Compassion in health professionals: Development and validation of the Capacity for Compassion Scale.

BACKGROUND: Health professionals witness pain and suffering when they care for sick people and their families. Compassion is a necessary quality in their work as it combines the will to help, alleviate suffering and promote the well-being of both the people they are attending and the professionals themselves. The aim of the study was to design and evaluate the psychometric properties of the Capacity for Compassion Scale (CCS). DESIGN: A quantitative, descriptive and cross-sectional study was carried out to evaluate the psychometric properties of the scale (reliability, temporal stability, content validity, criterion validity and construct validity). METHODS: The study was carried out in two phases: pilot study and final validation. The data were collected between April and May 2022. The sample was selected by convenience sampling and was made up of a total of 264 participants, 59 in the pilot phase and 205 in the final validation. RESULTS: The Capacity for Compassion Scale has been shown to have good psychometric properties in relation to reliability, temporal stability, and content, criterion, and construct validity. Factor analysis showed that there were four subdimensions of the scale: motivation/commitment, presence, shared humanity and self-compassion. The results also indicate that compassionate ability is significantly correlated with age and work experience. CONCLUSIONS: The Capacity for Compassion Scale shows adequate psychometric properties. This instrument measures the compassion capacity of health professionals, which is a valuable discovery for new lines of research in this field. IMPACT: Through this scale, low levels of capacity for compassion can be detected that negatively influence the quality of care provided by health professionals. The Capacity for Compassion Scale can therefore contribute to the identification of needs and promote training around compassion for health professionals. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution. WHAT PROBLEM DID THE STUDY ADDRESS?: Compassion in health professionals has positive effects on improving the quality of care, the satisfaction of professionals and the work environment. There are compassion cultivation programmes whose validity has been proven for the development of the dimensions of compassion. There is no specific instrument that measures capacity for compassion in healthcare professionals. WHAT WERE THE MAIN FINDINGS?: A scale is designed to measure capacity for compassion in health professionals. This is the only such scale available up until now. The scale measures four dimensions of compassion: motivation/commitment, presence, shared humanity and self-compassion. WHERE AND ON WHOM WILL THE RESEARCH HAVE AN IMPACT?: The development of specific programmes that can increase the compassion of health professionals with all the benefits that this can bring to health care is encouraged. It will be possible to analyse the effects of training programmes on the cultivation of compassion.

Bibliometric Analysis of the Scientific Production on Compassion Fatigue.

BACKGROUND: Compassion fatigue is a common phenomenon among healthcare professionals and includes several concepts that share a direct relationship with quality of life, with consequences on both physical and emotional well-being but also at the economic and organizational levels. OBJECTIVES: To analyze the profile of scientific publications on compassion fatigue, dissecting trends, and highlighting research opportunities. METHOD: Bibliometric analysis based on Donthu's guidelines, data collection from Web of Science (Clarivate Analytics), and analytic techniques (performance analysis and science mapping) with VOSviewer® and CiteSpace®. RESULTS: We obtained 1364 articles and found that the concept emerged in 1995 and is frequently associated with areas of general health. Through analysis, we identified the following research frontiers: "vicarious traumatization", "working", "survivor", "mental health", and "impact". CONCLUSION: There has been a growing interest in this subject among researchers, with an increase in scientific production related to areas of health such as nursing, providing a solid starting point for further investigation. Registration number from the Open Science Framework: osf.io/b3du8.

The impact of manual patient handling on work ability: A cross-sectional study in a Brazilian hospital.

AIM: To investigate the level of self-reported work ability and its association with manual patient handling in healthcare workers. DESIGN: Cross-sectional study adhering to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. METHODS: A total of 320 healthcare workers answered a self-administered questionnaire regarding manual patient handling, work ability, occupational factors, occurrence of low back pain and sociodemographic and lifestyle factors from November 2016 to March 2017. The association between manual patient handling and low back pain was analysed with Poisson regression models. RESULTS: The prevalence ratio of inadequate work ability was 43.42%. Manual patient handling (PR 1.375, 95% CI 1.038-1.821), bachelor education (PR 2.150, 95% CI 1.272-3.632), less than bachelor education (PR 2.166, 95% CI 1.218-3.855), seniority (PR 1.049, 95% CI 1.024-1.086), poor sleep quality (PR 1.425, 95% CI 1.13-1.796) and presence of low back pain (PR 2.003, 95% CI 1.314-3.052) were all positively associated with an inadequate work ability.

Influence of Palliative Care Training on Nurses' Attitudes towards End-of-Life Care during the COVID-19 Pandemic in Spain.

AIM: This study aims to assess the influence of training on nurses' attitudes toward end-of-life care during the COVID-19 pandemic alarm state in Spain. DESIGN: Cross-sectional descriptive study. Data collection was carried out by means of an ad hoc questionnaire using Google Forms in April and May 2020. The score of attitudes toward end-of-life care was used, to which sociodemographic variables and training in palliative care were added. METHODS: Data were collected from 238 nursing professionals who had cared for COVID-19 and non-COVID-19 adult patients at the end-of-life stage in a hospital or nursing home. RESULTS: Results showed that 51% of the nurses in the sample had training in palliative care. However, the percentage decreased to 38.5% among those who cared for COVID-19 patients and to 44.5% in those who cared for non-COVID-19 patients. In relation to attitudes about end-of-life care, more positive attitudes and a higher mean score were found in the trained group. CONCLUSIONS: Palliative care training is a key element in end-of-life care and is even more important in times of COVID-19. IMPACT: Although end-of-life accompaniment has been studied, few studies have included the influence of training on this during the pandemic. This study identifies key elements of accompaniment and training in a comparison of COVID-19 and non-COVID-19 patients during the pandemic. In relation to attitudes toward end-of-life care, the results showed a more positive attitude and a higher mean score in the trained group (3.43 ± 0.37 versus 3.21 ± 0.32), the difference being statistically significant (p < 0.001).

Fear-Avoidance Behavior and Sickness Absence in Patients with Work-Related Musculoskeletal Disorders.

(1) Background and objectives: The purpose of this work is to determine the association of fear-avoidance attitudes with sickness absence status, its duration and disability in a work accident context. (2) Materials and Methods: This is a descriptive observational design, conducting the study in two occupational insurance provider clinics with patients with nonspecific low back and neck pain during the study period. Clinical variables were the Fear Avoidance Questionnaire, Roland Morris Disability Questionnaire, Neck Disability Index, Numerical Pain Scale; sociodemographic variables were sex, age, occupational, educational level, sickness absence status, and duration in days of absence from work. Multiple logistic and linear regressions were used to explore the association between variables. (3) Results: Fear-avoidance behavior is related to sickness absence status (OR = 1.048, p = 0.007), and the physical activity dimension (OR = 1.098, p = 0.013) is more relevant than the work dimension (OR = 1.056, p = 0.028). The duration of sickness absence is related to higher values on the fear-avoidance behavior scale in its global dimension (b = 0.84, p = 0.003, r = 0.327), and the results of the physical activity dimension (B = 1.37, p = 0.035, r = 0.236) were more relevant than the work dimension (B = 1.21, p = 0.003, r = 0.324). Fear-avoidance behavior is related to disability in both dimensions (B = 0.912, p ˂ 0.001, r = 0.505). (4) Conclusions: Fear-avoidance behaviors may influence the typification of sickness absence status, its duration both in its physical activity and work dimension, and its disability reported with higher values than in other healthcare contexts.

Combined determination of B-type natriuretic peptide and high-sensitivity troponin I in the postmortem diagnosis of cardiac disease.

Cardiac disease is the most common cause of sudden death in Western countries. It is known that high-sensitivity troponin I (hs-cTnI), widely used for detection of myocardial injury, is a sensitive biochemical marker. B-type natriuretic peptide (BNP) is a reliable tool for diagnosing heart failure, and for establishing prognosis or disease severity. We aimed to evaluate the diagnostic efficacy of the postmortem determination of BNP in serum alone or in addition to other biomarkers, such as hs-cTnI and MB isoenzyme of creatine kinase (CK-MB), to ascertain whether its determination improves the post-mortem diagnosis of heart failure-associated causes of death. This study involved 133 cadavers with a mean age of 58.2 (± 17.6) years and a mean postmortem interval of 12.8 (±6.6) h. Cases were assigned into two diagnostic groups, according to the cause of death: cardiac deaths (N = 62) and control (N = 71). In the cardiac group, two categories were established according to morphological features of the heart: 'ischemic deaths' (N = 39), and 'congestive heart' (n = 23). Both hs-cTnI and BNP were useful in diagnosing cardiac deaths, whereas CK-MB did not have any diagnostic relevance. hs-cTnI is higher in cases which acute ischemia as the principal pathology, while the presence of high BNP values is significantly related with chronic cardiac situations with significant ventricular overload. Our findings show that postmortem determination of hs-cTnI and BNP provides valuable information; hs-cTnI is useful for diagnosis of cardiac deaths, mainly with ischemic implications, and BNP gave better results for the diagnosis of congestive heart failure.

Cuidado transcultural y estrategias familiares ante la dependencia: el fenómeno de los cuidadores extranjeros / Transcultural Care and Family Strategies to Deal with Dependency: The Phenomenon of Foreign Caregivers / Cuidado transcultural e estratégias familiares ante a dependência: o fenômeno dos cuidadores estrangeiros

Introducción: cuando un cuidador procede de un país diferente al de la persona cuidada se presenta una contraposición de culturas y prácticas sociales. El concepto de cuidado transcultural de Leininger hace eco de la diversidad cultural que supone esta contraposición y recomienda incorporarla en la práctica profesional, desarrollando cuidados que ella define como culturalmente competentes. Objetivo: conocer qué tipo de estrategias desarrollan los cuidadores extranjeros a la hora de cuidar personas de diferente origen y cómo estas se integran en el contexto social, cultural e institucional de la sociedad receptora. Materiales y métodos: método cualitativo, a través de entrevistas en profundidad a cuidadoras inmigrantes en la provincia de Huelva, así como a personal especializado en los cuidados de pacientes en situación de dependencia. Resultados: descripción de prácticas socioculturales que los cuidadores elaboran según su cultura y cómo intervienen en el ejercicio de los cuidados en la sociedad receptora. Conclusiones: los cuidadores extranjeros desarrollan en ocasiones estrategias afines a sus propias creencias priorizándolas sobre las de la persona cuidada o las de la sociedad receptora, lo que genera choques culturales. Se sugiere que los profesionales de enfermería deben identificarlas para poder intervenir, utilizando la formación y competencia cultural como herramientas para el cambio.

Introduction: When a caregiver comes from a country other than that of the person being cared for there is a clash of cultures and social practices. Leininger's concept of transcultural care echoes the cultural diversity this contrast or opposition involves and recommends incorporating it into professional practice by developing what she defines as culturally competent care. Purpose: The purpose of this study was to know what type of strategies foreign caregivers develop when caring for people of different origin and how these strategies are integrated into the social, cultural and institutional context of the recipient society. Study Materials and Methods: A qualitative approach was used, based on in-depth interviews with immigrant caregivers in the province of Huelva and with personnel specialized in dependent patient care. Results: The study provides a description of the socio-cultural practices caregivers develop, according to their culture, and how those practices intervene in the exercise of care in the recipient society. Conclusions: Foreign caregivers sometimes develop strategies akin to their own beliefs, giving them priority over those of the care recipient or the recipient society. This can cause cultural clashes. Nursing professionals must identify these clashes so as to be able to intervene, using training and cultural competency as tools for change.

Introdução: quando um cuidador vem de um país diferente ao da pessoa cuidada, apresenta-se uma contraposição de culturas e práticas sociais. O conceito de cuidado transcultural de Leininger reitera a diversidade cultural que essa contraposição supõe e recomenda incorporá-la na prática profissional desenvolvendo cuidados que ela define como culturalmente competentes. Objetivo: conhecer que tipo de estratégias desenvolvem os cuidadores estrangeiros na hora de cuidar de pessoas de diferente origem e como estas se integram no contexto social, cultural e institucional da sociedade receptora. Materiais e métodos: método qualitativo, por meio de entrevistas em profundidade a cuidadores imigrantes em Huelva (Espanha), assim como a pessoal especializado nos cuidados de pacientes em situação de dependência. Resultados: descrição de práticas socioculturais que os cuidadores elaboram segundo sua cultura e como intervêm no exercício dos cuidados na sociedade receptora. Conclusões: os cuidadores estrangeiros desenvolvem em ocasiões estratégias afins a suas próprias crenças e priorizam-nas sobre as da pessoa cuidada ou as da sociedade receptora, o que gera choques culturais. Sugere-se que os profissionais de enfermagem as identifiquem para poder intervir utilizando a formação e competência cultural como ferramentas para a mudança.

Actividades de la vida diaria y bienestar y su relación con la edad y el género en la vejez / Everyday life activities and well-being: Their relationships with age and gender in the elderly

El estudio que se presenta analiza las relaciones entre actividades de la vida diaria y bienestar con la edad y el género en personas mayo-res. El diseño de investigación fue una encuesta transversal a una muestra de 566 sujetos residentes en la provincia de Valencia (España). Los participantes contestaron a distintas secciones incluyendo ítems sociodemográficos, una medida de actividades de la vida diaria (Índice de Barthel) y las Escalas de Bienestar de Ryff. Los resultados principales con respecto a las actividades de la vida diaria fueron: a) relaciones positivas y sistemáticas con las dimensiones de bienestar; b) relaciones negativas con la edad; c) una media en el Índice de Barthel más alta para los hombres. Por lo que respecta a las dimensiones de bienestar de Ryff, los resultados también mostraron relaciones negativas de la edad con todas las dimensiones, que fueron de mayor cuantía para las dimensiones propias del bienestar psicológico frente al subjetivo. Se observaron también diferencias de género significativas en autonomía, crecimiento personal y autoaceptación: los hombres puntuaron más alto (AU)

Present study deals with the relationships among everyday life activities and well being with age and gender in the elderly. Research design was a cross-sectional survey of a sample of 566 elderly living in the Province of Valencia (Spain). These participants were surveyed on several dimensions, including sociodemographic information, everyday life activities (Barthel’s index) and Ryff’s Scales of Well-being. Main results with respect to everyday life activities were: a) positive relationships between well-being dimensions and Barthel’ index; b) negative relationships between age and Barthel’s index; and finally, c) higher Barthel’s index for men than for women. With respect to Ryff’s dimensions of well being, results also showed negative relationships of age with all dimensions, but these negative relations were larger for psychological dimensions than for subjective dimensions. There were also statistically significant gender differences in autonomy, personal growth and self-acceptance: men scored higher on the aforementioned well-being dimensions (AU)

El componente cultural de la muerte: acompañando a Fabala Dambele / The cultural component of death: accompanying Fabala Dambele

Las personas provenientes de diferentes culturas en el tramo final de sus vidas experimentan el fenómeno de la diferencia, ya que su forma de entender la muerte no se corresponde con la de la cultura occidental. La muerte no es gestionada desde la diversidad, y está sometida a las costumbres sociales dominantes. La investigación plantea la necesidad de respetar estas diferentes actitudes frente a la muerte, y así conseguir una competencia cultural en el ámbito de los cuidados paliativos. Los objetivos del presente trabajo son analizar, a partir de un caso, los problemas específicos que encontramos al trabajar con población inmigrante con enfermedad avanzada y/o terminal. Para ello, utilizaremos una metodología cualitativa, empleando como instrumento de recogida de datos la entrevista en profundidad, técnica cualitativa que nos permite llegar al emic del sujeto entrevistado gracias a su discurso. El análisis se realizará siguiendo el modelo de Taylor-Bodgan. El sobreesfuerzo que esto supone nos lleva a un enriquecimiento en un mundo en el que cada vez confluyen más formas diferentes de enfocar la situación terminal (AU)

People from different cultures suffer the phenomenon of difference at the end of their lives, because their understanding of death is not consistent with Western culture. Death is not managed through diversity, and is subject to the prevailing social customs. This study raises the need to respect these different attitudes towards death, achieving cultural experience in the field of palliative care. The objectives of this study are to analyse, using a case, the specific problems encountered in working with an immigrant population with advanced and/or terminal disease. Qualitative methodology was used, with data being collected by in-depth interview, a qualitative technique that allows us to emic of the subjects interviewed through their discourse. The analysis was performed following the model of Taylor-Bogdan. The extra effort that this entails leads to an enrichment in a world in which the increasing diversities merge to approach the end-of-life situation (AU)

Grandparent-grandchild relationships from the children’s perspective: shared activities and socialization styles

The objective of this study is to describe the relationships between grandchildren and their favourite grandparents, by studying the socialization styles used by latter and the shared activities undertaken. The participants were 360 children between 10 and 12 years old, who completed the grandparent-grandchild relationship questionnaire of Rico, Serra and Viguer (2001) and the socialization questionnaire of Rey and Ruiz (1990). The results demonstrate the importance of gender and family line in the selection of the favourite grandparent, differences being shown in the types of shared activities and in socialization styles. It is concluded that in the majority of cases the profile of the favourite grandparent is the maternal grandmother, retired or a house wife, aged between 60-70, who lives in the same city as his/her grandchild, and who has contact with them several times a week. Furthermore, favourite grandparents get more involved with granddaughters than with grandsons, both in support and care activities and in cultural-recreational activities, and they primarily employ a democratic style. However, there are differences depending on the gender of the grandchild, with democratic principles being used more with girls and authoritarian ones with boys (AU)

Este trabajo tiene como objetivo describir las relaciones entre los nietos y sus abuelos favoritos, a través del estudio de los estilos de socialización utilizados por los abuelos y de las actividades compartidas por ambos. Los participantes, 360 niños/as de 10-12 años, cumplimentaron el cuestionario sobre relaciones abuelos-nietos de Rico, Serra y Viguer (2001) y el cuestionario de estilos de socialización de Rey y Ruiz (1990). Los resultados mostraron la importancia del género y la línea familiar en la selección del abuelo favorito, observándose diferencias en los tipos de actividad compartida y en los estilos de socialización. Se concluyó que el perfil del abuelo/a favorito es mayoritariamente el de abuela materna, jubilada o ama de casa, de entre 60-70 años, que vive en la misma ciudad que su nieto/a, y mantiene contacto con él/ella varias veces a la semana. Además, los abuelos/as favoritos se implican más con las nietas que con los nietos tanto en actividades de ayuda y cuidado como en las lúdico-culturales y utilizan básicamente el estilo democrático. No obstante, se obtienen diferencias según el género del nieto, empleando en mayor medida principios democráticos con las niñas y autoritarios con los niños (AU)

Grandparent-grandchild relationships from the children's perspective: shared activities and socialization styles.

The objective of this study is to describe the relationships between grandchildren and their favourite grandparents, by studying the socialization styles used by latter and the shared activities undertaken. The participants were 360 children between 10 and 12 years old, who completed the grandparent-grandchild relationship questionnaire of Rico, Serra and Viguer (2001) and the socialization questionnaire of Rey and Ruiz (1990). The results demonstrate the importance of gender and family line in the selection of the favourite grandparent, differences being shown in the types of shared activities and in socialization styles. It is concluded that in the majority of cases the profile of the favourite grandparent is the maternal grandmother, retired or a house wife, aged between 60-70, who lives in the same city as his/her grandchild, and who has contact with them several times a week. Furthermore, favourite grandparents get more involved with granddaughters than with grandsons, both in support and care activities and in cultural-recreational activities, and they primarily employ a democratic style. However, there are differences depending on the gender of the grandchild, with democratic principles being used more with girls and authoritarian ones with boys.

Comparison between Spanish young and elderly people evaluated using Rivermead Behavioural Memory Test.

The first objective of this work was to compare scores obtained in the daily memory function between young and elderly people, and to check whether there are differences between the groups for each of the profile scores obtained in the memory test. A second aim of this paper is to study the relationship between everyday memory and age, while controlling for gender and educational level. The total and profile scores obtained in the Rivermead Behavioural Memory Test were compared in a sample of 60 young and 120 elderly people from Valencia (Spain). Results showed significant differences between the two groups: those between 18 and 30 years obtained a higher average than those over 65. Once the group comparison was controlled for gender and educational level, the statistical effect of age group disappeared. The non-significant effect of group can not be explained by the introduction of gender, because both its main effect and the interaction were not statistically significant. However, educational level had a statistically significant effect which may explain the non-significant effect of group in this new analysis. The main conclusion is the need to carefully control for educational level in all studies related with everyday memory and ageing, as the differences found could be due to generational differences more than to biological deterioration.

Efectos de método en las escalas de Ryff: Un estudio en población de personas mayores / Method effects in Ryff’s scales: a study in an elderly population

A pesar de su amplio uso, las escalas de Ryff han presentado problemas de validez factorial y en recientes investigaciones han mostrado efectos de método que, sin embargo, no han sido exhaustivamente investigados en la literatura, especialmente en poblaciones especiales, como la de mayores, estudiada en este trabajo. El objetivo de este trabajo es doble: estudiar la estructura factorial de la escala de Ryff en sus distintas versiones; y evaluar la presencia de efectos de método asociados a los ítems formulados en negativo. Para ello se usa una muestra de 556 personas mayores de 65 años no institucionalizadas de la Comunidad Valenciana. Se han probado de forma exhaustiva todos los modelos factoriales confirmatorios encontrados en la literatura para la escala, mediante análisis factorial confirmatorio estimado por máxima verosimilitud con correcciones robustas, y el de mejor ajuste fue el de seis factores original de los autores de la escala. Respecto a los factores de método, los resultados muestran un efecto consistente en todas las versiones del factor asociado a ítems negativos, que al ser contemplado en el modelo, ofrece una mejora del ajuste(AU)

Although widely used, Ryff’s scales have had some problems of factorial validity and recent investigations have also shown method effects. However, these method effects have not been deeply investigated in special populations such as the elderly, the population under study in this paper. The aim of this research is twofold: to study the factorial structure of Ryff’s scale in its different versions; and to evaluate the presence of method effects associated to negatively worded items. In order to accomplish these aims, a sample of 556 Valencian elderly people living in their homes has been surveyed. All confirmatory models used in the literature to test for factorial validity have been tested. Maximum likelihood with robust corrections has been used to estimate the models. Best fitting model posited a six factor structure, as originally proposed by the author. With respect to method bias, results shown a consistent and non-trivial method factor effect associated to negatively worded items(AU)

Modelo de ecuaciones estructurales para predecir el bienestar y la dependencia funcional en adultos mayores de la República Dominicana / Structural equation model for predicting well-being and functional dependency of the elderly in the Dominican Republic

OBJETIVO: Generar un modelo estructural multifactorial que explique la dependencia funcional y el bienestar a partir de algunas características sociodemográficas asociadas con esos dominios, en adultos mayores de la República Dominicana. MÉTODOS: Estudio transversal mediante encuesta en una muestra de 1397 personas de 65 años o más representativa de la población de adultos mayores de la República Dominicana. Se recabó información sociodemográfica de los entrevistados (sexo, edad, nivel de estudios, si realizaba alguna actividad remunerada y nivel de ingresos) y los datos necesarios para calcular el índice de Barthel y las respuestas a las preguntas de las escalas del bienestar psicológico de Ryff. Para identificar las relaciones entre las variables de interés se probaron tres modelos de ecuaciones estructurales. RESULTADOS: El modelo estructural de ajuste más satisfactorio relacionó las características sociodemográficas con la capacidad para realizar las actividades básicas de la vida diaria (ABVD) y las dimensiones del bienestar psicológico de las escalas de Ryff sin proponer factores latentes. La capacidad predictiva del modelo para las variables endógenas fue débil. La edad se relacionó negativamente con algunas dimensiones del bienestar y con la capacidad para realizar las ABVD; el sexo se relacionó con la dimensión de relaciones positivas con otros; y el nivel de estudios influyó positivamente sobre el dominio del ambiente, el crecimiento personal y el propósito en la vida, así como en la capacidad para realizar las ABVD. CONCLUSIONES: Los modelos validados brindan información necesaria para desarrollar políticas orientadas a dos niveles de acción complementarios: la promoción de la autonomía de los adultos mayores y el aumento de la cobertura de los sistemas de enseñanza formal. Estos resultados respaldan la conveniencia de aumentar las inversiones en políticas sociales.

OBJECTIVE: To produce a multivariate structural model that explains functional dependence and well-being in terms of certain related sociodemographic factors among elderly adults in the Dominican Republic. METHODS: A cross-sectional study that surveyed a sample of 1397 individuals 65 or more years of age, representing the Dominican Republic's elderly population. Those surveyed were asked for sociodemographic information (sex, age, level of education, employment status, and income level), data needed to determine their Barthel Index, and responses to questions from Ryff's Scale of Psychological Well-being. Three structural equation models were used to identify relationships among the key variables. RESULTS: The most fitting structural adjustment model linked sociodemographics to the ability to perform basic activities of daily living (BADL) and the Ryff's Scale of Psychological Well-being, without suggesting latent factors. With regard to endogenous variables, the model's predictive power was weak. Age was negatively associated with some areas of well-being and with the ability to perform BADL; sex was related to the area of positive relationships with others; and educational level positively influenced environment, personal growth, and having a sense of purpose, as well as the ability to perform BADL. CONCLUSIONS: The proven models provide information necessary for developing policies aimed at two levels of coordinated action: promoting autonomy among elderly adults and expanding enrollment in formal education programs. These results support efforts to increase investment in social policies.

Psychological and physical dimensions explaining life satisfaction among the elderly: a structural model examination.

The aim of the present paper is to analyze the effects of psychological well-being, physical functioning and socio-demographic factors on life satisfaction. Both a bivariate and a multivariate level of analyses have been used. Finally, a structural model explaining life satisfaction has been developed and validated. With respect to bivariate relations, there was evidence of significant positive relations between psychological well-being dimensions and life satisfaction and between physical conditions and life satisfaction as well. Also, as age increased there was a slow decrease in life satisfaction. Educational level was positively related to life satisfaction. A structural model gave valuable information about the pattern of multivariate relationships among the variables. A first result of the model was the large effect of physical and psychological well-being on life satisfaction, albeit it was psychological well-being the major predictor of life satisfaction. A second result was that the effects of socio-demographic variables on life satisfaction were low and they operated through the effects that maintain either on psychological well-being (or its individual indicators) or on physical conditions. The role gender or age played was indirect rather than direct.

[Structural equation model for predicting well-being and functional dependency of the elderly in the Dominican Republic]. / Modelo de ecuaciones estructurales para predecir el bienestar y la dependencia funcional en adultos mayores de la República Dominicana.

OBJECTIVE: To produce a multivariate structural model that explains functional dependence and well-being in terms of certain related sociodemographic factors among elderly adults in the Dominican Republic. METHODS: A cross-sectional study that surveyed a sample of 1,397 individuals 65 or more years of age, representing the Dominican Republic's elderly population. Those surveyed were asked for sociodemographic information (sex, age, level of education, employment status, and income level), data needed to determine their Barthel Index, and responses to questions from Ryff's Scale of Psychological Well-being. Three structural equation models were used to identify relationships among the key variables. RESULTS: The most fitting structural adjustment model linked sociodemographics to the ability to perform basic activities of daily living (BADL) and the Ryff's Scale of Psychological Well-being, without suggesting latent factors. With regard to endogenous variables, the model's predictive power was weak. Age was negatively associated with some areas of well-being and with the ability to perform BADL; sex was related to the area of positive relationships with others; and educational level positively influenced environment, personal growth, and having a sense of purpose, as well as the ability to perform BADL. CONCLUSIONS: The proven models provide information necessary for developing policies aimed at two levels of coordinated action: promoting autonomy among elderly adults and expanding enrollment in formal education programs. These results support efforts to increase investment in social policies.

Use of letrozole in assisted reproduction: a systematic review and meta-analysis.

BACKGROUND: Letrozole is the third-generation aromatase inhibitor (AI) most widely used in assisted reproduction. AIs induce ovulation by inhibiting estrogen production; the consequent hypoestrogenic state increases GnRH release and pituitary follicle-stimulating hormone (FSH) synthesis. METHODS: A systematic search of the literature was performed for both prospective and retrospective studies. Meta-analyses of randomized clinical trials (RCTs) were performed for three comparisons: letrozole versus clomiphene citrate (CC), letrozole + FSH versus FSH in intrauterine insemination (IUI) and letrozole + FSH versus FSH in IVF. In the absence of RCTs, non-randomized studies were pooled. RESULTS: Nine studies were included in the meta-analysis. Four RCTs compared the overall effect of letrozole with CC in patients with polycystic ovary syndrome. The pooled result was not significant for ovulatory cycles (OR = 1.17; 95% CI 0.66-2.09), or for pregnancy rate per cycle (OR = 1.47; 95% CI 0.73-2.96) or for pregnancy rate per patient (OR = 1.37; 95% CI 0.70-2.71). In three retrospective studies which compared L + FSH with FSH in ovarian stimulation for IUI, the pooled OR was 1.15 (95% CI 0.78-1.71). A final meta-analysis included one RCT and one cohort study that compared letrozole + gonadotrophin versus gonadotrophin alone: the pooled pregnancy rate per patient was not significantly different (OR = 1.40; 95% CI 0.67-2.91). CONCLUSIONS: Letrozole is as effective as other methods of ovulation induction. Further randomized-controlled studies are warranted to define more clearly the efficacy and safety of letrozole in human reproduction.

Criminalystic: effectiveness of lysochromes on the developing of invisible lipstick-contaminated lipmarks on human skin. A preliminary study.

Latent prints are an important evidence for identification. Nowadays, the technical means, the implementation of image processing techniques and the use of database makes it possible to detect and get information from some prints that seem to be useless at first sight. On the other hand, the possibility of using the print as a DNA source has to be considered, so as to double its identifying value. Human skin is a particularly difficult surface for developing this kind of evidences. Although different methods for locating and developing latent fingerprints on the skin have been already described, it has not been found any method, at the revised bibliography, to obtain and develop invisible lipmarks, that is, lipmarks from protective lipstick, or permanent or long-lasting lipstick. The aim of the work that follows is to determine the effectiveness of several reagents for developing invisible lipmarks on the corpses' skin. Preliminary results show that, under the described experimental conditions, the reagents used, Sudan III, Oil Red O and Sudan Black, are effective for obtaining recent latent lip prints on corpse's skin.

Home-based self-measurement of blood pressure: a proposal using new reference values (the PURAS study).

OBJECTIVES: To establish reference values for blood pressure by means of self-measurement of blood pressure (BP) conducted at home. DESIGN: Descriptive study of the distribution of self-measured BP at home and its correspondence with clinic-based measurements of BP. METHODS: The aim of this study is to define the home BP levels that correspond to clinic BP thresholds 140/90 mmHg (hypertension) and 130/85 mmHg (normality). The sample consisting of 1411 randomly selected adults stratified by age and gender. A pre-calibrated electronic device (Omron 705CP) was used for BP and heart rate (HR) measurements and a trained nurse performed clinic-based sphygmomanometer measurements. The same nurse provided tutorials for the subjects on how to obtain 12 self-measured BP values at home using the Omron device in a single day. RESULTS: Of the 1184 volunteers that attended the appointment, 195 were known as hypertensives and were excluded from the study. The average age of the remaining 989 subjects (50.4% females) was 44.3 years. Clinic BP values were significantly higher than self-measured BP at home regardless of age and gender. Both had good correlations (systolic BP, r=0.84 and diastolic BP, r=0.77). Using linear regression, the self-measured BP at home hypertension threshold would be 131/82 mmHg and the limit of normality 123/78 mmHg. Using corresponding percentiles, these values would be 134/85 and 124/80 mmHg, respectively. CONCLUSIONS: The self-measured BP at home values found in this study, when defining hypertension, are lower than values currently accepted (135/85 mmHg). Long-term studies are necessary to confirm these results.