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Frailty is a clinically discernible state in which decreased physiological reserve and function result in a reduced ability to cope with stressors. Information and communication technology (ICT) has been proposed as an aid to help with frailty, yet the use of ICT by older people, particularly women, is an understudied area.To analyze the association between use of ICT (specifically internet functions and social media) and frailty status in postmenopausal midlife and elderly women.A cross-sectional study was designed to investigate whether frailty status is related to ICT use in postmenopausal midlife and older women. Community-dwelling women attending primary health care centers for health checks were invited to participate in the study. Postmenopausal status was the only inclusion criterion, whereas limitations that could interfere with use of ICT were exclusion criteria. The Fried phenotype was used to assess frailty. Four types of ICT use were examined: the internet for e-mail, the internet for other functions, and social media (WhatsApp or Facebook). Chi-square test and multivariate multinomial regression analysis were used to examine the association between frailty status and ICT use.We included 409 women (age = 67.45 ± 7.81 years, mean ± SD), who were frail (n = 135, 33.01%), pre-frail (n = 159, 38.87%), or robust (n = 115, 28.11%). Frailty status was significantly and inversely associated with any ICT use, showing a strong association with use of WhatsApp (P 0.001) and internet searches (P 0.001). ICT non-use was a predictor of frailty, while ICT users were more likely to be robust (OR 10.62; 95% [CI], 5.34-21.10) or pre-frail (OR 9.03; [CI], 95% 5.18-15.74).Postmenopausal midlife and older women not using ICT were more likely to be frail.

To study the relationship between frequency of pain assessment and nursing workload, and also to analyze the frequency of pain assessment and its relation to knowledge and attitudes toward pain on nursing professionals in intensive care unit.An ambispective study was conducted in a Spanish tertiary-level intensive care unit between October 2017 and April 2018. For measurement of workload, the Nursing Activities Score scale was used, and for measurement of pain knowledge, the Knowledge and Attitudes Survey Regarding Pain was used.There were 1,207 measurements among 41 nurses and 1,838 among 317 patients. The average nursing workload was high (70.97 points). We found statistically significant positive association between nursing workload and the frequency of assessment (p .001), as well as frequency of assessment and patients with communicative capacity (p = .008).Nursing workload affects the registration and assessment of patients' pain, resulting in a greater number of records as the workload performed by nurses increases. It is necessary to study in greater depth how the severity of pain, gender of the patients, and workload of nurses influence pain registration and assessment.

The aim of this study was to identify the main medication errors, their causality and the highest risk areas in critical care.A descriptive, longitudinal and retrospective study.We performed a systematic analysis of the prescription, transcription and administration records of 2,634 dose units of medications that were administered to a total of 87 critically ill patients during 2018.Final results have shown important medication errors and a high number of significant drug interactions; prescription phase had the highest mistake rate (71%) and cause of errors (68%); transcription stage had a more variable error typology. A significant correlation was observed between the presence of causes and contributing factors to error during the prescription and the commission of errors during the nurse transcription, being the main risk areas the time of antibiotic administration, dilution errors, concentration and speed of administration of high-risk medications and the technique used for nasogastric tube drug administration.In critical care, an intolerable number of medication errors are still committed, placing the origin of many of them in the causality and contributing factors identified in the prescription stage.The origin of many of the medication errors and most interactions is in the prescription stage, being the nurse transcription (nurse intervention) in an important filter that prevents a considerable number of errors from finally reaching the patient. The schedule of administration of time-dependent antibiotics, high-risk medications and the technique of administering medications through a nasogastric tube are important risk areas for the commission of medication errors.目标: 这项研究旨在确定重症监护的主要药物错误,其因果关系和最高风险领域。 设计: 描述性、纵向和回顾性研究。 方法: 我们对2018年共87名危重病患者服用的2634个剂量单位的药物处方、誊写处方和给药记录进行系统分析。 结果: 最终结果显示存在重大的药物错误和极为明显的药物相互作用;处方阶段的错误率(71%)和错误原因(68%)最多;誊写阶段的错误类型更多变。处方过程中出现错误的原因和促成因素与护士誊写过程中出现的错误之间存在显著的相关性,主要的风险领域包括抗生素的使用时间、稀释错误,高风险药物的给药浓度和速度以及用于鼻胃管给药的技术问题。 结论: 在危重病护理中,依旧存在难以容忍的药物错误,许多错误的根源在于处方阶段识别的因果关系和促成因素。 影响: 许多药物错误和大多数交互作用的根源都在处方阶段,护士誊写(护士干预)是一个重要的筛选手段,可防范最终出现在患者身上的大量错误。时间依赖性抗生素、高风险药物的给药计划以及通过鼻胃管给药的技术是导致药物错误的重要风险领域。.

Objectives: the general aging of the population is related to the increase in the prevalence of sarcopenic disease; especially among older women, this pathology is closely related to nutrition and specifically to protein consumption in older adults. The aim of our study was to evaluate the possible relationship between a low protein intake and a higher prevalence of sarcopenic disease, a worse dietary pattern, and lower physical performance in postmenopausal women living in the community. Material and methods: the study was carried out in a total of 164 independent women over 65 years of age, recruited from a municipal social center in Valencia (Benimaclet). The presence of sarcopenic pathology was evaluated using the latest algorithm published by EWGSOP2, and the intake of nutrients through a three-day dietary record. Physical performance was evaluated through the iPaq-e questionnaire, as well as the SPPB test and the 4-meter gait speed test. Results: the total sample comprised 164 women with a mean age of ± 72 years; 26.2 % of the sample had a protein intake lower than recommended by the FAO/WHO; 25.6 % of the women presented some stage of sarcopenia; regarding the prevalence of sarcopenic obesity, 12.2 % of the sample was affected by this disease. Significant relationships were found between protein consumption and the prevalence of sarcopenia (p = 0.021) and sarcopenic obesity (p = 0.043). Significant related differences were found between the majority of macronutrients and micronutrients under study and protein consumption. No relationship was found between protein intake and physical performance. Conclusions: protein consumption in most of the women studied (73.8 %) was higher than the daily recommendations established by the FAO/WHO. There was a significant relationship between the prevalence of sarcopenia and sarcopenic obesity, and low protein intake. Higher protein intake was associated with a higher energy intake pattern. No relationship was found between protein intake and physical performance of the participants.Objetivos: el envejecimiento general de la población se encuentra relacionado con el aumento de la prevalencia de la enfermedad sarcopénica, especialmente entre las mujeres mayores. Esta patología se encuentra estrechamente relacionada con la nutrición y, concretamente, con el consumo proteico en los adultos mayores. El objetivo de nuestro estudio fue evaluar la posible relación entre un bajo consumo de proteínas y una mayor prevalencia de la enfermedad sarcopénica, un peor patrón dietético y un menor rendimiento físico en mujeres posmenopáusicas residentes en la comunidad. Material y métodos: el estudio se realizó en un total de 164 mujeres mayores de 65 años, independientes, reclutadas en un centro social municipal de Valencia (Benimaclet). La presencia de sarcopenia fue evaluada utilizando el último algoritmo publicado por el EWGSOP2, y la ingesta de nutrientes a través de un registro dietético de tres días. El rendimiento físico fue evaluado a través del cuestionario iPaq-e, así como el test SPPB y el test de velocidad de la marcha de 4 metros. Resultados: la muestra total comprendió un total de 164 participantes con una edad media de ± 72 años. Un 26,2 % de la muestra presentaban una ingesta de proteínas inferior a la recomendada por la FAO/OMS. El 25,6 % de las mujeres presentaban algún estadio de sarcopenia y, en cuanto a la prevalencia de la obesidad sarcopénica, un 12,2 % de la muestra se encontró afectada por dicha enfermedad. Se encontraron relaciones significativas entre el consumo de proteína y la prevalencia de la sarcopenia (p = 0,021) y la obesidad sarcopénica (p = 0,043). Se encontraron diferencias significativas relacionadas entre la mayoría de macronutrientes y micronutrientes a estudio y el consumo proteico. No se encontró ninguna relación entre la ingesta proteica y el rendimiento físico. Conclusiones: el consumo de proteínas en la mayoría de las mujeres estudiadas (73,8 %) fue superior a las recomendaciones diarias establecidas por la FAO/OMS. Existió una relación significativa entre la prevalencia de la sarcopenia y de la obesidad sarcopénica y un consumo bajo de proteínas. Un mayor consumo de proteínas se asoció con un patrón de ingesta energética superior. No se encontró relación alguna entre la ingesta proteica y el rendimiento físico de las participantes.

This study is an observational and cross-sectional study on the prevalence of sarcopenic disease in 202 autonomous older adults, 18.8 and 81.2% were men and women, respectively, living in their own homes in Valencia, Spain. Sarcopenia was diagnosed using the criteria and cutting points for the European Working Group on Sarcopenia in Older People 2 (EWGSOP2), using the tests: SARC-F, grip strength, sit-to-stand, gait speed, appendicular skeletal muscle mass and short physical performance battery. According to the EWGSOP2 criteria, probable sarcopenia was present in 21.1% and 18.3% of men and women, respectively, and the sum of confirmed and severe sarcopenia was 7.9% and 7.3% in men and in women, respectively. A relationship was shown between the prevalence of the disease and the age of the participants, but no significant differences were found between the sum of confirmed and severe sarcopenia between the sexes, nor a relationship between the amount of muscle mass and the strength of grip. The SARC-F questionnaire diagnosed 40% of the sarcopenia cases present in the study. More thorough research is needed to continue using the EWGSOP2 criteria in different populations to establish a correct prevalence of sarcopenic disease in different populations of the world.

Poorly controlled pain in patients is related to several complications, such as increased nosocomial infections and mortality, where nurses play a crucial role.To analyze determinants of pain as well as nurses' knowledge and attitudes towards pain in the inpatient services of a tertiary center in the Spanish public health network.The Knowledge and Attitudes Survey Regarding Pain questionnaire was administered to all nurses in the center from January to March 2019. Additional sociodemographic variables, such as gender, age, employment status, work experience, professional group, and academic degree, were collected and analyzed. Item Response Theory was used for discriminant analysis of each question and its relationship with the final score.A total of 282 questionnaires were collected from those distributed among nurses working in medical, surgical, oncological, and intensive care services. The average score obtained on pain-related knowledge and attitudes was 58.89%. We found significant differences (p .001) between the KASRP score and the professional group score. There were no differences in final score based on academic level or age. Questions related to pharmacology resulted in low scores and did not discriminate between levels of knowledge, being considered difficult. We did not find items that allowed discriminating between levels of knowledge.A knowledge gap exists regarding nurses' pharmacological and assessment concepts, and there are differences in knowledge depending on professional group. The KASRP allows for a good discrimination of low levels of knowledge.

Treating sarcopenia in older individuals remains a challenge, and nutritional interventions present promising approaches in individuals that perform limited physical exercise. We assessed the efficacy of leucine administration to evaluate whether the regular intake of this essential amino acid can improve muscle mass, muscle strength and functional performance and respiratory muscle function in institutionalized older individuals. The study was a placebo-controlled, randomized, double-blind design in fifty participants aged 65 and over (ClinicalTrials.gov identifier NCT03831399). The participants were randomized to a parallel group intervention of 13 weeks&rsquo, duration with a daily intake of leucine (6 g/day) or placebo (lactose, 6 g/day). The primary outcome was to study the effect on sarcopenia and respiratory muscle function. The secondary outcomes were changes in the geriatric evaluation scales, such as cognitive function, functional impairment and nutritional assessments. We also evaluated whether leucine administration alters blood analytical parameters and inflammatory markers. Administration of leucine was well-tolerated and significantly improves some criteria of sarcopenia in elderly individuals such as functional performance measured by walking time (p = 0.011), and improved lean mass index. For respiratory muscle function, the leucine-treated group improved significantly (p = 0.026) in maximum static expiratory force compared to the placebo. No significant effects on functional impairment, cognitive function or nutritional assessment, inflammatory cytokines IL-6, TNF-alpha were observed after leucine administration compared to the placebo. The use of l-leucine supplementation can have some beneficial effects on sarcopenia and could be considered for the treatment of sarcopenia in older individuals.

The aim of this study was to investigate the effects of a resistance training program (RTP) in older overweight women (OOW) using two different types of elastic devices. Methods: This study was a randomized controlled trial with pre- and postintervention measures. Participants included OOW, aged 60–85 years, with no medical history of disease that would preclude them from engaging in physical exercise. Participants were randomly divided into the following groups: elastic tubes with handles group (ETG; n = 22), traditional elastic bands group ( n = 21), and control group (CG; n = 20). Exercise groups (EGs) performed the following supervised RTP: 8 weeks, twice weekly, six overall body exercises, and 3–4 sets of 10 repetitions at a rate of perceived exertion (RPE) of 7–9 on the OMNI-Resistance Exercise Scale of perceived exertion. The controls did not change their usual lifestyle. Outcome measures included body composition (BC; total and regional percentage of fat mass [FM] and fat-free mass [FFM]) and physical performance (PP; dynamic and isometric strength, flexibility, agility/dynamic balance, and endurance). Results: Both EGs exhibited significantly reduced FM in the upper limbs (ULs) and trunk and increased FFM in the UL, while the ETG exhibited a significantly increased trunk FFM. Both EGs improved in PP, and there were no intergroup differences. Trunk FM and FFM and meters walked differed significantly between the ETG and CG. The CG did not exhibit any significant changes. Conclusion: Training with elastic devices at a moderate–high RPE produces short-term improvements in BC and PP in OOW.

Background: Sleep alterations can impair quality of life and contribute to disease progression but they, and their features and contributing factors, are rarely analysed in institutionalised older individuals. In this study, we investigated sleep alterations, the factors involved, and the role of cortisol in sleep-related problems in institutionalised individuals. Methods: We conducted a descriptive cross-sectional study in participants living in nursing homes in Valencia (Spain); sleep alterations were determined based on two validated tools: the Athens insomnia scale and Oviedo sleep questionnaire. Plasma cortisol was measured in the morning and determined by high performance liquid chromatography-mass spectroscopy, along with other blood analytical parameters. We also analysed any confounding factors (sleep duration, morning awakening time, intake of hypnotic and psychotropic medication, and cognitive function). Results: The mean age was 82.5 years (range: 65-99); approximately 80% were women and sleep alterations were present in 25-60% of the population, depending on the scale used or type of sleep disorder considered. There was no significant correlation between morning cortisol concentrations and sleep disorders, sex, age, or psychotropic drug ingestion (including hypnotic drugs). However, there was a significant correlation between cortisol and an Oviedo questionnaire subscale for evaluating insomniarelated adverse events, which remained significant after adjusting for multiple potentially confounding factors. Conclusion: Sleep disorders are common in institutionalised older individuals and are not related to sleep duration or decreased by ingestion of hypnotic medications. There is a significant relationship between morning cortisol levels in blood and insomnia-related sleep disorders (e.g. snoring with awakenings, nightmares, restless legs syndrome, etc.) but not directly with insomnia or hypersomnia.

Background Medication errors are a serious and complex problem in clinical practice, especially in intensive care units whose patients can suffer potentially very serious consequences because of the critical nature of their diseases and the pharmacotherapy programs implemented in these patients. The origins of these errors discussed in the literature are wide-ranging, although far-reaching variables are of particular special interest to those involved in training nurses. The main objective of this research was to study if the level of knowledge that critical-care nurses have about the use and administration of medications is related to the most common medication errors. Methods This was a mixed (multi-method) study with three phases that combined quantitative and qualitative techniques. In phase 1 patient medical records were reviewed; phase 2 consisted of an interview with a focus group; and an ad hoc questionnaire was carried out in phase 3. Results The global medication error index was 1.93%. The main risk areas were errors in the interval of administration of antibiotics (8.15% error rate); high-risk medication dilution, concentration, and infusion-rate errors (2.94% error rate); and errors in the administration of medications via nasogastric tubes (11.16% error rate). Conclusions Nurses have a low level of knowledge of the drugs they use the most and with which a greater number of medication errors are committed in the ICU. Electronic supplementary material The online version of this article (10.1186/s12913-019-4481-7) contains supplementary material, which is available to authorized users.

The conventional approach to sustainability is being extended through approaches such as the psychology of sustainability and sustainable development. Under such approaches, the analysis of sustainability also involves understanding improvements in people&rsquo, s quality of life in environments such as education and learning. Based on this theoretical approach, this study explored the relationships between anxiety, emotional intelligence, and mechanisms for coping with stressful situations. The mediating role of emotional intelligence in the relationship between anxiety and coping mechanisms was also assessed. The anxiety, emotional intelligence, and coping variables were measured using standardized tests administered to students. This cross-sectional study was based on self-reports by health students at universities in Valencia (Spain). The study conformed to the ethical standards established by the Declaration of Helsinki. In total, 434 students participated in the study. The students were aged between 17 and 54 years (M = 21, SD = 0.320). From the perspective of the psychology of sustainability, the results indicate that avoidance coping strategies are positively related to anxiety and are negatively related to emotional intelligence. However, the results also show that approach coping strategies are positively related to emotional intelligence. In addition, the analysis shows the mediating role of emotional intelligence in the relationship between anxiety and coping. This study shows the need to encourage the sustainable development of emotional intelligence among health professionals and to consider this sustainable development when designing education programs for health-related fields.

To evaluate the role of peripheral inflammation (leukocyte differential count, the proinflammatory cytokines IL-beta, TNF-α, IL-6, IL-8, and the inflammatory markers fibrinogen and C-reactive protein [CRP]) in frailty syndrome in patients with prostate cancer (CaP) undergoing antiandrogen therapy (ADT).A total of 46 men between 51 and 92 years of age with CaP and receiving ADT were classified as frail, prefrail or robust according to the Fried scale. A geriatric assessment was performed, based on the Minimental State Examination for cognitive function, the Barthel index for basic activities of daily living, the Yesavage scale for geriatric depression, and the Athens insomnia scale. In addition, blood samples were collected to assess peripheral inflammation biomarkers including proinflammatory cytokines, fibrinogen, CRP and leukocyte differential count, as well as other biochemical and hematological parameters.A significant negative correlation between the severity of frailty syndrome and lymphocyte count was observed (P0.01). The concentration of IL-6 (P0.05), CRP (P0.05), and fibrinogen (P0.01) were significantly associated with frailty syndrome, but not of TNF-α, IL-beta, or IL-8. The severity of frailty syndrome was not dependent upon the clinical disease stage at diagnosis, the time elapsed since CaP diagnosis, the presence of metastases, or prostatectomy.Further research into the role of leukocyte subtypes and peripheral inflammation and the associated adverse outcomes in patients with CaP under ADT is warranted in order to tailor interventions aimed at reducing symptoms of frailty syndrome, such as loss of muscle strength and low physical activity.

Objective: The purpose of this study was to examine whether a prebiotic formulation reduces frailty index (FI) levels in older people. Design: We conducted secondary analysis of a placebo-controlled, randomized, double-blind design study. Setting/Participants: The study included non-demented people over the age of 65 who were living in nursing homes and were able to walk. Fifty participants completed the study (75.3±7.3 years, 70% females). Intervention: Participants were randomly assigned to either a group who received daily Darmocare Pre® (inulin and fructooligosaccharides) for 13 weeks or a placebo group (maltodextrin). Measurement: The primary outcome in this secondary analysis was change in level of a 62-item FI compared to baseline. Results: At the 13-week follow-up, the placebo group had higher FI levels (preFI 0.23±0.11, postFI 0.24±0.12, p=0.012) and the intervention group had lower FI levels (preFI 0.22±0.09, postFI 0.20±0.08, p0.3, N=5) had the greatest reduction in their FI (0.04±0.01). Conclusion: A prebiotic intervention can reduce frailty levels in nursing home residents especially in those with higher levels of frailty.

There are numerous biological, psychological, and social factors that have a more or less prominent impact on the mental health of older adults [...]

Nowadays, the appearance of sarcopenia (S) or sarcopenic obesity (SO) is related to aging. According to the criteria of the European Working Group on Sarcopenia in Older People (EWGSOP), the feasibility of using salivary cortisol and testosterone levels was analyzed as diagnostic biomarkers of S or SO. One hundred and ninety non-institutionalized people aged &ge, 65 years were studied, independent of the activities of daily living (ADLs) (Barthel &gt, 60), and sociodemographic variables were determined together with criteria for the diagnosis of S and SO including grip force, lower body strength, appendicular skeletal muscle mass, physical performance, total body fat percentage, body mass index (BMI), waist circumference, and triceps skinfold, together with the levels of salivary cortisol and testosterone. Our results reflected that women presented a higher prevalence of S and SO (21.2% and 30.2%, respectively). A significant difference was observed between salivary testosterone levels and the age of the participants with differences by sex. Testosterone values in men with S and SO were significantly lower (p = 0.043 and p = 0.048, respectively), which suggests a potential use of the biomarker for diagnostic purposes. No significant differences were shown with cortisol values.

El artículo efectúa una revisión teórica del papel de las políticas activas de mercado de trabajo analizando sus metas y utilidades y de manera especial el nivel de impacto a corto, medio y largo plazo verificados en los estudios de mayor garantía técnica, valorando, finalmente, las recomendaciones principales en relación a su uso más efectivo.

A variety of valid tools are available to assess staff knowledge and attitudes regarding pain, among which is the Knowledge and Attitudes Survey Regarding Pain. Although this instrument has been widely and successfully used, a valid and adapted Spanish version is yet to be developed. The purpose of this study was to validate the Spanish version of the Knowledge and Attitudes Survey Regarding Pain. After translating and back-translating this tool, we conducted a cross-cultural adaptation and construct validation with 102 participants, including nursing professionals (in palliative care, oncology, and intensive care) from five health centers and final-year nursing students. All participants were recruited in the Principality of Asturias, Spain. We also evaluated the internal consistency and test-retest correlations. Cronbach's α was .781, and Pearson's r and the intraclass correlation coefficient between the test and retest scores were .881 and .883, respectively. The mean questionnaire scores in the test and retest phases were 65.8% and 67.6%, respectively. Palliative care nurses had the highest score, 70.8%, which differed significantly from the rest of the groups. The Spanish version of the Knowledge and Attitudes Survey Regarding Pain can effectively differentiate nursing staff in terms of their pain expertise. The results indicate that Spanish nurses have a gap in pharmacologic knowledge that is comparable to that found in other countries, but their foundation in general pain concepts was solid.

Background Frailty is a geriatric syndrome characterized by the clinical presentation of identifiable physical alterations and decreased physiological reserve. The assessment of frailty syndrome has been recently related with post-surgical outcomes and overall mortality in older individuals. Design and data sources We performed searches in Pubmed, Embase, Scopus, SCIELO and IME (Spanish medical index) databases from their start dates to February 2014 for original papers about the identification of the relationship between frailty and pre-operative risk evaluation in people aged 65 and over. Review methods We followed criteria of systematic PRISMA guidelines. Two independent reviewers extracted descriptive information on frailty criteria and outcomes from the selected papers: of the 77 articles retrieved from the searches, 32 met the study inclusion criteria. Results Severity of frailty syndrome significantly correlated with post-surgical mortality rates and with many although not all post-surgical complications. These relationships emerge in different type of surgical procedures and patients' features. The comparison of diagnostic tools to assess frailty in pre-operative risk evaluation are very few and to date, no recommendation can be made about the best scale to measure it. Conclusion Assessment of frailty syndrome should be added in the pre-operative risk assessment in older individuals.

Alteration in the immune system such as the number of white blood cells count (WBC) has been associated with frailty syndrome but their role in institutionalized older individuals have been rarely investigated. We evaluated the relationships between white blood cell subtypes, geriatric assessment, depression and frailty syndrome based on the criteria of physical phenotype. In particular, we aimed to analyze by a two-year follow-up and prospective study the predictive value of alterations in WBC, frailty and functional impairment in terms of hospitalizations and all-cause mortality in institutionalized older women. There was a significant and inverse correlation between the frailty score and lymphocyte count at baseline but it did not display any predictive effect for the outcomes (hospitalizations and mortality). In contrast, monocytes count was significantly correlated with number of hospital stays and predicted hospitalizations in the follow-up. High frailty score directly and better functional status (Barthel score) inversely predicted mortality in the follow-up with an HR of 1.87 (95%CI: 1.04-3.35), and 0.97 (95% CI: 0.96-0.99) (p .05 in both cases). Further investigation into the role of white blood cell subtypes in aging and its associated adverse outcomes in older adults is warranted. Physical phenotype of frailty besides general population, also predicted mortality in older institutionalized women and deserves specific intervention in this subgroup of older individuals.

Frailty is a geriatric syndrome characterised by the clinical presentation of identifiable physical alterations such as loss of muscle mass and strength, energy and exercise tolerance, and decreased physiological reserve. Frailty and depressive symptoms are common issues facing older adults and may be associated. It is not clear if the depression facilitates the appearance of frailty syndrome or vice versa or these two coexist independently in the same individuals.We performed searches in several databases (Embase, PubMed, CINAHL, Scopus, and PsycINFO) papers published between November 2003 to February 2014 about frailty syndrome and depression in people aged 65 and older published and the reference lists of from the articles retrieved were pearled in order to identify any which may have been missed in the initial search. Two independent reviewers extracted descriptive information on the prevalence and co-occurrence of frailty and depression in older individuals and of frailty criteria among depressed patients.Depression and frailty occur in a significant proportion of frail older individuals. Common pathophysiological alterations and biomarkers in the two syndromes have been recently described.Studies on the causal relationship between the two syndromes are clearly necessary in the future.

Frailty is a geriatric syndrome characterized by the clinical presentation of identifiable physical alterations such as loss of muscle mass and strength, energy and exercise tolerance, and decreased physiological reserve. Individuals with one or two of these alterations are defined as prefrail. The clinical features of prefrail older individuals have been investigated to a lesser extent compared to the frail population, even though this intermediate stage may provide insights into the mechanisms involved in the physical decline associated with aging and it is considered to be potentially reversible. We performed searches in the Medline, Embase, Scopus, Cinahl, and Cochrane databases from January 1995 to July 2013 for papers about the identification of prefrail people aged 65 and older published either in English or Spanish, and the reference lists of from the articles retrieved were pearled in order to identify any which may have been missed in the initial search. Two independent reviewers extracted descriptive information on frailty criteria and outcomes from the selected papers: of the 277 articles retrieved from the searches and 25 articles retrieved from pearling, 84 met the study inclusion criteria. The prevalence of prefrailty ranges between 35% and 50% in individuals aged over 60, is more common in women, and the age and the number of comorbidities in these individuals is similar to their frail counterparts. Weakness is the most prevalent symptom in prefrail individuals although there are some sex differences. Some serum biomarkers seem to discriminate prefrail from non-frail individuals but further research would be required to confirm this.

This paper provides a theoretical overview about the nature, goals and utilities of active labor market policies, analyzing their impact at short, middle and long level from the technical available evidence and the conditions for a successful practice.

Television fiction series sometimes generate an unreal vision of life, especially among young people, becoming a mirror in which they can see themselves reflected. The series become models of values, attitudes, skills and behaviours that tend to be imitated by some viewers. The aim of this study was to analyze the conflict management behavioural styles presented by the main characters of television fiction series. Thus, we evaluated the association between these styles and the age and sex of the main characters, as well as the nationality and genre of the fiction series. 16 fiction series were assessed by selecting two characters of both sexes from each series. We adapted the Rahim Organizational Conflict Inventory-II for observing and recording the data. The results show that there is no direct association between the conflict management behavioural styles presented in the drama series and the sex of the main characters. However, associations were found between these styles and the age of the characters and the genre of the fiction series.

The aim of this study was to compare the effects of a strength training program (STP) using free weights (FW) versus elastic tubing (ET) in 62 premenopausal, sedentary women diagnosed with metabolic syndrome (MS). Participants were randomly assigned to the FW or ET experimental group (EG) or a control group whose members remained sedentary. Members of each EG followed their assigned STP for 12 weeks, and biomarkers (BMs) related to MS and motor function (MF) parameters were evaluated. Both EGs showed a significant reduction in C-reactive protein level and a positive trend in the other BMs. Almost all MF parameters increased significantly in both EGs. No positive changes were found in the CG. These results indicate that the implementation of an STP, with either FW or ET, improves both metabolic health and MF and should be considered part of the basic approach to health care in women.

Aging can result in major changes in the composition and metabolic activities of bacterial populations in the gastrointestinal system and result in impaired function of the immune system. We assessed the efficacy of prebiotic Darmocare Pre (R) (Bonusan Besloten Vennootschap (BV), Numansdorp, The Netherlands) to evaluate whether the regular intake of this product can improve frailty criteria, functional status and response of the immune system in elderly people affected by the frailty syndrome. The study was a placebo-controlled, randomized, double blind design in sixty older participants aged 65 and over. The prebiotic product was composed of a mixture of inulin plus fructooligosaccharides and was compared with placebo (maltodextrin). Participants were randomized to a parallel group intervention of 13 weeks' duration with a daily intake of Darmocare Pre (R) or placebo. Either prebiotic or placebo were administered after breakfast (between 9-10 a.m.) dissolved in a glass of water carefully stirred just before drinking. The primary outcome was to study the effect on frailty syndrome. The secondary outcomes were effect on functional and cognitive behavior and sleep quality. Moreover, we evaluated whether prebiotic administration alters blood parameters (haemogram and biochemical analysis). The overall rate of frailty was not significantly modified by Darmocare Pre (R) administration. Nevertheless, prebiotic administration compared with placebo significantly improved two frailty criteria, e.g., exhaustion and handgrip strength (p

Purpose Serum vitamin D deficiency has been associated with frailty in people aged 65 and over, however its relationship with functional impairment has not been investigated in octogenerian (aged 80–90 years) institutionalized women. Methods We assessed functional impairment in this latter group by measuring frailty syndrome and other geriatric and psychological assessment scales: the Tinetti gait and balance index to determine the risk for falls, the Barthel index to measure the basic activities of daily living, the Lawton index for instrumental activities, the mini-mental score examination test for cognitive impairment, the Yesavage scale for geriatric depression, and the Norton scale for the risk of ulceration. Results Frail individuals had significantly reduced serum vitamin D concentrations (measured as total 25-hydroxyvitamin D; 25(OH)D) compared to robust individuals, but reduced 25(OH)D concentration did not significantly correlate with frailty syndrome severity, and mean 25(OH)D concentrations were within the recommended levels in all groups. The 25(OH)D concentration did not correlate with any of the blood analytical parameters measured and with the geriatric assessment scales used, suggesting a selective relationship with frailty. Conclusion These results highlight the need to individualize treatment such as vitamin D supplementation in order to treat frailty syndrome.

We used a complete battery of geriatric and psychometric tests to evaluate whether plasma-borne brain-derived neurotrophic factor (BDNF), a master molecule in neuroplasticity, is associated with the severity of functional and cognitive impairment in non-disabled older individuals. There was a significant positive correlation between BDNF plasma concentrations and the Barthel index, a measurement of the ability of individuals to perform the activities of daily living (p=0.03) and the concentration subcategory measured with the mini mental state examination (MMSE) test (p = 0.01). Furthermore, plasma BDNF inversely and significantly correlated with the blood eosinophil count (p = 0.01), the total cholesterol concentration (p = 0.04), and high-density lipoprotein cholesterol (p=0.04). However, BDNF did not correlate with any other socio-demographic or clinical characteristics, other analytical parameters measured in the blood, or any other geriatric assessment scales. Our results suggest that BDNF may play a role in the pathophysiology of functional impairment in the elderly and in some aspects of cognitive function. However, more studies are needed to understand the relationship between circulating BDNF and functional impairment to determine if BDNF represents a candidate biomarker for this type of cognitive impairment.

En este artículo se analizan los procesos de selección efectuados sobre la totalidad de los aspirantes a los cursos de Formación para el Empleo de la Comunidad de Madrid a mediados de los años noventa, para conocer el posible impacto adverso y el grado de segregación por género de la oferta formativa en dicha Comunidad. Los datos obtenidos en esta investigación ponen de manifiesto un «efecto negativo» en la selección que se traduce en una segregación por ramas y niveles de cualificación. Como resultado de ese efecto, las mujeres están infrarrepresentadas en el conjunto de las áreas «industriales» y en algunas ramas del sector servicios, especialmente las vinculadas a las nuevas tecnologías. En vista de esos resultados, los autores sugieren distintas estrategias para impulsar la incorporación de las mujeres en los cursos donde su presencia es escasa.

Increasing evidence suggests that systemic inflammation is associated with many pathophysiological processes including frailty in older adults. We evaluated the relationships between white blood cell subtypes, geriatric assessment, and frailty syndrome and in particular, how they correlate with individual frailty criteria (involuntary loss of weight, low energy or exhaustion, slow mobility, muscle weakness, and low physical activity) in frail older women. There was a significant and positive correlation between the frailty score and neutrophil count, but a significantly negative correlation was found when this score was compared to the lymphocyte count. These associations were significant only for two frailty criteria: poor muscular strength and low physical activity. Further investigation into the role of white blood cell subtypes in ageing and its associated adverse outcomes in older adults is warranted, in particular in the loss of muscular strength and for poor physical activity.

Las series de ficción televisivas generan, en ocasiones, una visión irreal de la vida, especialmente en los jóvenes, convirtiéndose en un espejo en el que se sienten reflejados. Se convierten en modelos de valores, actitudes, habilidades y comportamientos que tienden a ser imitados por ciertos espectadores. El objetivo del presente estudio ha sido analizar los estilos de gestión conductual de los conflictos escenificados por los protagonistas principales de las series de televisión de ficción. Para ello, se valoró la relación existente entre dichos estilos y la edad y el sexo de los protagonistas principales, así como la nacionalidad y el género de las series de ficción. Se han evaluado 16 series de ficción, seleccionando en cada una dos protagonistas (de ambos sexos). Para la observación y el registro se realizó una adaptación del Rahim Organizational Conflict Inventory-II. Los resultados reflejan que no existe una relación de los estilos de gestión conductual de los conflictos escenificados en las series de ficción y el sexo de los protagonistas. Se hallan relaciones entre dichos estilos y la edad de los protagonistas y el género de las series de ficción.

Sin resumen