The purpose of health and social policies is to encourage older people more longevity, remain free of disability and experience quality of life while living in their homes. The aim of this study was ...to describe the characteristics of 473 patients diagnosed with motor impairment in primary care, the objectives of home-based rehabilitation and its functional impact.
This prospective observational study was conducted in the Almería Health District. The analysed variables included age, gender, secondary diagnosis, Barthel Index (BI), physiotherapeutic objectives and techniques, and number of sessions.
The sample had a mean age of 83 years, and 59% were women. The assessed conditions with a high prevalence included osteoarticular pathology (55%), Alzheimer's disease (15.1%), cardiovascular disease (13.7%) and stroke (6.5%). The techniques applied mainly consisted of functional exercises (57.1%), caregiver education (13.8%), and technical assistance (5.7%). There were statistically significant differences (t = -15.79; p < 0.001) between initial (X = 34.8) and final BI (X = 48.1), with an improvement of 13.4 points in patients' functional capacity (95% confidence interval CI: -15.0 to -11.7). An equation was constructed to predict patients' final BI as a function of the initial BI using a multiple linear regression model. The regression model explained 78% of the variance in patients with motor impairment.
Important improvements were obtained in terms of functional capacity with a mean of ten sessions of physiotherapy. Lower patient age was correlated with higher initial and final functional capacities in primary care. This study aimed to present a useful starting point for decision making among management and health administration regarding this population group by approaching the process from the reality of practice and in relation to the rehabilitation provided.
ClinicalTrials.gov identifier: NCT02715245 ; Date of registration: 18 January 2016.
El presente trabajo trata de abordar un tema actual y de carácter social, la igualdad entre hombres y mujeres. Históricamente, se ha llevado a cabo una lucha imparable por parte de las mujeres para ...alcanzar la plena igualdad de derechos y libertades con respecto a los hombres. Aún en la actualidad, existen diferencias que perjudican a éstas y que se debe continuar tratando de erradicar. La educación desarrolla un papel crucial en la adquisición de estos valores, pues si el cambio es posible, está en mano de las futuras generaciones. El objetivo de este estudio ha sido el análisis de la percepción del alumnado de secundaria con respecto al tema. Metodología: se obtuvieron los datos de 182 participantes a través de una encuesta online durante la primavera de 2020. Resultados: En lo referente a los estereotipos ligados al genero, se destaca a nivel general un concepto positivo sobre los mismos. Sin embargo, al tratar el tema del amor, los porcentajes varian a favor de la toxicidad y perdida de la privacidad personal. Lo mismo sucede con respecto al trabajo, donde la mitad de los participantes no consideran que exista discriminacion en este ambito. Conclusiones: Según la literatura revisada y las respuestas de los jóvenes, se denota la necesidad de una educación que trate y abogue por la no discriminación por razón de género.
There are many studies whose results reveal possible risk factors for developing an infection after a total knee arthroplasty (TKA). The objective of this study is to analyse the risk factors that ...depend on the hospital and, especially, if the patellar replacement influences the appearance of periprosthetic infection. A retrospective study was performed, where data from the electronic registry of patients of people over 18 and who had undergone TKA, between the years 2015 and 2018, were reviewed. Dependent variables on the patients and the health care system were collected. The possible associations between the factors and the appearance of infection after TKA were studied using univariate and multivariate regression analyses. A total of 907 primary knee arthroplasties were included in the study. Those patients who had their patella replaced had a significantly higher risk of developing an infection (OR 2.07; 95% confidence interval 1.01–6.31). Likewise, patients who underwent surgery by surgeons with more than 10 years of experience were more than twice as likely to become infected than those operated on by younger surgeons (OR 2.64; 95%CI 1.01–6.97). Male patients were also found to be three times more likely to be infected than women (OR 2.99; 95%CI 1.32–5.74). Those interventions that were longer had a higher risk of infection. The same happened with patients who stayed in the hospital for a longer period of time. The rest of the variables did not show statistically significant results. In this study, it was found that the replacement of the patella may be a factor of infection, but it should be corroborated with randomized clinical trials. Furthermore, patients who underwent longer surgeries or those with prolonged hospital stays should be closely monitored to detect infection as soon as possible and establish the most appropriate treatment.
El progresivo envejecimiento de la poblacion obliga a las administraciones con competencias en materia sanitaria a intervenir en los efectos adversos de la falta de actividad fisica o funcional ...(depresion, ansiedad, deterioro cognitivo e insatisfaccion vital, entre otros). El objetivo de este estudio es comprobar si el nivel de ocupacion en actividades basicas de la vida cotidiana u ocio de una muestra de personas mayores de 55 anos tiene influencia sobre el grado de funcionamiento cognitivo y su satisfaccion vital. Se trata de un estudio transversal, con un muestreo no probabilistico por conveniencia, desarrollado con 302 personas mayores de 55 anos de varios centros participacion activa (CPA) de la provincia de Almeria (Espana). Los instrumentos utilizados para la valoracion comprendieron el Mini-Examen Cognoscitivo, la Escala de Satisfaccion de Filadelfia y el Cuestionario de Conducta Ocupacional de Mayores (C-COM). El analisis multigrupo de los datos tambien incluyo un modelo estructural mediante path analysis. Los resultados han verificado la influencia de la ocupacion en el deterioro cognitivo y la satisfaccion vital, tanto en hombres como en mujeres. Las actividades de ocio aportan una mayor satisfaccion vital que las ocupaciones del quehacer diario. La actitud hacia el envejecimiento ha sido el factor que ha arrojado una mayor correlacion con el nivel ocupacional de la persona. Los datos respaldan la necesidad de unas recomendaciones adecuadas para el diseno de programas especificos que favorezcan intervenciones individuales y colectivas enfocadas al ejercicio, la prevencion del deterioro cognitivo y el fomento de la satisfaccion vital. Palabras clave ocupacion; funcionamiento cognitivo; satisfaccion vital; personas mayores; actividades cotidianas y de ocio. The progressive aging of the population forces the administrations with competences in sanitary matters to intervene on the adverse effects of the lack of physical or functional activity (depression, anxiety, cognitive deterioration and vital dissatisfaction among others). The aim of this study was to verify if the level of occupation in basic activities of daily life or leisure of a sample of people over 55 years has influence on the degree of cognitive functioning and their life satisfaction. This is a cross-sectional study, with a non-probabilistic convenience sample carried out with 302 persons over 55 years of age from several active participation centres (CPA) in the province of Almeria (Spain). The instruments used for the assessment included the Mini Cognitive Examination, the Philadelphia Satisfaction Scale and the Senior Occupational Behavior Questionnaire (C-COM). The multigroup analysis of the data also included a structural model using path analysis. The results have verified the influence of occupation on cognitive deterioration and life satisfaction in both men and women. Leisure activities provide greater life satisfaction than the occupations of daily life. The attitude toward aging has been the factor that has shown a greater correlation with the occupational level of the person. The data support the need for adequate recommendations for the design of specific programs that favor individual and collective interventions focused on exercise, the prevention of cognitive deterioration and the promotion of life satisfaction. Keywords occupation; cognitive functioning; life satisfaction; elderly; everyday and leisure activities.
The impact of informal care immediately after pacemaker (PM) implantation has been well established; however, not much is known about its long-term effects. The present study compared personal ...characteristics, associated problems, workloads, time, and costs related to informal care provided to patients with PM under remote monitoring (RM) vs. conventional monitoring (CM) in the hospital, five years after implantation. The PONIENTE study was a controlled, non-randomized or masked clinical trial conducted with information obtained from the perspective of informal caregivers. Data were collected at 12 and 60 months after PM implantation. The patients in the study were assigned to two different groups: remote monitoring (RM) and conventional monitoring (CM). The “Disability, personal autonomy, and dependency situations survey” (EDAD) was administered to collect information on sociodemographic characteristics, time, care difficulties, health status, professional aspects, and impact on economic, family, or leisure aspects of the main caregivers providing care to patients with pacemakers. After five years, 55 patients completed the study (RM = 21; CM = 34). The average age was 63.14 years (SD = 14.90), 96% of them were women, and the most predominant marital status was married (72%). Informal caregivers lived in the homes of the patients in 70% of cases, and 88% indicated that they had to provide care six to seven days a week. The average cost per patient during the monitoring period studied was 13.17% lower in the RM group than in the CM group, and these differences were not statistically significant (p = 0.35). This study found similar results in the two groups under study with respect to sociodemographic characteristics, workload, time, and problems associated with health, leisure and family members. The costs associated with care were higher in the CM group; however, these differences were not statistically significant.
According to various studies and the Cambridge University Student Barometer, Spanish students have the worst academic results in mathematics and English among the European Union countries. The ...objective of this study has been to analyze the influence of the teacher on motivation, positive emotions, metacognition strategies, and the academic performance of the students in those classes. We analyzed responses from 604 students of English and 547 students of mathematics, aged between 13 and 19 years. The teacher plays a relevant role in the motivation and emotions generated in the students, issues that determine decision making in the students' learning and academic performance.
Cost-effectiveness studies on pacemakers have increased in the last years. However the number of long-term cost-utility studies is limited. The objective of this study was to perform a cost-utility ...analysis comparing remote monitoring (RM) versus conventional monitoring (CM) in hospital of older patients with pacemakers, 5 years after implant.
Under a controlled, not randomized, nor masked clinical trial, 83 patients with pacemakers were initially selected. After five years of follow-up, a total of 55 patients (CM = 34; RM = 21) completed the study. A cost-utility analysis of RM in terms of costs per gained quality-adjusted life years (QALYs) was conducted. The costs from the Public Health System (PHS) as well as patients and their relatives were taken into account for the study. The robustness of the results was verified by the probabilistic analyses through Monte-Carlo simulations.
After a five-year follow-up period, total costs were lower in the RM group by 23.02% than in the CM group (€274.52 versus €356.62; p = 0.033) because of a cost saving from patients' perspective (€59.05 versus €102.98; p = 0.002). However, the reduction of in-hospital visits derived from RM exhibited insignificant impact on the costs from the PHS perspective, with a cost saving of 15.04% (€215.48 vs. €253.64; p = 0.144). Costs/QALYs obtained by the RM group were higher as compared to the CM group, although there were no significant differences. The incremental cost-effectiveness ratio of CM in comparison to RM became positive (€301.16).
This study confirms RM of older patients with pacemakers appears still as a cost-utility alternative to CM in hospital after 5 years of follow-up.
ClinicalTrials.gov: (Identifier: NCT02234245 ). Registered 09 September 2014 - Prospectively registered.
The purpose of this study is to describe the creation and implementation of an ICT education program for the elderly in various Active Participation Centers in Almería (Spain), assessing its impact ...on quality of life. From a randomized sample of 200 individuals over the age of 55. Results reveal a high degree of participant satisfaction (76.6 %), as well as improvements in quality of life as compared to the control group after the 3 month program health factor: p = 0.004; leisure and activity factor: p = 0.001; Satisfaction with Life Factor: p < 0.001. The analysis conducted to determine the influence of age and gender on quality of life indicates that there are statistically significant differences in regards to age (the younger groups had higher scores) and gender (the males). This study may serve to facilitate similar works that promotes on-going education in different locations and across the lifespan.
With an ageing population and widening indications for pacemakers implantation, the number of persons carrying an implant is steadily increasing. The routine follow-up is thus a heavy burden for the ...respective NHS as well as for the patients and their relatives. Most of them of the studies have been performed in densely populated areas and nearby to the hospital. It is thus unknown whether these results could be applied also in rural areas such as Northern Norway with a more scattered population. The aim of this study was to assess the effectiveness of tele-monitoring (TM) in patients with pacemakers regarding reliability, safety and health-related quality of life, compared to traditional follow-up in outpatient clinic in a setting where geographical effects could possible influence the results.
The NORDLAND study is a controlled, randomized, non-masked clinical trial in pacemaker patients, with data collection carried out during the pre-implant stage and after 6 months. Between August of 2014 and November of 2015, 50 patients were assigned to either a tele-monitoring group (n = 25) or a conventional hospital monitoring (HM) group (n = 25). The EuroQol-5D (EQ-5D) utilities and visual analogue scale (VAS) and the Minnesota Living with Heart Failure Questionnaire (MLHFQ) were used to measure Health-Related Quality of Life. Baseline characteristics and number of hospital visits were also analyzed.
The baseline characteristics of the two study groups were similar for EQ-5D utilities (TM:0.81; HM:0.76; p = 0.47), EQ-5D VAS (TM: 64.00; HM:64.88; p = 0.86) and the MLHFQ (TM:20.20; HM:28.96; p = 0.07). At the 6 month follow-up, there were no significant differences between the groups in EQ-5D utilities (TM: 0.81; HM: 0.76; p = 0.54) and EQ-5D VAS scores (TM: 72.71; HM: 59.79; p = 0.08). The MLHFQ score was improved in both groups (TM: -4.40; HM: -15.13; p < 0.001). The number of in-office visits was similar in both groups (TM: 1.24 vs HM: 1.12; P = 0.30).
The NORDLAND trial shows that HRQoL is improved after implant in both groups. Without significant differences with regards to effectiveness and safety. In addition, provides a scientifically rigorous method to the field of HRQoL evaluations in patients with pacemakers.
ClinicalTrials.gov NCT02237404 , September 11, 2014.
•Having a blind child does not necessarily lead to parents’ maladjustment.•The results reveal a positive correlation between subjective psychological well-being and self-esteem.•There is a negative ...correlation between anxiety and subjective psychological well-being, and between anxiety and self-esteem.•The levels of self-esteem were significantly higher in families with blind children than the general population.•These results suggest that the process of adaptation described in previous research may be changing.
In this study, the relation between levels of anxiety, self-esteem and subjective psychological well-being is analyzed in a Spanish sample of 28 fathers and 33 mothers of blind children. The results reveal a positive correlation between subjective psychological well-being and self-esteem, and a negative correlation between anxiety and subjective psychological well-being, and between anxiety and self-esteem. In comparison with the general population, no statistically significant differences were found in anxiety and subjective psychological well-being; however, levels of self-esteem were significantly higher in families with blind children. These results suggest that the process of adaptation described in previous research may be changing, as having a blind child does not necessarily lead to parents’ maladjustment.
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