Situation of the Elderly Living Alone: Morbidity and Services Provided from the Field of Primary Health Care of Gran Canaria.

The elderly suffer a greater number of health problems and have greater need for assistance and care. (1) Background: to determine the profile of the elderly who live alone, identified according to the Primary Care Health Record of Gran Canaria, and to analyze the sociodemographic data of the target population and determine the characteristics related to morbidity. (2) Methods: descriptive, prospective, cross-sectional study carried out in the Primary Health Care Management of Gran Canaria. The study population was all adults over 65 years of age living alone. The instrument used was the Drago-Electronic Health Record. Data analysis was carried out using RStudio version 1.1.447 software, and descriptive analysis and inferential analysis were carried out using the Chi-square values, T-test for independent samples, and ANOVA. (3) Results: The sample amounted to 8679 subjects, predominantly female sex (86.14%) and with a mean age of 79.4 years. Of the sample, 6.4% lived alone. Based on the classification by Adjusted Morbidity Groups (AMG), subjects with "moderate complications" predominated at 45.5%. (4) Conclusions: It is necessary to implement this type of stratification tool, which allows interventions to be carried out in elderly people at risk.

Nucleic acid recognition and antiviral activity of 1,4-substituted terphenyl compounds mimicking all faces of the HIV-1 Rev protein positively-charged α-helix.

Small synthetic molecules mimicking the three-dimensional structure of α-helices may find applications as inhibitors of therapeutically relevant protein-protein and protein-nucleic acid interactions. However, the design and use of multi-facial helix mimetics remains in its infancy. Here we describe the synthesis and application of novel bilaterally substituted p-terphenyl compounds containing positively-charged aminoalkyl groups in relative 1,4 positions across the aromatic scaffold. These compounds were specifically designed to mimic all faces of the arginine-rich α-helix of the HIV-1 protein Rev, which forms deeply embedded RNA complexes and plays key roles in the virus replication cycle. Two of these molecules recognized the Rev site in the viral RNA and inhibited the formation of the RRE-Rev ribonucleoprotein complex, a currently unexploited target in HIV chemotherapy. Cellular assays revealed that the most active compounds blocked HIV-1 replication with little toxicity, and likely exerted this effect through a multi-target mechanism involving inhibition of viral LTR promoter-dependent transcription and Rev function. Further development of this scaffold may open new avenues for targeting nucleic acids and may complement current HIV therapies, none of which involve inhibitors interfering with the gene regulation processes of the virus.

Efecto de la vacunación antigripal en trabajadores de atención primaria y población general de Gran Canaria: estudio transversal / Effect of influenza vaccination in Primary Healthcare workers and the general population in Gran Canaria: A cross-sectional study

Objetivo: Estimar el efecto de la vacunación antigripal en los trabajadores de atención primaria y en la población atendida durante la campaña de vacunación antigripal 2015/2016. Diseño: Estudio transversal. Emplazamiento: Todos los centros asistenciales de atención primaria del Área de Salud de Gran Canaria. Participantes: Un total de 1.868 profesionales (33,5% hombres; 66,5% mujeres) y 795.605 personas de la población general (49,4% hombres; 50,6% mujeres). Mediciones principales: En profesionales, las variables de resultado fueron: declaraciones de gripe al Sistema de Vigilancia Epidemiológica y días de incapacidad temporal por enfermedad; en población general: gripes declaradas y coberturas vacunales en función del estado vacunal del sanitario. Se estimó la magnitud de asociación entre la vacunación y la morbilidad mediante modelos de regresión logística. Resultados: Los profesionales sanitarios que no se vacunaron tuvieron un riesgo de tener gripe 1,7 veces superior al de los profesionales que se vacunaron, aunque la diferencia no fue estadísticamente significativa; en población general se encontró una asociación significativa solo en mujeres (OR: 1,3; IC95%: 1,1-1,5). La cobertura poblacional fue significativamente mayor cuando médico y enfermero estaban vacunados (OR: 1,3; IC 95%: 1,3-1,3), y el número de gripes declaradas disminuyó cuando el enfermero estaba vacunado (OR: 0,9; IC 95%: 0,9-0,9). Conclusiones: Se observó un posible efecto protector de la vacunación antigripal en la población general, así como una influencia del estado vacunal de los sanitarios en las coberturas de los pacientes. Aun así, las bajas coberturas registradas apuntan a una necesidad de implementar medidas que propicien una actitud más favorable frente a la vacunación antigripal

Objective: To estimate the effect of the influenza vaccination in Primary Healthcare workers and the general population vaccinated during the 2015/2016 campaign. Design: Cross-sectional study. Setting: All the Primary Healthcare centres within the Gran Canaria healthcare region. Participants: A total of 1,868 Primary Healthcare workers (33.5% men; 66.5% women) and 795,605 individuals from the general population (49.4% men; 50.6% women). Principal measurements: The outcome variables in Primary Healthcare workers were: influenza cases reported to the Epidemiological Surveillance System, and the sick leave days due to illness. In the general population: reported flu cases and vaccination coverage in connection with the vaccination status of the healthcare professional. The magnitude of association between vaccination and morbidity was estimated applying logistic regression models. Results: Although not statistically significant, healthcare professionals that were not vaccinated had 1.7-fold increase in the risk of having influenza than those vaccinated. In the general population the association was significant in the female population (OR: 1.3; 95% CI: 1.1-1.5). Population coverage was significantly higher when both the doctor and nurse were vaccinated (OR: 1.3; 95 %CI: 1.3-1.3), and reported flu cases decreased when the nurse was vaccinated (OR: 0.9; 95%CI: 0.9-0.9). Conclusion: A possible protective effect of influenza vaccination was observed in the general population, as well as an influence of Primary Healthcare workers on the patients regarding this. Even so, the low coverages registered point to a need to implement measures that may lead to a more favourable attitude towards influenza vaccination

[Effect of influenza vaccination in Primary Healthcare workers and the general population in Gran Canaria: A cross-sectional study]. / Efecto de la vacunación antigripal en trabajadores de atención primaria y población general de Gran Canaria: estudio transversal.

OBJECTIVE: To estimate the effect of the influenza vaccination in Primary Healthcare workers and the general population vaccinated during the 2015/2016 campaign. DESIGN: Cross-sectional study. SETTING: All the Primary Healthcare centres within the Gran Canaria healthcare region. PARTICIPANTS: A total of 1,868 Primary Healthcare workers (33.5% men; 66.5% women) and 795,605 individuals from the general population (49.4% men; 50.6% women). PRINCIPAL MEASUREMENTS: The outcome variables in Primary Healthcare workers were: influenza cases reported to the Epidemiological Surveillance System, and the sick leave days due to illness. In the general population: reported flu cases and vaccination coverage in connection with the vaccination status of the healthcare professional. The magnitude of association between vaccination and morbidity was estimated applying logistic regression models. RESULTS: Although not statistically significant, healthcare professionals that were not vaccinated had 1.7-fold increase in the risk of having influenza than those vaccinated. In the general population the association was significant in the female population (OR: 1.3; 95%CI: 1.1-1.5). Population coverage was significantly higher when both the doctor and nurse were vaccinated (OR: 1.3; 95%CI: 1.3-1.3), and reported flu cases decreased when the nurse was vaccinated (OR: 0.9; 95%CI: 0.9-0.9). CONCLUSION: A possible protective effect of influenza vaccination was observed in the general population, as well as an influence of Primary Healthcare workers on the patients regarding this. Even so, the low coverages registered point to a need to implement measures that may lead to a more favourable attitude towards influenza vaccination.

8-Iodonaphthalene-1-carbaldehyde: A Versatile Building Block for Diversity-Oriented Synthesis.

The scarcely studied 8-halonaphthalene-1-carbaldehyde structure has been converted into the corresponding Ellman's imine and subjected to several transformations, thus achieving an assorted library of polycyclic carbo- and heterocycles. The potential of this scaffold for Diversity-Oriented Synthesis has been shown. Most of these skeletons are unprecedented and, therefore, cover unexplored regions of the chemical space.

Asymmetric Synthesis of Fluorinated Isoindolinones through Palladium-Catalyzed Carbonylative Amination of Enantioenriched Benzylic Carbamates.

The asymmetric synthesis of fluorinated isoindolinones has been achieved by a palladium-catalyzed aminocarbonylation reaction of the corresponding α-fluoroalkyl o-iodobenzylamines. A base-mediated anti ß-hydride elimination process was suggested to explain the partial erosion of the optical purity observed in some cases. This mechanistic rationale enabled the minimization of this partial racemization by fine-tuning the pKa of the base.

Resultados del estudio de percepciones de actores sociales sobre salud, promoción de la salud, participación social, y de planes municipales región central de occidente, Costa Rica - 2011 / Results of the study of perceptions of stakeholders on health, health promotion, social participation, and municipal plans central west, Costa Rica - 2011

La salud representa un derecho humano fundamental y se constituye a su vez en un componente indispensable para la vida. Además, es el resultado de la interacción de determinantes sociales, económicos, ambientales, espirituales, políticos; por consiguiente, debe abordarse desde un enfoque integral en el que se articulen esfuerzos individuales, colectivos e intersectoriales en procura de alcanzar propósitos comunes desde el enfoque de promoción de la salud. En este sentido, los gobiernos locales tienen un rol protagónico por ser los responsables de gestar políticas, impulsar la formulación e implementación de programas y proyectos de manera concertada. Por lo anterior, la Dirección Regional de Rectoría de la Salud Central de Occidente del Ministerio de Salud, realizó en el año 2011 un estudio de línea base a fin de dar respuesta a los siguientes interrogantes: ¿Cuáles son las percepciones sobre salud, promoción de la salud y participación social que tienen los actores sociales municipales y cuáles son las principales acciones en salud integradas en los planes estratégicos de alcaldías de las municipalidades que conforman la Región Central de Occidente, Costa Rica? El estudio fue de tipo descriptivo y exploratorio con enfoque cualitativo, que permitió el acercamiento a los actores sociales para obtener los datos mencionados y fuentes documentales de las municipalidades de la Región Central de Occidente. En este marco, el presente artículo recopila referentes teóricos-metodológicos utilizados, los principales hallazgos, las conclusiones y algunas recomendaciones generales derivadas del estudio. Los resultados obtenidos representan un insumo valioso para redefinir estrategias de negociación y abogacía así como procesos rectores que fomenten el posicionamiento del enfoque en el quehacer de los gobiernos locales y por ende, favorecer la construcción de una nueva cultura de salud desde una lógica positiva, proactiva e innovadora.

Health represents a fundamental human right and, at the same time, constitutes an indispensable component for life. In addition, it is the result of the interaction of social, economic, environmental, spiritual and political determinants; therefore, it must be addressed from an integral approach in where the individual, collective and cross-sectorial efforts are articulated in order to achieve common purposes from a promotion of health approach. In this sense, the local governments play a leading role because they are the responsible for developing policies, promoting the formulation and implementation of programs and projects on an agreed way. Therefore, the Regional Directorate of Health Rectory of the Central West of the Health Ministry conducted a baseline study in 2011 to provide answers to the following questions: What are the perceptions of health, health promotion and social participation that municipal stakeholders have and what are the main health actions integrated in their strategic mayor plans of the municipalities that constitute the Central West Region in Costa Rica? It was a descriptive and exploratory study with qualitative approach which enabled the approach to stakeholders to obtain the mentioned data and documentary sources of the municipalities in the Central West Region. In this context, this article collects theoretical-methodological referents, the main findings, conclusions and some general recommendations derived from the study. The obtained results definitely represent a valuable input to redefine negotiation and advocacy strategies as well as directing processes that encourage the positioning of the approach in the work of the local governments and therefore, promote the construction of a new culture of health from a positive, proactive and innovative logic.

Asymmetric allylation/ring closing metathesis: one-pot synthesis of benzo-fused cyclic homoallylic amines. Application to the formal synthesis of Sertraline derivatives.

A one-pot asymmetric allylation/ring closing metathesis (RCM) sequence for the synthesis of cyclic homoallylic amines has been developed. A library of six- and seven-membered benzo-fused products has been synthesized in good yields and complete diastereoselectivity. The new methodology has been applied to the formal syntheses of the antidepressant Sertraline and the epimeric Norsertraline. The methodology is amenable for the synthesis of analogs.

Base-dependent stereodivergent intramolecular aza-Michael reaction: asymmetric synthesis of 1,3-disubstituted isoindolines.

The nucleophilic addition (A(N)) / intramolecular aza-Michael reaction (IMAMR) process on Ellman's tert-butylsulfinyl imines, bearing a Michael acceptor in the ortho position, is studied. This reaction affords 1,3-disubstituted isoindolines with a wide range of substituents in good yields and diastereoselectivities. Interestingly, careful choice of the base for the aza-Michael step allows either the cis or the trans diastereoisomers to be exclusively obtained. This stereodivergent cyclization has enabled the synthesis of C2-symmetric bisacetate-substituted isoindolines. In addition, bisacetate isoindolines bearing two well-differentiated ester moieties are also noteworthy because they may allow for the orthogonal synthesis of ß,ß'-dipeptides using a single nitrogen atom as a linchpin.

Intramolecular Michael reaction of tert-butylsulfinyl ketimines: asymmetric synthesis of 3-substituted indanones.

Aromatic tert-butylsulfinyl ketimines bearing a suitable Michael acceptor at the ortho position readily undergo an intramolecular conjugate addition achieving indanone derivatives in good yields and complete diastereoselectivity.