Pharmacogenetics May Prevent Psychotropic Adverse Events in Autism Spectrum Disorder: An Observational Pilot Study.

INTRODUCTION: Up to 73% of individuals with autism spectrum disorder (ASD) and intellectual disability (ID) currently have prescriptions for psychotropic drugs. This is explained by a higher prevalence of medical and psychiatric chronic comorbidities, which favors polypharmacy, increasing the probability of the appearance of adverse events (AEs). These could be a preventable cause of harm to patients with ASD and an unnecessary waste of healthcare resources. OBJECTIVE: To study the impact of pharmacogenetic markers on the prevention of AE appearance in a population with ASD and ID. METHODS: This is a cross-sectional, observational study (n = 118, 72 participants completed all information) in the ASD population. Sociodemographic and pharmacological data were gathered. The Udvalg for Kliniske Undersøgelser Scale (UKU Scale) was used to identify AEs related to the use of psychotropic medication. Polymorphisms of DOP2, ABCB1, and COMT were genotyped and correlated with the AE to find candidate genes. Furthermore, a review of all medications assessed in a clinical trial for adults with autism was performed to enrich the search for potential pharmacogenetic markers, keeping in mind the usual medications. RESULTS: The majority of the study population were men (75%) with multiple comorbidities and polypharmacy, the most frequently prescribed drugs were antipsychotics (69%); 21% of the participants had four or more AEs related to psychotropic drugs. The most common were "Neurological" and" Psychiatric" (both 41%). Statistical analysis results suggested a significant correlation between the neurological symptoms and the DOP2 genotype, given that they are not equally distributed among its allelic variants. The final review considered 19 manuscripts of medications for adults with ASD, and the confirmed genetic markers for those medications were consulted in databases. CONCLUSION: A possible correlation between neurologic AEs and polymorphisms of DOP2 was observed; therefore, studying this gene could contribute to the safety of this population's prescriptions. The following studies are underway to maximize statistical power and have a better representation of the population.

Barriers and Facilitators of Communication in the Medication Reconciliation Process during Hospital Discharge: Primary Healthcare Professionals' Perspectives.

The WHO established that medication errors are the most common and preventable errors and represent an expenditure of 42 billion U.S. dollars annually. The risk of medication errors increases in transitions between levels of care, mainly from hospital care to primary healthcare after hospital discharge. In this context, communication is a key element in the safety of the medication reconciliation process. The aim of this paper was to describe the barriers to, and facilitators of, effective communication during the medication reconciliation process at hospital discharge in people over 65 years of age, from the perspective of primary healthcare professionals. A qualitative descriptive study was designed, and in-depth interviews were conducted with 21 individuals, of whom 13 were nurses and 8 were physicians. This study was carried out with healthcare professionals belonging to primary healthcare centres in Huelva (Spain). Following content analysis of the discourses we identified 19 categories, grouped into three areas: interlevel communication, communication between primary healthcare professionals, and communication between healthcare professionals and patients/caregivers. The barriers found mainly relate to the adequacy and use of technological tools, time available, workload and the level of collaboration of patients/caregivers. Facilitating elements for communication in medication reconciliation included technologies, such as computerized medical history, protocolization of clinical sessions, the presence of case management nurse and interdisciplinary teamwork.

Effect of Pesticide Exposure over DNA Damage in Farmers from Los Reyes, Michoacan in Mexico.

In the municipality of Los Reyes, Michoacán, in Mexico, several economic activities coexist; however, the most relevant is agriculture. It stands out as an agro-industrial center and commercial enclave in the region, suitable for the cultivation of sugar cane; however, currently fruit growing takes first place with blackberry, raspberry and blueberry, followed by avocado, peach, strawberry and other crops. A large quantity and variety of pesticides are applied to crops, consequently the population is at constant risk. This study aimed to evaluate whether pesticides are a factor in genetic damage to agricultural workers from Los Reyes, Michoacán, using alkaline comet assay. Fifty-nine residents participated (41 workers and 18 controls). Results included confounding factors (alcohol consumption, smoking habit, gender, age, BMI, etc.) indicated a non-significant statistical difference between two groups, with higher DNA damage values in workers that was higher than the values expected in a normal healthy unexposed population. It seems that the control measures, safe handling of pesticides and quality standards, required by the producers so that their products can be exported, have resulted in less damage, despite workers' activity, but higher damage than the reference values still requires regular surveillance of those exposed. The use of protective equipment or measures can reduce the risk of damage, so it is also necessary to promote their service and comply with labor regulations for agricultural workers.

Influence of the COVID-19 Pandemic on Medication Reconciliation in Frail Elderly People at Hospital Discharge: Perception of Healthcare Professionals.

The current demographic panorama in Spain corresponds to an aging population; this situation is characterized by the need to care for an elderly population, which contains polymedicated and pluripathological individuals. Polymedication is a criterion of frailty in the elderly and a risk factor for mortality and morbidity due to the increased risk of drug interactions and medication errors. There are numerous studies that measure reconciliation at hospital discharge and at admission, and even the methodology of reconciliation, but we have not found many studies that measure reconciliation in the context of the COVID-19 pandemic from the point of view of health professionals regarding difficulties and the strategies carried out, which is essential to begin to glimpse solutions. METHODS: This was a qualitative study based on 21 in-depth interviews and two discussion groups, conducted between January and April 2021 (13 nurses and 8 doctors, in rural and urban areas). The discourse was analyzed according to the Taylor-Bodgan model and processed using Atlas.ti software. RESULTS: The areas altered by the health crisis were access to patients, their reconciliation of medication, and changes in the care modality, including the greater use of telephone communication, changes in work organization, and time dedicated to patient care and family work. Difficulties encountered during COVID-19: change in medication format, the specific characteristics of the patient and their pathologies, and difficulties arising from communication with the patient and their family. The strategies applied: the collaboration of home assistants and caregivers, emphasis on patient-health professional communication, and the use of Information and Communication Technologies (ICT). CONCLUSION: The discharge was interrupted by the health crisis caused by COVID-19, in terms of both the traditional access of patients and by the remote care modalities generated by telemedicine.

Feasibility and cost of a telemedicine-based short-term plan for initial access in general dermatology in Andalusia, Spain.

BACKGROUND: In developed countries, health care delivery in dermatology is hampered by the low availability of dermatologists. OBJECTIVE: To analyze the feasibility of a teledermatology-based action plan to provide initial dermatologic care in areas with low availability of dermatologists. METHODS: A cross-sectional study describing the feasibility and cost of a 12-month action plan based on a store-and-forward teledermatology (TD) connecting primary care centers and a TD center. Teleconsultations from patients complaining of any cutaneous condition were included. The primary outcome measure was the percentage of patients not referred to the local dermatologist. RESULTS: Among the total of 15,523 teleconsultations attended in the TD-based action plan, 3360 (21.65%) required a face-to-face visit with a local dermatologist. In 32.32% (n = 5017) of the cases, a therapeutic and follow-up plan report was issued. The most common conditions managed were melanocytic nevi (15.63%, n = 2426), followed by seborrheic keratosis (14.89%, n = 2312), and actinic keratosis (8.65%, n = 1342). The average response time was 14.52 days (95% CI 14.35-15.23). The additional total investment in this action plan was $142,681.01, with a unit cost of 9.20$/patient. LIMITATIONS: Noncontrolled study. CONCLUSIONS: Experienced dermatologists working with store-and-forward TD can deliver a fast and effective response in health care areas with access limitations.

Attitudes of nursing degree students towards end of life processes. A cultural approach (Spain-Senegal).

INTRODUCTION: The concept of death is abstract, complex and has a number of meanings. Thus, its understanding and the approach taken to it depend, to a large extent, on aspects such as age, culture, training and religion. Nursing students have regular contact with the process of death and so it is of great interest to understand the attitudes they have towards it. As we live in a plural society it is even more interesting to not only understand the attitudes of Spanish students but, also, those of students coming from other countries. In the present article, we seek to identify and compare the attitudes held by nursing degree students at Hekima-Santé University (Senegal) and the University of Huelva (Spain) about end of life processes. The study identifies elements that condition attitudes and coping with death, whilst considering curricular differences with regards to specific end of life training. METHOD: A descriptive, cross-sectional and multi-center study was conducted. The overall sample (N = 142) was divided into groups: Hekima-Santé University (Dakar, Senegal) and the University of Huelva (Huelva, Spain). The measurement instruments used were an ad-hoc questionnaire and Bugen´s Coping with Death Scale. RESULTS: Statistically significant differences (p = 0.005, 95%CI) were found in relation to overall Bugen Scale scores. We can confirm that specialized end of life training (University of Huelva, Spain) did not lead to better coping when compared with a population whose academic curriculum did not provide specific training and who engaged in more religious practices (Hekima-Santé University, Senegal). CONCLUSIONS: In cultures where religion not only influences the spiritual dimension of the individual, but acts in the ethical and moral system and consequently in the economic, educational and family sphere, the accompaniment at the end of life transcends the formative plane. Considering the plural society in which we live, the training that integrates the Degree in Nursing with regard to the care of the final process, must be multidimensional in which spirituality and faith are integrated, working emotional and attentional skills, as well as cultural competence strategies in this process.

Educational interventions by nurses in caregivers with their elderly patients at home.

INTRODUCTION: The home is the natural setting for the development of informal care. The work that nurses are required to develop in this context (the carer/the elderly dependent/the home) focuses on training and educational activities to assist these two groups, such as demonstrating care activities to help dependent seniors, instruction in self-care techniques and teaching strategies for the use of human and material resources. AIMS: This article analyzes care education interventions performed by nurses, and the factors that facilitate, or limit, health care training. METHODOLOGICAL APPROACH: This is a qualitative, descriptive study designed to be flexible and openly analytical in its approach to the research problem and the dynamic nature of the home environment. Triangulation of the methodological techniques and study subjects was applied. RESULTS: Nursing interventions related to professional attitudes, such as encouraging communication and facilitating teaching; communication interventions in health education and counseling; and technical interventions aimed at improving access to health information and support for the informal carer. Lack of will, the advanced age of the carer, emotional state and work overload are factors that undermine care instruction, which if reversed, would become learning facilitators. The lack of time and resources in the home are the major limiting factors on care teaching, according to nurses. Evidence from our study suggests that care in the home is considered a key primary health care strategy, one in which nurses play a significant role.

Communication on Safe Caregiving between Community Nurse Case Managers and Family Caregivers.

Dependent elderly individuals are usually cared for at home by untrained family members who are unaware of the risks involved. In this setting, communication on safe caregiving is key. The aim of this study is to describe the factors influencing the process followed by community nurse case managers to provide communication on safe caregiving to family members caring for dependent elderly individuals. A phenomenological study, by focus group, was done in urban healthcare facilities. Key informants were seven community nurses, case managers with more than 12 years' experience. We did a thematic analysis and we identified the units of meaning to which the most relevant discourses were assigned. The concepts expressed were grouped until subcategories were formed, which were then condensed into categories. Four categories of analysis emerged: communication-related aspects; professional skills of nurse case managers; communication on safety and the caregiving role. To planner interventions, for the prevention of adverse events at home, is essential to consider these aspects: nurses' professional communication skills, factors inherent to safe caregiving, the characteristics of the home where care is provided, the personal and family circumstances of the caregiver, and whether or not the caregiver's role has been assumed by the family caregivers.

Pain catastrophizing, kinesiophobia and fear-avoidance in non-specific work-related low-back pain as predictors of sickness absence.

The influence of pain catastrophizing, kinesiophobia and fear-avoidance attitudes towards non-specific low-back pain has been scarcely studied in an occupational insurance provider context. The objective of this work is to ascertain the relationship between these psychosocial variables with work absence, its duration and the disability of subjects with work-related low back pain. This is a descriptive observational methodological strategy. All patients with work-related non-specific low back pain who attended to an occupational health hospital during the study period were included consecutively. Clinical variables of kinesiophobia, pain catastrophizing, fear-avoidance attitudes, disability and pain were collected; sociodemographic variables of sex, age, type of work, educational level, occupational status and duration in days of work absence were recorded. Kinesiophobia (b = 1.43, P = 0.011, r = 0.333), fear-avoidance beliefs in its global dimension (b = 0.910, P = 0.014, r = 0.321), fear-avoidance beliefs in its work dimension (b = 1.255, P = 0.016, r = 0.321) and pain catastrophizing (b = 0.997, P = 0.013, r = 0.340) show individual association with the duration of sickness absence. Kinesiophobia (b = 0.821, P = 0.011, r = 0.30) and fear-avoidance beliefs (b = 1.760, P = 0.016, r = 0.28) are associated with disability (Kinesiophobia, b = 0.880, P = 0.045, r = 0.26; Fear-avoidance beliefs, b = 0.724, P = 0.010, r = 0.34). Kinesiophobia, fear-avoidance beliefs and pain catastrophizing are related to an increase in the duration of work absence and disability in patients with back pain in an occupational insurance provider context.

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.

Influence of Psychosocial and Sociodemographic Variables on Sickness Leave and Disability in Patients with Work-Related Neck and Low Back Pain.

The purpose of this study was to describe the association between psychosocial factors in patients with work-related neck or low back pain (n = 129), in order to study sickness leave, its duration, the disability reported, and to analyze the relationship of these factors with different sociodemographic variables. This was a descriptive cross-sectional study. Data on kinesiophobia, catastrophizing, disability, and pain were gathered. Sociodemographic variables analyzed included sex, age, occupational, and educational level. Other data such as location of pain, sick leave status and duration of sickness absence were also collected. Educational level (p = 0.001), occupational level (p < 0.001), and kinesiophobia (p < 0.001) were found to be associated with sickness leave; kinesiophobia (b = 1.47, p = 0.002, r = 0.35) and catastrophizing (b = 0.72, p = 0.012, r = 0.28) were associated with the duration of sickness leave. Educational level (p =0.021), kinesiophobia (b = 1.69, p < 0.000, r = 0.505), catastrophizing (b = 0.76, p < 0.000, r = 0.372), and intensity of pain (b = 4.36, p < 0.000, r = 0.334) were associated with the degree of disability. In the context of occupational insurance providers, educational and occupational factors, as well as kinesiophobia and catastrophizing, may have an influence on sickness leave, its duration and the degree of disability reported.

The Mediterranean Diet, a Rich Source of Angiopreventive Compounds in Cancer.

Diet-based chemoprevention of cancer has emerged as an interesting approach to evade the disease or even target its early phases, reducing its incidence or slowing down tumor progression. In its basis in the essential role of angiogenesis for tumor growth and metastasis, angioprevention proposes the use of inhibitors of angiogenesis in cancer prevention. The anti-angiogenic potential exhibited by many natural compounds contained in many Mediterranean diet constituents makes this dietary pattern especially interesting as a source of chemopreventive agents, defined within the angioprevention strategy. In this review, we focus on natural bioactive compounds derived from the main foods included in the Mediterranean diet that display anti-angiogenic activity, as well as their possible use as angiopreventive agents.

Cardiopatías congénitas diagnosticadas prenatalmente en Cienfuegos. Estudio de 10 años / Congenital Heart Disease Diagnosed Prenatally in Cienfuegos. 10 Year Study

RESUMEN Fundamento: cardiopatía congénita es todo defecto cardíaco presente en el momento del nacimiento y se producen como consecuencia de alteraciones en la organogénesis. Constituyen la malformación estructural severa de mayor prevalencia y de mayor impacto en la morbimortalidad neonatal. Objetivo: determinar las características de las cardiopatías congénitas diagnosticadas prenatalmente en la provincia Cienfuegos en un estudio de 10 años. Método: se realizó un estudio descriptivo, retrospectivo de corte transversal. El universo estuvo conformado por 93 embarazadas con diagnóstico prenatal de cardiopatía congénita. Las variables analizadas fueron: asociación de la edad materna con la aparición de las cardiopatías, edad gestacional al momento del diagnóstico, año del diagnóstico prenatal y su relación con la evolución del embarazo, antecedentes patológicos, factores de riesgo, tipos de cardiopatías congénitas y su relación con la continuidad del embarazo, resultados de anatomía patológica de los fetos, relación entre el diagnóstico de cardiopatías congénitas y los resultados de anatomía patológica con la continuidad del embarazo, comportamiento del diagnóstico prenatal y el posible incremento anual de la tasa de mortalidad. Resultados: la edad materna más frecuente fue la comprendida entre 19-35 años, que se encontraban entre la 13-26 semana gestacional. El 78,4 % de las parejas decidieron la interrupción. La cardiopatía congénita más diagnosticada prenatalmente fue la comunicación interventricular seguida de la hipoplasia de cavidades izquierdas la cual ocupó el primer lugar en el diagnóstico anatomopatológico. Conclusiones: las cardiopatías congénitas actualmente siguen siendo una de las principales causas de muerte en el primer año de vida.

ABSTRACT Foundation: congenital heart disease is any heart defect present at birth and occurs as a result of alterations in organogenesis. They constitute the severe structural malformation of greater prevalence and greater impact on neonatal morbidity and mortality. Objective: to determine the characteristics of congenital heart diseases diagnosed prenatally in the province of Cienfuegos in a 10-year study. Method: a descriptive, retrospective cross-sectional study was carried out. The universe consisted of 93 pregnant women with a prenatal diagnosis of congenital heart disease. The variables analyzed were: association of maternal age with the appearance of heart disease, gestational age at diagnosis, year of prenatal diagnosis and its relationship with the evolution of pregnancy, pathological history, risk factors, types of congenital heart disease and its relationship with the pregnancy continuity, results of pathological anatomy of the fetuses, relationship between the diagnosis of congenital heart diseases and the results of pathological anatomy with the pregnancy continuity, behavior of the prenatal diagnosis and the possible annual increase in the mortality rate. Results: the most frequent maternal age was between 19-35 years, which were between 13 and 26 gestational weeks. A 78,4 % of couples decided pregnancy interruption. The most prenatally diagnosed congenital heart disease was inter-ventricular communication followed by hypoplasia of the left cavities, which was the most frequent anatomic-pathological diagnosis. Conclusions: congenital heart disease currently continues to be one of the main causes of death in the first year of life.

Coping strategies and quality of life in caregivers of dependent elderly relatives.

BACKGROUND: Despite the importance of coping in caregiving, there are few studies on the relationship between coping and quality of life in caregivers of the frail dependent elderly. Thus, this study aims to analyze the relationship between coping strategies and quality of life dimensions in primary caregivers of dependent elderly relatives. METHODS: A cross-sectional study was conducted from 86 caregivers. Predictive variables were coping strategies (problem-focused, emotion-focused, socially-supported, and dysfunctional); dependent variables were quality of life dimensions (psychological, physical, relational, and environmental); and potential confounding variables were age, gender, perceived health and burden of caregiver, and functional capacity of care receiver. Correlation coefficients were calculated and multiple linear regression analysis was performed. RESULTS: After controlling for potential confounders, dysfunctional coping was related to worse quality of life in the psychological dimension, while emotion-focused and socially-supported coping were related to superior psychological and environmental dimensions of quality of life. The physical and relational dimensions of quality of life were not related to coping strategies. CONCLUSIONS: 1) it is important to consider coping strategies in the assessment of primary caregivers of dependent elderly relatives; 2) the quality of life of caregivers is related to their coping strategies, 3) their quality of life can be worsened by avoidance-type coping, and 4) their quality of life can be improved by active emotion-focused coping and socially-supported coping.

Genetic and phenotypic characterization of Saccharomyces spp. strains isolated in distillery plants.

In this study, the biodiversity and some interesting phenotypic properties of Saccharomyces wild yeasts isolated in distilleries, at least 100 years old, located in La Mancha (Spain), were determined. Strains were genetically characterized by RFLP-mtDNA, which confirmed a great genetic biodiversity with 73% of strains with different mtDNA profiles, highlighting the large variability found in sweet and fermented piquette substrata. The predominant species identified was S. cerevisiae, followed by S. paradoxus and S. bayanus Due to the residual sugar-alcohol extraction process using warm water, a great number of thermophilic Saccharomyces strains with a great cell vitality were found to have potential use as starters in distillery plants. Interesting technological properties such as cell vitality and growth rate at different temperatures were studied. The thermal washing process for the extraction of alcohol and reducing sugars of some raw materials contributes to the presence of Saccharomyces strains with technologically interesting properties, especially in terms of vitality and resistance to high temperatures. Due to the fact that fermentation is spontaneous, the yeast biota of these environments, Saccharomyces and non-Saccharomyces, is very varied so these ecological niches are microbial reserves of undoubted biotechnological interest.

Changes in morphine-induced activation of cerebral Na(+),K(+)-ATPase during morphine tolerance: biochemical and behavioral consequences.

There is ample evidence of the biological changes produced by the sustained activation of opioid receptors. We evaluated the adaptive changes of cerebral Na(+),K(+)-ATPase in response to the sustained administration of morphine (minipumps, 45mg/kg/day, 6 days) in CD-1 mice and the functional role of these changes in opioid antinociception. The antinociceptive effect of morphine as determined with tail-flick tests was reduced in morphine-tolerant mice. There were no significant changes in the density of high-affinity Na(+),K(+)-ATPase α subunits labeled with [(3)H]ouabain in forebrain membranes from morphine-tolerant compared to those of morphine-naive animals. Western blot analysis showed that there were no significant differences between groups in the changes in relative abundance of α(1) and α(3) subunits of Na(+),K(+)-ATPase in the spinal cord or forebrain. However, the morphine-induced stimulation of Na(+),K(+)-ATPase activity was significantly lower in brain synaptosomes from morphine-tolerant mice (EC(50)=1.79±0.10µM) than in synaptosomes from morphine-naive mice (EC(50)=0.69±0.12µM). Furthermore, adaptive alterations in the time-course of basal Na(+),K(+)-ATPase activity were observed after sustained morphine treatment, with a change from a bi-exponential decay model (morphine-naive mice) to a mono-exponential model (morphine-tolerant mice). In behavioral studies the antinociceptive effects of morphine (s.c.) in the tail-flick test were dose-dependently antagonized by ouabain (1 and 10ng/mouse, i.c.v.) in morphine-naive mice, but not in morphine-tolerant mice. These findings suggest that during morphine tolerance, adaptive cellular changes take place in cerebral Na(+),K(+)-ATPase activity which are of functional relevance for morphine-induced antinociception.

Nivel de dependencia y percepción de salud tras la valoración enfermera / Level of dependency and perceived health nurse after the valuation

Objetivo: Identificar la capacidad funcional de un colectivode ancianos medida a través de las actividades dela vida diaria y la percepción de salud. Método: Se realizóun estudio descriptivo de carácter retrospectivo enuna residencia geriátrica con un total de 156 ancianos.La muestra estuvo compuesta por todos los residentesque en el momento del estudio estaban valorados por laenfermera. Resultados: El perfil demográfico es el de unresidente de una media superior a 75 años. El 71,3% delos residentes son mujeres. Las actividades del Índicede Barthel que reflejan mayor grado de dependencia son“lavarse” y “subir y bajar escaleras” y, la que menos,“comer”. La percepción de salud mediante las láminasde Coop-Wonca refleja una percepción “regular” o “mala”en la mayoría de los casos. A mayor grado de limitaciónfísica para las actividades de la vida diaria mayorpercepción negativa de salud. Conclusiones: El uso deinstrumentos estandarizados para la valoración geriátricaintegral nos permite detectar de manera rápida el estadodel anciano en su globalidad. De esa manera, se mejoranla calidad prestada así como la aplicación de un plande actuación interdisciplinar(AU)

To identify the functional ability of a group of elderly measuredthrough the activities of daily living and perceivedhealth. Method: A descriptive study of retrospective in a geriatricnursing home with a total of 156 elderly. The samplewas composed of all residents at the time of the studywere rated by the nurse. Results: The demographic profile isa resident of an average exceeding 75 years. The 71.3% ofresidents are women. The activities of the Barthel Index reflectinggreater reliance are “washed” and “up and downstairs” and the least “to eat”. The perception of health byCoop-Wonca reflects a perception “regulate” or “bad” inmost cases. A higher degree of physical limitations to activitiesof daily living more negative perception of health. Conclusions:The use of standardized instruments for the integratedgeriatric assessment allows us to swiftly detect thestatus of the elderly as a whole, thus improving the qualityprovided, as well as implementing an action plan interdisciplinary(AU)

Valoración del componente comunicativo/relacional de la práctica enfermera en Atención Primaria. El cuestionario GATHA-ENFERMERÍA / Assessment of the communicative/relational component in the nursing practice in primary care. The GATHA-NURSING questionnaire

Además de un pilar básico en la práctica enfermera, la comunicación es una de las variables más relevantes en la satisfacción de los usuarios con los servicios sanitarios. Objetivo: Construir un instrumento para valorar el componente comunicativo/relacional de la práctica enfermera en Atención Primaria. Metodología: Adaptación del GATHA-BASE mediante Grupo Nominal, Prueba de Jueces y pilotaje inicial. Validación a partir de 158 videograbaciones. El muestreo de ítems se realizó mediante juicio de los expertos, coeficiente de correlación ítem/total y cambio en el alfa de Cronbach. La consistencia interna, mediante el alfa de Cronbach; la fiabilidad intra e inter-observador, mediante el análisis gráfico (Bland y Altman). Resultados: Se obtuvo una Guía de Observación de 68 ítems, con un consenso entre expertos superior al 75% en todos los ítems. Tras la validación se generó un instrumento (Gatha-Enfermería), de 35 ítems, agrupados en tres ejes, con un alfa de Cronbach de 0,843. La concordancia inter e intra-observador son aceptables y con un patrón de distribución aleatoria.Conclusión: Se obtiene una validez de contenido amplia y un elevado consenso. El instrumento tiene buena consistencia interna y reproducibilidad, con capacidad para orientar diferentes ámbitos de la práctica clínica de enfermería (AU)

In addition to a core skill in Nursing practice, communication is one of the most relevant variables in the satisfaction of the users with the Health Services. Objective: To create an instrument to assess the communication/relationship component in Nursing practice in Primary Care. Method: Adaptation of the GATHA-BASE by Nominal Group, Proof of Judges and pilot study. Validation through 158 video-recorded consultations. Items Sampling by Experts Judgement, Item/Total Correlation Coefficient and change in the Cronbach's alpha. Internal consistency through the Cronbach's alpha; Intra and Inter-observer reliability by graphic analysis (Bland-Altman). Results: An Observational Guide of 68 items is obtained with a level of consensus superior to 75% amongst the experts for all the items. After the validation, a tool (GATHA-ENFERMERIA) is created consisting of 35 items organised in 3 categories, with a Cronbachs alpha of 0,843. The Inter and Intra-observer concordance are acceptable and with a pattern of random distribution. Conclusion: The outcome is wide validity of contents as well as high consensus. The tool has good internal consistency and test-retest reliability with capability to guide different aspects in clinical Nursing practice (AU)

The antinociceptive effect of morphine is reversed by okadaic acid in morphine-naive but not in morphine-tolerant mice.

The activation of specific subtypes of serine/threonine protein phosphatases (PPs) plays a role in the antinociceptive effect of acute morphine, but it is not known whether these enzymes are involved in morphine-induced antinociception in morphine-tolerant animals. We evaluated the effects of both okadaic acid (a selective inhibitor of some serine/threonine PPs) and its inactive analogue L-norokadaone on the antinociception induced by morphine in morphine-naive and -tolerant female mice in the tail-flick test. Okadaic acid (0.01 and 1 pg/mouse, i.c.v.), but not L-norokadaone (1 pg/mouse, i.c.v.), antagonized in a dose-dependent way the antinociception induced by morphine (1-16 mg/kg, s.c.) in morphine-naive animals. However, both okadaic acid (0.01 and 1 pg/mouse, i.c.v.) and L-norokadaone (1 pg/mouse, i.c.v.) were unable to modify the antinociceptive effect of morphine in morphine-tolerant mice. These results suggest that in morphine-induced thermal analgesia, the role of serine/threonine PPs highly sensitive to okadaic acid is different in morphine-tolerant and morphine-naive female mice.