Estudio multicéntrico sobre la prevalencia de la sospecha del maltrato hacia las personas mayores en el ámbito familiar

Tesis doctoral inédita leída en la Universidad Autónoma de Madrid, Facultad de Psicología, Departamento de Psicología Biológica y de la Salud. Fecha de lectura: 19 de diciembre de 200

Psychometric properties of the CASP-12 in a Spanish older community dwelling sample.

Current studies have shown that older people ́s Quality of Life (QoL) is more associated to individual ́s sense of happiness and subjective life satisfaction than to objective problems, such as physical functioning. CASP scale conceptualizes QoL based in a psycho-sociological perspective. Originally it consisted of 19 items (four factors: control, autonomy, self-realization and pleasure; the first letter of each factor were joined to create the acronym, CASP), but Wiggins, Netuvelli, Hyde, Higgs and Blane (2008) proposed a shorter version including 12 items and three factors (control combined with autonomy, pleasure and self-realization). Objective and methods. The aim of this study was to assess the structure of the CASP- 12 SHARE version using confirmatory factor analysis (CFA) in a sample of 1,108 people aged 60 years and over. We checked the CASP structures traditionally proposed (one-dimensional, four dimension first-order factor and second order factor model) and tested, for the first time, the three domains model proposed by Wiggins et al. (2008) with the objective of constructing a model with acceptable fit to the data that also retains the theoretical value of the scale. Results. The three factor model (1) pleasure, 2) self-realization and 3) autonomy and control) showed a good overall fit (CFI=.932; TLI=.912; RMSEA=.067). An adequate internal consistency was also obtained. Conclusion. This is the first study that explored the psychometric properties and validated a well-fitting three factor structure proposed by Wiggins and cols (2008) for the CASP-12 in a large population sample of older people from Spain. The results of the current study support a multidimensional model for the CASP-12 composed by three factors. The CASP-12 has potential to be used as a multidimensional tool to assess QoL in older people.pre-print270 K

Prevalence of elder abuse in Spanish dwelling in community

Authors posting Accepted Author Manuscript online should later add a citation for the Published Journal Article indicating that the Article was subsequently published, and may mention the journal title provided they add the following text at the beginning of the document: “NOTICE: this is the author’s version of a work that was accepted for publication in Medicina Clínica. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Medicina Clínica, 141.12 (2013): 522–526 DOI: http://dx.doi.org/10.1016/j.medcli.2012.09.048Aunque los malos tratos hacia las personas mayores no son un fenómeno nuevo, continúa estando oculto. A pesar de que se han realizado diversos estudios sobre prevalencia en diferentes países, los resultados de estos solo pueden ser utilizados como datos orientativos. El objetivo de este estudio es estimar la prevalencia de malos tratos en personas mayores sin deterioro cognitivo residentes en el ámbito comunitario que acudían a Centros de Atención Primaria o de Servicios Sociales. Pacientes y método: Se realizo´ un estudio transversal en el que participaron 340 personas mayores. Resultados: Se ha encontrado una prevalencia de malos tratos del 12,1%, siendo el tipo más frecuente el psicológico y siendo frecuente la presencia simultánea de diferentes tipos (maltrato psicológico y físico y sexual). Los malos tratos son más frecuentes en mujeres y los responsables son con mayor frecuencia los cónyuges. Conclusiones: Los datos obtenidos permiten avanzar en el conocimiento de los malos tratos hacia personas mayores en España, donde los precedentes de investigación en este área son aislados. No obstante, la cifra estimada de prevalencia de malos tratos no debe caer dentro del alarmismo social ni, por el contrario, en una «dejadez social».Although elder abuse is not a new phenomenon, it remains hidden. There have been carried out various preliminary studies about the prevalence of elder abuse in different countries. The aim of this study is to estimate the prevalence of suspicion of elder abuse in old persons without cognitive impairment, dwelling in community, who were attended in Primary Health Care or Social Services Centres. Patients and method: We carried out a transverse study in which 340 elders participated. Results: We found a 12.1% prevalence of suspicion of elder abuse. Psychological abuse suspicion was the most frequent type and it was very common the simultaneous presence of different types of abuse (psychological and physical and sexual). The suspicion of elder abuse was more frequent in women and spouses were responsible in a high great frequency. Conclusions: The information obtained allows advancing in the knowledge of elder abuse in Spain, where the research about this issue is poor. However, the prevalence found neither has to be considered as a social alarm nor as a social slackness.Este trabajo ha sido financiado por el Instituto de Mayores y Servicios Sociales (IMSERSO)

Older people’s personal strengths during the first wave of the covid-19 pandemic

Background: Although several biopsychosocial variables could play an important role as risk and protective factors of mental health, COVID-19 outbreak studies among older people have seldom focused on protective factors. The purpose of this study was to analyze how older adults’ personal strengths predict their well-being and emotional distress. Method: 783 Spanish people aged 60 and over completed a survey that included sociodemographic characteristics, perceived health, direct or indirect infection by COVID-19, resilience, gratitude, experiential avoidance, family functioning, emotional distress and well-being. Structural Equation Modelling (SEM) was performed. SEM invariance was also used to analyze whether there were differences between older people affected by COVID-19 and those not affected. Results: The best model supports the mediation effect of resilience, gratitude and experiential avoidance on older people’s well-being and emotional distress. Whether participants or relatives had been infected by the virus or not did not affect the results. Conclusions: Variables used as criteria in older adults are related to well-being and emotional distress, but only indirectly and mediated by resilience, gratitude and experiential avoidance. This confirms the importance of considering psychological strengths in older people’s well-being. Interventions focused on these personal resources should be considered.The authors thank all the participants in the study. This work was funded by Universidad San Pablo-CEU, CEU Universities (CEU-Santander, grant number MCOV20V3

Ethnicity and Clinical Outcomes in Patients Hospitalized for COVID-19 in Spain: Results from the Multicenter SEMI-COVID-19 Registry

Background: This work aims to analyze clinical outcomes according to ethnic groups in patients hospitalized for COVID-19 in Spain. (2) Methods: This nationwide, retrospective, multicenter, observational study analyzed hospitalized patients with confirmed COVID-19 in 150 Spanish hospitals (SEMI-COVID-19 Registry) from 1 March 2020 to 31 December 2021. Clinical outcomes were assessed according to ethnicity (Latin Americans, Sub-Saharan Africans, Asians, North Africans, Europeans). The outcomes were in-hospital mortality (IHM), intensive care unit (ICU) admission, and the use of invasive mechanical ventilation (IMV). Associations between ethnic groups and clinical outcomes adjusted for patient characteristics and baseline Charlson Comorbidity Index values and wave were evaluated using logistic regression. (3) Results: Of 23,953 patients (median age 69.5 years, 42.9% women), 7.0% were Latin American, 1.2% were North African, 0.5% were Asian, 0.5% were Sub-Saharan African, and 89.7% were European. Ethnic minority patients were significantly younger than European patients (median (IQR) age 49.1 (40.5-58.9) to 57.1 (44.1-67.1) vs. 71.5 (59.5-81.4) years, p < 0.001). The unadjusted IHM was higher in European (21.6%) versus North African (11.4%), Asian (10.9%), Latin American (7.1%), and Sub-Saharan African (3.2%) patients. After further adjustment, the IHM was lower in Sub-Saharan African (OR 0.28 (0.10-0.79), p = 0.017) versus European patients, while ICU admission rates were higher in Latin American and North African versus European patients (OR (95%CI) 1.37 (1.17-1.60), p < 0.001) and (OR (95%CI) 1.74 (1.26-2.41), p < 0.001). Moreover, Latin American patients were 39% more likely than European patients to use IMV (OR (95%CI) 1.43 (1.21-1.71), p < 0.001). (4) Conclusion: The adjusted IHM was similar in all groups except for Sub-Saharan Africans, who had lower IHM. Latin American patients were admitted to the ICU and required IMV more often

Parasitología Interactiva

Desarrollo de una guía interactiva donde se muestran los ciclos biológicos,imágenes y dibujos de los estadios evolutivos de los principales géneros y especies de parásitos protozoos relevantes en al ámbito veterinario

Prognostic Value of D-dimer to Lymphocyte Ratio (DLR) in Hospitalized Coronavirus Disease 2019 (COVID-19) Patients: A Validation Study in a National Cohort

Background: This study aimed to validate the role of the D-dimer to lymphocyte ratio (DLR) for mortality prediction in a large national cohort of hospitalized coronavirus disease 2019 (COVID-19) patients. Methods: A retrospective, multicenter, observational study that included hospitalized patients due to SARS-CoV-2 infection in Spain was conducted from March 2020 to March 2022. All biomarkers and laboratory indices analyzed were measured once at admission. Results: A total of 10,575 COVID-19 patients were included in this study. The mean age of participants was 66.9 (+/- 16) years, and 58.6% (6202 patients) of them were male. The overall mortality rate was 16.3% (n = 1726 patients). Intensive care unit admission was needed in 10.5% (n = 1106 patients), non-invasive mechanical ventilation was required in 8.8% (n = 923 patients), and orotracheal intubation was required in 7.5% (789 patients). DLR presented a c-statistic of 0.69 (95% CI, 0.68-0.71) for in-hospital mortality with an optimal cut-off above 1. Multivariate analysis showed an independent association for in-hospital mortality for DLR > 1 (adjusted OR 2.09, 95% CI 1.09-4.04; p = 0.03); in the same way, survival analysis showed a higher mortality risk for DLR > 1 (HR 2.24; 95% CI 2.03-2.47; p < 0.01). Further, no other laboratory indices showed an independent association for mortality in multivariate analysis. Conclusions: This study confirmed the usefulness of DLR as a prognostic biomarker for mortality associated with SARS-CoV-2 infection, being an accessible, cost-effective, and easy-to-use biomarker in daily clinical practice

PhDAY 2020 -FOO (Facultad de Óptica y Optometría)

Por cuarto año consecutivo los doctorandos de la Facultad de Óptica y Optometría de la Universidad Complutense de Madrid cuentan con un congreso propio organizado por y para ellos, el 4º PhDAY- FOO. Se trata de un congreso gratuito abierto en la que estos jóvenes científicos podrán presentar sus investigaciones al resto de sus compañeros predoctorales y a toda la comunidad universitaria que quiera disfrutar de este evento. Apunta en tu agenda: el 15 de octubre de 2020. En esta ocasión será un Congreso On-line para evitar que la incertidumbre asociada a la pandemia Covid-19 pudiera condicionar su celebración

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570