Computer Cognitive Rehabilitation in Older People: gradior Program

In the process of aging, there is a cognitive decline due to age. Cognitive impairment is one of the most common symptoms of neurodegenerative diseases such as dementia. Throughout decades, different types of cognitive interventions and approaches have been developed with the main objective of improving or maintaining the cognitive capacities of the elderly. Such is the case of computer cognitive rehabilitation that has been shown to be an effective form of stimulation capable of improving cognitive functioning in the older people. This document describes the computerized cognitive rehabilitation program gradior 4.5 (latest version), specifying its different components, application methodology and its most relevant aspects. The experience developed during the more than 20 years of existence of the program with thousands of patients coming from different devices and the different studies of efficacy and usability developed, in order to satisfy the needs, capacities, limitations and preferences of the users, have given place to this new improved version that makes it a flexible, dynamic, simple, useful and easy to use tool

Computer Cognitive Rehabilitation in Older People: gradior Program

In the process of aging, there is a cognitive decline due to age. Cognitive impairment is one of the most common symptoms of neurodegenerative diseases such as dementia. Throughout decades, different types of cognitive interventions and approaches have been developed with the main objective of improving or maintaining the cognitive capacities of the elderly. Such is the case of computer cognitive rehabilitation that has been shown to be an effective form of stimulation capable of improving cognitive functioning in the older people. This document describes the computerized cognitive rehabilitation program gradior 4.5 (latest version), specifying its different components, application methodology and its most relevant aspects. The experience developed during the more than 20 years of existence of the program with thousands of patients coming from different devices and the different studies of efficacy and usability developed, in order to satisfy the needs, capacities, limitations and preferences of the users, have given place to this new improved version that makes it a flexible, dynamic, simple, useful and easy to use tool.En el proceso de envejecimiento, se produce un declive cognitivo debido a la edad. El deterioro cognitivo es uno de los síntomas más comunes de enfermedades neurodegenerativas como la demencia. A lo largo de décadas se han desarrollado diferentes tipos de intervenciones cognitivas y enfoques con el objetivo principal de mejorar o mantener las capacidades cognitivas de las personas mayores. Tal es el caso de la rehabilitación cognitiva por ordenador, que se ha mostrado como una forma eficaz de estimulación capaz de mejorar el funcionamiento cognitivo en personas mayores. El presente documento describe el programa de rehabilitación cognitiva por ordenador gradior 4.5 (última versión), especificando sus diferentes componentes, metodología de aplicación y sus aspectos más relevantes. La experiencia desarrollada durante los más de 20 años de existencia del programa con miles de pacientes provenientes de diferentes dispositivos y los diferentes estudios de eficacia y usabilidad desarrollados, con el fin de satisfacer las necesidades, capacidades, limitaciones y preferencias de los usuarios, han dado lugar a esta nueva versión mejorada que la convierte en una herramienta flexible, dinámica, sencilla, útil y fácil de usar

Study on the Acceptability of an ICT Platform for Older Adults with Mild Cognitive Impairment

EhcoBUTLER is an Information and Communication Technology (ICT) solution funded by the EuropeanUnion (H2020; ID: 643566)and intended especially for elderly people with mild cognitive impairment (MCI) to improve their health, independence and quality oflife, particularly at the social level. The purpose of this study is to assess the acceptability of ehcoBUTLER based on a survey deliveredto potential users and actors involved in their care, exploring theirexpectations and preferences, while anticipating the system'sfunctional requirements. The survey was delivered online to 313participants (11% end users, 25% informal caregivers, 48% formalcaregivers and 16% administration/management staff) from eight countries. Participants rated the different functionalities ofehcoBUTLER positively, 86.1% perceiving it as an interesting and useful system. Likewise, they assessed it as a commerciallyattractive product (75.1%). End users expressed a stronger preference for the social module. Nevertheless, they would be ready topay a low monthly price for ehcoBUTLER. Professionals would be willing to pay choosing its functionalities modularly, but theywould also expect it to be funded by the National Health System, centres or businesses. The conclusion is that all participants foundehcoBUTLER interesting, useful and ergonomic. However, to effectively implement it, it is necessary to bridge the digital gap andaddress the issue of insufficient investment in products aimed atolder adults with cognitive impairment. To supplement cognitivetraining systems with social, emotional or entertainment functionalities could improve adherence to their use

Addressing suicide risk according to different healthcare professionals in Spain

This study analyzes the views of four groups of healthcare professionals who may play a role in the management of suicidal behavior. The goal was to identify key factors for suicide prevention in different areas of the healthcare system. Qualitative research was conducted using focus groups made up of different healthcare professionals who participated in the identification, management, and prevention of suicidal behavior. Professionals included were primary care physicians, psychologists, psychiatrists, and emergency physicians. ‘Suicide’ was amongst the most relevant terms that came up in discussions most of the times it appeared associated with words such as ‘risk’, danger’, or ‘harm’. In the analysis by categories, the four groups of professionals agreed that interventions in at-risk behaviors are first in importance. Prevention was the second main concern with greater significance among psychiatrists. Primary care professionals call for more time to address patients at risk for suicide and easier access to and communication with the mental health network. Emergency care professionals have a lack of awareness of their role in the detection of risk for suicide in patients who seek attention at emergency care facilities for reasons of general somatic issues. Mental health care professionals are in high demand in cases of self-harm, but they would like to receive specific training in dealing with suicidal behavior

Perceptions of Older People with Cognitive Impairment, Caregivers, and Professionals about ehcoBUTLER (Tablet Health Care Platform): A Qualitative Focus Group Study

EhcoBUTLER is a tablet platform mainly aimed at the elderly with mild cognitive impairment (MCI) to promote their well-being and health. The main objective of this study was to explore the perceptions and feedback level of the ehcoBUTLER potential users and stakeholders to improve its development. Through this exploration, the secondary objective was to contribute to the development of software/apps that promote their integral health. Focus groups were conducted (13 elderly with MCI, 13 with dementia, 12 caregivers, 11 professionals). The content and feedback level were analyzed. Participants liked the appearance of ehcoBUTLER, would like to use it, and were mainly interested in the emotional, healthy lifestyle, cognitive, and ergonomic tools. It is necessary to have prior training, more intuitive/customizable apps, low-price/free, offline/USB content, and add other activities/features. EhcoBUTLER is well-oriented to meet the needs and preferences of potential users. However, improvements in its usability, accessibility, and sustainability are needed. The participants’ perspectives provided a comprehensive view to improve ehcoBUTLER, so that in the future, it can benefit the elderly to be active agents in their health; support caregivers in their role and to have a respite; and professionals to have a multi-intervention platform. The present findings can contribute to the development of tablet software/apps that promote the integral well-being of this population

Anales de Edafología y Agrobiología Tomo 42 Número 11-12

Suelos. Estudio de la superficie y de la textura de bentonitas homoionicas. JI. Constantes relativas de equilibrio. por E. González Pradas, F. del Rey Bueno, C. Valenzue/a Calahorro y J. D. López González.-- Suelos AC sobre granitos de Galicia (NO de España) con especial referencia al ranker atlántico. III. Fracción orgánica, por M. Carballas, T. Carballas, A. Cabaneiro, M. C. Villar, M. C. Leiros y F. Guitián Ojea.-- Estudio del proceso de intercalación del eter benzo 15-corona-5 en óxido grafítico procedente de un grafito de la Sierra de Huelma (Jaén), por A. J. López Peintido, J. de D. López González, J. Peinado García y J. Rivera Utrilla.-- Estudio de un perfil con caracteres isohúmicos en la comarca de la Bureba (Burgos), Por R· Jiménez Ballesta, . G. Almendros, A.Polo y J. L. Martín de Vidales.-- Uso de algas marinas como fertilizantes de suelos gallegos. I. por P.Rodriguez Seoane, M. L. Andrade Couce, M. l. López López y F. Guitión Ojea. ..-- Uso de algas marinas como fertilizantes de suelos gallegos. II., por M. L. Andrade Couce, P. Rodriguez Seoane, F. Guitián Rivera, M. l. López López y F. Guitián Ojea.-- Transformaciones en la organización durante la alteración y edafogénesis de rocas esquistosas en Galicia, por B. M. Silva hermo y F. Macías Vázquez.-- La influencia conjunta del relieve y la vegetación sobre los suelos forestales de la dehesa del Camarate (Sierra Nevada), por J. Párraga Martínez, R. Delgado Calvo-Flores y J. Aguilar Ruiz.-- Haploxerolis de la sierra de María (Almería), por L. J. Alias y J. Martínez.-- La contaminación por metaIes pesados en la zona de Linares, por M. Serrano Peñuela, l. Saura Vilchez, G. Delgado Calvo-Flores y J. Aguilar Ruiz.-- Contribución al estudio morfológico y evolutivo de los suelos desarrollados sobre dolomías kakiritizadas en clima seco, por l. García Fernández, M. Simón. Torres y J. Aguilar Ruiz.-- Estudio de los suelos sobre jumillitas de la sierra de las Cabras (Albacete), por L. J. Alías Pérez, J, Hemández Bastida y Ma T. Fernández Tapia.-- Contribución al estudio morfológico y evolutivo de los suelos desarrollados sobre coluvios calizos en clima xérico, por l. García Fernández, M. Simón Torres y J. Aguilar Ruiz.-- Los acrisoles gleicos de la zona de Linares (Jaén), por G. Delgado, J. Aguilar y M. Simón.-- Retención de malation y dicofol sobre carbón activo, por E. González Pradas, A. Valverde García, M. Villafranca Sánchez y F. del Rey Bueno.-- Contribución al estudio de los suelos desarrollados sobre sedimentps fluviales recientes de Galicia, por Esther de Bias, F. Gil Sotres y F. Guitián Ojea.-- Estudio edáfico de los suelos del sector Salar-Alhama (Granada), por J. Fernández, E. Ortega, J. Párraga y J. Aguilar.—Fertilidad del Suelo. Respuesta del Rye-grass al fósforo añadido en suelos del Valle del Ebro, por Benigna Eleizalde.-- Number, distribution and characterization of heterotrophic. bact~ria in sorne Argentine soils, by M. A. Sagardoy and C. M. Salerno.-- Naturaleza y propiedades de la materia orgánica en dos tipos de compost de paja de trigo, por G. Almendros, M. C. Lobo, A. Polo y E. Dorado .-- Evolución de algunos compuestos nitrogenados en suelos argiudoles bajo cultivo de maiz, por Marta E. Conti, Ana María Rodríguez Janeiro y Claudia Marre.-- Aplicación del "Sistema de clasificación de las condiciones de fertilidad del suelo" a la cartografía de suelos de la zona de Linares, por G. Delgado y J. Aguilar.-- Acción del humus extraído de una turba sometida a tratamientos ácidos, alcalinos y oxidantes, sobre el desaM rrollo de la planta de lechuga, por C. Ortega y R. García de las Heras.—Nutrición y Fisiología Vegetal. Estudio comparativo de la estructura foliar, intercepción de luz y rendimiento en girasol, por Luis F. Hernández y Gustavo A. Orioli.-- Crecimiento de Chlorella Pyrenoidosa en relación a la presencia del ión bicarbonato en el medio de cultivo, por E. Fernández, E. Sánchez, P. Mateo, l. Bonilla y P. Ortega.-- Efecto del ión sulfato sobre la absorción de azufre, composición foliar y calidad del fruto en limonero Yema, por. F. G. Fernández, M. Caro y A. Cerda.-- Determinación del déficit de saturación hídrica (DSH) en hojas de cítricos y frutales, por A. León, A. Torrecillas, F. del Amor y M. C. Ruiz-Sánchez.-- Fraccionamiento de compuestos de fósforo en flores de Prunus armeniaca durante las etapas de la floración, por Ma Parra y T. Parra.-- Determinación de déficit hídricos nocivos en tejidos foliares de cítricos y frutales, por A. León, A. Torrecillas, F. del Amor y M. J. Sánchez-Blanco.-- Influencia de la aplicación de Edta-Fe y arcilla en judía (Phaseolus vulgaris, L.). Efecto sobre la absorción y distribución de macronutrientes, por I. Agui y M. Gómez-- Estudio del efecto de la presión osmótica del medio nutritivo sobre la composición del fruto de tomate (Lyropersicum eculentum), por Ma P. Sánchez Conde.-- Composición mineral y relaciones fisiológicas de piensos utilizados en la alimentación de vacuno de lidia, por M. Barroso, J. M. Hernández, J. M. Murillo, M. Chaves y A. Troncoso.-- Microbiología. Investigación de la precipitación de carbonato cálcico en la solubilización de fosfatos, por I. Pérez-García, M. A. Rivadeneyra, V. Salmeron y A. Ramos-Cormenzana.—Ecología. Predicción de parametros climáticos de interés ecológico en Galicia: y III. Evapotranspiración potencial y balance hídrico, por R. Retuerto, F. Ucieda y A. Carballeira.—Trabajos recapitulativos. Las clases de fosfatos, su disponibilitlad en suelos agrícolas y otros trabajos relacionados con el elemento fósforo. Parte II. Procesos de adsorción-desorción y estudios sobre fertilidad de suelos y nutrición vegetal, por P. de Arambarri.-- BibliografíaPeer reviewe

Evaluation of Nutritional Practices in the Critical Care patient (The ENPIC study) : Does nutrition really affect ICU mortality?

The importance of artificial nutritional therapy is underrecognized, typically being considered an adjunctive rather than a primary therapy. We aimed to evaluate the influence of nutritional therapy on mortality in critically ill patients. Methods: This multicenter prospective observational study included adult patients needing artificial nutritional therapy for >48 h if they stayed in one of 38 participating intensive care units for ≥72 h between April and July 2018. Demographic data, comorbidities, diagnoses, nutritional status and therapy (type and details for ≤14 days), and outcomes were registered in a database. Confounders such as disease severity, patient type (e.g., medical, surgical or trauma), and type and duration of nutritional therapy were also included in a multivariate analysis, and hazard ratios (HRs) and 95% confidence intervals (95%CIs) were reported. We included 639 patients among whom 448 (70.1%) and 191 (29.9%) received enteral and parenteral nutrition, respectively. Mortality was 25.6%, with non-survivors having the following characteristics: older age; more comorbidities; higher Sequential Organ Failure Assessment (SOFA) scores (6.6 ± 3.3 vs 8.4 ± 3.7; P < 0.001); greater nutritional risk (Nutrition Risk in the Critically Ill [NUTRIC] score: 3.8 ± 2.1 vs 5.2 ± 1.7; P < 0.001); more vasopressor requirements (70.4% vs 83.5%; P=0.001); and more renal replacement therapy (12.2% vs 23.2%; P=0.001). Multivariate analysis showed that older age (HR: 1.023; 95% CI: 1.008-1.038; P=0.003), higher SOFA score (HR: 1.096; 95% CI: 1.036-1.160; P=0.001), higher NUTRIC score (HR: 1.136; 95% CI: 1.025-1.259; P=0.015), requiring parenteral nutrition after starting enteral nutrition (HR: 2.368; 95% CI: 1.168-4.798; P=0.017), and a higher mean Kcal/Kg/day intake (HR: 1.057; 95% CI: 1.015-1.101; P=0.008) were associated with mortality. By contrast, a higher mean protein intake protected against mortality (HR: 0.507; 95% CI: 0.263-0.977; P=0.042). Old age, higher organ failure scores, and greater nutritional risk appear to be associated with higher mortality. Patients who need parenteral nutrition after starting enteral nutrition may represent a high-risk subgroup for mortality due to illness severity and problems receiving appropriate nutritional therapy. Mean calorie and protein delivery also appeared to influence outcomes. ClinicaTrials.gov NCT: 03634943