What factors should we modify to promote high functioning and prevent functional decline in people with schizophrenia?

BackgroundSince research in schizophrenia mainly focuses on deficits and risk factors, we need studies searching for high-functioning protective factors. Thus, our objective was to identify protective (PFs) and risk factors (RFs) separately associated with high (HF) and low functioning (LF) in patients with schizophrenia.MethodsWe collected information (sociodemographic, clinical, psychopathological, cognitive, and functional) from 212 outpatients with schizophrenia. Patients were classified according to their functional level (PSP) as HF (PSP > 70, n = 30) and LF (PSP ≤ 50, n = 95). Statistical analysis consisted of Chi-square test, Student’s t-test, and logistic regression.ResultsHF model: variance explained: 38.4–68.8%; PF: years of education (OR = 1.227). RFs: receiving a mental disability benefit (OR = 0.062) and scores on positive (OR = 0.719), negative-expression (OR = 0.711), and negative-experiential symptoms (OR = 0.822), and verbal learning (OR = 0.866). LF model: variance explained: 42.0–56.2%; PF: none; RFs: not working (OR = 6.900), number of antipsychotics (OR = 1.910), and scores on depressive (OR = 1.212) and negative-experiential symptoms (OR = 1.167).ConclusionWe identified specific protective and risk factors for high and low functioning in patients with schizophrenia and confirmed that high functioning factors are not necessarily the opposite of those associated with low functioning. Only negative experiential symptoms are a shared and inverse factor for high and low functioning. Mental health teams must be aware of protective and risk factors and try to enhance or reduce them, respectively, to help their patients improve or maintain their level of functioning

Proceso agrario en Bolivia y América Latina

El material esta distribuido en cinco partes. La primera está referida a los resultados y perspectivas de la Reforma Agraria en Bolivia. Está dividida en tres temáticas: la Reforma Agraria en las Tierras Altas, la Reforma Agraria en las Tierras Bajas y la Reforma Agraria en el Chaco. La segunda parte contiene las intervenciones realizadas por los invitados extranjeros sobre los resultados y perspectivas de la Reforma Agraria en América Latina y en México, Perú y Ecuador. La tercera parte corresponde a las intervenciones de los representantes de las organizaciones indígenas y campesinas bolivianas, que fueron invitados para debatir el tema Tierra, Democracia y Poder. Esta parte esta precedida por un recuento general de la situación de los Movimientos Indígenas-Campesinos en América Latina y sus perspectivas. La cuarta da cuenta de las intervenciones hechas por los representantes de las organizaciones de productores agrarios, campesinos y empresarios, quienes fueron invitados para debatir el tema Tierra, Economía e Integración. La última parte es una síntesis de las ideas y aspectos relevantes producto de las exposiciones y de las preguntas de los asistentes al seminario, que dejaron una estela de inquietudes e iniciativas que son el eslabón para futuros debates en otros espacios de reflexión en diferentes lugares del país, con la participación de actores y pensadores, operadores y promotores del desarrollo rural.Presentación 7; Introducción 8; La Reforma Agraria abandonada: valles y altiplano, Miguel Urioste F. de C. 19; Medio siglo de Reforma Agraria boliviana, Danilo Paz Ballivián 53; La tierra es de quien la trabaja, René Salomón Vargas 65; La Reforma Agraria en las tierras bajas de Bolivia, Carlos Romero Bonifaz 83; Lógicas de ocupación territorial en la agricultura y la forestería empresarial en las tierras bajas, Alan Bojanic 127; Antecedentes, situación actual y recomendaciones en la tenencia de la tierra en el oriente boliviano, Cámara Agropecuaria del Oriente 137; 50 años de la Reforma Agraria en el Chaco boliviano, Oscar Bazoberry Chali 145; Resultados de los cambios introducidos por la Reforma Agraria, Erwin Galoppo von Borries 177; La Reforma Agraria en Bolivia y el MST, Ermelinda Fernández Bamba 191; La Reforma Agraria en América Latina, Jacques Chonchol 205; De rústicas revueltas: Añoranza y utopía en el México rural, Armando Bartra 223; Reforma y contrarreforma agraria en el Perú, Laureano del Castillo Pinto 255; Reforma Agraria en el Ecuador, Fausto Jordán B. 285; 50 años después, emergencia étnica, Xavier Albó 321; Tierra, mujer y desarrollo, María Machaca 329; Tierra y territorio comunitario, Bienvenido Zacu 333; Tierra, migración y colonización, José Luis Méndez Chaurara 341; Tierra, coca y desarrollo, Dionisio Núñez 355; Tierra para todos, Ángel Durán 359; Tierra y producción orgánica, Mario R. Cordero Camacho 367; Tierra y producción campesina, María Julia Jiménez 377; Tierra y Territorio y Políticas para la Tierra, Elizabeth Jiménez Zamora 385; Ideas y aspectos relevantes del Seminario, John D.Vargas Vega 429

New insights into the genetic etiology of Alzheimer's disease and related dementias

Characterization of the genetic landscape of Alzheimer's disease (AD) and related dementias (ADD) provides a unique opportunity for a better understanding of the associated pathophysiological processes. We performed a two-stage genome-wide association study totaling 111,326 clinically diagnosed/'proxy' AD cases and 677,663 controls. We found 75 risk loci, of which 42 were new at the time of analysis. Pathway enrichment analyses confirmed the involvement of amyloid/tau pathways and highlighted microglia implication. Gene prioritization in the new loci identified 31 genes that were suggestive of new genetically associated processes, including the tumor necrosis factor alpha pathway through the linear ubiquitin chain assembly complex. We also built a new genetic risk score associated with the risk of future AD/dementia or progression from mild cognitive impairment to AD/dementia. The improvement in prediction led to a 1.6- to 1.9-fold increase in AD risk from the lowest to the highest decile, in addition to effects of age and the APOE ε4 allele

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

VI jornadas de intercambio de experiencias educativas

Se recogen las ponencias presentadas en las VI jornadas de intercambio de experiencias educativas.AsturiasUniversidad de Oviedo. Facultad de Ciencias de la Educación; Calle Aniceto Sela s. n.; 33005 Oviedo; +34985103215; +34985103214;ES