Prognostic value of defining characteristics in frail elderly syndrome: Hospital readmission and mortality outcomes.

OBJECTIVE: To identify the most relevant clinical characteristics of the nursing diagnosis frail elderly syndrome (FES) in hospitalized patients aged 65 or older and analyze their impact on 9-month mortality and hospital readmission. METHODS: A prospective and prognostic accuracy study was conducted in patients aged 65 or older, who were admitted to hospital more than 24 h. A consecutive convenience sampling process was used. Assessment included defining characteristics (DCs) of FES, clinical fraility scale (CFS), frail scale (FS), and 9-month mortality and hospital readmission. Statistical tests were used to verify associations between variables. Binary logistic regression analysis and area under the curve were used, to identify significant predictors for the outcomes and evaluate the prognostic accuracy of the DCs. FINDINGS: This study involved 150 patients. CFS scored 65 patients (43.3%, confidence interval 95% 35.2% a 51.6) as frail and proved a prognostic value of mortality at 9 month from pre-frail state (p = 0.020). The mean number of DCs for FES nursing diagnosis was 6.35 (SD = 3.14). Validated tools for measuring frailty were associated with all DCs, excepting nutritional imbalance: below body needs. The hospital readmission during the following 9 months was only statistically related to memory impairment (p = 0.07). CONCLUSION: Clinical frailty scale showed good results as a predictor of mortality. The study suggests exploring including it, in clinical manifestations of elderly frail syndrome. This study found that only memory impairment defining characteristic was predictive of hospital readmission. Further research should identify other relevant and prognostic clinical manifestations. IMPLICATION FOR NURSING PRACTICE: These findings highlight the importance of being vigilant on cognitive decline during hospital admissions. The most prevalent and determinant DCs identified in this study indicate that clinical should focus on preserving functional and mental abilities as well as mobility.

Delayed diagnosis of childhood deafness: the value of false negatives in the Programme for Early Detection of Neonatal Hearing Loss. / Retraso en el diagnóstico de sordera infantil: el valor de los falsos negativos en el Programa de Detección Precoz de Hipoacusias Neonatales.

INTRODUCTION: Despite its importance, the existence of false negatives (patients who are told they hear well, but they have some degree of hipacusia) is rarely evaluated in programs for early detection of hearing loss. The aim of this study is to determine the variables that can lead to a delayed diagnosis, especially the existence of false negatives and the lack of registration of risk factors. METHODS: A retrospective study of prevalence has been carried out, in which the medical records of children diagnosed with sensorineural hearing loss born within 2005 and 2012 in the health centers of study have been analyzed. RESULTS: Of the 32 children with sensorineural hearing loss, 16 passed the OAE, 12 did not passed the OAE, and in four they were not carried out. Of the children who passed the OAE, 57% have severe hearing loss. 66% of children with hearing loss presented a risk factor for hearing loss at birth, being the most frecuent family history of hearing loss, but only 7% of those with family history of hearing loss were included in the risk group. CONCLUSIONS: The results of the study indicate that the late diagnosis of hearing loss is related to the presence of false negatives to the OAE and the non-registration of risk factors.

Teoría de la mente en tareas de falsa creencia y producción narrativa en preescolares: investigaciones contemporáneas / Teoria da mente em tarefas de falsa crença e produção narrativa em pré-escolares: investigações contemporâneas / Theory of mind in false belief tasks and narrative production in preschoolers: contemporary research

Este artículo presenta una reflexión sobre el desarrollo de la producción narrativa y el de la teoría de la mente en la etapa preescolar. En cada campo se plantean sus bases conceptuales, reportes y evidencias investigativas. Se muestra que en la producción narrativa los niños adquieren de manera relativamente tardía en su primera infancia las primeras habilidades que les permiten organizar una narración para contarla a otros. Se señala, además, que el desarrollo de la teoría de la mente está relacionado con el del lenguaje, aunque se cuenta con menos estudios sobre su relación con la producción narrativa. Se identifica la necesidad de un marco integrador de las explicaciones de las variantes conceptuales y metodológicas planteadas en esta reflexión.

The paper conducts a reflection on the development of narrative production and the theory of mind at preschool level. Conceptual bases, reports, and research evidence were provided for each field. The study shows that children acquire the abilities to organize a narrative relatively late in early childhood, and that the development of the theory of mind is related to that of language, though there are few studies on its relation to narrative production. The study suggests the need for a framework that integrates the conceptual and methodological variations postulated in the reflection presented.

Este artigo apresenta uma reflexão sobre o desenvolvimento da produção narrativa e da teoria da mente na etapa pré-escolar. Em cada campo são usadas bases conceituais, registros e evidências investigativas. Mostra-se que na produção narrativa, as crianças adquirem de maneira relativamente tardia na primeira infância, as habilidades iniciais que lhes permitem organizar uma narração para contá-la a outros. ademais se assinala que o desenvolvimento da teoria da mente está relacionado com o da linguagem, embora existam menos estudos sobre sua relação com a produção narrativa. Identifica-se a necessidade de um marco integrador das explicações das variantes conceituais e metodológicas propostas nesta reflexão.