Estrategias de afrontamiento en relación con los eventos estresantes que ocurren al envejecer / Coping strategies in relation to the stressful events when aging

OBJETIVOS: Describir cuáles son los tipos de afrontamiento (coping) que se utilizan frente a los eventos estresantes que ocurren al envejecer y analizar cuáles son las variables asociadas al uso de estos tipos de afrontamiento, considerando el tipo de evento estresante -problema, pérdida, conflicto o problema de otro- y recursos individuales y sociales. MÉTODO: Datos de una encuesta representativa aplicada a 1,431 personas entre 60 y 94 años de edad (media = 71.9; DE = 7.9), residentes en sus viviendas en Santiago de Chile. Dos fases de análisis: análisis factorial exploratorio de una lista de posibles formas de afrontamiento, donde se identificaron 3 dimensiones: activo, evasivo y búsqueda de ayuda; y análisis de regresión logística multivariada sobre cada uno de estos 3 tipos de afrontamiento. RESULTADOS: Para los problemas se usó más el afrontamiento activo y la búsqueda de ayuda, frente a los conflictos se utilizó más el evasivo. Con la edad disminuyó la búsqueda de ayuda; a mayor educación más afrontamiento activo y menos evasivo; a mayor autoeficacia mayor afrontamiento activo; a menor disponibilidad de apoyo social mayor evitación. No hubo asociación con género controlando por las otras variables de los modelos. CONCLUSIONES: Se confirma la pertinencia de distinguir estos 3 tipos de afrontamiento, ya que los predictores se comportaron de distinta manera en cada uno de ellos

OBJECTIVE: To describe the strategies of coping with the stressful events that occur when aging and to analyze the variables associated with them, considering the type of stressful event -problem, loss, conflict or problems with others- and individual and social resources. METHOD: Data from a representative survey applied to 1,431 elderly people (60-94 years old; mean age = 71.9; SD = 7.9), residing in their homes in Santiago, Chile. Two phases of analysis: Exploratory factor analysis of a list of possible forms of coping, where three dimensions were identified: active, evasive and seeking help; and multivariate logistic regression analysis on each of these 3 types of coping. RESULTS: Regarding problems, older people used more active coping, including the search of help, whereas in the face of conflict, they were more evasive. With age, the search for help diminished; the higher the education, the more active and less evasive coping; with higher self-efficacy, greater active coping; with less availability of social support, greater avoidance. There was no association with gender when controlling for other variables of the models. CONCLUSION: The relevance of distinguishing these 3 types of coping is confirmed, since predictors behaved differently in each case

Chronic exposure to biomass fuel smoke and markers of endothelial inflammation.

Indoor smoke exposure may affect cardiovascular disease (CVD) risk via lung-mediated inflammation, oxidative stress, and endothelial inflammation. We sought to explore the association between indoor smoke exposure from burning biomass fuels and a selected group of markers for endothelial inflammation. We compared serum concentrations of amyloid A protein, E-selectin, soluble intercellular adhesion molecule 1 (ICAM-1) and VCAM-1, von Willebrand factor (vWF), and high-sensitivity C-reactive protein (hs-CRP) in 228 biomass-exposed vs. 228 non-exposed participants living in Puno, Peru. Average age was 56 years (s.d. = 13), average BMI was 26.5 kg/m(2) (s.d. = 4.4), 48% were male, 59.4% completed high school, and 2% reported a physician diagnosis of CVD. In unadjusted analysis, serum levels of soluble ICAM-1 (330 vs. 302 ng/ml; P < 0.001), soluble VCAM-1 (403 vs. 362 ng/ml; P < 0.001), and E-selectin (54.2 vs. 52.7 ng/ml; P = 0.05) were increased in biomass-exposed vs. non-exposed participants, respectively, whereas serum levels of vWF (1148 vs. 1311 mU/ml; P < 0.001) and hs-CRP (2.56 vs. 3.12 mg/l; P < 0.001) were decreased, respectively. In adjusted analyses, chronic exposure to biomass fuels remained positively associated with serum levels of soluble ICAM-1 (P = 0.03) and VCAM-1 (P = 0.05) and E-selectin (P = 0.05), and remained negatively associated with serum levels of vWF (P = 0.02) and hs-CRP (P < 0.001). Daily exposure to biomass fuel smoke was associated with important differences in specific biomarkers of endothelial inflammation and may help explain accelerated atherosclerosis among those who are chronically exposed.

[Validation of a brief screening test to assess functional capacity in Chilean older people]. / Validación de un test breve para el diagnóstico de capacidad funcional en adultos mayores en Chile.

BACKGROUND: The Pfeffer Functional Activities Questionnaire (PFAQ) is a validated instrument used in Chile to diagnose dependency in older people. AIM: To suggest a shorter and easier version of the PFAQ, with appropriate levels of sensitivity and specificity, which may be applied to the general older population. MATERIAL AND METHODS: Three Chilean surveys applied to older people were used, namely the Survey of Life Events of the Elderly, (n = 1,371) and the 2010 and 2013 National Surveys of Quality of Life of Older People (n = 1,954 and 2,644 respectively). To evaluate the instrument, we performed correlation analysis between items and principal components analysis. We calculated internal consistency using Cronbach alpha, we computed sensitivity and specificity indicators, and analyzed convergent and predictive validity. RESULTS: After constructing different scales, the one that gave more information and had the best balance between sensitivity and specificity was chosen. Items with less weight factor and greater gender bias were eliminated, keeping seven questions from the original PFAQ. Reliability was verified using Cronbach alpha's coefficient and from correlations between the new instrument and key variables. CONCLUSIONS: According to our goals, the proposed scale is solely conformed by items that do not have gender bias. It discriminates in the general population adequately, allowing the design of a shorter test, of easier implementation.

Validación de un test breve para el diagnóstico de capacidad funcional en adultos mayores en Chile / Validation of a brief screening test to assess functional capacity in Chilean older people

Background: The Pfeffer Functional Activities Questionnaire (PFAQ) is a validated instrument used in Chile to diagnose dependency in older people. Aim: To suggest a shorter and easier version of the PFAQ, with appropriate levels of sensitivity and specificity, which may be applied to the general older population. Material and Methods: Three Chilean surveys applied to older people were used, namely the Survey of Life Events of the Elderly, (n = 1,371) and the 2010 and 2013 National Surveys of Quality of Life of Older People (n = 1,954 and 2,644 respectively). To evaluate the instrument, we performed correlation analysis between items and principal components analysis. We calculated internal consistency using Cronbach alpha, we computed sensitivity and specificity indicators, and analyzed convergent and predictive validity. Results: After constructing different scales, the one that gave more information and had the best balance between sensitivity and specificity was chosen. Items with less weight factor and greater gender bias were eliminated, keeping seven questions from the original PFAQ. Reliability was verified using Cronbach alpha s coefficient and from correlations between the new instrument and key variables. Conclusions: According to our goals, the proposed scale is solely conformed by items that do not have gender bias. It discriminates in the general population adequately, allowing the design of a shorter test, of easier implementation.

[Giardia lamblia: comparison of two diagnostic methods and evaluation of response to treatment with metronidazole]. / Giardia lamblia: comparación de dos métodos de diagnóstico y evaluación de la respuesta al tratamiento con metronidazol.

During the period from March through November 1989, 70 children who were attended at the Pediatric Department at Central Hospital in Valencia, were enrolled in the study, it was thought that Giardia lamblia infection might be present. Giardia L. were identified using two different diagnostic procedures: from stool samples and duodenal aspirates for cysts or trophozoites examination. These children were treated with Metronidazole three dosage of 15, 30 and 50 mg/kg per day for a ten day period. Our study showed predominant giardiasis in children with ages ranging from 2 to 6 years old (60%) with a relationship between female and male sex 1.05:1. In this series, 72.8% of patients presented normal nutrition, and 55.7% of them were from the suburban area. The most frequent symptoms were abdominal pain, diarrhea, vomiting, abdominal distention, constipation and flatulence. The infants prevalent symptom was diarrhea (83.3%) and the older children and school children prevalent symptom was abdominal pain with 78.5 and 100% respectively. In this study, stool examination was positive in 97.1% of the children and duodenal aspirate was positive in all 70 children (100%); the first procedure showed predominant Giardia cysts (88.2%) and the second one showed predominant trophozoites (47.1%). All 70 patients (100%) were cured with Metronidazole to different dosage. Side effects were seen with only the maxim dose, such as nausea 40%, headache 10% and appearance of yeast into 50% of duodenal aspirate.