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Navas P, Arias VB, Vicente E, Esteban L, Guillén VM, Alvarado N, Heras I, Rumoroso P, García-Domínguez L, Verdugo MÁ. Empowering lives: How deinstitutionalization and community living improve the quality of life of individuals with intellectual and developmental disabilities. RESEARCH IN DEVELOPMENTAL DISABILITIES 2025; 157:104909. [PMID: 39799901 DOI: 10.1016/j.ridd.2024.104909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2024] [Revised: 12/18/2024] [Accepted: 12/28/2024] [Indexed: 01/15/2025]
Abstract
BACKGROUND The number of people with intellectual and developmental disabilities (IDD) living in residential settings has not changed substantially in recent years in Spain. To change this situation the project "My House: A Life in the Community" aims to promote the transition of individuals with IDD and high support needs into community settings. AIMS This paper deepens the understanding of the underlying mechanisms responsible for the changes observed in the process of deinstitutionalization. METHODS A longitudinal study was designed to evaluate the quality of life of individuals with IDD (n = 90) across different environments at two distinct time points: when they were living in an institution and nine months after transitioning to a community-based setting. A comparison group (n = 72) consisting of individuals who remained institutionalized was included to carry out intergroup comparisons. T-tests were used to estimate mean differences both between and within groups. Longitudinal path models were used to investigate the processes underlying the relationships between variables. RESULTS After transition, movers obtained significantly higher mean scores on all variables with large or very large effect sizes. However, simply moving to a different place was not the factor responsible for the observed improvements: positive changes in quality of life require the constant availability of opportunities to support decision making. IMPLICATIONS deinstitutionalization will only lead to improvements in quality of life if it favors people's control over their lives. Community living should therefore be understood not as an autonomous life but as a chosen one.
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Navas-Enamorado C, Capo X, Galmes-Panades AM, Ortega-Moral A, Sánchez-Polo A, Masmiquel L, Torrens-Mas M, Navas P, Gonzalez-Freire M. The association of circulating bioenergetic metabolites with healthy human aging. Exp Gerontol 2024; 194:112488. [PMID: 38879093 DOI: 10.1016/j.exger.2024.112488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Revised: 04/25/2024] [Accepted: 06/10/2024] [Indexed: 06/18/2024]
Abstract
Aging is an inevitable and gradual decline in several biological functions. Mitochondrial dysfunction is one of the most important hallmarks of aging. In this context, alterations in metabolites associated with mitochondrial dysfunction may serve as a significant biomarker. This study aimed to investigate the existence of a relationship between the key metabolites involved in bioenergetics metabolism and aging. 53 volunteers ranged 20-85 years participated in the study. We tested the association between different tricarboxylic acid (TCA) cycle metabolites, fatty acid metabolism, and amino acid metabolism with age, sex, body composition, and proxy markers of aging such as walking speed, grip strength and chair test. We found that lactic acid negatively correlated with age while several fatty acid metabolites, such as azelaic, sebacic, and linoleic acids, showed positive correlations with age (p < 0.05). Sex-specific trends, such as glycerol, and dodecanoic acid, were also observed for certain metabolites. Furthermore, citric acid levels were found to have a significant association with physical function and body composition measures. Participants with higher citric acid levels displayed improved performance in physical tests and favorable body composition indices. Additionally, fumaric acid and adipic acid showed positive correlations with fat-free body mass, while sebacic acid was negatively associated with measures of fat mass. These findings underscore the importance of understanding the role of circulating bioenergetics metabolites with age, sex variations, and their potential implications in body composition and physical performance.
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Navas P, Esteban L, Arias V, Verdugo MÁ. Improving Quality of Life and Reducing Behavioral Problems of People With Intellectual and Developmental Disabilities Through Deinstitutionalization. PSICOTHEMA 2024; 36:113-122. [PMID: 38661158 DOI: 10.7334/psicothema2023.303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
ANTECEDENTS People with intellectual and developmental disability (IDD) with extensive support needs are more likely to live in segregated and highly institutionalized environments. The aim of this study was to analyze changes in functioning and quality of life for people with IDD and extensive support needs after transitioning to ordinary homes in the community. METHOD The sample included 54 adults with IDD and extensive support needs, who were assessed at three time points: before transition, six months later, and one year after transition. The Resident Choice Scale, San Martin Quality of Life Scale, Active Support Participation Measure, and the Behavior Problem section of the Inventory for Client and Agency Planning were administered. Partial least squares-structural equation modeling (PLS-SEM) and t-tests for repeated measures were carried out. RESULTS There were significant improvements in decision-making, participation and independence in daily activities and quality of life, as well as a reduction in the presence and intensity of behavioral problems. CONCLUSIONS The benefits found in this study support transformation processes towards more inclusive services and professional practices that foster people's rights and feeling of belonging to the community.
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Bouza E, Asensio A, García Navarro J, González P, Acosta Benito M, Aguilar J, Barberán J, Cabrera J, Díez-Manglano J, Fernández C, Fernandez-Prada M, Fontán G, Cisneros J, Lorenzo-Vidal B, Martín Oliveros A, Navas P, Palomo E, Kestler M. [Recommendations for the prevention of healthcare-associated infections in nursing homes]. FARMACEUTICOS COMUNITARIOS 2024; 16:28-50. [PMID: 39156042 PMCID: PMC11326686 DOI: 10.33620/fc.2173-9218.(2024).02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 10/25/2023] [Indexed: 08/20/2024]
Abstract
Nursing homes (NH) although conceptually they should look as much like a home as possible, NH have unquestionable similarities with a nosocomium as they are places where many patients with underlying diseases and comorbidities accumulate and where the transmission of microorganisms between residents and between residents and caregivers is frequent.We have not found any recommendations specifically aimed at the prevention of nosocomial infections in MRI by the major Public Health Agencies and, therefore, the Health Sciences Foundation (Fundación de Ciencias de la Salud) has convened a series of experts and 14 Spanish scientific societies to discuss recommendations that could guide NH personnel in establishing written programs for the control and reduction of these infections. The present document is the result of these deliberations and contains suggestions for establishing such control programs on a voluntary and flexible basis in NH. We also hope that the document can help the health authorities to encourage this control activity in the different territorial areas of Spain. In our opinion, it is necessary to draw up a written plan and establish the figure of a coordinator or person responsible for implementing these projects. The document includes measures to be implemented and ways of quantifying the reality of different problems and of monitoring the impact of the measures established.
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Bouza E, Asensio A, García Navarro JA, González P, Costa Benito MA, Aguilar J, Barberán J, Cabrera J, Díez-Manglano J, Fernández C, Fernandez-Prada M, Fontán G, Cisneros JM, Lorenzo-Vidal B, Martín Oliveros A, Navas P, Palomo E, Kestler M. Recommendations for the prevention of healthcare-associated infections in nursing homes. REVISTA ESPANOLA DE QUIMIOTERAPIA : PUBLICACION OFICIAL DE LA SOCIEDAD ESPANOLA DE QUIMIOTERAPIA 2023; 36:552-561. [PMID: 37465867 DOI: 10.37201/req/078.2023] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/20/2023]
Abstract
Nursing homes (NH) conceptually should look as much like a home as possible. However NH have unquestionable similarities with a nosocomium as they are places where many patients with underlying diseases and comorbidities accumulate. There is evidence of transmission of microorganisms between residents and between residents and caregivers. We have not found any recommendations specifically aimed at the prevention of nosocomial infections in NH by the major Public Health Agencies and, therefore, the Health Sciences Foundation (Fundación de Ciencias de la Salud) has convened a series of experts and 14 Spanish scientific societies to discuss recommendations that could guide NH personnel in establishing written programs for the control and reduction of these infections. The present document is the result of these deliberations and contains suggestions for establishing such control programs on a voluntary and flexible basis in NH. We also hope that the document can help the health authorities to encourage this control activity in the different territorial areas of Spain. In our opinion, it is necessary to draw up a written plan and establish the figure of a coordinator or person responsible for implementing these projects. The document includes measures to be implemented and ways of quantifying the reality of different problems and of monitoring the impact of the measures established.
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Verdugo MÁ, Schalock RL, Gómez LE, Navas P. A Systematic Approach to Implementing, Evaluating, and Sustaining the Shared Citizenship Paradigm in the Disability Field. Behav Sci (Basel) 2023; 13:970. [PMID: 38131825 PMCID: PMC10740522 DOI: 10.3390/bs13120970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 10/01/2023] [Accepted: 11/23/2023] [Indexed: 12/23/2023] Open
Abstract
The disability field continues to face challenges in transforming and implementing meaningful and effective changes in person-centered services and supports aligned with the principles of the Convention on the Rights of Persons with Disabilities. To guide this transformative process effectively, a paradigm must be operationalized through a systematic approach. This article outlines such a systematic approach, consisting of two components: (a) aligning the paradigm's foundational pillars to the elements of an explanatory/implementation model (the Quality of Life and Supports Model) to facilitate the paradigm's operationalization, acceptance, and application and (b) aligning implementation, evaluation, and sustainability strategies with ecological systems, implementation targets, and the paradigm's foundational pillars to drive change across systems. The synergy and alignment between these components underscore the importance of linking public policies with professional and organizational practices to promote social inclusion and enhance the quality of life for people with disabilities. We provide practical examples highlighting the collaborative potential of this synergy and emphasize the significance of evidence-based and person-centered practices in promoting equal rights and social inclusion for people with disabilities.
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Esteban L, Navas P, Verdugo MÁ, Iriarte EG, Arias VB. A community living experience: Views of people with intellectual disability with extensive support needs, families, and professionals. RESEARCH IN DEVELOPMENTAL DISABILITIES 2023; 137:104503. [PMID: 37058934 DOI: 10.1016/j.ridd.2023.104503] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 03/28/2023] [Accepted: 04/03/2023] [Indexed: 05/10/2023]
Abstract
BACKGROUND Despite the benefits of community living for people with intellectual disabilities (ID) and extensive support needs, they remain highly institutionalized. AIMS To qualitatively analyze the perceptions of people with ID, including those with extensive support needs, professionals, and family members six months after the implementation of 11 community homes for 47 people in different regions of Spain METHODS: Thematic analysis of 77 individual interviews conducted with 13 people with ID, 30 professionals and 34 family members was performed using Nvivo12. RESULTS Seven themes were found: (1) "the room as I like it", (2) "sometimes I don't obey", (3) "here I do a bit of everything", (4) "lots of people love me here", (5) "all thanks to them, who have helped me" (6) "I miss my mom", and (7) "I'm happy here". IMPLICATIONS Transitioning into the community has shown a clear positive change in emotional well-being, opportunities to participate in activities or exercise control over one's life. Nevertheless, certain restrictions were still present in people's lives, which significantly limit their right to independent living. While many of these restrictions may disappear, professional practices typical of a medical model can be recreated in services located in the community.
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Gómez LE, Morán ML, Solís P, Pérez‐Curiel P, Monsalve A, Navas P. Health care for people with intellectual disability in Spain. JOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES 2023. [DOI: 10.1111/jppi.12455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
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Pérez Prieto I, Plaza-Florido A, Molina N, Casas-Matas A, Molina M, Yoldi A, Vaquero Á, Navas P, Castilla J, Ortega F, Altmäe S. P-103 Physical fitness is positively associated with sperm quality in healthy young men. Hum Reprod 2022. [DOI: 10.1093/humrep/deac107.099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Study question
Do sperm quality parameters differ between “high” and “low” cardiorespiratory fitness (CRF) and muscular strength levels in healthy young men?
Summary answer
Self-reported CRF was positively associated with sperm count and concentration, while muscular strength (objectively measured and self-reported) did not correlate with seminal parameters.
What is known already
Physical activity (i.e., any body movement that results in energy expenditure) levels are positively associated with sperm quality parameters in healthy men. In this context, physical fitness, which is modifiable by physical activity, is a powerful marker of health that integrates several body functions such as hematocirculatory, skeletomuscular, phsychoneurological and endocrine-metabolic. In particular, the main components of physical fitness (i.e., CRF and muscular strength) have been negatively related to the risk of all-cause mortality in any age population. However, the association of CRF and muscular strength with sperm quality parameters in healthy young men is unknown.
Study design, size, duration
This cross-sectional study included 253 healthy men (age= 22.63 ± 5.04 years, BMI= 22.84 ± 1.33). Semen samples and physical fitness assessment were performed between March 2019 and July 2021 at the sperm biobank (Ceifer Biobank – NextClinics). The study was approved by the Ethics Committee of Investigación Biomédica de Andalucía.
Participants/materials, setting, methods
CRF was self-reported using the The International FItness Scale (IFIS). Muscular strength was objectively assessed using a handgrip dynamometer and self-reported with IFIS. Semen samples were analysed by clinical technicians to determine sperm count, sperm concentration and progressive motility. Analysis of covariance (ANCOVA) was performed to obtain adjusted mean differences on sperm quality parameters between high and low CRF and muscular strength groups after including age and body mass index as confounders.
Main results and the role of chance
Men with higher CRF presented increased sperm count and concentration compared to men with lower CRF values (adjusted mean differences 43.581 x 106 [2.630, 84.532; 95% confidence interval] and 10.131 x 106/ml [0.799, 19.463; 95% confidence interval]; both p < 0.05). Muscular strength (objectively measured and self-reported) was not associated with any semen quality parameter (all p > 0.05) when including age and body mass index as covariates.
Limitations, reasons for caution
This study reported a positive association between self-reported CRF using IFIS questionnaire and sperm count and concentration in healthy young men. Although the validity of the self-reported CRF using IFIS has been widely proved in healthy young adults, objectively measured CRF is needed to further confirm our findings.
Wider implications of the findings
Infertility has increased in the last decades. Therefore, more research is needed to identify health indicators that affect sperm quality. Our results suggest that self-reported CRF could contribute to the identification of young men with poor seminal quality and a higher risk of infertility later in life.
Trial registration number
NA
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García-Domínguez L, Navas P, Verdugo MÁ, Arias VB, Gómez LE. Psychotropic drugs intake in people aging with intellectual disability: Prevalence and predictors. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2022; 35:1109-1118. [PMID: 35384179 PMCID: PMC9545215 DOI: 10.1111/jar.12996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 03/04/2022] [Accepted: 03/24/2022] [Indexed: 11/26/2022]
Abstract
Background Psychotropic medication is frequently administered to people with intellectual disability with mental health and/or behavioural problems, instead of other non‐pharmacological interventions. This study describes the mental health and behavioural problems of people aging with intellectual disability, their psychotropic medication intake, and the factors contributing to a greater medication intake. Method The sample consisted of 991 people with intellectual disability over 45 years. Descriptive statistics and multinominal logistic regression were carried out. Results Antipsychotics were the most used psychotropic drug. Older people with mild intellectual disability living in institutions and affected by mental health and behavioural problems were more likely to take larger amounts of psychotropic medication. Conclusions Antipsychotics continue to be widely used by people with intellectual disability and mental and behavioural health problems, especially those in institutionalised settings. Future research should consider if medication intake could be reduced providing better supports in the community and non‐pharmacological interventions.
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Del Castillo C, Castrodeza J, Blázquez Z, Ortiz-Bautista C, Valerio M, Valero M, Navas P, Villa A, Sousa I, Zatarain E, Martínez-Sellés M, Fernández-Avilés F. Late Cytomegalovirus Primoinfection in a Heart Transplant Recipient After COVID-19 Vaccine. J Heart Lung Transplant 2022. [PMCID: PMC8988561 DOI: 10.1016/j.healun.2022.01.1696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Lunsky Y, Jahoda A, Navas P, Campanella S, Havercamp SM. The mental health and well-being of adults with intellectual disability during the COVID-19 pandemic: A narrative review. JOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES 2022; 19:35-47. [PMID: 35601014 PMCID: PMC9115206 DOI: 10.1111/jppi.12412] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 01/27/2022] [Accepted: 01/27/2022] [Indexed: 12/31/2022]
Abstract
Prior to the start of the pandemic, adults with intellectual disability (ID) were more likely to experience mental health difficulties and face barriers obtaining mental health care. COVID-related public health restrictions, combined with heightened challenges to obtain timely mental health care, have served to worsen this situation internationally, with a combination of new onset conditions and worsening mental health for those already struggling. In this narrative review, we summarize literature on the mental health of adults with ID during the COVID-19 pandemic to describe what is known based on clinician perceptions, existing administrative health data, family and staff perceptions, and self-report. In addition to noting similarities and differences in findings based on the source of information, we also explored how experiences differed depending on where and when the research was conducted. Based primarily on research conducted during the first six months of the pandemic, there is a consistent finding across sources of increased anxiety, stress, and isolation. This review also explored the delivery of virtual mental health care and the impact of pandemic-based mental health interventions. There have been very few research studies evaluating clinical care during this time but clinicians have managed to provide supports virtually, which has been evaluated positively by some individuals. This narrative review concludes by identifying gaps in the literature and suggests key directions for future mental health research, policy, and practice efforts. Any mental health efforts now and during pandemic recovery need to have an understanding of how the mental health needs and services for adults with ID have evolved over the course of the pandemic. Further research is needed on the impact of both clinical interventions and other nonclinical efforts on the mental health of people with ID.
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Navas P, Verdugo MÁ, Martínez S, Amor AM, Crespo M, Deliu MM. Impact of COVID-19 on the burden of care of families of people with intellectual and developmental disabilities. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2021; 35:577-586. [PMID: 34888996 DOI: 10.1111/jar.12969] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 10/06/2021] [Accepted: 11/26/2021] [Indexed: 01/02/2023]
Abstract
AIM This study analysed the impact that COVID-19 and the response measures implemented by the Spanish Government have had on families of individuals with intellectual and developmental disabilities. METHOD Data on 323 family members (M = 52.3 years old; SD = 10.5) were collected through an online survey, which was focused on analysing difficulties experienced and service provision during lockdown. RESULTS Many families (66.3%) have seen their level of stress increased during lockdown because of, among other reasons, a greater burden of care. Difficulties were associated with the closure and changes in disability-related services. Families of people with extensive support needs have generally experienced greater difficulties. CONCLUSION Support services should have been considered essential services during lockdown. The failure to receive support has resulted in excessive burden on families, who had to assume a multitude of roles to support their family member with intellectual and developmental disability.
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Gómez LE, Navas P, Verdugo MÁ, Tassé MJ. Empirically supported psychological treatments: The challenges of comorbid psychiatric and behavioral disorders in people with intellectual disability. World J Psychiatry 2021; 11:1039-1052. [PMID: 34888172 PMCID: PMC8613764 DOI: 10.5498/wjp.v11.i11.1039] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 07/17/2021] [Accepted: 10/18/2021] [Indexed: 02/06/2023] Open
Abstract
This paper reviews the current state of knowledge on psychological interventions with empirical evidence of efficacy in treating common psychiatric and behavioral disorders in people with intellectual disability (ID) at all stages of their life. We begin with a brief presentation of what is meant by psychiatric and behavioral disorders in this population, along with an explanation of some of the factors that contribute to the increased psychosocial vulnerability of this group to present with these problems. We then conduct a review of empirically supported psychological therapies used to treat psychiatric and behavioral disorders in people with ID. The review is structured around the three generations of therapies: Applied behavior analysis (e.g., positive behavior support), cognitive behavioral therapies (e.g., mindfulness-based cognitive therapy), and contextual therapies (e.g., dialectical behavior therapy). We conclude with some recommendations for professional practice in the fields of ID and psychiatry.
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Molina NM, Sola-Leyva A, Pérez-Prieto I, Vargas E, Molina M, Yoldi A, Vaquero A, Navas P, Clavero-Gilabert A, Gonzalvo-López MC, Morales N, Ramírez JP, Castilla JA, Aguilera CM, Altmäe S. O-147 Differential seminal metabolomic signature is related to sperm quality. Hum Reprod 2021. [DOI: 10.1093/humrep/deab127.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Study question
What is the entire metabolomic profile of human semen and does the metabolic composition differ between men with good-quality and low-quality semen?
Summary answer
Human semen contains ∼700 different metabolites, and the metabolomic signature differs between normozoospermic men and men with altered seminal parameters.
What is known already
Semen contains a wide diversity of metabolites as has been identified in single and targeted metabolite studies. The full composition of metabolites in human semen, however, is not known. The knowledge of the complete metabolic signature in semen and whether there are differences between metabolic composition and seminal quality could enhance our knowledge of possible factors involved in reduced sperm quality and male infertility.
Study design, size, duration
Case-control study, where a total of 100 men (age= 29.73±8.9 years) from March 2019 to March 2020 participated. The study was approved by the Ethics Committee of Investigación Biomédica de Andalucia.
Participants/materials, setting, methods
Semen samples from 69 normozoospermic and 31 oligozoospermic men were collected at the University Hospital and sperm biobank (Ceifer Biobank - NextClinics). The complete metabolome from unprocessed seminal samples was analysed by Ultrahigh Performance Liquid Chromatography-Tandem Mass Spectroscopy (UPLC-MS/MS). Raw data were extracted, peak-identified and quality control processed using Metabolon’s hardware and software (metabolon.com). Multiple regression models controlling for age and sample collection centres were applied using R software.
Main results and the role of chance
In total, 695 different metabolites were detected in the seminal samples, where docosahexaenoate (DHA; 22:6n3, PubChem ID 445580), choline phosphate (1014), dihomo-linolenate (20:3n3 or n6, 5280581), docosapentaenoate (n6 DPA; 22:5n6, 6441454), adenosine 3’,5’-cyclic monophosphate (cAMP, 6076) and N-acetylalliin (122164824) metabolites were the most prevalent. The seminal metabolomic profiles differed significantly between men with normal and low sperm parameters. The most abundant metabolites in normozoospermic men belonged to Lipid Super-Pathway, while Nucleotide Super-Pathway was predominant in semen samples with low quality (p < 0.05). More specifically, the leading Sub-Pathway in normozoospermic men was Long Chain Polyunsaturated Fatty Acid (n3 and n6), whereas Purine and Pyrimidine Metabolism Sub-Pathway prevailed in low-quality semen samples, where DHA and cAMP dominated in men with normal and low seminal quality parameters, respectively (p < 0.05 in all comparisons).
Limitations, reasons for caution
This is the first study presenting the entire metabolome signature of unprocessed human semen, and these preliminary results need to be confirmed in a bigger sample size.
Wider implications of the findings
Semen analyses applied in clinics do not evaluate the functional status of sperm, leaving the infertility causes due to male factor frequently unknown. Our study results could help to understand the molecular background of reduced seminal quality and male infertility and lead to identification of molecular biomarkers of functional sperm.
Trial registration number
not applicable
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Molin. Romero M, Yoldi A, Gañán M, Navas P, De. Pico JL, Vaquero Á, Fuente PDL, Ramírez JP, Castilla JA. P–548 High-risk genetic matching on gamete donors: complete genes analysis or genotyping test? Hum Reprod 2021. [DOI: 10.1093/humrep/deab130.547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Study question
What carrier screening test is better to reduce the risk of offspring being affected by recessive diseases when genetic matching is performed with gamete donors: complete or targeted genes analysis?
Summary answer
The use of complete genes analysis in the carrier screening of gamete donors reduces the risk of offspring being affected by recessive diseases.
What is known already
Legislative measures and scientific societies alike call for more research to be conducted into recessive diseases in gamete donors, in order to reduce reproductive risk. However, it is still unclear which genes should be studied and what type of data analysis, targeted or nontargeted, should be performed.
Study design, size, duration
This descriptive observational study of 923 oocyte donors and 895 semen donors was conducted from January 2017 to August 2020, at a private gamete bank.
Participants/materials, setting, methods
1818 gamete donors screened by NGS and nontargeted analysis of the variants, the pathogenic variants detected were analysed to estimate the probability of high-risk genetic matching and to determine the results that would have been obtained if the three most commonly used genotyping tests for carriers of recessive diseases in ART had been applied.
Main results and the role of chance
The probability of high-risk genetic matching with gamete donation, screened by NGS and complete genes analysis, was 5.48%, versus the 0.57–2.8% that would have been obtained if the genotyping test had been applied. Of the 1739 total variants found, only 28.69% would have been detected by all three targeted tests considered and 45.66% of the variants would not have been detected by any of them.
Limitations, reasons for caution
The study was not based in the general population, was limited to a population of Mediterranean ethnic origin. In addition, our study only analysed 302 recessive diseases of the 1,300 plus that have been described.
Wider implications of the findings: Our study highlights the considerable heterogeneity of the genotyping tests commonly used in ART, which present significant differences in their ability to detect pathogenic variants. Therefore, the use of genotyping tests for genetic matching is associated with a higher reproductive risk, compared to the use of complete genes analysis.
Trial registration number
Not applicable
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Amor AM, Navas P, Verdugo MÁ, Crespo M. Perceptions of people with intellectual and developmental disabilities about COVID-19 in Spain: a cross-sectional study. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2021; 65:381-396. [PMID: 33555099 PMCID: PMC8013361 DOI: 10.1111/jir.12821] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 01/23/2021] [Accepted: 01/25/2021] [Indexed: 05/07/2023]
Abstract
BACKGROUND As the world battles COVID-19, there is a need to study the perceptions of people with intellectual and developmental disabilities (IDD) about the effects of the pandemic and associated lockdown on their lives. This work explores the perceptions of Spaniards with IDD during the lockdown with respect to four topics: access to information, emotional experiences, effects on living conditions and access to support. METHODS The topics were explored using a subset of 16 closed-ended questions from an online survey. In total, 582 participants with IDD completed the survey. The frequencies and percentages of responses to the questions were calculated, and chi-square tests performed to explore the relationship between participants' sociodemographic characteristics and responses. Given that people differed in the way in which they completed the survey, the relationship between participants' responses and completion method was also analysed. RESULTS Participants reported that the pandemic and subsequent lockdown have had a deleterious effect on their emotional well-being (around 60.0% of participants) and occupations (48.0% of students and 72.7% of workers). Although access to information and support was reportedly good overall, being under the age of 21 years and studying were associated with perceptions reflecting poorer access to information (V = .20 and V = .13, respectively) and well-being support (V = .15 and V = .13, respectively). Being supported by a third party to complete the survey was consistently related to perceptions of worse outcomes. CONCLUSIONS The study yielded data on the perceptions of people with IDD regarding the effects that COVID-19 and the subsequent lockdown have had on their lives. Suggestions on how to overcome the difficulties reported and future lines of research are discussed.
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Sarmiento E, Zatarain E, Jaramillo M, Navarro J, Sousa I, Ortiz C, Navas P, Carbone J. Lower Titers of IgA Antibodies to Pneumococcal Polysaccharide Antigens after Vaccination are a Risk Factor for Development of Bacterial Infection after Heart Transplantation. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Esteban L, Navas P, Verdugo MÁ, Arias VB. Community Living, Intellectual Disability and Extensive Support Needs: A Rights-Based Approach to Assessment and Intervention. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:3175. [PMID: 33808617 PMCID: PMC8003461 DOI: 10.3390/ijerph18063175] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 03/16/2021] [Accepted: 03/17/2021] [Indexed: 12/01/2022]
Abstract
People with intellectual disability (ID) and extensive support needs experience poorer quality of life than their peers whose disability is not as severe. Many of them live in residential settings that limit community participation and prevent them from exercising control over their lives. This work analyzes the extent to which professional practices are aimed at promoting the right to community living for people with ID and extensive support needs, as well as the rights that are particularly linked to it, such as the right to habilitation and rehabilitation and the right to privacy. A specific questionnaire was designed and administered to 729 adults with intellectual disability (M = 37.05; DT = 12.79) living in different settings (family home, residential facilities and group homes). Measurement and structural models were estimated using exploratory structural equation modeling. Results obtained reveal that people with extensive support needs receive less support in terms of guaranteeing their right to independent living and privacy, especially when they live in disability-related services. This study highlights the need to implement and monitor, using valid and reliable indicators, mesosystem strategies that guarantee the right to live and participate in the community, especially for individuals with ID and extensive support needs.
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Arias VB, Aguayo V, Navas P. Validity of DSM-5 Oppositional Defiant Disorder Symptoms in Children with Intellectual Disability. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:1977. [PMID: 33670742 PMCID: PMC7922344 DOI: 10.3390/ijerph18041977] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Revised: 02/09/2021] [Accepted: 02/11/2021] [Indexed: 01/27/2023]
Abstract
Oppositional defiant disorder (ODD) is one of the most frequently diagnosed disorders in children with intellectual disabilities (ID). However, the high variability of results in prevalence studies suggests problems that should be investigated further, such as the possible overlap between some ODD symptoms and challenging behaviors that are especially prevalent in children with ID. The study aimed to investigate whether there are differences in the functioning of ODD symptoms between children with (n = 189) and without (n = 474) intellectual disabilities. To do so, we analyzed the extent to which parental ratings on DSM-5 ODD symptoms were metrically invariant between groups using models based on item response theory. The results indicated that two symptoms were non-invariant, with degrees of bias ranging from moderately high ("annoys others on purpose") to moderately low ("argues with adults"). Caution is advised in the use of these symptoms for the assessment and diagnosis of ODD in children with ID. Once the bias was controlled, the measurement model suggested prevalences of 8.4% (children with ID) and 3% (typically developing children). Theoretical and practical implications are discussed.
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Romero M, Marín E, Guzmán-Parra J, Navas P, Aguilar JM, Lara JP, Barbancho MÁ. Relationship between parental stress and psychological distress and emotional and behavioural problems in pre-school children with autistic spectrum disorder. ANALES DE PEDIATRÍA (ENGLISH EDITION) 2021. [DOI: 10.1016/j.anpede.2020.03.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Navas P, Amor AM, Crespo M, Wolowiec Z, Verdugo MÁ. Supports for people with intellectual and developmental disabilities during the COVID-19 pandemic from their own perspective. RESEARCH IN DEVELOPMENTAL DISABILITIES 2021; 108:103813. [PMID: 33271448 PMCID: PMC7651232 DOI: 10.1016/j.ridd.2020.103813] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 10/28/2020] [Accepted: 11/05/2020] [Indexed: 05/15/2023]
Abstract
BACKGROUND Individuals with intellectual and developmental disabilities (IDD) represent a particularly vulnerable group to the threats posed by COVID-19. However, they have not yet been given a voice on how their living conditions have been affected by COVID-19. AIMS This study aims to report the impact on people with IDD of COVID-19 and the response measures applied in Spain during the lockdown. METHOD Data on 582 individuals with IDD were collected through a survey. Seven open questions were included to capture the perspectives of people with IDD on COVID-19 and its consequences. Content analysis was performed to identify themes and categories across participant responses. Chi-square tests were used to analyze the relationship between reporting a specific category and participants' characteristics. RESULTS Supports have been conditioned by the living context. People living in specific settings had fewer natural supports, while those living with their family relied heavily on it. Participants also lacked supports considered necessary. It is worth stressing that persons with IDD have also provided support to others. CONCLUSIONS Although people with IDD have generally received the assistance they need during the lockdown, it must be ensured that appropriate supports are provided regardless of the context in which they live.
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Romero-González M, Marín E, Guzmán-Parra J, Navas P, Aguilar JM, Lara JP, Barbancho MÁ. [Relationship between parental stress and psychological distress and emotional and behavioural problems in pre-school children with autistic spectrum disorder]. An Pediatr (Barc) 2020; 94:99-106. [PMID: 32402776 DOI: 10.1016/j.anpedi.2020.03.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 03/08/2020] [Accepted: 03/23/2020] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION The Autistic Spectrum Disorders (ASD) are characterised by general deficits in social communication, stereotypes, and restricted interests. The ASD have a high prevalence of additional psychiatric disorders that make their daily functioning worse, and reduces the quality of life of them and their families. MATERIAL AND METHODS In an effort to identify family environmental characteristics that may influence in the course of additional psychiatric disorders, this study has focused on the symptoms of parental stress and psychological distress as possible risk factors. A cross-section study was carried out on the relationship between the stress and psychological distress of the parents and its relationship with co-existing psychopathology in a population of pre-school children with ASD (2-6 years). RESULTS AND CONCLUSIONS High levels of stress and psychological distress of the parents arealready associated, since early childhood, with co-existing psychiatric symptoms, specifically with emotional and behavioural problems (p < 0.05). However, further longitudinal studies are needed for a better understanding of the causal relationship between these variables and their possible bidirectional relationship.
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Perez Olivares Delgado C, Tenorio J, Aurtenetxe A, Cristo MJ, Navas P, Hernandez I, Moreno A, Bedate P, Martinez A, Palomino J, Arribas F, Escribano P. P3677Heritable veno-oclusive pulmonary disease in iberian romani patients: the difficulty of genetic counseling and its impact in the perpetuation of the disease. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Pulmonary veno-oclussive disease (PVOD) is a rare form of pulmonary hypertension of poor prognosis and difficult diagnosis. A founder mutation in EIF2KA4 gene has been described in Iberian Romani patients with familial PVOD.
Aims
genetically and clinically characterize a cohort of Iberian Romani patients with familial PVOD. To perform the family screening, analyze the phenotype and socio-cultural determinants which may influence on disease's course and spreading.
Methods
Patients with familial PVOD were included from November 2011 until February 2019. Clinical and survival data were obtained from the Spanish National Registry of PAH. Genetic analysis of EIF2KA4 was performed in patients and relatives.
Results
13 index cases were included, all of them Iberian Romani, carrying the founder mutation (p.Pro1115Leu) in EIF2KA4. Genetic screening revealed 74 of healthy heterozygotes and 13 homozygotes: among them 10 affected and 3 unaffected at baseline assessment (7, 28 and 37 years old). More than half of their family members, including one complete family, refused genetic screening. The survival free of transplant or death was 77.3% and 52.4%, at 1 and 3 years, respectively.
Baseline characteristics Total n=23 Age, years (SD) 23.6 (11.8) Male sex, % 52.2 Functional class NYHA III-IV, % 85 Pulmonary vascular resistance, UW (SD) 10 (5.4) DLCO, % 31.1 6MWT, meters (SD) 352.4 (160) Lung transplant, % 47.8 Survival free of transplant 3 years, % 52.4 DLCO, diffusing capacity for carbon monoxide; 6MWT, 6-minute walk test.
Conclusions
Patients were seriously ill from a young age. They have early pregnancy and high number of children. The high frequency of endogamy in the Romani population is likely to have an important impact on the transmission of PVOD, as it would favor the appearance of new homozygous carriers. Currently, our major concern is the low range of family members that accepted to be studied, more than 50% of family members rejected genetic studies and counseling.
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Navas P, Llorente S, García L, Tassé MJ, Havercamp SM. Improving healthcare access for older adults with intellectual disability: What are the needs? JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2019; 32:1453-1464. [PMID: 31192529 DOI: 10.1111/jar.12639] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Revised: 04/29/2019] [Accepted: 05/28/2019] [Indexed: 02/02/2023]
Abstract
This qualitative study was carried out in Spain with the aim of identifying the changes that the health system should make to improve healthcare access for older adults with intellectual disability. Three hundred and sixty-nine family members and professionals expressed their opinion on how healthcare access could be improved. Participants responded to two open-ended questions included in a general survey about the health status of older individuals with intellectual disability. Most informants were women and professionals who had known the person with intellectual disability for more than 12 months. A system of categories, which showed good inter-rater agreement, was developed to analyse participants' written responses. Both family members and professionals emphasized the need to improve disability training for healthcare practitioners and highlighted the urgent need for flexibility in the structure of a healthcare system that currently overlooks the specific needs of this vulnerable population.
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