Benefits Perceived by Caregivers of Patients with Alzheimer's Disease on Physical and Emotional Health in an Interdisciplinary Program: A Qualitative Study.

Alzheimer's disease is the most common type of dementia, severely affecting the families and caregivers who live with those affected. The aim was to explore the physical, psychological, and behavioral benefits for caregivers of people with Alzheimer's disease. Fifteen semi-structured interviews were conducted with informal Alzheimer's caregivers upon completion of the program. Following a discussion on the topics, categories, and codes among the researchers, a consensus was reached to obtain the final themes and categories. Three main categories were obtained: (1) perceived benefits by the participants; (2) applicability of the knowledge; and (3) proposals for improvement. Participants expressed having perceived improvements in their ability to manage emotions and cope with the situation created by the disease, physical capacity, and in their relationships. In this sense, the application of the contents addressed during the intervention became a fundamental tool for the participants' daily lives. This study showed how an interdisciplinary intervention with psychological sessions, health education, and physical activities could be beneficial for improving both the physical and mental health of caregivers.

Cost-Effectiveness of the Comprehensive Interdisciplinary Program-Care in Informal Caregivers of People with Alzheimer's Disease.

People with Alzheimer's disease (AD) diagnosis who get informal care remain at home longer, reducing the demand for healthcare resources but increasing the stress of caregiving. Research on the effectiveness of physical training, psychoeducational, cognitive-behavioural, and health education programs in reducing the caregiver load and enhancing health-related quality of life (HRQoL) exist, but none exist about an integrated interdisciplinary program. The goals of this project are (1) to assess the Integral-CARE Interdisciplinary Program (IP) applicability, safety, effects on HRQoL, and the incremental cost-effectiveness ratio for AD caregivers; (2) to evaluate the IP applicability and cost-effectiveness to enhance the physical, psychoemotional, cognitive-behavioural dimensions, and the health education status of informal caregivers, and (3) to study the transference of the results to the public and private sectors. A randomized controlled trial will be conducted with an experimental (IP) and a control group (no intervention). The PI will be conducted over nine months using face-to-face sessions (twice a week) and virtual sessions on an online platform (once a week). There will be an initial, interim (every three months), and final assessment. Focus groups with social and health agents will be organized to determine the most important information to convey to the public and private sectors in Extremadura (Spain). Applicability, safety, HRQoL, incremental cost-effectiveness ratio, and HRQoL will be the main outcome measures, while secondary measures will include sociodemographic data; physical, psychoemotional, health education, and cognitive-behavioural domains; program adherence; and patient health status. Data will be examined per procedure and intention to treat. A cost-effectiveness study will also be performed from the viewpoints of private and public healthcare resources.

Relationship of Perceived Social Support with Mental Health in Older Caregivers.

BACKGROUND: Elderly caregivers present increased physical and mental health problems. These factors can lead to a lack of autonomy and a need for social support. This study aims to analyse the relationships between perceived social support and mental health status in elderly caregivers aged 65 and older. METHODS: a cross-sectional study based on data from the Spanish National Health Survey (ENSE-17) carried out on 7023 people. The study population was restricted to 431 caregivers aged ≥65 years. A study of the correlation between the mental health state and the perceived social support was carried out. Both variables were related to the sex of the caregiver. RESULTS: Perceived social support by older caregivers is significantly related to mental health (p = 0.001), and stress (p < 0.001). Also, there is a significant relationship between perceived social support and mental well-being (p = 0.001), self-esteem (p = 0.005) and stress (p = 0.001) in older women caregivers. CONCLUSIONS: Older caregivers have adequate mental well-being and perceive high social support. Perceived social support can contribute to improving the mental well-being of older caregivers.

Physical Strength Perception of Older Caregivers in Rural Areas.

BACKGROUND AND OBJECTIVE: In an aging population, it is increasingly common for older adults to take care of other older adults. Caregiving tasks may be conditioned by the aging process. This study aims to analyze the perceived physical strength of older caregivers and its impact on the functional capacity to engage in caregiving activities. METHODS: A discretionary sampling of caregivers (N = 107), ≥65 years old, in the rural health area of Badajoz (Spain) participated in this cross-sectional study. Measurements included questions about the caregiver's role (experience, years, hours, difficulties, demands) and their perceived physical strength, ability to perform activities of daily living (ADL), need for help or difficulty for caring. RESULTS: Older caregivers from rural areas perceived a lack of physical strength (71%). These caregivers need more help, have more difficulties, and show less ability to perform ADL. Furthermore, around 80% of the people who had a lack of strength were caring for people with severe or total dependence. There is a direct correlation between the perceived lack of physical strength and the ability to perform basic (r = 0.382, p < 0.01) and instrumental (r = 0.370, p < 0.01) activities. CONCLUSIONS: Therefore, the perception of strength and the characteristics of the cared for person may be crucial variables to successfully conduct caregiving tasks.

Therapeutic and prophylactic uses of invertebrates in contemporary Spanish ethnoveterinary medicine.

Zootherapeutic practices in ethnoveterinary medicine are important in many socio-cultural environments around the world, particularly in developing countries, and they have recently started to be inventoried and studied in Europe. In light of this, the purpose of this review is to describe the local knowledge and folk remedies based on the use of invertebrates and their derivative products in contemporary Spanish ethnoveterinary medicine. An overview in the fields of ethnozoology, ethnoveterinary medicine and folklore was made. Automated searches in the most important databases were performed. All related works were examined thoroughly and use-reports were obtained from 53 documentary sources. The traditional use of 18 invertebrate species and five ethnotaxa and a total of 86 empirical remedies based on the use of a single species was recorded. The two most relevant zoological groups were found to be insects and molluscs. A broad diversity of body parts or derivative products have been and are used to treat or prevent ca. 50 animal diseases or conditions, in particular diseases of the skin and subcutaneous tissue, different infectious livestock diseases, and disorders of the eye and adnexa. Cattle, sheep and equines form the group of domestic animals in which the greatest number of remedies are mentioned. In addition, seven magical remedies and practices are documented. In comparison with other culturally related areas, this is a rich heritage. The use-reports included here will help in the search for new and low-cost drugs for treating livestock and alternative materials for pharmaceutical purposes, future research addressing the validation of the effects and the development of organic farming.

[HEALTH, WELLBEING AND CONVIVIALITY OF THE ELDERLY. THE PORTUGUESE, SPANISH AND EUROPEAN SITUATION]. / Salud, bienestar y convivencia de Los ancianos. LA SITUACION PORTUGUESA, ESPAÑOLA Y EUROPEA.

OBJECTIVE: To characterize the specificities of aging in Portugal and Spain, in contrast to the reality of nineteen countries of the European Union. METHODOLOGY: The senior condition is characterized in different dimensions: health status, the level of wellbeing, conviviality and sense of loneliness. For that we have analyzed the results of the European Social Survey, round 5. RESULTS: In Portugal, compared to Spain, it has been identified in the elderly population: greater financial difficulties, poorer perceived health status and wellbeing but, simultaneously, less limitation in performing activities of daily life. Respecting to con- viviality, Portugal and Spain are distinct from other populations of the European reality analyzed, with a high frequency of con- vivial activities. CONCLUSION: In conclusion it was found the existence of national characteristics that suggest the existence of social and cultural factors that determine the experience of aging.

[SAFETY IN THE ELDERLY: HOME ACCIDENTS]. / Seguridad en personas mayores: accidentes en el hogar.

Home accidents are more common in the elderly and they can have serious consequences to the injured person's health. At home, chances to suffer accidents of any type are higher, because it's the place where old people spend most of their daily time. It is important to point out that a high percentage of domestic accidents could be easily avoided by taking some simple cautions. The main aim of this paper is to know how we can prevent most common domestic accidents in the aged population: falls, burnings, poisonings and fire prevention.

The use of wild vertebrates in contemporary Spanish ethnoveterinary medicine.

ETHNOPHARMACOLOGICAL RELEVANCE: This review documents the wide and varied repertoire of traditional practices based on the use of wild vertebrates in Spanish ethnoveterinary medicine (EVM) from the early 20th century to the present. Empirical practices, both ritual and magical, are recorded, and these EVM data are compared with those of other countries in the Mediterranean Region and Latin America. The data collected here could form a scientific foundation for future inventories of traditional knowledge and help in the discovery of new drugs for livestock. MATERIALS AND METHODS: A qualitative systematic review of international and national databases in the fields of ethnobiology, ethnoveterinary medicine, folklore and ethnography was made. Information was obtained from more than 60 documentary sources. RESULTS: We recorded the use of 30 wild vertebrates and a total of 84 empirical remedies based on the use of a single species. The two most relevant zoological groups are reptiles and mammals. A wide diversity of body parts or products have been and are used. The meat and skin of snakes are the animal products most commonly used. These zootherapeutic resources have been and are used to treat or prevent ca. 50 animal diseases or conditions, in particular digestive and reproductive ailments, together with some infectious diseases. Sheep, cattle and equines form the group of domestic animals in which the greatest number of useful species are employed. In addition, many remedies and practices of the magical type are documented. In comparison with other culturally related areas, this is a rich heritage. CONCLUSIONS: Contemporary Spanish EVM practices amass a great richness of wild animal-based remedies. A diversity of animal parts or products have been used, offering a cultural heritage that could be a fundamental step in the discovery of new and low-cost drugs for treating livestock and alternative materials for pharmaceutical purposes. This overview contributes to the inventory of some uses and rituals seriously threatened by the progressive loss of local veterinary knowledge.

[COMPREHENSIVE GERIATRIC ASSESSMENT SCALES]. / Escalas de valoración geriátrica integral.

The process of comprehensive geriatric assessment is one of the key elements of geriatric care management aimed at the population. it includes evaluating the clinical, functional, mental and social aspects of aging result and/or pathological processes that appear at this stage of the life cycle. For their achievement, as well as other tools, professionals have a large number of validated rating scales specifically designed in the assessment of the different areas or fields. Its use can be very useful, especially for the objectification of evaluation results. The future of research in this area goes through deepening the adequacy of the scales to the characteristics and needs of older people in each care level or place of care.

[Elderly caregivers of elderly people].

The ageing of the population is a reality in our society nowadays. The aging process changes increase the probability that health problems occur. This fact involves that the needs of care demanded by the population increase too. The care for the elderly generally are provided in home environments, where often, the primary caregiver is another old person. In this sense, must be taken into account that this stage of life, the old age, although there has been important improvements in the quality of life and in the resolution of health problems, presents certain limitations refers to physical and mental declines that affect to the functional capacity of elderly caregivers. For this reason, it is necessary to carry out a comprehensive geriatric assessment to identify unresolved needs and establish care strategies required to attend their demands for care.

[NURSING RESEARCH VISIBILITY: DATABASES AND IMPACT FACTOR]. / Visibilización de la investigación en enfermería.

Nowadays, mainly as a result of the implementation of processes of accreditation of the teaching and research activity, there is discussion about the publication in journals of nursing according to the impact factor or their indexing in certain databases, basic criteria for obtaining favorable evaluations in these processes promoted by quality agencies. To response to this problem we are going to analyze conceptually the current methodological support on which is based the analysis of the scientific quality of the research in our discipline, as well as the impact on its visibility and development.

[GENERIC DRUGS: IS BIOEQUIVALENCE SUFFICIENT TO ENSURE QUALITY, EFFICACY AND SAFETY?]. / Medicamentos genéricos.

This article is focusing on the current debate that prescription of generic drugs is producing among patients and healthcare professionals. Following European Medicine Agency (EMA) recommendations, a number of generic medicines have recently been withdrawn from the market in Spain. The authorization for these generic drugs was primarily based on clinical studies conducted at GVK Biosciences in Hyderabad, India. The EMA inspection of GVK revealed data manipulation of electrocardiograms during the development of some studies of generic medicines. These manipulations had taken place over a period of at least five years. The article is also dealing with the consideration that bioavailability and bioequivalence studies receive as a cornerstone to approve generic drugs, and the discrepancies between the national regulatory agencies of medicines to implement guidelines of approval. Likewise, in the last few years, the rapid expansion of clinical trial activity regarding generic medicines and other drugs in emerging markets, is often leading to doubt on the integrity of the way trials were performed and on the reliability of data obtained from these studies.

[PHARMACOLOGICAL TREATMENT IN PALLIATIVE CARE. DRUG ADMINISTRATION ROUTE, CONTINUOUS SUBCUTANEOUS INFUSION, ADVERSE SIDE EFFECTS, SYMPTOM MANAGEMENT]. / Farmacoogía en Cuidados Paliativos.

OBJECTVE: To achieve well-being in patients in Palliative Care is required to know which are the most common symptoms, which are the drugs used for relief, which are the routes of administration of drugs that are suitable, how effective the drugs are and what incompatibilities, interactions and adverse effects occur. The aim of this article is to review the relevant issues in the management of the drugs commonly used by nursing in Palliative Care and presenting recommendations to clinical practice. METHODOLOGY: Management interventions drugs for nurses in Palliative Care recommended by the scientific literature after a search of Scopus, CINAHL, Medline, PubMed, UpToDate and Google Scholar are selected. RESULTS: The oral route is the choice for patients in palliative situation and subcutaneous route when the first is not available. The symptoms, complex, intense and moody, should be systematically reevaluated by the nurse, to predict when a possible decompensation of it needing extra dose of medication. DISCUSSION: Nurses must be able to recognize the imbalance of well-being and act quickly and effectively, to get relief to some unpleasant situations for the patient as the pain symptoms, dyspnea or delirium. For the proper administration of rescue medication, the nurse should know the methods of symptomatic evaluation, pharmacokinetics and pharmacodynamics of drugs, the time intervals to elapse between different rescues and nccocc rocnnnco t thocm

[SAFETY PATIENT. USE AND MANAGEMENT OF CONTRAST MEDIA]. / Seguridad del paciente. USO Y ADMINISTRACIÓN DE MEDIOS DE CONTRASTE.

This article tries to point out the patient safety and the fundamental rol of nursing in the management of contrast media in the Imaging Diagnostic Services, two aspects of vital importance in the nurse practique. We will look at what the contrast agents are, how we can use them, what the routes of administration are, their adverse reactions and everything related to the patient safety that we, as professional, should do in our daily performance. And, of course, the process must include the information we need to give to the patient, verbally and written (informed consent) in the current legal framework. The aim of this work is to provide the nurse with updated knowledge that is necessary to carry out safety nursing care interventions within the context of the performance of diagnosis techniques using contrast agents.

[THE SCHOOL NURSE AND PRIMARY HEALTH NURSE, APROPOS THE DIABETES CARE AT SCHOOL IN EXTREMADURA]. / La enfermera escolar y La enfermera de Atención Primaria: A PROPÓSITO DE LA ATENCIÓN A LA DIABETES EN LA ESCUELA EN EXTREMADURA.

UNLABELLED: The amount of chronic health problems in students is increasing with the time (food allergies, diabetes mellitus...). The presence of a school nurse in the educational sites could be the key to control this kind of health issues. OBJECTIVE: Overhaul the function of a possible nurse in the schools of our region, with the target of trying to control and prevent diabetes mellitus and other illnesses. METHODOLOGY: We have reviewed the figure of a school nurse and the diabetes care in non-university schools, using scientific sources of information and the own experience. RESULTS: Many countries of the European environment are performing really important activities which have their benefits on the students'health; using the figure of a school nurse. However, the presence of this person is generally not constant in the educational sites, and requires some improvements. CONCLUSIONS: We must promote the establishment of school nurses in Spain so that we can take care and prevent many health problems which mostly affect youth and childhood.