Sex-moderated socio-labor aspects as mediators of a cognitive stimulation program in older adults: randomized clinical trial

Cognitive stimulation is essential for successful aging. The influence of sex and socio-occupational elements on this area remains unknown. This study aimed to analyze the possible mediation of those elements in the effectiveness of a cognitive stimulation program in primary care. A randomized clinical trial was conducted with 232 adults aged 65 years or older without cognitive impairment. The intervention produced significant cognitive improvements. Women improved independently of social and occupational factors, while men’s improvement occurred at a low role level (zero to one), a medium level of interests (two to three), with a medium level of mental occupation (neither high nor low), and with marked personal values. The mediating variables were the intervention group in both sexes and, also in men, a low and medium role level. Therefore, the intervention and roles appear as mediating variables moderated by sex. In conclusion, cognitive stimulation programs should be adapted

Short-term memory, attention, and temporal orientation as predictors of the cognitive impairment in older adults: A cross-sectional observational study

Late-life cognitive decline ranges from the mildest cases of normal, age-related change to mild cognitive impairment to severe cases of dementia. Dementia is the largest global burden for the 21st century welfare and healthcare systems. The aim of this study was to analyze the neuropsychological constructs (temporal orientation (TO), spatial orientation (SO), fixation memory (FM), attention (A), calculation (C), short-term memory (STM), language (L), and praxis (P)), semantic fluency, level of functionality, and mood that reveal the greatest deficit in the different stages ranging from normal cognition (NC) to cognitive impairment in older adults in a primary healthcare setting. The study included 337 participants (102 men, 235 women), having a mean age of 74 ± 6 years. According to their scores on the Spanish version of the Mini-Mental State Examination (MEC-35), subjects were divided into 4 groups: no deterioration (ND) (score 32-35), subtle cognitive impairment (SCI) (score 28- 31), level deterioration (LD) (score 24-27) and moderate deterioration (MD) (score 20-23). The ND group revealed significant differences in TO, STM, C, A, L, P, and S-T as compared to the other groups. The MD group (in all the neuropsychological constructs) and the ND and SCI groups showed significant differences on the Yesavage geriatric depression scale (GDS-15). All except the FM neuropsychological construct were part of the MEC-35 prediction model and all of the regression coefficients were significant for these variables in the model. Furthermore, the highest average percentage of relative deterioration occurs between LD and MD and the greatest deterioration is observed in the STM for all groups, including A and TO for the LD and MD groups. Based on our findings, community programs have been implemented that use cognitive stimulation to prevent cognitive decline and to maintain the neuropsychological constructs. © 2021 Gómez-Soria et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited

Factors Associated With Depressive Episode Recurrences in Primary Care: A Retrospective, Descriptive Study

Introduction and Objective: The early identification of depressive patients having a poor evolution, with frequent relapses and/or recurrences, is one of the priority challenges in this study of high prevalence mental disorders, and specifically in depression. So, this study aims to analyze the factors that may be associated with an increased risk of recurrence of major depression episodes in patients treated in primary care. Methods: A retrospective, descriptive study of cases-controls was proposed. The cases consisted of patients who had been diagnosed with major depression and who had presented recurrences (n = 101), in comparison with patients who had experienced a single major depression episode with no recurrence (n = 99). The variables of the study are age at first episode; number of episodes; perception of severity of the depression episode suffered prior to recurrence; number of residual symptoms; physical and psychiatric comorbidity; history of anxiety disorders; family psychiatric history; high incidence of stressful life events (SLEs); and experiences of physical, psychological, or sexual abuse in childhood. The differences of the variables were compared between the case subjects and the control subjects, using the Mann–Whitney, chi-square, and Fisher’s U statistics. A multivariate analysis (ordinary logistic regression) was performed. Results: The average age of those suffering more than one depressive episode is significantly older (5 years), and a higher percentage of subjects who have experienced more than one depressive episode have a history of anxiety disorders. In the multivariate analysis, the variables that obtained a significant value in the logistic regression analysis were age (OR: 1.03; value: 0.007) and having suffered sexual abuse during childhood (OR: 1.64; value: 0.072). Conclusion: These indicators should be considered by primary care physicians when attending patients suffering from major depression

Variability of the prevalence of depression in function of sociodemographic and environmental factors: ecological model

Major depression etiopathogenesis is related to a wide variety of genetics, demographic and psychosocial factors, as well as to environmental factors. The objective of this study is to analyze sociodemographic and environmental variables that are related to the prevalence of depression through correlation analysis and to develop a regression model that explains the behavior of this disease from an ecological perspective. This is an ecological, retrospective, cross-sectional study. The target population was 1,148,430 individuals over the age of 16 who were registered in Aragon (Spain) during 2010, with electronic medical records in the community’s primary health care centers. The spatial unit was the Basic Health Area (BHA). The dependent variable was the diagnosis of Depression and the ecological independent variables were: Demographic variables (gender and age), population distribution, typology of the entity, population structure by sex and age, by nationality, by education, by work, by salary, by marital status, structure of the household by number of members, and state of the buildings. The results show moderate and positive correlations with higher rates of depression in areas having a higher femininity index, higher population density, areas with a higher unemployment rate and higher average salary. The results of the linear regression show that aging +75 and rural entities act as protective factors for depression, while urban areas and deficient buildings act as risk factors. In conclusion, the ecological methodology may be a useful tool which, together with the statistical epidemiological analysis, can help in the political decision making process

The emotional well-being of Long COVID patients in relation to their symptoms, social support and stigmatization in social and health services: a qualitative study

Background Long COVID patients have experienced a decline in their quality of life due to, in part but not wholly, its negative emotional impact. Some of the most prevalent mental health symptoms presented by long COVID patients are anxiety, depression, and sleep disorders. As such, the need has arisen to analyze the personal experiences of these patients to understand how they are managing their daily lives while dealing with the condition. The objective of this study is to increase understanding about the emotional well-being of people diagnosed with long COVID. Methods A qualitative design was created and carried out using 35 patients, with 17 participants being interviewed individually and 18 of them taking part in two focus groups. The participating patients were recruited in November and December 2021 from Primary Health Care (PHC) centers in the city of Zaragoza (Northern Spain) and from the Association of Long COVID Patients in Aragon. The study topics were emotional well-being, social support networks, and experience of discrimination. All an inductive thematic content analyses were performed iteratively using NVivo software. Results The Long COVID patients identified low levels of self-perceived well-being due to their persistent symptoms, as well as limitations in their daily lives that had been persistent for many months. Suicidal thoughts were also mentioned by several patients. They referred to anguish and anxiety about the future as well as a fear of reinfection or relapse and returning to work. Many of the participants reported that they have sought the help of a mental health professional. Most participants identified discriminatory situations in health care. Conclusions It is necessary to continue researching the impact that Long COVID has had on mental health, as well as to provide Primary Health Care professionals with evidence that can guide the emotional treatment of these patients

Variables associated with a higher awareness of gender-based violence by students of the health sciences and social work

Objective To determine the attitudes towards equality and prevention of gender-based violence, and analyze variables associated with a higher awareness of gender-based violence by students of the health sciences and social work degrees. Method A cross-sectional descriptive study was carried out. The sample consisted of 437 students of the health sciences and social work degrees at the University of Zaragoza (Spain) during 2018 and 2019. The variables of the study were: Socio-demographic variables, academic variables, feminism attitudes towards women''s movement using Feminism and the women''s movement scale (FWMS), attitudes on gender-based violence using the Gender Equality and Prevention of Gender-based Violence Scale (GEPGVS). A correlational study and multiple linear regression were performed, in order to analyze the associated variables. Results Differences in attitudes towards gender-based violence were observed according to sex, age and attitudes in line with the feminist movement. Regarding the linear regression model, the results showed that the FWMS is a predictor of GEPGVS, as well as sex. Conclusions Holding attitudes in line with the feminist movement is a factor that may be promoted in order to increase the awareness of gender-based violence. Objetivo Determinar las actitudes hacia la igualdad y la sensibilización en cuanto a la violencia de género, y analizar las variables asociadas a una mayor sensibilización sobre la violencia de género de los estudiantes de ciencias de la salud y trabajo social. Método Se realizó un estudio descriptivo transversal. La muestra consistió en 437 estudiantes de los grados de ciencias de la salud y trabajo social de la Universidad de Zaragoza (España) durante 2018 y 2019. Las variables del estudio fueron variables sociodemográficas, variables académicas, actitudes hacia el movimiento feminista usando la Feminism and the women''s movement scale (FWMS) y actitudes hacia la violencia de género mediante la Escala sobre Igualdad y Prevención de la Violencia de Género (EIPVG). Se realizaron un estudio correlacional y una regresión lineal múltiple para conocer las variables asociadas a una mayor sensibilización. Resultados Se observaron diferencias en las actitudes hacia la violencia de género en función del sexo, la edad y las actitudes favorables al movimiento feminista. Con respecto al modelo de regresión lineal, los resultados mostraron que la FWMS es un predictor de la EIPVG, así como el sexo. Conclusiones Las actitudes favorables al movimiento feminista son un factor que puede promoverse para incrementar la sensibilización sobre la violencia de género

Effectiveness of a telerehabilitation intervention using ReCOVery APP of long COVID patients: a randomized, 3-month follow-up clinical trial

The main objective of this study is to analyze the clinical efficacy of telerehabilitation in the recovery of Long COVID patients through ReCOVery APP for 3 months, administered in the Primary Health Care context. The second objective is to identify significant models associated with an improvement in the study variables. An open-label randomized clinical trial was conducted using two parallel groups of a total of 100 Long COVID patients. The first group follows the treatment as usual methods established by their general practitioner (control group) and the second follows the same methods and also uses ReCOVery APP (intervention group). After the intervention, no significant differences were found in favour of the group intervention. Regarding adherence, 25% of the participants made significant use of the APP. Linear regression model establishes that the time of use of ReCOVery APP predicts an improvement in physical function (b = 0.001; p = 0.005) and community social support (b = 0.004; p = 0.021). In addition, an increase in self-efficacy and health literacy also contribute to improving cognitive function (b = 0.346; p = 0.001) and reducing the number of symptoms (b = 0.226; p = 0.002), respectively. In conclusion, the significant use of ReCOVery APP can contribute to the recovery of Long COVID patients. Trial Registration No.: ISRCTN91104012

Value Conflict, Lack of Rewards, and Sense of Community as Psychosocial Risk Factors of Burnout in Communication Professionals (Press, Radio, and Television)

Journalists are at particular risk of work-related stress and burnout. The objective of this study is to describe and analyze the principal factors involved in the appearance of burnout in communication professionals, as well as the possible interactions between them and with self-reported health, and to observe whether the variables involved are the same in different types of environments. To achieve this objective, 292 participants answered the following measurement instruments: Demographic and labor datasheet; Maslach Burnout Inventory (MBI General survey); Areas of Worklife Scale (AWS); and General Health Questionnaire (GHQ -12). The results were the following: Emotional Exhaustion (EE) shows direct correlation and statistical significance with the other two burnout dimensions, Depersonalization (DP) and Personal Accomplishment (PA), also with health perception variables and inverse and statistical significance with the workload, control, rewards, community, fairness, and values. A multiple linear regression model shows workload and values as inverse EE predictors, which confirms a burnout process in which EE contributes as the main dimension in DP and is shown to be a precursor of PA, itself. When comparing different types of media, journalists who work in institutional press offices presented significantly lower scores in PA and higher in control, rewards, community, justice, and values. Therefore, further research should be carried out in order to analyze the protective role of these variables regarding PA and burnout

The impact of the COVID-19 lockdown on depression sufferers: a qualitative study from the province of Zaragoza, Spain

Background and purpose: The impact of COVID-19 and its control measures have exacerbated existing mental health conditions. Although the deleterious effects of mental health problems are well known, fewer studies have examined the links between the Social Determinants of Health (SDHs) and depression. This study provides insights into the relationship between SDHs and depression during the first strict lockdown in Spain, which lasted for a period of 7 weeks. Methods: Fifty-two structured interviews were conducted with people diagnosed with depression during June 2020 in the province of Zaragoza (Spain). Interviews were conducted by telephone due to lockdown constraints. Inductive thematic content analysis was used to explore, develop, and define emergent categories of analysis, which were mapped against the SDH framework. Results: Listening to people’s experiences of living with depression during lockdown provided insights into their concerns and coping strategies, which are greatly influenced by the conditions in which they live, their job and their age. Examples of these factors include access to and quality of physical spaces, including housing conditions and public spaces for socialising, social support, adverse working conditions which include caring responsibilities, and access to digital technologies and healthcare services. Conclusion: SDHs have played a fundamental role in shaping people’s health and well-being during the COVID-19 pandemic, and this study has shown that they have a considerable effect on depression outcomes. Governments should consider implementing social welfare programs to tackle both psychosocial problems and material need during crisis situations

Geographic factors associated with poorer outcomes in patients diagnosed with covid-19 in primary health care

Background: The prognosis of older age COVID-19 patients with comorbidities is associated with a more severe course and higher fatality rates but no analysis has yet included factors related to the geographical area/municipality in which the affected patients live, so the objective of this study was to analyse the prognosis of patients with COVID-19 in terms of sex, age, comorbidi-ties, and geographic variables. Methods: A retrospective cohort of 6286 patients diagnosed with COVID-19 was analysed, considering demographic data, previous comorbidities and geographic variables. The main study variables were hospital admission, intensive care unit (ICU) admission and death due to worsening symptoms; and the secondary variables were sex, age, comorbidities and geographic variables (size of the area of residence, distance to the hospital and the driving time to the hospital). A comparison analysis and a multivariate Cox model were performed. Results: The multivariate Cox model showed that women had a better prognosis in any type of analysed prog-nosis. Most of the comorbidities studied were related to a poorer prognosis except for dementia, which is related to lower admissions and higher mortality. Suburban areas were associated with greater mortality and with less hospital or ICU admission. Distance to the hospital was also associated with hospital admission. Conclusions: Factors such as type of municipality and distance to hospital act as social health determinants. This fact must be taken account in order to stablish specifics prevention measures and treatment protocols