Contribution of the ELRs to the development of advanced in vitro models.

Developing in vitro models that accurately mimic the microenvironment of biological structures or processes holds substantial promise for gaining insights into specific biological functions. In the field of tissue engineering and regenerative medicine, in vitro models able to capture the precise structural, topographical, and functional complexity of living tissues, prove to be valuable tools for comprehending disease mechanisms, assessing drug responses, and serving as alternatives or complements to animal testing. The choice of the right biomaterial and fabrication technique for the development of these in vitro models plays an important role in their functionality. In this sense, elastin-like recombinamers (ELRs) have emerged as an important tool for the fabrication of in vitro models overcoming the challenges encountered in natural and synthetic materials due to their intrinsic properties, such as phase transition behavior, tunable biological properties, viscoelasticity, and easy processability. In this review article, we will delve into the use of ELRs for molecular models of intrinsically disordered proteins (IDPs), as well as for the development of in vitro 3D models for regenerative medicine. The easy processability of the ELRs and their rational design has allowed their use for the development of spheroids and organoids, or bioinks for 3D bioprinting. Thus, incorporating ELRs into the toolkit of biomaterials used for the fabrication of in vitro models, represents a transformative step forward in improving the accuracy, efficiency, and functionality of these models, and opening up a wide range of possibilities in combination with advanced biofabrication techniques that remains to be explored.

Self-Lubricating, Living Contact Lenses.

The increasing prevalence of dry eye syndrome in aging and digital societies compromises long-term contact lens (CL) wear and forces users to regular eye drop instillation to alleviate discomfort. Here a novel approach with the potential to improve and extend the lubrication properties of CLs is presented. This is achieved by embedding lubricant-secreting biofactories within the CL material. The self-replenishable reservoirs autonomously produce and release hyaluronic acid (HA), a natural lubrication and wetting agent, long term. The hydrogel matrix regulates the growth of the biofactories and the HA production, and allows the diffusion of nutrients and HA for at least 3 weeks. The continuous release of HA sustainably reduces the friction coefficient of the CL surface. A self-lubricating CL prototype is presented, where the functional biofactories are contained in a functional ring at the lens periphery, outside of the vision area. The device is cytocompatible and fulfils physicochemical requirements of commercial CLs. The fabrication process is compatible with current manufacturing processes of CLs for vision correction. It is envisioned that the durable-by-design approach in living CL could enable long-term wear comfort for CL users and minimize the need for lubricating eye drops.

Engineered living materials for the conversion of a low-cost food-grade precursor to a high-value flavonoid.

Microbial biofactories allow the upscaled production of high-value compounds in biotechnological processes. This is particularly advantageous for compounds like flavonoids that promote better health through their antioxidant, anti-bacterial, anti-cancer and other beneficial effects but are produced in small quantities in their natural plant-based hosts. Bacteria like E. coli have been genetically modified with enzyme cascades to produce flavonoids like naringenin and pinocembrin from coumaric or cinnamic acid. Despite advancements in yield optimization, the production of these compounds still involves high costs associated with their biosynthesis, purification, storage and transport. An alternative production strategy could involve the direct delivery of the microbial biofactories to the body. In such a strategy, ensuring biocontainment of the engineered microbes in the body and controlling production rates are major challenges. In this study, these two aspects are addressed by developing engineered living materials (ELMs) consisting of probiotic microbial biofactories encapsulated in biocompatible hydrogels. Engineered probiotic E. coli Nissle 1917 able to efficiently convert cinnamic acid into pinocembrin were encapsulated in poly(vinyl alcohol)-based hydrogels. The biofactories are contained in the hydrogels for a month and remain metabolically active during this time. Control over production levels is achieved by the containment inside the material, which regulates bacteria growth, and by the amount of cinnamic acid in the medium.

Genital Mutilation in Males.

PURPOSE OF THE REVIEW: Genital mutilation in males can range from minor injuries (cuts from a blade) to severe urological emergencies (testicular or penile amputation). Due to the rarity of these events, there is a lack of extensive reports, as most of the available literature is regarding single cases. Genital mutilation has been associated with psychotic and non-psychotic causes, psychiatric conditions, drug consumption, sexual practices, or even cultural or religious beliefs. It is crucial to perform a psychiatric evaluation of these patients to obtain the best therapeutic approach. This manuscript serves as a review of the currently available knowledge regarding male genital mutilation. RECENT FINDINGS: A great variety of reasons have been associated with genital mutilation. Previous authors have distinguished between those that present with a clear mental health precursor from cases with no psychotic background. Nevertheless, sometimes, it is difficult to make this distinction. Recently, reconstructive techniques for amputation cases have moved towards a microsurgical approach in order to improve outcomes. A holistic therapeutic approach must be performed to increase the chances of effective treatment. Close collaboration between urologists, psychiatrists, and emergency doctors is essential to ensure the best care for patients performing genital mutilation. Future publications must evaluate differences in treatment options and the impact that these have on the long-term well-being of patients undergoing genital self-mutilation.

The Effects of Vitamin D Supplementation in COVID-19 Patients: A Systematic Review.

Vitamin D has an immune-modulating effect on respiratory tract infections. For this reason, it has been proposed as part of the treatment in COVID-19. Furthermore, vitamin D deficiency has been associated with worse clinical outcomes of this disease. The aim of this systematic review was to determine whether vitamin D supplementation modifies the disease course. Therefore, eleven studies involving randomised clinical trials are analysed, in which groups of COVID-19 patients with or without vitamin D supplementation as part of the treatment are compared. A control group was treated with best available therapy, and in some of the clinical trials, also with a placebo. According to the outcomes, it seems that patients benefit from receiving a daily or maintained in time vitamin D dose regardless of vitamin D serum levels at the beginning of the trial. The administration of a single vitamin D dose does not seem to have any effect on the health status of these patients. However, the outcomes are heterogeneous and larger clinical trials are necessary.

Relación entre funciones ejecutivas y trastornos neuropsiquiátricos en pacientes con Alzheimer de diferente grado de severidad / Relationship Between Executive Functions and Neuropsychiatric Disorders in Patients with Alzheimer's Disease of Different Degrees of Severity / Relação entre funções executivas e transtornos neuropsiquiátricos em pacientes com Alzheimer de diferentes estágios de gravidade

El objetivo del estudio fue investigar las funciones ejecutivas (fe) y los trastornos neuropsiquiátricos (tn) en pacientes con enfermedad de Alzheimer (ea), en función del grado de severidad, en comparación con sujetos sin deterioro cognitivo (ssdc). Se estudia-ron 50 pacientes con ea y 60 ssdc en un estudio no experimental-transversal con un muestreo no probabilístico basado en una serie de criterios de inclusión. Se aplicó la batería de evaluación frontal y el inventario neuropsiquiátrico, y los resultados mostraron que existe una relación negativa de intensidad moderada entre las fe y lostn, con independencia del grado de severidad de la ea. Se puede concluir que, en fase leve, la euforia se relaciona tanto con la sensibilidad hacia la interferencia como con el control inhibitorio; en fase moderada, la irritabilidad se relaciona de manera positiva con la sensibilidad hacia la interferencia, y en la fase moderadamente grave, la programación motora se relaciona de manera negativa con la agitación.

The aim of the study was to investigate executive func-tions (ef) and neuropsychiatric disorders (nd) in pa-tients with Alzheimer's disease (ad) according to the degree of severity, compared to subjects without cognitive impairment (swci). Fifty patients with ad and 60 swci were studied in a non-experimental-cross-sectional study with non-probabilistic sampling based on a series of inclusion criteria. The frontal evaluation battery and the neuropsychiatric inventory were applied and the results showed that there is a negative relationship of moderate intensity between ef and nd, regardless of the degree of severity of ad. It can be concluded that, in the mild phase, euphoria is related both to sensitivity towards interference and to inhibitory control; in moderate phase irritability is positively related to sensitivity towards interference; and in the moderately severe phase, motor programming is nega-tively related to agitation.

O objetivo do estudo foi investigar as funções executivas (fe) e os transtornos neuropsiquiátricos (tn) em pacien-tes com doença de Alzheimer (da) de acordo com o estágio de gravidade, em comparação com sujeitos sem comprometimento cognitivo (sscc). Foram avaliados 50 pacientes com da e 60 sscc em um estudo transversal não experimental com amostragem não probabilística baseada em uma série de critérios de inclusão. A bateria de avaliação frontal e o inventário neuropsiquiátrico foram aplicados e os resultados mostraram que existe uma relação negativa de intensidade moderada entre a fe e os tn, independente do estágio de gravidade da da. Pode-se concluir que, na fase leve, a euforia está rela-cionada tanto à sensibilidade à interferência quanto ao controle inibitório; na fase moderada, a irritabilidade está positivamente relacionada à sensibilidade à inter-ferência e; na fase moderadamente grave, a programação motora está negativamente relacionada à agitação.

Manejo del duelo en familiares de pacientes oncopediátricos / Management of grief in family members of oncopediatric patients

Introducción: La recuperación del dolor de una familia por la muerte de un niño obedece a la forma en la que se cuida la etapa final de su vida, y es especialmente en esta etapa, donde Enfermería juega un papel fundamental en el apoyo a la familia que enfrenta la enfermedad crítica y la muerte de un hijo.Objetivos: Revisar la literatura científica existente sobre el manejo del duelo en familiares de pacientes oncopediátricos.Metodología: Revisión integradora exhaustiva en las bases de datos Pudmed, Scopus, Scielo y Cochrane. Fueron empleados los términos “oncology pediatric”, “family”, “grief” y “nursing”, unidos por el operador boleano “AND”.Resultados: Se han identificado las experiencias emocionales que siente la familia del paciente oncohematológico pediátrico y las habilidades en la práctica enfermera que protegen el cuidado emocional de la misma. Por su relevancia en este ámbito, cabe destacar la relación terapéutica entre la familia, el niño, y el equipo sanitario, y el poder de la habilidad comunicativa en la etapa final de la vida y la muerte.Conclusiones: El cuidado de la integridad emocional y del curso natural del duelo es vital dentro del plan de cuidados del niño y su familia. Subrayar la magnitud que tendría el entrenamiento de Enfermería en habilidades emocionales, comunicativas y psico-conductuales dentro de la atención integral del niño y su familia. (AU)

Introduction: Recovery from the pain of a family due to the death of a child is due to the way in which the final stage of life is cared for, and it is especially at this stage where Nursing plays a fundamental role in supporting the family facing critical illness and the death of a child.Objectives: To review the existing scientific literature on the management of grief in relatives of oncopediatric patients.Methodology: Comprehensive integrative review in the Pudmed, Scopus, Scielo and Cochrane databases. The terms «pediatric oncology», «family», «mourning» and «nursing» were used, joined by the Boolean operator «Y».Results: The emotional experiences felt by the family of the pediatric oncohematological patient and the skills in nursing practice that protect the emotional care of the same have been identified. Due to its relevance in this area, it is worth highlighting the therapeutic relationship between the family, the child, and the healthcare team, and the power of communication skills in the final stage of life and death.Conclusions: Caring for the emotional integrity and the natural course of grief is vital in the care plan for the child and his family. Emphasize the magnitude that should be the nursing training in emotional, communication and psycho-behavioral skills for the comprehensive care of the child and his family. (AU)

Perceptions of Older People with Cognitive Impairment, Caregivers, and Professionals about ehcoBUTLER (Tablet Health Care Platform): A Qualitative Focus Group Study.

EhcoBUTLER is a tablet platform mainly aimed at the elderly with mild cognitive impairment (MCI) to promote their well-being and health. The main objective of this study was to explore the perceptions and feedback level of the ehcoBUTLER potential users and stakeholders to improve its development. Through this exploration, the secondary objective was to contribute to the development of software/apps that promote their integral health. Focus groups were conducted (13 elderly with MCI, 13 with dementia, 12 caregivers, 11 professionals). The content and feedback level were analyzed. Participants liked the appearance of ehcoBUTLER, would like to use it, and were mainly interested in the emotional, healthy lifestyle, cognitive, and ergonomic tools. It is necessary to have prior training, more intuitive/customizable apps, low-price/free, offline/USB content, and add other activities/features. EhcoBUTLER is well-oriented to meet the needs and preferences of potential users. However, improvements in its usability, accessibility, and sustainability are needed. The participants' perspectives provided a comprehensive view to improve ehcoBUTLER, so that in the future, it can benefit the elderly to be active agents in their health; support caregivers in their role and to have a respite; and professionals to have a multi-intervention platform. The present findings can contribute to the development of tablet software/apps that promote the integral well-being of this population.

Antitumor Anesthetic Strategy in the Perioperatory Period of the Oncological Patient: A Review.

The stress response triggered by the surgical aggression and the transient immunosuppression produced by anesthetic agents stimulate the inadvertent dispersion of neoplastic cells and, paradoxically, tumor progression during the perioperative period. Anesthetic agents and techniques, in relation to metastatic development, are investigated for their impact on long-term survival. Scientific evidence indicates that inhaled anesthetics and opioids benefit immunosuppression, cell proliferation, and angiogenesis, providing the ideal microenvironment for tumor progression. The likely benefit of reducing their use, or even replacing them as much as possible with anesthetic techniques that protect patients from the metastatic process, is still being investigated. The possibility of using "immunoprotective" or "antitumor" anesthetic techniques would represent a turning point in clinical practice. Through understanding of pharmacological mechanisms of anesthetics and their effects on tumor cells, new perioperative approaches emerge with the aim of halting and controlling metastatic development. Epidural anesthesia and propofol have been shown to maintain immune activity and reduce catecholaminergic and inflammatory responses, considering the protective techniques against tumor spread. The current data generate hypotheses about the influence of anesthesia on metastatic development, although prospective trials that determinate causality are necessary to make changes in clinical practice.

Determinants of Adherence to a "GRADIOR" Computer-Based Cognitive Training Program in People with Mild Cognitive Impairment (MCI) and Mild Dementia.

BACKGROUND: Computer-based programs have been implemented from a psychosocial approach for the care of people with dementia (PwD). However, several factors may determine adherence of older PwD to this type of treatment. The aim of this paper was to identify the sociodemographic, cognitive, psychological, and physical-health determinants that helped predict adherence or not to a "GRADIOR" computerized cognitive training (CCT) program in people with mild cognitive impairment (MCI) and mild dementia. METHOD: This study was part of a randomized clinical trial (RCT) (ISRCTN: 15742788). However, this study will only focus on the experimental group (n = 43) included in the RCT. This group was divided into adherent people (compliance: ≥60% of the sessions and persistence in treatment up to 4 months) and non-adherent. The participants were 60-90 age and diagnosed with MCI and mild dementia. We selected from the evaluation protocol for the RCT, tests that evaluated cognitive aspects (memory and executive functioning), psychological and physical health. The CCT with GRADIOR consisted of attending 2-3 weekly sessions for 4 months with a duration of 30 min Data analysis: Phi and Biserial-point correlations, a multiple logical regression analysis was obtained to find the adherence model and U Mann-Whitney was used. RESULTS: The adherence model was made up of the Digit Symbol and Arithmetic of Wechsler Adult Intelligence Scale (WAIS-III) and Lexical Verbal Fluency (LVF) -R tests. This model had 90% sensitivity, 50% specificity and 75% precision. The goodness-of-fit p-value of the model was 0.02. CONCLUSIONS: good executive functioning in attention, working memory (WM), phonological verbal fluency and cognitive flexibility predicted a greater probability that a person would be adherent.

The Effectiveness of GRADIOR: A Neuropsychological Rehabilitation Program for People with Mild Cognitive Impairment and Mild Dementia. Results of a Randomized Controlled Trial After 4 and 12 Months of Treatment.

BACKGROUND: Computer-based cognitive training programs have been developed with promising results on the maintenance/improvement of cognitive performance in people with dementia. OBJECTIVE: The objective was to evaluate the effectiveness of the cognitive rehabilitation program "GRADIOR" in people with mild cognitive impairment and mild dementia. METHOD: This study was a single-blind multicenter randomized clinical trial. Participants were recruited from hospitals/day centers. The experimental group (EG) and control group (CG) received computer-based cognitive training (CCT) and routine daily care, respectively. Outcome measures at T0: baseline, T1: at 4 months, T2: at 12 months were compared within and between-groups. RESULTS: Significant differences or important effect sizes were detected at the intragroup and intergroup level for most variables, observing a trend of improvement and/or maintenance at 4 months by Visual Reasoning of Cambridge Cognitive Examination (CAMCOG), Digit and Arithmetic of WAIS-III, Semantic Verbal Fluency, Mini-Mental State Exam (MMSE), Trail Making Test (TMT)-A-Mistakes and at 12 months by Visual Reasoning of CAMCOG, Digit Symbol of WAIS-III, TMT-B-mistakes, Visual Memory of Rivermead Behavioural Memory Test, Lexical Verbal Fluency-P, Yesavage's Geriatric Depression Scale (GDS), TMT-A-time scales whose objective was to evaluate some executive functions and/or the memory. The CG presented a worsening trend for most of the measures towards 12 months. There was also a significant interaction between "time and group" for MMSE (F = 8.971; p = 0.03; η2 = 0.019) and the GDS (F = 3.414; p = 0.04; η2 = 0.041), as well as small effect sizes for TMT-A-time (F = 1.641; p = 0.21; η2 = 0.021) and TMT-A-mistakes (F = 0.908; p = 0.41; η2 = 0.019). CONCLUSION: CCT with GRADIOR has been proved to benefit cognitive functions (ISRCTN:15742788).

Development of bioactive catechol functionalized nanoparticles applicable for 3D bioprinting.

Efficient wound treatments to target specific events in the healing process of chronic wounds constitute a significant aim in regenerative medicine. In this sense, nanomedicine can offer new opportunities to improve the effectiveness of existing wound therapies. The aim of this study was to develop catechol bearing polymeric nanoparticles (NPs) and to evaluate their potential in the field of wound healing. Thus, NPs wound healing promoting activities, potential for drug encapsulation and controlled release, and further incorporation in a hydrogel bioink formulation to fabricate cell-laden 3D scaffolds are studied. NPs with 2 and 29 M % catechol contents (named NP2 and NP29) were obtained by nanoprecipitation and presented hydrodynamic diameters of 100 and 75 nm respectively. These nanocarriers encapsulated the hydrophobic compound coumarin-6 with 70% encapsulation efficiency values. In cell culture studies, the NPs had a protective effect in RAW 264.7 macrophages against oxidative stress damage induced by radical oxygen species (ROS). They also presented a regulatory effect on the inflammatory response of stimulated macrophages and promoted upregulation of the vascular endothelial growth factor (VEGF) in fibroblasts and endothelial cells. In particular, NP29 were used in a hydrogel bioink formulation using carboxymethyl chitosan and hyaluronic acid as polymeric matrices. Using a reactive mixing bioprinting approach, NP-loaded hydrogel scaffolds with good structural integrity, shape fidelity and homogeneous NPs dispersion, were obtained. The in vitro catechol NPs release profile of the printed scaffolds revealed a sustained delivery. The bioprinted scaffolds supported viability and proliferation of encapsulated L929 fibroblasts over 14 days. We envision that the catechol functionalized NPs and resulting bioactive bioink presented in this work offer promising advantages for wound healing applications, as they: 1) support controlled release of bioactive catechol NPs to the wound site; 2) can incorporate additional therapeutic functions by co-encapsulating drugs; 3) can be printed into 3D scaffolds with tailored geometries based on patient requirements.

Lack of Effective Surgical Team Communication During a Laparoscopic Roux-en-Y Gastric Bypass, Leading to a Severe Intraoperative Complication.

Introduction: Laparoscopic Roux-en-Y gastric bypass surgical technique systematization makes it a very safe technique that it is not exempt from intraoperative complications. One of the key aspects for performing a safe procedure is combining technical expertise with nontechnical skills, such as communication and teamwork. Materials and Methods: We describe a case that highlights the importance of surgical team interaction to avoid intraoperative complications during bariatric surgery, as an incidental stapling of the nasogastric tube. Results: This clinical case highlights the importance of effective teamwork and a culture of safety during complex laparoscopic surgical procedures. Conclusions: The lack of effective surgical team communication during a laparoscopic Roux-en-Y gastric bypass can be a cause of severe surgical complications that requires experience of the surgical team for its resolution.

Influencia de la actividad física en la prevención, tratamiento antineoplásico y supervivencia de pacientes con cáncer de mama / Influence of physical activity on the prevention, antineoplastic treatment and survival of patients with breast cancer

Introducción Durante las 2 últimas décadas, numerosos estudios han investigado el impacto de la actividad física en el tratamiento del cáncer. El objetivo de esta revisión versa en obtener recomendaciones basadas en la evidencia científica publicada más recientemente acerca de la influencia de la actividad física en el cáncer de mama, tanto en lo que se refiere a prevención, así como durante el tratamiento antineoplásico y supervivencia. Resultados La actividad física es capaz de interaccionar sobre diferentes mecanismos biológicos típicamente alterados en el cáncer de mama, como son: marcadores inflamatorios, hormonas sexuales, eje insulina/IGF-I, hormonas suprarrenales, vitamina D, sistema inmune, estrés oxidativo y reparación del ADN; dando así resultados positivos en cuanto a disminución del riesgo de carcinogénesis, aumento de calidad de vida y mejora de los efectos secundarios derivados del tratamiento, así como disminución de la recurrencia tumoral y aumento de la supervivencia global. Conclusión La actividad física aeróbica y de fuerza-resistencia aparecen ampliamente recomendadas y justificadas en la literatura científica para la prevención y mejora multidimensional de las pacientes con cáncer de mama y supervivientes, estableciendo una serie de precauciones/contraindicaciones ante situaciones de eventual riesgo. El conocimiento de la heterogeneidad del cáncer de mama y de los diferentes mecanismos biológicos implicados en su desarrollo y perpetuación permitirán personalizar la indicación y tratamiento farmacológico/físico para cada paciente. (AU)

Introduction In the last few decades, several studies have investigated the impact of physical activity on the treatment of cancer. The aim of this study was to establish recommendations based on the most recent scientific evidence on the effect of physical activity on breast cancer, in terms of prevention, antineoplastic treatment, and survival. Results Physical activity affects various biological mechanisms typically altered in breast cancer, such as inflammatory markers, sex hormones, insulin axis/IGF-1, adrenal hormones, vitamin D, the immune system, oxidative stress, and DNA repair. These findings indicate a positive impact in terms of reducing the risk of carcinogenesis, adverse treatment effects and tumoural recurrence, enhancing quality of life, and increasing overall survival. Conclusion Aerobic physical activity and strength-resistance training are widely recommended and justified in the scientific literature for prevention and multidimensional improvement in patients with breast cancer and breast cancer survivors, allowing a series of precautions/contraindications to be made in situations of eventual risk. Knowledge of the heterogeneity of breast cancer and of the various biological mechanisms involved in its development and perpetuation will allow personalised indications and drug/physical treatment for each patient. (AU)

Is Supplementation with Micronutrients Still Necessary during Pregnancy? A Review.

INTRODUCTION: Proper nutrition during pregnancy is important to prevent nutritional imbalances that interfere with pregnancy. Micronutrients play critical roles in embryogenesis, fetal growth, and maternal health, as energy, protein, vitamin, and mineral needs can increase during pregnancy. Increased needs can be met by increasing the intake of dietary micronutrients. Severe micronutrient deficiency or excess during pregnancy can have negative effects on fetal growth (intrauterine growth retardation, low birth weight, or congenital malformations) and pregnancy development (pre-eclampsia or gestational diabetes). We investigate whether it is necessary to continue micronutrient supplementation during pregnancy to improve women's health in this stage and whether this supplementation could prevent and control pathologies associated with pregnancy. AIM: The present review aims to summarize evidence on the effects of nutritional deficiencies on maternal and newborn morbidity. METHODS: This aim is addressed by critically reviewing results from published studies on supplementation with different nutrients during pregnancy. For this, major scientific databases, scientific texts, and official webpages have been consulted. PubMed searches using the terms "pregnancy" OR "maternal-fetal health" AND "vitamins" OR "minerals" OR "supplementation" AND "requirement" OR "deficiency nutrients" were performed. RESULTS: There are accepted interventions during pregnancy, such as folic acid supplementation to prevent congenital neural tube defects, potassium iodide supplementation to correct neurodevelopment, and oral iron supplementation during the second half of pregnancy to reduce the risk of maternal anemia and iron deficiency. A number of micronutrients have also been associated with pre-eclampsia, gestational diabetes mellitus, and nausea and vomiting in pregnancy. In general, experimental studies are necessary to demonstrate the benefits of supplementation with different micronutrients and to adjust the recommended daily doses and the recommended periconceptional nutrition for mothers. CONCLUSIONS: Presently, there is evidence of the benefits of micronutrient supplementation in perinatal results, but indiscriminate use is discouraged due to the fact that the side effects of excessive doses are not known. Evidence supports the idea that micronutrient deficiencies negatively affect maternal health and the outcome of pregnancy. No single micronutrient is responsible for the adverse effects; thus, supplementing or correcting one deficiency will not be very effective while other deficiencies exist.

Programas de formación para el apoyo entre iguales en salud mental en España / Training programs for peer support in mental health in Spain

Resumen Los problemas de salud mental son un tema relevante en todo el mundo. Pese a los avances, es necesario continuar trabajando para mejorar la calidad de vida del colectivo. La educación y el apoyo entre iguales son estrategias muy adecuadas para contribuir a su integración socio-laboral. Se ha realizado una revisión bibliográfica en bases de datos y páginas web para identificar experiencias españolas de formación de personas con Trastorno Mental Severo (TMS) basadas en el apoyo entre iguales. Se han encontrado siete experiencias de formación para el colectivo, cinco de ellas centradas en el apoyo entre iguales y otras en la figura de el/la asistente personal. El número de experiencias encontradas en España es muy reducido. Aunque los objetivos son comunes, se observan enfoques diferentes (entorno sanitario, laboral, social) que pueden ser muy relevantes para el diseño y aplicación de otras experiencias en diferentes contextos.

Abstract Mental health problems are a relevant issue all around the world. Mental illness affects one in four people throughout their lives, causing serious socio-economic and human rights-related consequences. In Spain, despite the progress made with psychiatric reform and the promotion of a community model, it is necessary to continue working to improve the quality of life of people with mental health problems. Education and peer support are highly recommended strategies to contribute to their social and occupational integration. Peer support is a relationship based on mutual support. It is established between two people: the person with mental health problems trained to provide the support and the person who receives it. This support enhances the recovery process. For this support to be effective, it is essential to previously train the person who will undertake the counselling functions. The relationship of support offers practical advice, suggestions, strategies and emotional and psychological support. In addition, maintaining an non-professional perspective is essential to help people to rebuild their sense of community after an unknown experience. Peer support brings benefits to all parties involved: support providers, receivers and implementing organizations or institutions. However, training programs for peer support are not widespread. In Spain, despite the recognition of the need to integrate people with mental health problems into society and to respond to their needs, there is no published research on guidelines for such training programs. For this reason, this research identifies the peer support training programs which have been or are being carried out in Spain and describe their formal characteristics. A bibliographic review of databases and web pages has been undertaken to identify Spanish experiences of training people with Severe Mental Disorder (SMD) based on peer support and to describe their formal characteristics (duration, methodology, evaluation and workplace). A total of 77 programs found in the electronic databases, 75 of which have been excluded as they are not Spanish experiences. Five programs were found in the searches carried out on the reports of conferences, congresses and websites of Spanish organizations and institutions. Finally, seven training experiences were selected for the group, five of them focused on peer support and others on the figure of the personal assistant. The study of the programs is carried out following the indications of the content analysis model. The training programs described have common objectives, however, they vary considerably in their approach, duration, names of support and evaluation providers and, to a lesser extent, in the contents, methodology and workplaces. Despite the expansion of peer support in mental health, the number of experiences found in Spain is limited. Any program must be adapted to the strengths of the individuals, the type of work, as well as to the needs of the community. Furthermore, if this new professional profile is regulated at work, it will contribute to improving the rates of social and occupational integration of people with mental health problems. It is necessary to continue developing and implementing experiences of these characteristics and to investigate their efficiency and effectiveness in order to be able to provide guidelines on peer support in the Spanish population.

Usability and User Experience of Cognitive Intervention Technologies for Elderly People With MCI or Dementia: A Systematic Review.

INTRODUCTION: Incorporating technology in cognitive interventions represents an innovation, making them more accessible, flexible, and cost-effective. This will not be feasible without adequate user-technology fit. Bearing in mind the importance of developing cognitive interventions whose technology is appropriate for elderly people with cognitive impairment, the objective of this systematic review was to find evidence about usability and user experience (UX) measurements and features of stimulation, training, and cognitive rehabilitation technologies for older adults with mild cognitive impairment (MCI) or dementia. METHOD: The Medline, PubMed, Scopus, ScienceDirect, and PsycINFO databases were searched for literature published in the last 10 years (2009-2019), and three researchers independently reviewed potentially eligible studies, following specific inclusion criteria. A systematic review of the studies was conducted, presenting a qualitative synthesis of usability and UX measures with their outcomes, study characteristics and features of the cognitive intervention technologies. RESULTS: Ten studies were selected: five were cognitive stimulation and five were cognitive training. Most of them (60%) were computer-based programs with a serious game format. Efficiency and effectiveness were the most frequent measurements used for collecting objective usability data, showing that elderly people with cognitive impairment require more time (45%) and help (40%) but can complete tasks (60%). Regarding UX or subjective usability data, questionnaires and scales were the most used methods, reporting positive experience despite certain difficulties with the interface in five studies. CONCLUSION: Measuring usability and UX in cognitive intervention technologies for older adults with MCI or dementia provides an integrated view that can contribute to their development according to the needs and characteristics of the target population. More research is required to include this population group in usability and UX studies, as well as standardized tools and consensus on the relationship of these terms to guarantee the future effectiveness of cognitive intervention technologies. REVIEW REGISTRATION: This review was registered in the PROSPERO (CRD42020158147) International Register of Systematic Review Protocols.

Methodological Designs Applied in the Development of Computer-Based Training Programs for the Cognitive Rehabilitation in People with Mild Cognitive Impairment (MCI) and Mild Dementia. Systematic Review.

In recent years, different computer-based cognitive training (CT) programs for people with dementia (PwD) have been developed following a psychosocial approach. AIM: This systematic review aims to identify the methodological designs applied in the development of computer-based training (CCT) programs for the rehabilitation of cognitive functioning in people with mild cognitive impairment (MCI) or mild dementia. METHODS: A systematic review was conducted using the databases PubMed and PsycINFO. The search period was between 2000-2019. The study selection and data extraction processes were carried out by two independent reviewers. The protocol was registered in International Prospective Register of Systematic Reviews (PROSPERO) under registration number CRD42020159027. RESULTS: Thirteen studies met the inclusion criteria. The most frequently used methodological design in the development of CCT programs for people with MCI or mild dementia was the user-centered design (UCD). This design involves an interactive system characterized by the inclusion of end users from the initial stages of its development, throughout the establishment of functional requirements, and in the evaluation of the program's usability and user-experience (UX). CONCLUSION: UCD was the most used methodological design for the development of CCT programs although there was quite some variation in how this design was applied. Recommendations for future studies about the development of CCT programs for people with MCI and mild dementia are given. Central focus should be the inclusion and active participation of end users from the initial stages of development.