Análisis del efecto de un programa de estimulación cognitiva en personas con envejecimiento normal en Atención Primaria: ensayo clínico aleatorizado / Analysis of the effect of a program of cognitive stimulation in elderly people with normal aging in primary care: Randomized clinical trial

Objetivo: Aportar evidencias de la eficacia de una intervención comunitaria en salud, que incluye un programa de estimulación cognitiva, para prevenir el deterioro de las capacidades cognitivas en nuestra población de personas mayores con cognición normal que viven en la comunidad. Diseño: Ensayo clínico aleatorizado (normas grupo CONSORT). Emplazamiento: Centro de salud San José Norte-Centro y Fundación La Caridad (Zaragoza). Participantes: Doscientas una personas de 65 años o más, con puntuación MEC de 28 puntos o más, 101 aleatorizados en el grupo intervención y 100 en el grupo control. Intervenciones: La intervención se realizó en 10 sesiones de 45 min, una por semana, con material propio, los cuadernos de colores de activación mental. Estos cuadernos trabajan las áreas de memoria, orientación, lenguaje, praxis, gnosis, cálculo, percepción, razonamiento lógico, atención-concentración y programación. Mediciones principales: Las variables de resultado fueron MEC, Set-test, Barthel y Lawton-Brody. Resultados: Analizando los incrementos sobre el nivel basal, para la variable MEC el grupo intervención obtiene, en media, 1,58 puntos más que el grupo control en la evaluación realizada inmediatamente después de la intervención. A los 6meses la mejora es de 1,51 puntos y al año de 2,04 puntos. Todos estos incrementos son estadísticamente significativos al nivel usual del 5%. No se observan diferencias estadísticamente significativas entre el grupo intervención y control en las variaciones sobre el nivel basal de las variables en Set-test, Barthel y Lawton-Brody. Conclusiones: La estimulación cognitiva con nuestro programa es eficaz para mantener el rendimiento cognitivo, medido con la variable MEC, en nuestra población de personas mayores con cognición normal que viven en la comunidad. No hay evidencia de que esa mejora se transfiera a las actividades de la vida diaria medidas con Barthel y Lawton-Brody

Objective: To provide evidence of the effectiveness of a community health intervention, that includes a cognitive stimulation program, to prevent the deterioration of cognitive abilities in our population of elderly people with normal cognition that are living in the community. Design: Randomized clinical trial (CONSORT group norms). Location: San José Norte-Centro Health Center and La Caridad Foundation (Zaragoza, Spain). Participants: 201 people aged 65 or older, with a MEC score of at least 28 points, which were randomized between the Intervention group (101) and the Control group (100). Intervention: The intervention was applied in 10 sessions of 45minutes, one per week. It used materials designed by one of the authors, which addressed the following areas: memory, orientation, language, praxis, gnosis, calculation, perception, logical reasoning, attention-concentration and programming. Main measurements: The main outcome variables were MEC, Set-Test, Barthel and Lawton-Brody. Results: Increases of the main result variables over their baseline level were analized. For MEC variable, the Intervention group obtained, on average, 1.58 points more than the Control group in the evaluation performed immediately after the intervention. After 6months, the improvement was 1.51 points and after a year, it was of 2.04 points. All these differences were statistically significant. For Set-Test, Barthel and Lawton-Brody variables, no statistically significant differences were observed between Intervention group and Control group. Conclusions; Cognitive stimulation with our program is effective to maintain or improve cognitive performance, measured with the variable MEC, our population of elderly people with normal cognition that are living in the community. There is no evidence that this improvement is transferred to the activities of daily life measured with Barthel and Lawton-Brody variables

[Analysis of the effect of a program of cognitive stimulation in elderly people with normal aging in primary care: Randomized clinical trial]. / Análisis del efecto de un programa de estimulación cognitiva en personas con envejecimiento normal en Atención Primaria: ensayo clínico aleatorizado.

OBJECTIVE: To provide evidence of the effectiveness of a community health intervention, that includes a cognitive stimulation program, to prevent the deterioration of cognitive abilities in our population of elderly people with normal cognition that are living in the community. DESIGN: Randomized clinical trial (CONSORT group norms) LOCATION: San José Norte-Centro Health Center and La Caridad Foundation (Zaragoza, Spain). PARTICIPANTS: 201 people aged 65 or older, with a MEC score of at least 28 points, which were randomized between the Intervention group (101) and the Control group (100). INTERVENTION: The intervention was applied in 10 sessions of 45minutes, one per week. It used materials designed by one of the authors, which addressed the following areas: memory, orientation, language, praxis, gnosis, calculation, perception, logical reasoning, attention-concentration and programming. MAIN MEASUREMENTS: The main outcome variables were MEC, Set-Test, Barthel and Lawton-Brody. RESULTS: Increases of the main result variables over their baseline level were analized. For MEC variable, the Intervention group obtained, on average, 1.58 points more than the Control group in the evaluation performed immediately after the intervention. After 6months, the improvement was 1.51 points and after a year, it was of 2.04 points. All these differences were statistically significant. For Set-Test, Barthel and Lawton-Brody variables, no statistically significant differences were observed between Intervention group and Control group. CONCLUSIONS: Cognitive stimulation with our program is effective to maintain or improve cognitive performance, measured with the variable MEC, our population of elderly people with normal cognition that are living in the community. There is no evidence that this improvement is transferred to the activities of daily life measured with Barthel and Lawton-Brody variables.

Accurate Measurements of Spectral Reflectance in Picasso's Guernica Painting.

The use of non-invasive spectral measurements to control the conservation status is a part of the preventive conservation of artworks which nowadays is becoming increasingly interesting. This paper describes how to use a spectral measuring device and an illumination system specifically designed for such a task in a very large dimension artwork painting (7.8 m wide × 3.5 m high). The system, controlled by a Cartesian robot, allows spectral measurements in a spectral range of 400-780 nm. The measured data array has a total of 2201 circular regions with 5.5 mm spot diameter placed on a square grid. Colorimetric calculations performed from these spectral measurements may be used to characterize color shifts related to reflectance changes in specific areas of the paint. A color shifting from the expected gray has been shown.

Prevalencia de depresión y factores asociados en usuarios de centros sociosanitarios / Prevalence of depression and associated factors in users of health centers

INTRODUCCIÓN. La depresión constituye uno de los síndromes más frecuentes e incapacitantes de la población mayor. La prevalencia más elevada se observa en los mayores que viven en residencias. En este medio todavía la depresión esta infradiagnosticada e infratratada. Es necesario que los centros diseñen programas para el diagnóstico de la depresión e identifiquen los factores asociados. El objetivo de este estudio es medir la prevalencia de sintomatología depresiva e identificar los factores de riesgo en este centro. MATERIAL Y MÉTODOS. Los participantes del estudio fueron un total de 101 residentes, mayores de 65 años, usuarios de la residencia de Miralbueno, previamente seleccionados, a los que se les controló mediante la escala de Yesavage, el MEC, la escala de Barthel y el índice de Lawton y Brody. También se recogieron datos sociodemográficos, así como la presencia de antecedentes depresivos, conflictos en el centro y patologías no psiquiátricas. RESULTADOS. La prevalencia de sintomatología depresiva medida con la escala Yesavage es del 39.6 %, y es más frecuente en residentes con un Lawton < 3, en mayores de 80 años y que no hayan padecido pérdidas recientes. CONCLUSIONES. Es más frecuente padecer sintomatología patológica de depresión si se tiene una mayor dependencia en las actividades instrumentales de la vida diaria y una edad mayor (AU)

INTRODUCTION. Depression is one of the most common and disabling syndromes of the elderly population. The highest prevalence was observed in the elderly living in nursing homes. In this medium yet depression is underdiagnosed and undertreated. Centers need to design software for the diagnosis of depression, identify associated factors. The aim of this study is to measure the prevalence of depressive symptoms and to identify risk factors in this center. INSTRUMENTS AND METHODS. Study participants were a total of 101 residents, over 65 years, users of Miralbueno residence, previously selected, to which were administered the scale of Yesavage, MEC, the Barthel and Lawton and Brody index. Also it was collected sociodemographic data and the presence of a history of depression, conflict in central and non-psychiatric disorders. RESULTS. The prevalence of depressive symptoms measured Yesavage scale is 39.6 %, being more frequent in residents with Lawton < 3, over 80 years and that have not suffered recent losses. CONCLUSIONS. It is more common developing pathological symptoms of depression if you have a greater reliance on instrumental activities of daily living and older (AU)

The validity of the 12-item Bem Sex Role Inventory in older Spanish population: an examination of the androgyny model.

The Bem Sex Role Inventory (BSRI) is the most commonly used and validated gender role measurement tool across countries and age groups. However, it has been rarely validated in older adults and sporadically used in aging and health studies. Perceived gender role is a crucial part of a person's identity and an established determinant of health. Androgyny model suggests that those with high levels of both masculinity and femininity (androgynous) are more adaptive and hence have better health. Our objectives were to explore the validity of BSRI in an older Spanish population, to compare different standard methods of measuring gender roles, and to examine their impact on health indicators. The BSRI and health indicator questions were completed by 120 community-dwelling adults aged 65+ living in Aragon, Spain. Exploratory factor analysis was performed to examine psychometric properties of the BSRI. Androgyny was measured by three approaches: geometric mean, t-ratio, and traditional four-gender groups classification. Relationships between health indicators and gender roles were explored. Factor analysis resulted in two-factor solution consistent with the original masculine and feminine items with high loadings and good reliability. There were no associations between biological sex and gender roles. Different gender role measurement approaches classified participants differently into gender role groups. Overall, androgyny was associated with better mobility and physical and mental health. The traditional four groups approach showed higher compatibility with the androgyny model and was better able to disentangle the differential impact of gender roles on health.

Integración social del anciano institucionalizado / Social integration of institutionalized elderly

El objetivo es describir las características clínicas y de dependencia de un grupo de ancianos con enfermedad mental, institucionalizados con el fin de conocer la posibilidad de integrarse en residencias de ancianos de la comunidad. Es un estudio descriptivo, transversal y cuantitativo llevado a cabo en el Centro Psiquiátrico de Rehabilitación (CPR) deSádaba, con personas mayores de 65 de edad. Los datos recogidos fueron: historias clínicas, entrevista que valora el comportamiento actual, índice de Barthel y escalas de evolución HoNOS y criterios de cronicidad. Según este estudio, hay un perfil clínico y de rendimiento en AVD que permite a pacientes con enfermedad mental gravey crónica el que sean derivados a recursos normalizados comunitarios (AU)

Objetive is to describe the clinical and dependency characteristics of a group of institutionalized elderly persons suffering from mental diseases, in order to determine the feasibility of their integration into local residential homes. A descriptive, transversal and quantitative study conducted at the Centro Psiquiátrico de Rehabilitación de Sádaba (Psychiatric Rehabilitation Centre of Sádaba) with people aged 65 years or over. Data was collected through medical records, interviews which assessed the current behaviour of the person, the Barthel Index, and the Evolution Scales HoNOS and Chronicity. According to this study, there is a clinical and performance profile in ADL that allows for patients with serious and chronic mental illness to be referred to standard resources within the local community (AU)

[Creation of a unit for education in the self-management of oat]. / Creación de una unidad de educación en el autocontrol del TAO.

Oral anticoagulant therapy (OAT) with Vitamin K antagonists requires frequent analytical controls that create a certain degree of dependency and a loss of autonomy in the patient. These drugs have an undesirable variability due to food and drug interactions, febrile processes, etc. which can modify the patient's INR and predispose them to a thromboembolic or hemorrhagic event. OAT self-control is supported by more than 15 years of experience in countries such as Germany and the Netherlands, and by comparative studies that reflect a reduction of thromboembolism and other adverse effects. The reason of this is because these patients are in the correct therapeutic range for longer periods of time due to more frequent controls (once a week against every 4-5 weeks of traditional control) and also to a better understanding of their treatment. In Aragon, OAT is a free health service and in our hospital, OAT has been an institutional aim since 2070. After a training course, the patient is capable to make their own INR determinations at home, to evaluate their results and adjust their own dose. Additionally the patient should acquire the appropriate knowledge to detect any adverse symptom and to know how to react to any problem in their treatment. This article summarizes our experience regarding the implementation of the programme and creation of the specific unit: the organization and training of the professionals involved, establishment of the patient selection criteria, and design of the patients' training course, follow-up strategy and equipment. In addition, the results of the study conducted in our Unit, showing a high degree of patient satisfaction, are included. At this moment 20% of our patients are included in the self-control strategy.

Creación de una unidad de educación en el autocontrol del TAO / Creation of a unit for education in the self-management of OAT

El tratamiento anticoagulante oral (TAO) con antagonistas de la vitamina K requiere frecuentes controles analíticos que crean en el paciente un cierto grado de dependencia y pérdida de autonomía. Estos fármacos tienen un indeseable efecto variable debido a interacciones medicamentosas, alimentarias, comorbilidad, etc. que puede provocar una modificación de la INR (International Normalized Ratio) del rango terapéutico correcto y la posibilidad de sufrir algún evento tromboembólico o hemorrágico. El programa de autocontrol del TAO está avalado por una experiencia superior a 15 años en países como Alemania y Holanda, y por numerosos estudios en los que queda reflejada una reducción de los efectos adversos, principalmente de carácter tromboembólico. Esto es debido a que los pacientes se encuentran más tiempo en el rango terapéutico correcto, al ser más frecuentes los controles analíticos y ajustes de dosis (una vez a la semana frente a las 4-5 semanas del control tradicional) y a un mejor conocimiento de su tratamiento. En la CCAA de Aragón esta prestación sanitaria gratuita y en nuestro hospital es un objetivo institucional desde el año 2010. El programa consiste en capacitar al paciente para realizarse la determinación de la INR en su autoanalizador, interpretar el resultado y ajustar su propia dosis acomodándola a los cambios sufridos. Así mismo, debe adquirir los conocimientos adecuados para advertir cualquier síntoma adverso y saber reaccionar ante cualquier problema en su tratamiento. En este artículo relatamos nuestra experiencia en la creación de la unidad y la implantación del programa: estructuración y formación de los profesionales implicados, elección de los criterios en la selección de los pacientes, material necesario, diseño del curso de aprendizaje de los pacientes, estrategia de la evolución y seguimiento. Además se incluyen los resultados de un estudio realizado en nuestra unidad, donde se muestra el alto grado de satisfacción de los pacientes adscritos. Se ha logrado implantar el programa con una gran aceptación. Actualmente se halla incluido el 20% del total de asistidos(AU)

Oral anticoagulant therapy (OAT) with Vitamin K antagonists requires frequent analytical controls that create a certain degree of dependency and a loss of autonomy in the patient. These drugs have an undesirable variability due to food and drug interactions, febrile processes, etc. which can modify the patient's INR and predispose them to a thromboembolic or hemorrhagic event. OAT self-control is supported by more than 15 years of experience in countries such as Germany and the Netherlands, and by comparative studies that reflect a reduction of thromboembolism and other adverse effects. The reason of this is because these patients are in the correct therapeutic range for longer periods of time due to more frequent controls (once a week against every 4-5 weeks of traditional control) and also to a better understanding of their treatment. In Aragon, OAT is a free health service and in our hospital, OAT has been an institutional aim since 2010. After a training course, the patient is capable to make their own INR determinations at home, to evaluate their results and adjust their own dose. Additionally, the patient should acquire the appropriate knowledge to detect any adverse symptom and to know how to react to any problem in their treatment. This article summarizes our experience regarding the implementation of the programme and creation of the specific Unit: the organization and training of the professionals involved, establishment of the patient selection criteria, and design of the patients' training course, follow-up strategy and equipment. In addition, the results of the study conducted in our Unit, showing a high degree of patient satisfaction, are included. At this moment 20% of our patients are included in the self-control strategy (AU)

Hemoperitoneo espontáneo secundario a rotura de adenoma hepatocelular / No disponible

No disponible