Influence of Puerperal Health Literacy on Tobacco Use during Pregnancy among Spanish Women: A Transversal Study.

Background: Despite the fact that tobacco use during pregnancy produces adverse perinatal effects, some women continue to smoke. Health literacy (HL) is essential for health outcomes in adults. However, little is known about HL in pregnant women or postpartum women. The study aimed to analyse the relationship between the degree of HL of women during the early puerperium and tobacco use during pregnancy. Methods: A multicentre, descriptive, cross-sectional study was carried out with women in the early puerperium in a region of eastern Spain, between November 2017 and May 2018. Their HL level was obtained using the Newest Vital Sign (NVS) tool. Multivariate logistic models were adjusted to es…

Delirium Assessment in Older People in Emergency Departments. A Literature Review.

Delirium is a neuropsychiatric syndrome often manifesting in acute disease conditions, and with a greater prevalence in the older generation. Delirium in the Emergency Department (ED) is a highly prevalent problem that typically goes unnoticed by healthcare providers. The onset of a delirium episode in the ED is associated with an increase in morbidity and mortality. Because delirium is a preventable syndrome, these statistics are unacceptable. Emergency Department staff therefore should strive to perform systematic screening in order to detect delirium. Different tools have been developed for the assessment of delirium by healthcare professionals other than psychiatrists or geriatricians. …

Factors associated with fear of falling among frail older adults

Some factors increase the fear of falling in frail older adults. Our aim is to quantify the influence of these factors. This cross-sectional study involved 229 community-dwelling prefrail and frail older adults aged 70 years and older. Fear of falling was moderate in 38.9% of our sample and high in 12.2%. Higher values were observed in women, those living alone, and those meeting criteria for slowness and feelings of exhaustion. A linear regression showed that being a woman, a history of falls, and depressive symptoms were related to higher fear of falling, while high levels of independence in basic and instrumental activities of daily living, along with good gait and balance, were associat…

Risk Factors and Number of Falls as Determinants of Quality of Life of Community-Dwelling Older Adults.

Background and purpose In older adults, the psychological impact and effects related to the loss of functional capacity are directly related to perceived quality of life (QOL). The predictors of better QOL are increased physical activity, lower prevalence of overweight, lower cases of depression, and lower rate of reported alcohol abuse. On the contrary, the predictors of decreased QOL are female gender, comorbidity, deficient nutritional condition, polypharmacy, loss of mobility, depression and dependency, poor economic conditions, and social isolation and loneliness. Furthermore, QOL in older adults is more dependent on the number of falls than comorbidity. The objective was to investigat…

Neuro-Psychiatric Alterations in Patients with Diabetic Foot Syndrome

Diabetic Foot Syndrome (DFS) is a common long-term complication of diabetes mellitus. DFS has recently been associated with adverse effects on brain function which could further impair the quality of life of these patients, as well as increase the social and economic burden, morbidity, and premature mortality of the disease. The current knowledge of neuropsychiatric alterations e.g. cognitive impairment, gait disorder, depression, and quality of life in patients with diabetic foot syndrome is summarized. The cognitive domains altered in DFS are executive function, memory, and psychomotor speed. Compared to diabetic patients without DFS, individuals with DFS present gait alterations caused …

Factors Affecting Attitudes towards Older People in Undergraduate Nursing Students

Background: The population of older people is increasing worldwide. The social and healthcare systems need many nurses to care for the elderly. Positive attitudes increase the preference to work with older people and improve the quality of care. This study describes attitudes towards the elderly in a sample of nursing students, and analyzes the potential factors influencing these attitudes. Methods: A cross-sectional study was carried out in nursing students during the academic course 2017–2018. Kogan’s Attitude Toward Old People Scale was used to assess student attitudes towards older people. Results: The study included 377 undergraduate nursing students, of which 75.9% were women. The mea…

Relationship between the risk of falling and prescribed medication in community-dwelling elderly subjects.

Abstract Introduction: The risk of falling increases with age. A third of the population over 65 has one or more falls per year. Objetive: to know the relationship between drug prescription and falls in the elderly. Materials and Methods: a study was carried out through a community intervention in individuals ≥ 70 years of age. Results: The sample was composed of 249 participants, 160 women (64%), with a mean age of 74.47 years (SD 5.33). During the 12 months prior to the study, the mean of falls per person was 0.5 (SD 0.94), the mean of the risk factors was 2.73 (SD 1.4) and the mean of the medication prescribed was 4.2 (SD 3.0). The percentage of the reduction of falls after the study was…

Nutritional Status and Risk Factors for Frailty in Community-Dwelling Older People: A Cross-Sectional Study

Objective: This study aims to assess the relationship that frailty has with nutritional status and functional risk factors in community-dwelling older adults. Methods: Cross-sectional study in community-dwelling older people, independent for walking and without impaired cognition. Frailty was assessed by Fried criteria. Nutritional status was analyzed by the Mini Nutritional Assessment Short Form (MNA-SF), biochemical markers (albumin, total proteins, cholesterol, lymphocytes, and hemoglobin)

Frailty Status Improvement after 5-Month Multicomponent Program PROMUFRA in Community-Dwelling Older People: A Randomized Controlled Trial

A study was made of the effect of the PROMUFRA multicomponent frailty program upon physical frailty, kinanthropometry, pain and muscle function parameters in frail and pre-frail community-dwelling older people. Eighty-one participants were randomly allocated to the intervention group (IG) or control group (CG). The IG performed PROMUFRA for 20 weeks, using six strength exercises with three series of 8–12 repetitions until muscular failure, and seven myofascial exercises, with one set of 10 repetitions. The CG continued their routine. The frailty criteria number (FCN), kinanthropometric parameters and muscle function were measured at baseline and after the program. Between-group differences …

Preferred Music Listening Intervention in Nursing Home Residents with Cognitive Impairment: A Randomized Intervention Study.

Background The current trend in addressing symptoms of dementia comprises non-pharmacological strategies such as music interventions for the management and improvement of cognitive function, memory, agitation, depression, or anxiety. Objective To determine the impact of a preferred music listening group intervention upon the functional, cognitive, and emotional dimensions in nursing home residents. Methods A randomized intervention study was carried out. The study was conducted from June to August 2015, and involved a preferred music listening group intervention lasting 60 minutes, 5 days/week during 8 weeks. A total of 119 adults aged ≥65 years, with annual permanent residence in the nursi…

Biology of frailty: Modulation of ageing genes and its importance to prevent age-associated loss of function

Frailty is associated with loss of functional reserve as well as with the prediction of adverse events in the old population. The traditional criteria of frailty are based on five physical determinations described in the Cardiovascular Health Study. We propose that biological and genetic markers of frailty should be used to increase the predictive capacity of the established clinical indeces. In recent times, research for biological markers of frailty has gained impetus. Finding a biological markers with diagnostic and prognostic capacity would be a major milestone to identify frailty risk, and also pre-frailty status. In the first section of the manuscript, we review the available biomarke…

The Role of Imaging Biomarkers in the Assessment of Sarcopenia

Background: The diagnosis of sarcopenia through clinical assessment has some limitations. The literature advises studies that include objective markers along with clinical assessment in order to improve the sensitivity and specificity of current diagnostic criteria. The decrease of muscle quality precedes the loss of quantity, so we studied the role magnetic resonance imaging biomarkers as indicators of the quantity and quality of muscle in sarcopenia patients. Methods: a cross-sectional analysis was performed to analyze what MR-derived imaging parameters correlate better with sarcopenia diagnostic criteria in women of 70 years of age and over (independent walking and community-dwelling wom…

Effectiveness of the PROMUFRA program in pre-frail, community-dwelling older people: A randomized controlled trial.

Abstract This study evaluated the effect of PROMUFRA program on physical frailty, kinanthropometric, muscle function and functional performance variables in pre-frail, community-dwelling older people. Participants (n = 50, 75 ± 7 years) were randomly assigned to two groups: intervention group (IG), and control group (CG). The IG performed multi-component exercise program, focused on high-intensity resistance training (HIRT) combined with self-massage for myofascial release (SMMR) for 12 weeks (2 d.wk−1). Two measurements were performed, at baseline and post-3 months. Participants (n = 43) were analyzed and significant differences were found in group-time interaction for muscle mass (p = 0.0…

Calidad de vida dermatológica en ancianos frágiles comunitarios

A Multicomponent Exercise Intervention that Reverses Frailty and Improves Cognition, Emotion, and Social Networking in the Community-Dwelling Frail Elderly: A Randomized Clinical Trial

Abstract Background Frailty can be an important clinical target to reduce rates of disability. Objective To ascertain if a supervised-facility multicomponent exercise program (MEP) when performed by frail older persons can reverse frailty and improve functionality; cognitive, emotional, and social networking; as well as biological biomarkers of frailty, when compared with a controlled population that received no training. Design This is an interventional, controlled, simple randomized study. Researchers responsible for data gathering were blinded for this study. Setting Participants from 2 primary rural care centers (Sollana and Carcaixent) of the same health department in Spain were enroll…

Delirium Predisposing and Triggering Factors in Nursing Home Residents: A Cohort Trial-Nested Case-Control Study.

Background Delirium is a common geriatric syndrome, with a prevalence of between 15-70% among older long-term care residents. It is associated with adverse outcomes, and its onset may prove imperceptible to health professionals. Few studies in institutionalized older people have analyzed the predictors of delirium. Objective The aim of the present study was to identify delirium predisposing and triggering factors, and develop a predictive model. Methods A cohort trial-nested case-control study covering a period of 12 consecutive months (April 2015 - March 2016) was carried out. Predisposing and triggering episodes of delirium were recorded. Results A total of 443 older persons were recruite…

Improved Nutritional Knowledge in the Obese Adult Population Modifies Eating Habits and Serum and Anthropometric Markers

Multicomponent lifestyle interventions achieve good results in the management of obesity among the adult population. However, their implementation in certain populations poses difficulties. A good level of nutritional knowledge enables people to make changes in their diet that improve their health. This study aims to assess the relationship between nutritional knowledge and nutritional parameters such as dietary intake, anthropometric parameters and biomarkers. A before&ndash

A home-based exercise program focused on proprioception to reduce falls in frail and pre-frail community-dwelling older adults.

Frailty and falls are closely associated with each other as well as with disability, hospitalization, and death. Exercise can reduce these risks in both robust and frail older people. This before-after, non-randomized intervention study assessed a one-year proprioception training program with individual daily home exercises in 564 community-dwelling people aged 70 years and over, with different frailty phenotypes. After the exercise program, we observed a moderate reduction in the mean number of falls, fear of falls, body mass index and body fat percentage in frail and pre-frail participants. These results suggest that a home proprioception program may be a viable alternative to complex mul…

Knowledge and Attitudes towards Palliative Care : Validation of the Spanish Version of Questionnaire on Palliative Care for Advanced Dementia

Background: Palliative care is essential in the care of people with advanced dementia, due to the increasing number of patients requiring care in the final stages of life. Nurses need to acquire specific knowledge and skills to provide quality palliative care. The Questionnaire on Palliative Care for Advanced Dementia (qPAD) is useful for assessing knowledge and attitudes toward palliative care, but its adaptation to the Spanish language and analysis of its effectiveness and usefulness for the Spanish culture is lacking. Objective: To report on the Spanish language adaptation and psychometric analysis of the qPAD. Methods: The Questionnaire on Palliative Care for Advanced Dementia Spanish v…

Interventions to Improve Health among Reproductive-Age Women of Low Health Literacy: A Systematic Review

Background: Limited or low health literacy (HL) has been associated with poor health outcomes, including inadequate self-caring and preventive behaviors. A few studies have systematically summarized the effect of interventions to improve reproductive health and care in women with insufficient HL. The main objective of the study was to investigate health care promotion interventions and examine their effectiveness on women with inadequate HL through a systematic review of randomized controlled trials (RCT). Methods: RCTs and quasi-experimental studies that assessed HL interventions to improve reproductive health of women with low HL were included. The study protocol was registered with PROSP…

A one-year proprioceptive exercise programme reduces the incidence of falls in community-dwelling elderly people: A before-after non-randomised intervention study.

Abstract Background The risk of falls increases with age. Balance alteration and polypharmacy are independent contributors to an increased risk of falls. Objective The primary aim was to assess whether a proprioceptive exercise programme reduces the incidence of falls. A secondary aim was to assess the association between drugs and falls. Design This was a before–after non-randomised intervention study. Participants The study recruited independent and cognitively intact community-dwelling people aged over 69 years, from December 2012 to May 2014. Methods The intervention was done by a nurse and consisted of a monthly supervised group session of proprioceptive training for 1 year, supplement…

Female gender and low physical activity are risk factors for academic stress in incoming nursing students.

PURPOSE Nursing students suffer from stress more frequently than other students. The objective was to analyze the academic stressors that most affect new nursing students. DESIGN AND METHODS A cross-sectional study on new nursing students. FINDINGS Two hundred and eighty-two students, 78% women, mean age of 21.46 (6.1) years. Giving presentations in class and lack of time for homework are the items that cause the greatest academic stress. Women had higher levels of academic stress, and higher levels of physical activity are related to lower academic stress. PRACTICE IMPLICATIONS Women have a higher level of academic stress. Doing sport is a protective factor that diminishes academic stress …

P139: Effectiveness of an intervention program in community-dwelling frail elderly people on functional recovery

Understanding illnesses through a film festival: an observational study

Abstract Audio-visual materials play a fundamental role in the context of education, care and clinical treatment, as they seem to have a high impact on public awareness. This study aims to describe what messages are perceived by the society at an International Festival of Short Films and Art on Diseases that may help to understand difficult topics, such as illness, dying and suffering. Through an observational, descriptive, cross-sectional study, using full participant observation and an open, self-administered questionnaire, 32 short films were analysed during a healthcare art festival. Categories were developed using inductive content analysis. The message perceived by the participants, a…

EQ-5D-3L for Assessing Quality of Life in Older Nursing Home Residents with Cognitive Impairment

Background: Quality of life (QoL) is recognized as an important patient-reported outcome measure. Assessing QoL in older people with cognitive impairment is a challenge due to discrepancies in the collection of data via proxies versus self-report. This study aimed to assess the psychometric properties of the self-reported EQ-5D (including the EQ index and EQ visual analog scale (VAS)) in nursing homes residents with cognitive impairment and to analyze its validity based on scales included in the comprehensive geriatric assessment. Methods: Cross-sectional, multicenter study analyzing the feasibility, acceptability, reliability, and validity of the EQ-5D based on 251 self-administered questi…

Changes in Salivary Amylase and Glucose in Diabetes: A Scoping Review

Background and Objective: Diabetes mellitus (DM) is a common long-term disease which can be related with salivary amylase levels. DM has recently been associated with salivary amylase diagnostics that could further impair diagnoses in the diabetic population, as well as being an interesting alternative to traditional methods of determine glucose levels. The main advantage of this method is related to the fact that it is a fast diagnostic method. The DM population experiences changes to their metabolism which affects their salivary parameters, making this an alternative procedure for diagnosis and follow-up of the illness due to the non-invasive nature of salivary analyzes. The objective of …

An undergraduate thesis training course for faculty reduces variability in student evaluations

Abstract Background The undergraduate thesis evaluation process is one of the most prevalent weak points in universities; the literature indicates the need to orient undergraduate thesis evaluators through specific training initiatives. Objectives The aim of this study was to analyze the discrepancies between the grades awarded by undergraduate thesis supervisors and by the panel of faculty examiners, and the effect of training targeted to faculty members. Design and methods A cross-sectional study was performed during the 2015–2016 academic year in a Spanish Nursing School. Settings and participants We analyzed the mean grades from undergraduate thesis evaluation rubrics and the effects of…

P138: Prevalence of falls in a sample of community-dwelling frail elderly people of la Ribera county (Valéncia, Spain) who participated in an intervention program

Health-Related Quality of Life in Community-Dwelling Older People with Cognitive Impairment: EQ-5D-3L Measurement Properties

Background: Assessing quality of life (QoL) in older people with cognitive impairment is a challenge. There is no consensus on the best tool, but a short, user-friendly scale is advised. Objective: This study aimed to assess the psychometric properties of the self-reported and generic EQ-5D (including the EQ index and EQ visual analog scale [VAS]) in community-dwelling older adults with cognitive impairment. Methods: Cross-sectional study analyzing the feasibility, acceptability, reliability, and validity of the EQ-5D based on 188 self-administered questionnaires in a sample of community-dwelling older adults with Mini-Mental State Examination (MMSE) scores of 10 to 24 points. Results: The …

Alteraciones en los pies en ancianos frágiles comunitarios con patología cardíaca. Factores de riesgo

Resultados preliminares de un programa comunitario de prevención de caídas: estudio Precari (prevención de caídas en La Ribera)

Resumen Objetivo Evaluar la posible reduccion en la incidencia de caidas y la ganancia funcional de un programa de prevencion de caidas. Material y metodos Doscientos cuarenta y nueve sujetos no institucionalizados fueron repartidos aleatoriamente en 3 grupos: el grupo intervencion mensual (GIM), el cual recibio instruccion teorica sobre prevencion de caidas y ejercicios que mejoran la funcion fisica y el equilibrio de forma mensual complementado con una clase practica con la misma periodicidad. El grupo intervencion trimestral (GIT), el cual recibio la misma informacion teorica con periodicidad trimestral. El grupo control (GC), instruido teoricamente al inicio del estudio, sin refuerzos p…

A Predictive Model of the Prevalence of Delirium in Elderly Subjects Admitted to Nursing Homes.

INTRODUCTION Delirium is common in geriatric patients admitted to nursing homes, with an incidence of 22-79% among long-term residents. AIM To establish a predictive model of the risk of delirium episodes in a sample of elderly people living in nursing homes. MATERIAL AND METHODS A retrospective, cross-sectional case-control study covering a period of 12 consecutive months (April 2014 - March 2015) was carried out. The included cases had suffered at least one episode of delirium during the study period. Sociodemographic and clinical variables as well as risk factors predisposing to or triggering episodes of delirium were recorded. RESULTS A total of 193 cases and 123 controls were recruited…

FallSkip device is a useful tool for fall risk assessment in sarcopenic older community people.

PURPOSE Fall prevention is a major health concern for the ageing population. Sarcopenia is considered a risk factor for falls. Some instruments, such as Time Up and Go (TUG), are used for screening risk. The use of sensors has also been shown to be a viable tool that can provide accurate, cost-effective, and easy to manage assessment of fall risk. One novel sensor for assessing fall risk in older people is the Fallskip device. The present study evaluates the performance of the FallSkip device against the TUG method in fall risk screening and assesses its measurement properties in sarcopenic older people. METHODS A cross-sectional study was made in a sample of community-dwelling sarcopenic a…