Non-motor symptom burden in patients with Parkinson's disease with impulse control disorders and compulsive behaviours : results from the COPPADIS cohort

The study was aimed at analysing the frequency of impulse control disorders (ICDs) and compulsive behaviours (CBs) in patients with Parkinson's disease (PD) and in control subjects (CS) as well as the relationship between ICDs/CBs and motor, nonmotor features and dopaminergic treatment in PD patients. Data came from COPPADIS-2015, an observational, descriptive, nationwide (Spain) study. We used the validated Questionnaire for Impulsive-Compulsive Disorders in Parkinson's Disease-Rating Scale (QUIP-RS) for ICD/CB screening. The association between demographic data and ICDs/CBs was analyzed in both groups. In PD, this relationship was evaluated using clinical features and treatment-related data. As result, 613 PD patients (mean age 62.47 ± 9.09 years, 59.87% men) and 179 CS (mean age 60.84 ± 8.33 years, 47.48% men) were included. ICDs and CBs were more frequent in PD (ICDs 12.7% vs. 1.6%, p < 0.001; CBs 7.18% vs. 1.67%, p = 0.01). PD patients had more frequent previous ICDs history, premorbid impulsive personality and antidepressant treatment (p < 0.05) compared with CS. In PD, patients with ICDs/CBs presented younger age at disease onset, more frequent history of previous ICDs and premorbid personality (p < 0.05), as well as higher comorbidity with nonmotor symptoms, including depression and poor quality of life. Treatment with dopamine agonists increased the risk of ICDs/CBs, being dose dependent (p < 0.05). As conclusions, ICDs and CBs were more frequent in patients with PD than in CS. More nonmotor symptoms were present in patients with PD who had ICDs/CBs compared with those without. Dopamine agonists have a prominent effect on ICDs/CBs, which could be influenced by dose

Primeras experiencias en evaluación de la competencia clínica de los médicos de familia de Catalunya

ObjetivoConstruir un instrumento válido para evaluar la competencia clínica de los médicos de familia y establecer el estándar de la profesión.DiseñoConstrucción de una prueba de evaluación clínica objetiva y estructurada por parte del Comité de Prueba de la Societat Catalana de Medicina Familiar i Comunitària (SCMFiC) con 27 situaciones clínicas representativas de la práctica de atención primaria, utilizando diversos instrumentos evaluativos, con una duración total de 5 horas y 30 minutos.EmplazamientoDos áreas básicas de salud de Barcelona para la realización de las dos ediciones de la prueba.ParticipantesMédicos de familia, miembros de la SCMFiC, que participaron voluntariamente tras haber sido invitados por carta.Mediciones y resultados principalesEn la primera edición de la prueba participaron 23 médicos, con una edad media de 36,6 años (DE, 6,9), siendo un 52,2% mujeres. En la segunda edición participaron 46 médicos, con una edad media de 30,9 (DE, 2,1), siendo un 76,1 mujeres. La prueba tuvo un coeficiente global de fiabilidad, alfa de Cronbach, de 0,83 en su primera edición y 0,65 en su segunda. La puntuación media global de los participantes de la primera edición fue de 56,9 (DE, 19,2), siendo 100 la puntuación máxima obtenible y la de los participantes de la segunda edición, 62,1 (DE, 4,1).ConclusionesLa experiencia de la SCMFiC es la primera por lo que refiere a la evaluación de la competencia clínica de los médicos de familia en nuestro ámbito, y se trata de una prueba fiable y válida para valorar la competencia de nuestros profesionales.ObjectivesTo construct a valid instrument to evaluate the clinical competence of family doctors and establish professional standards.DesignConstruction of an objective and structured clinical evaluation test by the Test Committee of the Catalan Society of Family and Community Medicine (SCMFiC) with 27 representative clinical situations of primary care practice. This used various evaluative instruments and lasted 5 hours and 30 minutes.Setting2 Barcelona health districts for the two runnings of the test.ParticipantsFamily doctors, SCMFiC members, who took part voluntarily after having been invited by letter.Measurements and main results23 doctors took part in the first running of the test. Their average age was 36.6 (SD 6.9) and 52.2% of them were women. 46 doctors took part in the second test. Their average age was 30.9 (SD 2.1) and 76.1 were women. The test had an overall reliability coefficient (Cronbach´s alpha) of 0.83 the first time and 0.65 the second time. The overall mean score of the participants the first time was 56.9 (SD 19.2), with 100 the top score possible, and 62.1 (SD 4.1) the second time.ConclusionsThis SCMFiC experiment is the first time the clinical competence of family doctors has been assessed in our area. It was a reliable and valid test to assess the competence of our health professionals

A multilingual background for telecollaboration Practices and policies in European higher education

The Trans-Atlantic and Pacific Project (TAPP) is a telecollaboration network linking European university classes with classes in the US and beyond for nearly 20 years. Such collaborations have enabled students to participate in realistic projects, fostering transversal and language skills – including English as a lingua franca – which are highlighted in university policies at European, country/region and institutional levels. In turn, telecollaboration can support Internationalisation at Home, along with virtual mobility objectives, increasingly prominent in European higher education. Considering the grassroots nature of TAPP, whose instructors design their own partnerships and assignments, this contribution examines TAPP projects in light of language policies from a dual bottom-up/top-down perspective. Thus, considering the importance of language policies of several European countries involved in TAPP (Belgium, France, Italy, Spain), this paper analyses how TAPP teaching-learning practices align with such policies in terms of multilingualism and interculturality. Attention is paid to students’ roles – subject-matter experts, linguists/translators, project managers, usability experts – and their native languages. Emphasis is placed on how students relate to English from their various perspectives as native speakers, second-language speakers, language experts or language learners. Lessons derived from the analysis of such practices can inform policy makers as they make provisions for Internationalisation at Home, mainly in Europe, while also introducing comparisons between European and US perspectives.Peer ReviewedPostprint (published version