Envejecimiento saludable: un primer acercamiento a la revisión de indicadores subjetivos de salud en zonas urbanas y rurales en Costa Rica / Healthy aging: An initial review of subjective health indicators in urban and rural areas in Costa Rica

Resumen En este artículo se presentan los resultados de una primera aproximación al análisis del efecto moderador del contexto social, cultural y geográfico en indicadores subjetivos del envejecimiento saludable en personas mayores de 46 años residentes en territorios con características diferenciadas en Costa Rica. Se trabajó con una muestra de 305 personas residentes en tres áreas geográficas: una urbana, una semiurbana y una tercera principalmente rural. La diferenciación de las tres zonas se basó en criterios de densidad poblacional, infraestructura y acceso a bienes y servicios. Los indicadores subjetivos del envejecimiento saludable analizados fueron: participación social, apoyo social, salud percibida, espiritualidad, autoeficacia, comportamientos de autocuidado, bienestar subjetivo (satisfacción con la vida y bienestar psicológico) y estado de ánimo; todas las variables fueron condicionadas por zona de residencia, edad y sexo. Para analizar los indicadores subjetivos se estimó un análisis de covarianza (ANCOVA) o un análisis multivariado de covarianza (MANCOVA), dependiendo del número de variables dependientes analizadas. En general, se identificaron indicadores subjetivos de envejecimiento saludable altos en las personas participantes del estudio, quienes reportaron altos niveles de participación social, satisfacción con la vida y estados de salud y ánimo positivos. Se encontraron diferencias por edad entre los grupos. Sin embargo, no se evidenciaron diferencias estadísticamente significativas en los indicadores subjetivos analizados según la zona de residencia o el sexo. En síntesis, este estudio encontró que los indicadores subjetivos de envejecimiento saludable analizados eran muy similares en residentes de tres zonas geográficas con características distintas. Estos hallazgos iniciales se discuten desde una perspectiva cultural y geográfica y en relación con los modelos de envejecimiento saludable.

Abstract This review exposes the results of a first approximation to the analysis of the moderator effect of the geographical, social, and cultural context on subjective indicators of healthy aging in the Costa Rican context. Costa Rica is a middle-income democratic country that is in an advanced demographic changing process; this phenomenon makes it one of the aged countries in the Latin American region. Therefore, studying healthy aging becomes relevant in the context of population demographic change in the present and future aging societies. The study compared several subjective indicators of healthy aging among people older than 46 who resided in three different geographical areas in the country. Participants were 305 healthy people from three locations: one urban (Heredia Central City), one semi-urban (Santa Ana Central City), and one mainly rural (Nicoya). Participants completed standardized assessment scales to evaluate social participation, social support, perceived health, spirituality, self-efficacy, self-care behaviors, and subjective well-being (life satisfaction and psychological well-being). All variables were conditioned by geographical zone (urban, semi-urban, and mainly rural), age, and gender. Either Analysis of Covariance (ANCOVA) or Multivariate Analysis of Covariance (MANCOVA) were estimated depending on the number of dependent variables analyzed to test the effect of the zone of residence, gender, and age, over the subjective indicator of healthy aging studied. In general, participants evidenced high scores on subjective indicators such as self-care, social support, spirituality, life satisfaction, and psychological well-being, which have been associated with health and well-being during the aging process. Participants reported high levels of social participation and perceived that they received adequate support for their daily life needs. Likewise, participants evidenced a general state of well-being, a positive state of health, high levels of self-efficacy, and positive moods. Differences were found among the groups by comparing age. However, no significant differences were found in the variables studied related to geographical areas of residence and sex, suggesting invariant comparison evidence by zone of residence and sex. Nevertheless, the results indicate that the subjective indicators of healthy aging studied are key to promoting healthy aging at the national level. It is considered necessary to improve opportunities for social participation aimed at older adults, to strengthen community and family social networks, to promote socio-economic support such as financial and instrumental support for activities of daily living, and finally emotional support such as listening, empathy and advice. Although the differences among geographical areas of residence of the people studied were not statistically significant in this study, the evidence suggested a trend of high well-being indicators mainly in the rural areas studied, and particularly more in males than in females. As this study only reached preliminary data, further research must obtain conclusive evidence, as previous research had suggested older people living in rural areas with high longevity indicators in Costa Rica might enjoy unusual environmental characteristics and personal protective factors that could be absent in most of the urban areas in the country. On the other hand, it will be necessary to include the historical and socio-cultural determinants focusing on context-specific review analyses in the mainstream research on healthy aging, even more in aged countries like Costa Rica. The findings are discussed within the inter-cultural emphasis and healthy aging models in order to contribute to a better understanding of how the context (physical-constructed and social/cultural) influences the differences, although subtle, in the study´s variables and participants, and how the process of aging might be different according to the multiple contextual conditions in which people live and adapt their capacities and abilities for coping with daily life demands.

Following the Inca's path to successful oral aging... no sacrifices, just nutrition

Inca civilization is a subject of great fascination due to its rapid development and successful oral aging centuries ago. Their diet was primarily plant-based, with lean animal protein, nuts, and seeds, and lacked fermentable sugars, preventing non-communicable diseases, such as caries and periodontal diseases. Developing national ageing policies and strategies to improve oral functionality and tackle economic barriers to a balanced diet, ensuring better nutrition and quality of life for older people are necessary to achieve Sustainable Development Goals (SDGs), with the World Health Organization estimating its necessity in meeting 12 of the 17 SDGs. Such policies would also honor our native ancestors.

FROM CRISIS TO OPPORTUNITY: A DEVELOPING COUNTRY'S EXPERIENCE OF MOTIVATING EFL/ESL TEACHERS IN THE POST-COVID-19 ERA

The COVID-19 pandemic has caused signicant changes in daily life, with many countries implementing quarantines and transitioning to online learning. As the vaccine is not expected to be available before 2021, online learning has become an inevitable option. Despite EFL/ESL teachers expressing favorable attitudes towards online instruction, there is a need to motivate them to return to universities for face-to-face instruction following the pandemic. This research aims to identify the factors that could encourage EFL/ESL teachers to resume traditional classroom instruction in Iranian universities. It is crucial to provide teachers and students with a safe learning environment equipped with the necessary tools and procedures, as their motivation is a key component of successful teaching and learning. The study calls for collaborative efforts from all concerned parties to raise awareness about the importance of boosting motivation to return to universities after the COVID-19 crisis

Analysis of treatment outcomes of elderly pulmonary tuberculosis aged 65 and above in Chongqing from 2015 to 2020 / 中国热带医学

@#Abstract: Objective　To analyze the treatment outcomes of elderly patients with pulmonary tuberculosis in Chongqing, so as to provide reference for the prevention and control strategies of the epidemic of elderly pulmonary tuberculosis. Methods　The data of tuberculosis cases aged ≥65 years in Chongqing from 2015 to 2020 were collected from the National Health Insurance Information Project Disease Prevention and Control Information system. Descriptive statistical methods were used to analyze the data. Results The registration rates of elderly active pulmonary tuberculosis patients and etiological positive patients were 110.95/10-5and 32.25/10-5 in 2015 and 84.06/10-5 and 57.29/10-5 in 2020. The annual decline rate of active tuberculosis registration was 5.40%, and the annual increase rate of pathogenic-positive tuberculosis registration was 12.18%. The registration rates of active tuberculosis patients and etiological positive patients in the whole population were 70.75/10-5 and 17.63/10-5 in 2015 and 50.34/10-5 and 29.14/10-5 in 2020. The annual decline rate of active tuberculosis registration was 6.58%, and the annual increase rate of pathogenic-positive tuberculosis registration was 10.57%. From 2015 to 2020, a total of 25 931 cases of elderly pulmonary tuberculosis were registered, of which 21 374 (82.43%) cases were successfully treated and 4 010 (15.80%) cases had unfavorable outcomes. The proportion of cured and death patients showed an increasing trend year by year (χ2trend=313.853, 100.502, P<0.01). From 2015 to 2020, the average annual successful treatment rate of elderly pulmonary tuberculosis in the whole city was 82.43%, with the lowest rate in southeast Chongqing (74.23%), followed by urban areas (81.99%). The success rate of elderly pulmonary tuberculosis treatment in the whole city, west Chongqing, northeast Chongqing and southeast Chongqing showed a downward trend year by year (χ2trend=230.199, 35.278, 108.076, 112.130, all P<0.01), with annual decline rates of 2.77%, 2.26%, 3.0% and 4.12%, respectively. Among the registered elderly patients, female, 65-<75 years old, Han nationality, newly diagnosed, no complications, and negative for etiology (χ2=15.234, 255.910, 146.842, 179.998, 25.575, 131.170, P<0.01) had higher success treatment rates. Conclusions The prevalence of pulmonary tuberculosis in the elderly population in Chongqing City is declining, but the positive registration rate of etiology is increasing annually, and the success rate of treatment is decreasing. Therefore, it is necessary to strengthen the systematic management, publicity and education of elderly patients (especially those in southeast Chongqing, male, positive patients and severe patients) to effectively control the epidemic of tuberculosis in the elderly.

Envejecimiento exitoso y calidad de vida en personas mayores institucionalizadas del norte de colombia

Objetivo: Determinar relación entre Envejecimiento exitoso y Calidad de vida de personas mayores institucionalizadas. Material y Método: Estudio descriptivo y correlacionai con muestreo intencional; previo consentimiento informado, participaron 14o personas mayores asistentes a un hogar del municipio de Montería, Colombia. Se incluyeron a personas de 6o y más años; sus características sociodemográficas fueron identificadas por una cédula de datos. La Calidad de vida se midió con WHOQOL-bref y el Envejecimiento exitoso con Successful Aging Inventory (SAI). Los datos recolectados por enfermeras/os, se procesaron en SPSS v22 y analizados con estadística descriptiva, normalidad con Kolmogorov Smirnov y corrección de Lilliefors; como no hubo distribución normal, el objetivo se respondió con correlación de Spearman. Resultados: Existe relación negativa y significativa entre Envejecimiento exitoso global (p= ,012), Desempeño funcional (p= ,025) y Proposito y satisfacción con la vida (p= ,012) con la dimensión Social de la Calidad de vida; se observo relación negativa y significativa (p= ,013) entre el Propósito y satisfacción con la vida con la dimensión Ambiental de la Calidad de vida. Conclusiones: la mayoría de las personas mayores presentaron un envejecimiento exitoso y tienen su Calidad de vida global y Percepción de su salud altas. Existe relación negativa y significativa entre Envejecimiento exitoso, Desempeño funcional y Propósito y satisfacción con la dimensión Social de la Calidad de vida; existe relación negativa y significativa entre el Propósito y satisfacción con la vida con la dimensión Ambiental de la calidad de vida. No hay relación entre los puntajes globales de Envejecimiento exitoso y Calidad de vida.

Objective: To determine the relationship between successful aging and quality of life among institutionalized elderly people. Materials and Methods: Descriptive and correlational study using intentional sampling. It was carried out, after prior informed consent, with 140 elderly people who attended a nursing home in the city of Monteria, Northern Colombia. People over 60 years and older were included and their sociodemographic characteristics were recorded in a data sheet. The quality of life was measured with the WHOQOL-bref questionnaire and the Successful aging was measured with the Succesful Aging Inventory (SAI). Data collected by nurses were processed in SPSS v22 and analyzed with descriptive statistics, Kolmogorov-Smirnov test for normality and Lilliefors correction. As there was no normal distribution, the Spearman's correlation was applied. Results: There is a negative and significant relationship between the overall successful aging (p= .012), functional performance (p= .025) and life purpose and satisfaction (p= .012) with the social dimension of quality of life; a negative and significant relationship (p= .013) was also observed between life purpose and satisfaction with the environmental dimension of quality of life. Conclusions: Most of the elderly people showed successful aging and had a high overall quality of life and health perception. There is a negative and significant relationship between successful aging, functional performance, as well as life purpose and satisfaction with the social dimension of quality of life; there is a negative and significant relationship between life purpose and satisfaction with the environmental dimension of quality of life. There is no relationship between the overall scores of successful aging and quality of life.

Objetivo: Determinar a relação entre envelhecimento bem-sucedido e qualidade de vida de pessoas idosas institucionalizadas. Material e Método: Estudo descritivo e correlacional com amostragem intencional. O estudo foi realizado, após consentimento informado prévio, com 140 idosos que frequentaram um asilo na cidade de Montería, no norte da Colômbia. Foram incluídas pessoas de 60 anos ou mais e suas características sociodemográficas foram registradas em uma ficha de dados. A qualidade de vida foi medida com o questionário WHOQOL-bref e o inventário Successful Aging Inventory (SAI) foi usado para medir o envelhecimento bem- sucedido. Os dados coletados pelos enfermeiros e enfermeiras foram processados por meio do programa SPSS versão 22 e analisados com estatísticas descritivas e teste Kolmogorov-Smirnov para normalidade e correção de Lilliefors. Como não houve distribuição normal, foi aplicada a correlação do Spearman. Resultados: Existe uma relação negativa e significativa entre o envelhecimento geral bem-sucedido (p= ,012), desempenho funcional (p= ,025) e propósito de vida e satisfação (p= ,012) com a dimensão social da qualidade de vida; uma relação negativa e significativa (p= ,013) também foi observada entre o propósito de vida e satisfação com a dimensão ambiental da qualidade de vida. Conclusões: A maioria dos idosos demonstrou um envelhecimento bem- sucedido e teve uma alta percepção geral de qualidade de vida e saúde. Há uma relação negativa e significativa entre o envelhecimento bem-sucedido, desempenho funcional, bem como propósito de vida e satisfação com a dimensão social da qualidade de vida; há uma relação negativa e significativa entre proposito de vida e satisfação com a dimensão ambiental da qualidade de vida. Não há relação entre as pontuações gerais do envelhecimento bem-sucedido e a qualidade de vida.

El impacto de la soledad y la fragilidad en el bienestar de los mayores europeos / The impact of loneliness and frailty on the well-being of older Europeans

Resumen Introducción: El bienestar es un constructo importante cuyos determinantes asociados deben ser identificados para comprender con mayor profundidad los procesos para envejecer de forma saludable. El estudio del impacto de la fragilidad en el bienestar de las personas mayores requiere incorporar los dominios físico, psicológico y social. Así, el adulto mayor frágil puede definirse a partir de la fragilidad física, junto con la soledad como fragilidad social. Este estudio propone un modelo para estudiar el impacto de la fragilidad física y la soledad sobre el bienestar de las personas mayores, diferenciando entre control, autonomía, placer y autorrealización. Método: Se realizó un estudio de carácter transversal con una muestra de 13569 personas mayores provenientes de la encuesta SHARE, para estimar un modelo de ecuaciones estructurales en el que se contemplaban los efectos de la fragilidad y la soledad en el bienestar (cuestionario CASP), controlado por el género, la edad y la salud percibida. Resultados: El modelo final contemplaba el efecto del género sobre el indicador de fuerza de prensión de fragilidad. Los resultados mostraron un ajuste adecuado del modelo a los datos y consiguieron explicar un 80.1% de la varianza de control, un 48.6% de la de autonomía, un 43.6% de la de placer y un 61.3% de la varianza de autorrealización. Conclusiones: La soledad y la fragilidad presentaron efectos diferenciales en función del componente de bienestar. Se discuten las implicaciones de dichos efectos en el desarrollo de intervenciones.

Abstract Introduction: Well-being is an important construct whose associated determinants must be identified in order to further understand the processes for healthy aging. The study of the impact of frailty on older people's wellbeing requires the incorporation of physical, psychological and social domains. Hence, frail older adults can be defined from physical frailty, together with loneliness as social frailty. This study proposes a model to study the impact of frailty and loneliness on well-being of older adults, differentiating among control, autonomy, pleasure and self-realization. Method: A cross-sectional study was carried out with a sample of 13569 older adults from the SHARE project was employed in order to estimate a structural equation model in which frailty and loneliness affected well-being (CASP questionnaire), while controlling for gender, age and perceived health. Results: The final model additionally contemplated the effect of gender on the grip strength frailty indicator. Results showed a good fit of the model to the data and could explain 80.1% of the variance of control, 48.6% of autonomy's, 43.6% of pleasure's and 61.3% of the variance of self-realization. Conclusions: Loneliness and frailty showed differential effects on the different components of well-being. Implications of these effects on intervention development are discussed

COVID-19 y vulnerabilidad frente a vejez exitosa y salud mental / COVID-19 and vulnerability vs. successful aging and mental health / COVID-19 e vulnerabilidade à velhice bem-sucedida e saúde mental

RESUMEN Introducción: La COVID-19 y las medidas generadas para proteger a los adultos mayores han marcado mucho más la vulnerabilidad de este grupo, incrementando factores de riesgos psicosociales como la desvinculación, el maltrato, la ansiedad, lo que demandó examinar patrones de vejez exitosa que generan y garantizan salud mental en personas de esta edad. Objetivo: Caracterizar aquellos indicadores de una vejez exitosa que promueven salud mental, a través de su expresión concreta en un paciente. Método: Enfoque cualitativo, privilegiando el estudio de caso único de carácter crítico. Para evaluar los criterios de salud mental y vulnerabilidad, se utilizó una entrevista semiestructurada. Para la caracterización de la vejez se trabajó con método biográfico y la técnica de historia de vida durante los meses de agosto a noviembre de 2021. Resultados: Se identificaron criterios de vulnerabilidad como la viudez y la soledad, pero predominaron fortalezas a nivel individual, micro y macrosocial, lo que se consolida con un estado mental saludable que se expresó en evidente funcionamiento y bienestar psicológico. Se presentaron en la paciente, todos los indicadores de vejez exitosa que se definieron, garantizando el tránsito satisfactorio por la etapa. Conclusiones: La paciente con una vejez exitosa posee redes de integración, activación y trascendencia que le permiten reestructurar su campo de acción en un contexto como el que ha implicado la COVID-19, garantizando autovaloración y sentido de vida, expresados de forma desarrolladoras para favorecer su salud mental y su desarrollo psicológico.

ABSTRACT Introduction: COVID-19 and the measures generated to protect older adults have marked much more the vulnerability of this group, increasing psychosocial risk factors such as disengagement, mistreatment, anxiety; which required examining patterns of successful old age that generate and guarantee mental health in the elderly. Objective: To characterize those indicators of a successful old age that promote mental health, through its concrete expression in a patient. Method: Qualitative approach, favoring the single critical case study. To assess the mental health and vulnerability criteria, a semi-structured interview was used. For the characterization of old age, we worked with the biographical method and the life history technique, from August to November 2021. Results: Vulnerability criteria such as widowhood and loneliness were identified, but prevailed micro and macrosocial strengths at an individual level, which is consolidated with a healthy mental state that was expressed in evident functioning and psychological well-being. All the indicators of successful aging that were defined were presented in the patient, guaranteeing satisfactory transit through the stage. Conclusions: The patient with a successful old age has networks of integration, activation and transcendence that allow him to restructure his field of action in a context such as COVID-19; guaranteeing self-assessment and a sense of life, expressed in a developing way to favor their mental health and psychological development.

RESUMO Introdução: A COVID-19 e as medidas geradas para proteger os idosos marcaram muito mais a vulnerabilidade desse grupo, aumentando fatores de risco psicossociais como desengajamento, maus-tratos, ansiedade, o que exigiu examinar padrões de velhice bem-sucedida que geram e garantem a saúde mental em pessoas desta idade. Objetivo: Caracterizar os indicadores de uma velhice bem-sucedida que promovem a saúde mental, por meio de sua expressão concreta em um paciente. Método: Abordagem qualitativa, privilegiando o estudo de caso único crítico. Para avaliar os critérios de saúde mental e vulnerabilidade, foi utilizada uma entrevista semiestruturada. Para a caracterização da velhice, trabalhou-se com o método biográfico e a técnica de história de vida durante os meses de agosto a novembro de 2021. Resultados: Foram identificados critérios de vulnerabilidade como viuvez e solidão, mas prevaleceram as forças no nível individual, micro e macrossocial, que se consolidou com um estado mental saudável que se expressou em evidente funcionamento e bem-estar psicológico. Todos os indicadores de envelhecimento bem-sucedido que foram definidos foram apresentados no paciente, garantindo um trânsito satisfatório pelo estágio. Conclusões: O paciente com velhice bem-sucedida possui redes de integração, ativação e transcendência que lhe permitem reestruturar seu campo de ação em um contexto como o que a COVID-19 implicou, garantindo autoavaliação e sentido de vida, expressa de forma crescente para favorecer sua saúde mental e desenvolvimento psicológico.

Achieving successful aging through exercise: intrinsic logic and path selection / 中华老年医学杂志

Physical exercise helps promote successful aging, meaning that physical exercise can promote the physical health of the elderly and achieve healthy aging.It can also improve the mental health of the elderly and help achieve active aging.In addition, it can enhance social participation of the elderly and help achieve productive aging.To take advantage of the benefits of exercise for successful aging, the selection of paths should follow the principles of evidence-based exercise and scientifically proven exercise to avoid ineffective exercise or other negative effects of exercise, give priority to the natural environment to maximize exercise benefits, consider harmonious integration into social situations to improve the sense of social participation of the elderly, and formulate specific exercise plans to offer customized exercise prescriptions to realize the best results.

Characteristics and Surgical Repair Outcomes of Obstetric Fistula Patients Managedata Teaching Hospital in Zambia: A Retrospective Cross-Sectional Study

BackgroundThe obstetric fistula is a chronic maternal morbidity of global public health concern. The condition is preventable and, in most cases, treatable. Surgicalrepairis themainstay of treatment with varying degrees of success. The aim of this study was to determine the characteristics, surgical outcomes and factors influencing surgical outcomes of women presenting with obstetric fistulas at a Teaching Hospital in Lusaka, Zambia. Methods: Aretrospective review of medical records for all women who underwent obstetric fistula repair surgeryat Women and Newborn Hospital from 2017 to 2019. Descriptive analysis was done. Fischer's exact test was used to measure association between surgical outcomes and variables in the model.: ResultsIn total,18 out of 29 records of patients who underwentfistularepairwereretrievedandanalyzed. Ages ranged from 15 to 47 years, mean age 29years.Overtwothirds(72.23%)weremultiparous, and over 3/4ths (77.8%) underwent caesarean section in the antecedent pregnancy. Success rate for fistula repair was 83%at 2 weeks post-operative.Study findings were inadequate to show a significant association between successful repair and factors in the model. Conclusion: Majority of women presenting with obstetric fistula were multiparous with a history of prolonged labour, delivery by caesarean section and poor birth outcomes. Success rate for obstetric fistula repair at Women and Newborn Hospital was 83% at 2weeks postoperative. Further studies are needed to assess long-term outcomes and factors influencing surgical outcomes.:

Balón de Bakri en el control de la hemorragia obstétrica. Experiencia de cinco años / Bakri's balloon in the control of obstetric hemorrhagia. Five years experiencie

Resumen OBJETIVO: Evaluar los desenlaces con la aplicación del balón de Bakri para contener la hemorragia posparto. MATERIALES Y MÉTODOS: Estudio descriptivo, analítico, observacional y retrospectivo efectuado en pacientes atendidas en el Hospital Central, San Luis Potosí, a quienes de enero 2012 a diciembre 2017 se les colocó un balón de Bakri para contener la hemorragia posparto. Se excluyeron los expedientes incompletos y las pacientes a quienes se colocó el balón en otra institución. El análisis estadístico se procesó en una hoja de Excel Office 2013. RESULTADOS: Se realizaron 143 colocaciones del balón de Bakri, 84.06% (n = 121) durante el posparto, 9% (n =13) en la poscesárea y 6.2% (n = 9) durante la cesárea. La colocación del balón se consideró exitosa en 90.2% (n = 129); hubo 14 (9.79%) fallas en el control de la hemorragia que ameritaron otro procedimiento. El 48.9% de las pacientes no tenían factores de riesgo. El promedio de permanencia del balón fue de 20 h. Se registró una muerte obstétrica directa, por choque hipovolémico. CONCLUSIONES: El éxito del balón de Bakri para contener la hemorragia obstétrica fue similar al reportado en la bibliografía. Su aplicación es una estrategia de segunda línea, secundaria a atonía y complicaciones bajas.

Abstract OBJECTIVE: To evaluate the outcomes with the application of the Bakri balloon to contain postpartum hemorrhage. MATERIALS AND METHODS: Descriptive, analytical, observational and retrospective study carried out in patients attended at the Central Hospital in San Luis Potosi who between the months of January 2012 to December 2017 had a Bakri balloon placed to contain postpartum hemorrhage. Incomplete records and patients who had the balloon placed in another institution were excluded. Statistical analysis was processed in an Excel Office 2013 spreadsheet. RESULTS: 143 Bakri balloon placements were performed, 84.06% (n = 121) during postpartum, 9% (n =13) post cesarean section and 6.2% (n = 9) during cesarean section. Balloon placement was considered successful in 90.2% (n = 129); there were 14 (9.79%) failures to control bleeding that warranted another procedure. Of the patients, 48.9% had no risk factors. The average length of stay was 20 hours. One direct obstetric death was recorded, due to hypovolemic shock. CONCLUSIONS: The success of the Bakri Balloon in containing obstetric hemorrhage was similar to that reported in the literature. Its application is a second line strategy, secondary to atony and low complications.

Los nuevos modelos sociales e identitarios de los adultos mayores profundizando el concepto de vejez exitosa / Os novos modelos sociais e identitários dos idosos aprofundando o conceito de envelhecimento bem-sucedido / The new social and identitary models of elderly people deepening the concept of successful aging

Cada vez surge más evidencia en la literatura especializada que indica que la figura del adulto mayor como decrépito e inactivo comienza a ser substituida por la figura de un adulto mayor saludable y capaz de emprender nuevos proyectos de vida. El objetivo de la revisión integradora bibliográfica que se propone es analizar en las evidencias disponibles en la literatura, algunas delas implicaciones psicosociales, confrontacionales y familiares en lo que se denomina "envejecimiento de éxito" o "successful aging". Para la selección delos artículos fueron consultadas las bases de datos electrónicos Google Scholar, Crossref, Medline, ISI. Fueron seleccionados trece estudios para la realización de la revisión sistemática utilizando el descriptor "successful aging" y "envejecimiento activo" y a partir de los mismos se profundizó interdisciplinariamente el descriptor utilizado utilizando conceptos psico-sociales y vinculares. En las conclusiones se indica que existe suficiente evidencia proveniente del campo interdisciplinario de la gerontología para poder indicar que nuevos procesos de envejecimiento se van imponiendo en las generaciones actuales de adultos mayores.(AU)

Há evidências crescentes na literatura especializada de que a figura do idoso como decrépito e inativo está começando a ser substituída pela figura de um idoso saudável, capaz de empreender novos projetos de vida. O objetivo da revisão bibliográfica integrativa proposta é analisar nas evidências disponíveis na literatura, algumas das implicações psicossociais, confrontacionais e familiares no que é chamado de "Successful Aging". Para a seleção dos artigos, consultamos os bancos de dados eletrônicos Google Scholar, Crossref, Medlinee ISI. Treze estudos foram selecionados para realizar a revisão sistemática usando o descritor "Envelhecimento com Sucesso" e, a partir deles,o descritor usado foi aprofundado interdisciplinarmente usando conceitos psico-sociais e de união. Nas conclusões se indica que há evidências suficientes provenientes do campo interdisciplinar da gerontologia para indicar que novos processos de envelhecimento estão sendo impostos às gerações atuais dos idosos.(AU)

There is more and more evidence in the specialized literature that indicates that the figure of the older adult as decrepit and inactive is beginning to be replaced by the figure of a healthy older adult capable of undertaking new life projects. The objective of the proposed inte grative bibliographic review is to analyze in the available evidence in the literature, some of the psychosocial, confrontational and family implications in what is called "successful aging". For the selection of the articles, the electronic databases Google Scholar, Crossref, Medline, and ISI were consulted. Thirteen studies were selected to carry out the systematic review using the descriptor "Successful Aging" and from them the descriptor used was deepened interdisciplinaryly using psycho-social and bonding concepts. In the conclusions, it is indicated there is enough evidence from the interdisciplinary field of gerontology to indicate that new processes of aging are being imposed on the current generations of older adults.(AU)

Prevalence of ‘Researcher’s defined’ and ‘Self-rated’ Successful Aging among Pre-Retirement Public Servants

Introduction@#The socioeconomic impact of aging population can be reduced if majority of people achieve successful aging. This study aimed to determine the prevalence of researcher's defined successful aging (RDSA) and self-rated successful aging (SRSA) among pre-retirement public servants and their predictors.@*Methods@#The sample included 1,064 pre-retirement public servants (50 to 60 years old) from nine government agencies. Data was analyzed using Multiple Logistic Regression to test for the association between the studied factors and SA.@*Results@#The prevalence of RDSA and SRSA was 37.5% and 98.7%, respectively. Results showed four (4) significant factors with higher odds of having RDSA were not obese, good social support, being physically active and younger age. Meanwhile, five (5) factors highly selected by respondents as predictors for SRSA were having good spiritual or religious practice, happy family, good psycho cognitive function, social support and good physical function.@*Conclusions@#The prevalence of SRSA was higher despite the presence of self-reported chronic diseases and physical limitation identified among respondents. The discrepancy in both prevalence of SA reflects the differences that exist between the criteria for SA perceived by respondents and researchers. Misperception among respondents of their aging process as 'successful' despite having diseases or disability may worsen their health status because they continue practicing unhealthy lifestyles without action to improve it. Promotional activities on SA, regular health screening since young and healthy working environment should be implemented by various agencies.

Soporte ventilatorio no invasivo como puente hacia el trasplante pulmonar: reporte de un caso / Bridging to lung transplant using noninvasive ventilatory support: a case report

El soporte ventilatorio no invasivo es una herramienta que ha demostrado mejorar la sobrevida de pacientes con falla muscular de la bomba respiratoria y el manejo de enfermedades pulmonares crónicas, incluso la ventilación no invasiva nocturna ha servido de puente hacia el trasplante pulmonar. Se presenta el caso de una adolescente de 14 años con enfermedad pulmonar crónica hipoxémica severa y falla ventilatoria secundaria, que requirió ventilación prolongada y traqueostomía en espera de trasplante pulmonar. Luego de reevaluar indemnidad de la vía aérea fue decanulada a soporte ventilatorio no invasivo, con uso alternado de mascarilla nasal nocturna y pieza bucal diurna, permitiendo descanso muscular respiratorio eficiente, y mejoría de flujo de tos con técnicas de apilamiento de aire. Este plan permitió una decanulación segura y realizar soporte continuo ventilatorio no invasivo con un programa de rehabilitación cardiorrespiratorio. Generalmente, el soporte ventilatorio no invasivo se utiliza en trastornos primarios de la bomba respiratoria. En este caso, se indicó para enfermedad pulmonar crónica hipoxémica, mostrando claros beneficios con oxigenación adecuada, buen rendimiento cardiovascular con mejor tolerancia al ejercicio y entrenamiento en el escenario de preparación al trasplante pulmonar.

Noninvasive Ventilatory Support has demonstrated to improve survival of patients with ventilatory pump muscle failure and nocturnal noninvasive ventilation is useful in chronic lung disease, even bridging to lung transplant. We present a 14 years old girl with severe hypoxemic chronic lung disease and secondary ventilatory failure, who required continuous long-term ventilation and underwent a tracheostomy waiting for lung transplant. After reevaluated the airway patency the patient was decannulated to Noninvasive Ventilation Support, alternating nocturnal nasal mask with diurnal mouth piece in order to provide efficient respiratory muscle rest, made air stacking and improved cough flow. This plan allows safe decannulation to continuous Noninvasive Ventilatory Support tailoring a rehabilitation cardiorespiratory program. Usually, Noninvasive Ventilation Support is prescribed for primary respiratory pump muscles failure, but in this case, it was applied for a hypoxemic chronic lung disease. Clear benefits were observed leading to appropriate oxygenation, good cardiovascular performance with better tolerance to exercise for training in the preparatory scenario of a lung transplant.

Uso de propóleo con hidróxido de calcio como medicación intraconducto en periodontitis apical asintomática. Reporte de caso / Uso de própolis com hidróxido de cálcio como medicação intraconducto na periodontite apical assintomática. Relato de Caso / Use of propolis with calcium hydroxide as an intracanal medicament in asymptomatic apical periodontitis. A case report

Resumen La miel y sus productos, a lo largo de la historia, han sido usados por diversas civilizaciones con fines terapéuticos debido a sus efectos curativos. En la actualidad existe un renovado interés en el uso de la apiterapia como coadyuvante en diversos tratamientos médicos, en donde destaca el propóleo por sus propiedades bactericidas, antiinflamatorias, anticancerígenas, entre otras. El objetivo de este artículo es describir un caso de un primer molar inferior izquierdo con diagnóstico de necrosis pulpar y periodontitis periapical asintomática que fue manejado con el uso de la mezcla de propóleo con hidróxido de calcio como medicación intraconducto entre citas, logrando observar un proceso de reparación ósea durante este lapso. Se concluye que el propóleo es una alternativa viable como coadyuvante del hidróxido de calcio en los casos que está indicada la medicación intraconducto.

Resumo O mel e seus produtos, ao longo da história, têm sido utilizados por várias civilizações para fins terapêuticos devido aos seus efeitos curativos. Atualmente, há um interesse renovado no uso da apiterapia como adjuvante em vários tratamentos médicos, onde a própolis se destaca por seu bactericida, antiinflamatório, anticâncer, entre outros. O objetivo deste artigo é descrever um caso de primeiro molar inferior esquerdo com diagnóstico de necrose pulpar e periodontite periapical assintomática que foi gerenciada com o uso da mistura de própolis com hidróxido de cálcio como medicamento intraconducto entre as consultas, conseguindo observar um processo de reparo ósseo durante esse período. Em conclusão, a própolis é uma alternativa viável como adjuvante ao hidróxido de cálcio nos casos indicados por medicação intraconducto.

Abstract Various civilizations have used honey and its products for therapeutic purposes throughout history because of their healing effects. There is a renewed interest in the use of apitherapy as an adjunct in various medical treatments. Propolis stands out for its bactericidal, anti-inflammatory, and anti-cancer properties, among others. This paper aims to describe the case of a lower left first molar diagnosed with pulp necrosis and asymptomatic periapical periodontitis that was managed with a mixture of propolis and calcium hydroxide as an intracanal medicament between appointments. A bone repair process was observed during this period. It is concluded that propolis is a viable alternative as a calcium hydroxide adjuvant when intracanal medication is indicated.

Laparoscopic evaluation and prevalence of endometriosis among infertile women: a prospective study

Background: Endometriosis can be defined as presence of endometrial mucosa outside the uterine cavity. There are no specific signs and symptoms of endometriosis and the presentation may vary depending upon the site of involvement. It is one of the common causes of subfertility and infertility in young women. The Management of endometriosis may include medical as well as surgical intervention. Laparoscopic interventions have found to have encouraging results in terms of increasing chances of fertility in young women with endometriosis.Methods: This was a prospective study in which women who had infertility and subsequently diagnosed to be having endometriosis were included. A detailed history was taken with particular emphasis on duration of symptoms, presence of additional co-morbidities and duration of infertility was recorded. Diagnostic laparoscopy was done in all the cases. Depending upon location and severity of endometriosis adhesiolysis, excision and ablation of endometrial lesions was done. Patients were followed up and successful pregnancies (spontaneous as well as secondary to assisted reproductive techniques) were recorded.Results: Out of 200 studied cases endometriosis was seen in 23 (11.5%) patients. the most common affected age group was between 26-30 years (47.83%). 18 patients (78.26%) had primary infertility whereas remaining 5 patients (21.74%) were found to have secondary infertility. The most common site was found to be ovaries which was found to be involved in all the cases. cystectomy (30.43%), endometrioma drainage and fulguration (13.04%) or adhesiolysis (34.78%) were the commonly done surgical interventions in cases. out of 18 patients who had successful ovulation following laparoscopic intervention 12 (66.66%) patients completed their pregnancies successfully.Conclusions: Laparoscopic interventions in patients with infertility have diagnostic as well as therapeutic value and are found to have good outcome in terms of successful pregnancy.

Enjoying Life and Health Status among Young Adults and Elderly: A Comparative Study in Light of the Globalization Effects on the Human Being of the 21st Century

The enjoying life and health status, consider one of the determinants of active adulthood and successful aging. Hence the importance of this study represented in investigate these variables, especially in the light of globalization, which left its negative effects clearly on the individual of this century as deep scarves, which positive psychology seeking to strengthen the positive and treat the negative aspects to achieve well-being. This descriptive study aimed to examine the relationship between enjoying life and health status among adults and the elderly, and to detect the differences in enjoying life and health status due to age, education, and sex. The sample consisted of 380 adults and elderly persons selected randomly. Data were collected by enjoying life scale and health status questionnaire which prepared by researchers in this study. The results showed that there was a significant statistical relationship between enjoying life and health status, and there were significant statistical differences in enjoying life and health status due to age, education, and sex. Level of enjoying life and health status was high in participants who are elderly, educated and females. These findings emphasized the importance of developing the enjoying life among young adults and the elderly to enjoy with health status and to achieve active adulthood and successful aging.

Aging, Resilience and Vulnerability of Selected Faculty and Staff (55 years old and above) in an Academic Community in the Philippines

Introduction@#A demographic shift towards population aging is evident worldwide. This presents challenges particularly to low-income and middle-income countries like the Philippines. Understanding perceptions of aging, resilience, vulnerability, and gender identity will help prepare the health care system and social services in addressing the needs of the Filipino older population. @*Objective@#To describe gender identity, perceptions of active aging, successful aging, resilience, and vulnerability among faculty and staff (working, retired) in an academic community in the Philippines.@*Methods@#Survey and focus group discussions were conducted among working and retired faculty and staff aged 55 years old and above. @*Results, Analysis, and Discussion@#Almost all respondents had the same gender identity as their biological sex. There were differences in the respondents’ perceptions of active aging and successful aging and in their sources of strength and worries. Compared with retired respondents more working respondents believed that active aging meant being strong and physically active or being involved in sports. Female respondents thought that being socially active in their community and church was indicative of active aging. In contrast, male respondents equated being physically healthy with active aging. More working respondents and females (than retired and male respondents) thought that successful aging meant participating in community-based activities. In terms of vulnerability, differences were noted in the respondents’ sources of strength and worries. In general, retired respondents and female respondents said they got their strength from their grandchildren and from their religion. In contrast, working respondents and male respondents relied on their families for strength. It was also noteworthy that more retired respondents did not have any old agerelated worries compared with working respondents. Female respondents worried about their families while male respondents worried about death. Subjective nuances of being an older working or a retired employee in an academic community surfaced in the FGDs. The importance of context was evident in shaping the informants’ perceptions of active aging and frailty, and in their sources of worries and happiness. Overall, this paper adds to the body of knowledge about aging in the Philippines by studying a group of older Filipinos in an academic community. It showed that particular aspects of Filipino culture such as gender roles, religion, and close family ties permeate one’s life until he or she reaches old age. The results can help academic communities in policy formulation and program development to ensure that their older employees — throughout their life course — can adequately address vulnerability and resiliency needs to achieve active and successful aging.

Breech presentation at term: outcomes and mode of delivery in a tertiary care teaching hospital In South India

The aim of this study was to study the outcomes of all patients who presented with breech presentation at term (≥37 weeks), to assess what percentage of patients were offered External cephalic version (ECV), the rates of success of the procedure and the rates of vaginal delivery following successful ECV. It was a retrospective study of 669 patients diagnosed with breech at term, their clinical records were retrieved and data like age, BMI, parity, type of breech and scan findings noted. ECV was done in 256 patients and was successful in 35.5% of women with 51.1% being multigravidas and 26.8% in primigravidas. 76.9% of women with successful ECV delivered vaginally.  There was no significant fetal or maternal morbidity documented as a result of ECV in this study.

Successful Aging and Personal Well-Being Among the Chilean Indigenous and Non-Indigenous Elderly / Envejecimiento exitoso y bienestar personal en adultos mayores chilenos indígenas y no indígenas / Envelhecimento bem-sucedido e bem-estar pessoal em idosos chilenos indígenas e não indígenas

ABSTRACT Objective: The aim of this research was to analyse the association between successful aging (SA) and subjective well-being (SWB) in different domains. Method: The study is quantitative and cross-sectional, with a sample consisting of 800 older people, including 569 indigenous (Aymara and Mapuche) participants living in northern and southern Chile. Results: Domains associated with SA are satisfaction with health, satisfaction with social relationships, satisfaction with future security, and satisfaction with spiritual and religious experiences. SA is also positively associated with being a woman, being young, and not being indigenous. Conclusion: The research has two main practical implications. First, SWB domains may be incorporated into socio-health interventions as they relate to elements that can be changed or improved (health, social inclusion, security, and beliefs). Second, this study suggests a situation of risk among older indigenous Chileans, confirming the premise that the life paths of indigenous Chileans at social risk give rise to a more socially unequal old age with; therefore, it is important to analyse positive aspects that promote better old age.

RESUMEN Objetivo: el objetivo de esta investigación consistió en analizar la asociación entre envejecimiento exitoso (SA) y bienestar subjetivo (SWB) en sus diferentes dominios. Metodología: se trata de un diseño cuantitativo y transversal, con una muestra compuesta por 800 adultos mayores, incluidos 569 indígenas (aymaras y mapuches), que viven en el norte y sur de Chile. Resultados: muestran que los dominios asociados con la SA son satisfacción con la salud, satisfacción con las relaciones sociales, satisfacción con la seguridad futura y satisfacción con las experiencias espirituales y religiosas. La SA también se asocia positivamente con ser mujer, ser joven y no ser indígena. Conclusión: la investigación tiene dos implicaciones prácticas principales. Primero, estos dominios del SWB pueden incorporarse a las intervenciones sociosanitarias, ya que se relacionan con elementos que se pueden cambiar o mejorar (salud, inclusión social, seguridad y creencias). En segundo lugar, este estudio sugiere una situación de riesgo entre los chilenos indígenas mayores, lo que confirma la premisa de que las trayectorias de vida de los indígenas chilenos que han enfrentado más riesgo social dan lugar a una vejez con más desigualdad social, por lo que es importante analizar aspectos positivos que promuevan un mejor envejecimiento.

RESUMO Objetivo: analisar a associação entre envelhecimento bem-sucedido e bem-estar subjetivo em seus diferentes domínios. Método: trata-se de um desenho quantitativo e transversal, com uma amostra composta por 800 idosos, incluídos 569 indígenas (aymaras e mapuches), que habitam no norte e no sul do Chile. Resultados: os domínios associados com o envelhecimento bem-sucedido são satisfação com a saúde, satisfação com as relações sociais, satisfação com a segurança futura e satisfação com as experiências espirituais e religiosas. Além disso, associa-se de forma positiva com ser mulher, jovem e não indígena. Conclusão: esta pesquisa tem duas implicações práticas principais. Na primeira, esses domínios do bem-estar subjetivo podem ser incorporados às intervenções sociossanitárias, já que estão relacionados com elementos que podem ser mudados ou melhorados (saúde, inclusão social, segurança e crenças). Em segundo lugar, este estudo sugere uma situação de risco entre os idosos chilenos indígenas, o que confirma a hipótese de que as trajetórias de vida dos indígenas chilenos que enfrentaram mais risco social levam a uma velhice com mais desigualdade social, razão pela qual é importante analisar aspectos positivos que promovam um melhor envelhecimento.

Qualidade de Vida e Participação em Iniciativas de Base Comunitária: Um estudo num município da zona centro de Portugal / Quality of Life and Participation in Community-Based Programs: A study with a municipality in central Portugal / Calidad de vida y participación en iniciativas comunitarias: un estudio en un municipio del centro de Portugal

Face ao reconhecimento da importância da participação social como fator promotor de envelhecimento bem-sucedido, procura-se, através de um estudo de natureza quantitativo, analisar os efeitos de variáveis sociodemográficas e da participação social em atividades/programas de base comunitária, promovidas por um município da zona centro de Portugal, ao nível da qualidade de vida de pessoas com mais de 56 anos, residentes no concelho.

Dado el reconocimiento de la importancia de la participación social como un factor que promueve el envejecimiento exitoso, un estudio cuantitativo busca analizar los efectos de las variables sociodemográficas y la participación social en actividades / programas basados en la comunidad promovidos. por un municipio del centro de Portugal, en términos de calidad de vida de las personas mayores de 56 años, residentes en el municipio.

Considering the recognition of social participation as a relevant factor for promoting successful ageing, a study of quantitative nature was conducted in order to analyze the effects of sociodemographic variables and of social participation in community-based activities/ programs, promoted by a municipality in central Portugal, into the level of quality of life of its habitants, over 56 years of age.