A Low Transition Temperature Mixture-based viscosupplementation complemented with celecoxib for osteoarthritis treatment.

Viscosupplementation consists of hyaluronic acid (HA) intra-articular injections, commonly applied for osteoarthritis treatment while non-steroidal anti-inflammatory drugs (NSAIDs) are widely administered for pain relief. Here, HA and a NSAID (celecoxib) were combined in a formulation based on a low transition temperature mixture (LTTM) of glycerol:sorbitol, reported to increase celecoxib's solubility, thus rendering a potential alternative viscosupplement envisioning enhanced therapeutic efficiency. The inclusion of glucosamine, a cartilage precursor, was also studied. The developed formulations were assessed in terms of rheological properties, crucial for viscosupplementation: the parameters of crossover frequency, storage (G') and loss (G'') moduli, zero-shear-rate viscosity, stable viscosity across temperatures, and shear thinning behaviour, support viscoelastic properties suitable for viscosupplementation. Additionally, the gels biocompatibility was confirmed in chondrogenic cells (ATDC5). Regarding drug release studies, high and low clearance scenarios demonstrated an increased celecoxib (CEX) release from the gel (6 to 73-fold), compared to dissolution in PBS. The low clearance setup presented the highest and most sustained CEX release, highlighting the importance of the gel structure in CEX delivery. NMR stability studies over time demonstrated the LTTM+HA+CEX (GHA+CEX) gel as viable candidate for further in vivo evaluation. In sum, the features of GHA+CEX support its potential use as alternative viscosupplement.

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.

Accuracy of ICG compared with technetium-99 m for sentinel lymph node biopsy in vulvar cancer.

PURPOSE: Sentinel lymph node biopsy with radioactive tracer is the standard-of-care in lymph node status assessment in vulvar cancer. Indocyanine green fluorescence-ICG is a promising detection method, due to its advantages over technetium-99 m. In vulvar cancer, the procedure is controversial due to study heterogeneity and the small sample size in previous studies. This study evaluates ICG sentinel lymph node detection compared with the criterion-standard with technetium (dual modality method). METHODS: Preoperative technetium and intraoperative ICG for sentinel lymph node have been prospectively evaluated in early-stage vulvar cancer. The primary endpoint was to determine accuracy in the detection rate for ICG compared with technetium. Secondary objectives included tracer modality relationship with obesity, tumor size and location. RESULTS: In total, 75 patients participated at 8 centers; 38 had lateral and 37 had midline vulvar tumors. The overall sentinel lymph node detection rate was 85.3 % for technetium and 82.7 % for ICG. For lateral tumors, the detection rate was 84.2 % vs. 89.5 %, while it was 86.5 % vs. 75.7 % for middle tumors, using technetium and ICG, respectively. The median sentinel node harvest was 1.7 (range 1-4), with 24 % metastatic involvement. The sensitivity and positive predictive value for ICG based on the standard technique with technetium was 91.08 % (95 % CI, 83.76-95.84) and 94.8 % (95 % CI, 84.84-96.48), respectively. No significant differences were found comparing the two tracers in patients with midline lesions, obesity (body mass index ≥ 30) and tumor size ≥ 2-4 cm. CONCLUSION(S): ICG shows comparable performance parameters to the gold-standard of radioisotope localization.

The Relationship between Subjective Aging and Cognition in Elderly People: A Systematic Review.

There is a growing body of evidence on the effects of subjective aging on health, well-being and quality of life. This review aims to synthesize findings about the link between subjective aging and cognition and cognitive decline. Furthermore, it provides an examination of variation sources such as subjective aging construct, cognitive domains, measures employed, age and moderator variables. A systematic search was performed in PubMed, PsychInfo and Web of Science, as well as grey literature searches in Google Scholar, OpenGrey, WorldCat and NDLTD, which resulted in 59 reports being included. Subjective aging is a relevant construct in the explanation and prediction of cognitive aging and cognitive decline in elderly adults. More positive views about own aging and self-perceptions of aging, as well as a younger subjective age, were consistently related to better cognition and lower risk of cognitive decline. However, there were differences due to subjective aging subdimensions and cognitive domains, as well as an effect of age. Additionally, there were concerns about the content validity of some measures employed, such as the Philadelphia Geriatric Center Morale Scale for subjective aging and the Mini Mental State Examination for global cognition. Further studies should employ longitudinal designs with a process-based approach to cognition and precise subjective aging measures.

Breast Cancer Patients' Experiences with Online Group-Based Physical Exercise in a COVID-19 Context: A Focus Group Study.

In patients with breast cancer, physical exercise reduces the toxicity of treatment; however, this physical exercise must meet a set of criteria, such as being guided by knowledgeable instructors. Thus, the aim of this study was to explore the perceptions of female breast cancer patients regarding the impact of an online physical exercise programme in the context of the COVID-19 pandemic. Nineteen female breast cancer patients participated in four focus group interviews as part of a qualitative study using a thematic analysis between December 2020 and May 2021. Three major themes emerged: "Experiences and perceptions of online physical exercise with breast cancer"; "Incorporating exercise-based activity for cancer-related side effects"; and "Increasing self-esteem and empowerment". Online, live-streamed, and supervised group activities help breast cancer patients engage and prevent the recurrence of cancer-related side effects, as well as to control COVID-19-related fear and provide an alternative to promote mental health-related quality of life.

Influence of Female Sex Hormones on Ultra-Running Performance and Post-Race Recovery: Role of Testosterone.

In recent years, increasing numbers of women have participated in extremely long races. In adult males, there is a clear association between physiological levels of endogenous sex hormones and physical performance. However, the influence of plasmatic sex hormones and the effects of different types of hormonal contraception (HC) on the modulation of physical performance in adult females remain to be fully clarified. Eighteen female ultra-endurance athletes were recruited to participate in the study. Different variables were studied, including hematological parameters, body mass index, and body composition. Strength measurements were obtained using the squat-jump and hand-grip test. A repeated-measures analysis demonstrated significant differences in hematological values of CK and LDH pre-race as compared to immediately post-race and after 24/48 h. Furthermore, statistical differences were found in squat-jump and hand-grip test results after the ultramarathon. Testosterone, estradiol, and the testosterone/estrogen ratio were significantly correlated with muscle fatigue and were found to be indirect markers of muscle damage. A multivariate analysis demonstrated the protective role of testosterone against muscle damage and severe fatigue. Fluctuations in endogenous testosterone levels were correlated with greater fatigability and muscle damage after the competition. Adjusting the menstrual cycle with HC would not provide any further benefit to the athlete's competitive capacity.

Therapeutic Liquid Formulations Based on Low Transition Temperature Mixtures for the Incorporation of Anti-Inflammatory Drugs.

Most nonsteroidal anti-inflammatory drugs (NSAIDs) present poor aqueous solubility, impairing their efficiency in physiological media. In this context, Low Transition Temperature Mixtures (LTTMs) are a promising platform to overcome drugs' poor solubility, forming therapeutic liquid formulations. In this work, the LTTMs of citric acid:L-arginine:water (C:A:W) and glycerol:sorbitol (G:S) were studied in terms of their features and assessed in terms of their ability to increase the solubility of six NSAIDs in physiological media. The physicochemical properties of LTTMs were characterized by state-of-art techniques commonly used for these systems. The cytotoxicity of G:S was also evaluated in L929 mouse fibroblasts and the viscosity, polarity, and pH properties of the studied mixtures were related to the solubility of NSAIDs. The pH and polarity were the parameters that most influenced the drugs' solubility. Ibuprofen, naproxen, ketoprofen, indomethacin, and flurbiprofen did not present any solubility improvement in the formulations tested. However, concentrated mixtures of C:A:W or G:S in the physiologic-mimicked media (PBS) rendered a celecoxib solubility 4 and 5 times higher than PBS, respectively. These therapeutic liquid formulations of celecoxib in C:A:W or G:S can be a promising tool to increase celecoxib's therapeutic efficiency in local applications.

Impact of the COVID-19 Pandemic on the Lifestyles and Quality of Life of Women With Fertility Problems: A Cross-Sectional Study.

Background: The COVID-19 pandemic has implied worldwide the imposition of confinement measures and mobility restrictions, to a greater or lesser extent. It has also meant the closure of some public medical services such as reproductive care. This situation may have impacted the health-related behaviour and quality of life of women with fertility problems. Objective: The objective of this study was to analyse the effects of confinement and the suspension of reproductive medical care on the lifestyle (diet, physical exercise, and smoking habits), anxiety and depression, and quality of life of infertile women by comparing their pre- and post-confinement situations. Methods: We carried out a cross-sectional, internet-based study. Information was collected on these women's adherence to the Mediterranean diet (MEDAS questionnaire), physical exercise (IPAQ-SF), anxiety and depression (HADS), and quality of life related to fertility (FertiQol) before, during, and after confinement. The survey was conducted between 1 September and 28 October 2020. Results: A total of 85 women participated. There had been a significant increase in anxiety and depression levels (P < 0.001) and an increase in tobacco consumption among female smokers during confinement vs. pre-confinement (62.5% had increased their consumption). The participants had also increased the mean number of hours they spent sitting (P < 0.001). There had also been an increase in vigorous and moderate exercise levels by 40 and 30%, respectively (P = 0.004). However, no differences were observed in these patients' eating habits as a result of confinement (P = 0.416). When the reproduction service was resumed, the participants showed higher anxiety level scores (P = 0.001) with respect to the pre-confinement situation as well as lower mean FertiQol scale score (P = 0.008). Conclusions: Confinement had increased anxiety and depression levels among these infertile women as well as tobacco use among the participants who were smokers. The prolonged closure of reproductive care units decreased the quality of life of the participants of this study. These results suggest the need to implement online programs to improve healthy habits and quality of life of this population group.

Unravelling the nature of citric acid:L-arginine:water mixtures: the bifunctional role of water.

The use of water as a component of deep eutectic systems (DES) has raised some questions regarding its influence on the nature of the mixture. Does it form a DES or an aqueous solution and what is the role of water? In this work, the nature of citric acid:l-arginine:water mixtures was explored through phase equilibria studies and spectroscopic analysis. In a first step, PC-SAFT was validated as a predictive tool to model the water influence on the solid liquid equilibria (SLE) of the DES reline using the individual-component approach. Hence, activity coefficients in the ternary systems citric acid:l-arginine:water and respective binary combinations were studied and compared using ePC-SAFT. It was observed that the water-free mixtures citric acid:l-arginine showed positive deviation from Raoult's law, while upon addition of water strong negative deviation from Raoult's law was found, yielding melting depressions around 100 K. Besides these strong interactions, pH was found to become acidic (pH = 3.5) upon water addition, which yields the formation of charged species ([H2Cit]- and [l-arg]+). Thus, the increased interactions between the molecules upon water addition might be caused by several mechanisms such as hydrogen bonding or ionic forces, both being induced by water. For further investigation, the liquid mixtures citric acid:l-arginine:water were studied by FTIR and NMR spectroscopy. FTIR spectra disproved a possible solubility enhancement caused by salt formation between citric acid and l-arginine, while NMR spectra supported the formation of a hydrogen bonding network different from the binary systems citric acid:water and l-arginine:water. Either being a DES or other type of non-ideal solution, the liquefaction of the studied systems is certainly caused by a water-mediator effect based on the formation of charged species and cross interactions between the mixture constituents.

Exploring daily patterns of work engagement among teachers: a latent growth modeling approach / Explorando patrones diarios de engagement en docentes: una aproximación mediante modelos de crecimiento latente

BACKGROUND: Starting from the Demands-Resources model, our aims through this diary research were to explore daily diary fluctuations in work engagement in a sample of teachers and to look for the effects of that on affect and satisfaction at home. METHOD: Several Latent Growth Curve (LCGA) models were run on two dimensions of work engagement (vigor and dedication) with an exploratory focus, to look for different grouped oscillation patterns. Then, several repeated measures MANCOVA explored whether those patterns were related to affect and satisfaction at night. RESULTS: Two distinct latent trajectories were found for work engagement dimensions. However, neither of them showed any notable development over time. Furthermore, our latent classes were found to be related to inter-individual differences in positive and negative affect, and the satisfaction at home domain, but no interesting within-subjects (overall time) effects were found. CONCLUSIONS: Contrary to our expectations, we provide some evidence of the stability of work engagement over the working week. In addition, following previous results, work engagement levels across the working week were found to be related to levels of affect and satisfaction at home, adding evidence to the spillover potential of work engagement on individuals' key personal resources

ANTECEDENTES: partiendo del modelo de demandas y recursos, este estudio pretende explorar distintos patrones semanales de oscilación en el compromiso laboral de una muestra de maestros, y observar cómo dichos patrones se relacionan con los niveles de afecto y satisfacción en su ámbito extralaboral. MÉTODO: las trayectorias se fijaron mediante varios modelos de curva latente (LCGA) en dos dimensiones del compromiso laboral (vigor y dedicación). Luego, una serie de MANCOVA de medidas repetidas exploraron la relación entre dichas trayectorias y los niveles de afecto y satisfacción extra laboral. RESULTADOS: se localizaron dos trayectorias distintas para ambas dimensiones. No obstante, no se observaron grandes oscilaciones temporales. Asimismo, las trayectorias se relacionaron con diferencias individuales en los niveles de afecto y satisfacción en contexto extralaboral. No se apreciaron efectos intra-sujeto (tiempo) reseñables. CONCLUSIONES: a pesar de evidencias previas, los análisis parecen indicar que el compromiso laboral se comporta de forma estable. Por otro lado, se observó un efecto de contagio entre el nivel de compromiso laboral, el afecto y la satisfacción en el contexto extralaboral, añadiendo evidencia a la relación entre el compromiso y los recursos personales de los trabajadores

Exploring daily patterns of work engagement among teachers: A Latent growth modeling approach.

BACKGROUND: Starting from the Demands-Resources model, our aims through this diary research were to explore daily diary fluctuations in work engagement in a sample of teachers and to look for the effects of that on affect and satisfaction at home. METHOD: Several Latent Growth Curve (LCGA) models were run on two dimensions of work engagement (vigor and dedication) with an exploratory focus, to look for different grouped oscillation patterns. Then, several repeated measures MANCOVA explored whether those patterns were related to affect and satisfaction at night. RESULTS: Two distinct latent trajectories were found for work engagement dimensions. However, neither of them showed any notable development over time. Furthermore, our latent classes were found to be related to inter-individual differences in positive and negative affect, and the satisfaction at home domain, but no interesting within-subjects (overall time) effects were found. CONCLUSIONS: Contrary to our expectations, we provide some evidence of the stability of work engagement over the working week. In addition, following previous results, work engagement levels across the working week were found to be related to levels of affect and satisfaction at home, adding evidence to the spillover potential of work engagement on individuals' key personal resources.

Efficacy of an Internet-Based Intervention to Promote a Healthy Lifestyle on the Reproductive Parameters of Overweight and Obese Women: Study Protocol for a Randomised Controlled Trial.

Background: Infertility is estimated to affect 15% of couples of reproductive age. Weight management problems (being obese or overweight) are among the problems that produce infertility, both in women seeking spontaneous pregnancy and in those undergoing assisted reproduction techniques. Over the last few decades, the prevalence of obesity has increased alarmingly in our society and is now considered one of the most important public health problems. The combination of diet and exercise to achieve weight loss are currently considered an effective intervention for the improvement of reproductive parameters in overweight or obese infertile women. In other population groups, it has been shown that Internet-based interventions are just as effective as traditional ones, and these cover a larger population with a good cost-benefit ratio. However, to the best of our knowledge, no studies so far have analysed any specific online interventions for this group of infertile women. Thus, the objective of this project will be to evaluate the effectiveness of an online program to promote a healthy lifestyle among women who are overweight or obese who also have a diagnosis of infertility and are on the waiting list for in vitro fertilisation treatment. Methods: This will be a randomised controlled clinical trial conducted in 94 women which will compare a self-administered Internet-based intervention promoting a healthy lifestyle in terms of diet and exercise (n = 47) to a control group that will receive standard medical care. The online program will comprise nine modules, will last for 3 months, and will be monitored every 3 months after the intervention until the final follow-up at 12 months. The main outcome will be the spontaneous pregnancy rate. Secondary outcomes will include changes in body composition, dietary and physical exercise habits, glycaemic profiles, lipid profiles, hormonal profiles, and patient quality of life related to their fertility problems. The data analysis will be done on an intention-to-treat basis. Discussion: The aim of this study is to increase our knowledge of the effectiveness of online interventions specifically adapted to infertile women who are overweight or obese in the promotion of healthy lifestyles.

Trombosis de la vena ovárica derecha tras histerectomía subtotal y colposacropexia vía laparoscópica: a propósito de un caso / Right ovarian vein thrombosis after subtotal laparoscopic hysterectomy and colposacropexy: report of clinical case

La trombosis de la vena ovárica es una complicación infrecuente que suele ocurrir durante el postparto, comúnmente tras una cesárea. Sin embargo, existen otras causas como son: la cirugía abdominal, las infecciones, las neoplasias malignas o los estados procoagulantes. La sintomatología es variada e inespecífica. En el estudio de esta entidad, tanto la Resonancia Magnética como el TAC con contraste intravenoso juegan un papel importante. Puesto que las complicaciones pueden ser mortales, es fundamental el tratamiento inmediato con anticoagulación y antibioterapia. El caso presentado a continuación supone uno de los posibles diagnósticos a considerar en una paciente intervenida de histerectomía subtotal laparoscópica con colposacropexia, que presenta dolor abdominal persistente tras la cirugía y riesgo de trombosis moderado por sus factores de riesgo.

Ovarian vein thrombosis is a rare complication that might happen in the postpartum period, most commonly after a cesarean section. However, there are many other causes such as abdominal surgery, infection, malignant neoplasms and procoagulant statuses. Symptoms are varied and unspecific. The computed tomography with intravenous contrast and the magnetic resonance play an important role in the diagnosis. As complications can be fatal, treatment with anticoagulants and antibiotics is necessary. We present a case in which ovarian vein thrombosis needs to be considered in the differential diagnosis in a woman after a subtotal laparoscopic hysterectomy with colposacropexy with moderate risk factors of thrombosis.

Influencia de los factores psicosociales en la enfermedad de Crohn / Influence of psychosocial factors in Crohn's disease / Influência de fatores psicossociais na doença de Crohn

OBJETIVO: Conocer la influencia de los factores psicosociales en la enfermedad de Crohn. METODOLOGÍA: Se utilizó la Escala de Estrés Percibido, la Escala de Apoyo Social Percibido y la Escala Multidimensional de Locus de Control. Se recopilaron los datos de pacientes con enfermedad de Crohn - en fase de brote y quiescencia - y sanos. Los niveles de estos factores se compararon para conocer su impacto en la enfermedad de Crohn. RESULTADOS: Diferencias estadísticamente significativas se encontraron en las tres variables en los grupos. Los pacientes con enfermedad de Crohn en fase de brote percibieron los niveles de estrés más altos. Los pacientes con enfermedad de Crohn que estaban en fase de recidiva presentaron los mayores niveles de apoyo social, identificándose el efecto modulador que tiene esta variable sobre el estrés. Y, por último, los pacientes con enfermedad de Crohn con brote presentaron mayor nivel de locus de control externo. CONCLUSIÓN: Son necesarias intervenciones enfermeras en la enfermedad de Crohn relacionadas con mayor manejo del estrés, aumento del apoyo social y disminución del locus de control externo

OBJECTIVE: To know the influence of psychosocial factors in the Crohn ́s disease. METHODOLOGY: The Perceived Stress Scale, Scale of Social Support Perceived and Multidimensional Scale of Locus of Control was used. Data was collected from patients with Crohn ́s disease -in outbreak and quiescence phase- and healthy. The levels ofthese factors were compared to know its impact in the Crohn ́s disease. RESULTS: Statistically significant differences found in the three variables in the groups. Patients with Crohn's disease outbreak phase perceived the highest stress levels. Patients with Crohn's disease who were in the relapse phase had the highest levels of social support, identifying the modulating effect that this variable has on stress. And finally, patients with Crohn's disease with outbreak had a higher level of external control locus. CONCLUSIONS:Nurse interventions are necessary in the Crohn ́s disease therapy in order to better manage the stress, increase the social support network and change the locus of control, decreasing the external locus of control

OBJETIVO: Conhecer a influência de fatores psicossociais na doença de Crohn. METODOLOGIA: Utilizou-se a Escala de Estresse Percebido, Escala de Apoio Social Percebido e Escala Multidimensional de Lócus de Controle. Os dados foram coletados de pacientes com doença de Crohn - em fase de cessação e quiescência - e saudáveis. Os níveis desses fatores foram comparados para conhecer seu impacto na doença de Crohn. RESULTADOS: Diferenças estatisticamente significantes foram encontradas nas três variáveis nos grupos. Pacientes com doença de Crohn na fase de exacerbação perceberam os maiores níveis de estresse. Pacientes com doença de Crohn em fase de remissão apresentaram os maiores níveis de suporte social, identificando o efeito modulador dessa variável no estresse. E finalmente, os pacientes com doença de Crohn exacerbaçao tinham um nível mais alto de locus de controle externo. CONCLUSÃO: As intervenções do enfermeiro são necessárias na terapia da doença de Crohn para melhor manejo do estresse, aumento da rede de apoio social e mudança do locus de controle, diminuindo o locus de controle externo

Polymer Science and Engineering Using Deep Eutectic Solvents.

The green and versatile character of deep eutectic solvents (DES) has turned them into significant tools in the development of green and sustainable technologies. For this purpose, their use in polymeric applications has been growing and expanding to new areas of development. The present review aims to summarize the progress in the field of DES applied to polymer science and engineering. It comprises fundamentals studies involving DES and polymers, recent applications of DES in polymer synthesis, extraction and modification, and the early developments on the formulation of DES-polymer products. The combination of DES and polymers is highly promising in the development of new and 'greener' materials. Still, there is plenty of room for future research in this field.

Family and community support among older Chilean adults: the importance of heterogeneous social support sources for quality of life.

Family and community social networks act as social resources that promote well-being at advanced ages. In this study, we analyze the association between social support received from personal social networks (social support from various family members and friends) and community social networks (social support from neighbors and the neighborhood, age, ethnic, or religious group peers and formal social support networks) and quality of life (QoL) for a sample of older Chilean persons (n = 777). The results confirm that social support from family (partner, children, and extended family) and friends, integration in the community (neighbors) and social support from informal systems (social groups) are associated with QoL. Moreover, the model including both types of support explains 25.8% of variance in QoL. The results and their possible implications are discussed.

La influencia de la pareja en el ajuste a la enfermedad cardiaca / The influence of the couple in coping with heart disease

Resumen El objetivo del presente estudio fue analizar la influencia del apoyo social de la pareja en el ajuste a la enfermedad cardiaca, así como su influencia en la adhesión a las pautas clínicas. La muestra estuvo compuesta por 109 pacientes con sus parejas. Se llevaron a cabo las mediciones mientras realizaban el Programa de Rehabilitación Cardiaca del Hospital Ramón y Cajal de Madrid. Los resultados indican que la pareja no es una fuente de apoyo relevante para el ajuste a la enfermedad del paciente (apoyo recibido [p = 0.46] y satisfacción con el apoyo recibido [p = 0.41]. Sin embargo, el apoyo de la pareja sí resulta especialmente importante de cara al cumplimiento de hábitos cardiosaludables, sobre todo en el seguimiento realizado a los 8 y a los 12 meses (p < 0.001), lo que conduce a analizar la posibilidad de que la pareja no sea importante para el ajuste a la enfermedad debido posiblemente a que la muestra está pasando por una intervención clínica y, por tanto, es posible que otras fuentes como profesionales de la salud u otros pacientes estén ejerciendo un papel predominante de apoyo. En el momento en que esta supervisión clínica desaparece, el apoyo de la pareja es de vital importancia para la adhesión a las pautas recomendadas, las cuales tienen relación con cambios en el estilo de vida y, por tanto, en la prevención de recaídas.

Abstract The main aim of our study is to analyze the influence of social support on cardiac illness adjustment and on health recommendations adherence. The sample was 109 patients and their partners, all of them included in the Cardiac Rehabilitation Program of the Ramon y Cajal Hospital in Madrid. Our results show that partner support has not a significant impact on patients¿ adjustment (received support [P = .46] and satisfaction with received support [P = .041]). However, partner support has a significant effect on adherence to health recommendations (food, physical exercise, smoking, etc), most of all in the 8 and 12 months' follow-up (P < .001). Perhaps, in the first stages of illness, support provided for other sources (health professionals, other patients, etc.) could be more important than partner support, most of all taking into account that patients were included in a clinical intervention. As supervision decreases, the effect of partner support on adherence increases. The implications of our results for future interventions and research are discussed.

Elementos estructurales de la red social, fuentes de apoyo funcional, reciprocidad, apoyo comunitario y depresión en personas mayores en Chile / Structural dimension of social networks, sources of functional support, reciprocity, community support, and depression among elder people in Chile

La asociación entre apoyo social y depresión en el caso de las personas mayores constituye un objeto de estudio de especial relevancia en sociedades con altas tasas de envejecimiento, como es el caso de Chile. La presente investigación se centra en el papel jugado por variables de carácter psicosociológico: tipo de apoyo en función de la fuente de procedencia, reciprocidad en el apoyo según tipo de apoyo y fuente de procedencia, y apoyo comunitario. Se aplicaron escalas de depresión y apoyo social ampliamente utilizadas en una muestra (n=493) de la región de Arica-Parinacota, en el Norte de Chile. Se realiza un análisis de regresión jerárquica y de ecuaciones estructurales. Los resultados sugieren que el cónyuge y los hijos son las fuentes de apoyo relevantes para los síntomas de depresión, sobre todo en sus funciones instrumental y emocional. La reciprocidad en el apoyo es una variable fundamental para dar cuenta de la relación existente entre fuentes de apoyo social y depresión

The relation among aeging, social support, and depression is a key subject in societies with rising aeging rates, as Chile is. The present piece of research focus on the rol played by psychosociological variables: type of support by source, reciprocity in support by type and source of support, and communitary support. Validated and widely used scales for depression and social support where applied in a sample (n=493) obtained from Arica-Parinacota region, north of Chile. Hierarchichal regression and structural equation model (SEM) are used. Results suggest that partner and adult children constitute the main sources of support (specially emotional and instrumental) against depression. Reciprocity is a key variable to account for the relation between sources of support and depression

Ethnicity, Social Support, and Depression Among Elderly Chilean People.

Recent evidence regarding the relationship between social support and depression in elderly people shows the important role of ethnicity. This research describes the characteristics of social support in a sample of elderly people aged 60 and above living in northern Chile (n = 493), and analyzes the differences in the relationship between social support and depression between an indigenous group (Aymara population, n = 147) and a nonindigenous group (white, Caucasian, mestizo, n = 346). Various dimensions of social support were considered: structural elements, functional social support according to source, and community participation. The results show the existence of significant differences in the characteristics and dimensions of social support depending on sex, ethnicity, and marital status. Further, the central role of the family group is observed for both Aymara and nonindigenous elderly people. The hierarchical regression models obtained result in notable differences in the role of the structural, functional, and community elements of support in explaining depression for the ethnic groups considered.

Support groups and cardiac rehabilitation: effects of partner participation on anxiety and depression

This study analyzes the effect on levels of patient anxiety and depression of a partner joining a cardiac rehabilitation program support group, also taking into account the sex of the patient. The study was undertaken using a two-group comparison design with pre-and post-test measures in non-equivalent groups. The sample comprised patients in the cardiac rehabilitation program (CRP) at the Ramón y Cajal Hospital, Madrid (Spain). Analysis of covariance (ANCOVA) showed direct effects of sex and partner participation in support groups on the anxiety trait. Similarly, interaction effects were observed between the sex variable and partner participation. These results indicate the pertinence of designing separate groups for patients and partners (AU)

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