Desarrollo y validación de un instrumento observacional para la evaluación del bienestar en personas con demencia desde la perspectiva de la atención centrada en la persona: Listado de Indicadores de Bienestar / Development and validation of an observational tool for the assessment of well-being in people with dementia from the perspective of Person Centred Care: list of Well-being Indicators of Wellbeing

INTRODUCCIÓN: En el contexto del modelo de atención centrada en la persona, se expone la creación y validación de un instrumento observacional para la evaluación del bienestar en personas con demencia, desde una perspectiva que pretende destacar los efectos que el entorno físico y social tienen en la persona, y cómo se reflejan en su bienestar. MATERIAL Y MÉTODO: El Listado de Indicadores de Bienestar (LIBE) se creó siguiendo un proceso inductivo iterativo con profesionales de distintas disciplinas, hasta llegar a la versión validada. Se validó en dos estudios sucesivos con una muestra de 79 personas con demencia. Se realizaron análisis de capacidad de discriminación de los indicadores que componen la escala, consistencia interna, fiabilidad interjueces, y validez convergente y discriminante. RESULTADOS: Se obtuvo una consistencia interna α de Cronbach de 0,81. Respecto a la fiabilidad interjueces, el CCI hallado entre los 3 evaluadores fue significativo para todos los indicadores con puntuaciones entre 0,59 y 1,00. Se estudió la validez convergente comparando las puntuaciones en cada indicador de LIBE con las puntuaciones en cada ítem de QUALID, y se encontraron asociaciones significativas entre la categoría de respuesta en ciertos ítems de QUALID y la categoría de respuesta en ciertos indicadores de LIBE. Para la validez discriminante se compararon las puntuaciones obtenidas en cada indicador de LIBE con las puntuaciones en cada ítem de PAINAD-Sp, y no se encontró ninguna asociación significativa. CONCLUSIÓN: LIBE ofrece una medida observacional de conductas consideradas indicadores de bienestar en personas con demencia que viven en centros residenciales. Es un instrumento válido y fiable, que ofrece una perspectiva diferente de medida de un constructo poco explorado en las poblaciones con demencia. Es un instrumento fácil de aplicar, con distintos usos (clínicos, de intervención, de investigación), y aplicable por profesionales de distintas disciplinas

INTRODUCTION: Within the context of Person Centred Care, the present paper shows the creation and validation process of an observational tool for the assessment of the wellbeing of people with dementia, from a perspective that seeks to highlight the effects that the physical and social environment have on the person, and how these are reflected in the well-being. METHODS: The List of Wellbeing Indicators (LIBE) was created following an inductive iterative process with professionals from different disciplines, until the validated version was reached. It was then validated in two successive studies with a sample of 79 people with dementia. Discrimination capacity of the scale indicators, internal consistency, inter-rater reliability, and convergent and divergent validity were determined. RESULTS: An internal consistency of Cronbach́s alpha 0.81 was obtained. The inter-rater reliability, analysing intraclass correlation coefficient (ICC) within the 3 raters, was significant for all the indicators in the tool, with scores between 0.59-1.00. Convergent validity was studied comparing scores in each LIBE indicator with scores in each QUALID indicator, and some significant associations were found between response categories in both tools. For the discriminant validity, the scores obtained in each LIBE indicator were compared with the scores in each PAINAD-Sp item, and no significant associations were found. CONCLUSION: LIBE offers an observational measure of behaviours that can be considered well-being indicators in people with dementia living in residential care. LIBE is a valid and reliable tool that offers a different perspective of measuring a construct that has been infrequently explored in dementia population. Is also an easy to apply tool, with different uses (clinical, intervention, research), and applicable for professionals of several disciplines

[Development and validation of an observational tool for the assessment of well-being in people with dementia from the perspective of Person Centred Care: List of Well-being Indicators of Wellbeing]. / Desarrollo y validación de un instrumento observacional para la evaluación del bienestar en personas con demencia desde la perspectiva de la atención centrada en la persona: Listado de Indicadores de Bienestar.

INTRODUCTION: Within the context of Person Centred Care, the present paper shows the creation and validation process of an observational tool for the assessment of the wellbeing of people with dementia, from a perspective that seeks to highlight the effects that the physical and social environment have on the person, and how these are reflected in the well-being. METHODS: The List of Wellbeing Indicators (LIBE) was created following an inductive iterative process with professionals from different disciplines, until the validated version was reached. It was then validated in two successive studies with a sample of 79 people with dementia. Discrimination capacity of the scale indicators, internal consistency, inter-rater reliability, and convergent and divergent validity were determined. RESULTS: An internal consistency of Cronbach́s alpha 0.81 was obtained. The inter-rater reliability, analysing intraclass correlation coefficient (ICC) within the 3 raters, was significant for all the indicators in the tool, with scores between 0.59-1.00. Convergent validity was studied comparing scores in each LIBE indicator with scores in each QUALID indicator, and some significant associations were found between response categories in both tools. For the discriminant validity, the scores obtained in each LIBE indicator were compared with the scores in each PAINAD-Sp item, and no significant associations were found. CONCLUSION: LIBE offers an observational measure of behaviours that can be considered well-being indicators in people with dementia living in residential care. LIBE is a valid and reliable tool that offers a different perspective of measuring a construct that has been infrequently explored in dementia population. Is also an easy to apply tool, with different uses (clinical, intervention, research), and applicable for professionals of several disciplines.

Efectos de la visualización de contenidos personalizados a través de la realidad virtual, en el bienestar y la implicación de personas con demencia avanzada. Un estudio cualitativo de 4 casos / Effects of visualisation of personalised contents, presented using virtual reality, on the well-being and engagement of people with advanced dementia. A qualitative study of 4 cases

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Estudio Palidem: cuidados al final de la vida en pacientes con demencia avanzada institucionalizados / The Palidem study: care at the end of life in institutionalized patients with advanced dementia

OBJETIVO: Desarrollar un plan de atención específi co en pacientes con demencia avanzada institucionalizados, planificando los cuidados mediante el control sintomático, tomando decisiones con el cuidador principal, realizando un apoyo psicológico y espiritual. MÉTODO: Estudio descriptivo de periodo en el Centro Txara 1, desde el 1 de julio de 2014 hasta el 31 de diciembre de 2016, identifi cando a aquellos residentes con demencia avanzada y síndrome de declive. Se recoge trimestralmente el grado de control de síntomas (Symptom Management at the End-of-Life in Dementia) (SM-EOLD), utilizando la escala PAINAD para la valoración del dolor; el confort en el momento de la agonía se determina diariamente (The Comfort Assessment in Dying with Dementia) (CAD-EOLD), estableciendo con el cuidador principal la toma de decisiones basadas en los objetivos asistenciales paliativos. Tras el fallecimiento se realiza una encuesta de satisfacción al cuidador (Satisfaction with Care at the End-of-Life in Dementia) (SWC-EOLD) y contacto periódico con la pastoral para el apoyo espiritual. RESULTADOS: Se han analizado 74 residentes, con una edad media de 87 años, un 79 % mujeres, con 4,6 medicamentos de media, con enfermedad de Alzheimer como principal causa de demencia. En el control de síntomas en fase estable no se detecta inestabilidad física o conductual relevante, detectándose en un 5 % la presencia de dolor. De 50 residentes fallecidos, el 94 % sucede en el propio centro, en un 67 % se puede registrar el grado de confort destacando la presencia de disnea y disfagia, al ser la infección respiratoria aspirativa la principal causa de fallecimiento. En un 66 % de la población seleccionada se realiza atención espiritual. Un 30 % de los cuidadores principales responden a la encuesta de satisfacción, con un alto porcentaje de aceptación en el nivel de cuidados. CONCLUSIONES: La identificación de los pacientes con demencia avanzada en situación de final de vida permite estructurar un plan de atención en el centro gerontológico, conociendo las necesidades sintomáticas, el grado de confort o bienestar y consensuando las decisiones en cuanto a la proporcionalidad de cuidados con la familia. Ante situaciones de descompensación aguda, la coordinación con los recursos sociosanitarios disponibles es fundamental para poder llevar a cabo las decisiones adoptadas del equipo sanitario con el cuidador principal

OBJECTIVE: To develop a specific care plan for institutionalized patients with advanced dementia based on symptom control and including joint decision making with the primary caregiver as well as psychological and spiritual support. METHOD: A descriptive 1-period study at Centro Txara 1, from July 1 2014 to December 31 2016, which identified residents with advanced dementia and geriatric failure-to-thrive syndrome. Symtom control extent was quarterly assessed using the Symptom Management at the End-of-Life in Dementia (SM-EOLD) scale, and the PAINAD scale for pain; comfort at the end of life was assessed daily with the Comfort Assessment in Dying with Dementia (CAD-EOLD) instrument, and decisions were made jointly with the primary caregiver based on the goals of palliative care. After the death of the patient a satisfaction survey was administered to the caregiver (Satisfaction with Care at the End-of-Life in Dementia, SWC-EOLD), who was also provided with regular contact with the pastoral care team for spiritual support. RESULTS: A total of 74 residents were assessed with a mean age of 87 years; 79% were females, mean number of drugs was 4.6, and Alzheimer's disease was the primary cause of dementia. Stable-phase symptom control identified no relevant phisical or behavioral instability, but pain was found in 5% of the sample. Of 50 residents who passed away, 94% died in the hospice; in 67% comfort degree could be collected, and the presence of shortness of breath and dysphagia stood out, as aspiration-induced respiratory infection was the primary cause of death. Spiritual care was provided for 66% of the study population. In all, 30% of primary caregivers responded to the satisfaction survey showing a high percentage of acceptance of level of care. CONCLUSIONS: Identifying patients with advanced dementia at the end of life allows the development of a hospice care plan considering symptom needs, comfort degree and wellbeing, and involving consensus decisions about care proportionality with the family. Should an acute decompensation occur, coordination with the available social and healthcare resources is key for implementing the decisions agreed between the healthcare team and the primary caregiver

Resequencing of Common Bean Identifies Regions of Inter-Gene Pool Introgression and Provides Comprehensive Resources for Molecular Breeding.

Common bean ( L.) is the most important grain legume for human consumption and is a major nutrition source in the tropics. Because bean production is reduced by both abiotic and biotic constraints, current breeding efforts are focused on the development of improved varieties with tolerance to these stresses. We characterized materials from different breeding programs spanning three continents to understand their sequence diversity and advance the development of molecular breeding tools. For this, 37 varieties belonging to , (A. Gray), and L. were sequenced by whole-genome sequencing, identifying more than 40 million genomic variants. Evaluation of nuclear DNA content and analysis of copy number variation revealed important differences in genomic content not only between and the two other domesticated species, but also within , affecting hundreds of protein-coding genomic regions. A large number of inter-gene pool introgressions were identified. Furthermore, interspecific introgressions for disease resistance in breeding lines were mapped. Evaluation of newly developed single nucleotide polymorphism markers within previously discovered quantitative trait loci for common bacterial blight and angular leaf spot provides improved specificity to tag sources of resistance to these diseases. We expect that this dataset will provide a deeper molecular understanding of breeding germplasm and deliver molecular tools for germplasm development, aiming to increase the efficiency of bean breeding programs.

Inclusion of service robots in the daily lives of frail older users: A step-by-step definition procedure on users' requirements.

The implications for the inclusion of robots in the daily lives of frail older adults, especially in relation to these population needs, have not been extensively studied. The "Multi-Role Shadow Robotic System for Independent Living" (SRS) project has developed a remotely-controlled, semi-autonomous robotic system to be used in domestic environments. The objective of this paper is to document the iterative procedure used to identify, select and prioritize user requirements. Seventy-four requirements were identified by means of focus groups, individual interviews and scenario-based interviews. The list of user requirements, ordered according to impact, number and transnational criteria, revealed a high number of requirements related to basic and instrumental activities of daily living, cognitive and social support and monitorization, and also involving privacy, safety and adaptation issues. Analysing and understanding older users' perceptions and needs when interacting with technological devices adds value to assistive technology and ensures that the systems address currently unmet needs.

Genome-Wide Linkage and Association Mapping of Halo Blight Resistance in Common Bean to Race 6 of the Globally Important Bacterial Pathogen.

Pseudomonas syringae pv. phaseolicola (Psph) Race 6 is a globally prevalent and broadly virulent bacterial pathogen with devastating impact causing halo blight of common bean (Phaseolus vulgaris L.). Common bean lines PI 150414 and CAL 143 are known sources of resistance against this pathogen. We constructed high-resolution linkage maps for three recombinant inbred populations to map resistance to Psph Race 6 derived from the two common bean lines. This was complemented with a genome-wide association study (GWAS) of Race 6 resistance in an Andean Diversity Panel of common bean. Race 6 resistance from PI 150414 maps to a single major-effect quantitative trait locus (QTL; HB4.2) on chromosome Pv04 and confers broad-spectrum resistance to eight other races of the pathogen. Resistance segregating in a Rojo × CAL 143 population maps to five chromosome arms and includes HB4.2. GWAS detected one QTL (HB5.1) on chromosome Pv05 for resistance to Race 6 with significant influence on seed yield. The same HB5.1 QTL, found in both Canadian Wonder × PI 150414 and Rojo × CAL 143 populations, was effective against Race 6 but lacks broad resistance. This study provides evidence for marker-assisted breeding for more durable halo blight control in common bean by combining alleles of race-nonspecific resistance (HB4.2 from PI 150414) and race-specific resistance (HB5.1 from cv. Rojo).

Estudio de la implicación en un grupo de personas con demencia con atención tradicional y un grupo con atención centrada en la persona / Study of engagement in a group of people with dementia in traditional care settings and a group with person centred care

Introducción. Las personas con demencia en contexto residencial presentan un grado elevado de apatía y desconexión con el entorno. La ausencia de estimulación y la baja frecuencia de actividades personalizadas, características en los centros residenciales, podrían ser elementos contextuales que favorecen estos comportamientos. El modelo de atención centrado en la persona (MACP) promueve la participación de las personas en actividades cotidianas acorde con sus recursos, sus intereses y necesidades. El objetivo de este estudio es comparar la frecuencia de conductas de implicación y desimplicación en las actividades cotidianas en 2 grupos de usuarios residentes en unidades psicogeriátricas, asistido uno de ellos según el modelo tradicional y el otro según el MACP. Metodología. Participaron en el estudio 28 sujetos con deterioro cognitivo y residentes en unidades psicogeriátricas: 14 usuarios de una unidad tradicional (grupo control) y 14 en una unidad en la que se incorporaron intervenciones relativas al MACP (grupo experimental). Los grupos fueron equivalentes en deterioro cognitivo, capacidades funcionales y años de ingreso. Se utilizó el Registro de Implicación/Engagement para observar en ambos grupos la frecuencia de 12 categorías de comportamiento de implicación en 2 períodos diferenciados: antes de las intervenciones asociadas al MACP y 18 meses después de haber comenzado las mismas. Resultados. Ambos grupos vieron incrementada la frecuencia de sus conductas de implicación en el período post; sin embargo, el grupo experimental disminuyó los comportamientos de desimplicación, mientras que el grupo control los aumentó. Conclusiones. Acorde con los datos, intervenciones asociadas al MACP podrían minimizar los comportamientos de desconexión con el entorno que suceden en el contexto residencial vinculando a las personas al contexto y facilitando la participación e implicación en las actividades de la vida diaria (AU)

Introduction. People with dementia in the residential care setting have a high level of apathy and disengagement. The lack of stimulation and customised activities, a common aspect in residential centres, could be contextual elements that promote these behaviours. The person-centred care model (PCCM) promotes the participation of people in their daily activities in relation to their resources, interests, and needs. The aim of this study is to compare the frequency of engagement behaviours in the daily activities in two groups of users residing in Psychogeriatric Units, one receiving a traditional care model and the other assisted under PCCM. Methodology. The study involved 28 patients with cognitive impairment in Psychogeriatric Units, 14 of whom were in a traditional unit (control group), and 14 were in a unit where PCCM (experimental group) was implemented. Groups were equivalent in cognitive impairment, functional capabilities, and years in the long-term care institution. The Registering Engagement Instrument (REI) was used to observe the frequency of 12 categories of engagement behaviour in two distinct periods in both groups: before the interventions associated with PCCM, and 18 months after starting them. Results. Both groups increased the frequency of their engagement behaviours in the post-evaluation, but the experimental group decreased their disengagement behaviours while the control group increased them. Conclusions. According to the data, PCCM interventions could reduce disengagement behaviours in the residential context, and could facilitate the participation and involvement in the activities of daily living (AU)

Meta-QTL for resistance to white mold in common bean.

White mold, caused by the fungus Sclerotinia sclerotiorum (Lib.) de Bary, is a major disease that limits common bean production and quality worldwide. The host-pathogen interaction is complex, with partial resistance in the host inherited as a quantitative trait with low to moderate heritability. Our objective was to identify meta-QTL conditioning partial resistance to white mold from individual QTL identified across multiple populations and environments. The physical positions for 37 individual QTL were identified across 14 recombinant inbred bi-parental populations (six new, three re-genotyped, and five from the literature). A meta-QTL analysis of the 37 QTL was conducted using the genetic linkage map of Stampede x Red Hawk population as the reference. The 37 QTL condensed into 17 named loci (12 previously named and five new) of which nine were defined as meta-QTL WM1.1, WM2.2, WM3.1, WM5.4, WM6.2, WM7.1, WM7.4, WM7.5, and WM8.3. The nine meta-QTL had confidence intervals ranging from 0.65 to 9.41 Mb. Candidate genes shown to express under S. sclerotiorum infection in other studies, including cell wall receptor kinase, COI1, ethylene responsive transcription factor, peroxidase, and MYB transcription factor, were found within the confidence interval for five of the meta-QTL. The nine meta-QTL are recommended as potential targets for MAS for partial resistance to white mold in common bean.

[Study of engagement in a group of people with dementia in traditional care settings and a group with person centred care]. / Estudio de la implicación en un grupo de personas con demencia con atención tradicional y un grupo con atención centrada en la persona.

INTRODUCTION: People with dementia in the residential care setting have a high level of apathy and disengagement. The lack of stimulation and customised activities, a common aspect in residential centres, could be contextual elements that promote these behaviours. The person-centred care model (PCCM) promotes the participation of people in their daily activities in relation to their resources, interests, and needs. The aim of this study is to compare the frequency of engagement behaviours in the daily activities in two groups of users residing in Psychogeriatric Units, one receiving a traditional care model and the other assisted under PCCM. METHODOLOGY: The study involved 28 patients with cognitive impairment in Psychogeriatric Units, 14 of whom were in a traditional unit (control group), and 14 were in a unit where PCCM (experimental group) was implemented. Groups were equivalent in cognitive impairment, functional capabilities, and years in the long-term care institution. The Registering Engagement Instrument (REI) was used to observe the frequency of 12 categories of engagement behaviour in two distinct periods in both groups: before the interventions associated with PCCM, and 18 months after starting them. RESULTS: Both groups increased the frequency of their engagement behaviours in the post-evaluation, but the experimental group decreased their disengagement behaviours while the control group increased them. CONCLUSIONS: According to the data, PCCM interventions could reduce disengagement behaviours in the residential context, and could facilitate the participation and involvement in the activities of daily living.

Desarrollo de un instrumento de registro de implicación/engagement en la actividad para la observación sistemática de personas mayores con deterioro cognitivo / Development of a tool for recording involvement/engagement in activities in the systematic observation of elderly persons with cognitive impairment

Introducción: A medida que se incrementa el grado de deterioro cognitivo de las personas con demencia, los beneficios esperables de las intervenciones son limitados, sin embargo, a nivel clínico se dan cambios observables que no se reflejan en las medidas estandarizadas. De esta forma se hace patente la necesidad de desarrollar instrumentos específicos de evaluación de los distintos aspectos relevantes, uno de los cuales es el engagement o grado de implicación en las actividades que realizan y que se considera un indicador de calidad de vida y calidad de atención. El objetivo del presente estudio es el desarrollo actual de un instrumento de Registro de Implicación-Engagement y la obtención de medidas de confiabilidad. Método: Se desarrolló un estudio piloto realizado con 19 personas distribuidas en 2 grupos en los que se realizaron observaciones sistemáticas por 2 psicólogos para evaluar la fiabilidad inter-jueces del instrumento por medio del porcentaje de acuerdo. Resultados: Se obtuvo un instrumento de registro observacional compuesto por 15 categorías de implicación/ no implicación obteniéndose un alto grado de acuerdo entre los observadores. Conclusión: Los resultados muestran las posibilidades de desarrollo de un instrumento sensible de registro de Implicación-Engagement que permita la obtención de resultados objetivos sobre los efectos de las intervenciones en las personas con demencia en fases más avanzadas. Por otro lado, estos resultados son un impulso para el desarrollo de instrumentos observacionales para la evaluación de estas intervenciones cuyo objetivo sea la mejora de la calidad de vida de las personas con demencia (AU)

Introduction: As the level of cognitive impairment in people with dementia increases, it seems that the interventions aimed at this group do not obtain the expected results. Thus, it is clear that there is a need to develop specific assessment tools. One of the important aspects in people with dementia is the engagement, involvement in task and activities. Engagement is considered a quality of life and quality of care indicator. The aim of the study is to develop an Engagement recording tool for mapping people with dementia, and to obtain reliability measures. Method: The present paper aims to present the current development of engagement behaviours. The pilot study had a sample of 19 people distributed into two groups, which were observed in order to obtain inter-rater reliability measurements using the percentage of inter-rater agreement. Results: An observational mapping instrument was developed that achieved a high inter-rater reliability. Conclusion: The Engagement recording tool makes it possible to gather promising results on the effects of the interventions for people with severe dementia. On the other hand, these results point to the possibilities of more specific tools to assess the different interventions which aim is to improve quality of life and quality of care in people with dementia (AU)

Adaptación y validación de la versión española de la escala de evaluación de dolor en personas con demencia avanzada: PAINAD-Sp / Adaptation and validation of the Spanish version of the Pain Evaluation Scale in patients with advanced dementia: PAINAD-Sp

Introducción. El dolor está considerado como un grave problema en el entorno residencial afectando entre un 49 y un 83% de los residentes. El proceso evolutivo de la enfermedad de Alzheimer puede conllevar dificultades de comunicación y comprensión de las escalas de evaluación de dolor, dificultando su evaluación y tratamiento. El objetivo principal de este estudio fue validar la versión española del PAINAD (PAINAD-Sp) y evaluar su aplicabilidad en un Centro Gerontológico en España. Material y métodos. Veinte usuarias diagnosticadas de demencia avanzada fueron observadas por 5 observadores con diferentes perfiles profesionales durante 5 min en 3 condiciones: reposo, durante actividad agradable y en situación de dolor. La PAINAD-Sp fue administrada simultáneamente a una escala analógica visual. Resultados. Los resultados muestran que el alfa de Cronbach se encontraba entre 0,467 y 0,827 (con una media de 0,692, que subía si el ítem de respiración se eliminaba). La fiabilidad interjueces variaba entre 0,587 y 0,956. La correlación entre la medida total en PAINAD-Sp y en una Escala Visual Analógica fue estadísticamente significativa (p < 0,05) en todas las medidas y variaba entre 0,517 y 0,868. Conclusiones. Los resultados del estudio muestran que la escala PAINAD-Sp es eficaz para medir el dolor en personas con demencia sin capacidad de comunicación. Esta escala puede ser usada por diferentes profesionales de la salud con poco entrenamiento y presenta una buena fiabilidad (AU)

Introduction. Pain in elderly people is considered a major concern in nursing home facilities affecting between 49% and 83% of the residents. Progression of Alzheimer's Disease causes more communication difficulties in patients with advanced dementia and therefore more problems to understand even the most simple pain evaluation scales. Identification and implementation of appropriate pain management strategies depends on an adequate pain assessment. Material and methods. The main objective of the study was to validate the Spanish version of the PAINAD Scale (PAINAD-Sp) and to assess its applicability in Spanish Geriatric Nursing Homes. The 20 patients diagnosed with severe dementia from a Geriatric Centre in Spain were observed by five observers with different professional profiles for 5 minutes to each participant, and PAINAD-Sp Scale was administered simultaneously to a Visual Analogical Scale-VAS. Three different observational conditions were established: resting condition, during presumably pleasant activity and during presumable painful activity. Results. Cronbach's alpha ranged between 0.467 and 0.827 (average 0.692), and rose if Breathing item was deleted. Inter-rater reliability ranged between 0.587 and 0.956. Correlation between PAINAD-Sp Scale total measures and VAS was statistically significant (P<.05) in all measures and ranged from 0.517 to 0.868. Conclusions. Findings in the study showed that the scale is useful to measure pain in non communicative patients suffering from dementia. The scale maintains good levels of reliability for different healthcare professionals even when they have little training (AU)

[Adaptation and validation of the Spanish version of the Pain Evaluation Scale in patients with advanced dementia: PAINAD-Sp]. / Adaptación y validación de la versión española de la escala de evaluación de dolor en personas con demencia avanzada: PAINAD-Sp.

INTRODUCTION: Pain in elderly people is considered a major concern in nursing home facilities affecting between 49% and 83% of the residents. Progression of Alzheimer's Disease causes more communication difficulties in patients with advanced dementia and therefore more problems to understand even the most simple pain evaluation scales. Identification and implementation of appropriate pain management strategies depends on an adequate pain assessment. MATERIAL AND METHODS: The main objective of the study was to validate the Spanish version of the PAINAD Scale (PAINAD-Sp) and to assess its applicability in Spanish Geriatric Nursing Homes. The 20 patients diagnosed with severe dementia from a Geriatric Centre in Spain were observed by five observers with different professional profiles for 5 minutes to each participant, and PAINAD-Sp Scale was administered simultaneously to a Visual Analogical Scale-VAS. Three different observational conditions were established: resting condition, during presumably pleasant activity and during presumable painful activity. RESULTS: Cronbach's alpha ranged between 0.467 and 0.827 (average 0.692), and rose if Breathing item was deleted. Inter-rater reliability ranged between 0.587 and 0.956. Correlation between PAINAD-Sp Scale total measures and VAS was statistically significant (P<.05) in all measures and ranged from 0.517 to 0.868. CONCLUSIONS: Findings in the study showed that the scale is useful to measure pain in non communicative patients suffering from dementia. The scale maintains good levels of reliability for different healthcare professionals even when they have little training.

[Development of a tool for recording involvement/engagement in activities in the systematic observation of elderly persons with cognitive impairment]. / Desarrollo de un instrumento de registro de implicación/engagement en la actividad para la observación sistemática de personas mayores con deterioro cognitivo.

INTRODUCTION: As the level of cognitive impairment in people with dementia increases, it seems that the interventions aimed at this group do not obtain the expected results. Thus, it is clear that there is a need to develop specific assessment tools. One of the important aspects in people with dementia is the engagement, involvement in task and activities. Engagement is considered a quality of life and quality of care indicator. The aim of the study is to develop an Engagement recording tool for mapping people with dementia, and to obtain reliability measures. METHOD: The present paper aims to present the current development of engagement behaviours. The pilot study had a sample of 19 people distributed into two groups, which were observed in order to obtain inter-rater reliability measurements using the percentage of inter-rater agreement. RESULTS: An observational mapping instrument was developed that achieved a high inter-rater reliability. CONCLUSION: The Engagement recording tool makes it possible to gather promising results on the effects of the interventions for people with severe dementia. On the other hand, these results point to the possibilities of more specific tools to assess the different interventions which aim is to improve quality of life and quality of care in people with dementia.

AsTeRICS: a new flexible solution for people with motor disabilities in upper limbs and its implication for rehabilitation procedures.

PURPOSE: To present the AsTeRICS construction set, and examine different combinations of sensors installed in the platform and how users interact with them. METHOD: Nearly 50 participants from Austria, Poland and Spain were included in the study. They had a heterogeneous range of diagnoses, but as a common feature all of them experienced motor limitations in their upper limbs. The study included a 1 h session with each participant where the user interacted with a personalized combination of sensors, based on a previous assessment on their motor capabilities performed by healthcare professionals. The sensors worked as substitutes for a standard QWERTY keyboard and a standard mouse. Semi-structured interviews were conducted to obtain participants' opinions. All collected data were analyzed based on the qualitative methodology. RESULTS: The findings illustrated that AsTeRICS is a flexible platform whose sensors can adapt to different degrees of users' motor capabilities, thus facilitating in most cases the interaction of the participants with a common computer. CONCLUSION: AsTeRICS platform can improve the interaction between people with mobility limitations and computers. It can provide access to new technologies and become a promising tool that can be integrated in physical rehabilitation programs for people with motor disabilities in their upper limbs. IMPLICATIONS FOR REHABILITATION: The AsTeRICS platform offers an interesting tool to interface and support the computerized rehabilitation program of the patients. Due to AsTeRICS platform high usability features, family and rehabilitation professionals can learn how to use the AsTeRICS platform quickly fostering the key role of their involvement on patients' rehabilitation. AsTeRICS is a flexible, extendable, adaptable and affordable technology adapted for using computer, environmental control, mobile phone, rehabilitation programs and mechatronic systems. AsTeRICS makes possible an easy reconfiguration and integration of new functionalities, such as biofeedback rehabilitation, without major changes in the system.

Diversification and population structure in common beans (Phaseolus vulgaris L.).

Wild accessions of crops and landraces are valuable genetic resources for plant breeding and for conserving alleles and gene combinations in planta. The primary genepool of cultivated common beans includes wild accessions of Phaseolus vulgaris. These are of the same species as the domesticates and therefore are easily crossable with cultivated accessions. Molecular marker assessment of wild beans and landraces is important for the proper utilization and conservation of these important genetic resources. The goal of this research was to evaluate a collection of wild beans with fluorescent microsatellite or simple sequence repeat markers and to determine the population structure in combination with cultivated beans of all known races. Marker diversity in terms of average number of alleles per marker was high (13) for the combination of 36 markers and 104 wild genotypes that was similar to the average of 14 alleles per marker found for the 606 cultivated genotypes. Diversity in wild beans appears to be somewhat higher than in cultivated beans on a per genotype basis. Five populations or genepools were identified in structure analysis of the wild beans corresponding to segments of the geographical range, including Mesoamerican (Mexican), Guatemalan, Colombian, Ecuadorian-northern Peruvian and Andean (Argentina, Bolivia and Southern Peru). The combined analysis of wild and cultivated accessions showed that the first and last of these genepools were related to the cultivated genepools of the same names and the penultimate was found to be distinct but not ancestral to the others. The Guatemalan genepool was very novel and perhaps related to cultivars of race Guatemala, while the Colombian population was also distinct. Results suggest geographic isolation, founder effects or natural selection could have created the different semi-discrete populations of wild beans and that multiple domestications and introgression were involved in creating the diversity of cultivated beans.

Gene-based single nucleotide polymorphism markers for genetic and association mapping in common bean.

BACKGROUND: In common bean, expressed sequence tags (ESTs) are an underestimated source of gene-based markers such as insertion-deletions (Indels) or single-nucleotide polymorphisms (SNPs). However, due to the nature of these conserved sequences, detection of markers is difficult and portrays low levels of polymorphism. Therefore, development of intron-spanning EST-SNP markers can be a valuable resource for genetic experiments such as genetic mapping and association studies. RESULTS: In this study, a total of 313 new gene-based markers were developed at target genes. Intronic variation was deeply explored in order to capture more polymorphism. Introns were putatively identified after comparing the common bean ESTs with the soybean genome, and the primers were designed over intron-flanking regions. The intronic regions were evaluated for parental polymorphisms using the single strand conformational polymorphism (SSCP) technique and Sequenom MassARRAY system. A total of 53 new marker loci were placed on an integrated molecular map in the DOR364 × G19833 recombinant inbred line (RIL) population. The new linkage map was used to build a consensus map, merging the linkage maps of the BAT93 × JALO EEP558 and DOR364 × BAT477 populations. A total of 1,060 markers were mapped, with a total map length of 2,041 cM across 11 linkage groups. As a second application of the generated resource, a diversity panel with 93 genotypes was evaluated with 173 SNP markers using the MassARRAY-platform and KASPar technology. These results were coupled with previous SSR evaluations and drought tolerance assays carried out on the same individuals. This agglomerative dataset was examined, in order to discover marker-trait associations, using general linear model (GLM) and mixed linear model (MLM). Some significant associations with yield components were identified, and were consistent with previous findings. CONCLUSIONS: In short, this study illustrates the power of intron-based markers for linkage and association mapping in common bean. The utility of these markers is discussed in relation with the usefulness of microsatellites, the molecular markers by excellence in this crop.

Efectos del entrenamiento en estrategias de regulación emocional en el bienestar de cuidadores de enfermos de Alzheimer / Effects of training in emotional regulation strategies on the well-being of carers of Alzheimer patients

Introducción. El presente estudio muestra los resultados de una intervención psicoeducativa que pretende dotar de estrategias de regulación de las emociones positivas y negativas con cuidadores de enfermos de Alzheimer. Material y métodos. En este estudio participaron 52 cuidadores informales de enfermos de Alzheimer. Estos cuidadores se distribuyeron en 2 grupos: grupo experimental (n=20) y grupo control (n=32). Todos fueron evaluados antes y después de la intervención a través de diferentes instrumentos de medida de los estresores, moduladores y consecuencias del cuidado. Resultados. En el contraste intergrupos, el grupo experimental, en comparación con el grupo control, obtuvo puntuaciones más altas en afecto positivo, bienestar subjetivo, regulación emocional y satisfacción con el cuidado, y valores inferiores en estrés percibido y afecto negativo. En el contraste intragrupos, los sujetos del grupo experimental registraron, inmediatamente tras la intervención, descensos significativos en las puntuaciones relativas a los pensamientos disfuncionales y la atención emocional. En los sujetos del grupo control se registra una mayor puntuación en apoyo psicosocial y un descenso en la satisfacción con el cuidado. Conclusiones. El programa desarrollado ha contribuido a que sus participantes experimenten un mayor bienestar emocional, atiendan a sus emociones de modo más adecuado y sufran menos pensamientos disfuncionales en relación con el cuidado. Estudios posteriores deberán confirmar establecer la estabilidad de los cambios registrados, dado el carácter progresivo del aprendizaje de las habilidades entrenadas y las cambiantes necesidades asociadas al cuidado(AU)

Introduction. The present research shows the results of a psychoeducational intervention programme centered on the regulation of the emotion among Alzheimer patients’ caregivers. Materials and methods. 52 informal caregivers of Alzheimer's patients participated. These caregivers were distributed into two groups: the experimental group (n=20) and the control group (n=32). All the participants were evaluated before and after the intervention programme through the application of different measurement tools measuring variables related to the care giving process; stressors, modulation variables and care giving consequences. Results. In the inter group contrast, the experimental group, when compared with the control condition, obtained higher scores in positive affect, subjective well-being, regulation of emotions, and satisfaction with caregiving. However, the experimental group recorded lower values in perceived stress and negative affect. With reference to the intragroup contrast, the experimental group showed a significant decrease in dysfunctional thoughts and emotional attention. The control group registered higher levels of psychosocial support and lower satisfaction with caregiving. Conclusions. The training programme, that we both developed and conducted, has contributed to a greater feeling of emotional well-being amongst the its participant caregivers, who now take more adequate care of their emotions and suffer fewer dysfunctional thoughts in relation to caregiving. In future studies, the stability of the results presented in this investigation should be established due to the progressive character of the skills learned during the programme, and the changing needs associated with the caregiving process(AU)

[Effects of training in emotional regulation strategies on the well-being of carers of Alzheimer patients]. / Efectos del entrenamiento en estrategias de regulación emocional en el bienestar de cuidadores de enfermos de Alzheimer.

INTRODUCTION: The present research shows the results of a psychoeducational intervention programme centered on the regulation of the emotion among Alzheimer patients' caregivers. MATERIALS AND METHODS: 52 informal caregivers of Alzheimer's patients participated. These caregivers were distributed into two groups: the experimental group (n = 20) and the control group (n = 32). All the participants were evaluated before and after the intervention programme through the application of different measurement tools measuring variables related to the care giving process; stressors, modulation variables and care giving consequences. RESULTS: In the inter group contrast, the experimental group, when compared with the control condition, obtained higher scores in positive affect, subjective well-being, regulation of emotions, and satisfaction with caregiving. However, the experimental group recorded lower values in perceived stress and negative affect. With reference to the intragroup contrast, the experimental group showed a significant decrease in dysfunctional thoughts and emotional attention. The control group registered higher levels of psychosocial support and lower satisfaction with caregiving. CONCLUSIONS: The training programme, that we both developed and conducted, has contributed to a greater feeling of emotional well-being amongst the its participant caregivers, who now take more adequate care of their emotions and suffer fewer dysfunctional thoughts in relation to caregiving. In future studies, the stability of the results presented in this investigation should be established due to the progressive character of the skills learned during the programme, and the changing needs associated with the caregiving process.