Awareness, attitudes and preferences of patients 40 to 59 years of age on advance care planning in a private hospital

@#<p style="text-align: justify;"><strong>BACKGROUND:</strong> Decisions during medical crisis made by the more-abled family member. More often than not, it is the adult son or daughter who makes it. As such, it creates stress and anxiety in the family who will be left behind.With Advance Care Planning (ACP), symptoms of stress, anxiety and depression are reduced for both the patients and their families.<br /><strong>OBJECTIVE:</strong> To describe and examine the awareness, preferences and attitudes of in-patients aged 40-59 years old in Rivera Medical Center, Inc. towards advance care planning through the Advance Care Planning Questions (ACPQ).<br /><strong>METHODS:</strong> Descriptive,correlational, cross-sectional study design was used. Necessary permissions were obtained. The modified questionnaire underwent validity prior to the actual application. Coding was done in Microsoft Excel while the statistical analyses were made using SPSS.<br /><strong>RESULTS:</strong> The ACPQ Cebuano version has good reliability (Cronbach's a=0.71-0.92). Participants were 49 years old (±5.5), mostly female (62%), married (74%), Cebuano/Visayan (82%), at high school level (48%), Christian of Catholic (98%), regular employees (42%), earning less than Php 10,000 a month (36%), living with their spouse and children (66%), having hypertension (44%) or diabetes mellitus (22%), and in "good" health despite the current hospitalization (60%). Majority have limited awareness of ACP (14-22%) but were willing to discuss and learn about ACP (70%). Awareness, attitudes and preferences towards ACP can be greatly influenced by the doctors.<br /><strong>CONCLUSION:</strong> Limited public understanding and awareness cause the negative reception and slow progress of ACP in the Philippines. The unconscious fear of death accounts for the unease and hesitance whenever the topic on death surfaces, impeding acceptance of ACP. The doctor, being the preferred decision-maker, should therefore be competent enough to help the family understand and cause a positive attitude towards ACP.</p>

Voluntariado en medicina. Proyecciones asociadas a su desarrollo / Volunteering in medicine. Projections associated with its development

Introducción: El voluntariado en Chile existe a múltiples niveles, destacando en este artículo los proyectos universitarios en que participan alumnos de medicina UC, dada su relevancia a nivel de formación extracurricular y en el proceso de adquisición de destrezas no técnicas relevantes en torno al profesionalismo médico. Esto ocurre tanto en relación con el trabajo logístico organizativo detrás de proyectos de esta índole, como en la transmisión de ideas-fuerza específicas entre quienes participan de estos como voluntarios. Sin embargo, no se conoce con detalle la participación de estudiantes en proyectos de voluntariado,ni su percepción respecto a estos. Objetivo: Este estudio busca describir la participación de alumnos de Medicina UC en proyectos de voluntariado, especialmente en relación con la Dirección de Pastoral y Cultura Cristiana UC. Método: Estudio descriptivo. Se utilizaron datos de participación en proyectos de la Dirección de Pastoral y Cultura Cristiana UC (años 2010-2013); se realizó una encuesta electrónica a estudiantes de Medicina, evaluando participación en voluntariado y otras actividades extracurriculares. Resultados: En los dos proyectos analizados en este estudio, (Misión País y Misión de vida) se observa que un alto porcentaje de los alumnos que participan lo hacen en cargos de liderazgo, que fluctúa en torno al 50 por ciento en los diversos años y proyectos. La encuesta sobre actividades extracurriculares fue respondida por el 11,4 por ciento de los encuestados. Entre ellos, se observó una alta participación en actividades de voluntariado (70,1 por ciento ha participado en trabajos o misiones voluntarias durante algún verano de su formación universitaria), especialmente en relación con cargos específicos de liderazgo de proyectos. Conclusiones: Las actividades de voluntariado entre los estudiantes de Medicina constituyen una oportunidad muy relevante de formación de destrezas no técnicas, especialmente en habilidades de liderazgo, colaboración y trabajo en equipo. Futuras líneas de trabajo y proyecciones de estudio pueden incluir consolidar un buen catastro y estudios de seguimiento, así como analizar el impacto en la práctica clínica y en el desarrollo profesional y personal de la participación en proyectos de voluntariado.(AU)

Activities related to volunteering are widely presented in the university context, specially between students from the School of Medicine, Pontificia Universidad Católica de Chile. These activities are relevant towards an extracurricular development of non-technical skills related to medical professionalism. This is related to the organizational work needed to account the relevant tasks, and to the mission of each specific activity of volunteering. However, we don't know the perception of the students regards these activities, nor the details of the participation in each activity. Objective: To describe the participation of medicine students from the Pontificia Universidad Católica de Chile in volunteering projects. Special emphasis is done in projects related to the Dirección de Pastoral y Cultura Cristiana UC. Methods: Descriptive study. Data from participation in projects related to the Dirección de Pastoral de Cultura Cristiana UC were obtained for years 2010-2013. Also, an electronic survey was done to medicine students, evaluating participation in volunteering activities and in other extracurricular activities. Results: In both projects of volunteering analyzed in this study, there is a high participation of medical students between leadership positions. 11.4 pertcent of the medicine students competed the electronic survey. There is a high participation in volunteering activities, especially in relation to leadership positions. Conclusions: Between medicine students, volunteering activities are related to an opportunity of development of non-technical skills, specially related to leadership and teamwork. New studies could deepen into these activities, analyzing the potential impact in the clinical practice and the human and professional development of these students. (AU)

Un estudio de la relación entre la memoria, la narrativa y el lenguaje en alumnado con trastorno específico del lenguaje (TEL) / A Study of the Relationship between Memory, Narrative and Language in Pupils with Specific Language Impairment (SLI)

En esta investigación se estudiaron las relaciones entre el lenguaje, la narrativa y la memoria en alumnado con Trastorno Específico del Lenguaje (TEL). La muestra estuvo compuesta por 32 alumnos con TEL y 23 niños con desarrollo típico, diagnosticados con el CELF-3, el Peabody, el ITPA, el Subtest de Dígitos del WISC-IV, el Subtest de Localización Espacial de la WMS-III y la tarea del recontado del cuento Rana, ¿dónde estás?. Los resultados obtenidos relacionan estrechamente la memoria de trabajo y la superestructura narrativa. Además, se distinguen tres subtipos de TEL atendiendo al déficit en memoria. Finalmente, entre todas las dimensiones que conforman el diagnóstico del TEL, son los problemas narrativos los que permiten advertir de mayores dificultades en la memoria.

This research studied the links between language, narrative and memory in Specific Language Impairments (SLI) students. The sample consisted of 32 children diagnosed with SLI and 23 typically developed children, according to different tests as CELF-3, Peabody, ITPA, Digit Span subtest of the WISC-IV, Spatial Span subtest of the WMS-III and the task of retelling the tale Frog, where are you?. The results show a close connection between working memory and narrative superstructure. Besides, three SLI subtypes could be differentiated according to the memory deficits. Finally, among all dimensions that allow the diagnosis of SLI, the narrative problems aware us of bigger memory difficulties.

Diagnóstico de necesidades de salud de la población de adultos viejos de un sector de la comunidad de Puerto Rico / Diagnosis of health needs of the elderly population of a community of Puerto Nuevo

The purpose of this study was to identify the health needs of the non-institutionalized population, 65 years and over, residing in a sector of the community of Puerto Nuevo. This was the first urbanization established in Puerto Rico in the early 50's. The ®snowball® technique was use to identify all the residents 65 year and over of the mentioned sector. Eighty five elderly persons were interviewed to gather data of the following variables: demographics, health conditions, preventive measures, activities of daily living (ADLs, IADLs), health services utilization, psychosocial aspects and use of programs and services available for the elderly population. Statistical analysis included descriptive measures and chi-square. Results revealed a population with a higher education and economic level than the average for this age group in Puerto Rico. People over 75 years over reported more functional limitations than the 65-74 years interviewees did. In comparison with men, women were less educated and presented a higher percent of widows, persons living alone and functional limitations. In almost all the interviewees, help was available in case of need. The majority expressed satisfaction with their family and social lives. Very few utilized programs and services available for elderly persons. It is concluded that in order to improve their quality of life, this population needs to be managed in an holistic mode to address their biopsychosocial needs and to be educated in health promotion issues to prevent further functional limitations. They also need education about the available services for elderly persons.

The immunopathology of human schistosomiasis. III. Immunoglobulin isotype profiles and response to praziquantel

Immunoglobulin (Ig) isotype (IgG, IgG1, IgG2, IgG3, IgG4, IgM, IgD and IgE) levels were investigated, both pre- and post-treatment with praziquantel (PZQ), in 43 adults and children chronically infected with Schistosoma mansoni, by means of a two-site, isotype-specific immunoenzymometric assay. The patients were classified as responders (R) or non-responders (NR) on the basis of their circumoval precipitin test (COPT) results 12 months after treatment. In comparison with controls, pre-treatment R children showed significantly higher levels of IfG, IgG1, IgG4 (p<0.001) and IgE (p<0.01), and diminished IgG2 (p<0.05), while NR children showed significantly elevated levels only of IgE (p<0.05). Twelve months after therapy, R children maintained significantly lower levels of IgG2, but showed significantly decreased levels of IgG, IgG1, IgG4, and IgE, while the Ig isotype profile of NR children was unaltered. Adult R and NR showed similar isotype profiles before chemotherapy, with the exception of significantly elevated IgM levels in R. Twelve months after therapy, R adults showed significantly decreased levels of IgG, IgG1, and IgG4, while NR adults showed only diminshed IgG4 levels. These results reveal different Ig isotype profiles in untreated adults and children chronically infected with S. mansoni. The results further show that pre-treatment Ig isotype profile may be significantly modified after an effective R to chemotherapy, accounted for by down regulation of the IgG1 isotype in association with negative seroconversion of the COPT in R patients. The COPT reaction has been associated with the highly specific egg glycoprotein antigen omega 1, which shows a significant reduction in reactivity six months after treatment. IgG1 may thus play a main role in the response against the omega 1 antigen.

Definición del problema de la calidad de la atención médica y su abordaje científico: un nodelo para la realidad mexicana / A scientific approach to the definition of quelity in medical care: a model for mexican reality

Tiene como objetivo analizar el problema de la calidad de la atención médica en México, así como la evolución de ka misma en las diferentes instituciones prestadoras de servicios de salud, y conclue que las estrategias de garantia de calidad de tipo descentralizado-participativo son la mejor opción para abordar el problema de la calidad en países como nuestro, y que cualquier programa de calidad debe incluir cinco elementos fundamentales: la evaluación, la monitoréa, el diseño, el desarrollo y el cambio organizacional.