Cognitive plasticity as a moderator of functional dependency in elderly patients hospitalized for bone fractures.

INTRODUCTION: Bone fractures in older adults involve hospitalization and surgical intervention, aspects that have been related to loss of autonomy and independence. Several variables have been studied as moderators of how these patients recover. However, the implications of cognitive plasticity for functional recovery have not been studied to date. OBJECTIVE: The present study analyzes the relationship between cognitive plasticity--defined as the capacity for learning or improved performance under conditions of training or performance optimization--and functional recovery in older adults hospitalized following a bone fracture. PATIENTS AND METHODS: The study comprised 165 older adults who underwent surgery for bone fractures at a hospital in southern Spain. Participants were evaluated at different time points thereafter, with instruments that measure activities of daily life (ADL), namely the Barthel Index (BI) and the Lawton Index, as well as with a learning potential (cognitive plasticity) assessment test (Auditory Verbal Learning Test of Learning Potential, AVLT-LP). RESULTS: Results show that most of the participants have improved their level of independence 3 months after the intervention. However, some patients continue to have medium to high levels of dependency and this dependency is related to cognitive plasticity. CONCLUSION: The results of this study reveal the importance of the cognitive plasticity variable for evaluating older adults hospitalized for a fracture. They indicate a possible benefit to be obtained by implementing programs that reduce the degree of long-term dependency or decrease the likelihood of it arising.

Valoración de un programa de habilidades interpersonales en niños superdotados / Evaluation of an interpersonal skills program in gifted children

Algunos trabajos de investigación informan que cierto número de niños superdotados muestran problemas de adaptación social y habilidades sociales e interpersonales, mientras que otros consideran que esto no ocurre. Partiendo de lo anterior, Neihart, Reis, Robinson y Moon (2002) hablan de enfoque de resiliencia versus enfoque de riesgo. En este trabajo se considera el beneficio de aplicar programas de entrenamiento en habilidades interpersonales en niños superdotados para prevenir posibles problemas. Por ello, se pretende valorar la eficacia de un programa de entrenamiento en resolución de problemas interpersonales en esta población. En esta investigación participaron 40 niños superdotados de edades comprendidas entre 7 y 13 años, divididos en un grupo tratamiento y un grupo control de lista de espera. Los resultados mostraron diferencias significativas en las medidas de valoración directa en el grupo tratamiento tras la aplicación del programa. También se detectaron diferencias significativas entre el grupo tratamiento y el grupo control en las medidas postratamiento a favor del primero, y se confirmó la relación del potencial de aprendizaje de los niños con los beneficios obtenidos. En definitiva, el programa de entrenamiento se muestra eficaz en la mejora de las habilidades de solución de problemas interpersonales evaluadas en niños superdotados.

Certain research studies report that a number of gifted children show social adaptation issues, as well as problems with social and interpersonal skills, while others consider that this does not occur. In this regard, Neihart, Reis, Robinson and Moon (2002) speaks of a resilience approach versus a risk approach. From the risk viewpoint, this paper presents the benefits of applying training programs in interpersonal skills as to prevent potential problems in gifted children. For this reason, we aim to evaluate the effectiveness of a training program for solving interpersonal problems in this population. Participants include 40 gifted children aged 7 to 13, divided into a treatment group and a control - waitlisted - group. Program application results show significant differences in direct assessment measurements in the treatment group. An increase in effect sizes between the treatment group and the control group is also detected, in favor of the former, and a relationship between the children's learning potential and the benefits obtained is also confirmed. In short, the training program proves effective in interpersonal problem-solving skill improvement in children with high intellectual capacity.

Cognitive plasticity, cognitive functioning and quality of life (QoL) in a sample of young-old and old-old adults in southern Spain.

BACKGROUND AND AIMS: The present study was designed to assess the differences in cognitive plasticity, cognitive functioning and quality of life (QoL) in young-old and old-old adults, and to determine whether variables related to QoL can predict cognitive plasticity in old age. METHODS: The study population consisted of 215 people living in sheltered accommodation for elderly people in southern Spain. Participants were divided into two groups according to age: young-old aged (between 65 and 80 years) and old-old (81 and above). Participants were assessed by means of cognitive performance tests, a QoL questionnaire, and the auditory verbal learning test-learning potential (AVLT-LP) as a measure of cognitive plasticity. RESULTS: No significant differences were found in cognitive plasticity between the young-old and old-old adults, although the former performed better on immediate and sustained verbal recall. Likewise, no significant inter-group differences arose in most of the QoL variables. However, differences in cognitive plasticity did appear as a function of the level of cognitive functioning of the old adults, and cognitive functioning has been shown to be the best predictor of cognitive plasticity in old age. CONCLUSIONS: Differences in cognitive plasticity between young-old and old-old adults only appear when the cognitive functioning of individuals is taken into account, rather than their age group. The variables cognitive functioning, social integration and education level appear to be the best predictors of cognitive plasticity in old age.

Using learning potential to evaluate children with specific language impairment

This article presents research on a learning potential assessment that was administered to 32 preschool children with typical development, and 32 with specific language impairment receiving treatment at CADIT: the Children’s Center for Early Intervention and Development. The study’s main objective was to examine whether the language-impaired group’s cognitive profile could improve by applying learning potential methodology. Its second aim was to demonstrate the effectiveness of mediation in both groups. The results revealed significant differences between the two groups at pretest on most subscales. As for the second objective, we observed differences between pretest and posttest scores in both groups. In the second group, all differences were significant except in the case of classification and auditory memory, while in the first group, the differences between pretest and posttest scores were significant on all sub-scales but visual memory (AU)

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El envejecimiento, la asignaturaolvidada en la universidad española: ¿El iceberg de un tipode negligencia? / Ageing, the forgotten course in Spanish university: the iceberg type of negligence?

El envejecimiento poblacional ha condicionado que la mayorparte de la actividad profesional de numerosos tituladosde diferentes carreras se realice en personas ancianas.En su vertiente no intencional, el abandono del ancianocomo tipo de maltrato se puede deber a un conocimientoinadecuado (tal y como se define la impericia profesional).Por ello, la etapa de formación de la carrera reviste granimportancia en el cumplimiento de la misión universitaria.Así, todos los profesionales que desarrollen su actividadprofesional con mayores deben tener conocimientos en gerontologíaque les permitan obtener, en cada momento,los mejores resultados posibles. Metodología: análisis descriptivode los planes de estudio de las carreras de Enfermería,Medicina, Fisioterapia, Trabajo Social, TerapiaOcupacional y Ciencias de la Actividad Física y el Deporte.Conclusiones: excepto en Enfermería y Terapia Ocupacional,el resto de titulaciones universitarias no ofertanasignaturas troncales relacionadas con el envejecimiento (AU)

Population aging has conditioned most of the professionalactivity of many graduates of different degrees, to be conductedin older people. In its unintended side, abandoningthe elderly, such as type of abuse, may be due to inadequateknowledge (defined as the professional skill), so the trainingstage of the race of great importance in meeting the universitymission. Thus, all the professionals who develop theirprofessional activity with older should have knowledge ingerontology to enable them to obtain at each moment thebest possible results. Methodology: descriptive analysis ofthe curricula of degree programs in Nursing, Medicine,Physiotherapy, Social Work, Occupational Therapy andScience of Physical Activity and Sport. Conclusions: exceptin Nursing and Occupational Therapy, the other universitydegrees offered no core subjects related to aging (AU)

[Memory lapses and memory: relationship between objective and subjective memory in old age]. / Olvidos y memoria: relaciones entre memoria objetiva y subjetiva en la vejez.

INTRODUCTION: research into memory in geriatrics and gerontology has become increasingly important in recent years. However, various studies have shown that not all aspects or types of memory are affected in the same way or with the same severity by old age. OBJECTIVES: the present study aimed to establish differential profiles in objective and subjective memory associated with old age with a view to establishing criteria that could be used to distinguish between age-associated memory loss and pathological memory loss, thus aiding diagnosis of cognitive impairment. MATERIAL AND METHODS: a total of 143 participants between 60 and 98 years of age were evaluated using a battery of tests comprising the validated Spanish version of the Mini-Mental State Examination [Lobo's Mini-Examen Cognoscitivo (MEC)], diverse tests for objective memory [the auditory verbal learning test of learning potential (AVLT-LP) and a working memory test], and the subjective memory questionnaire. RESULTS AND CONCLUSIONS: significant differences were found between distinct age groups in different measures of subjective and objective memory. In general terms, persons who complained most about memory problems were not those with poorer performance on objective memory tests. The results show that measures of subjective and objective memory assess different aspects of memory.

Olvidos y memoria: relaciones entre memoria objetiva y subjetiva en la vejez / Memory lapses and memory: relationship between objective and subjective memory in old age

Introducción: la importancia del estudio de la memoria en geriatría y gerontología ha ido aumentando considerablemente en los últimos años. Sin embargo, diferentes trabajos han puesto de manifiesto que no todas las facetas ni tipos de memoria se ven afectados del mismo modo ni en el mismo grado por el envejecimiento. Objetivos: el trabajo que se presenta se dirige a establecer perfiles diferenciales en memoria asociados a la edad con el fin de fijar criterios que sirvan para diferenciar los olvidos o pérdidas de memoria que pueden deberse al envejecimiento con las pérdidas patológicas de memoria, de tal modo que se disponga de normas precisas de diagnóstico del deterioro cognitivo. Material y métodos: en esta investigación han participado 143 personas, de 60 a 98 años que han sido evaluadas con una batería formada por el Mini-Examen Cognoscitivo (MEC), diferentes pruebas de memoria objetiva, entre las que se encuentran tareas de memoria de trabajo y Auditory Verbal test-potencial de aprendizaje (AVLT-PA) y el cuestionario de quejas subjetivas de memoria. Resultados y conclusiones: en primer lugar, se han encontrado diferencias significativas entre los diferentes grupos de edad establecidos en las diferentes medidas de memoria subjetiva y objetiva utilizadas. En segundo lugar, en términos generales, las personas que más se quejan sobre sus problemas de memoria no fueron aquellas que mostraron un peor rendimiento en las pruebas de memoria objetiva, y por último, los resultados muestran que las medidas subjetivas de memoria y las medidas objetivas evalúan aspectos diferentes

Introduction: research into memory in geriatrics and gerontology has become increasingly important in recent years. However, various studies have shown that not all aspects or types of memory are affected in the same way or with the same severity by old age. Objectives: the present study aimed to establish differential profiles in objective and subjective memory associated with old age with a view to establishing criteria that could be used to distinguish between age-associated memory loss and pathological memory loss, thus aiding diagnosis of cognitive impairment. Material and methods: a total of 143 participants between 60 and 98 years of age were evaluated using a battery of tests comprising the validated Spanish version of the Mini-Mental State Examination [Lobo¿s Mini-Examen Cognoscitivo (MEC)], diverse tests for objective memory [the auditory verbal learning test of learning potential (AVLT-LP) and a working memory test], and the subjective memory questionnaire. Results and conclusions: significant differences were found between distinct age groups in different measures of subjective and objective memory. In general terms, persons who complained most about memory problems were not those with poorer performance on objective memory tests. The results show that measures of subjective and objective memory assess different aspects of memory (AU)

[Sensitivity to pain, self-regulation, coping and personality in healthy adult women]. / Sensibilidad al dolor, autorregulación, afrontamiento y personalidad en mujeres adultas sanas.

The goals of this study were to investigate the relation between sensitivity to pain and subjectively perceived intensity of pain, and to establish which psychological variables affect lesser or greater objective sensitivity to experimental pain. The study sample consisted of 74 adult women without regular pain symptoms. Experimental pain was induced by means of the Portable Electronic Dolorimeter (DEP). Intensity of induced pain was evaluated using a Visual Analogic Scale (VAS). Psychological characteristics studied were self-government, stress-coping strategies, sensitivity to anxiety and the five personality dimensions evaluated by the BFQ of Caprara, Barbaranelli and Borgogni (1995). Results revealed a positive relation between sensitivity to pain and subjective intensity of pain. An analysis of variance also revealed statistically significant differences between groups with low and high sensitivity to pain in the following variables: self-motivation, focalization in problem-solving, positive reappraisal of stressful events, energy and mental openness. The importance of the study lies in the identification of specific psychological factors for intervention in the psychological treatment of pain.

Sensibilidad al dolor, autorregulación, afrontamiento y personalidad en mujeres adultas sanas / Sensitivity to pain, self-regulation, coping and personality in healthy adult women

Los objetivos de este estudio han sido investigar la relación existente entre la sensibilidad al dolor y la intensidad percibida del dolor, y determinar qué variables psicológicas influyen en la sensibilidad al dolor experimental en una muestra de 74 mujeres adultas sin síntomas habituales de dolor. El dolor experimental fue inducido mediante el dolorímetro electrónico portátil (DEP)® y la intensidad de dolor producida fue evaluada mediante una escala visual analógica (EVA). Las características psicológicas estudiadas han sido autogobierno, estrategias para el afrontamiento del estrés, sensibilidad a la ansiedad y las cinco dimensiones de personalidad evaluadas por el BFQ de Caprara, Barbaranelli y Borgogni (1995). Los resultados indican una relación positiva entre sensibilidad al dolor e intensidad subjetiva de dolor, y el análisis de varianza realizado muestra además diferencias estadísticamente significativas entre los grupos bajo y alto en sensibilidad al dolor en las variables automotivación, focalización en la solución de problemas, reevaluación positiva de los acontecimientos estresantes, energía y apertura mental (AU)

The goals of this study were to investigate the relation between sensitivity to pain and subjectively perceived intensity of pain, and to establish which psychological variables affect lesser or greater objective sensitivity to experimental pain. The study sample consisted of 74 adult women without regular pain symptoms. Experimental pain was induced by means of the Portable Electronic Dolorimeter (Dolorímetro Electrónico Portátil: DEP)®. Intensity of induced pain was evaluated using a Visual Analogic Scale (VAS). Psychological characteristics studied were self-government, stress-coping strategies, sensitivity to anxiety and the five personality dimensions evaluated by the BFQ of Caprara, Barbaranelli and Borgogni (1995). Results revealed a positive relation between sensitivity to pain and subjective intensity of pain. An analysis of variance also revealed statistically significant differences between groups with low and high sensitivity to pain in the following variables: self-motivation, focalization in problem-solving, positive reappraisal of stressful events, energy and mental openness. The importance of the study lies in the identification of specific psychological factors for intervention in the psychological treatment of pain (AU)

Impacto de una campaña escolar de prevención de riesgos / Assessment of a school campaign on risk prevention

La prevención de accidentes infantiles, como estrategia dirigida a la posterior prevención de riesgos laborales se ha convertido en un tópico de gran interés por sus ventajas en incidencia, transversalidad y economía, por ello parece interesante la valoración del impacto de este tipo de acciones. En este estudio se presenta la valoración de una campaña de prevención de accidentes infantiles aplicada en la comunidad andaluza, denominada: “Aprende a Crecer con Seguridad”. La campaña pretende mejorar la “cultura de la prevención” en la población infantil con la finalidad de que estos conocimientos se generalicen y repercutan en el futuro sobre la prevención de accidentes laborales. Para valorar la campaña se ha empleado un diseño quasiexperimental pre/post con Grupo Control no equivalente con la aplicación de diversos instrumentos de evaluación elaborados a tal efecto. Los resultados muestran diferencias significativas del Grupo Experimental en conocimientos sobre prevención y en la generalización de estos conocimientos al ámbito laboral. Así mismo, se concluye que en los pueblos grandes y en las capitales los conocimientos sobre riesgos y prevención son superiores a los pueblos pequeños y que los participantes con mayores conocimientos sobre prevención tienen menor tasa de accidentalidad(AU)

The prevention of child accidents as a strategy for the subsequent prevention of risks at work has become a very interesting topic due to its advantages in terms of incidence, transversality and economy. Therefore, the assessment of the impact of this kind of actions seems to be worthwhile. This paper describes the assessment of a campaign for the prevention of child accidents carried out in Andalusia under the headline “Learn how to grow up safely.” This campaign aims at improving “prevention culture” among the population of children so that this knowledge eventually lead to the prevention of work accidents in the future. Program assessment was performed through a quasi-experimental pre/post design with a non-equivalent control group. Results show that the experimental group had a significant higher knowledge on prevention that was in turn extended to the workplace. As a conclusion, it appears that knowledge on risks and prevention is higher in big towns and capitals than in small towns. Finally, it is noteworthy that participants with higher knowledge on prevention have a lower accident rate(AU)

Influence of level of activity on cognitive performance and cognitive plasticity in elderly persons.

As a result of the rapid increase in the elderly population over recent decades, the analysis of factors influencing cognitive aging has become a focus of great interest for current research. In this area, numerous papers have indicated a relation between specific psychosocial variables and the level of activity and cognitive performance and plasticity in old age. This study aimed at testing a theoretical model, which establishes relations between level of activity, cognitive performance and cognitive plasticity in old age. In this study 176 elderly persons participated and were evaluated by means of a cognitive screening test, two cognitive plasticity evaluation tests and a questionnaire on the level of activity before and after retirement. A structural equation analysis was carried out on the data, which reveal significant relations between level of activity after retirement and cognitive performance and plasticity. Similarly, a significant relation is established between cognitive functioning and plasticity. The findings lend support to studies affirming that a high level of activity protects against cognitive decline and is related to cognitive plasticity in old age.

Eficacia de un programa de entrenamiento en memoria en el mantenimiento de ancianos con y sin deterioro cognitivo / Effectiveness of a memory training programme in the maintenance of status in the derly people with and without cognitive decline

el objetivo de este estudio ha sido analizar el efecto de un entrenamiento en memoria en el mantenimiento cognitivo de ancianos con y sin deterioro cognitivo. Método: En la investigación han participado 98 ancianos (59 grupo tratamiento y 39 grupo control) que han sido evaluados en tres momentos temporales (antes del entrenamiento, después del mismo y tras 9 meses) con diversas pruebas de funcionamiento cognitivo. Las personas del grupo tratamiento han participado en un programa de entrenamiento en memoria de 14 sesiones. Resultados: Los resultados muestran que los ancianos del grupo tratamiento mejoran su rendimiento cognitivo en las evaluaciones posteriores al entrenamiento mientras que las del grupo control sufren un declive de tal manera que, aunque no existen diferencias significativas de partida entre grupos, éstas sí que se producen una vez introducida la fase entrenamiento. Conclusiones: los resultados muestran los efectos positivos de este tipo de intervenciones cuando se trabaja conpoblación anciana

The aim of this study was to analyse the effect of memory training on cognitive maintenance inolder adults with and without cognitive decline. Method: 98 older adults participated in the study (59 in the treatment group and 39 in the control group). Subjects were evaluated at the three points in time using diverse cognitive functioning tests - before training, immediately after training, and nine months after training. Subjects in the treatment group participated in a memory-training programme during 14 sessions. Results: Older adults in the treatment group improved their cognitive performance in the post-training tests, while members of the control group presented a decline. Thus, while there were no initial significant inter-group differences, these differences became apparent after the training phase. conclusions: the results show the positive effects of this type of training when working with the older adult population

Validez de la evaluación del potencial de aprendizaje / The validity of the learning potencial assessment

La evaluación del potencial de aprendizaje surge como alternativa a la evaluación tradicional de la inteligencia asociada a la evaluación de niños y adolescentes con déficits o problemas de aprendizaje. Sin embargo, en la actualidad, está recibiendo gran atención por parte de diferentes grupos de investigación internacionales, no sólo en relación a sus supuestos y su metodología, sino también a su aplicabilidad en otras poblaciones objetivo. En este trabajo se revisan tres cuestiones importantes relacionadas con su validez, que han sido muy debatidas en una serie de trabajos publicados recientemente. Éstas son: su supuesto básico de evaluación de la capacidad de aprendizaje, las diferentes alternativas para llevar a cabo la medida del cambio que implica su aplicación y los estudios de validez desarrollados (AU)

The assessment of Learning Potential, is an assessment methodology that was born firstly, as an alternative to traditional intelligence assessment aproach, asociated to children and young people with deficits or learning disabilities. Nowadays, however, Learning Potential Assessment is receiving an important attention on differents international research groups, not only in order to its aims and methodology, but also to its applicability on other populations. In this work, three important cuestions related to Learning Potential Assessment validity, that have been discussed in several works published recently, have been reviewed. These cuestions are, its way of performing the assessment of learning ability, the different alternatives to do the change measurement that involves its application and the validity studies that have been developed (AU)

[The factors that influence the use of antibiotics in primary care]. / Factores que influyen sobre la utilización de antibióticos en atención primaria.

OBJECTIVE: To identify factors influencing volume, quality and power of antibiotic prescription in primary care. DESIGN: Descriptive, crossover study. SETTING: Sanitary Region Coast of Ponent, 1992. PARTICIPANTS: They were studied 468 practitioners of primary care attention. 68 practitioners were excluded by various reasons. MEASUREMENTS AND MAIN RESULTS: The factors studied were: factors coming from the practitioner, the centre, and the assisted population. The following parameters were analysed: amount of prescribed antibiotics in DDDs, election level ("antibiotic power") and percentage of DDDs of low intrinsic value. It was used for the comparison of means, Student-Fisher t test and the confidence intervals of the difference. Also it was used the step-wise multiple regression analysis. Greater use of antibiotics. The variability can be explained through regression in a 45.7% in function of the doctors factors, not integrated in a team, older, doctor who works in a rural centre, of young population and of smaller revenue. Greater antibiotic power. It's explained in a 5.09% by the medical factors like man, that works in a not educational centre and of greater population revenue. Greater percentage of DDDs of low intrinsic value. It's greater in doctors not specialized in family care, permanent job, of greater age, men, not reformed professional and not of an educational centre. CONCLUSIONS: The volume of prescription of antibiotics and in minor extent its quality of prescription are in some part justified by variables coming from the practitioner, the centre and the assisted population. The antibiotic power mainly doesn't.

[Drug prescriptions in Catalonia following the Decree of Selective Financing of Drugs]. / La prescripción farmacéutica en Cataluña tras el Decreto de Financiación Selectiva de Medicamentos.

OBJECTIVES: To assess the consequences of the Selective Financial Decree for prescription drugs in Catalonia. METHODS: Observational longitudinal study of the registry of prescribed pharmaceutical specialties that were charged to the Catalan Service of Health, from august 1991 to July 1994. 243.8 million of prescriptions were analyzed. RESULTS: Between the 12 months prior to the Decree and the 12 months following, the number of drug prescriptions was reduced by 10%. As a whole, the drugs included in the decree were loosing sales before the Decree; 38% of then were not been prescribed at all during the period studied. The main groups affected by the Decree were, vitamins associations, stimulants an associations with cough suppressants, mainly with a low therapeutic value. There has only been and important and clear substitution effect in antianemic and cough suppressants associations. CONCLUSION: In general, substitutions between pharmaceutical groups were few and positive.

[Relationship between the physician's profile and transient work incapacity of his patients]. / Relación entre el perfil del médico de cabecera y la incapacidad laboral transitoria de sus pacientes.

OBJECTIVE: To discover the relation between doctor's profile and his patient's unfitness for work. DESIGN: This was an observational crossover study. SETTING: Regional health authorities of Sant Feliu (Barcelona). PARTICIPANTS: 30 general practitioners throughout the whole of 1992. MEASUREMENTS AND MAIN RESULTS: Temporary doctors concede significance less unfitness for work (p = 0.002), and less unfitness motivated by flu (p = 0.028) than the others. Doctors belonging to the morning shift concede more upper respiratory infectious process (p = 0.03) than doctors belonging to the afternoon shift. Younger doctors and those specialised in family practice concede less unfitness for work motivated by flu than the others (p = 0.020) and (p = 0.019) respectively. CONCLUSIONS: The doctor's stability of work is the most influential factor analysed of the unfitness for work of his patients.

[Determining factors of the quality of prescription measured in intrinsic value and its potential use]. / Factores condicionantes de la calidad de la prescripción, medida en valor intrínseco y grado potencial de uso.

OBJECTIVE: To determine whether the following factors-medical training in family practice, age of the doctor, health care organization and percentage of patients over 65 years--influence the quality of pharmaceutical prescription as measured in terms of its intrinsic value and potential use of the prescription. DESIGN: Descriptive cross study. SITE. Regional health authorities of Costa de Ponent. Barcelona. PARTICIPANTS: 400 general practitioners throughout the whole of 1992. MAIN MEASUREMENTS AND RESULTS: Doctors belonging to the new health system and specialising in family practise, present higher intrinsic value and potential use of the prescription (statistically confirmed), as well as a greater concentration of prescription of the top 100 prescribed medicines. Doctors no more than 40 years old had better prescription but no statistical differences were found. An aged population had nearly no influence. CONCLUSIONS: The characteristics of the doctor (organization, training) are conditioning factors in the quality of pharmaceutical prescription.