La necesidad de comunicarse en medicina / The Need to Communicate in Medicine

Partiendo de la teoría del ecosistema social se explica la necesidad de la comunicación en las sociedades humanas, así como el papel que la tecnología ha tenido precisamente en el ámbito de la comunicación. Asimismo se explica el proceso de comunicación desde la teoría centro-periferia, insistiendo en el papel del centro social como emisor, y de la periferia social como receptora, en el proceso de comunicación. Finalmente se detallan las diferentes formas de comunicación en medicina: entre colegas, entre el médico y su equipo, entre el médico y la institución a la que pertenece, entre el médico y sus pacientes, entre el médico y los familiares de los pacientes, entre el médico y sus estudiantes o discípulos, entre el médico y la sociedad, entre el médico y los proveedores de material tecnológico y medicamentos, etc. Se concluye que la educación en medicina debe tener cada vez más en cuenta la necesidad de proporcionar una formación suficiente en comunicación a los futuros médicos, para que puedan cumplir mejor su función social

On the basis of social ecosystem theory the need for communication in human societies is explained, as well as the role that technology has played precisely in the field of communication. The process of communication has also been explained from centre-periphery theory, focusing on the role of the social centre as transmitter, and of the social periphery as receiver, in the process of communication. Finally, different modes of communication in medicine are explained: between colleagues, between the doctor and his team, between the doctor and his institution, between the doctor and his patients, between the doctor and his patients' relatives, between the doctor and his students and disciples, between the doctor and society, between the doctor and suppliers of technological equipment and/or drugs, etc. It is concluded that medical education must increasingly take into account the need to provide a sufficient training in communication to future doctors, so that they can better perform their social function

Mortality and refusal in the longitudinal 90+ project.

Attrition is one of the most important threats for longitudinal studies on aging mainly due to refusal and mortality. This study deals with those individuals who were assessed in the base line of 90+ project but died, dropped out or were examined in the follow-up. Participants of the 90+ project baseline consist of a sample of 188 older than 90 years, independent individuals (mean age = 92.9; 67 men and 121 women) living in the community (n = 76) or in residences (n = 112). They were assessed through the European Survey on Aging Protocol (ESAP) by collecting anthropometric, health and life styles, bio-behavioral, psychological and social data. After 6-14 months from the baseline, 55% individuals were re-assessed, 11% died and 34% dropped out for several reasons. Comparisons between the individuals deceased, interviewed and those who dropped out yielded significant differences mainly due to contextual variables. The mortality rate of participants living in residences is three times greater than those of participants living in the community. Trying to determine the differences between these three groups due to bio-psycho-social variables, we found that regular physical activity, mental status, leisure activities, fitness, perceived control and openness assessed at the baseline differentiate our three groups. Finally, 90% of those individuals who died were identified at the baseline as "non successful agers", while more than a half of those who participated and a third of the non-participants were identified as "successful agers". It can be concluded that among those independent but very old people, mortality is less important than willing to participate and contextual, behavioral and psychological factors are relevant for distinguishing mortality, survival and participation.

[Successful aging: criteria and predictors]. / Envejecimiento con éxito: criterios y predictores.

In the Anglo-Saxon scientific literature, successful aging has been consolidated during the last four decades. Nevertheless, several terms have been used as synonymous: healthy, active, productive, optimal, positive aging. Although, all these terms have been described through a broad set of bio-psycho-social factors, usually, research in this field reduces successful aging to daily life functioning and physical health. Also, in spite of the fact that authors consider that determinants might be multi-domain, empirical research usually reduces them to life styles. Logically, the prevalence of this kind of ageing found empirically is not very consistent and research of its determinants or predictors refers to biomedical conditions. In this study, data from 458 participants (170 males and 288 females; mean age: 66.47, range: 55-75) from ELEA ("Longitudinal Study of Active Aging") were examined. The results show (depending on the simple or multidimensional definitions used) a very varied range of proportions of successfully aging older persons as well as a large number of multi-domain predictors of successful ageing, among which are intelligence, personality and motivational psychological characteristics.

Envejecimiento con éxito: criterios y predictores / Successful aging: criteria and predictors

En la literatura científica anglosajona, envejecimiento con éxito es un término que ha ido consolidándose en los últimos años, al mismo tiempo que ha ido adoptando distintas denominaciones: «envejecimiento activo», «productivo», «saludable», «óptimo» o «positivo». A pesar de que estos conceptos han sido descritos mediante factores bio-psicosociales, la investigación empírica los ha reducido a variables funcionales y salud física y, aunque los autores consideran que los determinantes de este tipo de envejecimiento son también multi-dominio, su búsqueda e investigación ha sido también reducida a los estilos de vida. Lógicamente, la prevalencia de este tipo de envejecimiento hallada empíricamente es poco consistente y la investigación de sus determinantes o predictores se refi ere a condiciones biomédicas. En este trabajo hemos analizado los resultados de 458 personas (170 varones y 288 mujeres, media de edad: 66,47, rango: 55-75) participantes en el estudio ELEA (Estudio Longitudinal de Envejecimiento Activo). Los resultados ponen de manifiesto (en dependencia de las definiciones operacionales simples o multidimensionales utilizadas) una amplia disparidad en la proporción de personas que envejecen con éxito, así como un amplio número de predictores multidominio de envejecimiento con éxito, entre los cuales se encuentran variables psicológicas intelectuales, de la personalidad y motivacionales (AU)

In the Anglo-Saxon scientific literature, successful aging has been consolidated during the last four decades. Nevertheless, several terms have been used as synonymous: healthy, active, productive, optimal, positive aging. Although, all these terms have been described through a broad set of bio-psycho-social factors, usually, research in this fi eld reduces successful aging to daily life functioning and physical health. Also, in spite of the fact that authors consider that determinants might be multi-domain, empirical research usually reduces them to life styles. Logically, the prevalence of this kind of ageing found empirically is not very consistent and research of its determinants or predictors refers to biomedical conditions. In this study, data from 458 participants (170 males and 288 females; mean age: 66.47, range: 55-75) from ELEA («Longitudinal Study of Active Aging») were examined. The results show (depending on the simple or multidimensional definitions used) a very varied range of proportions of successfully aging older persons as well as a large number of multi-domain predictors of successful ageing, among which are intelligence, personality and motivational psychological characteristics (AU)