Elämänviivapiirros iäkkäiden ihmisten tutkimuksessa

Summary: Life-line drawing in studying older people

La salud bucodental de los españoles mayores de 64 años. Impacto en el estado de salud individual

Introducción: los cambios epidemiológicos sufridos en los países occidentales en el siglo XX han propiciado un aumento del número absoluto y de la proporción de ancianos en todos ellos. Pacientes y Método: se realizó un estudio descriptivo transversal de prevalencia de enfermedades bucodentales en una población de 3.460 individuos en 7 Comunidades Autónomas españolas, tanto institucionalizados (10%) como no institucionalizados (90%). Resultados: la edad media de los encuestados fue de 73,6±7 años. Un 31,4% de los individuos del estudio eran desdentados totales. Los individuos dentados presentaban un promedio de 14,8±8 dientes. El CAOD de los individuos de la muestra fue de 20,8±10, siendo de 23,7±9,8 en los institucionalizados. La última visita al dentista había sido de media 4 años y medio antes, pero los institucionalizados hacía 7 años. Discusión: es totalmente inaceptable que la prevención y el tratamiento las enfermedades bucodentales. especialmente entre las personas de edad más avanzada, se sigan considerando como un aspecto totalmente optativo para el mantenimiento de la salud del individuo. Estudios epidemiológicos. bacteriológicos e Inmunológicos demuestran que la enfermedad periodontal o la caries pueden ser las causantes de un importante aumento de la morbi-mortalidad especialmente entre las personas de más edad.

Seguro de fallecimiento con anticipación parcial de la prestación por dependencia.

En este trabajo proponemos un seguro de fallecimiento en el que al asegurado se le anticipa parte de la cuantía del seguro en el caso que se convierta en dependiente o agrave su situación de dependencia. El importe del anticipo estará en función del grado de dependencia que haya alcanzado. El asegurado podrá utilizar este anticipo para financiar la adquisición, o adecuación, de una determinada infraestructura como consecuencia de la falta de autonomía. Calcularemos las primas así como las provisiones matemáticas y realizaremos la comparación con el seguro de fallecimiento tradicional; también plantearemos la problemática de la carencia.

Effectiveness of a drug dosing service provided by community pharmacists in polymedicated elderly patients with renal impairment a comparative study

Background: Drug dosing errors are common in renal-impaired patients. Appropriate dosing adjustment and drug selection is important to ensure patients" safety and to avoid adverse drug effects and poor outcomes. There are few studies on this issue in community pharmacies. The aims of this study were, firstly, to determine the prevalence of dosing inadequacy as a consequence of renal impairment in patients over 65 taking 3 or more drug products who were being attended in community pharmacies and, secondly, to evaluate the effectiveness of the community pharmacist"s intervention in improving dosing inadequacy in these patients when compared with usual care. Methods: The study was carried out in 40 Spanish community pharmacies. The study had two phases: the first, with an observational, multicentre, cross sectional design, served to determine the dosing inadequacy, the drug-related problems per patient and to obtain the control group. The second phase, with a controlled study with historical control group, was the intervention phase. When dosing adjustments were needed, the pharmacists made recommendations to the physicians. A comparison was made between the control and the intervention group regarding the prevalence of drug dosing inadequacy and the mean number of drug-related problems per patient. Results: The mean of the prevalence of drug dosing inadequacy was 17.5% [95% CI 14.6-21.5] in phase 1 and 15.5% [95% CI 14.5-16.6] in phase 2. The mean number of drug-related problems per patient was 0.7 [95% CI 0.5-0.8] in phase 1 and 0.50 [95% CI 0.4-0.6] in phase 2. The difference in the prevalence of dosing inadequacy between the control and intervention group before the pharmacists" intervention was 0.73% [95% CI (−6.0) - 7.5] and after the pharmacists" intervention it was 13.5% [95% CI 8.0 - 19.5] (p < 0.001) while the difference in the mean of drug-related problems per patient before the pharmacists" intervention was 0.05 [95% CI( -0.2) - 0.3] and following the intervention it was 0.5 [95% CI 0.3 - 0.7] (p < 0.001). Conclusion: A drug dosing adjustment service for elderly patients with renal impairment in community pharmacies can increase the proportion of adequate drug dosing, and improve the drug-related problems per patient. Collaborative practice with physicians can improve these results.

Effectiveness of a drug dosing service provided by community pharmacists in polymedicated elderly patients with renal impairment a comparative study

Background: Drug dosing errors are common in renal-impaired patients. Appropriate dosing adjustment and drug selection is important to ensure patients" safety and to avoid adverse drug effects and poor outcomes. There are few studies on this issue in community pharmacies. The aims of this study were, firstly, to determine the prevalence of dosing inadequacy as a consequence of renal impairment in patients over 65 taking 3 or more drug products who were being attended in community pharmacies and, secondly, to evaluate the effectiveness of the community pharmacist"s intervention in improving dosing inadequacy in these patients when compared with usual care. Methods: The study was carried out in 40 Spanish community pharmacies. The study had two phases: the first, with an observational, multicentre, cross sectional design, served to determine the dosing inadequacy, the drug-related problems per patient and to obtain the control group. The second phase, with a controlled study with historical control group, was the intervention phase. When dosing adjustments were needed, the pharmacists made recommendations to the physicians. A comparison was made between the control and the intervention group regarding the prevalence of drug dosing inadequacy and the mean number of drug-related problems per patient. Results: The mean of the prevalence of drug dosing inadequacy was 17.5% [95% CI 14.6-21.5] in phase 1 and 15.5% [95% CI 14.5-16.6] in phase 2. The mean number of drug-related problems per patient was 0.7 [95% CI 0.5-0.8] in phase 1 and 0.50 [95% CI 0.4-0.6] in phase 2. The difference in the prevalence of dosing inadequacy between the control and intervention group before the pharmacists" intervention was 0.73% [95% CI (−6.0) - 7.5] and after the pharmacists" intervention it was 13.5% [95% CI 8.0 - 19.5] (p < 0.001) while the difference in the mean of drug-related problems per patient before the pharmacists" intervention was 0.05 [95% CI( -0.2) - 0.3] and following the intervention it was 0.5 [95% CI 0.3 - 0.7] (p < 0.001). Conclusion: A drug dosing adjustment service for elderly patients with renal impairment in community pharmacies can increase the proportion of adequate drug dosing, and improve the drug-related problems per patient. Collaborative practice with physicians can improve these results.

La generatividad en la vejez y su relación con el bienestar: ¿Quién más contribuye es quien más se beneficia?

El objetivo de la investigación fue la adaptación al español de las escalas de interés y comportamientos generativos de McAdams, así co-mo el estudio de la generatividad en la vejez y su relación con el bienestar. La muestra estuvo compuesta por 165 voluntarios mayores de 65 años que, además de las versiones españolas de las escalas de generatividad, completa-ron instrumentos para evaluar satisfacción con la vida y orientación al futu-ro. Los resultados indicaron que la fiabilidad de las versiones españolas de las escalas de generatividad fue aceptable y similar a las originales en inglés. Mientras el interés generativo se relacionó con la satisfacción con la vida, los comportamientos generativos no lo hicieron. Sin embargo, ambas esca-las sí se relacionaron con la orientación al futuro, aunque esta relación no se confirmó en un análisis multivariable. Los resultados resaltan la importancia de la generatividad en la vejez y de distinguir entre interés y acción generati-va, ya que sus beneficios podrían ser muy diferentes.

Anticonvulsants in the treatment of aggression in the demented elderly: an update

Complex psychopathological and behavioral symptoms, such as delusions and aggression against care providers, are often the primary cause of acute hospital admissions of elderly patients to emergency units and psychiatric departments. This issue resembles an interdisciplinary clinically highly relevant diagnostic and therapeutic challenge across many medical subjects and general practice. At least 50% of the dramatically growing number of patients with dementia exerts aggressive and agitated symptoms during the course of clinical progression, particularly at moderate clinical severity. METHODS: Commonly used rating scales for agitation and aggression are reviewed and discussed. Furthermore, we focus in this article on benefits and limitations of all available data of anticonvulsants published in this specific indication, such as valproate, carbamazepine, oxcarbazepine, lamotrigine, gabapentin and topiramate. RESULTS: To date, most positive and robust data are available for carbamazepine, however, pharmacokinetic interactions with secondary enzyme induction limit its use. Controlled data of valproate do not seem to support the use in this population. For oxcarbazepine only one controlled but negative trial is available. Positive small series and case reports have been reported for lamotrigine, gabapentin and topiramate. CONCLUSION: So far, data of anticonvulsants in demented patients with behavioral disturbances are not convincing. Controlled clinical trials using specific, valid and psychometrically sound instruments of newer anticonvulsants with a better tolerability profile are mandatory to verify whether they can contribute as treatment option in this indication.

Vanhuskuvat muuttuvat - miten ja miksi?

Abstract: Images of older people vary - how and why?

Anticonvulsants in the treatment of aggression in the demented elderly: an update

Complex psychopathological and behavioral symptoms, such as delusions and aggression against care providers, are often the primary cause of acute hospital admissions of elderly patients to emergency units and psychiatric departments. This issue resembles an interdisciplinary clinically highly relevant diagnostic and therapeutic challenge across many medical subjects and general practice. At least 50% of the dramatically growing number of patients with dementia exerts aggressive and agitated symptoms during the course of clinical progression, particularly at moderate clinical severity. METHODS: Commonly used rating scales for agitation and aggression are reviewed and discussed. Furthermore, we focus in this article on benefits and limitations of all available data of anticonvulsants published in this specific indication, such as valproate, carbamazepine, oxcarbazepine, lamotrigine, gabapentin and topiramate. RESULTS: To date, most positive and robust data are available for carbamazepine, however, pharmacokinetic interactions with secondary enzyme induction limit its use. Controlled data of valproate do not seem to support the use in this population. For oxcarbazepine only one controlled but negative trial is available. Positive small series and case reports have been reported for lamotrigine, gabapentin and topiramate. CONCLUSION: So far, data of anticonvulsants in demented patients with behavioral disturbances are not convincing. Controlled clinical trials using specific, valid and psychometrically sound instruments of newer anticonvulsants with a better tolerability profile are mandatory to verify whether they can contribute as treatment option in this indication.

Exploring the use of mobile communications in a retirement home in Toronto: Preliminary results

This paper describes preliminary results of a qualitative case study on mobile communication conducted in an elders¿ retirement home in Toronto (Ontario, Canada) in May 2012. This is part of an international research project on the relationship between mobile communications and older people.Secondary data at a Canadian level contextualizes the case study. We focus ondemographic characteristics and on adoption and use of information and communication technologies (ICTs) broken by age.Participants in the study (21 individuals) are between 75 and 98 years of age, thereforewe can consider that the gathered evidence refers to the ¿old¿ older. Mobile phoneusers in the sample describe very specific uses of the mobile phone, while non-usersreport not facing external pressures for adopting that technology. The main channel formediated communication is the landline; in consequences mobile phones ¿when used¿ constitute an extra layer of communication. Finally, when members of the personal network of the individuals live abroad they are more prone to use Internet and Skype. We are also able to find ex-users of both mobile telephony and computers/internet who stopped using these technologies because they did not find any use for them.

Personas adultas mayores y comunicación móvil: voz y SMS

Todavía sabemos poco sobre las formas de adopción, o rechazo, de la comunicación móvil por parte de las personas adultas mayores. ¿De qué manera utilizan la telefonía móvil? ¿Cuáles son los motivos de rechazo de este tipo de telefonía, si los hay?Discutimos los resultados de un caso de estudio cualitativo con personas adultas mayores (60 años o más), desarrollado en el área metropolitana de Montevideo en 2012. Los y las participantes valoran la conectividad permanente que brinda el teléfono móvil. Lo utilizan en combinación con otros canales, como el teléfono fijo, para una diversidad de objetivos y con diferentes interlocutores. Además de las llamadas de voz, los SMS son de uso habitual. Entre los no usuarios encontramos tanto el discurso del rechazo como el de la indiferencia hacia el celular. Finalmente, todos los usuarios de Internet son, también, usuarios de teléfono celular.

Mobile Phones, Restrictions and Discontinuities

By means of a qualitative approach I bring insights on the relationship older people (60+) have with mobile communication in a low income district of Lima (Peru). The case study I conducted in September 2013 included interviews and one focus group with 20 inhabitants of San Juan de Miraflores district. The user/non-user dichotomous classification turned out to be too narrow in this context. While some participants reported a common, bidirectional use of the device, restrictions and discontinuities played a role. Some described an asymmetric use of the mobile phone, as they used it exclusively for receiving calls, while never making outgoing calls. Others described discontinuities in ownership, which was the case when their mobile was stolen and they could not replace it immediately. My initial hypothesis is that such restrictions are related to income, skills and age.

Du retraité méritant au senior actif : genèse et transformations de la figure sociale de la vieillesse en Suisse

«Crise de l'assurance-vieillesse », «déséquilibre démographique», «vieillissement de la population », « faillite des systèmes de retraite », voilà des expressions qui occupent une place prépondérante dans tes discours portant sur l'avenir de la sécurité sociale aujourd'hui. Les autorités politiques suisses comme européennes font part de leur inquiétude face à la situation d'urgence que présenteraient les « sociétés vieillissantes ». En effet, alors que F assurance-vieillesse s'adressait initialement à une catégorie résiduelle de personnes qui parvenait à vivre plusieurs années au-delà de 65 ans, elle couvre maintenant près d'un cinquième de la population globale. Partant, les autorités fédérales appellent à une restriction des conditions d'accès à la rente de vieillesse. À première vue, les débats qui portent sur cette question dans l'arène politique relèvent de considérations essentiellement techniques liées aux conditions économiques de perpétuation de l'assurances-vieillesse. Il s'agit de modifier les règles d'accès à l'assurance ainsi que le montant des prestations afin d'assainir les caisses tout en faisant face à l'augmentation du nombre de retraités. Ce travail de thèse aborde cette question par une autre approche. Nous partons du postulat que les débats portant sur l'avenir de la politique de la vieillesse sont révélateurs d'une lutte entre acteurs du champ de régulation sociale qui participent d'un travail d'élaboration d'une pensée d'Etat, au sens de P Bourdieu. Cette lutte a pour objet l'imposition de catégories de pensées, soit la définition de ce qu'est un âgé aujourd'hui et de ce qu'il est moralement acceptable d'attendre de lui Nous montrons que cette question peut être comprise à l'aune de l'histoire du traitement social de la vieillesse dont nous relatons ici la genèse et les transformations. Nous soulignons également combien cette pensée d'Etat marque la manière dont les retraités aujourd'hui cherchent à se valoriser face à la déstabilisation de leur statut social. Summary "Crisis of social insurance for older people", "demographic imbalance", "aging of the population", "bankruptcy of pensions systems" ; these are some of the many expressions that today play a importance part in discussion about the future of social security. The Swiss and European political authorities show they are concerned about the crisis that "aging societies" are said to be facing. Indeed, while social insurance for old age used to concern a residual category of people who managet! to live to more than 65 years old, it now covers about a fifth of the global population. Hence, the Federal authorities are calling for a tightening of the conditions for access to retirement benefits. At first glance, the debates in the political arena »elated to (his question mainly deal with technical considerations linked to the economic conditions for the perpetuation of the insurance for old age. Ease of access and the level of the benefits have to be reduced in order to balance the funds, in the face of the rise of the number beneficiaries. This thesis study addresses this question through a different approach. We start from the proposition that debates concerning the future of social policy for old age reveal a struggle between those involved in (he field of social regulation ; this struggle is part of the development of the thought of the State as conceived by P. Bourdieu. The aim of this fight is to impose normative categories of thought, that is to say in relation to our subject, the definition of what an older person is today and what is morally acceptable to expect of him or her. We show that this question can be understood in the light of the the history of the social treatment of old age that we report here. Moreover, we show that this thought of the State explains the way retired people seek to value themselves and confront the destabilisation of their social status.

Notes florístiques i corològiques, 707- 712

Notes florístiques i corològiques del Baix Empordà

Subjetivación y vinculación en el proceso de envejecimiento

Subjetivación y vinculación son dos conceptos que hacen referencia a dos procesos indispensables para realizar un buen envejecimiento. El artículo desarrolla estos conceptos teóricos, en el marco de un proyecto de intervención con ancianos: un trabajo de grupo llamado <