No abstract

Older people are at an increased risk of developing multiple comorbidities causing subsequent cognitive, functional decline and frailty and increasing the risk of adverse healthcare outcomes. Public Health Nurses (PHNs), geriatricians and researchers developed the Risk Instrument for Screening in the Community (RISC) to record the presence of problems, severity (mild, moderate, severe) of concerns and caregiver networks' ability to manage the patient across three domains: mental state, activities of daily living and medical state. The aim of this study was to explore the experiences of healthcare professionals who had used the RISC with community-dwelling older adults, between countries. Five focus groups (n = 28) were conducted in five countries (Australia, Northern Ireland, Portugal, Republic of Ireland and Spain). Four main themes were identified from participants' experiences using the RISC: 'Tool Usability'; 'Benefits for Patients and Carers'; 'Operational Challenges'; and 'Recommendations for Improvement'. Some cultural differences were found between participants with regards to terminologies such as 'caregiver network' and 'insight' and expectation in relation to caring. Disciplinary differences were identified related to different conceptualisations of health. The RISC offers an innovative approach to identify and score risk in community dwelling older adults. However, further research is necessary to reflect cultural and disciplinary norms.

No abstract

BackgroundIt has been demonstrated that hyperuricemia protects from Parkinson’s disease (PD), but this relation is controversial in patients with gout. Inflammatory properties of urate monosodium(UMS) crystals deposition that appears when uric acid(UA) levels exceed its solubility faces antioxidant and neuroprotective features of soluble UA. Both, UMS crystals deposition and hyperuricemia coexist in gouty patients.There is several data that demonstrates that hyperuricemia protects from Parkinson’s disease (PD). Results from different studies about the relation between them are controversial. Inflammatory properties of the urate crystals faces antioxidant and neuroprotective features of soluble UA. Both, UMS crystals and hyperuricemia coexist in gouty patients.ObjectivesTo study if gout protects from Parkinson disease in a mediterranean urban population.MethodsPrimary care based matched case-control study. It has been carried out using the electronic clinical record database from the public health (Institut Català de la Salut) of the city of Barcelona. The database contains anonymous data from almost 1 million and a half people. Just people that were 40 years or older were studied. Were considered cases patients with a PD diagnose, or taking high specific anti-Parkinson’s drugs (like l-dope, rasagiline, selegiline…), between 2006 and 2016. For every case we randomly selected four controls matched by gender and age. Data on risk factors was also collected for each individual (diabetes mellitus, hypertension, hypercholesterolemia and tobacco consumption before the PD diagnose), as well as age and gender. A multivariate logistic regression model was used to study the association of gout and PD adjusted by the presence of other risk factors. Adjusted Odds Ratios (aOR) and their 95% CI are provided.Results21 789 persons with a PD diagnose and 87 156 controls were included. Mean age was 75.5 (SD 10.9) years. 55.6% were females. 2.5% of PD patients had a previous gout diagnose, compared to 4.8% of controls (p<0.001). Multivariate Logistic regression model showed for gout: aOR=0.55 (0.50–0.61). Diabetes mellitus: aOR=1.18 (1.14–1.23); hypertension: aOR=0.7 (0.72–0.77); tobacco: aOR=0.55 (0.52–0.58); high cholesterol levels: aOR=0.60 (0.58–0.61).ConclusionsGout shows a protective effect on the development of Parkinson’s disease, pointing that the antioxidant and neuro protective effect of UA seems to overcome its inflammatory properties in gouty patients.Gout shows a protective effect on the development of Parkinson’s disease, pointing that the antioxidant and neuro protective effect of UA seems to overcome itsinflammatory properties in gouty patients.Disclosure of InterestNone declared