Psychopathological Symptoms in Caregivers of Demented and Nondemented Patients

Currently, more than 1 in 10 adults living in the Organization for Economic Co‐operation and Development is involved in nonprofessional care of a dependent family member. The main causes of dependence are dementia, followed by other conditions such as cerebrovascular accidents, limb impairment, depression, and vision impairment. Although care provided by the caregiver is crucial to the well‐being of the cared person, it can also have negative consequences on the caregiver’s emotional state. This chapter aims to describe the psychopathological symptoms experienced by caregivers based on the condition of the person cared for. A bibliographic search was conducted to examine the effects of care on the emotional state of caregivers, distinguishing patients with dementia from those with other conditions. Depressive and anxiety symptoms were the most frequent psychopathological symptoms, both in caregivers of demented and nondemented patients, experienced by caregivers of patients with dementia, cerebrovascular accidents, traumatic brain injury, schizophrenia, cancer, amyotrophic lateral sclerosis, and autism spectrum disorder. In caregivers of patients with bipolar disorder and vision impairment, depressive symptoms were most prominent, whereas anxiety symptoms were common in caregivers of patients with spinal cord injuries. Sleep disturbances were found among caregivers of dementia and schizophrenia patients. Strategies for preventing psychopathological symptoms were provided and the importance of professional support when they occur was pointed out

Redesigning pictographs for patients with low health literacy and establishing preliminary steps for delivery via smart phones.

BackgroundPictographs (or pictograms) have been widely utilized to convey medication related messages and to address nonadherence among patients with low health literacy. Yet, patients do not always interpret the intended messages on commonly used pictographs correctly and there are questions how they may be delivered on mobile devices.ObjectiveOur objectives are to refine a set of pictographs to use as medication reminders and to establish preliminary steps for delivery via smart phones.MethodsCard sorting was used to identify existing pictographs that focus group members found "not easy" to understand. Participants then explored improvements to these pictographs while iterations were sketched in real-time by a graphic artist. Feedback was also solicited on how selected pictographs might be delivered via smart phones in a sequential reminder message. The study was conducted at a community learning center that provides literacy services to underserved populations in Seattle, WA. Participants aged 18 years and older who met the criteria for low health literacy using S-TOFHLA were recruited.ResultsAmong the 45 participants screened for health literacy, 29 were eligible and consented to participate. Across four focus group sessions, participants examined 91 commonly used pictographs, 20 of these were ultimately refined to improve comprehensibility using participatory design approaches. All participants in the fifth focus group owned and used cell phones and provided feedback on preferred sequencing of pictographs to represent medication messages.ConclusionLow literacy adults found a substantial number of common medication label pictographs difficult to understand. Participative design processes helped generate new pictographs, as well as feedback on the sequencing of messages on cell phones, that may be evaluated in future research

Problem-solving intervention to prevent depression in non-professional caregivers:A randomized controlled trial with 8 years of follow-up

Background Studies of psychological interventions for the prevention of depression have found significant effects in the short-term, but the long-term efficacy has yet to be determined. This study evaluated the 8-year effect of a randomized controlled trial for indicated prevention of depression in female caregivers.Methods A total of 173 non-professional female caregivers with subclinical depressive symptoms not meeting criteria for a major depressive episode (MDE) were randomized to either a brief problem-solving intervention (n = 89) or usual-care control group (n = 84). Blinded evaluators conducted an assessment at the 8-year follow-up. The primary outcome was Depression Status, defined by diagnoses of MDE since the 1-year follow-up using the Structured Clinical Interview for the Disorders of the DSM-5. The secondary outcome was current Depressive Symptom Severity. Regression analyses were conducted to evaluate the effect of the intervention on the outcomes.Results There were no significant differences in the Depression Status between the problem-solving (30.3%) and control groups (26.2%) (adjusted OR 1.25, 95% CI-0.58 to 2.69). Depressive Symptom Severity, however, was significantly lower in the problem-solving group compared to the control group at this follow-up, amounting to a small effect size of Cohen's d = 0.39 (adjusted B =-3.32, p = 0.018).Conclusions This is the first study to assess such a long-term follow-up of intervention of indicated prevention of depression. Results seem to indicate that the protective effect of the intervention became smaller over time during follow-up. Future research should replicate these results

Cuestionario de Personalidad de Eysenck Revisado-Abreviado para cuidadores informales

[Abstract] The objective of this study was to analyze the psychometric properties of the Spanish version of the Eysenck Personality Questionnaire Revised-Abbreviated (EPQR-A) in informal caregivers. Trained, independent evaluators administered the EPQR-A and evaluated informal caregivers’ depressive symptoms, automatic negative thoughts, self-efficacy, and pleasant social contacts, and clinical experts assessed major depressive episode in 592 caregivers (87.2% women, mean age 55.4 years). Women scored significantly higher on Neuroticism than men (p < .001). Subscale internal consistencies were .77 for Neuroticism, .75 for Extraversion, .47 for Sincerity; and .24 for Psychoticism. These four factors accounted for 38.1% of total variance. However, a three-factor model (excluding Psychoticism) better fit the data. Neuroticism was significantly, inversely correlated with both self-efficacy (r = -.35) and pleasant social contacts (r = -.22), and positively correlated with both depressive symptoms (r = .59) and negative thoughts (r = .53). Extraversion was significantly, inversely correlated with both depressive symptoms (r = -.22) and negative thoughts (r = -.22), and positively correlated with both selfefficacy (r = .36) and pleasant social contacts (r = .16). A cutoff score of 4 on Neuroticism suitably discriminated between depressed and non-depressed informal caregivers (sensitivity = 68.1%, specificity = 79.9%).[Resumen] El objetivo de este estudio fue analizar las propiedades psicométricas de la versión española del Eysenck Personality Questionnaire Revised-Abbreviated (EPQR-A) en cuidadores informales. Evaluadores independientes entrenados administraron el EPQR-A y evaluaron la sintomatología depresiva, pensamientos automáticos negativos, autoeficacia y contactos sociales agradables y clínicos expertos valoraron el diagnóstico de episodio depresivo mayor a 592 cuidadores (87.2% mujeres, media de edad 55.4 años). Las mujeres obtuvieron una puntuación en Neuroticismo significativamente mayor que los hombres (p < .001). La consistencia interna de las subescalas fue .77 en Neuroticismo, .75 en Extraversión, .47 en Sinceridad y .24 en Psicoticismo. Estos factores explicaron el 38.1% de la varianza. Pero un modelo de tres factores (excluyendo Psicoticismo) ajustó mejor con los datos. El Neuroticismo correlacionó significativa e inversamente con autoeficacia (r = -.35) y contactos sociales (r = -.22), y directamente con sintomatología depresiva (r = .59) y pensamientos negativos (r = .53). La Extraversión correlacionó significativa e inversamente con sintomatología depresiva (r = -.22) y pensamientos negativos (r = -.22), y directamente con autoeficacia (r = .36) y contactos sociales (r = .16). Un punto de corte de 4 en Neuroticismo discriminó adecuadamente entre cuidadores deprimidos y no deprimidos (sensibilidad= 68.1%; especificidad= 79.9%)

Integrated drag coefficient formula for estimating the wave attenuation capacity of Rhizophora sp. mangrove forests

Recently, bulk drag coefficient (C˜D) formulations used to quantify wave energy dissipation by Rhizophora mangroves were developed from laboratory data; however, these formulations have not yet been validated with field data. Additionally, due to the complex geometry of mangrove trees within forests and spatial variability, common criteria for determining the adequate geometric characteristics of mangrove forests are lacking and are required to obtain accurate definitions for C˜D. This paper addresses these knowledge gaps by proposing a newly integrated C˜D formulation based on the comprehensive characterization of a Rhizophora mangle forest combined with wave measurements in field, and by using numerical modeling for the calibration process. The field campaign consisted of 23 continuous days of recorded wave data and spatial distribution observations of the geometric characteristics of the mangrove forest. The variation in frontal area per unit height per square meter (Ahm) along the mangrove forest was reported for three zones with different densities identified along the study transect, with decreasing root density from the vegetation edge to the forest interior. On average, the incident wave height decreased by 34% at 63 m in mangrove forests, and the wave attenuation ratios (r) varied between 0.001 and 0.01 m-1. To estimate the C˜D values associated with these wave height attenuation ratios, the Simulating Waves Nearshore (SWAN) numerical model was used to calibrate the model results with the field observations. The variation in the tree frontal area along the mangrove forest and the wave conditions at the site are considered during the calibration process. To further characterize C˜D for this type of mangrove species, the C˜D values acquired from the calibration together with the values reported in the literature from laboratory experiments are presented as a function of the Keulegan-Carpenter number (KC). Root diameter is defined as the characteristic length according to the inherent geometric characteristics of a Rhizophora sp. forest. The new formulation allows us to predictably estimate C˜D values that can be used as inputs in drag force-based models to estimate the attenuation of wave energy produced by Rhizophora sp. forests

Diversidad de especies y distribución de cangrejos de agua dulce (decapoda: Pseudothelphusidae) de la cuenca del río grande de térraba, vertiente pacífica de Costa Rica

During the last decades, knowledge on biodiversity of freshwater decapods has increased considerably; however, information about ecology of these crustaceans is scarce. Currently, the freshwater decapod fauna of Costa Rica is comprised by representatives of three families (Caridea: Palaemonidae and Atyidae; Brachyura: Pseudothelphusidae). The present study aims to describe the species diversity and distribution of freshwater crabs inhabiting the basin of the Rio Grande de Térraba, Pacific slope of Costa Rica, where the Instituto Costarricense de Electricidad (ICE) plans to implement one of the largest damming projects in the region. Samples were collected in 39 locations at an altitude ranging from 20 to 1,225 m. Sampling was carried out during several months in 2007, 2009 and 2010. We collected a total of 661 crabs, comprising eight species of Pseudothelphusidae of three genera, representing 53% of the 15 pseudothelphusid crab species currently recorded from Costa Rica. The most common species was Ptychophallus paraxanthusi followed by P. tristani. Freshwater crabs were more frequently encountered in the middle-low region of the basin (between 311 and 600 m) and less frequently in the medium-high basin (between 601 and 1,225 m). Ptychophallus paraxanthusi showed the widest distribution and was collected in altitudes ranging from 20 to 700 m. The Rio Grande de Térraba region can be considered as a relatively small, but highly diverse system. Therefore, any alteration of the basin of Rio Grande de Térraba, and especially the possible construction of a hydroelectric power plant, needs to be carefully analyzed to mitigate the damaging effects of this project on the freshwater crabs. More ecological information about freshwater crabs from Costa Rica and the Central American region are needed to reach a first reasonable overview on the ecological role of these decapods in freshwater systems

Buenas prácticas de innovación docente en la Universidad de Córdoba

La propuesta presenta la creación de una nueva asignatura en el grado de Medicina: Aplicación Clínica de las Ciencias Médicas Básicas –cuyo desarrollo ha implicado una inversión de 6.000 euros– que se imparte en el segundo semestre del segundo curso de la titulación. Se trata de una asignatura dirigida en exclusiva al aprendizaje y evaluación de las competencias transversales que, según los autores de la misma, supondrá una mejora para el alumnado a la hora de incorporarse al mercado de trabaj

Reconstructions of conductivity and permittivity from EIT data on a human chest by D-bar methods

A direct D-bar reconstruction algorithm is presented for reconstructing a complex conductivity from 2-D EIT data. The method is applied to simulated data and archival human chest data. Permittivity reconstructions with this new method and conductivity reconstructions with the fully nonlinear D-bar method based on [1] depicting ventilation and perfusion in the human chest are presented

Motherhood and Treatment Outcome in Female Patients with Compulsive Buying–Shopping Disorder

Motherhood has been proposed as an internal facilitating factor for the recovery of women with mental disorders. However, at the same time, there are significant barriers that may be interfering with the access and adherence to treatment for these women. The present longitudinal study aimed to deepen the sociodemographic and clinical profile of women with children and compulsive buying-shopping disorder (CBSD), and to explore the association between motherhood and response to treatment. The total sample included 77 women with a diagnosis of CBSD (n = 49 mothers) who received cognitive behavioral therapy (CBT) for 12 weeks. No association between psychopathology and motherhood was observed. The group of mothers reported an older age of onset of the CBSD, a lower amount of money spent per compulsive-buying episode, and a higher likelihood of family support for the CBSD. Moreover, this group showed lower risk of relapse. The findings support the theoretical proposal that considers motherhood as an internal facilitating factor for recovery and treatment adherence of mothers with addictions

Motherhood and Treatment Outcome in Female Patients with Compulsive Buying-Shopping Disorder

Motherhood has been proposed as an internal facilitating factor for the recovery of women with mental disorders. However, at the same time, there are significant barriers that may be interfering with the access and adherence to treatment for these women. The present longitudinal study aimed to deepen the sociodemographic and clinical profile of women with children and compulsive buying-shopping disorder (CBSD), and to explore the association between motherhood and response to treatment. The total sample included 77 women with a diagnosis of CBSD (n = 49 mothers) who received cognitive behavioral therapy (CBT) for 12 weeks. No association between psychopathology and motherhood was observed. The group of mothers reported an older age of onset of the CBSD, a lower amount of money spent per compulsive-buying episode, and a higher likelihood of family support for the CBSD. Moreover, this group showed lower risk of relapse. The findings support the theoretical proposal that considers motherhood as an internal facilitating factor for recovery and treatment adherence of mothers with addictions