Disability and its influence in nutritional assessment tools in elderly people living in nursing homes

Introduction: Poor nutritional status is associated with increased morbidity and mortality, especially in older people. Objective: The aim of this study was to assess nutritional status in elderly nursing home residents with different nutritional test, and to determine which parameters used for nutritional assessment can be carried out in this population, which usually have a high prevalence of functionally dependent residents. Methods: A cross-sectional study was performed in 383 elderly. The nutritional assessment tools used were the Mini Nutritional Assessment (MNA), the new ESPEN consensus definition of malnutrition, and the tool for Controlling Nutritional Status (CONUT). Moreover, the ability to perform basic activities of daily living was assessed with the Barthel index (BI). Results: According to BI, 78.9% had a total dependence and only 20.9% could be weighed and heighed. The prevalence of malnutrition with MNA, ESPEN and CONUT was 21.3%, 17.6% and 20.7%, respectively. The agreement between MNA vs ESPEN criteria was moderate (?= 0.483), but with CONUT was low. Conclusions: Nursing homes had a high percentage of totally dependent residents. This high degree of functional dependence made difficult to obtain some anthropometric parameters such as weight and height, which are essential to carry out most nutritional tests. MNA, CONUT and the new ESPEN criteria of malnutrition showed a high prevalence of malnutrition and risk of malnutrition in subjects in which they could be performed. Introducción: un estado nutricional deficiente está asociado con un incremento de la morbilidad y la mortalidad, especialmente en personas ancianas. Objetivo: el objetivo de este estudio fue evaluar el estado nutricional en ancianos institucionalizados en residencias geriátricas mediante diferentes test nutricionales, y determinar qué parámetros utilizados en la valoración nutricional pueden ser realizados en esta población. Métodos: se llevó a cabo un estudio transversal en 383 ancianos. Las herramientas de valoración nutricional empleadas fueron el Mini Nutritional Assessment (MNA), el nuevo consenso de definición de malnutrición, y el CONUT. Además, la capacidad de realizar las actividades básicas de la vida diaria fue evaluada con el índice de Barthel. Resultados: según el índice de Barthel, hasta un 78, 9% de los residentes tenía una dependencia total, y en solo el 20, 9% se pudo determinar el peso y la talla. La prevalencia de malnutrición con MNA, el consenso de ESPEN y CONUT fueron 21, 3%, 17, 2% y 20, 7%, respectivamente. La concordancia (kappa) entre el MNA y el ESPEN fue moderada (? = 0, 483), pero con CONUT fue baja. Conclusiones: en las residencias geriátricas públicas existe un elevado porcentaje de ancianos totalmente dependientes. Este alto grado de dependencia funcional dificulta la obtención de algunos parámetros antropométricos como el peso y la talla, que son esenciales para llevar a cabo la mayoría de los test de valoración nutricional. El MNA, el CONUT y los nuevos criterios de desnutrición de la ESPEN mostraron una elevada prevalencia de desnutrición y de riesgo de desnutrición en esta población de ancianos institucionalizados, en aquellos en los que fue posible realizarlos

Solid-state NMR characterisation of the thermal transformation of a Hungarian white illite

1H, 27Al, 29Si and 39K solid-state NMR are reported from a Hungarian illite 2:1 clay for samples heated up 1600 °C. This single-phase sample has a small amount of aluminium substitution in the silica layer and very low iron-content (0.4 wt%). Thermal analysis shows several events that can be related to features in the NMR spectra, and hence changes in the atomic scale structure. As dehydroxylation occurs there is increasing AlO4 and AlO5-contents. The silica and gibbsite layers become increasingly separated as the dehydroxylation progresses. Between 900 and 1000 °C the silica layer forms a potassium aluminosilicate glass. The gibbsite-layer forms spinel/γ-Al2O3 and some aluminium-rich mullite. Then on heating to 1600 °C changes in the 29Si and 27Al MAS NMR spectra are consistent with the aluminosilicate glass increasing its aluminium-content, the amount of mullite increasing probably with its silicon-content also increasing, and some α-Al2O3 forming

Experiencia de enseñanza integrada entre las cátedras B de anatomía e histología de la Facultad De Odontología, Universidad Nacional De Córdoba

La integración es una operación que consiste en conjugar dos o más contenidos interdependientes de aprendizaje, pertenecientes a la misma disciplina o a disciplinas diferentes, en vista de resolver problemas, estudiar un tema o desarrollar habilidades. Desde hace varios años, las cátedras B de Histología y de Anatomía, Facultad de Odontología, Universidad Nacional de Córdoba, realizan actividades orientadas a facilitar la integración de los contenidos del sistema estomatognático, a nivel macroscópico y microscópico, en los alumnos que cursan esas asignaturas en el segundo cuatrimestre de la carrera de Odontología. Entre los años 2002 y 2006 se desarrolló la primera etapa de enseñanza integrada (EI) de Anatomía e Histología, en la que el equipo docente y un grupo reducido de alumnos trabajaron a manera de experiencia piloto. Esta primera etapa brindó la oportunidad de poner a prueba estrategias metodológicas y consolidar conocimientos pedagógicos y específicos por parte de los docentes participantes, así como también planificar futuras actividades de EI. Los resultados obtenidos en esa primera etapa, así como también la experiencia desarrollada por el equipo docente responsable, motivaron la decisión de extender –desde el año 2007 hasta la actualidad- esta modalidad de enseñanza a la totalidad de los alumnos, incorporando a todos los docentes de las dos cátedras. Se ha comprobado que la experiencia de EI de Anatomía e Histología favorece la capacitación y el perfeccionamiento docente en aspectos interdisciplinarios y en nuevas estrategias de enseñanza, así como también la disposición para las tareas colaborativas en equipo y el compromiso en sus actividades. En cuanto a los alumnos, los resultados indican que esta modalidad de trabajo contribuye no sólo al aprendizaje significativo, sino también al desarrollo de competencias demandadas en las Ciencias de la SaludpublishedVersio

Application of the finite-temperature Lanczos method for the evaluation of magnetocaloric properties of large magnetic molecules

We discuss the magnetocaloric properties of gadolinium containing magnetic molecules which potentially could be used for sub-Kelvin cooling. We show that a degeneracy of a singlet ground state could be advantageous in order to support adiabatic processes to low temperatures and simultaneously minimize disturbing dipolar interactions. Since the Hilbert spaces of such spin systems assume very large dimensions we evaluate the necessary thermodynamic observables by means of the Finite-Temperature Lanczos Method.Comment: 7 pages, 10 figures, invited for the special issue of EPJB on "New trends in magnetism and magnetic materials

Economic Valuation of Health Care Services in Public Health Systems: A Study about Willingness to Pay (WTP) for Nursing Consultations

Background: Identifying the economic value assigned by users to a particular health service is of principal interest in planning the service. The aim of this study was to evaluate the perception of economic value of nursing consultation in primary care (PC) by its users. Methods and Results: Economic study using contingent valuation methodology. A total of 662 users of nursing consultation from 23 health centers were included. Data on demographic and socioeconomic characteristics, health needs, pattern of usage, and satisfaction with provided service were compiled. The validity of the response was evaluated by an explanatory mixed-effects multilevel model in order to assess the factors associated with the response according to the welfare theory. Response reliability was also evaluated. Subjects included in the study indicated an average Willingness to Pay (WTP) of €14.4 (CI 95%: €13.2–15.5; median €10) and an average Willingness to Accept [Compensation] (WTA) of €20.9 (CI 95%: €19.6–22.2; median €20). Average area income, personal income, consultation duration, home visit, and education level correlated with greater WTP. Women and older subjects showed lower WTP. Fixed parameters explained 8.41% of the residual variability, and response clustering in different health centers explained 4–6% of the total variability. The influence of income on WTP was different in each center. The responses for WTP and WTA in a subgroup of subjects were consistent when reassessed after 2 weeks (intraclass correlation coefficients 0.952 and 0.893, respectively). Conclusions: The economic value of nursing services provided within PC in a public health system is clearly perceived by its user. The perception of this value is influenced by socioeconomic and demographic characteristics of the subjects and their environment, and by the unique characteristics of the evaluated service. The method of contingent valuation is useful for making explicit this perception of value of health services

Molecular profiling of immunoglobulin heavy-chain gene rearrangements unveils new potential prognostic markers for multiple myeloma patients

Altres ajuts: This work was partially supported by[...] , CIBERONC-CB16/12/00233, and "Una manera de hacer Europa" (Innocampus; CEI-2010-1-0010)". M.G.-A., I.P.-C., and C.J. are supported by the Fundación Española de Hematología y Hemoterapia (FEHH, co-funded by Fundación Cris in the latter case), A.M. by the European Social Fund and the Spanish Education Council through the University of Salamanca, [...]. All Spanish funding is co-sponsored by the European Union FEDER program.Multiple myeloma is a heterogeneous disease whose pathogenesis has not been completely elucidated. Although B-cell receptors play a crucial role in myeloma pathogenesis, the impact of clonal immunoglobulin heavy-chain features in the outcome has not been extensively explored. Here we present the characterization of complete heavy-chain gene rearrangements in 413 myeloma patients treated in Spanish trials, including 113 patients characterized by next-generation sequencing. Compared to the normal B-cell repertoire, gene selection was biased in myeloma, with significant overrepresentation of IGHV3, IGHD2 and IGHD3, as well as IGHJ4 gene groups. Hypermutation was high in our patients (median: 8.8%). Interestingly, regarding patients who are not candidates for transplantation, a high hypermutation rate (≥7%) and the use of IGHD2 and IGHD3 groups were associated with improved prognostic features and longer survival rates in the univariate analyses. Multivariate analysis revealed prolonged progression-free survival rates for patients using IGHD2/IGHD3 groups (HR: 0.552, 95% CI: 0.361−0.845, p = 0.006), as well as prolonged overall survival rates for patients with hypermutation ≥7% (HR: 0.291, 95% CI: 0.137−0.618, p = 0.001). Our results provide new insights into the molecular characterization of multiple myeloma, highlighting the need to evaluate some of these clonal rearrangement characteristics as new potential prognostic markers

The Science of Sungrazers, Sunskirters, and Other Near-Sun Comets

This review addresses our current understanding of comets that venture close to the Sun, and are hence exposed to much more extreme conditions than comets that are typically studied from Earth. The extreme solar heating and plasma environments that these objects encounter change many aspects of their behaviour, thus yielding valuable information on both the comets themselves that complements other data we have on primitive solar system bodies, as well as on the near-solar environment which they traverse. We propose clear definitions for these comets: We use the term near-Sun comets to encompass all objects that pass sunward of the perihelion distance of planet Mercury (0.307 AU). Sunskirters are defined as objects that pass within 33 solar radii of the Sun’s centre, equal to half of Mercury’s perihelion distance, and the commonly-used phrase sungrazers to be objects that reach perihelion within 3.45 solar radii, i.e. the fluid Roche limit. Finally, comets with orbits that intersect the solar photosphere are termed sundivers. We summarize past studies of these objects, as well as the instruments and facilities used to study them, including space-based platforms that have led to a recent revolution in the quantity and quality of relevant observations. Relevant comet populations are described, including the Kreutz, Marsden, Kracht, and Meyer groups, near-Sun asteroids, and a brief discussion of their origins. The importance of light curves and the clues they provide on cometary composition are emphasized, together with what information has been gleaned about nucleus parameters, including the sizes and masses of objects and their families, and their tensile strengths. The physical processes occurring at these objects are considered in some detail, including the disruption of nuclei, sublimation, and ionisation, and we consider the mass, momentum, and energy loss of comets in the corona and those that venture to lower altitudes. The different components of comae and tails are described, including dust, neutral and ionised gases, their chemical reactions, and their contributions to the near-Sun environment. Comet-solar wind interactions are discussed, including the use of comets as probes of solar wind and coronal conditions in their vicinities. We address the relevance of work on comets near the Sun to similar objects orbiting other stars, and conclude with a discussion of future directions for the field and the planned ground- and space-based facilities that will allow us to address those science topics

Actualización de la batería estándar y batería ampliada de pruebas alérgicas de contacto por el Grupo Español de Investigación en Dermatitis de Contacto y Alergia Cutánea (GEIDAC)

After the meeting held by the Spanish Contact Dermatitis and Skin Allergy Research Group (GEIDAC) back in October 2021, changes were suggested to the Spanish Standard Series patch testing. Hydroxyethyl methacrylate (2% pet.), textile dye mixt (6.6% pet.), linalool hydroperoxide (1% pet.), and limonene hydroperoxide (0.3% pet.) were, then, added to the series that agreed upon in 2016. Ethyldiamine and phenoxyethanol were excluded. Methyldibromoglutaronitrile, the mixture of sesquiterpene lactones, and hydroxyisohexyl 3-cyclohexene (Lyral) were also added to the extended Spanish series of 2022. (c) 2024 AEDV. Published by Elsevier Espana, S.L.U. This is an open access article under the CC BY -NC -ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)