Effectiveness of interventions aimed at improving grief and depression in caregivers of people with dementia: A systematic review and meta-analysis

Caregivers of people suffering from dementia may go through a grieving process prior to the death of the cared-for person, which is related to mental health and physical problems. Interventions aimed at improving grief and depression are being used in response to these difficulties. The aim of this study was to synthesize and evaluate the evidence for the effectiveness of interventions aimed at improving the grief process in home-based caregivers of people with dementia with the aim of reducing grief and depression. A systematic review, including a meta-analysis, was designed. Following the PRISMA guideline, original articles were searched in the databases: Medline, WOS, Scopus and PsycINFO, up to September 2022. Articles that evaluated interventions aimed at improving the grief process in caregivers of people with dementia, whose care recipients were alive at the beginning of the study at minimum and living at home were selected. Grief and depression were considered outcome variables. A meta-analysis was carried out with a fixed effects model for these variables and for the domains of the Caregiver Grief Scale (CGS). Eight articles met the inclusion and exclusion criteria. Most of the interventions aimed at improving the grief process showed an improvement in grief and depression. The "emotional pain" and "absolute loss" domains of the CGS stood out with an improvement in these variables. Interventions aimed at improving the grief process are relatively effective in reducing grief and depression. Interventions that are even more effective and more robust studies are needed.The Spanish Ministry of Universities has supported the first author of this research through the University Teacher Training Programme, with reference number (FPU19/04001). Funding for open access charge: Universidad de Huelva / CBUA

Design and validation of the questionnaire for the inclusive assessment of the "philosophical potentials" of people with intellectual (dis)abilities based on the "Free Thinking Approach"

El artículo presenta el primer estudio validado de capacidades (entendidas como “potenciales filosóficos”) de personas con (dis)capacidad intelectual o diversidad funcional intelectual. La investigación ha evaluado tres potenciales filosóficos concretos: en primer lugar, los potenciales de pensamiento entendidos como procesos de empoderamiento crítico y no solo como destrezas cognitivas. En estos potenciales, la importancia de las preguntas filosóficas de las personas es un elemento indispensable; en segundo lugar, los potenciales creativos entendidos como procesos de razonamiento divergente o lateral en el cual se tratan de buscar soluciones alternativas a problemas reales o imaginarios; y, en tercer lugar, los potenciales morales entendidos como procesos de toma de decisiones que tenga en cuenta la dimensión ética y emocional de cualquier persona como parte de una comunidad moral y política. Este cuestionario utiliza la metodología denominada “Enfoque Pensamiento Libre” en contextos de desventajas cognitivas, una metodología que se inspira en la “metodología Lipman” y otras metodologías procedentes del campo de la educación emocional y educación en valores. La conclusión a la que hemos llegado es que la validación de este cuestionario supone la confirmación de la importancia del “diálogo filosófico” en los procesos de empoderamiento de las personas con desventajas cognitivas, en este caso, la (dis)capacidad intelectual, para evitar la exclusion o injusticia epistémica de las voces subalternas. Después de las sesiones realizadas durante un curso escolar, las personas con (dis)capacidad realizaron avances significativos en los items analizados en el cuestionario y que aparecen en este artículo. Este cuestionario puede ser implementado en los Centros Ocupacionales o Centros Educativos donde los profesionales de los servicios sociales comunitarios o de la educación formal deseen evaluar las capacidades de las personas a las que tradicionalmente se las ha excluído de estas dimensiones.This article presents the first validated study of capacities (understood as "philosophical potentials") of people with intellectual (dys)ability or intellectual functional diversity. The research carried out aims to assess three specific philosophical potentials: firstly, thinking potentials understood as processes of critical empowerment and not only as cognitive skills, in these potentials, the importance of people's philosophical questions is an indispensable element; secondly, creative potentials understood as processes of divergent or lateral reasoning in which alternative solutions to real or imaginary problems are sought; and thirdly, moral potentials understood as decision-making processes that take into account the ethical and emotional dimension of any person as part of a moral and political community. This questionnaire uses the methodology called "Free Thinking Approach" in contexts of cognitive disadvantage, a methodology that is inspired by the "Lipman methodology" and other methodologies from the field of emotional education and values education. The conclusion we have reached is that the validation of this questionnaire confirms the importance of the "philosophical dialogue" in the processes of empowerment of people with cognitive disadvantages, in this case (dis)intellectual capacity to avoid the exclusion or epistemic injustice of the subaltern voices of our complex societies. After the sessions carried out during a school year, people with disabilities made significant progress in the items analysed in the questionnaire and which appear in this article. This questionnaire can be implemented in Occupational Centres or Educational Centres where professionals of community social services or formal education wish to assess the philosophical potentials of people who have traditionally been excluded from these dimensions

Spain: social contexts and psychological adjustment in Spanish adolescents

The HBSC survey carried out in the Spring of 2006 had access to 21811 adolescent schoolboys and schoolgirls between 11 and 18 years of age. They came from various regions, belonged to families with a range of purchasing power and attended schools in both the private and public sectors. This study presents the most significant results regarding adolescent social relationships and mental health

Buenas Prácticas en los Programas Universitarios para Mayores en España

Ana Isabel Muñoz Alcón y Francisco Trullén Galve (Universidad Catolica de Ávila); María P. García de la Torre y Francisco Ascón Belver (Universidad de A Coruña); M. Isabel Luis Rico, Ángel Gañán Adánez, Tamara de la Torre Cruz, Vanesa Baños Martínez (Universidad de Burgos); Yolanda Lázaro Fernández y Jaime Cuenca Amigo (Universidad de Deusto); Camino Caballero Posado (Universidad de Extremadura); Mª Adoración Holgado Sánchez y Mª Teresa Ramos Bernal (Universidad Pontificia de Salamanca); Sara Serrate González, Javier Alba Barrios y José Manuel Muñoz Rodríguez; Miguel Ángel Nombela Castaño (Universidad de Vigo

Desarrollo Económico de la Comarca de Cartagena 2016

El presente informe tiene la finalidad de servir como una herramienta de diagnóstico de la situación económica del tejido empresarial de la Comarca de Cartagena, promoviendo medidas que contribuyen al desarrollo estratégico de la Comarca. A partir del estudio y análisis del contexto socioeconómico sectorial que han realizado los investigadores especialistas en cada uno de los sectores de actividad, así como del análisis por parte de los paneles de expertos consultados, se incluye a continuación un estudio por sectores de actividad de las actuaciones que deberían considerarse para establecer las líneas estratégicas de contenido económico en la Comarca de Cartagena en los próximos años. Las políticas que permitan desarrollar dichas actuaciones asegurarán la competitividad de las pequeñas y medianas empresas en general y el adecuado progreso económico de la Comarca en particular. Los principales pilares de competitividad sobre los que deberían asentarse las actuaciones estratégicas para la comarca se han clasificado por sectores de actividad atendiendo a las infraestructuras, el conocimiento (formación y cualificación), el desarrollo de las tecnologías de la información y las comunicaciones, la innovación, la financiación y la eficiencia de las Administraciones Públicas. El informe se estructura en una primera aproximación a la situación macroeconómica de la Comarca en su contexto Regional y Nacional desde el punto de vista de la oferta y la demanda, así como un detalle prospectivo de la economía para los próximos meses. A continuación se detalla el análisis sectorial dividido en los sectores: turismo, comercio, industria, agroalimentación y tecnológico. Adicionalmente, se incluye un análisis y diagnóstico económicofinanciero a nivel microeconómico de las pymes de la Comarca. Por último, se incluyen a modo de resumen las principales conclusiones y recomendaciones derivadas del estudi

Identification of 1,2,3-triazolium salt-based inhibitors of Leishmania infantum trypanothione disulfide reductase with enhanced antileishmanial potency in cellulo and increased selectivity

N-methylation of the triazole moiety present in our recently described triazole-phenyl-thiazole dimerization disruptors of Leishmania infantum trypanothione disulfide reductase (LiTryR) led to a new class of potent in- hibitors that target different binding sites on this enzyme. Subtle structural changes among representative library members modified their mechanism of action, switching from models of classical competitive inhibition to time- dependent mixed noncompetitive inhibition. X-ray crystallography and molecular modeling results provided a rationale for this distinct behavior. The remarkable potency and selectivity improvements, particularly against intracellular amastigotes, of the LiTryR dimerization disruptors 4c and 4d reveal that they could be exploited as leishmanicidal agents. Of note, L. infantum promastigotes treated with 4c significantly reduced their low- molecular-weight thiol content, thus providing additional evidence that LiTryR is the main target of this novel compound.This work has been financially supported by the Spanish MICINN (Projects PID2019-104070RB-C21, PID2019-104070RB-C22 and PID2020-115331 GB-I00), the Spanish Agencia Estatal Consejo Superior de Investigaciones Científicas (CSIC, Projects CSIC-PIE-201980E100 and CSIC-PIE-201980E028), and the Comunidad de Madrid (PLATESA2-CM ref. S-2018/BAA-4370). The Spanish MEC is also acknowledged for FPU grants to A. R. and to J.C.G. P.A.S.M. thanks to the Division of Physio- logical Chemistry and the Otto-Loewi Research Center of the Medical University of Graz for their support with the scienfic cluster where the calculations contained in this work were run. We thank Ricardo Lau- reano-Rodríguez, Juan Antonio Rodríguez-Gutierrez, and Laura Lagar- tera for technical assistance with SPR experiments.Peer reviewe

Efficacy of clozapine versus standard treatment in adult individuals with intellectual disability and treatment-resistant psychosis (CLOZAID): study protocol of a multicenter randomized clinical trial

BackgroundIntellectual disability (ID) affects approximately 1% of the worldwide population and individuals with ID have a higher comorbidity with mental illness, and specifically psychotic disorders. Unfortunately, among individuals with ID, limited research has been conducted since ID individuals are usually excluded from mental illness epidemiological studies and clinical trials. Here we perform a clinical trial to investigate the effectiveness of clozapine in the treatment of resistant psychosis in individuals with ID. The article highlights the complexity of diagnosing and treating psychopathological alterations associated with ID and advocates for more rigorous research in this field.MethodsA Phase IIB, open-label, randomized, multicenter clinical trial (NCT04529226) is currently ongoing to assess the efficacy of oral clozapine in individuals diagnosed with ID and suffering from treatment-resistant psychosis. We aim to recruit one-hundred and fourteen individuals (N=114) with ID and resistant psychosis, who will be randomized to TAU (treatment as usual) and treatment-with-clozapine conditions. As secondary outcomes, changes in other clinical scales (PANSS and SANS) and the improvement in functionality, assessed through changes in the Euro-QoL-5D-5L were assessed. The main outcome variables will be analyzed using generalized linear mixed models (GLMM), assessing the effects of status variable (TAU vs. Clozapine), time, and the interaction between them.DiscussionThe treatment of resistant psychosis among ID individuals must be directed by empirically supported research. CLOZAID clinical trial may provide relevant information about clinical guidelines to optimally treat adults with ID and treatment-resistant psychosis and the benefits and risks of an early use of clozapine in this underrepresented population in clinical trials.Trial registrationClinicaltrials.gov: NCT04529226. EudraCT: 2020-000091-37