RuralCovidLife: A new resource for the impact of the pandemic on rural Scotland.

RuralCovidLife is part of Generation Scotland's CovidLife project, investigating the impact of the COVID-19 pandemic and mitigation measures on people in Scotland. The RuralCovidLife project focuses on Scotland's rural communities, and how they have been impacted by the pandemic. During survey development, Generation Scotland consulted with people living or working in rural communities, and collaborated with a patient and public involvement and engagement (PPIE) group composed of rural community leaders. Through this consultation work, the RuralCovidLife survey was developed to assess the issues most pertinent to people in rural communities, such as mental health, employment, transport, connectivity, and local communities. Between 14th October and 30th November 2020, 3,365 participants from rural areas in Scotland took part in the survey. Participant ages ranged from 16 to 96 (mean = 58.4, standard deviation [SD] = 13.3), and the majority of the participants were female (70.5%). Over half (51.3%) had taken part in the original CovidLife survey. RuralCovidLife includes a subsample (n = 523) of participants from the Generation Scotland cohort. Pre-pandemic data on health and lifestyle, as well as biological samples, are available for these participants. These participants' data can also be linked to past and future healthcare records, allowing analysis of retrospective and prospective health outcomes. Like Generation Scotland, RuralCovidLife is designed as a resource for researchers. RuralCovidLife data, as well as the linked Generation Scotland data, is available for use by external researchers following approval from the Generation Scotland Access Committee. RuralCovidLife can be used to investigate mental health, well-being, and behaviour in participants living in rural areas during the COVID-19 pandemic, as well as comparisons with non-rural samples. Moreover, the sub-sample with full Generation Scotland data and linkage can be used to investigate the long-term health consequences of the COVID-19 pandemic in rural communities.

Comparing Recommendations to Reality: First Aid Training and Equipment for Amateur Yacht Crews on Ocean Passages.

INTRODUCTION: The aim of this study was to establish the first aid skills possessed and equipment carried by sailors participating in the 2018 Atlantic Rally for Cruisers and to compare these with expert recommendations for skills and diagnostic/monitoring equipment to be carried aboard. METHODS: A questionnaire survey was done of 179 boats at Las Palmas, and 88 completed questionnaires were returned. The recommendations were derived from a Delphi study that recruited telemedical providers, first aid trainers, and doctors and nurses with experience in ocean crossing in a small boat. The results were considered with reference to the published literature on accidents and injuries in sailors. RESULTS: Forty-two percent of boats had crew that had completed no or only 1 d of first aid training in the previous 5 y. Twenty-eight percent said that they had too little first aid training; lack of time was cited most frequently for not doing more training. Twenty-three percent only carried a basic or inshore medical kit. The Delphi study generated a core list of 6 skills and 11 pieces of diagnostic/monitoring equipment that should be available. CONCLUSIONS: When compared, the results of the questionnaire and the Delphi study demonstrated a gap in knowledge/preparation among amateur, oceangoing yacht crews. There is a need for increased education about core first aid skills for sailing out of reach of outside assistance and useful diagnostic/monitoring equipment to have available.

The role and structure of the multidisciplinary team in the management of advanced Parkinson's disease with a focus on the use of levodopa-carbidopa intestinal gel.

A multidisciplinary team (MDT) approach is increasingly recommended in Parkinson's disease (PD) treatment guidelines, but no standard of care exists for such an approach, and the guidelines do not provide clarification on how it should be implemented. This paper reviews evidence of MDT interventions in people with PD and provides expert clinical perspectives for an MDT approach, with a focus on advanced PD and levodopa-carbidopa intestinal gel (carbidopa-levodopa enteral suspension in the USA). The key recommendations are to enable the best possible treatment of people with PD locally by facilitating a close structured collaboration of different health care professionals working in a fixed network structure; to refer people with PD to established MDT centers in a timely manner; to establish regular meetings for the MDT enabling interdisciplinary exchange and learning; to optimize individual treatment and carefully evaluate available treatment options; to ensure treatment decisions are agreed jointly between people with PD, their caregivers, family, and health care professional; and to include specialists outside of neurology from adjuvant medical departments as necessary when implementing advanced therapies.

Cardiovascular Risk Factors in Patients on Dialysis.

Cardiovascular disease (CVD) is the leading cause of death in patients undergoing dialysis. This article summarizes identified CVD risk factors, elaborates on how risk factors impact patients, and discusses the implications to the nephrology community based on the current evidence-based practice.

Addressing Needs of Long-Term Care Facility Residents During Acute Hospitalization.

Patients who reside in long-term care facilities for extended periods of time offer many health care challenges. Recognition of early signs of illness, care transitions, and underutilization of community resources are common concerns.

The metric properties of a novel non-motor symptoms scale for Parkinson's disease: Results from an international pilot study.

Non-motor symptoms (NMS) in Parkinson's disease (PD) are common, significantly reduce quality of life and at present there is no validated clinical tool to assess the progress or potential response to treatment of NMS. A new 30-item scale for the assessment of NMS in PD (NMSS) was developed. NMSS contains nine dimensions: cardiovascular, sleep/fatigue, mood/cognition, perceptual problems, attention/memory, gastrointestinal, urinary, sexual function, and miscellany. The metric attributes of this instrument were analyzed. Data from 242 patients mean age 67.2 +/- 11 years, duration of disease 6.4 +/- 6 years, and 57.3% male across all stages of PD were collected from the centers in Europe, USA, and Japan. The mean NMSS score was 56.5 +/- 40.7, (range: 0-243) and only one declared no NMS. The scale provided 99.2% complete data for the analysis with the total score being free of floor and ceiling effect. Satisfactory scaling assumptions (multitrait scaling success rate >95% for all domains except miscellany) and internal consistency were reported for most of the domains (mean alpha, 0.61). Factor analysis supported the a prori nine domain structure (63% of the variance) while a small test-retest study showed satisfactory reproducibility (ICC > 0.80) for all domains except cardiovascular (ICC = 0.45). In terms of validity, the scale showed modest association with indicators of motor symptom severity and disease progression but a high correlation with other measures of NMS (NMSQuest) and health-related quality of life measure (PDQ-8) (both, rS = 0.70). In conclusion, NMSS can be used to assess the frequency and severity of NMS in PD patients across all stages in conjunction with the recently validated non-motor questionnaire.

Prevalence of nonmotor symptoms in Parkinson's disease in an international setting; study using nonmotor symptoms questionnaire in 545 patients.

2006, there was, no single instrument (questionnaire or scale) for attempting a comprehensive assessment of the wide range of nonmotor symptoms (NMS) of Parkinson's disease (PD). The PD nonmotor group, a multidisciplinary group of experts including patient group representatives developed and validated the NMS screening questionnaire (NMSQuest) comprising 30 items. The NMSQuest is a self completed screening tool designed to draw attention to the presence of NMS. In this paper, we present the results gathered from 545 patients using the definitive version of the NMSQuest highlighting the prevalence of the wide range of NMS flagged in the NMSQuest from consecutive PD patients in an international setting.

International multicenter pilot study of the first comprehensive self-completed nonmotor symptoms questionnaire for Parkinson's disease: the NMSQuest study.

Nonmotor symptoms (NMS) of Parkinson's disease (PD) are not well recognized in clinical practice, either in primary or in secondary care, and are frequently missed during routine consultations. There is no single instrument (questionnaire or scale) that enables a comprehensive assessment of the range of NMS in PD both for the identification of problems and for the measurement of outcome. Against this background, a multidisciplinary group of experts, including patient group representatives, has developed an NMS screening questionnaire comprising 30 items. This instrument does not provide an overall score of disability and is not a graded or rating instrument. Instead, it is a screening tool designed to draw attention to the presence of NMS and initiate further investigation. In this article, we present the results from an international pilot study assessing feasibility, validity, and acceptability of a nonmotor questionnaire (NMSQuest). Data from 123 PD patients and 96 controls were analyzed. NMS were highly significantly more prevalent in PD compared to controls (PD NMS, median = 9.0, mean = 9.5 vs. control NMS, median = 5.5, mean = 4.0; Mann-Whitney, Kruskal-Wallis, and t test, P < 0.0001), with PD patients reporting at least 10 different NMS on average per patient. In PD, NMS were highly significantly more prevalent across all disease stages and the number of symptoms correlated significantly with advancing disease and duration of disease. Furthermore, frequently, problems such as diplopia, dribbling, apathy, blues, taste and smell problems were never previously disclosed to the health professionals.

Diagnosing restless legs syndrome (RLS) in primary care.

This paper represents a review of current opinion and information on the effective diagnosis of restless legs syndrome (RLS) in a primary care setting. RLS can be a distressing condition--it can cause serious sleep disturbance and has a significant impact on quality of life comparable to that of depression or type 2 diabetes. The prevalence of adults whose RLS is severe enough to warrant medical advice has been estimated to be approximately 3%, but only a small proportion of these patients currently report having been diagnosed in primary care, despite stating that they have presented to their GP. The benefits of increased understanding of the symptoms of RLS and how patients present in primary care are discussed, with emphasis on how this will help GPs more effectively diagnose and manage the patients affected. Guidelines on how to diagnose RLS in a primary care setting are given--when a patient presents with sleep disturbance, RLS should be routinely considered and, where existing, be readily diagnosed in a primary care setting on the basis of the patient's clinical history, a physical examination and with the aid of four questions based on the International RLS Study Group (IRLSSG) four essential diagnostic criteria.