Evolution of Quality of Life and Treatment Adherence after One Year of Intermittent Bladder Catheterisation in Functional Urology Unit Patients

Objective: To determine patient difficulties and concerns when performing IBC (Intermittent Bladder Catheterisation), as well as the evolution of adherence, quality of life, and emotional state of patients one year after starting IBC. Method: A prospective, observational, multicentre study conducted in 20 Spanish hospitals with a one-year follow-up. Data sources were patient records and the King's Health Questionnaire on quality of life, the Mini-Mental State Examination (MMSE), and the Hospital Anxiety and Depression Scale (HADS). Perceived adherence was measured using the ICAS (Intermittent Catheterization Adherence Scale) and perceived difficulties with IBC were assessed using the ICDQ (Intermittent Catheterization Difficulty Questionnaire). For data analysis, descriptive and bivariate statistics were performed for paired data at three points in time (T1: one month, T2: three months, T3: one year). Results: A total of 134 subjects initially participated in the study (T0), becoming 104 subjects at T1, 91 at T2, and 88 at T3, with a mean age of 39 years (standard deviation = 22.16 years). Actual IBC adherence ranged from 84.8% at T1 to 84.1% at T3. After one year of follow-up, a statistically significant improvement in quality of life (p <= 0.05) was observed in all dimensions with the exception of personal relationships. However, there were no changes in the levels of anxiety (p = 0.190) or depression (p = 0.682) at T3 compared to T0. Conclusions: Patients requiring IBC exhibit good treatment adherence, with a significant proportion of them performing self-catheterisation. After one year of IBC, a significant improvement in quality of life was noted, albeit with a significant impact on their daily lives and their personal and social relationships. Patient support programmes could be implemented to improve their ability to cope with difficulties and thus enhance both their quality of life and the maintenance of their adherence

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

FACTORES ASOCIADOS A MAL ESTADO DE SALUD PERCIBIDO O A MALA CALIDAD DE VIDA EN PERSONAS MAYORES DE 65 AÑOS

Fundamento: Hoy en d a, en los pa ses desarrollados, llegar a una edad avanzada ha dejado de ser algo excepcional, sin embargo muchas personas no logran envejecer con una buena calidad de vida. El presente trabajo tiene como objetivos, contribuir a un mejor conocimiento de los principales factores que influyen en la calidad de vida y la percepci n de la salud de los mayores de 65 a os, as como determinar qu ventajas y desventajas presenta cada uno de los tres instrumentos de medida de la salud y la calidad de vida frente a los otros dos instrumentos utilizados. M todos: A partir de 911 encuestas a personas mayores de 65 a os no institucionalizadas, realizadas a domicilio, se hizo un an lisis multivariante mediante regresi n log stica, poniendo en relaci n los resultados obtenidos en el Perfil de Salud de Nottingham (PSN), el Euroqol y el EAS con las caracter siticas sociodemogr ficas, el nivel de recursos econ micos, el grado de apoyo sociofamiliar, el estado de salud f sica y mental y la capacidad funcional. Resultados: Los principales factores que se asocian con la percepci n de un mal estado de salud y mala calidad de vida en el Euroqol y el PSN son los trastornos de ansiedad (Odd Ratios entre 1,8 (IC:1,2-2,8) para movilidad y 7,9 (IC:4,5-13,9) para Perfil 11111), trastornos depresivos (OR:1,8 (IC:1,3-2,6) para dolor/malestar ?3,3 (IC:2,1-5,1) para aislamiento social), falta de ejercicio (OR:1,4 (IC:1-2,1) para ansiedad/depresi n ?3,9 (IC:2,5-6,2) para actividades cotidianas), dependencia para las actividades b sicas de la vida diaria (OR:0,5 (IC:0,3-0,9) para reacci n emocional ?4,8 (IC:3-7,6) para actividades cotidianas) y dependencia para las actividades instrumentales de la vida diaria (OR:1,5 (IC:1,1-2,1) para Escala Visual Anal gicac < 70 ? 7,1 (IC:2,9-17,2) para cuidado personal). Conclusiones: La salud mental y la capacidad funcional son los factores que m s influyen en la percepci n del estado de salud y la calidad de vida de las personas mayores. Dado que los tres instrumentos utilizados han obtenido resultados semejantes, el Euroqol ofrece ventajas por su brevedad, incluyendo una valoraci n global y por dimensiones

Las mujeres y el tabaco : enfoque de género en el control de la epidemia en Andalucía

YesEn este documento se podrá encontrar una presentación de la evolución histórica del fenómeno del tabaquismo en la población femenina, las dificultades y limitaciones que existen para las mujeres, las intervenciones generales sobre tabaquismo y experiencias que muestran la eficacia cuando se diseñan acciones específicas y accesibles para ellas

Theoretical foundations of the Study of Latino (SOL) Youth: implications for obesity and cardiometabolic risk

PURPOSE: This article describes the conceptual model developed for the Hispanic Community Health Study/Study of Latino Youth, a multisite epidemiologic study of obesity and cardiometabolic risk among U.S. Hispanic/Latino children. METHODS: Public health, psychology, and sociology research were examined for relevant theories and paradigms. This research, in turn, led us to consider several study design features to best represent both risk and protective factors from multiple levels of influence, as well as the identification of culturally relevant scales to capture identified constructs. RESULTS: The Socio-Ecological Framework, Social Cognitive Theory, family systems theory, and acculturation research informed the specification of our conceptual model. Data are being collected from both children and parents in the household to examine the bidirectional influence of children and their parents, including the potential contribution of intergenerational differences in acculturation as a risk factor. Children and parents are reporting on individual, interpersonal, and perceived organizational and community influences on children's risk for obesity consistent with Socio-Ecological Framework. CONCLUSIONS: Much research has been conducted on obesity, yet conceptual models examining risk and protective factors lack specificity in several areas. Study of Latino Youth is designed to fill a gap in this research and inform future efforts

Juntas / Juntes

Multitud d'autores i autors aporten píndoles de microliteratura, de gèneres diversos, al tercer volum amb què l'Institut Universitari d'Estudis Feministes i de Gènere Purificación Escribano vol respondre al desafiament per l'eradicació de la violència contra les dones.Tercer 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 I a través de microliteratura

Innovar en la enseñanza universitaria

Se recogen experiencias docentes innovadoras desarrolladas en la Universidad de Alcalá con el objetivo de indagar en las posibilidades y obstáculos surgidos en los procesos de cambio e innovación. En dichas experiencias docentes se han implementado nuevas metodologías, experiencias piloto y Proyectos de Innovación, que han contribuido a clarificar el proceso y a indagar en propuestas de acción contextualizadas. Las experiencias de dividen en cuatro bloques: estrategias de aprendizaje activo; estrategias de integración curricular; innovación en la educación; y uso de las nuevas tecnologías.MadridBiblioteca de Educación del Ministerio de Educación, Cultura y Deporte; Calle San Agustín 5 -3 Planta; 28014 Madrid; Tel. +34917748000; [email protected]