Detection of West Nile virus-specific antibodies and nucleic acid in horses and mosquitoes, respectively, in Nuevo Leon State, northern Mexico, 2006-2007.

In the last 5 years, there has been only one reported human case of West Nile virus (WNV) disease in northern Mexico. To determine if the virus was still circulating in this region, equine and entomological surveillance for WNV was conducted in the state of Nuevo Leon in northern Mexico in 2006 and 2007. A total of 203 horses were serologically assayed for antibodies to WNV using an epitope-blocking enzyme-linked immunosorbent assay (bELISA). Seroprevalences for WNV in horses sampled in 2006 and 2007 were 26% and 45%, respectively. Mosquito collections in 2007 produced 7365 specimens representing 15 species. Culex mosquitoes were screened for WNV RNA and other genera (Mansonia, Anopheles, Aedes, Psorophora and Uranotaenia) were screened for flaviviruses using reverse-transcription (RT)-PCR. Two pools consisting of Culex spp. mosquitoes contained WNV RNA. Molecular species identification revealed that neither pool included Culex quinquefasciatus (Say) (Diptera:Culicidae) complex mosquitoes. No evidence of flaviviruses was found in the other mosquito genera examined. These data provide evidence that WNV is currently circulating in northern Mexico and that non-Cx. quinquefasciatus spp. mosquitoes may be participating in the WNV transmission cycle in this region.

A Community Program of Integrated Care for Frail Older Adults: +AGIL Barcelona.

OBJECTIVES: To assess the 3-month impact on physical function of a program for community-dwelling frail older adults, based on the integration of primary care, geriatric medicine, and community resources, implemented in "real life". DESIGN: Interventional cohort study. SETTING: Primary care in Barcelona, Spain. PARTICIPANTS: Individuals aged ≥80 years (n=134), presenting at least one sign of frailty (i.e., slow gait speed, weakness, memory complaints, involuntary weight loss, poor social support). INTERVENTION: After frailty screening by the primary care team, candidates were referred to a geriatric team (geriatrician + physical therapist), who performed a comprehensive geriatric assessment and designed a tailored multidisciplinary intervention in the community, including a) multi-modal physical activity (PA) sessions, b) promotion of adherence to a Mediterranean diet c) health education and d) medication review. MEASUREMENTS: Participants were assessed based on a comprehensive geriatric assessment including physical performance (Short Physical Performance Battery -SPPB- and gait speed), at baseline and at a three month follow-up. RESULTS: A total of 112 (83.6%) participants (mean age=80.8 years, 67.9% women) were included in this research. Despite being independent in daily life, participants' physical performance was impaired (SPPB=7.5, SD=2.1, gait speed=0.71, SD=0.20 m/sec). After three months, 90.2% of participants completed ≥7.5 physical activity sessions. The mean improvements were +1.47 (SD 1.64) points (p<0.001) for SPPB, +0.08 (SD 0.13) m/sec (p<0.001) for gait speed, -5.5 (SD 12.10) sec (p<0.001) for chair stand test, and 53% (p<0.001) improved their balance. Results remained substantially unchanged after stratifying the analyses according to the severity of frailty. CONCLUSIONS: Our results suggested that a "real-world" multidisciplinary intervention, integrating primary care, geriatric care, and community services may improve physical function, a marker of frailty, within 3 months. Further studies are needed to address the long-term impact and scalability of this implementation program.

[Agrammatism and its symptoms]. / El agramatismo y su sintomatología.

INTRODUCTION: We present a review the issue of agrammatism in order to examine its symptoms, the regularity with which they are observed, and the proposals suggested within the framework of Cognitive Neuropsychology to account for them. DEVELOPMENT: First, we focus on the debate regarding the status of agrammatism as an aphasic category with both theoretical and clinical validity, presenting two confronted views. On the one hand, the view that argues against the category of agrammatism due the variable performance of agrammatic patients in linguistic tasks. On the other hand, we present the view of those authors who defend, despite the variability, the notion of agrammatism as an aphasic syndrome. In the second section of the paper, we discussed the different symptoms that, on the basis of the available evidence, have been associated to agrammatism and the proposed explanations. We start by discussing the symptoms that agrammatic patients present in language production; in particular, we highlight the following: a) problems related to grammatical morphemes; b) a reduced sentence length; c) a noun-verb dissociation, with a better performance with nouns; d) difficulties in sentence construction, and finally, e) alteration in word order. Then, we discuss the symptoms that agrammatic patients have shown in language comprehension. CONCLUSION: In general, on the basis of the different agrammatic symptoms we have discussed, we favour the view of agrammatism as multicomponential syndrome rather than unitary one, with deficits in both morpholexical and syntactic language components.

Skin cancer attitudes: a cross-national comparison.

A questionnaire concerning attitudes towards skin cancer, sun exposure and general environmental issues was administered to 132 holiday-makers on a beach in south-west England and (in translation) to 142 visitors to another beach in north-west Italy. Following the Janis & Mann (1977) classification of strategies for coping with decision conflicts, subscales were derived measuring tendencies to 'avoid' thinking about environmental issues, to 'bolster' prior attitudes (by playing down the seriousness of the risk of skin cancer while attending to the pleasures of sunbathing), and to be 'vigilant' concerning risk information and the need for specific protective behaviour (e.g. sunscreen use). The British scored higher than the Italians, and women higher than men, on vigilance, but there were no gender or nationality differences on the other subscales considered as a whole. Responses were also related to the covariates of age and self-reported vulnerability to sunburn. Those who showed less concern with environmental issues also tended to play down the risks of skin cancer and be less vigilant with regard to self-protection. It is suggested that health promotion should address both cultural norms concerning exposure to the sun and people's intuitive notions about their relative personal vulnerability.

Acceso y cesión de la información genética contenida en la historia clínica (2. parte) / The access and use possibilities of the genetic information content in medical records

Una de las cuestiones más delicadas relacionadas con el tratamientode los datos genéticos en el sector sanitario, es la relativaa las posibilidades de acceso y uso de esta información,objeto de interés para terceros ajenos al ámbito sanitario. Elobjetivo del estudio, es delimitar los requisitos, condiciones ysujetos que pueden tener acceso a la información contenida enla historia clínica. Para ello, se ha analizado críticamente la normativainternacional y nacional que regula el tratamiento deestos datos, delimitando los conceptos legales, los principiosfundamentales que rigen su protección y los derechos del afectadoen relación con el tratamiento de este tipo de información.Se ha detectado la ausencia en el Ordenamiento jurídico españolde una norma específica que regule el tratamiento de losdatos genéticos y de una mención particular dentro de las normasque regulan los derechos del paciente en materia de documentaciónclínica, al reconducir la protección de la informacióngenética a la categoría genérica de datos relativos a la salud y alas normas reguladoras de los mismos. Esto se traduce en unainsuficiente protección para esta información de carácter personal,cuya divulgación puede colocar al individuo en una situaciónde vulnerabilidad frente a intereses de terceros. Por ello, ha deapelarse a una aplicación estricta de los principios y derechosque rigen en materia de protección de datos, pues los derechosfundamentales constituyen un pilar básico a tener en cuenta enel tratamiento de los datos genéticos

One of the most delicated questions in relation with thegenetic data processing in the health sector, is the relative tothe access and use possibilities of this information, an interestpoint for third persons outside the health area. Theobjective of this investigation is to delimit the requisites, conditionsand individuals who can access to the informationcontent in the case-history. For that, it has been criticallyanalyzed the international and national guidelines whichregulate the data treatment, delimiting the legal concepts,the fundamental principles that rules its protection and therights of the affected in relation with the treatment for thiskind of information. It has detected the absence of a specificnorm in the Spanish Legislation which rules the genetic datatreatment and a particular mention inside the norms thatrules the patient´s rights in the matter of clinic documents,to renew the protection of the genetic information to thegeneric category of data relative to the health and the rulednorms of selfsame. That means, no enough protection forthis personal information, for which circulation can cause avulnerable situation to the individual in relation with third persons.For that, it is necessary a severe application of theprinciples and rights that rules in matter of data protection,because the fundamental rights are one of the main pointsto take in account in the genetic data treatment

El agramatismo y su sintomatología / Agrammatism and its symptoms

Introducción. Se presenta una revisión sobre el agramatismo con el objetivo de examinar cuál es su sintomatología, la regularidad con la que se presenta y las explicaciones propuestas desde la neuropsicología cognitiva para dar cuenta de la misma. Desarrollo. En primer lugar, se expone el debate acerca del estado de agramatismo como categoría afásica con validez teórica y clínica, distinguiendo dos posturas enfrentadas: por un lado, la de quienes cuestionan la categoría clínica del agramatismo debido a la variabilidad que se observa en la ejecución de las tareas lingüísticas de los pacientes diagnosticados clínicamente como agramáticos; por otro lado, la postura de quienes defienden, a pesar de las posibles variaciones, la existencia del agramatismo como síndrome afásico. En la segunda sección se discuten los síntomas que, según los datos obtenidos hasta el momento, se han asociado con el agramatismo, así como las explicaciones propuestas. Se exponen primero los síntomas que se observan en la producción lingüística de estos pacientes. Entre ellos destacan: 1. Problemas relacionados con los morfemas gramaticales; 2. Una longitud media de emisión oracional reducida; 3. Una disociación entre nombre y verbo, con una mejor ejecución en los nombres; 4. Dificultades en la construcción de oraciones; y 5. Alteraciones en el orden de las palabras. A continuación, se tratan los síntomas que los pacientes considerados agramáticos manifiestan en el ámbito de la comprensión del lenguaje. Conclusión. En su conjunto, la revisión de los síntomas que se observan en el paciente agramático que hemos presentado en este artículo apoya una visión del agramatismo como síndrome multicomponencial más que como un síndrome unitario, y los componentes

Introduction. We present a review the issue of agrammatism in order to examine its symptoms, the regularity with which they are observed, and the proposals suggested within the framework of Cognitive Neuropsychology to account for them. Development. First, we focus on the debate regarding the status of agrammatism as an aphasic category with both theoretical and clinical validity, presenting two confronted views. On the one hand, the view that argues against the category of agrammatism due the variable performance of agrammatic patients in linguistic tasks. On the other hand, we present the view of those authors who defend, despite the variability, the notion of agrammatism as an aphasic syndrome. In the second section of the paper, we discussed the different symptoms that, on the basis of the available evidence, have been associated to agrammatism and the proposed explanations. We start by discussing the symptoms that agrammatic patients present in language production; in particular, we highlight the following: a) problems related to grammatical morphemes; b) a reduced sentence length; c) a noun-verb dissociation, with a better performance with nouns; d) difficulties in sentence construction, and finally, e) alteration in word order. Then, we discuss the symptoms that agrammatic patients have shown in language comprehension. Conclusion. In general, on the basis of the different agrammatic symptoms we have discussed, we favour the view of agrammatism as multicomponential syndrome rather than unitary one, with deficits in both morpholexical and syntactic language components