Explore the vast range of titles available.

Policy makers need to consider the situation of the poor provision of Palliative Care (PC) in Europe. This deficiency has significant impact on older persons' health and contributes to increased healthcare costs later in life. The InAdvance project (ref. 825750) has generated new policy recommendations based on solutions for the early detection and referral of PC in older adults. These recommendations emphasize the positive impact on the quality of life of older patients and their families as well as the cost-effectiveness of implementing such strategies. For this purpose, various stakeholders contributed to the formulation of these policy recommendations. Initially, the drafting process commenced with healthcare professionals (HCPs)directly involved with patients in need of PC from Greece, Portugal, Spain and the UK. Additionally, an internal workshop with project partners facilitated dialogue among different healthcare institutions, engaging different HCPs in contact with older people in PC. This discussion initially pinpointed common challenges experienced across the diverse pilot sites, with the reality on the ground varying based on pathologies and the settings where PC services are provided. Once these common challenges were identified, partners set out the issues clearly and defined best practices how these issues can be addressed at national level. In parallel, a survey was circulated among AGE Platform Europe members of the Task Force on Dignified and Healthy Ageing to initiate a consultation. This aimed to understand the main barriers and facilitators in accessing PC for older people in their respective countries. Twenty-six completed surveys were received representing 17 different European countries. The contributions resulted in the identification of six main challenges impacting the quality and accessibility of PC: i) PC is neither available nor accessible for all; ii) Education and public awareness about PC is lacking; iii) Non-person-centred care leads to late identification of needs; iv) Fragmentation and discontinuity of care; v) Cost-effectiveness of early admission to PC; and vi) Diverse legal context in Europe. Finally, the drafted recommendations were presented and validated during a workshop organised in the European and Economic Social Committee (EESC) in Brussels. Twenty-two EU stakeholders attended this event and provided valuable feedback and insights on PC from different perspectives. The methodology employed in formulating these recommendations incorporates diverse perspectives and inputs from various professional backgrounds and an international audience. This approach serves as a first attempt and the basis for an open dialogue at national level. The outcomes of this work will be disseminated to policy makers working for EU institutions who have the potential to influence policy making in Europe. Additionally, it will be shared with policy makers at national level in Greece, Portugal, Spain and the UK, where they can exert influence on local and regional policies.              

Bipolar depression is associated with marked cognitive deficits. Pharmacological treatments for this condition are limited and may aggravate depressive and cognitive symptoms. Therefore, therapeutic interventions that preserve adequate cognitive functioning are necessary. Our previous results demonstrated significant clinical efficacy of transcranial direct current stimulation (tDCS) in the Bipolar Depression Electrical Treatment Trial (BETTER). Here, cognitive outcomes of this study are reported. We randomized 59 patients with bipolar disorder I or II in an acute depressive episode to receive active (12 2 mA, 30-min, anodal-left, cathodal-right prefrontal cortex tDCS sessions) or sham tDCS. Patients were on stable pharmacological regimen for at least 2 weeks. A battery of 12 neuropsychological assessments in five cognitive domains (attention and processing speed, memory, language, inhibitory control, and working memory and executive function) was performed at baseline, after two weeks and at endpoint (week 6). No significant differences between groups over 6 weeks of treatment were observed for any cognitive outcomes. Moreover, no decrease in cognitive performance was observed. Our findings warrant further replication in larger studies. Trial Registration: clinicaltrials.gov Identifier: NCT02152878

This study aimed to describe the main entomological triatomine-related indicators in the western mesoregion of Rio Grande do Norte. This is a descriptive cross-sectional retrospective study developed on a historical analysis of information on the triatomine capture carried out by the Chagas Disease Control Program, from 2008 to 2013. Five species were captured, of which the Triatoma brasiliensis and Triatoma pseudomaculata, by occupying the domestic and peridomestic environment, sequentially, and Panstrongylus lutzi by the highest rate of natural infection. A prevalence of nymphs among the captured specimens, a higher triatominal density in the peridomicile, infestation, colonization and natural infection rates of 5.6%, 49.6% and 0.8%, respectively, a significant difference in the distribution of specimens between the municipalities investigated and lack of declining infestation and colonization rates between 2009 and 2012 was observed. Findings suggest the need for continuous surveillance, facilitated by the association between field teams and communities, with emphasis on the proposal of health education for the recognition and notification of triatomines by the population.

Transcranial magnetic stimulation (TMS) is a noninvasive brain stimulation technique with potential to improve memory. Mild cognitive impairment (MCI), which still lacks a specific therapy, is a clinical syndrome associated with increased risk of dementia. This study aims to assess the effects of high-frequency repetitive TMS (HF rTMS) on everyday memory of the elderly with MCI. We conducted a double-blinded randomized sham-controlled trial using rTMS over the left dorsolateral prefrontal cortex (DLPFC). Thirty-four elderly outpatients meeting Petersen’s MCI criteria were randomly assigned to receive 10 sessions of either active TMS or sham, 10 Hz rTMS at 110% of motor threshold, 2,000 pulses per session. Neuropsychological assessment at baseline, after the last session (10th) and at one-month follow-up, was applied. ANOVA on the primary efficacy measure, the Rivermead Behavioural Memory Test, revealed a significant group-by-time interaction p = 0.05 , favoring the active group. The improvement was kept after one month. Other neuropsychological tests were heterogeneous. rTMS at 10 Hz enhanced everyday memory in elderly with MCI after 10 sessions. These findings suggest that rTMS might be effective as a therapy for MCI and probably a tool to delay deterioration.

Bearded Capuchin or Black-striped Capuchin monkeys (Sapajus lidibinosus) are New World robust capuchin monkeys widely used in medical research. Few data are available concerning hematological reference values for these species, with no studies available from the Northeast region in Brazil. The aim of this study was to determine the hematological reference values for healthy bearded capuchin monkeys and to analyze the influence of sex and age factors. Blood samples were collected from 50 healthy bearded capuchin monkeys housed in captivity. These were analysed for total erythrocyte, hemoglobin, leukocyte and platelet count, packed cell volume (PCV), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH) and mean corpuscular hemoglobin concentration (MCHC). When considering the age factor, significant differences were reported for total erythrocyte count, PCV, hemoglobin, total leucocytes, band neutrophils, eosinophils and lymphocytes (higher in juveniles). Significant sex-associated differences were noted for total erythrocyte count, PCV, hemoglobin (higher in males) and number of lymphocytes (higher in females).We have reported for the first time the hematological profile of bearded capuchin monkeys in captivity in the state of Paraíba, Brazil. These results can contribute for a better understanding of the normal physiology of capuchin monkeys, while demonstrating that factors such as sex and age influence hematological parameters should be taken into consideration in the hematological evaluation of this species. RESUMO: Os macacos-prego (Sapajus lidibinosus) são macacos capuchinhos robustos do Novo Mundo amplamente utilizados na pesquisa médica. Poucos dados estão disponíveis sobre valores de referência hematológicos para essas espécies, e não há estudos na região Nordeste no Brasil. O nosso objetivo foi determinar os valores de referência hematológicos para macacos-prego saudáveis e analisar a influência de fatores como o sexo e a idade. Foram coletadas amostras de sangue de 50 macacos-prego saudáveis alojados em cativeiro. Determinaram-se as contagens de eritrócitos, hemoglobina, leucócitos e plaquetas, hematócrito, volume corpuscular médio (MCV), hemoglobina corpuscular média (MCH) e concentração média de hemoglobina corpuscular (MCHC). Foram encontradas diferenças significativas relacionadas à idade para a contagem total de eritrócitos, hematócrito, hemoglobina, leucócitos totais, neutrófilos em banda, eosinófilos e linfócitos (maior em juvenis). Diferenças significativas associadas ao sexo foram observadas para a contagem total de eritrócitos, hematócrito, hemoglobina (maior nos machos) e número de linfócitos (maior nas fêmeas). Relatamos o primeiro perfil hematológico de macacos-prego alojados em cativeiro no estado da Paraíba, Brasil. Estes resultados contribuem para uma melhor compreensão da normal fisiologia dos macacos-prego e demonstram que fatores como sexo e a idade têm influência e devem ser considerados na sua avaliação hematológica.

Lettuce (Lactuca sativa L.) is one of the main leafy vegetables in the world, being present in several countries. Due to its composition, which includes a substance with antioxidant action and beneficial effects on health, it is consumed constantly. However, due to ongoing climate change that has had global effects, the crop has been suffering a reduction in productivity and quality. Thus, technologies aiming to mitigate the effects of climate extremes have been developed. In lettuce production, biostimulants make it possible to improve the growth and sustainable development of plants. This is due to their ability to activate physiological and biochemical processes in plants, resulting in an increase in the production of bioactive compounds such as vitamins, amino acids, and antioxidants. In addition, biostimulants contribute to improving the nutritional quality of lettuces, making them more resistant and adapted to different environmental conditions, resulting in a more sustainable development for the crop. This review aims to compile and discuss the available scientific evidence on the use of biostimulants in lettuce cultivation, addressing their mechanisms of action, the types of substances used, the results obtained in different cultivation systems, and their potential to promote more efficient and adaptable agriculture in the face of environmental changes.

Background: The last WHO definition of palliative care (PC) recognizes the integration of early PC in the course of illness and in conjunction with other therapies that are intended to treat disease as the way to provide optimal care. There is wide literature highlighting the benefits of early implementation of PC in oncological patients and there is a growing recognition of PC as an integral aspect of cancer treatment with the establishment of a range of specific guidelines concerning palliative cancer care. Nevertheless, these advances are not developed to the same extent in the approach of non-oncological chronic conditions. In this regard, patients of non-cancer diseases are rarely offered these services and even when they are admitted to a PC unit they are typically closer to death and have a lower functional level than those with cancer. It is important to highlight this situation as the great majority of adults in need of PC die from non-oncological diseases – such as cardiovascular diseases, chronic respiratory diseases or diabetes – accounting a higher percentage than those with cancer. Aims and objectives: INADVANCE project (funded under the H2020 Programme) seeks an earlier, integrated and more effective implementation of PC to adequately address the needs of non-oncological chronic patients. Thus, this workshop is focused on early PC among patients with chronic conditions. This analysis will be encouraged by presenting the current state of early PC among this profile of patients, some experiences in their management at different healthcare systems. Finally, at the end of the workshop a common discussion between all presenters and attendants will be performed in order to analyze main barriers and facilitators to organize and implement PC services addressed to chronic complex patients. Format: A 90-minutes workshop session will be organized in order to achieve the aforementioned objectives. Two people from INADVANCE project will be in charge of organizing and running the workshop with the participation of the following speakers in these topics: “Introduction” (5min): outline of the main objectives and structure of the session (Ascensión Doñate). “Early PC for patients with complex chronic conditions” (10min): presentation of INADVANCE project, the current state of the art of PC services among non-oncological chronic conditions, how to identify patients in need of PC (Ascensión Doñate). “Experiences in the provision of PC among non-oncological conditions” (40min): five presentations of local experiences (Soledad Giménez, Vania Dimitrova, Panagiotis Bamidis, Adriano Fernandes & Gordon Linklater). Time for questions. “Barriers and facilitators to effectively implement PC” (30min): open discussion with speakers and attendants to the workshop (Soledad Giménez). For this session several materials will be arranged, such as a boards, markers or post-it. “Sum up” (5min): main conclusions (Ascensión Doñate).          Target audience: People interested in PC, care and management of chronic conditions at clinical and organizational level. Learnings: Workshop participants will learn about differences in the provision of integrated PC between cancer vs. non-cancer diseases, real experiences improving the PC of chronic complex conditions and challenges for future improvement.