Genome-scale metabolic modeling of the human milk oligosaccharide utilization by Bifidobacterium longum subsp. infantis.

Bifidobacterium longum subsp. infantis is a representative and dominant species in the infant gut and is considered a beneficial microbe. This organism displays multiple adaptations to thrive in the infant gut, regarded as a model for human milk oligosaccharides (HMOs) utilization. These carbohydrates are abundant in breast milk and include different molecules based on lactose. They contain fucose, sialic acid, and N-acetylglucosamine. Bifidobacterium metabolism is complex, and a systems view of relevant metabolic pathways and exchange metabolites during HMO consumption is missing. To address this limitation, a refined genome-scale network reconstruction of this bacterium is presented using a previous reconstruction of B. infantis ATCC 15967 as a template. The latter was expanded based on an extensive revision of genome annotations, current literature, and transcriptomic data integration. The metabolic reconstruction (iLR578) accounted for 578 genes, 1,047 reactions, and 924 metabolites. Starting from this reconstruction, we built context-specific genome-scale metabolic models using RNA-seq data from cultures growing in lactose and three HMOs. The models revealed notable differences in HMO metabolism depending on the functional characteristics of the substrates. Particularly, fucosyl-lactose showed a divergent metabolism due to a fucose moiety. High yields of lactate and acetate were predicted under growth rate maximization in all conditions, whereas formate, ethanol, and 1,2-propanediol were substantially lower. Similar results were also obtained under near-optimal growth on each substrate when varying the empirically observed acetate-to-lactate production ratio. Model predictions displayed reasonable agreement between central carbon metabolism fluxes and expression data across all conditions. Flux coupling analysis revealed additional connections between succinate exchange and arginine and sulfate metabolism and a strong coupling between central carbon reactions and adenine metabolism. More importantly, specific networks of coupled reactions under each carbon source were derived and analyzed. Overall, the presented network reconstruction constitutes a valuable platform for probing the metabolism of this prominent infant gut bifidobacteria.IMPORTANCEThis work presents a detailed reconstruction of the metabolism of Bifidobacterium longum subsp. infantis, a prominent member of the infant gut microbiome, providing a systems view of its metabolism of human milk oligosaccharides.

Occupational balance of Spanish occupational therapists - a challenge.

BACKGROUND: Occupational balance is a central aspect in occupational therapy. Awareness of occupational balance/imbalance among occupational therapists could influence the orientation of their professional interventions. OBJECTIVE: To describe and compare the occupational balance status of occupational therapists working in Spain. MATERIAL AND METHODS: Cross-sectional descriptive study using an online questionnaire. Participants were occupational therapists working in Spain who answered a questionnaire including 22 questions on the sociodemographic and employment data and the Spanish version of the Occupational Balance Questionnaire (OBQ-E) ranging 0-65 where higher ratings equal better occupational balance. RESULTS: A total of 648 currently working occupational therapists participated. Mostly women, with median age of 32 years, without partner, children, or dependents. The median OBQ-E was 37 (IQR = 27; 45). Statistically significant differences were found between the medians of participants varying in the categories 'hired as an occupational therapist', weekly work hours, and population working with children and adults. CONCLUSIONS AND SIGNIFICANCE: Spanish occupational therapists presented a moderate occupational balance that varied between subgroups. Professional recognition, working hours, and the population they attend are aspects that influence their occupational balance. Knowledge of occupational therapists' occupational balance could contribute to the development of policies aimed at promoting it.

Intervenciones basadas en el ejercicio y el entorno para la prevención de caídas en personas con deterioro cognitivo que viven en centros de cuidado: revisión sistemática y metaanálisis / Interventions based on exercise and physical environment for preventing falls in cognitively impaired older people living in long-term care facilities: a systematic review and meta-analysis

Esta revisión evalúa la efectividad de las intervenciones que utilizan el ejercicio y/o la modificación ambiental para la prevención de caídas en ancianos institucionalizados con deterioro cognitivo. Durante julio de 2014 se consultaron las principales bases bibliográficas y recursos especializados sobre el tema. Se seleccionaron ensayos controlados aleatorizados sobre intervenciones destinadas a prevenir caídas, que incluían el ejercicio físico y/o modificaciones del entorno, aplicadas en esta población. Dos revisores valoraron independientemente la elegibilidad y la calidad metodológica de los estudios. Se agruparon los datos cuando fue adecuado. Se identificaron 14 estudios con 3.539 participantes que utilizaban el ejercicio y/o la modificación ambiental de forma única o combinada con otras intervenciones. Ambas intervenciones demostraron efectividad en la reducción del número de caídas, desde un enfoque combinado. No obstante, hacen falta más estudios para asegurar la efectividad del uso del ejercicio y del entorno para la prevención de caídas en esta población (AU)

This systematic review aims to report the effectiveness of interventions based on exercise and/or physical environment for reducing falls in cognitively impaired older adults living in long-term care facilities. In July 2014, a literature search was conducted using main databases and specialised sources. Randomised controlled trials assessing the effectiveness of fall prevention interventions, which used exercise or physical environment among elderly people with cognitive impairment living in long-term care facilities, were selected. Two independent reviewers checked the eligibility of the studies, and evaluated their methodological quality. If it was adequate, data were gathered. Fourteen studies with 3,539 participants using exercise and/or physical environment by a single or combined approach were included. The data gathered from studies that used both interventions showed a significant reduction in fall rate. Further research is needed to demonstrate the effectiveness of those interventions for preventing falls in the elderly with cognitive impairment living in long-term care establishments (AU)

[Interventions based on exercise and physical environment for preventing falls in cognitively impaired older people living in long-term care facilities: A systematic review and meta-analysis]. / Intervenciones basadas en el ejercicio y el entorno para la prevención de caídas en personas con deterioro cognitivo que viven en centros de cuidado: revisión sistemática y metaanálisis.

This systematic review aims to report the effectiveness of interventions based on exercise and/or physical environment for reducing falls in cognitively impaired older adults living in long-term care facilities. In July 2014, a literature search was conducted using main databases and specialised sources. Randomised controlled trials assessing the effectiveness of fall prevention interventions, which used exercise or physical environment among elderly people with cognitive impairment living in long-term care facilities, were selected. Two independent reviewers checked the eligibility of the studies, and evaluated their methodological quality. If it was adequate, data were gathered. Fourteen studies with 3,539 participants using exercise and/or physical environment by a single or combined approach were included. The data gathered from studies that used both interventions showed a significant reduction in fall rate. Further research is needed to demonstrate the effectiveness of those interventions for preventing falls in the elderly with cognitive impairment living in long-term care establishments.

Fractura de fémur: aspectos rehabilitadores / No disponible

La fractura de fémur es una de las patologías más prevalentes y que provoca una importante morbimortalidad y discapacidad en los pacientes atendidos en los servicios de rehabilitación hospitalarios. El abordaje de la misma ha de ser interdisciplinario, debiendo existir una estrecha relación entre los servicios de urgencias, geriatría, cirugía ortopédica y traumatología y rehabilitación con el objetivo de realizar intervenciones que permitan obtener resultados más eficaces y eficientes. Los servicios de rehabilitación deben garantizar un tratamiento integral de la fractura de fémur. La prevención de los dos factores que predisponen a la misma como son las caídas y la osteoporosis, con intervenciones basadas fundamentalmente en la promoción de la actividad física y el ejercicio terapeútico. El tratamiento rehabilitador del paciente afecto de fractura de fémur ha de tener como objetivo fundamental el recuperar la capacidad de deambulación previa. Para realizar una correcta planificación se deberán tener en cuenta aspectos relacionados con la situación previa del paciente como las enfermedades concomitantes, el grado de funcionalidad y la situación sociofamiliar. Los programas se iniciarán de forma precoz, en el postoperatorio inmediato, estimulando la carga y deambulación en las fases tempranas con el objeto de minimizar las complicaciones de la inmovilización(AU)

A fractured femur is one of the most prevalent diseases and causes significant morbidity-mortality and disability in patients in hospital rehabilitation services. The same approach must be interdisciplinary and should be a close relationship between the emergency services, geriatrics, orthopedics and rehabilitation with the aim of developing interventions that can produce more effective and efficient results. Rehabilitation services should ensure a comprehensive treatment of hip fracture. The prevention of the two factors that predispose to it as are the falls and osteoporosis, mainly based interventions in promoting physical activity and therapeutic exercise. The rehabilitative treatment of the patient suffering from a fractured femur has a fundamental aim recover to walking. For proper planning should take into account issues related to the previous situation of the patient and concomitant diseases, the degree of functionality and social and family situation. The program is initiated early, in the immediate postoperative period, stimulating the load and walking in the early stages in order to minimize(AU)

Condicionantes en la prescripción, uso y entrenamiento de las ayudas técnicas en geriatría en diferentes ámbitos asistenciales / No disponible

Las ayudas técnicas (AT) forman parte de los recursos utilizados en Geriatría para promover la autonomía del anciano en sus actividades cotidianas. La prescripción de la AT la pueden realizar diferentes profesionales que forman parte del equipo asistencial, cada uno de ellos dentro de su competencia y en muchas ocasiones la prescripción es fruto del trabajo interdisciplinar. La valoración que el terapeuta ocupacional (TO) realiza sobre la funcionalidad del anciano y el conocimiento de los componentes de la actividad le permitirá establecer los recursos necesarios para tratar o paliar la dependencia. Por ello, la prescripción, el ajuste y el entrenamiento de la AT también forman parte de las competencias de este profesional. Se han escogido cuatro entornos asistenciales diferentes en Geriatría donde el TO desarrolla su labor. Se describen, según nuestra experiencia, las ventajas, desventajas y los condicionantes encontrados durante la prescripción, el uso y entrenamiento de la AT en cada uno de estos ámbitos. El entorno, el estado funcional del paciente y proceso recuperador, la estancia, el cuidador, el seguimiento, el trabajo interdisciplinar y el acceso a la AT son los principales condicionantes que pueden afectar positiva o negativamente sobre la efectividad de la AT en el anciano (AU)

Technical Aids (TA) are part of the recourses used in Geriatrics to promote independence in elderly peoples’ daily activities. The prescription of TA can be carried out by various professionals who form part of the assistanceteam, each worker within their own field and, on many occasions, it is the fruit of interdisciplinary work. Assessment of an elderly person by an occupational therapist (OT), coupled with their knowledge of the patient’s routine allows us to establish the recourses necessary to treat or alleviate the patient’s dependency.Therefore, the prescription, adjustment and treatment with TA forms part of the field in this profession. Four different care settings have been chosen where TA is being developed. We have described, according our experience, the determining factors, advantages and disadvantages encountered during prescription, use and training with TA in each context. The environment, the functional state of the patient and the recovery process, their stay, their carer, their monitoring, the interdisciplinary work and access to TA are the principal conditions which can positively or negatively affect the effectiveness of the TA on the elderly patient in question (AU)