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Aging is a major risk factor for neurodegenerative diseases like dementia and Alzheimer's disease. Even in non-pathological aging, decline in cognitive functioning is observed in the majority of the elderly population, necessitating the importance of studying the processes involved in healthy aging in order to identify brain biomarkers that promote the conservation of functioning. The default mode network (DMN) has been of special interest to aging research due to its vulnerability to atrophy and functional decline over the course of aging. Prior work has focused almost exclusively on functional (i.e. undirected) connectivity, yet converging findings are scarce. Therefore, we set out to use spectral dynamic causal modeling to investigate changes in the effective (i.e. directed) connectivity within the DMN and to discover changes in information flow in a sample of cognitively normal adults spanning from 48 to 89 years (n = 63). Age was associated to reduced verbal memory performance. Modeling of effective connectivity revealed a pattern of age-related downregulation of posterior DMN regions driven by inhibitory connections from the hippocampus and middle temporal gyrus. Additionally, there was an observed decline in the hippocampus' susceptibility to network inputs with age, effectively disconnecting itself from other regions. The estimated effective connectivity parameters were robust and able to predict the age in out of sample estimates in a leave-one-out cross-validation. Attained education moderated the effects of aging, largely reversing the observed pattern of inhibitory connectivity. Thus, medial prefrontal cortex, hippocampus and posterior DMN regions formed an excitatory cycle of extrinsic connections related to the interaction of age and education. This suggests a compensatory role of years of education in effective connectivity, stressing a possible target for interventions. Our findings suggest a connection to the concept of cognitive reserve, which attributes a protective effect of educational level on cognitive decline in aging (Stern, 2009).
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Envejecimiento Saludable , Adulto , Humanos , Anciano , Red en Modo Predeterminado , Imagen por Resonancia Magnética , Envejecimiento/fisiología , Encéfalo/patología , EscolaridadRESUMEN
BACKGROUND: The evaluation of spiritual requirements in patients can facilitate the delivery of spiritual care as an essential element of holistic healthcare. The objective of this research was to develop and evaluate the psychometric properties of a questionnaire on patients' spiritual needs in medical-surgical hospital settings. METHODS: This research utilized an exploratory sequential design, involving the creation of a pool of items through both inductive and deductive methods. The questionnaire's psychometric properties were then assessed using various techniques, such as face and content validity, item analysis, construct validity, internal consistency, stability, confirmatory factor analysis, and the Gradual Response Model of Samejima. The data analysis was conducted using MPLUS software, version 5.1. RESULTS: The study's results showed that a four-factor structure (interpersonal connectedness, relationship with God, transcendence, and peaceful environment) with 43 items was successfully extracted through exploratory factor analysis. The confirmatory factor analysis supported the findings of the exploratory factor analysis. The Cronbach's alpha coefficients for the scale and factors ranged between 0.83 and 0.95. Furthermore, the interclass correlation coefficients for the scale and factors were between 0.89 and 0.96. CONCLUSIONS: The questionnaire designed in this study is a reliable and valid instrument that can be utilized by healthcare, educational, and research institutions to evaluate the spiritual needs of patients in medical-surgical hospital settings.
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Hospitales , Espiritualidad , Humanos , Psicometría/métodos , Reproducibilidad de los Resultados , Encuestas y CuestionariosRESUMEN
AIM AND OBJECTIVES: The aim of this study was to explore the sources of ethical conflict and the decision-making processes of ICU nurses and physicians during the first and subsequent waves of the COVID-19 pandemic. BACKGROUND: Depside several studies exploring ethical conflicts during COVID-19 pandemic, few studies have explored in depth the perceptions and experiences of critical care professionals regarding these conflicts, the decision-making process or which have analysed the complexity of actually implementing the recommendations of scientific societies and professional/healthcare institutions in interdisciplinary samples. DESIGN: A descriptive phenomenological study. METHODS: Thirty-eight in-depth interviews were conducted with critical care nurses and physicians from five hospitals in Spain and Italy between December 2020 and May 2021. A thematic content analysis of the interview transcripts was conducted by two researchers. Consolidated criteria for reporting qualitative research (COREQ) were employed to ensure the quality and transparency of this study. RESULTS: Two main themes emerged as sources of ethical conflict: the approach to end of life in exceptional circumstances and the lack of humanisation and care resources. The former comprised two subthemes: end-of-life care and withholding and withdrawal of life-sustaining treatment; the latter comprised three subthemes: the impossibility of guaranteeing the same opportunities to all, fear of contagion as a barrier to taking decisions and the need to humanise care. CONCLUSIONS: Professionals sought to take their decisions in line with professional ethics and bioethical principles, but, nevertheless, they experienced moral dilemmas and moral distress when not being able to care for, or to treat, their patients as they believed fit. RELEVANCE TO CLINICAL PRACTICE: Further education and training are recommended on the provision of end-of-life and post-mortem care, effective communication techniques via video calls, disclosure of bad news and bioethical models for decision-making in highly demanding situations of uncertainty, such as those experienced during the COVID-19 pandemic.
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COVID-19 , Pandemias , Humanos , Toma de Decisiones , COVID-19/epidemiología , Cuidados Críticos , Investigación CualitativaRESUMEN
OBJECTIVES: This study aimed to analyze the different factors that intervene in the task of caring for relatives of people with Alzheimer's and other dementias. A first objective focused on assessing the relation between burden and anticipatory grief, considering the possibility of social support and the risk of psychopathology. A second objective aimed to examine whether caregiver burden modulates the relationships between anticipatory grief and psychopathology. A cross-sectional design was employed. METHODS: The sample consists of 129 participants who care for a family member with Alzheimer's and other dementias. A protocol based on a battery of tests has been applied and a mediation analysis was carried out. RESULTS: The results show a positive relationship between burden and anticipatory grief. Social support could have an indirect relationship with anticipatory grief, based on its effect on the level of psychopathology and caregiver burden. Finally, a modulation model reflects that the relationship between anticipatory grief and psychopathology is strong, the latter having a greater effect as a result variable than as a risk variable. However, it seems that the relationship between grief and psychopathology is better explained directly than not through the modulating effect of the caregiver burden. SIGNIFICANCE OF RESULTS: The results obtained encourage us to think that an approach focused on intervening in the anticipatory grief may be an opportunity to reduce or buffer other caregiving outcomes, especially those related to the perception of caregiver burden and psychopathology.
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BACKGROUND: Major depressive disorder (MDD) has been linked to episodic memory deficits that may be improved after pharmacological treatment, but it is unclear whether there is a class of antidepressants that is more effective than others to ameliorate these deficits in MDD. In addition, the possible effects of clinical and sociodemographic variables on the improvement of MDD memory deficits after pharmacological treatment are currently unknown. Our aims are to study the possible neuropsychological effects of second-generation antidepressant classes on the episodic memory of MDD patients and to study the potential effects of clinical and demographic variables as moderators of the effects of antidepressants on the memory of depressed patients through a meta-analysis approach. PROCEDURES: Nine articles were included in our study. A structural equation model meta-analysis was performed. RESULTS: Our results suggest that selective serotonin reuptake inhibitors and serotonine-noradrenaline reuptake inhibitors would bring about a substantial improvement in the memory of depressed patients, whereas other antidepressant classes would cause rather modest effects. Our results also suggest that clinical and demographic variables play a very important role as mediators of memory improvement after MDD treatment. Thus, a relatively low level of symptom severity, a high degree of clinical improvement, a younger age, and more years of education were positively related to memory improvement after MDD treatment. CONCLUSIONS: Although antidepressant class is an important variable linked to memory improvement in MDD, overall, the degree of memory amelioration in depression is very closely related to clinical and demographic variables of patients with depression.
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Afecto/efectos de los fármacos , Antidepresivos de Segunda Generación/uso terapéutico , Trastorno Depresivo Mayor/tratamiento farmacológico , Memoria Episódica , Inhibidores Selectivos de la Recaptación de Serotonina/uso terapéutico , Inhibidores de Captación de Serotonina y Norepinefrina/uso terapéutico , Adulto , Anciano , Antidepresivos de Segunda Generación/efectos adversos , Trastorno Depresivo Mayor/diagnóstico , Trastorno Depresivo Mayor/psicología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Recuperación de la Función , Inhibidores Selectivos de la Recaptación de Serotonina/efectos adversos , Inhibidores de Captación de Serotonina y Norepinefrina/efectos adversos , Resultado del TratamientoRESUMEN
OBJECTIVE: To study the influence of cognitive reserve (CR) on cognitive performance of individuals with subjective cognitive complaints (SCCs) within a period of 36 months. DESIGN: We used a general linear model repeated measures procedure to analyze the differences in performance between three assessments. We used a longitudinal structural equation modeling to analyze the relationship between CR and cognitive performance at baseline and at two follow-up assessments. SETTING: Participants with SCCs were recruited and assessed in primary care health centers. PARTICIPANTS: A total of 212 participants older than 50 years with SCCs. MEASUREMENTS: Cognitive reserve data were collected with an ad hoc questionnaire administered to the subjects in an interview. General cognitive performance (GCP), episodic memory (EM), and working memory (WM) have been evaluated. The Mini-Mental State Examination and the total score of Spanish version of the Cambridge Cognitive Examination evaluated the GCP. Episodic memory was assessed with the Spanish version of the California Verbal Learning. Working memory was evaluated by the counting span task and the listening span task. RESULTS: The satisfactory fit of the proposed model confirmed the direct effects of CR on WM and GCP at baseline, as well as indirect effects on EM and WM at first and second follow-up. Indirect effects of CR on other cognitive constructs via WM were observed over time. CONCLUSION: The proposed model is useful for measuring the influence of CR on cognitive performance over time. Cognitive response acquired throughout life may influence cognitive performance in old age and prevent cognitive deterioration, thus increasing processing resources via WM.
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Trastornos del Conocimiento/diagnóstico , Trastornos del Conocimiento/etiología , Disfunción Cognitiva/diagnóstico , Reserva Cognitiva/fisiología , Función Ejecutiva/fisiología , Trastornos de la Memoria/complicaciones , Adulto , Anciano , Anciano de 80 o más Años , Envejecimiento/psicología , Disfunción Cognitiva/clasificación , Disfunción Cognitiva/psicología , Femenino , Humanos , Análisis de Clases Latentes , Masculino , Memoria Episódica , Memoria a Corto Plazo/fisiología , Persona de Mediana Edad , Modelos Estadísticos , Pruebas Neuropsicológicas , Encuestas y Cuestionarios , Aprendizaje Verbal/fisiologíaRESUMEN
Self-determination, as a person dispositional characteristic, is indeed influenced by situational characteristics that shape actions across contexts. Research has also reported differences in self-determination as a function of personal factors, but there is a need to integrate this knowledge in a general model aiming to analyse the impact of contextual variables in adolescents with and without disabilities. An integrative model of self-determination and related contextual factors was tested through a structural equation modelling approach. Participants were adolescents that reported their perceptions on self-determination dimensions and opportunities. Results indicated that educational and family contexts impacted self-determination and provided further understanding on self-determination dimensions' entity and function. Relevant implications for self-determination measure, comprehension and promotion derived from this study are discussed.
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Personas con Discapacidad , Discapacidad Intelectual , Adolescente , Humanos , Autonomía PersonalRESUMEN
BACKGROUND: Studies addressing critical care nurses' practices regarding physical restraints have focused on individual nurses' knowledge and attitudes but lack the understanding of other social influences that could affect nurses' intentions to use them. OBJECTIVE: The objective of this study was to determine critical care nurses' attitudes, subjective norms, perceived behavioural control, and intentions to use physical restraints in intubated patients and the relationship between them and sociodemographic, professional, and contextual factors using a survey approach. METHODS: A cross-sectional, multicentre study was conducted in a convenience sample of 12 intensive care units from eight hospitals in Spain (n = 354). The Physical Restraint-Theory of Planned Behaviour questionnaire and a researcher-developed survey were used to collect structural and clinical data from each unit. Multilevel model analysis was used. RESULTS: Critical care nurses showed a moderate level of intention to use physical restraints 12.52 (standard deviation = 3.81) [3-21]. More than a half (52%) agreed restraints were safe. The highest perceived barrier against physical restraint use was patient cooperation. Although nurses did not feel that others expected them to use restraints, they did not perceive high levels of disapproval of such practice. Nurses who had received previous training on restraints and who worked in units with a flexible family visitation policy, an informed consent form for restraint use, analgosedation and restraint protocols, and nurse-driven analgosedation management reported lower levels of intention to use restraints. Working in smaller units (beta -1.81; 95% confidence interval [CI]: -0.18, -3.44) and working in units with a consent form for restraint use (beta -4.82; 95% CI: -2.80, -6.85) were the variables with the highest impact on nurses' intentions to use restraints. CONCLUSIONS: Critical care nurses' intentions to use physical restraints are moderate and are influenced by intrapersonal, patient, and contextual factors. Nurses who work in units with organisational policies and alternatives to restraints demonstrated lower levels of intention to use them.
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Enfermería de Cuidados Críticos , Enfermeras y Enfermeros , Actitud del Personal de Salud , Competencia Clínica , Cuidados Críticos , Estudios Transversales , Conocimientos, Actitudes y Práctica en Salud , Humanos , Intención , Restricción Física , Encuestas y CuestionariosRESUMEN
AIMS: To develop and psychometrically test a Theory of Planned Behaviour (TPB) questionnaire to assess nurses' intention to use physical restraints (PRs) in intubated patients. DESIGN: A psychometric instrument validation study conducted in three phases. METHODS: A theory-driven questionnaire was developed. Eight experts validated the content of the preliminary 58-item questionnaire. A pilot study was conducted including 101 critical care nurses to test the reliability of the items. Construct validity and reliability were tested in a cross-sectional study of 12 units from eight hospitals in Spain (N = 354) from October - December 2017. Participants completed the questions based on the TPB, and socio-demographic and professional variables. RESULTS: The instrument comprised 48 items. All the direct and indirect constructs exhibited acceptable reliability. Confirmatory factor analysis indicated satisfactory fit indices for factorial structure according to the TPB. Nurses showed favourable attitudes, low perception of social pressure and modest perception of behaviour control. Perceived behavioural control and attitude were moderately positively correlated with the intention to use restraints, whereas subjective norm revealed the lowest correlation. Overall, the model explained 33% of the variance in intention. CONCLUSIONS: The Physical Restraint TPB questionnaire is a 48-item self-reporting theoretically based instrument with acceptable reliability and construct validity to identify nurses' intentions to use PRs in intubated patients. IMPACT: Unravelling the key determinants of nurses' intentions to use PRs should be examined to tailor quality improvement projects aimed at de-implementing restraints use in practice and to promote safer care.
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Actitud del Personal de Salud , Enfermería de Cuidados Críticos/normas , Personal de Enfermería en Hospital/psicología , Restricción Física/psicología , Restricción Física/normas , Adulto , Enfermería de Cuidados Críticos/estadística & datos numéricos , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Personal de Enfermería en Hospital/estadística & datos numéricos , Proyectos Piloto , Desarrollo de Programa , Psicometría , Reproducibilidad de los Resultados , Restricción Física/estadística & datos numéricos , España , Encuestas y CuestionariosRESUMEN
BACKGROUND: It has been hypothesized that the deterioration in the ability to name famous people in normal aging and cognitive impairment is a continuum in which meaning-based representations and form-based representations are differentially impaired, with early impairments in lexical access but not in semantic access. AIMS: This hypothesis is tested in a follow-up study comparing the performance of fifty-six participants with amnestic mild cognitive impairment and forty-one control participants were assessed. METHOD: A lexical task was conducted involving recognition and naming of famous people from photographs. Proportional semantic and phonological access measures were calculated. RESULTS: Comparisons revealed significant differences between baseline and follow-up, with improvements in semantic access in the control group and decrements in phonological access in the group with amnestic mild cognitive impairment. Phonological access and reaction time measures were significantly and positively correlated, and semantic access and reaction time were significantly and negatively correlated. CONCLUSIONS: These results add evidence to the hypothesis that the decrease of processing resources is related to the increase of difficulties in lexical access throughout aging. Patterns of change must be replicated over longer periods of time.
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Disfunción Cognitiva/psicología , Semántica , Anciano , Anciano de 80 o más Años , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Fonética , Tiempo de Reacción , Aprendizaje VerbalRESUMEN
BACKGROUND: Mild cognitive impairment (MCI) is a complex entity, which can involve persistence of the symptoms, conversion to dementia or improvement. The aim was to study the transitions between normal cognitive ageing and three MCI subtypes by using Markov transition models for different intervals between baseline and the follow-up assessment. METHODS: A total of 294 participants over 50 years old attending primary care centres were assessed and diagnosed at baseline as multi-domain amnestic MCI (22 participants), single domain amnestic MCI (44), non-amnestic MCI (non-amnestic MCI) (26) or controls (202). We adopted an overlapping interval strategy by constructing six different mid-point time intervals according to the time between the baseline and the follow-up assessment. We used Markov transition models to study diagnostic changes in the groups in the different time intervals RESULTS: The rate of change was lowest in the control group. In the single domain amnestic MCI and non-amnestic MCI groups, the same diagnosis was usually retained or changed to normal cognitive functioning. In the multi-domain amnestic MCI group, the rate of transition to normal functioning was lowest, and the conversion to dementia was the highest of all groups. The best fit to the Markov models was found for the period between 18-21 months, whereas the worst fit was for the period between 9-15 months CONCLUSIONS: Markov models provide a comprehensive view of transitions between MCI and normal cognitive functioning. Time interval strategies seem to provide a good opportunity to monitor diagnostic transitions, although wider intervals including subsequent assessments are needed. The low rates of conversion to dementia are discussed.
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Disfunción Cognitiva/diagnóstico , Cadenas de Markov , Anciano , Anciano de 80 o más Años , Amnesia/diagnóstico , Amnesia/psicología , Estudios de Casos y Controles , Trastornos del Conocimiento/diagnóstico , Trastornos del Conocimiento/psicología , Disfunción Cognitiva/psicología , Demencia/diagnóstico , Demencia/psicología , Progresión de la Enfermedad , Femenino , Humanos , Masculino , Trastornos de la Memoria/psicología , Persona de Mediana Edad , Modelos Psicológicos , Pruebas Neuropsicológicas , Escalas de Valoración Psiquiátrica , Psicometría , Factores de RiesgoRESUMEN
BACKGROUND: Ethical conflicts in nursing have generally been studied in terms of temporal frequency and the degree of conflict. This study presents a new perspective for examining ethical conflict in terms of the degree of exposure to conflict and its typology. OBJECTIVES: The aim was to examine the level of exposure to ethical conflict for professional nurses in critical care units and to analyze the relation between this level and the types of ethical conflict and moral states. RESEARCH DESIGN: This was a descriptive correlational study. Central and dispersion, normality tests, and analysis of variance were carried out. PARTICIPANTS AND RESEARCH CONTEXT: A total of 203 nurses were from two third-level teaching hospitals in Spain. Both centers are part of the University of Barcelona Health Network. Participants filled out the Ethical Conflict in Nursing Questionnaire-Critical Care Version. ETHICAL CONSIDERATIONS: This investigation received the approval of the ethical committees for clinical investigation of the two participating hospitals. Participants were informed of the authorship and aims of the study. FINDINGS: The index of exposure to ethical conflict was [Formula: see text]. The situations involving analgesic treatment and end-of-life care were shown to be frequent sources of conflict. The types of ethical conflict and moral states generally arranged themselves from lesser to greater levels of index of exposure to ethical conflict. DISCUSSION: The moderate level of exposure to ethical conflict was consistent with other international studies. However, the situations related with family are infrequent, and this presents differences with previous research. The results suggest that there is a logical relationship between types of conflict and levels of exposure to ethical conflict. CONCLUSION: The types of ethical conflict and moral states were related with the levels of exposure to ethical conflict. The new perspective was shown to be useful for analyzing the phenomenon of ethical conflict in the nurse.
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Conflicto Psicológico , Enfermería de Cuidados Críticos/ética , Ética en Enfermería , Personal de Enfermería en Hospital/psicología , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Modelos Psicológicos , Principios Morales , Personal de Enfermería en Hospital/estadística & datos numéricos , España , Estrés Psicológico , Encuestas y Cuestionarios , Adulto JovenRESUMEN
PURPOSE: The purpose of this study was to analyze the factor structure of the abbreviated Spanish version of the World Health Organization Quality of Life (WHOQOL-BREF; WHOQOL Group in Psychol Med 28(3): 551-558, 1998b) questionnaire in a sample of individuals from several Spanish-speaking countries. METHOD: The data were based on a sample of 1,972 undergraduates from nine Spanish-speaking countries. Within the framework of a somewhat wider research protocol, they were administered the WHOQOL-BREF. RESULTS: The data were initially analyzed using a confirmatory factor analysis, which yielded a poor fit to the four-factor theoretical model. Based on these results, the best solution was estimated assuming structural invariance across countries. The data showed a four-factor structure that differed slightly from the model proposed. This four-factor model was subsequently analyzed using exploratory structural equation modeling (ESEM; Asparouhov and Muthén in Struct Equ Model 16(3): 397-438, 2009) to obtain the invariant structure across countries and an estimation of the relation between the four latent factors. The results obtained allowed us to establish that the factor structure of WHOQOL-BREF maintains the four-factor solution hypothesized for a Spanish-speaking population, although the solution has a different and more complex configuration than the original one with a clear tendency toward non-orthogonality of the latent factors. CONCLUSIONS: As has been suggested by some studies on the application of ESEM, it is reasonable to think that the ESEM approximation is a useful approach for conducting the factor analysis of instruments measuring complex psychological phenomena.
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Psicometría/métodos , Psicometría/normas , Calidad de Vida/psicología , Encuestas y Cuestionarios , Adolescente , Adulto , América Central , Análisis Factorial , Femenino , Humanos , Lenguaje , Masculino , Modelos Teóricos , América del Sur , España , Organización Mundial de la Salud , Adulto JovenRESUMEN
This systematic review considered evidence of children's and adolescents' typical brain connectivity development studied through resting-state functional magnetic resonance imaging (rs-fMRI). With aim of understanding the state of the art, what has been researched thus far and what remains unknown, this paper reviews 58 studies from 2013 to 2023. Considering the results, rs-fMRI stands out as an appropriate technique for studying language and attention within cognitive domains, and personality traits such as impulsivity and empathy. The most used analyses encompass seed-based, independent component analysis (ICA), the amplitude of the low frequency fluctuations (ALFF), and fractional ALFF (fALFF). The findings highlight key themes, including age-related changes in intrinsic connectivity, sex-specific patterns, and the relevance of the Default Mode Network (DMN). Overall, there is a need for longitudinal approaches to trace the typical developmental trajectory of neural networks from childhood through adolescence with fMRI at rest.
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BACKGROUND: Ethical conflicts are arising as a result of the growing complexity of clinical care, coupled with technological advances. Most studies that have developed instruments for measuring ethical conflict base their measures on the variables 'frequency' and 'degree of conflict'. In our view, however, these variables are insufficient for explaining the root of ethical conflicts. Consequently, the present study formulates a conceptual model that also includes the variable 'exposure to conflict', as well as considering six 'types of ethical conflict'. An instrument was then designed to measure the ethical conflicts experienced by nurses who work with critical care patients. The paper describes the development process and validation of this instrument, the Ethical Conflict in Nursing Questionnaire Critical Care Version (ECNQ-CCV). METHODS: The sample comprised 205 nursing professionals from the critical care units of two hospitals in Barcelona (Spain). The ECNQ-CCV presents 19 nursing scenarios with the potential to produce ethical conflict in the critical care setting. Exposure to ethical conflict was assessed by means of the Index of Exposure to Ethical Conflict (IEEC), a specific index developed to provide a reference value for each respondent by combining the intensity and frequency of occurrence of each scenario featured in the ECNQ-CCV. Following content validity, construct validity was assessed by means of Exploratory Factor Analysis (EFA), while Cronbach's alpha was used to evaluate the instrument's reliability. All analyses were performed using the statistical software PASW v19. RESULTS: Cronbach's alpha for the ECNQ-CCV as a whole was 0.882, which is higher than the values reported for certain other related instruments. The EFA suggested a unidimensional structure, with one component accounting for 33.41% of the explained variance. CONCLUSIONS: The ECNQ-CCV is shown to a valid and reliable instrument for use in critical care units. Its structure is such that the four variables on which our model of ethical conflict is based may be studied separately or in combination. The critical care nurses in this sample present moderate levels of exposure to ethical conflict. This study represents the first evaluation of the ECNQ-CCV.
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Conflicto Psicológico , Cuidados Críticos/ética , Ética en Enfermería , Principios Morales , Encuestas y Cuestionarios/normas , Adulto , Códigos de Ética , Análisis Factorial , Femenino , Humanos , Masculino , Persona de Mediana Edad , Psicometría , Reproducibilidad de los Resultados , España , Recursos HumanosRESUMEN
BACKGROUND: Museums and cultural institutions are increasingly aware of both the interests and needs of society. Accordingly, these institutions are becoming allies in terms of health and well-being due to the importance of their social functions. Presently, many institutions create cultural activities aimed at cognitively impaired people, a group on the rise owing to the prevalence of dementia and the aging of society. Nevertheless, scientific evidence in this field remains scarce. As a result, the main objective of this research was to empirically evaluate and identify the benefits that cultural interventions can bring to cognitively impaired participants. METHOD: A meta-analysis (MA) was performed following PRISMA guidelines. When inclusion and eligibility criteria had been established, articles were subsequently selected through a strategic search of Web of Science, SCOPUS, PubMed, and Medline. RESULTS: Twenty-six studies met the eligibility criteria, involving a total of 1201 participants with cognitive impairment. The results showed a statistically non-significant effect size when analyzing these cultural interventions for cognitively impaired people overall. However, when conducting partial meta-analyses (MA'), focusing on studies related to a specific disease, a particular type of treatment, or a specific type of evaluation, the results concurred with the conclusion of the previous systematic review (SR). CONCLUSION: Despite the high heterogeneity of the studies, benefits were identified in emotional well-being and social aspects but not in clinical ones such as the deterioration of cognitive or motor function, among others.
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In recent years several meta-analyses regarding resting-state functional connectivity in patients with schizophrenia have been published. The authors have used different data analysis techniques: regional homogeneity, seed-based data analysis, independent component analysis, and amplitude of low frequencies. Hence, we aim to perform a meta-analysis to identify connectivity networks with different activation patterns between people diagnosed with schizophrenia and healthy controls using voxel-wise analysis. METHOD: We collected primary studies exploring whole brain connectivity by functional magnetic resonance imaging at rest in patients with schizophrenia compared with healthy controls. We identified 25 studies included high-quality studies that included 1285 patients with schizophrenia and 1279 healthy controls. RESULTS: The results indicate hypoactivation in the right precentral gyrus and the left superior temporal gyrus of patients with schizophrenia compared with healthy controls. CONCLUSIONS: These regions have been linked with some clinical symptoms usually present in Plea with schizophrenia, such as auditory verbal hallucinations, formal thought disorder, and the comprehension and production of gestures.
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Background/Objective: Neuroimaging studies have shown brain abnormalities in Down syndrome (DS) but have not clarified the underlying mechanisms of dysfunction. Here, we investigated the degree centrality (DC) abnormalities found in the DS group compared with the control group, and we conducted seed-based functional connectivity (FC) with the significant clusters found in DC. Moreover, we used the significant clusters of DC and the seed-based FC to elucidate differences between brain networks in DS compared with controls. Method: The sample comprised 18 persons with DS (M = 28.67, SD = 4.18) and 18 controls (M = 28.56, SD = 4.26). Both samples underwent resting-state functional magnetic resonance imaging. Results: DC analysis showed increased DC in the DS in temporal and right frontal lobe, as well as in the left caudate and rectus and decreased DC in the DS in regions of the left frontal lobe. Regarding seed-based FC, DS showed increased and decreased FC. Significant differences were also found between networks using Yeo parcellations, showing both hyperconnectivity and hypoconnectivity between and within networks. Conclusions: DC, seed-based FC and brain networks seem altered in DS, finding hypo- and hyperconnectivity depending on the areas. Network analysis revealed between- and within-network differences, and these abnormalities shown in DS could be related to the characteristics of the population.
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OBJECTIVE: The aim of our work is to study the possible role of clinical variables, neuropsychological performance, and the 5HTTLPR, rs25531, and val108/58Met COMT polymorphisms on the prediction of depression remission after 12 weeks' treatment with fluoxetine. These variables have been studied as potential predictors of depression remission, but they present poor prognostic sensitivity and specificity by themselves. METHODS: Seventy-two depressed patients were genotyped according to the aforementioned polymorphisms and were clinically and neuropsychologically assessed before a 12-week fluxetine treatment. RESULTS: Only the La allele of rs25531 polymorphism and the GG and AA forms of the val 108/158 Met polymorphism predict major depressive disorder remission after 12 weeks' treatment with fluoxetine. None of the clinical and neuropsychological variables studied predicted remission. CONCLUSIONS: Our results suggest that clinical and neuropsychological variables can initially predict early response to fluoxetine and mask the predictive role of genetic variables; but in remission, where clinical and neuropsychological symptoms associated with depression tend to disappear thanks to the treatment administered, the polymorphisms studied are the only variables in our model capable of predicting remission. However, placebo effects that are difficult to control require cautious interpretation of the results.
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Antidepresivos/uso terapéutico , Catecol O-Metiltransferasa/genética , Trastorno Depresivo Mayor/tratamiento farmacológico , Trastorno Depresivo Mayor/genética , Fluoxetina/uso terapéutico , Polimorfismo Genético , Inhibidores Selectivos de la Recaptación de Serotonina/uso terapéutico , Proteínas de Transporte de Serotonina en la Membrana Plasmática/genética , Adulto , Catecol O-Metiltransferasa/metabolismo , Trastorno Depresivo Mayor/diagnóstico , Trastorno Depresivo Mayor/fisiopatología , Manual Diagnóstico y Estadístico de los Trastornos Mentales , Resistencia a Medicamentos , Femenino , Estudios de Asociación Genética , Humanos , Masculino , México , Persona de Mediana Edad , Pruebas Neuropsicológicas , Polimorfismo de Nucleótido Simple , Pronóstico , Inducción de Remisión , Proteínas de Transporte de Serotonina en la Membrana Plasmática/metabolismoRESUMEN
Abusive supervision impacts employees' emotions negatively and creates feelings of shame and fear. But it remains unclear how daily employees' positive and negative emotions are affected and if they can recover. Applying the affective event theory and job demands-resources model we hypothesized that daily abusive supervision influences employees' positive and negative emotions fluctuation over the day, recovery after work, and employee emotions the next morning. Two daily surveys were answered by 52 Mexican employees for ten days providing 347 registers in the morning and 255 in the afternoon. Hierarchical linear modeling shows alteration of positive and negative emotions in the afternoon and next day, and a positive effect over recovery in relaxation, mastery and control restoring positive emotions. However, negative emotions cannot be recovered for the following day. Additionally, we found effects of predictive variables, as the days of the week go by, positive emotions in the afternoon and negative emotions in the morning decrease. Gender shows for men a more negative effect on positive emotions in the afternoon, next morning and on mastery-recovery. Marital status revealed effect over married individuals incrementing the four recovery dimensions, increasing positive emotions, and reducing negative emotions in the afternoon and next morning. Tenure has an effect over abusive supervision, the longer employees in the company, more likely they suffer abusive supervision. We show how employees restore positive emotions after daily recovery and that negative emotions cannot be recovered for the following day; revealing how abusive managers cause emotional damage to employees every day.