No abstract

No abstract

Declaration of interest:The CLaSP study is funded by the European Commission (Joint Programme -Neurodegenerative Disease Research "European research projects for the evaluation of health care policies, strategies and interventions for Neurodegenerative Diseases").

No abstract

This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

No abstract

Background: Recent data suggest that imbalances in the composition of the gut microbiome (GM) could exacerbate the progression of Parkinson's Disease (PD). The effect of Levodopa (LD) has been poorly assessed and those of LD-carbidopa intestinal gel (LCIG) have not been evaluated so far. The aim of this study was to identify the effect of LD and, in particular, LCIG on GM and metabolome. Methods: Faecal DNA samples from 107 patients with clinical diagnosis of PD were analyzed by next-generation-sequencing of V3 and V4 regions of the 16S rRNA gene. PD patients were classified in different groups: patients on LCIG (LCIG-Group) (n= 38) and on LD (LD-Group) (n= 46). We also included a group of patients (n = 23) without antiparkinsonian medicaments (Naïve-Group). Faecal metabolic extracts were evaluated by Gas Chromatography Mass Spectrometry (GC-MS). Results: The multivariate analysis showed a significant higher abundance in the LCIG-Group of Enterobacteriaceae, Escherichia and Serratia compared to LD-Group. Compared to Naïve-Group, the univariate analysis showed a reduction of Blautia, Lachnospirae in LD-Group. Moreover, an Accepted Article This article is protected by copyright. All rights reserved increase of Proteobacteria, Enterobacteriaceae and a reduction of Firmicutes, Lachnospiraceae and Blautia was found in the LCIG-Group. No significant difference was found in the multivariate analysis of these comparisons. The LD-Group and LCIG-Group were associated to a metabolic profile linked to gut inflammation. Conclusion: Our results suggest that LD and mostly LCIG might significantly influence the microbiota composition and host/bacteria metabolism acting as stressors in precipitating a specific inflammatory intestinal microenviroment, potentially related to the PD state and progression.

Delivering healthcare to people living with Parkinson’s disease (PD) may be challenging in face of differentiated care needs during a PD journey and a growing complexity. In this regard, integrative care models may foster flexible solutions on patients’ care needs whereas Parkinson Nurses (PN) may be pivotal facilitators. However, at present hardly any training opportunities tailored to the care priorities of PD-patients are to be found for nurses. Following a conceptual approach, this article aims at setting a framework for training PN by reviewing existing literature on care priorities for PD. As a result, six prerequisites were formulated concerning a framework for training PN. The proposed training framework consist of three modules covering topics of PD: (i) comprehensive care, (ii) self-management support and (iii) health coaching. A fourth module on telemedicine may be added if applicable. The framework streamlines important theoretical concepts of professional PD management and may enable the development of novel, personalized care approaches.