Montserrat Puig

Genomic structure of phage B40-8 of Bacteroides fragilis.

Very few data are available on the molecular biology of Bacteroides fragilis bacteriophages, which have been considered in several studies as indicators of faecal contamination. Phage B40-8, initially isolated from an urban sewage sample using a strain of B. fragilis (HSP40) isolated from a clinical specimen, was chosen in this study as a prototype for morphological and molecular studies. Like most of the phages infective for B. fragilis, B40-8 belongs to the Siphoviridae family. Its genome has been found to be a double-stranded DNA molecule, of approximately 51.7 kb, containing a rather low percentage (38.9 mol%) of G + C. The ends of the molecule appeared not to be cohesive but permuted, with a terminal redundancy of 7.3%. A genomic map was constructed. Three major proteins (MP) out of 15 peptides in the SDS-PAGE profile were selected for N-terminal sequencing. From these data, degenerate probes were designed to locate the ORFs in the genomic map. Immunodetection by electron microscopy revealed that MP1 and MP3 were structural proteins of the phage head and that MP2 was a constituent of the tail. A genomic library of the phage was prepared, and a clone including the MP2 ORF was identified and sequenced.

Description of a DNA amplification procedure for the detection of bacteriophages of Bacteroides fragilis HSP40 in environmental samples.

A molecular test based on DNA amplification by PCR was developed for the detection of bacteriophages of Bacteroides fragilis strain HSP40 in the environment. These specific phages are associated with faecal contamination of human origin. A homologous DNA region of 1.5 kb, identified previously by hybridisation, was used to design primers for the detection of B. fragilis HSP40 phages. A nested-PCR procedure for the DNA amplification of those phages was developed. The sensitivity of the nested-PCR was between 10(-1) and 10(-2) PFU for purified HSP40 phage solutions, sewage and seawater samples, and between 1 and 10 PFU for river water samples. Specific amplification of HSP40 phages was observed when viral suspensions of 10(3) PFU/ml or lower were used. Common levels of B. fragilis phages found in sewage are 10(1)-10(2) PFU/ml. A total of 24 water samples (sewage, river water and seawater) were tested both by PCR and by plaque assay, to evaluate the efficiency of the molecular method in field samples. The data obtained by PCR in environmental samples showed good concordance with the PFU counts and a higher sensitivity.

Detection of phages infecting Bacteroides fragilis HSP40 using a specific DNA probe.

Nine bacteriophage isolates of Bacteroides fragilis, obtained from urban sewage and pig faeces samples using four different host strains (HSP40, RYC4023, RYC2056 and RYC3318), were compared on the basis of morphology, host range, DNA restriction patterns, DNA hybridisation and protein composition. All the phages are siphovirus and, as judged from cleavage by restriction endonucleases, their genome is composed of double-stranded DNA of similar size ( approximately 51-kb). Host range analysis differentiated two types of phages: (1) phages that clearly infect B. fragilis strains HSP40 (B40-2, B23-1, B23-2, B23-3 and B23-4, of which B40-8 is the phage type); and (2) the group of bacteriophages that were not infectious for HSP40 (B56-1, B56-2 and B18-1). Similarity in DNA restriction patterns and protein characteristics was found in the HSP40 infectious phages. Anti-B40-8 serum recognised only the proteins of the phages of this type. Although all phages showed similar major protein sizes, minor specific bands were detected. Bacteriophages B56-1, B56-2 and B18-1 showed heterogeneity in their DNA restriction profiles although some degree of DNA-DNA homology between all genomes was observed. Southern blot analysis with phage B40-8 DNA based probes identified a 1.5-kb DNA region homologous for all HSP40 phage isolates, but absent in the genome of the other phage isolates that did not infect this bacterial strain. The homologous region was used as a specific probe to specifically detect B. fragilis HSP40 phages.

Defining the Role of the Nurse in Population-Based Cancer Screening Programs

Nurses are pivotal in cancer prevention and early detection, but the nurses role in cancer screening programs has been described only in very general terms without specification of activities needed to develop the role. To identify the set of activities that compose the role of the cancer screening nurse, the authors of the current article performed a critical descriptive literature review to document nursing involvement in cancer screening, covering articles published from 2000-2012. A total of 726 potentially relevant studies were identified, and 22 of those were included in the review. Nurses carry out follow-up, coordinate treatment, ensure continuity throughout the process, provide up-to-date and pertinent information to facilitate patient knowledge and choice, work to ensure coordination among the various levels of care, provide ongoing training, lead research and publications concerning daily practice, and collaborate in investigation oriented toward early detection. The literature revealed that the nurses role in cancer screening involves case management as the main activity as well as, exceptionally, carrying out diagnostic tests.

Cross-sectional survey on awareness of colorectal cancer and a screening programme for primary health care professionals in Catalonia, Spain.

This study aimed to assess whether primary health care professionals have accurate information regarding colorectal cancer (CRC) screening procedures, surveillance recommendations and referral strategies. This cross-sectional descriptive study was based on a survey conducted among primary health care professionals in Barcelona, Spain. The questionnaire was used to gather information regarding CRC screening procedures as well as demographic and professional characteristics of the study subjects. A CRC and screening awareness score (ranging from 0 to 12) was created based on the survey questions. The response rate was 58.9% (206/305). The estimated mean score (standard deviation) was 8.43 (SD: 1.30). For four questions, more than 60% of the answers were incorrect: one related to risk factors, two concerning follow-up colonoscopy, and one related to surveillance. Only 30.8% of the participants believed that they were responsible for determining the appropriate surveillance intervals and for scheduling colonoscopies. Although the professionals had sufficient knowledge of CRC screening, professional knowledge of some aspects related to the major non-modifiable risk factors for the disease and surveillance colonoscopy procedures could be improved. Frequent communication with professionals is necessary to maintain updated screening-related information. Possible methods for facilitating communication could include continuous briefings, regular message reminders or educational websites.

Lifestyle of the Elderly Receiving Home Care in Spain

The aim of this study is to examine the lifestyle characteristics and health status of the elderly in order to identify aspects that might help promote active ageing. Participants were 26 elderly citizens aged 75 or over who were the recipients of home care services in Vilafranca del Penedes (Barcelona, Spain). They were recruited by means of convenience sampling, and a case study approach was adopted. Fieldwork was conducted in April 2007, with a specially designed questionnaire administered in the context of an in-depth interview. Quantitative data were analyzed with SPSS 15, while qualitative data were analysed and grouped by category. The results indicated that 53.8% of the elderly interviewees perceived their health status as being regular, most did not have adequate nutrition and hydration, while 42.3% had chewing problems and 65.3% presented slight dependence. Most of them received visits at home, but did not go on leisure outings. The only exercise they took was walking. These findings highlight the need to promote and strengthen activities for healthy ageing, and to ensure that people over 75 receive adequate care. Programmes should be implemented to improve those aspects that are currently under-addressed

Qualidade de vida e carga sobre cuidadores informais de idosos dependentes na Catalunha

“Efficacy of the program InCARE in the burden of informal caregivers of older people after a stroke” BACKGROUND: Stroke is the leading cause of disability in Portuguese older people. Despite the advances in the health care system, allowing more stroke survivors living at home be cared by their families, the evidence suggests higher levels of burden in caregivers, dissatisfaction with the quantity and quality of information they received and with the support received. The state-of-the art, also suggests, there is a need for implementing a psychoeducational intervention programmes based on problem solving and on practical skills acquisition to reduce burden in caregivers. AIM: The study aimed at: (1) assessing the practical skills of caregivers of older stroke survivors; (2) evaluating an intervention program to reduce burden in caregivers during the 1st (M1) and 3rd (M2) month after the intervention. METHODOS: The quasi-experimental study was developed with 174 informal caregivers of dependent older stroke survivors, allocated in: i) experimental group (n = 85); and ii) control group (n = 89). Data collection occurred in community-dwelling of health care units in northern Portugal. RESULTS: The data suggests higher levels of burden in the 1st and 3rd month of the control group in comparison with the experimental group, in which a decrease after a follow-up was verified. (M2). CONCLUSION: The results of the InCARE program suggests the importance of early structured interventions to achieve practical skills by informal caregivers of older stroke survivors as a therapeutic intervention to reduce burden.

Quality of life and care burden among informal caregivers of elderly dependents in Catalonia

“Efficacy of the program InCARE in the burden of informal caregivers of older people after a stroke” BACKGROUND: Stroke is the leading cause of disability in Portuguese older people. Despite the advances in the health care system, allowing more stroke survivors living at home be cared by their families, the evidence suggests higher levels of burden in caregivers, dissatisfaction with the quantity and quality of information they received and with the support received. The state-of-the art, also suggests, there is a need for implementing a psychoeducational intervention programmes based on problem solving and on practical skills acquisition to reduce burden in caregivers. AIM: The study aimed at: (1) assessing the practical skills of caregivers of older stroke survivors; (2) evaluating an intervention program to reduce burden in caregivers during the 1st (M1) and 3rd (M2) month after the intervention. METHODOS: The quasi-experimental study was developed with 174 informal caregivers of dependent older stroke survivors, allocated in: i) experimental group (n = 85); and ii) control group (n = 89). Data collection occurred in community-dwelling of health care units in northern Portugal. RESULTS: The data suggests higher levels of burden in the 1st and 3rd month of the control group in comparison with the experimental group, in which a decrease after a follow-up was verified. (M2). CONCLUSION: The results of the InCARE program suggests the importance of early structured interventions to achieve practical skills by informal caregivers of older stroke survivors as a therapeutic intervention to reduce burden.