tendency of the IMR, they require specialized actions, as well as the reduction of mortality due to chronic diseases

Objetivo: Analizar las tendencias temporales y el perfil epidemiológico de las principales causas de mortalidad en residentes de la ciudad de Lagarto, Sergipe, entre 2006 y 2015. Método: series epidemiológicas, descriptivas e históricas, a través de datos secundarios sobre muertes relatadas en la Mortalidad Información SIM). El análisis fue realizado por el Programa de Regresión del Joinpoint, obteniendo Variaciones de las tasas de mortalidad a través de la Posibilidad de regresión. Resultados: 5.586 muertes fueron reportadas, con predominio de hombres 58% y ancianos 59.61%. Se observó un aumento en la tasa de mortalidad global del 1,58% anual (IC 95%: 0,5 a 2,6, p = 0,01). Sólo las tasas de mortalidad infantil (IMR) y sus componentes presentaron tendencias en declive. Conclusión: A pesar de la tendencia decreciente del IMR, ellos requieren acciones especializadas, así como la reducción de la mortalidad por enfermedades crónicas

Student nurses at Spanish universities and their attitude toward xenotransplantation.

INTRODUCTION: Recent immunological and transgenic advances are a promising alternative using limited materials of human origin for transplantation. However, it is essential to achieve social acceptance of this therapy. OBJECTIVE: To analyze the attitude of nursing students from Spanish universities toward organ xenotransplantation (XTx) and to determine the factors affecting their attitude. MATERIALS AND METHODS: Type of study: A sociological, multicentre, and observational study. STUDY POPULATION: Nursing students enrolled in Spain (n = 28,000). SAMPLE SIZE: A sample of 10 566 students estimating a proportion of 76% (99% confidence and precision of ±1%), stratified by geographical area and year of study. Instrument of measurement: A validated questionnaire (PCID-XenoTx-RIOS) was handed out to every student in a compulsory session. This survey was self-administered and self-completed voluntarily and anonymously by each student in a period of 5-10 min. STATISTICAL ANALYSIS: descriptive analysis, Student's t test, the chi-square test, and a logistic regression analysis. RESULTS: A completion rate: 84% (n = 8913) was obtained. If the results of XTx were as good as in human donation, 74% (n = 6564) would be in favor and 22% (n = 1946) would have doubts. The following variables affected this attitude: age (P < 0.001); sex (P < 0.001); geographical location (P < 0.001); academic year of study (P < 0.001); attitude toward organ donation (P < 0.001); belief in the possibility of needing a transplant (P < 0.001); discussion of transplantation with one's family (P < 0.001) and friends (P < 0.001); and the opinion of one's partner (P < 0.001). The following variables persisted in the multivariate analysis: being a male (OR = 1.436; P < 0.001); geographical location (OR = 1.937; P < 0.001); an attitude in favor of donation (OR = 1.519; P < 0.001); belief in the possibility of needing a transplant (OR = 1.497; P = 0.036); and having spoken about the issue with family (OR = 1.351; P < 0.001) or friends (OR = 1.240; P = 0.001). CONCLUSIONS: The attitude of nursing students toward organ XTx is favorable and is associated with factors of general knowledge about organ donation and transplantation and social interaction.

Efecto de un programa de actividad física en el medio acuático sobre las constantes hemodinámicas en mujeres embarazadas / Effect of a physical activity programme in the aquatic environment on haemodynamic constants in pregnant women

OBJETIVO: Evaluar el efecto de un programa de actividad física en el medio acuático con inmersión hasta el cuello, de seis semanas de duración, sobre las constantes hemodinámicas en mujeres gestantes. MÉTODO: Se llevó a cabo un programa de actividad física en el medio acuático, de seis semanas de duración a un total de 46 mujeres embarazadas, que fueron distribuidas en grupo experimental que participó en el programa (n=18) y grupo control (n=28) que desarrolló los cuidados habituales. En los dos grupos se valoraron diferentes medidas hemodinámicas antes y después del programa. RESULTADOS: Al inicio del programa el promedio de presión arterial sistólica era similar en ambos grupos pero la presión arterial diastólica era ligeramente mayor en el grupo experimental. Cuando se contrastan las medidas en la última sesión, resultan significativamente mayores las presiones arteriales (sistólica, diastólica y media), en el grupo control (p< 0,050). De forma similar, los valores iniciales de volumen plasmático no diferían en ambos grupos, pero tras la intervención las mujeres del grupo control evidencian un mayor promedio (p< 0,010). La fracción de excreción de sodio (FENa) aumenta significativamente en el grupo experimental, tras la realización del programa, cuyo promedio se triplica (p< 0,050). Los niveles plasmáticos de aldosterona no muestran diferencias significativas entre ambos grupos en las distintas mediciones. CONCLUSIÓN: Un programa de ejercicios de natación e inmersión, en mujeres gestantes, contribuye al equilibrio hidrosalino, previniendo el aumento excesivo de volumen plasmático habitual en el embarazo, y en la actividad del eje renina-aldosterona

OBJECTIVE: To evaluate the effect of a physical activity programme in the aquatic environment with immersion up to the neck, of six weeks duration, on haemodynamic constants in pregnant women. METHODS: A six-week physical activity programme in the aquatic environment was carried out with a total of 46 pregnant women, who were distributed into an experimental group (n = 18), which participated in the programme, and a control group (n = 28), which followed routine care. In both groups different haemodynamic measurements were evaluated before and after the program. RESULTS: At the beginning of the programme the mean systolic blood pressure was similar between groups, but diastolic blood pressure was slightly higher in the experimental group. When the measurements at the last session were compared, arterial pressures (systolic, diastolic and mean) were significantly higher in the control group (p <.050). Similarly, the initial plasma volume values did not differ between groups, but after the intervention, the control group women showed a higher mean (p <.010). The fraction of sodium excretion (FENa) increased significantly in the experimental group, after the programme, with a mean three times higher (p <.050). Aldosterone plasma levels did not show significant differences between the groups in the different measurements. CONCLUSIONS: A programme of swimming and immersion exercises in pregnant women contributes to hydrosaline balance, preventing an excessive increase in usual plasma volume during pregnancy and in the activity of the renin-aldosterone axis

Efectos del ayuno en sujetos que realizan el ramadan sobre la calidad de vida y su relación con la diabetes y la hipertensión / Fasting's effects on people in ramadan about their quality of life and the relationship with diabetes and hypertension

El precepto islámico del Ramadán (R), impone a las personas que lo practican importantes modificaciones fisiológicas debido a las restricciones hídricas y dietéticas a lo largo del día y durante un mes, lo que tiene una especial repercusión física e intelectual de los musulmanes. El objetivo del presente estudio es describir los efectos del ayuno del Ramadán en la calidad de vida, así como, su repercusión en la Diabetes e Hipertensión. Participaron un total de 44 sujetos, 22 hombres y 22 mujeres. Con edades comprendidas entre los 14-80 años residentes en Tetuán y Ceuta. En un diseño de grupo único, creando subgrupos en función del sexo o patología. Las mediciones principales son las 8 escalas que miden los 36 items del cuestionario SF-36. Durante el R se evidencia en hombres y mujeres un mayor deterioro de la función física, siendo también significativa una disminución de la percepción de salud mental en el sexo masculino. En las personas diabéticas la percepción de disminución de la calidad de vida es mayor en relación a los parámetros físicos, así como en la salud mental y salud en general. Los sujetos hipertensos presentaron de forma significativa peores valores en los ítems de salud física y mental. El mes de R, en el conjunto de la población, provoca una menor percepción de la calidad de vida, más pronunciada en el caso de las mujeres. En concreto, los diabéticos y los hipertensos, estudiados, perciben una menor calidad de vida que en condiciones normales en cuanto a función física y rol físico se refiere(AU)

The Islamic precept of Ramadan (R) imposes on individuals who practice it important physiological modifications due to the hydric and dietetic restrictions along a whole month plus a day, all of which have a crucial repercussion over the physical and intellectual performance of Muslim. The objective of this study was todescribe the effects of fasting during R in quality of life and its relationship with pathologies such as diabetes and hypertension. It took part 44 individuals, 22 men and 22 women with an age among 14 and 80 year old, from Tetuan and Ceuta. A model in only one group, making sub-models according to sex and pathology. The main measuring are the eight scales that measure 36 items in the SF-36 survey. During R we can see worst results in both men and women in relation with physical function. We can also observe a decrease in the perception of mental health in male sex the perception is even higher in diabetic people in relation to physical parameters, as in mental health in general. Worst values show individuals suffering of hypertension in their perception of physical and mental health.This month of R in the population as a whole causes a less perception in quality of life which is even worst in the case of women. Being concrete, diabetic and hypertension people receive a less quality of life than in normal conditions talking about physical role and function(AU)

Mapa de la enfermedad de Alzheimer y otras demencias en España. Proyecto MapEA / Map of Alzheimer's disease and other dementias in Spain. MapEA Project

Introducción. En el contexto actual de aumento de la esperanza de vida y progresivo envejecimiento de la población cabe esperar un incremento muy significativo del número de personas con deterioro cognitivo y demencia. No cabe duda que España se enfrenta a un reto de preocupantes dimensiones sociosanitarias en las próximas décadas. El proyecto «Mapa de la enfermedad de Alzheimer y otras demencias en España» pretende analizar el estado actual de las herramientas de planificación y organización, actividades de prevención y detección temprana, proceso asistencial y recursos específicos disponibles en las comunidades autónomas para la atención y el cuidado de las personas con deterioro cognitivo y demencia, con el objeto de identificar las áreas de mejora y emitir recomendaciones. Metodología. El grupo de trabajo estuvo formado por un Comité Asesor nacional de 5 expertos y los correspondientes Comités de Expertos de cada comunidad autónoma constituidos por profesionales del ámbito de la Neurología, Geriatría, Psiquiatría y Atención Primaria así como representantes de Asociaciones de Familiares de personas con Alzheimer y otras demencias. Se llevaron a cabo reuniones de cada comité local en las que se revisó la situación actual de la atención de acuerdo con el cuestionario guía elaborado por el Comité Asesor. Resultados. Los planes específicos disponibles en España están en su mayoría obsoletos o no se han llegado a implantar. En líneas generales no se llevan a cabo actividades de prevención ni de detección temprana. Hay una gran heterogeneidad de rutas asistenciales de acceso al diagnóstico, tratamiento y seguimiento de la enfermedad y no todas las pruebas diagnósticas están disponibles en las diferentes regiones sanitarias. En general, los recursos disponibles se consideran escasos y poco conocidos. Conclusiones. El estudio Mapa de la enfermedad de Alzheimer y otras demencias en España ha permitido detectar los principales puntos susceptibles de cambio y optimización tanto en gestión, organización y coordinación de los recursos como en información y formación de las personas implicadas. Además, el estudio ha revelado que en España se dan las condiciones necesarias de disponibilidad de profesionales implicados y capacitados y de existencia de potenciales recursos diagnósticos y asistenciales para encarar este margen de mejora mediante la aprobación y el desarrollo de un Plan Nacional de Alzheimer, respaldado por un compromiso de voluntades políticas profundo y veraz, y que será el marco idóneo para el desarrollo de estas posibilidades (AU)

Introduction. In the current context of increased life expectancy and progressive aging of the population a very significant increase in the number of people with cognitive impairment and dementia is expected. Consequently, Spain will face an enormous social and health problem in the next decades. The Mapa de la enfermedad de Alzheimer y otras demencias en España project aims to analyse plans, prevention and early diagnosis activities, process of care and resources available across the 17 Spanish regions for the management of cognitive impairment and dementia in order to identify improvement areas, as well as to provide a list of recommendations. Methods. The working group consisted of an Advisory Committee of 5 national experts and a Committee of Experts from each region made up of professionals in the field of Neurology, Geriatrics, Psychiatry, and Primary Care, as well as representatives of Family Associations of People with Alzheimer's and other dementias. The Expert Committee of each region held meetings in which the current situation of care was reviewed. Results. Plans available in Spain for dementia management are mostly obsolete or have not been implemented. Prevention and early detection activities are generally not carried out. There is great variability of care process that patients must follow for the diagnosis, treatment, and follow-up of the disease, and not all diagnostic test are available in different regions. In general, resources are considered scarce and unknown. Conclusions. The Mapa de la enfermedad de Alzheimer y otras demencias en España study has been able to detect the main points that require changing n the management, organisation, and coordination of resources, such as information and training of the personnel involved. Furthermore, the study has revealed that, in Spain, the necessary conditions are in place in Spain, such as the availability and capacity of professionals involved, as well as there being the potential diagnostic and health care resources to address this room for improvement through the approval and development of a National Alzheimer's Plan, supported by a deep and truthful political commitment, which will be the ideal framework for the development of these possibilities (AU)

[Map of Alzheimer's disease and other dementias in Spain. MapEA Project]. / Mapa de la enfermedad de Alzheimer y otras demencias en España. Proyecto MapEA.

INTRODUCTION: In the current context of increased life expectancy and progressive aging of the population a very significant increase in the number of people with cognitive impairment and dementia is expected. Consequently, Spain will face an enormous social and health problem in the next decades. The Mapa de la enfermedad de Alzheimer y otras demencias en España project aims to analyse plans, prevention and early diagnosis activities, process of care and resources available across the 17 Spanish regions for the management of cognitive impairment and dementia in order to identify improvement areas, as well as to provide a list of recommendations. METHODS: The working group consisted of an Advisory Committee of 5 national experts and a Committee of Experts from each region made up of professionals in the field of Neurology, Geriatrics, Psychiatry, and Primary Care, as well as representatives of Family Associations of People with Alzheimer's and other dementias. The Expert Committee of each region held meetings in which the current situation of care was reviewed. RESULTS: Plans available in Spain for dementia management are mostly obsolete or have not been implemented. Prevention and early detection activities are generally not carried out. There is great variability of care process that patients must follow for the diagnosis, treatment, and follow-up of the disease, and not all diagnostic test are available in different regions. In general, resources are considered scarce and unknown. CONCLUSIONS: The Mapa de la enfermedad de Alzheimer y otras demencias en España study has been able to detect the main points that require changing n the management, organisation, and coordination of resources, such as information and training of the personnel involved. Furthermore, the study has revealed that, in Spain, the necessary conditions are in place in Spain, such as the availability and capacity of professionals involved, as well as there being the potential diagnostic and health care resources to address this room for improvement through the approval and development of a National Alzheimer's Plan, supported by a deep and truthful political commitment, which will be the ideal framework for the development of these possibilities.

Effect of a physical activity programme in the aquatic environment on haemodynamic constants in pregnant women. / Efecto de un programa de actividad física en el medio acuático sobre las constantes hemodinámicas en mujeres embarazadas.

OBJECTIVE: To evaluate the effect of a physical activity programme in the aquatic environment with immersion up to the neck, of six weeks duration, on haemodynamic constants in pregnant women. METHODS: A six-week physical activity programme in the aquatic environment was carried out with a total of 46 pregnant women, who were distributed into an experimental group (n = 18), which participated in the programme, and a control group (n = 28), which followed routine care. In both groups different haemodynamic measurements were evaluated before and after the program. RESULTS: At the beginning of the programme the mean systolic blood pressure was similar between groups, but diastolic blood pressure was slightly higher in the experimental group. When the measurements at the last session were compared, arterial pressures (systolic, diastolic and mean) were significantly higher in the control group (p <.050). Similarly, the initial plasma volume values did not differ between groups, but after the intervention, the control group women showed a higher mean (p <.010). The fraction of sodium excretion (FENa) increased significantly in the experimental group, after the programme, with a mean three times higher (p <.050). Aldosterone plasma levels did not show significant differences between the groups in the different measurements. CONCLUSION: A programme of swimming and immersion exercises in pregnant women contributes to hydrosaline balance, preventing an excessive increase in usual plasma volume during pregnancy and in the activity of the renin-aldosterone axis.

[Quality of life related to health in a population of healthy pregnant women after a program of physical activity in the aquatic environment.] / Calidad de vida relacionada con la salud en una población de gestantes sanas tras un programa de actividad física en el medio acuático (PAFMAE).

OBJECTIVE: Moderate physical exercise brings benefits to pregnant women during pregnancy. The aim of this research is to evaluate the effect on the quality of life of a six-week aquatic physical activity program in healthy pregnant women. METHODS: A six-week physical activity program was conducted in the aquatic environment, from May to July 2016 in a sports center, to a total of 46 pregnant women, who were distributed in Experimental (n = 18) and Control (n = 28) groups, to which the health-related quality of life questionnaire SF-36 v2 was applied before and after the program. The t-student test for paired samples was statistically applied for intragroup means, and for the differences between groups, the t-student test for independent samples. RESULTS: At the end of the physical activity program, it was clearly established that it acted positively on the following dimensions whose mean values were: perception of Body Pain (BP) before 66.1 and after 68.4 perception of General Health (GH) before 81.3 and then 83.6, Emotional Role (ER) before 89.0 and Then 93.5 and Mental Health (MH) 80.7 before and 84.2 after. CONCLUSIONS: The practice of a program of physical activity in the aquatic environment for pregnant women provides benefits related to the perception of health-related quality of life.

OBJETIVO: El ejercicio físico moderado aporta beneficios a la mujer gestante durante el embarazo. La finalidad de este trabajo fue evaluar el efecto sobre la calidad de vida de un programa de actividad física en el medio acuático, de seis semanas de duración, en mujeres gestantes sanas. METODOS: Se llevó a cabo un programa de actividad física en el medio acuático, desde mayo hasta julio de 2016 en un centro deportivo, de seis semanas de duración a un total de 46 mujeres embarazadas, que fueron distribuidas en grupo Experimental (n=18) y grupo Control (n=28), a las que se le aplicó el cuestionario de calidad de vida relacionada con la salud "SF- 36 v2" antes y después del programa. Estadísticamente se aplicó para medias intragrupo la prueba t-student para muestras pareadas, y para las diferencias entre grupos, la prueba t-student para muestras independientes. RESULTADOS: Al finalizar el programa de actividad física se constató como el mismo actuó positivamente sobre las siguientes dimensiones, cuyos valores de la media fueron: percepción de Dolor Corporal (DC) antes 66,1 y después 68,4 percepción de Salud General (SG) antes 81,3 y después 83,6, Rol Emocional (RE) antes 89,0 y después 93,5 y Salud Mental (SM) 80,7 antes y 84,2 después. CONCLUSIONES: La práctica de un programa de actividad física en el medio acuático para embarazadas sanas brinda beneficios relacionados con la percepción de calidad de vida relacionada con la salud.

Efectividad de un programa de actividad física mediante el método Pilates en el embarazo y en el proceso del parto / Effectiveness of a physical activity programme based on the Pilates method in pregnancy and labour

Objetivo: Valorar la eficacia y seguridad de un programa de actividad física por medio del método Pilates de ocho semanas de duración en mujeres gestantes sobre parámetros funcionales, como el peso, la tensión arterial, fuerza, flexibilidad, curvatura de la columna y parámetros en el parto, como tipo de parto, episiotomía, analgesia y peso del recién nacido. Método: Se realizó un ensayo clínico aleatorizado sobre gestantes, consistente en la aplicación de un programa de actividad física mediante el método Pilates, diseñado específicamente para esta población. Se agrupó una muestra compuesta por un total de 105 mujeres gestantes, las cuales estaban divididas en grupo intervención (n=50) (32,87±4,46 años) y grupo control (n=55) (31,52±4,95 años). El grupo intervención asistió a un programa de actividad física por medio del método Pilates, durante 2 sesiones semanales, mientras que el grupo control no realizó el programa. Resultados: Tras finalizar la intervención se observaron mejoras significativas (p<0,05) en la tensión arterial, fuerza de prensión manual, flexibilidad isquiosural y curvatura de la columna y además mejoras en el proceso del parto, disminuyendo el número de cesáreas y de partos distócicos, de episiotomías, de analgesia y del peso del recién nacido. Conclusión: Un programa de actividad física 8 semanas por medio del método Pilates mejora parámetros funcionales en las gestantes y podría beneficiar la finalización del parto (AU)

Objective: To assess the effectiveness and safety of a physical activity programme based on use of the Pilates method, over eight weeks in pregnant women, on functional parameters, such as weight, blood pressure, strength, flexibility and spinal curvature, and on labour parameters, such as, type of delivery, episiotomy, analgesia and newborn weight. Method: A randomized clinical trial was carried out on pregnant women, applying a programme of physical activity using the Pilates method, designed specifically for this population. A sample consisting of a total of 105 pregnant women was divided into two groups: intervention group (n=50) (32.87±4.46 years old) and control group (n=55) (31.52±4.95 years old). The intervention group followed a physical activity programme based on the Pilates method, for 2 weekly sessions, whereas the control group did not follow the program. Results: Significant improvements (p<0.05) in blood pressure, hand grip strength, hamstring flexibility and spinal curvature, in addition to improvements during labour, decreasing the number of Caesareans and obstructed labour, episiotomies, analgesia and the weight of the newborns were found at the end of the intervention. Conclusion: A physical activity programme of 8 weeks based on the Pilates method improves functional parameters in pregnant women and benefits delivery (AU)

Effectiveness of a physical activity programme based on the Pilates method in pregnancy and labour. / Efectividad de un programa de actividad física mediante el método Pilates en el embarazo y en el proceso del parto.

OBJECTIVE: To assess the effectiveness and safety of a physical activity programme based on use of the Pilates method, over eight weeks in pregnant women, on functional parameters, such as weight, blood pressure, strength, flexibility and spinal curvature, and on labour parameters, such as, type of delivery, episiotomy, analgesia and newborn weight. METHOD: A randomized clinical trial was carried out on pregnant women, applying a programme of physical activity using the Pilates method, designed specifically for this population. A sample consisting of a total of 105 pregnant women was divided into two groups: intervention group (n=50) (32.87±4.46 years old) and control group (n=55) (31.52±4.95 years old). The intervention group followed a physical activity programme based on the Pilates method, for 2 weekly sessions, whereas the control group did not follow the program. RESULTS: Significant improvements (p<0.05) in blood pressure, hand grip strength, hamstring flexibility and spinal curvature, in addition to improvements during labour, decreasing the number of Caesareans and obstructed labour, episiotomies, analgesia and the weight of the newborns were found at the end of the intervention. CONCLUSION: A physical activity programme of 8 weeks based on the Pilates method improves functional parameters in pregnant women and benefits delivery.

Regulation of Fn14 Receptor and NF-κB Underlies Inflammation in Meniere's Disease.

Meniere's disease (MD) is a rare disorder characterized by episodic vertigo, sensorineural hearing loss, tinnitus, and aural fullness. It is associated with a fluid imbalance between the secretion of endolymph in the cochlear duct and its reabsorption into the subarachnoid space, leading to an accumulation of endolymph in the inner ear. Epidemiological evidence, including familial aggregation, indicates a genetic contribution and a consistent association with autoimmune diseases (AD). We conducted a case-control study in two phases using an immune genotyping array in a total of 420 patients with bilateral MD and 1,630 controls. We have identified the first locus, at 6p21.33, suggesting an association with bilateral MD [meta-analysis leading signal rs4947296, OR = 2.089 (1.661-2.627); p = 1.39 × 10-09]. Gene expression profiles of homozygous genotype-selected peripheral blood mononuclear cells (PBMCs) demonstrated that this region is a trans-expression quantitative trait locus (eQTL) in PBMCs. Signaling analysis predicted several tumor necrosis factor-related pathways, the TWEAK/Fn14 pathway being the top candidate (p = 2.42 × 10-11). This pathway is involved in the modulation of inflammation in several human AD, including multiple sclerosis, systemic lupus erythematosus, or rheumatoid arthritis. In vitro studies with genotype-selected lymphoblastoid cells from patients with MD suggest that this trans-eQTL may regulate cellular proliferation in lymphoid cells through the TWEAK/Fn14 pathway by increasing the translation of NF-κB. Taken together; these findings suggest that the carriers of the risk genotype may develop an NF-κB-mediated inflammatory response in MD.