A review of the six-minute walk test: Its implication as a self-administered assessment tool

Promoting self-management and monitoring physical activity are important strategies in chronic heart disease (CHD) management. The six-minute walk test (6MWT) is a commonly used sub-maximal exercise test for measuring physical functional capacity. The aim of this paper is to review the current literature on 6MWT relating to methodological issues as well as exploring the potential of the protocol to be adopted as a self-administered exercise test. The Medline, CINAHL, Science Direct and the World Wide Web using the search engine Google, were searched for articles describing the administration, reliability and validity of the 6MWT. Findings of the integrative literature review the 6MWT is a simple, safe tool. To date, the capacity for self-administration of the 6MWT has not been investigated. Adapting the 6MWT as a patient-reported outcome measure may enhance the capacity, not only for clinicians to monitor functional status, but also promote self-management by enabling individuals to monitor changes in their functional capacity

Leptin as a metabolic link to multiple sclerosis.

Clinical and experimental data, together with epidemiological studies, have suggested that the pathogenesis of multiple sclerosis (MS) might involve factors that link the immune system with metabolic status. Moreover, recent research has shown that leptin, the adipocyte-derived hormone that controls food intake and metabolism, can promote experimental autoimmune encephalomyelitis, an animal model of MS. In patients with MS, the association of leptin with disease activity has been dissected at the molecular level, providing new mechanistic explanations for the role of this hormone in MS. Here, we review the intricate relationship between leptin and other metabolic modulators within a framework that incorporates the latest advances linking the CNS, immune tolerance and metabolic status. We also consider the translational implications of these new findings for improved management of MS

Suitability of aquatic mosses for biomonitoring micro/meso plastics in freshwater ecosystems

Abstract Background Mesoplastics (5–25 mm) and microplastics (0.001–5 mm) are emerging pollutants of great concern. However, reliable methods of monitoring these types of plastic in river ecosystems have not yet been established. The goal of this work was to evaluate, for the first time, the suitability of Fontinalis antipyretica as a biomonitor of meso- and micro-plastics in rivers. With this aim, native samples of the moss and devitalized moss clones, held inside the bags, were compared for the uptake of fluorescent polystyrene particles under laboratory conditions, and for retention of plastic debris in the field, in sites close to wastewater treatment plants. Results In the laboratory experiment, the moss retained smaller microplastics, and a higher number of polystyrene meso and microplastics was counted in the moss bags than in the native moss. In the field study, the moss retained plastic debris chiefly in the form of fibres regardless of the capacity and flow rate of the wastewater treatment plants affecting each sampling site. The uniform morphology of moss clone seems to affect the retention of this type of pollutant. The FTIR analysis confirmed the particles entrapped by the moss bags as plastic, specifically polyethylene and polyamide type 6, among the most common plastic polymers detected in rivers. Conclusions The study findings highlighted the value of using uniform material, as the clone exhibited a greater accumulation efficiency with respect to the native moss. The mesh bags could act as selective filters and/or prevent the loss of adhering plastics. In the field, the bags favour plastic fibres retention despite the river flow. Finally, although FTIR is useful for the identification of plastic type, it is not very sensitive when small quantities of ground samples are used

Vitamina C : una estrategia didáctica polifuncional

El presente trabajo tiene como objetivo contextualizar contenidos curriculares de química: incursionando en el área de bioquímica, como elementos básicos de la formación en química del estudiante; proporcionando información general sobre las propiedades de la vitamina C que permitan al estudiante, como ciudadano, tener libertad de elección frente a la vasta publicidad que se ofrece, entre otros, en los medios masivos de comunicación; aplicando su cultura científica a situaciones de la vida cotidiana y, por lo tanto, valorando la importancia de la educación científica para poder ser capaz de conocer mejor lo que consume y poder opinar en forma crítica sobre ello. Se presentan técnicas sencillas para investigar la presencia de vitamina C en alimentos de uso común. Se discuten distintas estrategias de presentación y tratamiento del tema en los distintos niveles escolares con objetivos diferentes y se analizan cambios en la metodología de trabajo en el aula. Este trabajo fue presentado bajo la modalidad de taller en el XV Congreso Nacional e Internacional de Profesores de Química y los resultados y conclusiones a las que se arribaron fueron ampliamente satisfactorias, ya que permitieron una revalorización de la tarea educativa buscando un currículo más abierto donde el estudiante se sienta partícipe de su proceso de aprendizaje y encuentre contenidos científicos útiles para su vida.This paper attempts to contextualise chemistry curricula contents, entering the field of biochemistry, as basic elements for the formation of chemistry in the student by providing general information on the properties of C vitamin that allows the student, as a citizen, the freedom to choose in front of the huge publicity offered to them, among others, by the mass media. They can apply their scientific culture to everyday life, thus assessing how important scientific education is to be able to better know what is consumed and give a critical opinion. We present simple techniques to find C vitamin in commonly used food. We discuss different strategies to present and deal with this subject at different school levels with different aims, and we analyse the changes in the classroom working methodology. This paper was presented as a workshop in the 15th National and International Congress of Chemistry Professors and its results and conclusion were highly satisfactory, as they allowed revaluing the educational task aiming at a more open curriculum where the student feels part of his learning process and finds scientific contents useful in his everyday life

European 'NAFLD Preparedness Index' - Is Europe ready to meet the challenge of fatty liver disease?

Background & Aims: Non-alcoholic fatty liver disease (NAFLD), which is closely associated with obesity, metabolic syndrome, and diabetes, is a highly prevalent emerging condition that can be optimally managed through a multidisciplinary patient centred approach. National preparedness to address NAFLD is essential to ensure that health systems can deliver effective care. We present a NAFLD Preparedness Index for Europe. Methods: In June 2019, data were extracted by expert groups from 29 countries to complete a 41-item questionnaire about NAFLD. Questions were classified into 4 categories: policies/civil society (9 questions), guidelines (16 questions), epidemiology (4 questions), and care management (12 questions). Based on the responses, national preparedness for each indicator was classified into low, middle, or high-levels. We then applied a multiple correspondence analysis to obtain a standardised preparedness score for each country ranging from 0 to 100. Results: The analysis estimated a summary factor that explained 71.3% of the variation in the dataset. No countries were found to have yet attained a high-level of preparedness. Currently, the UK (75.5) scored best, although falling within the mid level preparedness band, followed by Spain (56.2), and Denmark (43.4), whereas Luxembourg and Ireland were the lowest scoring countries with a score of 4.9. Only Spain scored highly in the epidemiology indicator category, whereas the UK was the only country that scored highly for care management. Conclusions: The NAFLD Preparedness Index indicates substantial variation between countries’ readiness to address NAFLD. Notably, even those countries that score relatively highly exhibit deficiencies in key domains, suggesting that structural changes are needed to optimise NAFLD management and ensure effective public health approaches are in place. Lay summary: Non-alcoholic fatty liver disease (NAFLD), which is closely associated with obesity, metabolic syndrome, and diabetes, is a highly prevalent condition that can be optimally managed through a multidisciplinary patient-centred approach. National preparedness to address NAFLD is essential to allow for effective public health measures aimed at preventing disease while also ensuring that health systems can deliver effective care to affected populations. This study defined preparedness as having adequate policies and civil society engagement, guidelines, epidemiology, and care management. NAFLD preparedness was found to be deficient in all 29 countries studied, with great variation among the countries and the 4 categories studied

Dalhousie dyspnea scales: construct and content validity of pictorial scales for measuring dyspnea

BACKGROUND: Because there are no child-friendly, validated, self-report measures of dyspnea or breathlessness, we developed, and provided initial validation, of three, 7-item, pictorial scales depicting three sub-constructs of dyspnea: throat closing, chest tightness, and effort. METHODS: We developed the three scales (Throat closing, Chest tightness, and Effort) using focus groups with 25 children. Subsequently, seventy-nine children (29 children with asthma, 30 children with cystic fibrosis. and 20 children who were healthy) aged 6 to 18 years rated each picture in each series, using a 0–10 scale. In addition, each child placed each picture in each series on a 100-cm long Visual Analogue Scale, with the anchors "not at all" and "a lot". RESULTS: Children aged eight years or older rated the scales in the correct order 75% to 98% correctly, but children less than 8 years of age performed unreliably. The mean distance between each consecutive item in each pictorial scale was equal. CONCLUSION: Preliminary results revealed that children aged 8 to 18 years understood and used these three scales measuring throat closing, chest tightness, and effort appropriately. The scales appear to accurately measure the construct of breathlessness, at least at an interval level. Additional research applying these scales to clinical situations is warranted

Well-Being and psychological consequences of temporary contracts : the case of younger Italian employees

Working conditions in Western countries have changed dramatically in the last twenty years, witnessing the emergence of new forms of employment contracts. The number of "standard" fulltime permanent jobs has decreased, while non-standard work arrangements such as temporary, contingent or part-time contracts have become much more common. This paper analyses the impact of temporary contracts and job insecurity on well-being among younger Italian employees. We use the "Health Conditions and Use of the Health Service Survey" carried out by the Italian National Institute of Statistics in conjunction with the Bank of Italy's Survey on Households Income and Wealth (SHIW). We consider four dimensions of individual well-being: physical health, mental health, self-assessed health and happiness. To account for individual heterogeneity we match each temporary worker with a permanent worker using propensity score matching. Well-being of matched individuals is compared to estimates of the average effect of working with a temporary as opposed to a permanent contract. Our analysis reveals a negative relationship between psychological well-being, happiness and having a temporary job and is particularly marked for male

Well-being and psychological consequences of temporary contracts: the case of younger Italian employees

Working conditions in Western countries have changed dramatically in the last twenty years, witnessing the emergence of new forms of employment contracts. The number of "standard" fulltime permanent jobs has decreased, while non-standard work arrangements such as temporary, contingent or part-time contracts have become much more common. This paper analyses the impact of temporary contracts and job insecurity on well-being among younger Italian employees. We use the "Health Conditions and Use of the Health Service Survey" carried out by the Italian National Institute of Statistics in conjunction with the Bank of Italy's Survey on Households Income and Wealth (SHIW). We consider four dimensions of individual well-being: physical health, mental health, self-assessed health and happiness. To account for individual heterogeneity we match each temporary worker with a permanent worker using propensity score matching. Well-being of matched individuals is compared to estimates of the average effect of working with a temporary as opposed to a permanent contract. Our analysis reveals a negative relationship between psychological well-being, happiness and having a temporary job and is particularly marked for males

The global NAFLD policy review and preparedness index: Are countries ready to address this silent public health challenge?

Background & Aims: Non-alcoholic fatty liver disease (NAFLD) is a highly prevalent, yet largely underappreciated liver condition which is closely associated with obesity and metabolic disease. Despite affecting an estimated 1 in 4 adults globally, NAFLD is largely absent on national and global health agendas. Methods: We collected data from 102 countries, accounting for 86% of the world population, on NAFLD policies, guidelines, civil society engagement, clinical management, and epidemiologic data. A preparedness index was developed by coding questions into 6 domains (policies, guidelines, civil awareness, epidemi ology and data, NAFLD detection, and NAFLD care management) and categorising the responses as high, medium, and low; a multiple correspondence analysis was then applied. Results: The highest scoring countries were India (42.7) and the United Kingdom (40.0), with 32 countries (31%) scoring zero out of 100. For 5 of the domains a minority of countries were cat egorised as high-level while the majority were categorised as low-level. No country had a national or sub-national strategy for NAFLD and <2% of the different strategies for related conditions included any mention of NAFLD. National NAFLD clinical guide lines were present in only 32 countries. Conclusions: Although NAFLD is a pressing public health prob lem, no country was found to be well prepared to address it. There is a pressing need for strategies to address NAFLD at na tional and global levels. Lay summary: Around a third of the countries scored a zero on the NAFLD policy preparedness index, with no country scoring over 50/100. Although NAFLD is a pressing public health prob lem, a comprehensive public health response is lacking in all 102 countries. Policies and strategies to address NAFLD at the na tional and global levels are urgently needed