Living with diabetes: quality of care and quality of life

Background: The aim of this research was to characterize the experience of living with diabetes mellitus (DM) and identify patients" opinions of the quality of care received and the results of interventions. Methods: A descriptive, exploratory evaluation study using qualitative methodology was performed. Participants consisted of 40 adult patients diagnosed with DM and followed up in a public hospital in Barcelona, Spain. A semistructured interview and a focus group were used and a thematic content analysis was performed. Results: Patients described DM as a disease that is difficult to control and that provokes lifestyle changes requiring effort and sacrifice. Insulin treatment increased the perception of disease severity. The most frequent and dreaded complication was hypoglycemia. The main problems perceived by patients affecting the quality of care were related to a disease-centered medical approach, lack of information, limited participation in decision-making, and the administrative and bureaucratic problems of the health care system. Conclusion: The bureaucratic circuits of the health care system impair patients" quality of life and perceived quality of care. Health professionals should foster patient participation in decision-making. However, this requires not only training and appropriate attitudes, but also adequate staffing and materials.

L'ensenyament de la història i el living history

Hi ha diferents estratègies per apropar la història als escolars. La utilització de les fonts primàries (objectes, documents, etc.) esdevé una estratègia important per fer viure els temps passats. Els objectes i els documents del passat ens permeten intervenir a partir del plantejament d'enigmes i preguntes que l'alumnat pot anar resolent a partir d'una veritable recerca històrica. Una de les estratègies utilitzades en el món anglosaxó és el living history. Es tracta de "fer reviure" el passat a través de la representació de fets, estil de vida i personatges propis d'una època determinada. Aquesta estratègia s'empra en espais de presentació del patrimoni, especialment en museus i assentaments històrics i arqueològics. Dos elements són fonamentals en aquest tipus d'intervencions: la preparació del context de presentació del patrimoni i els mediadors entre la institució o espai patrimonial i els visitants. A continuació, es presenta, de manera concreta, el cas de Colonial Williamsburg, institució dels EUA pionera en la utilització d'aquesta estratègia de presentació i interpretació del patrimoni històric i arqueològic.

Polyamine metabolism and signaling in plant abiotic stress protection

Polyamines (PAs) are small polycationic compounds present in all living organisms. Compelling evidences indicate a role for PAs in plant protection against stress. During the recent years, genetic, molecular and ‘omic’ approaches have been undertaken to unravel the role of PAs in stress signaling. Overall, results point to intricate relationships between PAs, stress hormone pathways and ROS signaling. Such cross-regulations condition stress signaling through the modulation of abscisic acid (ABA) and ROS amplification-loops. In this chapter we compile our recent findings which elucidate molecular mechanisms and signalingpathways by which PAs contribute to stress protection in plants.

Poverty and living arrangements among youth in Spain, 1980-2005

One of the most relevant demographic events in Spain from a recent historical perspective was the baby boom of the 1960s and 1970s. The “adapting to circumstances” of these generations of youth and their families through delayed emancipation and childbearing has been key in preventing a decline in their economic status. The results show that the reduction of the poverty risk among non-emancipated youth for the period 1980-2005 is explained by the fact that an increasing number of young Spaniards live with two employed parents. Thus, emancipation delay is found most in those families that can best afford it. Furthermore, the salaries of young workers remaining in the parental home have become an important factor in reducing their family poverty risk. On the other hand, fertility decline is readily explained by the economic difficulties young couples encounter in sustaining their offspring

Are we living longer but less healthy? Trends in mortality and morbidity in Catalonia (Spain), 1994-2011

Evidence on trends in prevalence of disease and disability can clarify whether countries are experiencing a compression or expansion of morbidity. An expansion of morbidity as indicated by disease have appeared in Europe and other developed regions. It is likely that better treatment, preventive measures and increases in education levels have contributed to the declines in mortality and increments in life expectancy. This paper examines whether there has been an expansion of morbidity in Catalonia (Spain). It uses trends in mortality and morbidity from major causes of death and links of these with survival to provide estimates of life expectancy with and without diseases and functioning loss. We use a repeated cross-sectional health survey carried out in 1994 and 2011 for measures of morbidity; mortality information comes from the Spanish National Statistics Institute. Our findings show that at age 65 the percentage of life with disease increased from 52% to 70% for men, and from 56% to 72% for women; the expectation of life unable to function increased from 24% to 30% for men and 40% to 47% for women between 1994 and 2011. These changes were attributable to increases in the prevalences of diseases and moderate functional limitation. Overall, we find an expansion of morbidity along the period. Increasing survival among people with diseases can lead to a higher prevalence of diseases in the older population. Higher prevalence of health problems can lead to greater pressure on the health care system and a growing burden of disease for individuals.

Old Women, Young Souls: History as a Living Matter

The passionate and deceptive life stories of the protagonists in Angela Carter’s Wise Children (1990) and Rose Tremain’s The Cupboard (1984), women in their seventies and eighties, are entangled with historical events that influenced England, Europe and the rest of the world. In these novels, Angela Carter and Rose Tremain challenge not only notions of ageing by presenting elder protagonists who are lively and strong, but also the idea of history as unique, true and unquestionable by conferring on them the status of story and historytellers.

Study of the effect of oral health on physical condition of professional soccer players of the Football Club Barcelona

Objectives: The objective of this study was to evaluate the oral health status of professional soccer players of F.C. Barcelona and its relation to the incidence of sport lesions. Methods: Thirty professional soccer players were consecutively evaluated in the seasons 2003/4, 2004/5 and 2005/6. A research protocol to assess their oral health was developed. DMFT, Quigley & Hein plaque index (PI), Löe & Silness gingival index (GI), World Health Organization malocclusion index, Ramfjord teeth probing pocket depth (PPD), TMJ examination and history of dental trauma were recorded. All physical injuries sustained by players during the season were documented from F.C. Barcelona medical services. Results: Mean DMFT score was 5.7 (SD 4.1), Quigley & Hein plaque index score was 2.3 (SD 1.1), Löe & Silness gingival index was 1.1 (SD 0.8), and periodontal pocket depth was 1.9 mm (SD 0.3). Pearson"s analysis showed a significant correlation between PI and GI (p<0.01). Nine players (30%) presented bruxism - the same proportion of those with severe malocclusion. Seven (23.3%) players had suffered uncomplicated crown fractures. The mean incidence of physical injuries was 8 (SD 3.4) per player. PI and PPD showed a statistically significant correlation to muscle injuries (p<0.05). Conclusions: Soccer players, despite intensive medical follow-up, have significant oral health problems such as untreated caries, gingivitis or malocclusion, and suffer dental trauma as a result of sports activities. Their physical condition could also be associated to oral health

Aggressivity, violence, sociability and conflict resolution: What genes can tell us.

Conflicts are inherent to the human condition, as they are for all living beings. Disputes about resources or access to mating partners are among the most common causes of conflict. Conflict is herein defined as a struggle or contest between individuals or parties, and may involve a variety of aggressive behaviours. In humans, aggressiveness, violence and conflicts, including individual predisposal to conflict resolution, have traditionally been said to have deep cultural roots, but recent research in both neuroscience and genetics has shown the influence of genes on such complex behavioural traits. In this paper, recent data on the genetic aspects of these interrelated behaviours will be put together, including the effects of particular genes, the influence of stress and gender on gene regulation, and gene-environment interactions, all of which may influence biological predisposal to conflict resolution. Other genetically influenced behavioural aspects involved in conflicts and conflict resolution, such as sociability, will also be discussed. The importance of taking into account genetic and biological data to provide strategies for conflict resolution will be highlighted.

Use and perception of urban green spaces in Barcelona

Background: Although the mechanisms are not well understood yet, evidence exists of the benefits of urban green spaces for human health. As a consequence, one of the concerns of public health interventions must be to promote the use of urban green spaces within cities. Aims: This study aims to explore the citizens’ purposes of use of urban green spaces as well as the elements related to the characteristics of these places that condition their use. Methods: In-depth interviews were conducted with non-hospitalised people living in different areas of Barcelona, with different socioeconomic status and different residential distance to urban green spaces (n = 20). Thematic content analysis of the qualitative data was performed. Results: Physical pursuits and attention restoration were identified as prominent purposes of use of urban green spaces. The natural features of urban green spaces were identified as the most relevant determiners for the use of these places. Conclusions: To promote the use of urban green spaces, qualitative findings from this study suggest that purpose-built places should be provided. Moreover, natural features of urban green spaces must be particularly taken into account when designing and maintaining them.

Patterns of variability of retinol levels in a harbour porpoise population from an unpolluted environment

Organochlorine compounds (OC) are known to induce vitamin A (retinoids) deficiency in mammals, which may be associated with impairment of immunocompetence, reproduction and growth. This makes retinoids a potentially useful biomarker of organochlorine impact on marine mammals. However, use of retinoids as a biomarker requires knowledge about its intrapopulation patterns of variation in natural conditions, information which is not currently available. We investigated these patterns in a cetacean population living in an unpolluted environment. 100 harbour porpoises Phocoena phocoena from West Greenland were sampled during the 1995 hunting season. Sex, age, morphometrics, nutritive condition, and retinol (following saponification) and OC levels in blubber were determined for each individual. OC levels found were extremely low and therefore considered unlikely to affect the population adversely: mean blubber concentrations, expressed on an extractable basis, were 2.04 (SD = 1.1) ppm for PCBs and 2.76 (SD = 1.66) ppm for tDDT. The mean blubber retinol concentration for the overall population was 59.66 (SD = 45.26) mu g g(-1). Taking into account the high contribution of blubber to body mass, blubber constitutes a significant body site for retinoid deposition in harbour porpoises. Retinol concentrations did not differ significantly between geographical regions or sexes, but they did correlate significantly (p <0.001) with age. Body condition, measured by determining the lipid content of the blubber, did not have a significant effect on retinol levels but the individuals examined were considered to be in an overall good nutritive condition. It is concluded that measurement of retinol concentrations in blubber samples is feasible and has a potential for use as a biomarker of organochlorine exposure in cetaceans. However, in order to do so, biological information, particularly age, is critical for the correct assessment of physiological impact

Gestió dels residus alimentaris municipals procedents de les activitats comercials del municipi de Montmeló per tal de reduir, reutilitzar i reciclar-los

En el present treball es proposa com lluitar contra el malbaratament alimentari que es genera al llarg de tota la cadena alimentària, sent aquest degut a causa d'una planificació poc adequada. L'objectiu principal és planificar i implantar un sistema de gestió per tal de recuperar l'excedent alimentari que es genera als comerços i les indústries del municipi de Montmeló, elaborant així un protocol per tal de poder redistribuir aquest aliment als sectors de la població en situacions econòmiques més precàries. Com a objectius secundaris, es pretén conscienciar, fomentar i potenciar el treball en xarxa entre els diferents agents implicats, com ara: la ciutadania, les entitats socials (Càritas Parroquial Montmeló), sector privat (establiments alimentaris del municipi, mercat municipal, indústries del sector alimentari) i el sector públic (departament de serveis socials, medi ambient, comerç i brigada municipal). A l'hora de planificar i implantar un sistema de gestió per tal de recuperar l'excedent alimentari, s'ha analitzat i valorat el camí que hi realitza, des d'on es genera fins al beneficiari final. Aquest s'ha gestionat per etapes, en les que s'han identificat els generadors, el tipus i quantitat d'aliment que malbaraten. S'ha proposat un nou sistema de recollida d'informació i les pautes que han de seguir per garantir el bon estat de l'aliment com: una taula de conservació, un protocol de funcionament, un document d'entrega i una fitxa de control de les condicions d'higiene. Per tal d'assolir una bona coordinació entre totes les parts, s'han realitzat reunions conjuntes entre els generadors, serveis socials i Càritas on s'ha acabat signant un acord de col·laboració. Entre les conclusions més rellevants cal destacar que ha servit per establir un precedent d'aprofitament alimentari al municipi de Montmeló, aconseguint alimentar a un gran nombre de famílies amb greus problemes econòmics. A més s'ha arribat a disminuir la quantitat de residus generats, amb el conseqüent estalvi de recursos econòmics i materials on s'ha recuperat un total de 5.760 Kg d'aliments aptes pel consum.

The experience of identity transformation process for people living with tetraplegia and paraplegia = El proceso de reconstrucción de la identidad de las personas afectadas de una paraplejia o tetraplejia

A spinal cord injury (SCI) is perceived as a source of biographical disruption, not only at a physical level but also in terms of people’s life stories, their motivation and their self-esteem. The aim of this study is to explore the factors that people with spinal cord injuries perceive as contributing to rebuilding their sense of self. Two focus groups were established from the SCIcommunity, one of which was made up of 14 people with paraplegia and the other of 9 people with tetraplegia. In addition, four individual interviews were conducted with the participants. The results of content analysis show that the two most prominent factors in the process of identity renegotiation are the partial transformation of the subject’s identity followed by a coming to terms with that new identity. To rebuild self-worth, the importance of finding a balance between change and continuity was identified. Renegotiation of identity after a spinal cord injury is a complex phenomenon that greatly influences the SCI individual’s quality of life perceptions. Reaching a balance between the changes experienced due to the injury and finding a sense of continuity can be either facilitated or obstructed by the economic, political, legal, architectural, and social context

Parental body condition does not correlate with offspring sex-ratio in Cory's shearwater

We analyzed offspring sex ratio variation in Mediterranean Cory's Shearwater (Calonectris d. diomedea) during two consecutive breeding seasons in two colonies. We test for differential breeding conditions between years and colonies looking at several breeding parameters and parental condition. We then explored the relationship between offspring sex ratio and parental condition and breeding parameters. This species is sexually dimorphic with males larger and heavier than females; consequently we expected differential parental cost in rearing sexes, or a greater sensitivity of male chicks to adverse conditions, which may lead to biased sex ratios. Chicks were sexed molecularly by the amplification of the CHD genes. Offspring sex ratio did not differ from parity, either at hatching or fledging, regardless of the colony or year. However, parental body condition and breeding parameters such as egg size and breeding success were different between years and colonies. Nevertheless, neither nestling mortality nor body condition at fledging varied between years or colonies, suggesting that male and female chicks were probably not differentially affected by variability in breeding conditions.

Evolutionary analysis of mitogenomes from parasitic and free-living flatworms

Mitochondrial genomes (mitogenomes) are useful and relatively accessible sources of molecular data to explore and understand the evolutionary history and relationships of eukaryotic organisms across diverse taxonomic levels. The availability of complete mitogenomes from Platyhelminthes is limited; of the 40 or so published most are from parasitic flatworms (Neodermata). Here, we present the mitogenomes of two free-living flatworms (Tricladida): the complete genome of the freshwater species Crenobia alpina (Planariidae) and a nearly complete genome of the land planarian Obama sp. (Geoplanidae). Moreover, we have reanotated the published mitogenome of the species Dugesia japonica (Dugesiidae). This contribution almost doubles the total number of mtDNAs published for Tricladida, a species-rich group including model organisms and economically important invasive species. We took the opportunity to conduct comparative mitogenomic analyses between available free-living and selected parasitic flatworms in order to gain insights into the putative effect of life cycle on nucleotide composition through mutation and natural selection. Unexpectedly, we did not find any molecular hallmark of a selective relaxation in mitogenomes of parasitic flatworms; on the contrary, three out of the four studied free-living triclad mitogenomes exhibit higher A+T content and selective relaxation levels. Additionally, we provide new and valuable molecular data to develop markers for future phylogenetic studies on planariids and geoplanids.