"Guttmann Cognitest®," a digital solution for assessing cognitive performance in adult population: A feasibility and usability pilot study.

Background: As the world population continues to age, the prevalence of neurological diseases, such as dementia, poses a significant challenge to society. Detecting cognitive impairment at an early stage is vital in preserving and enhancing cognitive function. Digital tools, particularly mHealth, offer a practical solution for large-scale population screening and prompt follow-up assessments of cognitive function, thus overcoming economic and time limitations. Objective: In this work, two versions of a digital solution called Guttmann Cognitest® were tested. Methods: Two hundred and one middle-aged adults used the first version (Group A), while 132 used the second one, which included improved tutorials and practice screens (Group B). This second version was also validated in an older age group (Group C). Results: This digital solution was found to be highly satisfactory in terms of usability and feasibility, with good acceptability among all three groups. Specifically for Group B, the system usability scale score obtained classifies the solution as the best imaginable in terms of usability. Conclusions: Guttmann Cognitest® has been shown to be effective and well-perceived, with a high potential for sustained engagement in tracking changes in cognitive function.

Investigating the application of "Guttmann Cognitest"® in older adults and people with acquired brain injury.

Introduction: Digital solutions for cognitive assessment are currently not only widely used in experimental contexts but can also be useful in clinical practice for efficient screening and longitudinal follow-up. The "Guttmann Cognitest"®, which includes seven computerized tasks designed to assess main cognitive functions, revealed in a previous validation study to be a potential useful tool to assess cognitive functioning in healthy middle-aged adults. Method: Here, we present results from a validation in two different populations: one consisting of older adults, and the other comprising young and middle-aged individuals, some of them affected by acquired brain injury. To perform a convergent validity test, older adults were also administered with the MOCA, while young and middle-aged individuals were administered with a short neuropsychological assessment including gold-standard neuropsychological tests. We also conducted sensitivity and specificity analysis to establish the utility of this instrument in identifying potential cognitive dysfunctions in the two groups. Results: Results demonstrated strong convergent validity as well as good specificity and sensitivity characteristics. Discussion: This tool is a valid and useful instrument to assess cognitive functioning and detecting potential cases of cognitive dysfunctions in older adults and clinical populations.

Reply to Inzitari et al. Comment on "Blancafort Alias et al. A Multi-Domain Group-Based Intervention to Promote Physical Activity, Healthy Nutrition, and Psychological Wellbeing in Older People with Losses in Intrinsic Capacity: AMICOPE Development Study. Int. J. Environ. Res. Public Health 2021, 18, 5979".

This is a reply to the comment by Inzitari et al [...].

Percepción de los residentes sobre el impacto de la pandemia COVID 19 en la formación en profesionalismo / Residents ́perspective of the impact of the COVID 19 pandemic on professional competency training

Introducción: el profesionalismo es clave para construir la identidad de los profesionales sanitarios. El objetivo de este trabajo ha sido conocer en un colectivo de residentes, la influencia de la primera ola de la pandemia por SARS-CoV2 en sus competencias del profesionalismo. Materiales y métodos: estudio descriptivo transversal mediante cuestionario electrónico, remitido a 167 residentes, para medir su percepción sobre el impacto de la pandemia COVID-19 en el profesionalismo, con una escala verbal de cuatro niveles: excelente, por encima de lo esperado, lo esperado, por debajo de lo esperado. Se realizó, además, una pregunta abierta de "reflexión personal" analizada cualitativamente mediante un proceso de triangulación. La encuesta se hizo en el Hospital Universitario Fundación Alcorcón en los dos meses siguientes a la primera ola pandémica. Resultados: respondieron 59 residentes (35,3%) de 21 especialidades. Sus lugares de trabajo fueron muy variados. Los atributos del profesionalismo valorados por encima de esperado o excelente fueron: trabajo en equipo (74,6%), empatía (71,2%) y responder a las necesidades del paciente por encima de las propias (69,5%). Se encontró por debajo de lo esperado la gestión de las emociones (22%). Discusión: la pandemia COVID-19 ha contribuido a reforzar la identidad profesional de los residentes, manifestándose a través de muchas dimensiones del profesionalismo. La gestión de las emociones fue la que obtuvo menor valoración.

Introduction: Professionalism is essential to build the identity of health professionals. The aim in this study was to determine, in a group of residents, the influence of the first wave of SARS-CoV2 pandemic on their professionalism competencies. Methods: Cross-sectional descriptive study with an electronic survey sent to 167 residents of Hospital Universitario Fundación Alcorcón to assess their perception of the impact of COVID-19 pandemic on professionalism, with a four-level verbal scale: excellent, above expected, expected, below expected. In addition, an open-ended "personal reflection" question was qualitatively analyzed through a triangulation process. The survey was completed immediately after the first pandemic wave. Results: The questionnaire was answered by 59 residents (35.3%) of 21 specialties from different workplaces. The attributes of professionalism rated above expected or excellent were: teamwork (74.6%), empathy (71.2%) and responding to patient's needs above their own (69.5%). Management of emotions (21%) was found to be below expectations. Discussion: COVID-19 pandemic has contributed to reinforce the professional identity of the residents, expressing itself through many dimensions of professionalism. Emotional management was the lowest rated.

A Multi-Domain Group-Based Intervention to Promote Physical Activity, Healthy Nutrition, and Psychological Wellbeing in Older People with Losses in Intrinsic Capacity: AMICOPE Development Study.

The World Health Organization has developed the Integrated Care of Older People (ICOPE) strategy, a program based on the measurement of intrinsic capacity (IC) as "the composite of all physical and mental attributes on which an individual can draw". Multicomponent interventions appear to be the most effective approach to enhance IC and to prevent frailty and disability since adapted physical activity is the preventive intervention that has shown the most evidence in the treatment of frailty and risk of falls. Our paper describes the development of a multi-domain group-based intervention addressed to older people living in the community, aimed at improving and/or maintaining intrinsic capacity by means of promoting physical activity, healthy nutrition, and psychological wellbeing in older people. The process of intervention development is described following the Guidance for reporting intervention development studies in health research (GUIDED). The result of this study is the AMICOPE intervention (Aptitude Multi-domain group-based intervention to improve and/or maintain IC in Older PEople) built upon the ICOPE framework and described following the Template for Intervention Description and Replication (TIDieR) guidelines. The intervention consists of 12 face-to-face sessions held weekly for 2.5 h over three months and facilitated by a pair of health and social care professionals. This study represents the first stage of the UK Medical Research Council framework for developing and evaluating a complex intervention. The next step should be carrying out a feasibility study for the AMICOPE intervention and, at a later stage, assessing the effectiveness in a randomized controlled trial.

COVID-19 mortality risk factors in older people in a long-term care center.

PURPOSE: Despite high rates of COVID-19 infection and increased related mortality have been reported among older adults admitted in long-term care facilities, a limited amount of information is available about the natural course of this pandemic and prognostic factors in such population. In the current study, we aimed to investigate the epidemiologic, demographics, clinical, or therapeutic factors that may predict the prognosis in a cohort of COVID-19 infected institutionalized older in a nursing home. METHODS: We conducted a retrospective analysis of all COVID-19 confirmed institutionalized older in a nursing home from March 15 to June 5, 2020. Epidemiological, demographic, and frailty status before infection, and clinical, laboratory, treatment, and outcome data during infection were collected. We used bivariate analysis and multivariate logistic regression to identify risk factors for mortality. RESULTS: The analysis comprised all 100 COVID-19 confirmed cases during the study period. The median age was 85 years; 62% were female. The case fatality rate was 20%. In the bivariate analysis, male gender, fever, respiratory symptoms, severe cognitive decline, a low Barthel index, and lymphocytopenia were significantly associated with mortality. Patients treated with hydroxychloroquine plus azithromycin were related to a higher chance of survival than those without pharmacological treatment. Multivariate logistic regression analysis identified male gender, low Barthel index, no pharmacological treatment, and lymphocytopenia as independent risk factors associated with mortality. CONCLUSIONS: Male gender, low Barthel index, and lymphocytopenia are independent risk factors for COVID-19 mortality in institutionalized older patients in long-term care nursing homes. Treatment with hydroxychloroquine and azithromycin was associated with lower mortality in these patients.

Encefalitis asociada a anticuerpos contra el receptor de NMDA / Encephalitis associated with anti-NMDA antibodies

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Single-incision versus standard laparoscopic cholecystectomy: comparison of surgical outcomes from a single institution.

BACKGROUND: Laparoscopic cholecystectomy via the three-trocar technique is widely used for symptomatic gallbladder stones. Single-incision laparoscopic surgery (SILS) for cholecystectomy is a well-established procedure and represents the next step in developing the concept of mini-invasive surgery. We here described our 24-month experience SILS cholecystectomy. METHODS: Between February 2009 and 2011, patients referred for cholecystectomy to the General and Endocrine Unit of our institution who agreed to undergo SILS were included in a prospective study. All operations were performed by the same surgical team specially trained in this type of surgery. The umbilicus was the sole point of entry for all patients. The same operative technique was used in all patients. Data of patients undergoing SILS cholecystectomy were compared with those from an uncontrolled group of patients undergoing standard laparoscopic cholecystectomy during the same study period. RESULTS: The SILS and standard cholecystectomy groups included 120 patients each. SILS was performed in all patients and none of them required conversion to an open procedure. The median operating time of 45 minutes in the SILS group was not significantly different from that in the standard laparoscopic cholecystectomy group. We suture fascial edge with simple stitches under direct vision, thus reducing the risk of incisional hernia in SILS group (P=.046). CONCLUSIONS: SILS cholecystectomy was technically feasible and safe and represents a reproducible alternative to standard laparoscopic cholecystectomy in selected patients. The definitive clinical, esthetic, and functional advantages of this technique require further analysis.