The association between low cognitive reserve and subjective memory complaints in functionally independent older women.

BACKGROUND: Several factors have been found to defend against pathologic cognitive decline in aging (i.e., cognitive reserve [CR]); however, other factors, including subjective memory complaints (SMC) and decreased functionality are considered early indicators of underlying neurocognitive dysfunction. Despite these known associations, the relationship between the presence of CR and SMC remains equivocal. This study sought to determine the relationship between objectively measured CR and SMC in a sample of functionally independent older women. METHODS: This cross-sectional study recruited women aged ≥60 years who attended fitness or continuing education programs at the University for Seniors in Mexico City. Participants underwent a battery of physical and cognitive evaluations, including the Cognitive Reserve Questionnaire (CRQ), and were asked probing questions used to identify the presence of SMC. RESULTS: The 269 participants had a median age of 69 years; most were single (40.5 %), lived alone (32.7 %), retired (58.2 %), well-educated (≥12 years of education), and functionally independent (89.2 %). 62 % scored "high" on the CRQ, while 9.3 % scored "low". After adjusting for multiple covariates, an independent association between CRQ score and the probability to have SMC was found (adjusted OR = 0.87, 95% CI 0.80-0.95, p-value = 0.002). CONCLUSIONS: This study identified a relationship between low CR and the presence of SMC, independently of the cognitive function and motoric marker of muscle strength (i.e., low gait speed and handgrip strength) in functionally independent older women over 60y. This relationship remains independent of other variables such as age, symptoms of depression and instrumented activities of daily living.

The Paradoxical Effect of Living Alone on Cognitive Reserve and Mild Cognitive Impairment among Women Aged 60+ in Mexico City.

An elderly person who lives alone must often be autonomous and self-sufficient in daily living activities. We explored if living alone and marital status were associated with mild cognitive impairment and low cognitive reserve in a sample of Mexican women aged 60+ attending continuing education courses using a cross-sectional design. Objective cognitive functions were assessed using the MMSE and Blessed Dementia Scale. We administered the Cognitive Reserve Questionnaire. Independence skills were assessed with the Katz index and Lawton index. Multivariate logistic regression analysis was used. We recruited 269 participants (x¯ = 69.0 ± 5.8 years). Single, widowed, separated, and divorced women comprised 73% of the participants. A third lived alone and 84% had completed high school. Mild cognitive deficit was observed among 24.5-29.0%; the upper range for cognitive reserve was 61.7%. Living alone versus living with someone was associated with cognitive impairment (OR = 0.51, p = 0.04) and with low to medium cognitive reserve (OR = 0.51, p = 0.02) after adjusting for confounding variables. Living alone was an independent factor associated with a lower probability of displaying mild cognitive impairment and a higher probability of displaying high cognitive reserve. Women living alone in this study had a more robust cognitive framework and had built their own support networks.

Bioética utilitarista y Covid 19 / Utilitarian bioethics and Covid 19

Ante la propuesta de reflexionar sobre Bioética Utilitarista y COVID 19, es importante antes que nada encuadrar este tema como "Pautas bioéticas ante una pandemia" tomando del principio de utilidad, una guía de acción para situaciones críticas en el campo de la salud. Sobre este tema se ha escrito mucho en los últimos meses, todos opinamos, pero nadie tiene nada claro y las decisiones se toman en el día a día, por cada país, cada institución, cada profesional y cada persona. En este contexto, se busca ayudar iluminando por medio de la reflexión bioética con el fin de hacer un aporte aparentemente sutil, pero necesario e importante: es hora que la bioética pase de la teoría a la realidad y salga a la calle, al consultorio, a las emergencias, a las carpas, a los sitios de triaje, a las terapias intensivas y también posicionarse en las decisiones políticas dándoles la luz que necesitan para ser más acertadas. Para ello se debe primero determinar qué es una catástrofe, tener en cuenta las acciones recomendadas por los organismos internacionales, las sociedades profesionales entre otras y finalmente proponer unas acciones encuadradas en el marco de unos principios y valores universales que nos ayuden en la mejor toma de decisiones

Given the proposal to reflect on Utilitarian Bioethics and COVID 19, it is important first of all to frame this topic as "Guidelines bioethics in the face of a pandemic "taking from the principle of utility, a action guide for critical situations in the health field. Much has been written on this topic in recent months, we all have our say, but nobody has anything clear and decisions are made on a daily basis, for every country, every institution, every professional and every person. In this context, it seeks to help by illuminating through the bioethical reflection in order to make an apparently subtle contribution, but necessary and important: it is time for bioethics to move from theory to reality and go out to the street, to the office, to emergencies, tents, triage sites, intensive therapies and also position themselves in political decisions by giving them the light they need to be more accurate. To do this, you must first determine what a catastrophe is, take into account take into account the actions recommended by international organizations, professional societies among others and finally propose some actions framed within the framework of principles and values universal to help us make better decisions

De los Comités de Ética Asistencial hacia una Bioética Institucional / From the Commithees on Assitance Ethics to Institutional Bioethics

Throughout these 40 years, the Hospital or healthcare Ethics Committees, either at the initiative of the professionals themselves or the health units and in the latter decade also on the recommendation of health authorities both at international and national level, this is how the Organization of the United Nations for Education, Science and Culture (UNESCO) in the Universal Declaration on Bioethics and Human Rights of October 2005 (1) in its article 19 regarding committees: "Committees should be created, promoted and supported, at the appropriate level of independent, multidisciplinary and pluralistic ethics with a view to: a) evaluate ethical, legal, scientific and social problems relevant issues raised by research projects relating to Humans; b) provide advice on ethical problems in clinical contexts; c) evaluate the advances of science and technology, formulate recommendations and contribute to the preparation of guidance on the issues that fall within the scope of this Declaration; " (one) This consensus document does not specify whether the committees are of type assistance, research, local, national or international; however, it makes the characteristics of these and their functions. Considering: the premises of Gamboa GA. et al. (2) as well as the UNESCO recommendations (1), we can say that: "The Committees Bioethics are, in summary, those interdisciplinary instances of the institutions where they can well serve as a reflexive conscience for the personal and collective improvement of all who are part of that institution or benefit from its services

ACCIONES COLECTIVAS Y RECURSOS NATURALES EN CONFLICTO: HISTORIA AMBIENTAL DE LUCHAS URBANAS POR AGUA Y SIERRAS EN TANDIL, ARGENTINA / COLLECTIVE ACTIONS AND NATURAL RESOURCES IN CONFLICT: ENVIRONMENTAL HISTORY OF URBAN STRUGGLES FOR WATER AND HILLS IN TANDIL, ARGENTINA

En el municipio de Tandil, diferentes expresiones socioambientales han tenido lugar a nivel local en las últimas décadas. Algunas de estas acciones responden a los efectos ambientales de ciertas actividades -la minería, la instalación de actividades contaminantes, la lucha urbana por el acceso a la tierra, al agua y a mejores condiciones ambientales, la problemática de los residuos sólidos urbanos e industriales y otros reclamos de justicia ambiental-. El presente trabajo discute desde una perspectiva teórica y mediante el análisis empírico de ciertos casos, las principales consideraciones epistemológicas asociadas a conceptos centrales que permiten entender y explicar el accionar social frente a la lucha ambiental. Por ello, interesa identificar ciertas problemáticas, describiendo los conflictos y las acciones colectivas de las luchas urbanas que reclaman mejoras en las condiciones ambientales a nivel local. El objetivo del presente trabajo es situar determinadas acciones colectivas en espacio y tiempo. Para ello se analizan cuatro casos de luchas urbanas suscitados por dos recursos naturales en pugna: el paisaje serrano y el recurso hídrico subterráneo. La selección del estudio de caso como método de investigación responde al carácter exploratorio del tema abordado. La inferencia lógica inductiva favorece la identificación de las categorías de análisis más propicias para su abordaje y pone en evidencia formas de organización, estrategias colectivas, y respuestas frente a los reclamos. Se emplean como técnicas de producción de conocimiento: la comparación, la observación documental -periódicos locales, sitios Web, archivos públicos y privados- y entrevistas a informantes calificados. En todos los casos bajo análisis las luchas se enmarcan en un contexto de crisis del Estado como proveedor de espacios de participación que favorecen la legitimación de nuevos espacios para el reclamo socioambiental. En particular cada caso presenta singularidades y generalidades que son posibles identificar y describir.

Different social-environmental expressions have occurred at the local level in the last decades in the Municipality of Tandil. Some of these actions respond to environmental effects of some activities -mining, contaminating activities installation, the urban struggles for access to land, water or better environmental conditions, the problems of urban and industrial solid waste and other environmental justice claims. This work discusses, from a theoretical approach and through the empirical analysis of certain cases, the main epistemological considerations associated to central concepts which allow to understand and explain social actions against the environmental struggle. Therefore, it is interesting to identify certain problems describing the conflicts and collective actions of urban struggles claiming improvement in the local environmental conditions. The main goal of this work is to establish some collective actions in space and time. In order to do this, four case studies of urban struggle caused by two natural resources competing, the mountain landscape and undergraound water resources, are analyzed. iCase study selection as research method responds to the exploratory nature of the topic addressed. Inductive logic inference favors the identification of the most appropriate category analysis for its approach and leave proof of organization forms, collective strategies and answers against the claims presented. Comparison, documental observation -local newspapers, websites, private and public files- and interviews to qualified informants were used as knowledge production techniques. In all the cases under study, struggles are framed by State crisis context as the provider of participation spaces that favor the legitimation of new spaces for the social-environmental claim. Particularly each case presents particularities and generalities that are possible to identify and describe.