Analysis of the Psychosocial Sphere of Older Adults in Extreme Poverty in the Peruvian Amazon.

The situation of social exclusion in which older adults live in extreme poverty is a problem that leads to psychological alterations such as depression or cognitive deterioration. Our objective was to analyze the living conditions and the psychosocial sphere of older adult people living in extreme poverty in Requena del Tapiche in Peru. This was an observational, descriptive, cross-sectional study. Sixty participants between 60 and 100 years of age of both sexes were included who gave their informed consent. Sociodemographic variables were analyzed, and the Gijón, family Apgar, Yesavage, and Pfeiffer scales were used. The sample was composed of 55% women and 45% men, with a mean age of 79.2 years (SD 6.67). More than half live alone or with their spouse. Fifty-seven percent sleep on the floor or on wood, and about 82% do not have safe water. Family dysfunction is found in 40%, and 98% are at social risk or with an established social problem and a precarious economic situation. More than 60% suffer from depressive symptoms, which are more frequent in women. We conclude that older adults perceive deficient family support, observing a deteriorated social situation. Most of them are at risk of social exclusion and loneliness, making them more vulnerable. They show sadness, with a high rate of depression. People with more cognitive impairment live alone, and those in social exclusion suffer a higher degree of depression. More cooperative projects and health promotion interventions developed in the peripheral neighborhoods of Requena del Tapiche are needed to improve the impact on the health of older adult people in extreme poverty.

Is There an Adequate Therapeutic Approach to Thyroid Pathology in Patients with Down Syndrome?

Thyroid dysfunction stands as the most prevalent endocrine disorder in individuals with Down syndrome, particularly showcasing both clinical and subclinical hypothyroidism. TSH and FT4 blood values serve as common diagnostic and treatment adjustment markers. In Down syndrome (DS), hormone values may deviate from those observed in the general population, which may lead to overdiagnosis and consequent iatrogenesis of subclinical hypothyroidism. The objective of this study was to analyze the appropriateness of the replacement therapeutic approach by identifying the TSH and FT4 values that can be considered normal in these patients. METHODS: A cross-sectional study was conducted in 503 subjects with DS of both sexes and without age limit drawn from the Health Program for individuals with DS in Valencia (Spain) from February 1993 to November 2021. The exclusion criteria included hyperthyroidism, nodules, tumors, or individuals under treatment with drugs influencing iodine metabolism. The normality of data distribution was assessed using the Shapiro-Wilk test. Outliers were detected using the Reed's criterion. Hormone values were estimated using quantile regression models for the 2.5th and 97.5th percentiles. RESULTS: The normal values identified were 0.88-11.25 mIU/L for TSH and 0.71-1.63 ng/dL for FT4. The Wald test indicated no significant differences in the reference intervals based on age or sex. CONCLUSION: The establishment of these values, which, in people with DS, can be considered unique, is of great importance, allowing a watchful waiting attitude to be maintained before starting replacement therapy that is unnecessarily or adjusting medication in diagnosed cases.

Loneliness and social support: Differential predictive power on depression and satisfaction in senior citizens.

The lack of social support and the feelings of loneliness among older adults are associated with physical and mental health negative outcomes. This study attempts to test for their differential predictive power on depression and satisfaction in seniors. Data were drawn from a sample of 335 older adults ranging from 55 to 80 years old, with a mean age of 63.97 years (standard deviation = 5.56) attending a learning program at the University of Valencia during the academic year 2014-2015. In addition to health and wellbeing outcomes, we used the Functional Social Support Questionnaire DUKE-UNC, and two scales of loneliness, the de Jong Gierveld Loneliness Scale and the University of California Loneliness Scale version 3. Using structural equations models with Mplus, two models were proposed to assess the predictive power of social support and loneliness on wellbeing outcomes, specifically life satisfaction and depression, while controlling for health. Results confirm the negative association between loneliness and satisfaction with life and the positive one with depression.

Defensa del diploma de estudios avanzados / Defense of the advanced studies diploma

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Presentación del trabajo de investigación y defensa del Diploma de Estudios Avanzados / Presentation of research studies to obtain the Advanced Studies Diploma

Las normativas para las “lecturas”, “defensas” o exposiciones para la obtención del Diploma deEstudios Avanzados (DEA) están claramente defi nidas en cada Universidad y en los reglamentos derégimen interno de cada Departamento Universitario que desarrolla programas de doctorado, pero solamente hacen referencia a los aspectos formales, tales como plazos, duraciones, composición de tribunales, etc. y no se recogen de forma explícita los contenidos que deberán ser expuestos en las mismas. La demanda, en nuestra Unidad Docente de MFyC, tanto de residentes como de médicos de familia en dicho asesoramiento, nos ha llevado a la necesidad de elaborar un documento que recoja los consejos prácticos y las orientaciones para la presentación del trabajo del Diploma de Estudios Avanzados

In Spain scientifi c production in primary care has increased at a remarkable rate in the last few years.Spain now occupies fourth place amongst the countries with the highest rate of recent production.Castilla-La Mancha also occupies fourth place amongst the Spanish autonomous communities in scientific production in Primary Care, as regards production per million inhabitants. Temporal progression of the impact factors and citations is positive and has shown an increase in recent years.The mean impact factor of the journals in which primary care articles are published is increasingevery year. This means that Primary Care professionals in Castilla-La Mancha are publishing in higherquality journals more frequently