RESUMEN
BACKGROUND: The illness trajectory of Parkinson's disease leads to a higher need for care. Little is known about the prevalence of residents with Parkinson's disease in nursing homes, the care situation and the expertise of nurses in these institutions. OBJECTIVE: This study examined the prevalence rate of residents with Parkinson's disease in nursing homes in Germany. In addition, from the subjective point of view of nurse managers, the work of carers, the coordination as well as information and knowledge of the nursing staff were explored. METHOD: The cross-sectional survey of nurse managers from 500 randomized selected nursing homes in Germany was conducted from January to June 2020. The questionnaire used was developed based on the literature. The data were analyzed descriptively. RESULTS: Questionnaires from 85 residential wards in 57 care facilities were analyzed (response rate 11.4%). The prevalence rate of residents with Parkinson's disease was 13.9%. More than a half had a diagnosis of dementia (52.8%). Affected persons received regular treatment and medical consultations. There were no central coordination of care and no specially trained nursing staff. DISCUSSION: Residents with Parkinson's disease are a common occurrence and they show complex symptoms and comorbidities. The frequency of falls with hospital stays and the low number of Parkinson-specific assistive technologies showed that the knowledge of nursing staff can be increased. Central coordination and support for this should be established in long-term care.
Asunto(s)
Enfermedad de Parkinson , Estudios Transversales , Alemania/epidemiología , Humanos , Cuidados a Largo Plazo , Casas de Salud , Enfermedad de Parkinson/diagnóstico , Enfermedad de Parkinson/epidemiologíaRESUMEN
The exocyst, a conserved, octameric protein complex, helps mediate secretion at the plasma membrane, facilitating specific developmental processes that include control of root meristem size, cell elongation, and tip growth. A genetic screen for second-site enhancers in Arabidopsis identified NEW ENHANCER of ROOT DWARFISM1 (NERD1) as an exocyst interactor. Mutations in NERD1 combined with weak exocyst mutations in SEC8 and EXO70A1 result in a synergistic reduction in root growth. Alone, nerd1 alleles modestly reduce primary root growth, both by shortening the root meristem and by reducing cell elongation, but also result in a slight increase in root hair length, bulging, and rupture. NERD1 was identified molecularly as At3g51050, which encodes a transmembrane protein of unknown function that is broadly conserved throughout the Archaeplastida. A functional NERD1-GFP fusion localizes to the Golgi, in a pattern distinct from the plasma membrane-localized exocyst, arguing against a direct NERD1-exocyst interaction. Structural modeling suggests the majority of the protein is positioned in the lumen, in a ß-propeller-like structure that has some similarity to proteins that bind polysaccharides. We suggest that NERD1 interacts with the exocyst indirectly, possibly affecting polysaccharides destined for the cell wall, and influencing cell wall characteristics in a developmentally distinct manner.