Factores determinantes en la contratación de personas adultas mayores, en un ámbito laboral empresarial, que influyen de manera psicofisiológica

This review article analyzes the factors that determine the hiring or not of older adults in the business field, and how this has psychophysiological repercussions. The results determined three sub-themes: hiring determinants, where factors that influence the hiring of older adults are identified, such as age, prejudice, academic level and how interesting their level of competitiveness and behavior; The second sub-theme lies in the relation of the meaning of work and hiring, in which it has been found that work is of great importance for older adults since it contributes to their personal and social development. This demonstrates the importance of research on the subject, since the cessation of work activities brings with it a cluster of consequences and it is necessary to project what the future of each Mexican will be in their old age, both psychophysiologically and economically.El presente artículo de revisión analiza los factores que determinan la contratación o no de personas adultas mayores en el ámbito empresarial, y cómo esto tiene repercusiones psicofisiológicas. Los resultados determinaron tres subtemas: determinantes de contratación, dónde se identifican factores que influyen para la contratación de adultos mayores, como lo son la edad, los prejuicios, nivel académico y lo interesante su nivel de competitividad y su comportamiento; el segundo subtema yace en la relación del significado de trabajo y la contratación, en el cual se ha encontrado que el trabajo es de gran importancia para los adultos mayores puesto que contribuye en su desarrollo personal y social. Esto demuestra la importancia de investigar sobre el tema, ya que el cese de actividades laborales trae consigo un cúmulo de consecuencias y es necesario proyectar cuál será el futuro de cada mexicano en su etapa de vejez, tanto de manera psicofisiológica como económica

Design and evaluation of a mobile-based intervention for Maya adults during the COVID-19 pandemic

Introduction: The COVID-19 pandemic has had a direct impact on mental health. International organisations have emphasised the vulnerability of indigenous people. Digital Mental Health approaches deliver online therapy as an evidence-based, effective, and accessible treatment option for common mental health problems. However, the evidence regarding these approaches is limited in indigenous populations. The objective of this study is to describe the design, development, and evaluation of the efficacy of a self-applied online intervention regarding the psychological symptoms of depression, anxiety, and fear of COVID-19 in a sample of the Maya population. Method: A prospective longitudinal quantitative study was designed, where a single group was measured before and after receiving the online intervention. This study took place from April to September 2021 and consisted of six sessions delivered via WhatsApp in Spanish and Mayan. Results: The initial assessment was implemented with 82 participants who were evaluated using the Patient Health Questionnaire, Scale for Generalised Anxiety Disorder and the Fear of COVID-19 Scale; 18 participants remained in the intervention for the post-as-sessment. Statistical differences were observed in PRE and POST measures of depression and anxiety, but not in fear of COVID-19. Conclusions: This study produced positive results for the first online mental health intervention implemented in the Latin American indigenous population. Future studies might consider developing similar interventions for other indigenous communities in Latin America.</p

Role of age and comorbidities in mortality of patients with infective endocarditis

[Purpose]: The aim of this study was to analyse the characteristics of patients with IE in three groups of age and to assess the ability of age and the Charlson Comorbidity Index (CCI) to predict mortality. [Methods]: Prospective cohort study of all patients with IE included in the GAMES Spanish database between 2008 and 2015.Patients were stratified into three age groups:<65 years,65 to 80 years,and ≥ 80 years.The area under the receiver-operating characteristic (AUROC) curve was calculated to quantify the diagnostic accuracy of the CCI to predict mortality risk. [Results]: A total of 3120 patients with IE (1327 < 65 years;1291 65-80 years;502 ≥ 80 years) were enrolled.Fever and heart failure were the most common presentations of IE, with no differences among age groups.Patients ≥80 years who underwent surgery were significantly lower compared with other age groups (14.3%,65 years; 20.5%,65-79 years; 31.3%,≥80 years). In-hospital mortality was lower in the <65-year group (20.3%,<65 years;30.1%,65-79 years;34.7%,≥80 years;p < 0.001) as well as 1-year mortality (3.2%, <65 years; 5.5%, 65-80 years;7.6%,≥80 years; p = 0.003).Independent predictors of mortality were age ≥ 80 years (hazard ratio [HR]:2.78;95% confidence interval [CI]:2.32–3.34), CCI ≥ 3 (HR:1.62; 95% CI:1.39–1.88),and non-performed surgery (HR:1.64;95% CI:11.16–1.58).When the three age groups were compared,the AUROC curve for CCI was significantly larger for patients aged <65 years(p < 0.001) for both in-hospital and 1-year mortality. [Conclusion]: There were no differences in the clinical presentation of IE between the groups. Age ≥ 80 years, high comorbidity (measured by CCI),and non-performance of surgery were independent predictors of mortality in patients with IE.CCI could help to identify those patients with IE and surgical indication who present a lower risk of in-hospital and 1-year mortality after surgery, especially in the <65-year group

Treatment with tocilizumab or corticosteroids for COVID-19 patients with hyperinflammatory state: a multicentre cohort study (SAM-COVID-19)

Objectives: The objective of this study was to estimate the association between tocilizumab or corticosteroids and the risk of intubation or death in patients with coronavirus disease 19 (COVID-19) with a hyperinflammatory state according to clinical and laboratory parameters. Methods: A cohort study was performed in 60 Spanish hospitals including 778 patients with COVID-19 and clinical and laboratory data indicative of a hyperinflammatory state. Treatment was mainly with tocilizumab, an intermediate-high dose of corticosteroids (IHDC), a pulse dose of corticosteroids (PDC), combination therapy, or no treatment. Primary outcome was intubation or death; follow-up was 21 days. Propensity score-adjusted estimations using Cox regression (logistic regression if needed) were calculated. Propensity scores were used as confounders, matching variables and for the inverse probability of treatment weights (IPTWs). Results: In all, 88, 117, 78 and 151 patients treated with tocilizumab, IHDC, PDC, and combination therapy, respectively, were compared with 344 untreated patients. The primary endpoint occurred in 10 (11.4%), 27 (23.1%), 12 (15.4%), 40 (25.6%) and 69 (21.1%), respectively. The IPTW-based hazard ratios (odds ratio for combination therapy) for the primary endpoint were 0.32 (95%CI 0.22-0.47; p < 0.001) for tocilizumab, 0.82 (0.71-1.30; p 0.82) for IHDC, 0.61 (0.43-0.86; p 0.006) for PDC, and 1.17 (0.86-1.58; p 0.30) for combination therapy. Other applications of the propensity score provided similar results, but were not significant for PDC. Tocilizumab was also associated with lower hazard of death alone in IPTW analysis (0.07; 0.02-0.17; p < 0.001). Conclusions: Tocilizumab might be useful in COVID-19 patients with a hyperinflammatory state and should be prioritized for randomized trials in this situatio

Clonal chromosomal mosaicism and loss of chromosome Y in elderly men increase vulnerability for SARS-CoV-2

The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) had an estimated overall case fatality ratio of 1.38% (pre-vaccination), being 53% higher in males and increasing exponentially with age. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, we found 133 cases (1.42%) with detectable clonal mosaicism for chromosome alterations (mCA) and 226 males (5.08%) with acquired loss of chromosome Y (LOY). Individuals with clonal mosaic events (mCA and/or LOY) showed a 54% increase in the risk of COVID-19 lethality. LOY is associated with transcriptomic biomarkers of immune dysfunction, pro-coagulation activity and cardiovascular risk. Interferon-induced genes involved in the initial immune response to SARS-CoV-2 are also down-regulated in LOY. Thus, mCA and LOY underlie at least part of the sex-biased severity and mortality of COVID-19 in aging patients. Given its potential therapeutic and prognostic relevance, evaluation of clonal mosaicism should be implemented as biomarker of COVID-19 severity in elderly people. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, individuals with clonal mosaic events (clonal mosaicism for chromosome alterations and/or loss of chromosome Y) showed an increased risk of COVID-19 lethality

Adelante / Endavant

Séptimo desafío por la erradicación de la violencia contra las mujeres del Institut Universitari d’Estudis Feministes i de Gènere "Purificación Escribano" de la Universitat Jaume

Condicionantes de la participación y uso del espacio público de personas mayores en el Cerro del Cuatro, Jalisco México

The relation between the environment and the elderly has been a very important issue for environmental gerontology. The objective of this article is to analyze how the physical and social structures that today constitute the public space used by and in which the elderly participates in Cerro del Cuatro, Jalisco, have been erected. A qualitative research was executed through the ethnographic method, semi-structured interviews, and participant observation of 8 selected cases. A thematic analysis, under the framework of Bourdieu's theory of social fields, was carried out. It was identified that the public space in which elderly participate has been constructed from a perspective of vulnerability, evident in the deficient characteristics of the spaces and services they have.La relación entre entorno y personas mayores ha sido un tema de suma importancia para la gerontología ambiental. El objetivo de este artículo es analizar cómo han sido erigidas las estructurantes físicas y sociales que hoy conforman el espacio público que usan y en el que participan las personas adultas mayores en el Cerro del Cuatro, Jalisco. Se llevó a cabo una investigación cualitativa a través del método etnográfico, por medio de entrevistas semiestructuradas y observación participante con ocho casos seleccionados. Se hizo un análisis temático bajo el marco de la teoría de campos sociales de Bourdieu. Se identificó que el espacio público en el que participan ha sido construido desde una perspectiva de vulnerabilidad, evidente en las características deficientes de los espacios y servicios con los que cuentan

Reciprocidad entre ancianos indígenas. El otro lado de las redes sociales de apoyo

In the indigenous population and among older adults have been identified as survival strategies activation of social support networks. From the principle of reciprocity is an exchange of favors and gifts called social supports from various networks that contribute to access to material, emotional and instrumental resources that were identified among Otomi older adults (Mexico) through qualitative research.La población indígena, incluidos los adultos mayores, ha identificado la activación de redes sociales de apoyo como estrategias de supervivencia. A partir del principio de reciprocidad se realiza un intercambio de favores y regalos, denominados apoyos sociales, que provienen de diversas redes y contribuyen al acceso a recursos materiales, emocionales e instrumentales. Tal estudio se realizó entre adultos mayores otomíes (México) a través de una investigación cualitativa.Nella popolazione indigena e tra gli adulti più anziani sono state identificate come strategie di sopravvivenza l'attivazione di reti di supporto sociale. A partire dal principio di reciprocità avviene uno scambio di favori e di doni chiamati supporti sociali provenienti da varie reti che favoriscono l'accesso alle risorse materiali, emotive e strumentali identificate tra gli adulti più anziani di Otomi (Messico) con una ricerca qualitativa

Días buenos, días malos: aislamiento social de las mujeres mayores

En México, a partir del 23 de marzo se ha implementado la Jornada Nacional de Sana Distancia que implica la indicación de quedarse en casa para evitar la transmisión del coronavirus. Entre los sectores más vulnerables ante el coronavirus se encuentran las personas mayores

Clinical and cost-effectiveness analysis of early detection of patients at nutrition risk during their hospital stay through the new screening method CIPA: a study protocol

Abstract Background Malnutrition is highly prevalent in hospitalized patients and results in a worsened clinical course as well as an increased length of stay, mortality, and costs. Therefore, simple nutrition screening systems, such as CIPA (control of food intake, protein, anthropometry), may be implemented to facilitate the patient’s recovery process. The aim of this study is to evaluate the effectiveness and cost-effectiveness of implementing such screening tool in a tertiary hospital, consistent with the lack of similar, published studies on any hospital nutrition screening system. Methods The present study is carried out as an open, controlled, randomized study on patients that were admitted to the Internal Medicine and the General and Digestive Surgery ward; the patients were randomized to either a control or an intervention group (n = 824, thereof 412 patients in each of the two study arms). The control group underwent usual inpatient clinical care, while the intervention group was evaluated with the CIPA screening tool for early detection of malnutrition and treated accordingly. CIPA nutrition screening was performed upon hospital admission and classified positive when at least one of the following parameters was met: 72 h food intake control < 50%, serum albumin < 3 g/dL, body mass index < 18.5 kg/m2 (or mid-upper arm circumference ≤ 22.5 cm). In this case, the doctor decided on whether or not providing nutrition support. The following variables will be evaluated: hospital length of stay (primary endpoint), mortality, 3-month readmission, and in-hospital complications. Likewise, the quality of life questionnaires EQ-5D-5 L are being collected for all patients at hospital admission, discharge, and 3 months post-discharge. Analysis of cost-effectiveness will be performed by measuring effectiveness in terms of quality-adjusted life years (QALYs). The cost per patient will be established by identifying health care resource utilization; cost-effectiveness will be determined through the incremental cost-effectiveness ratio (ICER). We will calculate the incremental cost per QALY gained with respect to the intervention. Discussion This ongoing trial aims to evaluate the cost-effectiveness of implementing the malnutrition screening tool CIPA in a tertiary hospital. Trial registration Clinical Trial.gov ( NCT02721706 ). First receivevd: March 1, 2016 Last updated: April 8, 2017 Last verified: April 201