Socioeconomic status, loneliness, and depression among older adults: a cross-sectional study in Spain.

BACKGROUND: The association between socioeconomic status and depression is weaker in older adults than in younger populations. Loneliness may play a significant role in this relationship, explaining (at least partially) the attenuation of the social gradient in depression. The current study examined the relationship between socioeconomic status and depression and whether the association was affected by loneliness. METHODS: A cross-sectional design involving dwelling and nursing homes residents was used. A total of 887 Spanish residents aged over 64 years took part in the study. Measures of Depression (GDS-5 Scale), Loneliness (De Jong-Gierveld Loneliness Scale), Socioeconomic Status (Education and Economic Hardship), and sociodemographic parameters were used. The study employed bivariate association tests (chi-square and Pearson's r) and logistic regression analyses. RESULTS: The percentage of participants at risk of suffering depression was significantly higher among those who had not completed primary education (45.5%) and significantly lower among those with university qualifications (16.4%) (X2 = 40.25;p <.001), and respondents who could not make ends meet in financial terms faced a higher risk of depression (X2 = 23.62;p <.001). In terms of the respondents who experienced loneliness, 57.5% were at risk of depression, compared to 19% of those who did not report loneliness (X2 = 120.04;p <.001). The logistic regression analyses showed that having university qualifications meant a 47% reduction in the risk of depression. This risk was 86% higher among respondents experiencing financial difficulties. However, when scores for the loneliness measure were incorporated, the coefficients relating to education and economic hardships ceased to be significant or were significantly reduced. CONCLUSION: Loneliness can contribute to explaining the role played by socioeconomic inequalities in depression among older adults.

A systematic review of ageing in place among Indigenous People in Canada, USA, México, Chile and New Zealand.

The ageing in place (AIP) model enjoys widespread recognition in gerontology and has been strongly encouraged through social policy. However, progress remains to be made in terms of analysing AIP for minority groups and groups with diverse life pathways in old age. This systematic review aims to identify studies that address the AIP model in indigenous communities, answering the following questions: In which geographical contexts and for which Indigenous Peoples have AIP been researched? Which physical dimensions are considered in the assessment of AIP? Which social dimensions are considered in the assessment of AIP? This systematic review applied the SALSA (Search, Appraisal, Synthesis and Analysis) method to AIP among Indigenous older adults on the Web of Science, PsycINFO, MEDLINE and Scopus digital platforms for publications from 2011 to 2021. We identified 12 studies conducted in five countries in North and South America and Oceania. The results show that the following elements of the physical environment are assessed: household, neighbourhood, local surroundings or reserve and native territories. Meanwhile, assessed elements of the social environment are as follows: personal characteristics, attachment to place, social networks, social participation and social policies. There is discussion of the need to develop AIP in order to promote successful ageing among Indigenous older adults.

Pedestrian Crossing Intention Forecasting at Unsignalized Intersections Using Naturalistic Trajectories.

Interacting with other roads users is a challenge for an autonomous vehicle, particularly in urban areas. Existing vehicle systems behave in a reactive manner, warning the driver or applying the brakes when the pedestrian is already in front of the vehicle. The ability to anticipate a pedestrian's crossing intention ahead of time will result in safer roads and smoother vehicle maneuvers. The problem of crossing intent forecasting at intersections is formulated in this paper as a classification task. A model that predicts pedestrian crossing behaviour at different locations around an urban intersection is proposed. The model not only provides a classification label (e.g., crossing, not-crossing), but a quantitative confidence level (i.e., probability). The training and evaluation are carried out using naturalistic trajectories provided by a publicly available dataset recorded from a drone. Results show that the model is able to predict crossing intention within a 3-s time window.

[Studying loneliness and social support networks among older people: a systematic review in Europe.] / La investigación sobre soledad y redes de apoyo social en las personas mayores: una revisión sistemática en Europa.

OBJECTIVE: During the ageing process the loss of family and social relationships is frequent which conditions loneliness, similarly the current COVID-19 pandemic has generated more social limitations in this age group and has increased the risk factors to trigger feelings of loneliness. This paper aimed to examine how loneliness among older people had been studied in Europe over the last ten years. Specific objectives were: i) to describe the methodological aspects; ii) to identify the scales or questions for the assessment of loneliness; iii) what were the main variables or dimensions that were related to loneliness in old age. METHODS: A total of 1,591 articles were found in WoS and Scopus digital platforms. After initial assessment of titles and abstracts, full text reading and review of the established criteria, 42 scientific articles were finally included in the systematic review. RESULTS: The countries that had carried out the most studies were the Netherlands and Spain. Most of the research was quantitative and uses the De Jong Gierveld Loneliness Scale (DJGLS) and the University of California at Los Angeles (UCLA) Loneliness Scale. The most analysed variables were: marital status, household structure, social support networks, social participation, depression, health problems, co-morbidity and physical functioning. CONCLUSIONS: The scientific interest in studying loneliness, with a focus on social support networks, in older people in Europe and strategically addressing loneliness as a public health problem is confirmed.

OBJETIVO: Durante el proceso de envejecimiento es frecuente la pérdida de relaciones familiares y sociales, lo cual condiciona la soledad. Además, la actual pandemia de la COVID-19 ha generado más limitaciones en las relaciones sociales de este grupo de edad y ha aumentado los factores de riesgo para desencadenar sentimientos de soledad. Este trabajo tuvo el objetivo de examinar cómo se había estudiado la soledad en las personas mayores en Europa en los últimos diez años. Se propusieron como objetivos específicos: i) describir los aspectos metodológicos; ii) identificar las escalas o preguntas para la valoración de la soledad; iii) cuáles eran las principales variables o dimensiones que se relacionaban con la soledad en la vejez, priorizando el rol de las redes de apoyo social. METODOS: Se encontraron 1.591 artículos en total en las plataformas digitales WoS y Scopus. Tras la valoración inicial de los títulos y resúmenes, lectura de texto completo y revisión de los criterios establecidos, al final se incluyeron en la revisión sistemática 42 artículos científicos. RESULTADOS: Los países que más estudios habían realizado eran Países Bajos y España, en su mayoría las investigaciones eran cuantitativas y utilizaban las escalas De Jong Gierveld Loneliness Scale (DJGLS) y University of California at Los Angeles (UCLA) Loneliness Scale. Las variables más analizadas fueron: estado civil, estructura del hogar, redes de apoyo social, participación social, depresión, problemas de salud, comorbilidad y funcionalidad física. CONCLUSIONES: Se confirma el interés científico por estudiar la soledad, con un énfasis central en las redes de apoyo social, en las personas mayores en Europa y abordar estratégicamente la soledad como un problema de Salud Pública.

La investigación sobre soledad y redes de apoyo social en las personas mayores: una revisión sistemática en Europa / Studying loneliness and social support networks among older people: a systematic review in Europe

FUNDAMENTOS: Durante el proceso de envejecimiento es frecuente la pérdida de relaciones familiares y sociales, lo cual condiciona la soledad. Además, la actual pandemia de la COVID-19 ha generado más limitaciones en las relaciones sociales de este grupo de edad y ha aumentado los factores de riesgo para desencadenar sentimientos de soledad. Este trabajo tuvo el objetivo de examinar cómo se había estudiado la soledad en las personas mayores en Europa en los últimos diez años. Se propusieron como objetivos específicos: i) describir los aspectos metodológicos; ii) identificar las escalas o preguntas para la valoración de la soledad; iii) cuáles eran las principales variables o dimensiones que se relacionaban con la soledad en la vejez, priorizando el rol de las redes de apoyo social. MÉTODOS: Se encontraron 1.591 artículos en total en las plataformas digitales WoS y Scopus. Tras la valoración inicial de los títulos y resúmenes, lectura de texto completo y revisión de los criterios establecidos, al final se incluyeron en la revisión sistemática 42 artículos científicos. RESULTADOS: Los países que más estudios habían realizado eran Países Bajos y España, en su mayoría las investigaciones eran cuantitativas y utilizaban las escalas De Jong Gierveld Loneliness Scale (DJGLS) y University of California at Los Angeles (UCLA) Loneliness Scale. Las variables más analizadas fueron: estado civil, estructura del hogar, redes de apoyo social, participación social, depresión, problemas de salud, comorbilidad y funcionalidad física. CONCLUSIONES: Se confirma el interés científico por estudiar la soledad, con un énfasis central en las redes de apoyo social, en las personas mayores en Europa y abordar estratégicamente la soledad como un problema de Salud Pública.(AU)

BACKGROUND: During the ageing process the loss of family and social relationships is frequent which conditions loneliness, similarly the current COVID-19 pandemic has generated more social limitations in this age group and has increased the risk factors to trigger feelings of loneliness. This paper aimed to examine how loneliness among older people had been studied in Europe over the last ten years. Specific objectives were: i) to describe the methodological aspects; ii) to identify the scales or questions for the assessment of loneliness; iii) what were the main variables or dimensions that were related to loneliness in old age. METHODS: A total of 1,591 articles were found in WoS and Scopus digital platforms. After initial assessment of titles and abstracts, full text reading and review of the established criteria, 42 scientific articles were finally included in the systematic review. RESULTS: The countries that had carried out the most studies were the Netherlands and Spain. Most of the research was quantitative and uses the De Jong Gierveld Loneliness Scale (DJGLS) and the University of California at Los Angeles (UCLA) Loneliness Scale. The most analysed variables were: marital status, household structure, social support networks, social participation, depression, health problems, co-morbidity and physical functioning. CONCLUSIONS: The scientific interest in studying loneliness, with a focus on social support networks, in older people in Europe and strategically addressing loneliness as a public health problem is confirmed.(AU)

Income inequalities, social support and depressive symptoms among older adults in Europe: a multilevel cross-sectional study.

This study analysed the association between income inequality and depression from a multilevel perspective among older adults in Europe, including an examination of the role of social support. The data came from Eurostat's European Health Interview Survey (EHIS). Selected participants were aged 65 years or above (n = 68,417) and located in 24 European countries. The outcome variable (depression) was measured using the eight-item Patient Health Questionnaire (PHQ-8). The resulting dataset included individual-level (level-1) and aggregate-level (level 2) exposure variables. Level-1 included income quintiles and social support as exposure variables and sex, age, living alone, limitation in activities of daily living and general activity limitation as control variables. Level 2 included the Gini coefficient, healthcare expenditure and dependency ratio. A multilevel linear regression analysis was performed with maximum likelihood (ML) estimation. All the income quintiles from 1 to 4 showed higher average scores for depression than quintile 5 (the highest). Higher social support scores were associated with lower scores for depression. An interaction was found between income quintile and social support, with higher levels of social support associated with lower scores for depression in quintiles 1 and 2. Higher Gini coefficient scores were associated with higher scores for depression. A significative random slope for social support was also found, meaning that the relationship between social support and depression differed across countries. No significant interaction was found between the Gini coefficient and social support. The study findings suggest that more unequal societies provide a less favourable context for the mental health of older adults. There are also significant country-dependent differences in terms of the relationship between support and mental health among older adults. Supplementary Information: The online version contains supplementary material available at 10.1007/s10433-021-00670-2.

Aging and Family Relationships among Aymara, Mapuche and Non-Indigenous People: Exploring How Social Support, Family Functioning, and Self-Perceived Health Are Related to Quality of Life.

Family relationships play a central role in wellbeing among older adults in Chile. Based on the theory of social production functions, this study examined the relationship between perceived social support from children, partners and relatives, family functioning, self-perceived health and quality of life (QoL) among Chilean older adults. The study used a multi-ethnic sample of Chilean older adults living in rural areas in the regions of Arica and Parinacota (north) and Araucanía (south). A model was analyzed that emphasizes relationships differentiated by the source of support, family functioning and self-perceived health in the explanation of QoL. The results obtained from the structural equation modelling (SEM) analysis showed the existence of indirect relationships of social support from children, partners and other family members via family functioning, while self-perceived health was directly associated with QoL. The findings indicate that family functioning is a main variable in the contrasted model, in addition to confirming the importance of distinguishing the role of the various sources of support. Research is needed to examine in detail intergenerational relationships and other relationships with family members who are significant in the wellbeing of older adults. This research corroborates that family relationships have a specificity that needs to be addressed in gerontological social intervention, as well as continuing along the lines of strengthening or improving existing family ties (more quality) over the quantity of social relationships.

Prevalence of intestinal parasitism in preschool and school children in Colombia: Systematic review and meta-analysis.

OBJECTIVE: Intestinal parasitic infections (IPIs) are a public health challenge in developing countries such as Colombia, causing anaemia and delayed growth and development in children. We aimed to estimate the geographical and prevalence trend of IPIs in the last 30 years in school and preschool children in Colombia. METHODS: We conducted a systematic review and meta-analysis. We identified potential manuscripts through PubMed, EMBASE, Web of Science, LILACS, Scielo and Google Scholar on the IPIs prevalence in school and preschool children in Colombia. Articles included in the qualitative analysis were published between 1990 and 2020 in English or Spanish and met the inclusion criteria. Subsequently, a random-effects meta-analysis, a meta-regression and a trend analysis were performed. RESULTS: We identified 2292 articles; 109 were included in the qualitative review, and 79 articles were included in the meta-analysis. The estimated IPI prevalence was 55% (95% CI: 48-63). By age group, the prevalence in preschool children was 37% (95% CI: 26-49) and 66% (95% CI: 52-78) in schoolchildren. The prevalence by region was heterogeneous, with the Amazon being the highest (69%) and the Santanderes the lowest (28%). In the last 20 years, the prevalence of helminthiasis has decreased (from 64.66% in 1990-1995 to 22.09% in 2016-2020). CONCLUSION: The prevalence of IPIs is high (>30%) in three of the seven regions in Colombia. Biannual administration of mass deworming in schoolchildren is recommended in the Amazon region. Public policies aiming to control IPIs should be reinforced. Further prevalence studies should include Cesar, Guaviare, Vichada and Vaupés, where the epidemiology of IPIs is unknown. SUSTAINABLE DEVELOPMENT GOALS: Good health and wellbeing, clean water and sanitation, sustainable cities and communities.

Factor Validity of Measurement for Burnout in Chilean Prison Officers / Medida de Validez Factorial para el Burnout en Oficiales de Prisiones Chilenas

Abstract The objective of this research was to perform the factorial validity of the Maslach Burnout Inventory Human Services (MBIHSS) in prison officers in Chile through a first-order factor analysis and a confirmatory analysis. The sample was constituted by all the prison officers in the Region of Arica and Parinacota (N=334). Of these, 44 did not participate in the study, since they were in a medical leave, vacation or special permit, transfer in progress, or similar situation. Therefore, the final number of participants was 290 subjects. The Burnout Syndrome (BS) was estimated through the adaptation to Spanish (Gil-Monte, 2005) of the Maslach Burnout Inventory, in its version for human services professionals (MBI-HSS) (Maslach & Jackson, 1986), validated in Chile (Olivares, 2009). By way of conclusion, the present investigation found similarities in the MBI-HSS in terms of dimensionality and reliability analysis, and despite the international observations of the instrument, an adjusted proposal (standardization and validation) of the MBI-HSS is provided for contexts Prisoners with 18 items, since in Chile there is no validation of the MBI-HSS in prison officers;

Resumen El objetivo de esta investigación fue realizar la validez factorial de Maslach Burnout Inventory Human Services (MBIHSS) en funcionarios de prisiones en Chile a través de un análisis factorial de primer orden y un análisis confirmatorio. La muestra estuvo constituida por todos los funcionarios penitenciarios de la Región de Arica y Parinacota (N=334). De estos, 44 no participaron en el estudio, ya que se encontraban en un permiso médico, vacaciones o permiso especial, transferencia en curso o situación similar. El número final de participantes, por lo tanto, fue de 290 sujetos. El Sindrome de Burnout (BS) se estimò mediante la adaptación al espanol (Gil-Monte, 2005) del Maslach Burnout Inventory, en su versión para profesionales de servicios humanos (MBI-HSS) (Maslach & Jackson, 1986), validado en Chile (Olivares, 2009). A modo de conclusión, la presente investigación encontró similitudes en el MBI-HSS en términos de análisis de dimensionalidad y confiabilidad, y a pesar de las observaciones internacionales del instrumento, se proporciona una propuesta ajustada (estandarización y validación) del MBI-HSS para contextos Prisioneros con 18 items, ya que en Chile no hay validación del MBI-HSS en los funcionarios de prisiones

Modelo de envejecimiento con éxito: la relevancia de los síntomas depresivos en las personas mayores chilenas / Model of successful ageing: the relevance of depressive symptoms among older Chileans people

Resumen: Antecedentes: Las diversas maneras de envejecer en Chile, especialmente determinadas por la identidad étnica indígena, son escasamente abordadas, siendo necesario dar cuenta de las variables personales, psicosociales y de salud que promueven el Envejecimiento con Éxito (EE). Objetivos: Explorar un modelo teórico explicativo del EE en una muestra de personas mayores indígenas y no indígenas, considerando diversas variables personales, psicosociales y de salud relacionas con EE. Asimismo, se busca contrastar el posible efecto de la pertenencia étnica - ser o no ser indígenaen este modelo. Método: Estudio cuantitativo y transversal que contó con la participación de 232 personas mayores del Pueblo Aymara y 545 no indígenas que viven en el extremo norte de Chile. Se utilizaron instrumentos previamente validados en población equivalente para medir envejecimiento con éxito, religiosidad y espiritualidad, apoyo social comunitario, problemas de salud, actividades de la vida diaria y depresión. Para comprobar el ajuste del modelo teórico a los datos se utilizó un análisis de ecuaciones estructurales. De manera específica, se estimó un modelo estructural multigrupo para personas indígenas y personas no indígenas. Resultados: Los resultados indican que existe invarianza en función de la etnia para el constructo EE. Tal como se muestra en el modelo hipotetizado y posteriormente contrastado, el EE se relaciona directamente con depresión y espiritualidad. La asociación de integración comunitaria, dependencia física en las actividades de la vida diaria y el apoyo social se percibido se produce a través de su asociación con depresión y espiritualidad. Conclusiones: Este estudio apoya la hipótesis de que el EE es un proceso multidimensional, relacionado con la pertenencia étnica y que la salud mental ocupa un rol importante en su comprensión.

Abstract: Background: The diverse ways of ageing in Chile, especially determined by indigenous ethnic identity, are scarcely addressed. It is necessary to account for the personal, psychosocial and health variables that promote Successful Ageing (SA). Objective: This research explores a theoretical explanatory model of successful ageing (SA) in a sample of indigenous and non-indigenous older people, considering several personal, psychosocial and health variables related to SA. It also seeks to contrast the possible effect of ethnicity - being or not being indigenous - in this model. Method: Quantitative, cross-sectional study with the participation of 232 elderly Aymara people and 545 non-indigenous people living in the extreme north of Chile. Instruments and scales previously validated in equivalent population were used to measure successful aging, religiosity and spirituality, community social support, health problems, dependence in activities of daily living and depression. Structural equation modeling (SEM) was used to estimate the adjutsment of the theoretical model to the data. Specifically, a multigroup analysis was performed to adjust the model for indignous and non-indigenous groups. Results: The results indicate that there is invariance in function of ethnicity for the SA construct. As shown in the hypothesized and subsequently contrasted model, SA is directly related to depression and spirituality. On the other hand, community integration, physical dependence and perceived social support relates indirectly with SA, through the association with depression and spirituality. Conclusions: This study support the hypothesis that SA is a multidimensional process, determining by ethnicity and that mental health plays an important role.

The Social Gradient in Mental Health and Well-Being for Indigenous Older Adults Living in Rural Areas: A Cross-Sectional Comparison With Rural Non-indigenous Population in Chile.

Objectives: To compare differences in depression, loneliness and personal well-being in a sample made up of indigenous (Aymara and Mapuche) and non-indigenous older people resident in original rural territories. Methods: A cross-sectional study involving 800 older adults living in a rural context in Chile, of whom 201 were Aymara, 368 Mapuche and 231 non-indigenous. Validated instruments were included for depression, loneliness and personal well-being (outcome variables). Ordinary least squares regression analyses were performed. Results: Membership of an indigenous group was significantly associated with lower scores for depression and loneliness and higher scores for personal well-being. The interactions of severe deprivation and housing deprivation with indigenous group membership were significantly associated with lower loneliness scores and higher personal well-being scores for Aymara and Mapuche participants. Discussion: Native rural settings and territories may offer a degree of protection to indigenous peoples. Cultural continuity enhanced by rural areas would produce a culturally constructed resilience against deprivation.

Uso de metformina y un inhibidor de SGLT2 en el manejo de lipodistrofia congénita generalizada. Reporte de caso / Use of metformin and an SGLT2 inhibitor to treat congenital generalized lipodystrophy. Case report

Resumen Introducción. La lipodistrofia congénita generalizada (LCG) es un síndrome genético autosómico recesivo extremadamente raro que se caracteriza por ausencia generalizada de tejido adiposo, deficiencia en la producción de hormonas como la leptina y complicaciones metabólicas potencialmente serias como diabetes mellitus tipo 2 (DM2), esteatohepatitis e hipertrigliceridemia. Presentación del caso. Paciente femenina de 17 años con un diagnóstico tardío de LCG y con diabetes mellitus (erróneamente clasificada como tipo I), hipertrigliceridemia severa e infecciones a repetición. Luego de introducir metformina y un inhibidor del SGLT2 en el manejo de la paciente, se logró un adecuado control metabólico. Conclusión. Con frecuencia, el desconocimiento de algunas enfermedades huérfanas lleva a diagnósticos erróneos y, por tanto, a tratamientos inadecuados que en algunos casos pueden empeorar la condición clínica de los pacientes. Por lo anterior, en el caso de la LCG, es necesario que la comunidad médica tenga una mejor comprensión de sus aspectos diagnósticos y terapéuticos para brindar un diagnóstico y tratamiento oportunos.

Abstract Introduction: Generalized congenital lipodystrophy (GDL) is an extremely rare autosomal recessive genetic syndrome characterized by generalized absence of adipose tissue, deficient production of hormones such as leptin, and potentially serious metabolic complications such as type 2 diabetes mellitus (DM2), steatohepatitis and hypertriglyceridemia. Case presentation: This is the case of a 17-year-old female patient with a late diagnosis of GDL and with diabetes mellitus (erroneously classified as type 1), severe hypertriglyceridemia and recurrent infections. Adequate metabolic control was achieved after the introduction of metformin and an SGLT2 inhibitor. Conclusion: Lack of knowledge about some orphan diseases usually leads to misdiagnosis and, therefore, to inadequate treatments that may worsen the clinical condition of patients. Therefore, in the case of GDL, the medical community should have a better understanding of its diagnostic and therapeutic aspects in order to provide timely diagnosis and treatment.

Fibroelastoma papilar mitral como causa de ictus en paciente joven / Mitral papillary fibroelastoma as a cause of stroke in a young patient

RESUMEN El fibroelastoma papilar es un tumor poco frecuente, con una prevalencia estimada entre el 1 y el 7,9% de todos los tumores cardíacos primarios, los que -a su vez- presentan una muy baja incidencia (entre 0,001 y 0,28%), pues la gran mayoría de ellos (casi un 90%) son benignos. Se presenta el caso de un hombre de 41 años de edad que debutó con un accidente cerebrovascular. En el estudio ecocardiográfico se halló un tumor cardíaco en la valva anterior mitral sugerente de fibroelastoma papilar. Se decidió la intervención quirúrgica ante la posibilidad de complicaciones embólicas derivadas, con recurrencia de episodios isquémicos cerebrovasculares. Se realizó resección triangular de dicha tumoración y anuloplastia mitral con buen resultado. El estudio anatomopatológico confirmó el diagnóstico.

ABSTRACT Papillary fibroelastoma is an infrequent tumor, with a prevalence estimated between 1 and 7.9% of all primary cardiac tumors, which -at the same time- have a very low incidence (between 0.001 and 0.28%), because the great majority of them (almost a 90%) are benign. Here is presented the case of a 41-year-old man who had a stroke. A cardiac tumor in the anterior mitral valve suggestive of papillary fibroelastoma was found in the echocardiographic study. The surgical intervention was decided because of the possibility of resulting embolic complications with recurrence of cerebrovascular ischemic events. A triangular resection of the tumor and mitral annuloplasty were performed with good results. The pathological study confirmed the diagnosis.

Cardiac amyloidosis: a review of a series of cases.

Antecedentes y objetivo: La amiloidosis cardíaca es una entidad que permanece infradiagnosticada, a pesar de los avances recientes en su diagnóstico y tratamiento. El objetivo de este estudio es revisar una serie de casos de amiloidosis cardíaca para describir los principales datos clínicos y los hallazgos en las pruebas de imagen. Materiales y métodos: Estudio retrospectivo de pacientes con diagnóstico principal o secundario de amiloidosis cardíaca en los informes de alta de pacientes hospitalizados en este centro desde 2006 hasta 2016. Se revisaron los datos clínicos de los pacientes, así como las pruebas de imagen (ECG, ecocardiograma, gammagrafía cardíaca, resonancia magnética cardíaca). Se realizó seguimiento de los pacientes hasta enero de 2018. Resultados: Se analiza a 30 pacientes (20 varones) con media de 65 años. Los principales datos ecocardiográficos fueron dilatación biauricular, disfunción diastólica e hipertrofia ventricular izquierda (HVI) en un 97%. Sólo el 6.7% cumplía criterios de HVI en el electrocardiograma. Hasta un 33% tenía disfunción sistólica. Se realizó gammagrafía y resonancia magnética cardíaca en un 33%. La supervivencia a los 12 meses fue de 61%. Conclusión: La presencia de insuficiencia cardíaca, fibrilación auricular o trastornos de conducción junto a datos ecocardiográficos indicativos debe alertar al clínico. Otros datos como disfunción sistólica o sexo femenino no deben disminuir la sospecha. El estudio debe completarse con gammagrafía y resonancia magnética cardíaca, ya que el diagnóstico temprano tiene implicaciones pronósticas y terapéuticas. Background and objective: Cardiac amyloidosis is an entity that remains underdiagnostic, despite recent advances in its diagnosis and treatment. The aim of this study is to review a series of diagnosed cases of cardiac amyloidosis to describe the main clinical data and the findings in the imaging tests. Materials and methods: Retrospective study of patients with primary or secondary diagnosis of cardiac amyloidosis in discharge reports of patients hospitalized in our center from 2006 to 2016. The clinical data of the patients were reviewed, as well as the imaging tests (ECG, echocardiogram, cardiac scintigraphy, cardiac magnetic resonance). Patients were followed until January 2018. Results: We analyze 30 patients (20 men) with an average of 65 years. The main echocardiographic data were biatrial dilatation, diastolic dysfunction and left ventricular hypertrophy (LVH) in 97%. Only 6.7% met criteria for LVH in the electrocardiogram. Up to 33% had systolic dysfunction. Scintigraphy and cardiac magnetic resonance were performed in 33%. Survival at 12 months was 61%. Conclusion: The presence of heart failure, atrial fibrillation or conduction disorders with suggestive echocardiographic data should alert the clinician. Other data such as systolic dysfunction or female sex should not decrease the suspicion. The study should be completed with gammagraphy and cardiac magnetic resonance since early diagnosis has prognostic and therapeutic implications.

Amiloidosis cardíaca: revisión de una serie de casos / Cardiac amyloidosis: a review of a series of cases

Resumen Antecedentes y objetivo: La amiloidosis cardíaca es una entidad que permanece infradiagnosticada, a pesar de los avances recientes en su diagnóstico y tratamiento. El objetivo de este estudio es revisar una serie de casos de amiloidosis cardíaca para describir los principales datos clínicos y los hallazgos en las pruebas de imagen. Materiales y métodos: Estudio retrospectivo de pacientes con diagnóstico principal o secundario de amiloidosis cardíaca en los informes de alta de pacientes hospitalizados en este centro desde 2006 hasta 2016. Se revisaron los datos clínicos de los pacientes, así como las pruebas de imagen (ECG, ecocardiograma, gammagrafía cardíaca, resonancia magnética cardíaca). Se realizó seguimiento de los pacientes hasta enero de 2018. Resultados: Se analiza a 30 pacientes (20 varones) con media de 65 años. Los principales datos ecocardiográficos fueron dilatación biauricular, disfunción diastólica e hipertrofia ventricular izquierda (HVI) en un 97%. Sólo el 6.7% cumplía criterios de HVI en el electrocardiograma. Hasta un 33% tenía disfunción sistólica. Se realizó gammagrafía y resonancia magnética cardíaca en un 33%. La supervivencia a los 12 meses fue de 61%. Conclusión: La presencia de insuficiencia cardíaca, fibrilación auricular o trastornos de conducción junto a datos ecocardiográficos indicativos debe alertar al clínico. Otros datos como disfunción sistólica o sexo femenino no deben disminuir la sospecha. El estudio debe completarse con gammagrafía y resonancia magnética cardíaca, ya que el diagnóstico temprano tiene implicaciones pronósticas y terapéuticas.

Abstract Background and objective: Cardiac amyloidosis is an entity that remains underdiagnostic, despite recent advances in its diagnosis and treatment. The aim of this study is to review a series of diagnosed cases of cardiac amyloidosis to describe the main clinical data and the findings in the imaging tests. Materials and methods: Retrospective study of patients with primary or secondary diagnosis of cardiac amyloidosis in discharge reports of patients hospitalized in our center from 2006 to 2016. The clinical data of the patients were reviewed, as well as the imaging tests (ECG, echocardiogram, cardiac scintigraphy, cardiac magnetic resonance). Patients were followed until January 2018. Results: We analyze 30 patients (20 men) with an average of 65 years. The main echocardiographic data were biatrial dilatation, diastolic dysfunction and left ventricular hypertrophy (LVH) in 97%. Only 6.7% met criteria for LVH in the electrocardiogram. Up to 33% had systolic dysfunction. Scintigraphy and cardiac magnetic resonance were performed in 33%. Survival at 12 months was 61%. Conclusion: The presence of heart failure, atrial fibrillation or conduction disorders with suggestive echocardiographic data should alert the clinician. Other data such as systolic dysfunction or female sex should not decrease the suspicion. The study should be completed with gammagraphy and cardiac magnetic resonance since early diagnosis has prognostic and therapeutic implications.

Espiritualidad, religiosidad y síntomas depresivos en personas mayores del norte de Chile / Spirituality, religiosity, and depressive symptoms among elderly Chilean people in the north of Chile

Resumen: La depresión no es un trastorno inevitable en la vejez, aunque su prevalencia sea significativamente alta y, especialmente, en las personas mayores chilenas. De cara a la promoción de la salud mental y al tratamiento de los síntomas depresivos se vuelve relevante ahondar en aquellos factores que puedan inhibir su incidencia. Al respecto, este estudio analiza la asociación entre la religiosidad, la espiritualidad y la depresión en personas mayores de 60 años. Se dispone de una muestra de 777 personas mayores de la región de Arica y Parinacota, 65% son mujeres, 43% tiene entre 60 y 69 años (media: 69.93 años, DT=7.12), 48 tiene pareja (casado o convive) y la mayoría vive en la ciudad de Arica (87%). Se realizaron análisis descriptivos, bivariados y un modelo de regresión jerárquica para depresión. Los resultados comprueban que solo las experiencias espirituales se relacionan con menor incidencia de síntomas depresivos. Concluyendo, los hallazgos muestran que en el tratamiento de la depresión geriátrica se podrían incluir recursos personales/psicológicos que movilizan el afrontamiento, la resiliencia y el optimismo, como es el caso de la espiritualidad.

Abstract: Depression is not an inevitable disorder in old age, although its prevalence is significantly high and especially among elderly Chilean people. In order to promote mental health and the treatment of depressive symptoms it becomes relevant to delve into those factors that can inhibit their incidence. In this regard, this study analyses the association between religiosity, spirituality and depression in people over 60 years. The sample was made up of 777 older Chilean adults living in the region of Arica and Parinacota, 65% are women, 43% are between 60 and 69 years old (mean: 69.93 years, SD = 7.12), 48 have a partner (married or living together) and the majority live in the city of Arica (87%). Descriptive and bivariate analyses of the study variables and a hierarchical regression analysis was conducted for the depression variable. The results prove that only spiritual experiences are related to lower incidence of depressive symptoms. Concluding, the findings show that in the treatment of geriatric depression could be included personal/psychological resources that mobilize coping, resilience and optimism, as is the case of spirituality.

Tres críticas sobre el psicoanálisis / Three critics about psychoanalysis

Resumen Desde diversos escenarios han aparecido algunas críticas al psicoanálisis, en tanto dispositivo clínico, desde hace muchos años. Estas diatribas, que se plantean desde lugares comunes, como, por ejemplo, la salud mental, las diferentes formas de concepción del psiquismo, los círculos académicos, los ámbitos universitarios, las instancias de investigación o la ciencia, diversos medios de comunicación e, inclusive, la opinión popular (doxa), podrían resumirse concretamente en tres: ¿para qué es necesario un psicoanálisis si es "largo", "costoso" y "no es efectivo"? Sin embargo, ¿son verosímiles estas críticas? O, por el contrario, ¿aparecen como mitos no comprobados sobre el psicoanálisis y su forma de operar? A fin de proporcionar una respuesta plausible en primera instancia, los aportes de Sigmund Freud y Jacques Lacan, así como de algunos autores contemporáneos, permitirán dilucidar las problemáticas que se erigen en torno a la duración que puede llegar a tener un psicoanálisis, qué estatuto tiene el dinero en el dispositivo analítico y cómo puede entenderse el término de efectos terapéuticos; en segundo lugar, las cuestiones aquí planteadas se someten a reflexión en el marco de algunos momentos históricos específicos, como lo son la primacía actual del discurso capitalista y el advenimiento de las sociedades democráticas.

Abstract From various scenarios have appeared some criticisms of psychoanalysis, as a clinical device, for many years. These diatribes, which pose from common places such as mental health, different forms of conception of the psychism, academic circles, university areas, research or science, various media and even popular opinion (doxa), they could be summarized concretely in three: why is a psychoanalysis necessary if it is long, expensive and not effective? But are these criticisms credible? Or, on the contrary, do they appear as un-proven myths about psychoanalysis and its way of operating? To give a plausible answer, in the first instance, the contributions of Sigmund Freud and Jacques Lacan, as well as of some contemporary authors, will make it possible to elucidate the problems that arise around the duration that a psychoanalysis can have, what status have the money in the analytical device and how the term of therapeutic effects can be understood; Secondly, the issues raised here are reflected in the context of some specific historical moments, such as the current primacy of capitalist discourse and the advent of democratic societies.

Successful Aging and Personal Well-Being Among the Chilean Indigenous and Non-Indigenous Elderly / Envejecimiento exitoso y bienestar personal en adultos mayores chilenos indígenas y no indígenas / Envelhecimento bem-sucedido e bem-estar pessoal em idosos chilenos indígenas e não indígenas

ABSTRACT Objective: The aim of this research was to analyse the association between successful aging (SA) and subjective well-being (SWB) in different domains. Method: The study is quantitative and cross-sectional, with a sample consisting of 800 older people, including 569 indigenous (Aymara and Mapuche) participants living in northern and southern Chile. Results: Domains associated with SA are satisfaction with health, satisfaction with social relationships, satisfaction with future security, and satisfaction with spiritual and religious experiences. SA is also positively associated with being a woman, being young, and not being indigenous. Conclusion: The research has two main practical implications. First, SWB domains may be incorporated into socio-health interventions as they relate to elements that can be changed or improved (health, social inclusion, security, and beliefs). Second, this study suggests a situation of risk among older indigenous Chileans, confirming the premise that the life paths of indigenous Chileans at social risk give rise to a more socially unequal old age with; therefore, it is important to analyse positive aspects that promote better old age.

RESUMEN Objetivo: el objetivo de esta investigación consistió en analizar la asociación entre envejecimiento exitoso (SA) y bienestar subjetivo (SWB) en sus diferentes dominios. Metodología: se trata de un diseño cuantitativo y transversal, con una muestra compuesta por 800 adultos mayores, incluidos 569 indígenas (aymaras y mapuches), que viven en el norte y sur de Chile. Resultados: muestran que los dominios asociados con la SA son satisfacción con la salud, satisfacción con las relaciones sociales, satisfacción con la seguridad futura y satisfacción con las experiencias espirituales y religiosas. La SA también se asocia positivamente con ser mujer, ser joven y no ser indígena. Conclusión: la investigación tiene dos implicaciones prácticas principales. Primero, estos dominios del SWB pueden incorporarse a las intervenciones sociosanitarias, ya que se relacionan con elementos que se pueden cambiar o mejorar (salud, inclusión social, seguridad y creencias). En segundo lugar, este estudio sugiere una situación de riesgo entre los chilenos indígenas mayores, lo que confirma la premisa de que las trayectorias de vida de los indígenas chilenos que han enfrentado más riesgo social dan lugar a una vejez con más desigualdad social, por lo que es importante analizar aspectos positivos que promuevan un mejor envejecimiento.

RESUMO Objetivo: analisar a associação entre envelhecimento bem-sucedido e bem-estar subjetivo em seus diferentes domínios. Método: trata-se de um desenho quantitativo e transversal, com uma amostra composta por 800 idosos, incluídos 569 indígenas (aymaras e mapuches), que habitam no norte e no sul do Chile. Resultados: os domínios associados com o envelhecimento bem-sucedido são satisfação com a saúde, satisfação com as relações sociais, satisfação com a segurança futura e satisfação com as experiências espirituais e religiosas. Além disso, associa-se de forma positiva com ser mulher, jovem e não indígena. Conclusão: esta pesquisa tem duas implicações práticas principais. Na primeira, esses domínios do bem-estar subjetivo podem ser incorporados às intervenções sociossanitárias, já que estão relacionados com elementos que podem ser mudados ou melhorados (saúde, inclusão social, segurança e crenças). Em segundo lugar, este estudo sugere uma situação de risco entre os idosos chilenos indígenas, o que confirma a hipótese de que as trajetórias de vida dos indígenas chilenos que enfrentaram mais risco social levam a uma velhice com mais desigualdade social, razão pela qual é importante analisar aspectos positivos que promovam um melhor envelhecimento.

Successful ageing in older persons belonging to the Aymara native community: exploring the protective role of psychosocial resources.

Objectives: The aim of this study is to analyse the process of successful ageing in older persons who state their belonging to a native Chilean ethnic group. There has recently been a notable increase in interest regarding analysis of the cultural processes and variables associated with successful ageing. However, there is a lack of studies analysing successful ageing in native ethnic groups; that is, ethnic communities living in their natural environmental surroundings. Methods: A cross-sectional research design was used. The sample was composed by 232 indigenous Aymara persons aged over 60 years who live in the far north of Chile. Data were collected using a questionnaire made up of validated measurement scales for successful ageing, community support, quality of life, religiousness/spirituality, and health. Results: The results suggest that indigenous persons age successfully, particularly in the context of physical functionality. Successful ageing is positively related with community integration, social support from informal systems (social groups), quality of life, and religiousness (forgiveness). In contrast, successful ageing is negatively related with depression. Conclusions: Cultural practices and an active lifestyle are ethnic cultural resources enabling persons to successfully cope with ageing. The results suggest that interventions would benefit from incorporating actions within a context of community integration. Particular attention to preventing deterioration in mental health would help to foster a successful ageing process.