Morphological evaluation of cardoon (Cynara cardunculus L.): assessing biodiversity for applications based on tradition, innovation and sustainability

Selected cardoon cultivars established in the “Serra da Estrela” region were analysed to evaluate morphological characteristics related principally to the production of cardoon flowers, which are a compulsory ingredient for particular Mediterranean PDO cheese regions. The biodiversity of twelve cardoon cultivars installed in an experimental field were evaluated over three growing seasons using thirty-four morphological descriptors. Statistically significant differences were found between cultivars for twenty-four morphological characteristics which indicate a wide genetic diversity. The relationship among the cultivars and characteristics was analysed using principal component analysis. A three dimensional template was found to be very significant and explained 71% of the total variation. The first component is dominated positively by plant height, diameter of stalk, inflorescence characteristics and flower production, while the second component is positively dominated by leaf characteristics. Cultivars A26, D32 and D33, present a plant architecture simultaneously well adapted for flower production, ease of harvesting and plant biomass. These characterizations and understandings can be useful for a plant breeding programme to develop cultivars for innovative potential applications besides flowers, and also for application by other cheese producers in Mediterranean regions.info:eu-repo/semantics/publishedVersio

Variability in storm climate along the Gulf of Cadiz: the role of large scale atmospheric forcing and implications to coastal hazards

In the context of increased coastal hazards due to variability in storminess patterns, the danger of coastal damages and/or morphological changes is related to the sum of sea level conditions, storm surge, maximum wave height and run up values. In order to better understand the physical processes that cause the variability of the above parameters a 44 years reanalysis record (HIPOCAS) was used. The HIPOCAS time-series was validated with real wave and sea-level data using linear and vector correlation methods. In the present work changes in the magnitude, duration, frequency and approach direction of the Atlantic storms over the Gulf of Cadiz (SW Iberian Peninsula) were identified by computing various storm characteristics such as maximum wave height, total energy per storm wave direction and storm duration. The obtained time-series were compared with large-scale atmospheric indices such as the North Atlantic Oscillation (NAO) and the East Atlantic pattern. The results show a good correlation between negative NAO values and increased storminess over the entire Gulf of Cadiz. Furthermore, negative NAO values were correlated with high residual sea level values. Finally, a joint probability analysis of storm and sea level analysis resulted in increased probabilities of the two events happening at the same time indicating higher vulnerability of the coast and increased coastal risks. The above results were compared with coastal inundation events that took place over the last winter seasons in the province of Cadiz.info:eu-repo/semantics/publishedVersio

Sin vino... ¿estás seguro, corazón? de la trilogía mediterránea a la paradoja francesa

• Introducción: Somos un grupo de trabajo formado por enfermeras y enfermeros del servicio de Reanimación de Cirugía Cardiaca (RCC) del CHGUV, que pretendemos conocer qué opinión tienen los profesionales de enfermería del área de cardiología de nuestro hospital, al respecto de la controversia suscitada en diferentes ámbitos de la sociedad, por el distinto tratamiento que se le otorga al vino: bien como alimento funcional cardiosaludable, bien como una peligrosa bebida alcohólica… • Objetivos: Ilustrar al profesional de la salud sobre la existencia de estudios científicos cuyas conclusiones avalan el papel del vino como alimento cardiosaludable, siempre con una ingesta moderada y en el entorno de una dieta equilibrada. Conocer la opinión de los profesionales de Enfermería al respecto de incluir el vino, de manera opcional y como componente esencial de la Dieta Mediterránea, en las recomendaciones terapéuticas y nutricionales de sus pacientes. • Material y Método: En una aproximación al método de la investigación-acción, se procura información a los profesionales de enfermería, que van a ser encuestados, sobre las conclusiones de los dos importantes estudios analizados: Una vez definida la población de la Región Mediterránea, fundamentamos nuestro trabajo en las conclusiones de dos relevantes estudios -Estudio 7 Países y Estudio MONICA (Multifactorial monitoring of trends and determinates in cardiovascular diseases)- realizados en la última mitad del siglo XX sobre los hábitos alimentarios de la población de distintos países y los antecedentes sobre el tema en la bibliografía consultada al respecto publicada en los 10 últimos años. Se analizan en dichos estudios factores socioeconómicos y hábitos alimentarios relacionados con la ingesta moderada de vino y otras bebidas alcohólicas como la cerveza en distintos países de la cuenca mediterránea y su repercusión en la morbi-mortalidad por patología coronaria. Conoceremos la opinión de los profesionales de enfermería en cardiología sobre aplicar las conclusiones de dichos estudios en las recomendaciones terapéuticas y educación sanitaria de sus pacientes: Estudio prospectivo transversal aleatorizado, mediante un cuestionario autoadministrado. Encuesta realizada en nuestro hospital en la 2ª y 4ª semana de marzo de 2009, entre las enfermeras/os de la Fundación Instituto Cardiológico y la RCC, sobre la percepción que los profesionales de Enfermería tienen del vino y sus efectos sobre la salud. • Resultados: De los resultados obtenidos del primer estudio se destaca que la mayor longevidad y menor incidencia de patología cardiovascular en la población mediterránea se relacionaba con los hábitos alimentarios, que incluyen el vino, y estilo de vida propios. Se acuñó el término “Trilogía Mediterránea” para el grupo de alimentos comunes a esta región; pan (cereales), vino y aceite de oliva. El segundo estudio evidenciaba una significativa menor tasa de incidencia de patología cardiovascular (1/3 parte) en Francia, respecto al resto de países estudiados. Al no hallarse diferencias entre los factores de riesgo, la explicación a esta “paradoja francesa”, se encontró en las especificidades cuali-cuantitativas de su dieta, en la que el consumo moderado-alto de vino es una característica peculiar y distintiva. • Conclusiones: Existe un consenso generalizado en el ámbito sociosanitario para recomendar la Dieta Mediterránea como patrón alimentario cardiosaludable. La promoción del alcohol es cuestionada y tiene detractores dentro de la comunidad científica, al relacionarla con el alcoholismo y otras patologías derivadas del abuso. Los profesionales de Enfermería son muy reticentes a recomendar abiertamente un consumo moderado a sus pacientes. A pesar de los argumentos de las conclusiones de los estudios considerados, se muestran en desacuerdo con la inclusión del vino en la dieta cardiosaludable de sus pacientes. Creemos que son problemas distintos y el vino, en cuanto que han quedado demostrados sus efectos positivos sobre la salud, debe tener una consideración y tratamiento diferentes por parte de los profesionales, siempre desde el consumo moderado y en el contexto de un patrón alimentario adecuado, como alimento funcional y genuino de nuestra dieta mediterránea. Se debería profundizar sobre las causas reales y el origen de estas reticencias de los profesionales respecto al consumo moderado de vino y la opinión de los pacientes.• Introduction: We are a working group composed of nurses Resuscitation Service of Cardiac Surgery (RCS) of CHGUV; we want to know what opinions have nurses in the area of cardiology at our hospital, about the controversy in different areas of society, given the different treatment that it gives the wine well as heart-healthy functional food or as a dangerous alcoholic beverage… • Objective: Illustrate the health care professional about the existence of scientific studies whose conclusions attest to the role of wine as a heart-healthy food, always with a moderate intake and in the vicinity of a balanced diet. Know the opinion of nursing professionals in this regard include wine, and as an optional component of the Mediterranean Diet, in order to nutritional and therapeutic recommendations of their patients. • Material and Methods: In an approach to the method of action research, seeks information to nurses, who will be interviewed on the findings of two major studies reviewed: Having defined the population of the Mediterranean region, we base our work on the findings of two major studies -7 Countries Study and Study MONICA (Monitoring of Trends and Multifactorial determinate in Cardiovascular Diseases)- made in the last half century on the eating habits of people from different countries and background on the topic the literature consulted in this regard published in the last 10 years. These studies are analyzed in socioeconomic factors and dietary habits associated with moderate intake of wine and other alcoholic beverages like beer, in different countries of the Mediterranean basin and its impact on morbidity and mortality from coronary heart disease. Know the opinion of nurses in cardiology on implementing the conclusions of such studies in the therapeutic and health education of their patients: A prospective randomized cross through a questionnaire. Survey in our hospital in the 2nd and 4th week of March 2009, between nurses Heart Institute Foundation and the RCC, on the perception that nursing professionals have the wine and its health effects. • Results: From the results of the first study highlights the increased longevity and reduced incidence of cardiovascular disease in the Mediterranean population was related to dietary habits, including wine, and lifestyle of their own. Coined the term “Mediterranean trilogy” for the food group common to this region, bread (grain), wine and olive oil. The second study evidenced a significantly lower incidence of cardiovascular disease (1/3 part) in France, compared to other countries studied. By not find differences between risk factors, the explanation of this “French paradox”, was found in the qualitative and quantitative specific diet in which moderate-high consumption of wine is a peculiar and distinctive feature. • Conclusions: There is general agreement in the social health field to recommend the Mediterranean diet as heart-healthy eating pattern. The promotion of alcohol is disputed and has detractors within the scientific community to relate to alcoholism and other conditions resulting from abuse. Nursing professionals are reluctant to openly recommend moderate consumption to their patients. Despite the arguments of the conclusions of the studies considered, it disagrees with the inclusion of wine in their patients’ heart-healthy diet. We believe they are different problems and wine, as they have been proven positive effects on health, should be a consideration and different treatment by professionals, always moderate consumption and in the context of an appropriate dietary pattern, as a functional food and genuine of our Mediterranean diet. Should delve into the real causes and origin of this reluctance of health professionals in moderate wine consumption and patients’ opinions

Burden of heart failure on caregivers in China: results from a cross-sectional survey

James DS Jackson,1 Sarah E Cotton,1 Sara Bruce Wirta,2 Catia C Proenca,3 Milun Zhang,4 Raquel Lahoz,5 Frederico J Calado5 1Real World Research, Adelphi Real World, Bollington, Cheshire, UK; 2Real World Evidence Center of Excellence, Novartis Sweden AB, Stockholm, Sweden; 3Wellmera AG, Basel, Switzerland; 4Health Economics and Outcomes Research & Access Strategy, Novartis Pharma China, Beijing, China; 5Real World Evidence Center of Excellence, Novartis Pharma AG, Basel, Switzerland Purpose: Family and friends play a pivotal role in caring for patients with heart failure (HF); however, evidence of the impact of caregiving is limited. The objectives of this study were to describe the burden of caregiving on informal caregivers of patients with chronic HF in China.Materials and methods: A cross-sectional survey of cardiologists, their patients with HF, and those patients’ caregivers was conducted. Patient record forms were completed by 150 cardiologists for 10 consecutive patients. Caregivers of these patients were invited to complete a questionnaire.Results: Overall, 458 caregivers completed a questionnaire (mean ± standard deviation age 60.1±10.6 years; 60% female; 77% spouses; 74% retired). Caregivers spent a mean of 24.5 (16.9) hours caregiving per week, and a third reported a reduction in their social activity, time for themselves, or time for family. Caregivers in employment took several days off work in the past 3 months owing to caregiving, sometimes resulting in reduced income. Up to 79% of caregivers reported an impact on their physical or emotional well-being, and 57% reported deterioration in their objective health status. Inconsistencies stemming from differences in the three-level five-dimension EuroQol questionnaire and HF Caregiver Questionnaire were observed for the impact of caregiving on caregivers’ health-related quality of life. Conclusion: Assisting patients with HF is associated with caregiver burden. Addressing the needs of caregivers may help to promote their continued support and improve patient outcomes.Keywords: burden, caregiver, China, health-related quality of life, heart failure&nbsp

Burden of heart failure on patients from China: results from a cross-sectional survey

James DS Jackson,1 Sarah E Cotton,1 Sara Bruce Wirta,2 Catia C Proenca,3 Milun Zhang,4 Raquel Lahoz,5 Frederico J Calado5 1Real World Research, Adelphi Real World, Bollington, UK; 2Real World Evidence, Cardio-Metabolics Franchise, Novartis Sweden AB, Stockholm, Sweden; 3Wellmera AG, Basel, Switzerland; 4Health Economics and Outcomes Research and Access Strategy, Novartis Pharma China, Beijing, China; 5Real World Evidence, Cardio-Metabolics Franchise, Novartis Pharma AG, Basel, Switzerland Purpose: Little evidence exists on the burden that chronic heart failure (HF) poses specifically to patients in China. The objective of this study, therefore, was to describe the burden of HF on patients in China.Materials and methods: A cross-sectional survey of cardiologists and their patients with HF was conducted. Patient record forms were completed by 150 cardiologists for 10 consecutive patients. Patients for whom a patient record form was completed were invited to complete a patient questionnaire.Results: Most of the 933 patients (mean [SD] age 65.8 [10.2] years; 55% male; 80% retired) included in the study received care in tier 2 and 3 hospitals in large cities. Patients gave a median score of 4 on a scale from 1 (no disruption) to 10 (severe disruption) to describe how much HF disrupts their everyday life. Patients in paid employment (8%) missed 10% of work time and experienced 29% impairment in their ability to work due to HF in the previous week. All aspects of patients’ health-related quality of life (QoL) were negatively affected by their condition. Mean ± SD utility calculated by the 3-level 5-dimension EuroQol questionnaire was 0.8±0.2, and patients rated their health at 70.3 (11.5) on a 100 mm visual analog scale. Patients incurred costs associated with HF treatment, travel, and professional caregiving services.Conclusion: HF is associated with poor health-related QoL and considerable disruption in patients’ lives. Novel and improved therapies are needed to reduce the burden of HF on patients and the health care system. Keywords: patient burden, health-related quality of life, heart failure, survey, real-world&nbsp

Care pathways and treatment patterns for patients with heart failure in China: results from a cross-sectional survey

James DS Jackson,1 Sarah E Cotton,1 Sara Bruce Wirta,2 Catia C Proenca,3 Milun Zhang,4 Raquel Lahoz,5 Bogdan Balas,5 Frederico J Calado5 1Real World Research, Adelphi Real World, Bollington, UK; 2Real World Evidence, Cardio-Metabolic Franchise, Novartis Sweden AB, Stockholm, Sweden; 3Wellmera AG, Basel, Switzerland; 4Health Economics and Outcomes Research, Novartis Pharma China, Beijing, China; 5Medical Affairs, Cardio-Metabolic Franchise, Novartis Pharma AG, Basel, Switzerland Purpose: The objective of this study was to describe the clinical care pathways, management and treatment patterns, and hospitalizations for patients with heart failure (HF) in China. Subjects and methods: A cross-sectional survey of cardiologists and their patients with HF was conducted. Patient record forms were completed by 150 cardiologists for 10 consecutive patients. Patients for whom a patient record form was completed were invited to complete a patient self-completion questionnaire. Results: Most of the 1,500 patients (mean [SD] age 66 [10] years; 55% male) included in the study received care in tier-2 and -3 hospitals in large cities. Cardiologists were responsible for initial consultation, diagnosis, and treatment of patients with HF. The use of guideline-recommended diagnostics was high. However, guideline-recommended double- and triple-combination therapy was received by only 51% and 18% of patients, respectively. In total, 20% of patients with HF reported that they were not consulted on the choice of therapy. Concordance was high (≥80%) between matched cardiologist and patient pairs for the occurrence of side effects, while cardiologists more often under- than overreported the occurrence of side effects of treatment reported by patients. Conclusion: The management of HF was predominantly overseen by cardiologists. The use of diagnostic tests was high, but the use of guideline-recommended treatment was low in this population. Improved communication between patients and cardiologists is essential to optimize treatment decision making and to increase awareness of treatment side effects. Keywords: heart failure, disease management, patient preference, treatment satisfaction, real-world evidenc