Diseño de una escala de medida del grado de convivencia en pacientes con un proceso crónico / Design of a measuring scale to evaluate the degree of living wth a chronic illnes, such as Parkinson´disease

INTRODUCCIÓN. Conocer cómo los pacientes conviven con un proceso crónico es necesario para proporcionar un cuidado individualizado e integral. En la actualidad, no existe ninguna escala validada que evalúe la convivencia con un proceso crónico, como es la enfermedad de Parkinson. OBJETIVOS. Los objetivos fueron: 1) definir el concepto Convivencia con un proceso crónico; 2) diseñar una escala de medición del grado de convivencia en pacientes con un proceso crónico, y en concreto, con la enfermedad de Parkinson. METODOLOGÍA. Se llevaron a cabo dos pasos metodológicos. Respecto al primero, se realizó un análisis del concepto Convivencia con un proceso crónico, a través del método evolutivo de Rodgers. El segundo paso metodológico fue el diseño de la escala, a través de la guía propuesta por DeVellis. RESULTADOS. A través del análisis de concepto se identificó que la Convivencia con un proceso crónico es un proceso complejo, dinámico, cíclico y multidimensional compuesto por los atributos de Aceptación, Afrontamiento, Automanejo, Integración y Adaptación. En cuanto a los resultados del diseño de la escala, se desarrolló una medida autocumplimentada, con cinco opciones de respuesta, tipo Likert y 27 ítems. CONCLUSIONES. La escala diseñada, es una medida innovadora y de interés potencial clínico que permite identificar qué factor o factores hacen que la persona conviva mejor o peor con la enfermedad y, consecuentemente, intervenir de manera integral, acorde con las necesidades individuales de cada persona (AU)

INTRODUCTION. Understanding how a person lives with a chronic illness is necessary to provide care according to the individual’s needs. Nowadays, there is no validated scale to measure how the person is living with a chronic condition, such as Parkinson’s disease. OBJECTIVES. The objectives were to: 1) define the concept of Living with a chronic illness; 2) design a measuring scale of the degree of Living with a chronic illness, in particular with Parkinson’s disease. METHODOLOGY. Two methodological steps were carried out. Regarding the first methodological step, a concept analysis of Living with a chronic illness was done using Rodgers’ evolutionary method. The second methodological step was the design of the scale, following DeVellis guideline. RESULTS. Through the concept analysis it was identified that Living with a chronic illness is a complex, dynamic, cyclic and multidimensional process, involving the attributes of Acceptance, Coping, Self-management, Integration and Adjustment. In relation to the design of the scale, it was developed a self-reported measure, with five Likert response options and 27 items. CONCLUSIONS. The designed scale, is an innovative measure with a high potential interest in clinical community to identify with are the factor(s) that make the person have a positive or negative living with the disease. Consequently, nurses could intervene in a holistic way, according to the patient individual needs (AU)

[Design of a Measuring Scale to Evaluate the Degree of Living with a Chonic Illness, Such as Parkinson's Disease]. / quirúrgica Diseño de una escala de medida del grado de convivencia en pacientes con un proceso crónico, como la enfermedad de Parkinson.

Introduction: Understanding how a person lives with chronic illness is necessary to provide care according to the individual's needs. Nowadays, there is no validated scale to measure how the person is living with a chronic condition, such as Parkinson's disease. Objectives: The objectives were to: 1) define the concept of Living with a chronic illness; 2) design a measuring scale of the degree of Living with a chronic illness, in particular with Parkinson's disease. Methodology: Two methodological steps were carried out. Regarding the first methodological step, a concept analysis of Living with a chronic illness was done using Rodgers' evolutionary method. the second methodological step was the design of the scale, following DeVellis guideline. Results: Through the concept analysis it was identified that Living with a chronic illness is a complex, dynamic, cyclic and multidimensional process, involving the attributes of Acceptance, Coping, Self-management, Integration and Adjustment. In relation to the design of the scale, it was developed a self-reported measure, with five Likert response options and 27 items. Conclusions: The designed scale, is an innovative measure with a high potential interest in clinical community to identify with are the factor(s) that make the person have a positive or negative living with the disease. Consequently, nurses could intervene in a holistic way, according to the patient individual needs.

Social Network Type and Long-Term Condition Management Support: A Cross-Sectional Study in Six European Countries.

BACKGROUND: Network types and characteristics have been linked to the capacity of inter-personal environments to mobilise and share resources. The aim of this paper is to examine personal network types in relation to long-term condition management in order to identify the properties of network types most likely to provide support for those with a long-term condition. METHOD: A cross-sectional observational survey of people with type 2 diabetes using interviews and questionnaires was conducted between April and October 2013 in six European countries: Greece, Spain, Bulgaria, Norway, United Kingdom, and Netherlands. 1862 people with predominantly lower socio-economic status were recruited from each country. We used k-means clustering analysis to derive the network types, and one-way analysis of variance and multivariate logistic regression analysis to explore the relationship between network type socio-economic characteristics, self-management monitoring and skills, well-being, and network member work. RESULTS: Five network types of people with long-term conditions were identified: restricted, minimal family, family, weak ties, and diverse. Restricted network types represented those with the poorest self-management skills and were associated with limited support from social network members. Restricted networks were associated with poor indicators across self-management capacity, network support, and well-being. Diverse networks were associated with more enhanced self-management skills amongst those with a long-term condition and high level of emotional support. It was the three network types which had a large number of network members (diverse, weak ties, and family) where healthcare utilisation was most likely to correspond to existing health needs. DISCUSSION: Our findings suggest that type of increased social involvement is linked to greater self-management capacity and potentially lower formal health care costs indicating that diverse networks constitute the optimal network type as a policy in terms of the design of LTCM interventions and building support for people with LTCs.

Fervidobacterium thailandense sp. nov., an extremely thermophilic bacterium isolated from a hot spring.

Strain FC2004T, a strictly anaerobic, extremely thermophilic heterotroph, was isolated from a hot spring in Thailand. Typical cells of strain FC2004T were rod shaped (0.5-0.6×1.1-2.5 µm) with an outer membrane swelling out over an end. Filaments (10-30 µm long) and membrane-bound spheroids containing two or more cells inside (3-8 µm in diameter) were observed. The temperature range for growth was 60-88°C (optimum 78-80°C), pH range was 6.5-8.5 (optimum pH 7.5) and NaCl concentration range was 0 to <5 g l-1 (optimum 0.5 g l-1). S0 stimulated growth yield. S2O32- and NO3- did not influence growth. Glucose, maltose, sucrose, fructose, cellobiose, CM-cellulose and starch were utilized for growth. The membrane was composed mainly of the saturated fatty acids C16:0 and C18:0. The DNA G+C content was 45.8 mol%. The 16S rRNA gene sequence of strain FC2004T revealed highest similarity to species of the genus Fervidobacterium: F. pennivorans DSM 9078T (97-96 %), F. islandicum AW-1 (96 %), F. changbaicum CBS-1T (96 %), F. islandicum H21T (95 %), F. nodosum Rt17-B1T (95 %), F. riparium 1445tT (95 %) and F. gondwanense AB39T (93 %). Phylogenetic analysis of 16S rRNA gene sequences and average nucleotide identity analysis suggested that strain FC2004T represented a novel species within the genus Fervidobacterium, for which the name Fervidobacterium thailandense sp. nov. is proposed. The type strain is FC2004T (=JCM 18757T=ATCC BAA-2483T).

Social Support and Health in Diabetes Patients: An Observational Study in Six European Countries in an Era of Austerity.

INTRODUCTION: Support from individual social networks, community organizations and neighborhoods is associated with better self-management and health outcomes. This international study examined the relative impact of different types of support on health and health-related behaviors in patients with type 2 diabetes. METHODS: Observational study (using interviews and questionnaires) in a sample of 1,692 type 2 diabetes patients with 5,433 connections from Bulgaria, Greece, Netherlands, Norway, Spain, and the United Kingdom. Outcomes were patient-reported health status (SF-12), physical exercise (RAPA), diet and smoking (SDCSCA). Random coefficient regression models were used to examine linkages with individual networks, community organizations, and neighborhood type (deprived rural, deprived urban, or affluent urban). RESULTS: Patients had a median of 3 support connections and 34.6% participated in community organizations. Controlled for patients' age, sex, education, income and comorbidities, large emotional support networks were associated with decrease of non-smoking (OR = 0.87). Large practical support networks were associated with worse physical and mental health (B = -0.46 and -0.27 respectively) and less physical activity (OR = 0.90). Participation in community organizations was associated with better physical and mental health (B = 1.39 and 1.22, respectively) and, in patients with low income, with more physical activity (OR = 1.53). DISCUSSION: Participation in community organizations was most consistently related to better health status. Many diabetes patients have individual support networks, but this study did not provide evidence to increase their size as a public health strategy. The consistent association between participation in community organizations and health status provides a clear target for interventions and policies.

Emerging trends in diabetes care practice and policy in The Netherlands: a key informants study.

BACKGROUND: Effective self-management is viewed as the cornerstone of diabetes care. Many interventions and policies are available to support self-management, but challenges remain regarding reaching specific subgroups and effectively changing lifestyles. Here, our aim was to identify emerging policies and practices regarding diabetes care in The Netherlands. METHODS: Study with a purposeful sample of key informants, covering a range of stakeholders. They were individually interviewed, using a flexible and semi-structured approach. A thematic analysis was done, guided by an international framework, which resulted in 28 themes. RESULTS: After a decade of investing in diabetes care in The Netherlands, stakeholders seem to have shifted their focus towards a view that effective self-management is expected in most people. The expectation is that individuals' personal networks, community organizations and emerging information technologies will facilitate this. If support of self-management is required, this has to be provided by local coalitions of health and social care organizations, with involvement of municipalities. Poor reach in specific subgroups of the population, such as economically deprived people, is recognized but has not led to targeted policies. CONCLUSIONS: The role of healthcare providers in supporting patients' self-management in diabetes care seems to be changing in The Netherlands.

A cloning strategy to obtain recombinant proteins with identical primary structure to the native forms.

Recombinant gene strategies using fusion tags for purification are essential procedures to obtain large protein quantities. However, most cloning systems result in recombinant proteins with added amino acids inexistent in their native forms which can lead to significant changes in protein properties. An original and simple cloning strategy is proposed to obtain proteins identical in amino acid sequence to the native proteins.

General anesthesia: as a challenge and treatment need option in pediatric dentistry.

OBJECTIVE: The purpose of this study was to determine the type and characteristics of the interventions, indications of dental treatment and procedures performed to patients treated under general anesthesia (GA) by pediatric dentistry residents, during the 1997-1999 period. METHOD: A sample of 57 hospital records of patients treated as part of the Special Pediatric Course at the Puerto Rico Pediatric Hospital were reviewed. Statistical analysis was done using the chi-square test for inferences on proportions. RESULTS: MR patients made up 59.7% and NMR patients made up 40.3% of the sample studied. Ages ranged from 2 to 35 years with a mean age of 11 years (SD=8.54). MR patients were classified into 7 categories: mental retardation (38.2%), cerebral palsy (14.7%), epileptic (5.9%), mental syndromes (26.9%), hydrocephalic (5.9%), autism (5.9%) and others (2.9%). The NMR were classified into 5 categories: early childhood caries (65.2%), cardiac patients (8.7%), maxillofacial anomalies (4.3%), organic syndromes (13.1%) and others (8.7%). The dental procedures performed were: dental extractions 84%(MR) and 68% (NMR), restorative procedures 87.3%(MR) and 12.7%(NMR). Oral prophylaxis was performed in 76.8%, fissure sealants in 10.7% and topical fluoride applications in 21.8%. CONCLUSION: Dental extraction was a frequently performed procedure in both groups. The prevalence of exodontia and restorative procedures indicates the need to design and implement prevention programs for special pediatric patients.